Providing sex and relationships education for looked-after children: a qualitative exploration of how personal and institutional factors promote or limit the experience of role ambiguity, conflict and overload among caregivers

Objectives: To explore how personal and institutional factors promote or limit caregivers promoting sexual health and relationships (SHR) among looked-after children (LAC). In so doing, develop existing research dominated by atheoretical accounts of the facilitators and barriers of SHR promotion in care settings. Design: Qualitative semistructured interview study. Setting: UK social services, residential children’s homes and foster care. Participants: 22 caregivers of LAC, including 9 foster carers, 8 residential carers and 5 social workers; half of whom had received SHR training. Methods: In-depth interviews explored barriers/facilitators to SHR discussions, and how these shaped caregivers’ experiences of discussing SHR with LAC. Data were systematically analysed using predetermined research questions and themes identified from reading transcripts. Role theory was used to explore caregivers’ understanding of their role. Results: SHR policies clarified role expectations and increased acceptability of discussing SHR. Training increased knowledge and confidence, and supported caregivers to reflect on how personally held values impacted practice. Identified training gaps were how to: (1) Discuss SHR with LAC demonstrating problematic sexual behaviours. (2) Record the SHR discussions that had occurred in LAC’s health plans. Contrary to previous findings, caregivers regularly discussed SHR with LAC. Competing demands on time resulted in prioritisation of discussions for sexually active LAC and those ‘at risk’ of sexual exploitation/harm. Interagency working addressed gaps in SHR provision. SHR discussions placed emotional burdens on caregivers. Caregivers worried about allegations being made against them by LAC. Managerial/ pastoral support and ‘safe care’ procedures minimised these harms. Conclusions: While acknowledging the existing level of SHR promotion for LAC there is scope to more firmly embed this into the role of caregivers. Care needs to be taken to avoid role ambiguity and tension when doing so. Providing SHR policies and training, promoting interagency working and providing pastoral support are important steps towards achieving this

尼西黑陶: A Study of Tibetan Black Pottery

This paper addresses the contemporary production of traditional crafts through a close study of Tibetan black pottery. By considering the traditional process, materials, and techniques of Nixi pottery alongside contemporary changes in markets, resource availability, and production methods, this paper suggests possible directions for the development of traditional crafts. Ultimately, the paper challenges traditional distinctions between “arts” and “crafts,” suggesting the inherent mobility of crafts as their makers respond to changes in the social, political, and economic contexts of production

Perinatal outcome in mothers with heart disease attending the combined Obstetric and Cardiology Clinic at Groote Schuur Hospital

Includes bibliographical references.ith the advances made in the management of cardiac conditions, much importance has been placed on the maternal outcome in pregnancies complicated by heart disease. However, to enable attending clinicians to provide suitable counseling and manage the pregnancy appropriately, the potential complications arising in the fetus and neonate also require attention. Adverse neonatal and perinatal outcome is more common in pregnant women with cardiac disease. Analysis of the available data pertaining to the South African population is important, as this population’s profile, like that of Africa, differs from that of industrialized countries. The relevance of maternal heart disease is highlighted by the National Committee for the Confidential Enquiries into Maternal Deaths (NCCEMD) in South Africa ( http://www.doh.gov.za/docs/reports/2012/Report_on_Confidential_Enquiries_into_ Maternal_Deaths_in_South_Africa ). Objectives To describe the perinatal outcome in women with heart disease and to determine whether there is an associated adverse outcome related to babies born to mothers with heart disease. Methods 82 patients were collected serially over 18 months. Neonatal outcome was recorded. Adverse neonatal outcome was defined as perinatal mortality, admission to NICU and the need for delivery room resuscitation. Results Perinatal mortality rate in this cohort was good, and better than the rate in the general population from whence this cohort came, but was linked to a high rate of obstetric intervention. The rate of adverse neonatal outcome is better than the rate in industrialized countries. Conclusion Perinatal outcome is good when mothers with heart disease are managed in a multidisciplinary clinic

