The OneTogether collaborative approach to reduce the risk of surgical site infection: identifying the challenges to assuring best practice

Background: Surgical site infections (SSI) account for 16% of healthcare associated infections, and are associated with considerable morbidity, mortality and increased costs of care. Ensuring evidence-based practice to prevent SSI is incorporated across the patient’s surgical journey is complex. OneTogether is a quality improvement collaborative of infection prevention and operating department specialists, formed to support the spread and adoption of best practice to prevent SSI. This paper describes the findings of an expert workshop on infection prevention in operating departments. Methods: A total of 84 delegates from 75 hospitals attended the workshop, comprising 46 (55%) theatre nurses/operating department practitioners; 16 (19%) infection control practitioners and 22 (26%) other healthcare practitioners. Discussion focused on evidence, policy implementation and barriers to best practice. Responses were synthesised into a narrative review. Results: Delegates reported significant problems in translating evidence-based guidance into everyday practice, lack of local polices and poor compliance. Major barriers were lack of leadership, poorly defined responsibilities, and lack of knowledge/training. Conclusions: This workshop has provided important insights into major challenges in assuring compliance with best practice in relation to the prevention of SSI. The OneTogether partnership aims to support healthcare practitioners to improve the outcomes of patients undergoing surgery by reducing the risk of SSI

The Experience of Ofsted: fear, judgement and symbolic violence

After framing the issues with an overview of comparative international models of accountability in teacher education (in the US and Australia (e.g. Cochran-Smith et al 2016, Darling-Hammond and Hyler 2013 and Marshall et al 2012), this chapter assesses Ofsted in its role as a regulator of quality in educational standards. The absence of an overall national regulator in other countries has a consequence of instituting ‘fear’ as a technology of compliance in the English context. The chapter focuses specifically on one particular inspection of initial teacher education (ITE) courses run by a HE/FE partnership in the West Midlands of England but the conclusions it draws are applicable more widely to the role of Ofsted as a market regulator as it currently operates in the HE and FE sectors (and the education sector as a whole) in England. The inspection took place in March 2013 and this chapter draws on the experiences of HE and FE teacher educators from the partnership to provide a basis for discussion. It will illustrate how the English model of accountability has moved way beyond both US and Australian models. Drawing on the work of Paul Virilio and Francesc Torralba the chapter explores the role fear plays in inspection, positioning it as a key ingredient in the institutional habitus that is introduced and affirmed by Ofsted

The Relationship between Affective Response to Exercise and Activity Level among Children

Childhood obesity is a health epidemic in the United States. There have been many interventions designed to prevent and treat childhood obesity, but these programs have seen only moderate success. Exercise enjoyment influences children's physical activity, but little is known about obese children's enjoyment of exercise. The present study evaluated exercise enjoyment and subsequent physical activity among an ethnically diverse sample of children (n=25) participating in an 11-week obesity intervention. It was hypothesized that children would engage in progressively more physical activity over the course of the intervention and that their enjoyment of exercise would predict improvements in physical activity. Additional hypotheses were that 1) ethnicity, age, and BMI would influence both enjoyment and physical activity levels, and 2) reported hope would increase. Results showed the children engaged in less physical activity and reported lower exercise enjoyment over the 11-week intervention. African-American children were most active and Hispanic children were least active. Older children enjoyed exercise less and were less active than their younger counterparts. Reported hope showed a non-significant trend toward increasing. Pathways beliefs increased significantly but agency beliefs showed no change. Replicating the present study to better understand exercise enjoyment and hope among children who are obese could lead to more effective, targeted interventions

Governing Bodies: How the Organization of Social Groups Shapes Political Ambition.

Nascent ambition is an essential element of democracy that has implications for representation and equality yet we know surprisingly little about who is ambitious and why. I propose a unique framework for understanding nascent ambition, arguing that gender roles and gendered obstacles and opportunities affect its presence in men and women—and that they often do so differently for different social groups. I test this framework using data from the Citizen Participation Study, employing an innovative research design that identifies potential candidates for office and exploits variation across three different social groups—race, class, and religion—in their understandings of women’s roles as mothers and leaders. I then go beyond an examination of roles to analyze the importance of gendered experiences in shaping nascent ambition, focusing on recruitment, participation in single-gendered organizations, and experiencing discrimination. Finally, I look across these social groups to examine how differences between these groups on the dimensions of privilege, narrative, and mutability influence both levels of and ingredients for nascent ambition for the men and women in these groups. I find that both the levels of and the ingredients for nascent ambition vary across groups. My results largely support the roles and experiences framework I propose, revealing that gendered social roles matter more for women’s nascent ambition than men’s. I also find that variations across groups on the dimensions of privilege, narrative, and mutability affect nascent ambition, demonstrating that privilege in particular plays a key role in determining levels of ambition.PHDPolitical ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/113566/1/kfgall_1.pd