Mapping maternity care facilities in England

Objective. To describe the organisation of maternity care at trust and unit level in England. Methods. All NHS trusts providing maternity care participated in a survey as part of the Healthcare Commission review of maternity care in England in 2007. Data on trusts and numbers of units were also collected in 2009 as part of the Birthplace in England programme. Results. Models of care provision are limited: in 2007 two-thirds of trusts provided choice between home birth and birth in an obstetric unit only. Geographical variation is substantial, with approximately 70% of trusts in the North-West, Yorkshire and Humberside and London Strategic Health Authority regions having only obstetric units, compared with 50% or less in the South-West and East Midlands. Availability and proximity of specialist facilities for women and babies within trusts varies and is linked with obstetric units. Changes in trust configuration, identified in 2009, have largely resulted from opening alongside midwifery units, then available in a quarter of trusts. Freestanding midwifery units continue to provide care for small numbers of women, commonly in more rural areas. Conclusions. In 2007, 66% of trusts had no midwifery-led units and this is likely to have limited the choices that women were able to make about their planned place of birth and the possibility of having midwife-led care in nonobstetric unit settings. Recent data suggest that women’s options for care may have increased, although capacity and staffing issues, reflected in closures to admissions, may affect these

Informal economic activities and deprived neighbourhoods.

This report reviews the relative advantages and disadvantages of some types of informal activity to people in deprived neighbourhoods. It cites ways to incentivise and support people who can move from informal to formal status

Physically fit or physically literate? Children with special educational needs understanding of physical education

The role of physical literacy within physical education (PE) has become a widely debated topic in recent years. Its role in educating children about physicality through embodiment, skill acquisition and reading the environment is argued to be of great benefit to children. However, whether children understand the role of PE in the development of these competencies is not clear, and this is even truer for children who have special educational needs (SEN). Drawing on qualitative phenomenological data from 30 children in key stages 2 and three (7 to 14 years of age) who have SEN, this paper explores notions of physical fitness and physical literacy as understood by children in PE lessons. It aims to gain insight into the ways that children understand the purpose of PE, and places these perceptions within a physical literacy framework, using the National Curriculum for PE (NCPE) as a foundation. Findings demonstrate that children with SEN perceive PE as a means for improving physical fitness, whereas concepts surrounding physical literacy appear to be lost. The paper concludes by making recommendations for factoring physical literacy components more forcibly into the PE curriculum, and through initial teacher training and continued professional development

The quality of different types of child care at 10 and 18 months. A comparison between types and factors related to quality.

The quality of care offered in four different types of non-parental child care to 307 infants at 10 months old and 331 infants at 18 months old was compared and factors associated with higher quality were identified. Observed quality was lowest in nurseries at each age point, except that at 18 months they offered more learning activities. There were few differences in the observed quality of care by child-minders, grandparents and nannies, although grandparents had somewhat lower safety and health scores and offered children fewer activities. Cost was largely unrelated to quality of care except in child-minding, where higher cost was associated with higher quality. Observed ratios of children to adults had a significant impact on quality of nursery care; the more infants or toddlers each adult had to care for, the lower the quality of the care she gave them. Mothers' overall satisfaction with their child's care was positively associated with its quality for home-based care but not for nursery settings

Estimating the incidence, prevalence and true cost of asthma in the UK: secondary analysis of national stand-alone and linked databases in England, Northern Ireland, Scotland and Wales-a study protocol.

