Front‐line perspectives on ‘joined‐up’ working relationships: a qualitative study of social prescribing in the west of Scotland

Cross-sector collaboration has been promoted by government policies in the United Kingdom and many western welfare states for decades. Literature on joint working has focused predominantly on the strategic level, neglecting the role of individual practitioners in putting ‘joined-up working’ into practice. This paper takes the case of ‘social prescribing’ in the West of Scotland as an instance of joined-up working, in which primary healthcare professionals are encouraged to refer patients to non-medical sources of support in the third sector. This study draws on social capital theory to analyse the quality of the relationships between primary healthcare professionals and third sector practitioners. Eighteen health professionals and 15 representatives of third sector organisations participated in a qualitative interview study. Significant barriers to collaborative working were evident. The two stakeholder groups expressed different understandings of health, with few primary healthcare professionals considering non-medical sources of support to be useful or relevant. Health professionals were mistrustful of unknown third sector organisations, and concerned about their accountability for referrals that were not successful or positive for the patient. Third sector practitioners sought to build trust through face-to-face interactions with health professionals. However, primary healthcare professionals and third sector practitioners were not connected in effective networks. We highlight the on-going imbalance of power between primary healthcare professionals and third sector organisations. Strategic collaborations should be complemented by efforts to build shared understandings, trust and connections between the diverse frontline workers whose mutual co-operation is necessary to achieve effective joined-up working

EMPLOYMENT, GENDER, EDUCATION AND OTHER RELEVANT VARIABLES: THE FINANCIAL CRISIS IMPACT IN SPAIN

Abstract The present paper aims to ascertain whether gender differences continue to exist in Spain’s working population. It sets out to obtain empirical evidence of the employment profile according to gender, quantify the extent to which self-employment or salaried employment is associated with certain characteristics (age, education, marital status and economic sector) and to analyse the evolution undergone during the recent economic crisis (2005-2009). In the study multivariate analysis statistical techniques will be applied to micro-data from the Working Population Survey compiled by Spain’s National Statistics Office (INE). Results shows that significant gender differences in employment status are seen when this is disaggregated and that the economic crisis has had a negative impact especially in certain groups.

La praxis pedagógica

La Pedagogía puede considerarse praxis tanto en su vertiente teórica como práctica. La Pedagogía "teórica" debe revalorizarse en términos de praxis. No sólo explicativa o interpretativa, también transformativa, mediadora entre otras prácticas educativas. Pero en esta ponencia queremos referirnos a la Pedagogía en su vertiente práctica, cuando es práctica y no sólo pensamiento. La Pedagogía como práctica es interacción intersubjetiva, deliberativa, argumentativa, imbuída o informada éticamente, que requiere de variados "saber hacer" (savoir faire), que en el sentido aristotélico es a la vez praxis (relación entre sujetos) y poiesis (relación de los sujetos con objetos). Interacción incluida y atravesada por la realidad social, que también es práctica social subjetiva objetivada, condicionante, como alienante o liberadora. Nos preguntamos en qué consiste su especificidad, y cuáles son sus nexos con otras prácticas educativas. Sabemos que a diferencia del momento reflexivo con énfasis analítico, la praxis demanda una mirada sintética, orientada a la acción; y a diferencia de limitarse al conocimiento de la realidad, requiere de la utopía; conlleva un carácter propositivo, una elección de valores ético políticos, una construcción de sentidos culturales, que trascienden la descripción y la explicación. Referirse a la Pedagogía requiere una distinción reflexiva entre "lo pedagógico" -que trata sobre la educación- y "lo didáctico" -que trata sobre la enseñanza. Reconocemos que no puede haber educación sin enseñanza, pero también que la enseñanza no agota la educación. Temas como ciudadanía, género, violencia, trabajo, no se resuelven dictando clases o desarrollando unidades didácticas particulares. La Pedagogía y la intervención pedagógica abordan la participación de diversos actores educacionales, no limitados a los enseñantes; toman decisiones acerca de relevancias temáticas, previas al planeamiento didáctico; trabajan sobre los ámbitos institucionales, no sólo en el análisis sino en la intervención guiada por valores. Específicamente, la Pedagogía recupera las nociones de formación y humanismo, implícitas en la propuesta del "Bildung"

Alien Registration- Budd, Flora M. (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/24096/thumbnail.jp

A Christian at Kabul

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Alien Registration- Hawkins, Flora M. (Portland, Cumberland County)

https://digitalmaine.com/alien_docs/24574/thumbnail.jp

Thyroid stimulating hormone (TSH) ≥2.5mU/l in early pregnancy: prevalence and subsequent outcomes

Objective: There remains controversy over how women with abnormal thyroid function tests in pregnancy should be classified. In this study we assessed the proportion of women with thyroid stimulating hormone (TSH) ≥ 2.5 mU/l in a large obstetric cohort, and examined how many have gone on to develop thyroid disease in the years since their pregnancy. Study design: 4643 women were recruited and samples taken in early pregnancy between 2007 and 2010. Thyroid function tests were analysed in 2014; in women with raised TSH computerised health records and prescription databases were used to identify thyroid disease detected since pregnancy. Results: 58 women (1.5%) had a TSH over 5 mU/l and 396 women (10.3%) had TSH between 2.5 and 5 mU/l. Women with TSH > 5mU/l delivered infants of lower birthweight than those with TSH < 2.5 mU/l; there were no other differences in obstetric outcomes between the groups. Of those who have had thyroid tests since their pregnancy, 78% of those with TSH > 5 mU/l and 19% of those with TSH between 2.5 and 5 mU/l have gone on to be diagnosed with thyroid disease. Conclusions: Using a TSH cut-off of 2.5 mU/l in keeping with European and US guidelines means that over 12% of women in this cohort would be classified as having subclinical hypothyroidism. Treatment and monitoring of these women would have major implications for planning of obstetric services