Political Change through Narrative

When faced with well-organized opposition, political organizations often incorporate new strategies into their campaigns. Some progressive organizations situate their work within overarching frameworks or perspectives called narratives, which are designed to shift the terms of public discourse to favor particular social and political goals. Despite the theoretical significance of narratives, actual efforts to connect everyday change-making activities to narrative development are often complicated by practical and theoretical obstacles. I address this dilemma in collaboration with Maine People’s Alliance (MPA), a progressive community action group with 32,000 members throughout Maine. We ask how an organization such as MPA can pursue the abstract goal of a “narrative” while remaining committed to more concrete change-making activities that measure an organization’s success. To answer this question and the three tensions of power, practicality, and perceptions that it spawns, we build on the work of community organizers, social movement framing theorists, scholars who study political myth, narrative analysts, and policy analysts. We explore a new integration of narratives and policymaking that simultaneously develops an alternative perspective and accomplishes measurable political change. This investigation uncovers the two tiers of narrative: organizational narratives and public worldviews. By focusing on organizational narratives, we explore various methods of story collection and evaluation to develop a model of narrative development that accommodates the varied realities and complexities of MPA, MPA membership, and the current political environment

Complications of anticoagulation in pregnant women with mechanical heart valves

Includes abstract. Includes bibliographical references

Editorial: Labour in the Countryside

Despite a difficult few months for Labour, we are seeing some green shoots of hope where we might not have expected them. The Batley and Spen by-election was a narrow hold, but what was particular intriguing was that the party appears to have attracted a new sort of voter from the more rural or semirural parts of the constituency in the Spen Valley, including the villages around Cleckheaton and Heckmondwike. Meanwhile, whilst it is never ideal to lose your deposit, it was also welcome and interesting to see the Tories lose what everyone thought was a safe seat in Chesham and Amersham to the Liberal Democrats – without a doubt partly because of tactical voting. Some of the issues raised on the doorstep included HS2 and planning reform: both of which matter to local people in part because of destruction of the greenbelt and other natural habitats and areas of beauty

When Mountain meets Road: Mfankind\u27s connection to nature through sublime theory in Shelley\u27s Mont Blanc and McCarthy\u27s The Road

Cormac McCarthy\u27s The Road (2005) is a strong example of how post-modern dystopian fiction has captivated the mass imagination. Contemporary scholars have discussed The Road thoroughly, commenting on the text\u27s redemptive journey, post-apocalyptic message or cauterized terrain. However, I argue that McCarthy\u27s novel is not merely a modern text with an alienating landscape. Rather, the story conveys a strongly sublime aesthetic, which is recognizable from nineteenth­century British Romantic works such as Percy Bysshe Shelley\u27s Mont Blanc (1817). These texts have a shared obsession vvith the fictional representation and investigation of the sublime aesthetic and humankind\u27s relationship with the natural world. Indeed, there is a fascinating correlation betvveen the tvvo texts, in terms of how the authors create a union betvveen humankind and nature. A1ont Blanc and The Road each have a functioning triad within, by which nature and humankind are balanced and reach equilibrium through the use of a third party. McCarthy\u27s and Shelley\u27s respective works show strong connections and are clearly connected. However, I do not propose that McCarthy drew directly from Romantic texts. Instead, I argue that the relationship betvveen The Road and Af ont Blanc can best be explained through l\Iichel Foucault\u27s theory of the episteme, and I thus argue that they share similar themes and concerns because both authors tap into the same societal, aesthetic and historical topio when producing their respective literary texts. I contend that issues that spurred on the Romantic poets to write, have resurfaced again in the tv:enty-first century, and are contributing to modern literature in new and excmng ways

The over-expression, purification and crystallisation of the alternative oxidase

The alternative oxidase (AOX) is an integral monotopic membrane protein which branches from respiratory chain at the point of the Q-pool in the mitochondria of all flowers, some fungi, and some protists such as the human parasite Trypanosoma brucei. The aim of this project is threefold: to establish an over-expression and purification protocol for recombinant Sauromatum guttatum alternative oxidase (SgrAOX); to use expressed SgrAOX for structural analysis such as crystallography; and finally to use in silico methods to model the alternative oxidase protein. Of these three, only the first and last have been attempted previously, with varying success. The second, namely structural analysis, has never been attempted with SgrAOX. In order to achieve the aims of this project, primarily laboratory-based protein production were used, in conjunction with downstream analysis using structural biology techniques. The in silico modelling was carried out using a wide range of algorithms freely available on the World Wide Web. Results of this project are: the determination of an over-expression system and purification protocols in two E.coli strains, producing enough protein to use for the second objective detailed above. While no crystal structure has been obtained, significant steps toward identifying a protocol for rAOX crystallisation have been made. Results from structural analysis support modelling predictions and give novel insights into the thermostability of the protein. New and detailed homology models have been created and critically evaluated, with a very recent crystal structure from our collaborators providing a unique set of data for model evaluation. The outcome of this project has contributed towards the determination of conditions under which SgrAOX protein may form crystals, and therefore bringing the acquisition of a SgrAOX protein structure closer