How organisational arrangements affect service provision

This research shows the importance of good organisational support for care giving. Organisational arrangements can shape what individual staff members do in the highly skilled work of meeting resident needs. This may challenge traditional views about care quality that focus attention only on care workers

HIV testing intervention development among men who have sex with men in the developed world

HIV testing is a ‘gateway’ technology, enabling access to treatment and HIV prevention. Biomedical approaches to prevention, such as pre-exposure prophylaxis and treatment as prevention, require accurate and regular HIV test results. HIV testing also represents a powerful ‘teachable moment’ for behavioural prevention. An increasing range of HIV tests and the emergence of self-managed diagnostic technologies (e.g. self-testing) means there is now considerable diversification of when, where and how results are available to those who test. These changes have profound implications for intervention development and, indeed, health service redesign. This paper highlights the need for better ways of conceptualising testing in order to capitalise on the health benefits that diverse HIV testing interventions will bring. A multidimensional framework is proposed to capture ongoing developments in HIV testing among men who have sex with men and focus on the intersection of: (1) the growing variety of HIV testing technologies and the associated diversification of their pathways into care; (2) psychosocial insights into the behavioural domain of HIV testing; and (3) better appreciation of population factors associated with heterogeneity and concomitant inequities. By considering these three aspects of HIV testing in parallel, it is possible to identify gaps, limitations and opportunities in future HIV testing-related interventions. Moreover, it is possible to explore and map how diverse interventions may work together having additive effects. Only a holistic and dynamic framework that captures the increasing complexity of HIV testing is fit for purpose to deliver the maximum public health benefit of HIV testing

Reforming Testamentary Undue Influence in Canadian and English Law

The traditional doctrine of testamentary undue influence developed in nineteenth century England. Its utility, however, is limited since the doctrine requires the person alleging undue influence to provide direct proof of coercion according to a high standard. In England the doctrine has remained static and there have been calls for reform. In Canada, some courts have ceased to apply the traditional doctrine so that today there is no one consistent and coherent doctrine of testamentary undue influence. This article explores two possible reforms of the doctrine both of which are evident in recent Canadian case law: a presumption of testamentary undue influence and a modified doctrine of testamentary undue influence. It is argued that testators in both England and Canada would be best protected by a three-tiered approach comprising a modified doctrine of undue influence. It entails a presumption of validity where certain measures are taken in the execution of a will; the modification of key elements of the traditional doctrine relating to the testator\u27s state of mind, reliance on circumstantial evidence and the standard ofproof- and the adoption of the modified doctrine in those cases where a party challenges the inter vivos and testamentary gifts of a deceased donor on the basis of undue influence

A meta-ethnographic study of health care staff perceptions of the WHO/UNICEF Baby Friendly Health Initiative

Background Implementation of the Baby Friendly Health Initiative (BFHI) is associated with increases in breastfeeding initiation and duration of exclusive breastfeeding and ‘any’ breastfeeding. However, implementation of the BFHI is challenging. Aim To identify and synthesise health care staff perceptions of the WHO/UNICEF BFHI and identify facilitators and barriers for implementation. Method Seven qualitative studies, published between 2003 and 2013 were analysed using meta-ethnographic synthesis. Findings Three overarching themes were identified. First the BFHI was viewed variously as a ‘desirable innovation or an unfriendly imposition’. Participants were passionate about supporting breastfeeding and improving consistency in the information provided. This view was juxtaposed against the belief that BFHI represents an imposition on women's choices, and is a costly exercise for little gain in breastfeeding rates. The second theme highlighted cultural and organisational constraints and obstacles to BFHI implementation including resource issues, entrenched staff practices and staff rationalisation of non-compliance. Theme three captured a level of optimism and enthusiasm amongst participants who could identify a dedicated and credible leader to lead the BFHI change process. Collaborative engagement with all key stakeholders was crucial. Conclusions Health care staff hold variant beliefs and attitudes towards BFHI, which can help or hinder the implementation process. The introduction of the BFHI at a local level requires detailed planning, extensive collaboration, and an enthusiastic and committed leader to drive the change process. This synthesis has highlighted the importance of thinking more creatively about the translation of this global policy into effective change at the local level

Challenges in teaching English to young learners:global perspectives and local realities

Drawing on data from a recent research international research project, this article focuses on the challenges faced by teachers of English to young learners against the backdrop of the global rise of English. A mixed-methods approach was used to obtain the data, including a survey, which was completed by 4,459 teachers worldwide, and case studies, including observations and interviews with teachers, in five different primary schools in five different countries. A number of challenges emerged as affecting large numbers of teachers in different educational contexts, namely, teaching speaking, motivation, differentiating learning, teaching large classes, discipline, teaching writing, and teaching grammar. Importantly, some of these challenges have not been highlighted in the literature on young learner teaching to date. Other challenges are more localised, such as developing teachers' English competence. The article argues that teacher education should focus less on introducing teachers to general approaches to English language teaching and more on supporting teachers to meet the challenges that they have identified

Conservation biology of the endangered St. Helena Plover Charadrius sanctaehelenae

Oceanic islands contribute significantly to global biodiversity due to the high levels of endemism they exhibit. Many island species have, however, become extinct following the arrival of humans, and many others remain threatened. This thesis focuses on one of these threatened island species; the St. Helena Plover, Charadrius sanctaehelenae. The objectives of my PhD were threefold: to understand the current status of the St. Helena Plover, to investigate aspects of its environment that may threaten its persistence, and to compare conservation options. Observational data were used to understand how variation in the environment influences the plover’s distribution and demography. This information was used to inform a controlled trial investigating the use of nest exclosures as a way to improve productivity. New understanding of the species’ population ecology was brought together to create a stochastic meta-population model. This model was used to understand the influence of demographic and life history parameters on the population growth rate and to compare alternative conservation options. Indicators of the future status of the St. Helena Plover population appear mixed; with numbers predicted to decline slowly, but with a high chance of species persistence over the timeframe simulated, 50 years. Nest predation by introduced species, predominately cats, was predicted to suppress nest survival and bring productivity at some sites below that required for population stability. The use of nest exclosures did not increase nest survival and led to a decrease in adult survival. Habitat characteristics were more important in determining the species distribution than influencing its demography. The plovers appeared to select breeding habitat to maximise the visibility from the nest and the accessibility of invertebrate prey. Simulations suggested that predator control would have a large beneficial effect on the population growth rate and that concurrent habitat improvement would have greater than additive benefits. Targets for conservation management include Deadwood Plain; predator control as this key site was predicted to lead to the largest increase in the overall population growth rate, and Man and Horse; there may be potential at this site to increase adult survival, which was found to be the most influential demographic parameter.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

HPLC and capillary electrophoresis for determination of acids, terpenes and aldehydes in natural rosins

Rosins are natural compounds derived from pine tree resin. They have many uses in industry, including paints, adhesives and soldering fluxes. In this work HPLC and CE was used to characterise rosin samples which are composed of 90% acidic compounds and 10% neutral compounds including aldehydes and terpenes. Cyclodextrin-modified CE methods were developed for the separation of acids, terpenes and aldehyde groups. The presence and concentration of acids in several rosin samples was investigated