Family Migration: Understanding the Drivers, Impacts and Support Needs of Migrant Families

This report by the independent Expert Advisory Group on Migration and Population analyses the rules around family migration in Scotland and the UK and recommends future action

UK Immigration Policy After Leaving the EU: Impacts on Scotland's Economy, Population and Society

Debut report by independent Expert Advisory Group on Migration and Population looks specifically at how the ending of free movement and future UK Immigration policy will affect Scotland's devolved responsibilities

Report of the ESRC Expert Advisory Group on International Development October 2014

Very real transformations are now occurring in the nature and extent of poverty, in the processes leading to impoverishment, inequality and injustice, and in the policy space and practices that can address these. The purpose of this report is to identify for ESRC the new challenges that these unfolding realities pose for social science researchers in the field of international development.This will (a) inform emerging ESRC research strategy more broadly and (b) inform the development of joint funding arrangements between ESRC and funding partners. In our increasingly interconnected world, the emerging research priorities in international development that we document inevitably dovetail closely with emergent social science agendas more generally.There is not one discipline for ‘the developing world’ and many for ‘the developed’. Development studies research and teaching centres do bring new tools, frameworks, methods and experience to grapple with these future development pressures and problems, but all social science disciplines are expanding their boundaries to think more globally rather than territorially – and in ways that the emergence of international development studies as a field has been encouraging. Re-emphasising the opportunities for research in international development to draw on and feed into wider methodological, theoretical and substantive research repertoires echoes a core principle of the post-2015 Sustainable Development Agenda which is to be ‘integrated, holistic and universal, applying to all countries and all people’ and which thus eschews specific geographical foci. It echoes, too, the proposed Sustainable Development Goals which, beyond the principles of ending extreme poverty, seek to integrate social, economic, and environmental sustainability and inclusive growth within “a common understanding of our shared humanity, based on mutual respect and mutual benefit.”The ‘Third World’ and its euphemisms are fast becoming history. International development studies research does not secure its identity in a focus on a particular sub-set of countries or methods. International development research is, however, characterised by a problem-focused approach which this report is built around. But whilst much research in international development studies is unashamedly impact-led and supports a ‘what works’ agenda that speaks directly to wider policy concerns, this report prioritises, too, increased attention to the rapid transformations in global environments, economy, societies, cultures, politics and technologies that now reshape poverty and so reshape ‘what works’ as well as ‘for whom, when and why’.These changes are happening so fast and are so massive that for research to have maximum impact in informing the alleviation of mid-21st century poverty and inequality, it will need to be couched within new conceptualisations and new theorisations that capture these future realities. In particular, given the rising inequalities associated with current economic growth and new geographies of poverty that do not easily fall into particular countries,‘worlds,’ or points of the compass, it is our contention that ‘international development’ research needs not only to dwell on a broader range of countries and regions, but also to capture changing global orders producing and addressing poverty. In particular, embracing research on ‘middle income countries’ (MICs) is now important for understanding not only the predicament of the poor within, but also the drivers of steeply rising inequalities there which are of significance to the poor in countries with middle income aspirations. It will help, too, in understanding the nature of the multi-polar international order in which this will happen. In addition, BRICS and other MICs are sources of enormous social policy innovation that other countries stand to learn from; yet are often not well analysed. This report outlines challenges for a wide range of research, from that focused on refining specific interventions (education, health etc.) to the much broader analytical challenges that will necessitate conceptual breakthroughs and new analytical paradigms. Given the availability of more operational funding for the former, we suggest that there is a clear opportunity (and need) for ESRC to focus more (though not exclusively) on the broader questions and conceptual challenges. There are many ways to relate the cross cutting issues that we identify. Rather than develop a matrix, we set out key challenges and opportunities for research in relation to eight key trends: 1. Increasing inequalities in a connected world 2. Massive, differentiated urbanisation 3. Climate change and pushing against planetary limits 4. Emerging sensitivity to shocks, and their securitisation 5. Increasing political multipolarity 6. Emerging challenges to nation states in delivering development: social and physical infrastructure 7. New cultural shaping of poverty 8. Digital development, Big Data and the technological revolution We also highlight more methodological challenges: - Levering change: learning, incentives and beyond - Governing ‘international development’: measurement and beyon

Review at a multidisciplinary tumor board impacts critical management decisions of pediatric patients with cancer

BackgroundOptimal cancer care requires a multidisciplinary approach. The purpose of the current study was to evaluate the impact of a multidisciplinary tumor board on the treatment plans of children with solid tumors.ProceduresThe records of 158 consecutive patients discussed at a formal multidisciplinary pediatric tumor board between July 2012 and April 2014 were reviewed. Treatment plans were based on clinical practice guidelines and on current Children’s Oncology Group protocols. Alterations in radiologic, pathologic, surgical, and medical interpretations were analyzed to determine the impact on changes in recommendations for clinical management.ResultsOverall, 55 of 158 children (35%) had alterations in radiologic, pathologic, medical, or surgical interpretation of clinical data following multidisciplinary discussion. Of these, 64% had changes to the initial recommendation for clinical management. Review of imaging studies resulted in interpretation changes in 30 of 158 patients studied (19%), with 12 clinical management changes. Six of 158 patients (3.9%) had changes in pathologic interpretation, with four patients (2.5%) requiring treatment changes. In eight patients (5%), a change in medical management was recommended, while in 11 patients (7%) there were changes in surgical management that were based solely on discussion and not on interpretation of imaging or pathology.ConclusionsFormal multidisciplinary review led to alterations in interpretation of clinical data in 35% of patients, and the majority led to changes in recommendations for treatment. Comprehensive multidisciplinary tumor board incorporated into the care of children with cancer provides additional perspectives for families and care providers when delineating optimal treatment plans.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135428/1/pbc26201.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135428/2/pbc26201_am.pd

