"All that is solid...": the destructive tendencies of the Conservative Party

Is there a winning future for the Conservatives? Tom Barker and Conor Farrington outline the party's recent history and find that it has often demonstrated a careless approach to institutions and objectives it has otherwise claimed to champion. For there to be a winning future, the Conservatives must seek to genuinely rebuild, rather than merely pay lip-service to, a One Nation party

The artificial pancreas: challenges and opportunities

Research into closed-loop systems is advancing, but many issues remain. Conor Farrington reports. After a long lead-in period, artificial pancreas technology is well on its way to revolutionising the treatment of diabetes. The concept of closed-loop insulin delivery for people with diabetes in response to near-continuous blood glucose monitoring (CGM) was first elaborated in the 1950s, and functioning bedside and wearable systems were developed in the 1970s and 1980s. However, uptake was restricted by the size and complexity of component devices, and by various clinical and technical challenges

The Brex Factor: how a citizens’ assembly on Brexit could learn from reality tv

Some politicians and political scientists have suggested that a citizens’ assembly would be the best way to build public consent for any Brexit solution. For this to work, argues Conor Farrington, any initiative would need to innovate to engage the public, and in this it could learn from mass television entertainment

Blended e-learning and end of life care in nursing homes: a small-scale mixed-methods case study.

BACKGROUND: A 'blended' (e-learning and facilitated workshops) training course for Group C staff (i.e. staff with relatively infrequent contact with end of life care) has been delivered across several English counties with the aim of improving end of life care in nursing and residential care homes. This paper evaluates the impact of the course on participants' understandings of and confidence in delivering end of life care in one nursing home, while also considering barriers to change in practice. METHODS: A mixed-methods case study approach, incorporating pre- and post-course questionnaires (SHA East of England End of Life Care Education Programme 'ABC' Project Work Force C or Non Nurse Workforce B Pre and Post Course Questionnaire; E-Learning in End of Life Care Study Pre and Post Course Questionnaire), documentary analysis, semi-structured interviews, and observation of course workshops. Participants were 20 members of staff at a nursing home in a city in the East of England, including 14 Health Care Assistants (carers) and 6 others (administrative, activities, hosting, and catering staff). The questionnaires and interviews assessed understandings of and confidence towards end of life care delivery. RESULTS: Improvements in participants' confidence in delivering end of life care were observed, particularly in the core competency areas of symptom management, communication, and advance care planning. A shift towards more detailed and more holistic understandings of end of life care was in evidence; some participants also championed end of life care in the home as a result of the course. Several barriers to changes in practice were encountered, including uneven participation, the absence of mechanisms for disseminating new insights and knowledge within the home, and a widespread perception that nurses' professional dominance in the home made sustainable change difficult to enact. CONCLUSIONS: While blended e-learning courses have the potential to generate positive change in participants' understandings of and confidence about End of Life Care, organizational and inter-professional obstacles must be overcome in order to translate these changes into improved end of life care delivery in nursing (and residential) homes

Climate neutrality not just carbon neutrality: how the AIA is working are working to find out more about the non-CO2 effects of aviation

The aviation industry is increasingly under pressure from passengers, environmental groups, governments and policy makers to reduce its climate impact and become a more sustainable industry. The main focus has been on developing new aircraft and propulsion technology to reduce or eliminate greenhouse gas emissions or at least become carbon neutral. However, aviation’s climate impact extends beyond carbon emissions. On clear days, aircraft flying in cold and humid conditions can be seen forming condensation trails, or contrails. In many cases these contrails disappear within a matter of minutes. However, if aircraft are flying in atmosphere where the relative humidity with respect to ice is greater than 100% (ice-supersaturated), contrails can persist for hours and may evolve into cirrus clouds. Like clouds, contrails reflect incoming solar energy back out to space creating a cooling effect, but they also absorb surface radiated energy creating a warming effect. The net effect is usually a warming of the atmosphere. In fact, one recent study suggested that between 1940 and 2018, the net global warming impact of contrails, measured in terms of radiative forcing, may have been as much as three-quarters of that of the total net radiative forcing generated by aviation (Lee et al. 2021) Therefore, although future aircraft operations may become carbon-neutral, they may not be climate-neutral if contrails are generated In recent months, engineers, scientists and industry partners working on the Aviation Impact Accelerator project (AIA) have been trying to estimate the climate impact of contrails now and in the future. But the science of contrails is relatively less well understood and their climate impact is highly uncertain

Factors Affecting Recruitment of Participants for Studies of Diabetes Technology in Newly Diagnosed Youth with Type 1 Diabetes: A Qualitative Focus Group Study with Parents and Children.