INTRODUCTION: Asthma is now one of the most common long-term conditions in the UK. It is therefore important to develop a comprehensive appreciation of the healthcare and societal costs in order to inform decisions on care provision and planning. We plan to build on our earlier estimates of national prevalence and costs from asthma by filling the data gaps previously identified in relation to healthcare and broadening the field of enquiry to include societal costs. This work will provide the first UK-wide estimates of the costs of asthma. In the context of asthma for the UK and its member countries (ie, England, Northern Ireland, Scotland and Wales), we seek to: (1) produce a detailed overview of estimates of incidence, prevalence and healthcare utilisation; (2) estimate health and societal costs; (3) identify any remaining information gaps and explore the feasibility of filling these and (4) provide insights into future research that has the potential to inform changes in policy leading to the provision of more cost-effective care. METHODS AND ANALYSIS: Secondary analyses of data from national health surveys, primary care, prescribing, emergency care, hospital, mortality and administrative data sources will be undertaken to estimate prevalence, healthcare utilisation and outcomes from asthma. Data linkages and economic modelling will be undertaken in an attempt to populate data gaps and estimate costs. Separate prevalence and cost estimates will be calculated for each of the UK-member countries and these will then be aggregated to generate UK-wide estimates. ETHICS AND DISSEMINATION: Approvals have been obtained from the NHS Scotland Information Services Division's Privacy Advisory Committee, the Secure Anonymised Information Linkage Collaboration Review System, the NHS South-East Scotland Research Ethics Service and The University of Edinburgh's Centre for Population Health Sciences Research Ethics Committee. We will produce a report for Asthma-UK, submit papers to peer-reviewed journals and construct an interactive map

Development of an Interpretive Simulation Tool for the Proton Radiography Technique

Proton radiography is a useful diagnostic of high energy density (HED) plasmas under active theoretical and experimental development. In this paper we describe a new simulation tool that interacts realistic laser-driven point-like proton sources with three dimensional electromagnetic fields of arbitrary strength and structure and synthesizes the associated high resolution proton radiograph. The present tool's numerical approach captures all relevant physics effects, including effects related to the formation of caustics. Electromagnetic fields can be imported from PIC or hydrodynamic codes in a streamlined fashion, and a library of electromagnetic field `primitives' is also provided. This latter capability allows users to add a primitive, modify the field strength, rotate a primitive, and so on, while quickly generating a high resolution radiograph at each step. In this way, our tool enables the user to deconstruct features in a radiograph and interpret them in connection to specific underlying electromagnetic field elements. We show an example application of the tool in connection to experimental observations of the Weibel instability in counterstreaming plasmas, using $\sim 10^8$ particles generated from a realistic laser-driven point-like proton source, imaging fields which cover volumes of $\sim10$ mm$^3$. Insights derived from this application show that the tool can support understanding of HED plasmas.Comment: Figures and tables related to the Appendix are included in the published journal articl

Economies of deprived neighbourhoods: summary of research

This report provides a synthesis and summaries of three rapid evidence reviews concerning the economies of deprived neighbourhoods. It covers the overall dynamics of local economies and provides more detailed evidence concerning skills, worklessness and the informal economy

The status of clinical trials: Cause for concern

<p>Abstract</p> <p>Background</p> <p>Americans see clinical research as important, with over 15 million American residents participating in NIH-sponsored studies in 2008 and growing yearly.</p> <p>Methods</p> <p>Documents reporting NIH supported Clinical Research projects were reviewed.</p> <p>Results</p> <p>When compared with other studies, the number of interventional Phase III and Phase IV trials have decreased from 20% to 4.4% from 1994-2008.</p> <p>Conclusions</p> <p>This finding most likely has occurred for several reasons. One reason is that the physician lacks an infrastructure for designing and carrying out trials. This lack is because of an absence of a coordinated effort to train clinical trialists. It is clear that the Nation needs a more purposeful approach to developing and maintaining the infrastructure for designing and conducting clinical trials. Building it de novo trial by trial is profoundly inefficient, to say nothing about time consuming and error prone.</p

Improving the professional knowledge base for education: Using knowledge management (KM) and Web 2.0 tools

Improving education systems is an elusive goal. Despite considerable investment, international studies such as the OECD Teaching and Learning International Survey (TALIS) project and the McKinsey Report How the world’s best performing schools come out on top indicate that improving teacher quality is more important than increased financial investment. Both reports challenge governments, academics and practitioners to adopt new ways of sharing and building knowledge. This paper makes the case for national education systems to adopt tried and tested knowledge management and web 2.0 tools used by other sectors and highlights the neglected potential of teacher educators as agents for improvement