Paradox as invitation to act in problematic change situations

It has been argued that organizational life typically contains paradoxical situations such as efforts to manage change which nonetheless seem to reinforce inertia. Four logical options for coping with paradox have been explicated, three of which seek resolution and one of which ‘keeps the paradox open’. The purpose of this article is to explore the potential for managerial action where the paradox is held open through the use of theory on ‘serious playfulness’. Our argument is that paradoxes, as intrinsic features in organizational life, cannot always be resolved through cognitive processes. What may be possible, however, is that such paradoxes are transformed, or ‘moved on’ through action and as a result the overall change effort need not be stalled by the existence of embedded paradoxes

A national analysis of trends, outcomes and volume-outcomes relationships in thyroid surgery

OBJECTIVES: Thyroid conditions are common and their incidence is increasing. Surgery is the mainstay treatment for many thyroid conditions, and understanding its utilisation trends and morbidity are central to improving patient care. DESIGN: An N=near-all analysis of the English administrative dataset to identify trends in thyroid surgery specialisation, volume-outcome relationships, and the incidence and risk factors for short- and long-term morbidity. MAIN OUTCOME MEASURES: Between 2004 and 2012, 72594 patients underwent elective thyroidectomy in England. Information about age, sex, morbidities, thyroid disease and surgery, adjuvant treatments, and complications including hypocalcaemia and vocal palsy were recorded. RESULTS: Mean age at surgery was 49±30 and a female predominance (82%) was observed. Most patients underwent hemithyroidectomy (51%) or total thyroidectomy (32%). Patients underwent surgery for benign (52.5%), benign inflammatory (21%), and malignant (17%) thyroid diseases. Thyroid surgery grew by 2.9% a year and increased in specialization. Increased surgeon volume significantly reduced lengths of stay: the proportion of length of stay outliers fell from 11.8% for patients of occasional thyroidectomists (50 thyroidectomies a year). Post-discharge vocal palsy and hypocalcaemia occurred in 1.87% and 1.58% of cases respectively. High-volume surgeons had a reduced incidence of vocal palsy and volumes >30 were consistently protective. CONCLUSIONS: Thyroid surgery is increasingly specialised. High-volume surgeons achieve lower complications rates, including lower vocal palsy rates, and length of stay. This article is protected by copyright. All rights reserved

Integration of vitamin A supplementation with the expanded program on immunization does not affect seroconversion to oral poliovirus vaccine in infants.

Childhood immunization programs may provide infrastructure for delivering vitamin A supplements to infants in developing countries. The effect of giving vitamin A, an immune enhancer, on antibody responses to trivalent oral poliovirus vaccine (TOPV) is unknown. A randomized, double-blind, placebo-controlled clinical trial was conducted to determine the effect of giving

Dietary elimination of children with food protein induced gastrointestinal allergy – micronutrient adequacy with and without a hypoallergenic formula?

Background: The cornerstone for management of Food protein-induced gastrointestinal allergy (FPGIA) is dietary exclusion; however the micronutrient intake of this population has been poorly studied. We set out to determine the dietary intake of children on an elimination diet for this food allergy and hypothesised that the type of elimination diet and the presence of a hypoallergenic formula (HF) significantly impacts on micronutrient intake. Method: A prospective observational study was conducted on children diagnosed with FPIGA on an exclusion diet who completed a 3 day semi-quantitative food diary 4 weeks after commencing the diet. Nutritional intake where HF was used was compared to those without HF, with or without a vitamin and mineral supplement (VMS). Results: One-hundred-and-five food diaries were included in the data analysis: 70 boys (66.7%) with median age of 21.8 months [IQR: 10 - 67.7]. Fifty-three children (50.5%) consumed a HF and the volume of consumption was correlated to micronutrient intake. Significantly (p <0.05) more children reached their micronutrient requirements if a HF was consumed. In those without a HF, some continued not to achieve requirements in particular for vitamin D and zinc, in spite of VMS. Conclusion: This study points towards the important micronutrient contribution of a HF in children with FPIGA. Children, who are not on a HF and without a VMS, are at increased risk of low intakes in particular vitamin D and zinc. Further studies need to be performed, to assess whether dietary intake translates into actual biological deficiencies

Protocol for the Smoking, Nicotine and Pregnancy (SNAP) trial: double-blind, placebo-randomised, controlled trial of nicotine replacement therapy in pregnancy

Background: Smoking in pregnancy remains a public health challenge. Nicotine replacement therapy (NRT) is effective for smoking cessation in non-pregnant people, but because women metabolise nicotine and cotinine much faster in pregnancy, it is unclear whether this will be effective for smoking cessation in pregnancy. The NHS Health Technology Assessment Programme (HTA)-funded smoking, nicotine and pregnancy ( SNAP) trial will investigate whether or not nicotine replacement therapy ( NRT) is effective, cost-effective and safe when used for smoking cessation by pregnant women. Methods/Design: Over two years, in 5 trial centres, 1050 pregnant women who are between 12 and 24 weeks pregnant will be randomised as they attend hospital for ante-natal ultrasound scans. Women will receive either nicotine or placebo transdermal patches with behavioural support. The primary outcome measure is biochemically-validated, self-reported, prolonged and total abstinence from smoking between a quit date ( defined before randomisation and set within two weeks of this) and delivery. At six months after childbirth self-reported maternal smoking status will be ascertained and two years after childbirth, self-reported maternal smoking status and the behaviour, cognitive development and respiratory symptoms of children born in the trial will be compared in both groups. Discussion: This trial is designed to ascertain whether or not standard doses of NRT ( as transdermal patches) are effective and safe when used for smoking cessation during pregnancy