BACKGROUND: Relatively little is known about parents' or children's attitudes toward recruitment for, and participation in, studies of new diabetes technologies immediately after diagnosis. This study investigated factors affecting recruitment of participants for studies in newly diagnosed youth with type 1 diabetes. METHODS: Qualitative focus group study incorporating four recorded focus groups, conducted in four outpatient pediatric diabetes clinics in large regional hospitals in England. Participants comprised four groups of parents (n = 22) and youth (n = 17) with type 1 diabetes, purposively sampled on the basis of past involvement (either participation or nonparticipation) in an ongoing two-arm randomized trial comparing multiple daily injection with conventional continuous subcutaneous insulin infusion regimens from the onset of type 1 diabetes. RESULTS: Stress associated with diagnosis presents significant challenges in terms of study recruitment, with parents demonstrating varied levels of willingness to be approached soon after diagnosis. Additional challenges arise regarding the following: randomization when study arms are perceived as sharply differentiated in terms of therapy effectiveness; burdens arising from study participation; and the need to surrender new technologies following the end of the study. However, these challenges were mostly insufficient to rule out study participation. Participants emphasized the benefits and reassurance arising from support provided by staff and fellow study participants. CONCLUSIONS: Recruitment to studies of new diabetes technologies immediately after diagnosis in youth presents significant challenges, but these are not insurmountable. The stress and uncertainty arising from potential participation may be alleviated by personalized discussion with staff and peer support from fellow study participants.This work was supported by the National Institute of Health Research Cambridge Biomedical Research Centre; Wellcome Strategic Award (100574/Z/12/Z); Efficacy and Mechanism Evaluation, National Institutes for Health Research (#14/23/09); The Leona M. & Harry B. Helmsley Charitable Trust (#2016PG-T1D045); JDRF (#2-SRA- 2014-256-M-R).This is the final version of the article. It first appeared from Mary Ann Liebert via http://dx.doi.org/10.1089/dia.2016.015

From theory to practice: Two ecosystemic approaches and their applications to understanding school bullying

School professionals, particularly school counsellors and school psychologists, require detailed knowledge of many important factors that contribute to the personal, academic, and vocational development of the students in their charge (e.g., psychosocial development, curricula developments, local community developments and initiatives, national and international policy developments). The amount of detail and knowledge required by school counsellors/psychologists is bewildering, even before consideration of the individual differences in those who require their help. A framework can provide school professionals with a parsimonious approach to organising, synthesising and understanding all the information that needs to be considered in relation to a child within a particular environment. The current article reviews and comments upon the usefulness of two such theoretical frameworks - Bronfenbrenner's ecological model (1979, 1989) and Spiel, Reimann, Wagner, and Schober's (2008) Bildung-Psychology approach - to an exploration and understanding of a common issue; namely, bully/victim problems among school pupils. It is argued that such ecological/systemic approaches could usefully inform the design and evaluation of future efforts to address school bullying and violence. By extension, we propose that the simplicity of such models is of great value to the school professional who seeks a framework that can guide them in their work. Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013

Should the Prime Minister Sit in the House of Lords?

By long‐standing convention, the prime minister sits in the House of Commons. This article adopts the perspective of a thought experiment in which the premier moves to the House of Lords instead, exploring the potential advantages and drawbacks of this scenario from multiple perspectives. This move would entail shifts in the prime minister's roles and responsibilities, with knock‐on implications for the day‐to‐day functioning of the upper house. While a red‐bench premier would be less connected with the quotidian dynamics of electoral politics, they could also take a more strategic, long‐term view of politics and engage more actively in deliberative debate in a revitalised second chamber. The shift would also prompt significant debates surrounding non‐elective aspects of the constitution, including the House of Lords, raising important questions about legitimacy and representation. While acknowledging the unlikelihood of such a change, the article argues nonetheless that—as with all thought experiments—taking the possibility seriously can stimulate deeper thinking and challenge conventional assumptions about constitutional arrangements