Efficacy of Telephone Information and Advice on Welfare: the Need for Realist Evaluation

In the context of increased marketisation in welfare provision, formal information and advice (I&A) is widely assumed to enable users, as consumers, to make informed choices about services, support and care. There is emerging evidence that telephone I&A services represent important ways of providing such services. This article proposes a framework that identifies key areas of focus delineating the efficacy of I&A, which is then used in a comprehensive literature review to critique existing research on outcomes and/or impact of telephone I&A. Existing, predominately quantitative, research has critical weaknesses. There is a lack of adequate contextual focus, understanding agency, and how I&A is used in different contexts to influence causal processes. The article contends that the efficacy of I&A is not adequately reported and provides much needed theoretical clarity in key areas, including the desirability of further realist evaluation approaches

The grit in the oyster: using energy biographies to question socio-technical imaginaries of ‘smartness’

It has been argued that responsible research and innovation (RRI) requires critique of the ‘worlds’ implicated in the future imaginaries associated with new technologies. Qualitative social science research can aid deliberation on imaginaries by exploring the meanings of technologies within everyday practices, as demonstrated by Yolande Strengers’ work on imaginaries of ‘smartness’. In this paper, we show how a novel combination of narrative interviews and multimodal methods can help explore future imaginaries of smartness through the lens of biographical experiences of socio-technical changes in domestic energy use. In particular, this approach can open up a critical space around socio-technical imaginaries by exploring the investments that individuals have in different forms of engagement with the world. The paper works with a psychosocial conceptual framework that draws on theoretical resources from science and technology studies to explain how valued forms of subjectivity may be conceptualised as emerging out of the ‘friction’ of engagement with the world. Using this framework, we show how biographical narratives of engagement with technologies from the Energy Biographies project can extend into critical deliberation on future imaginaries. The paper demonstrates the value of ‘thick’ data relating to the affective dimensions of subjective experience for RRI

Questioning policy, youth participation and lifestyle sports

Young people have been identified as a key target group for whom participation in sport and physical activity could have important benefits to health and wellbeing and consequently have been the focus of several government policies to increase participation in the UK. Lifestyle sports represent one such strategy for encouraging and sustaining new engagements in sport and physical activity in youth groups, however, there is at present a lack of understanding of the use of these activities within policy contexts. This paper presents findings from a government initiative which sought to increase participation in sport for young people through provision of facilities for mountain biking in a forest in south-east England. Findings from qualitative research with 40 young people who participated in mountain biking at the case study location highlight the importance of non-traditional sports as a means to experience the natural environments through forms of consumption which are healthy, active and appeal to their identities. In addition, however, the paper raises questions over the accessibility of schemes for some individuals and social groups, and the ability to incorporate sports which are inherently participant-led into state-managed schemes. Lifestyle sports such as mountain biking involve distinct forms of participation which present a challenge for policy-makers who seek to create and maintain sustainable communities of youth participants

The Global Impact of Science Gateways, Virtual Research Environments and Virtual Laboratories

Science gateways, virtual laboratories and virtual research environments are all terms used to refer to community-developed digital environments that are designed to meet a set of needs for a research community. Specifically, they refer to integrated access to research community resources including software, data, collaboration tools, workflows, instrumentation and high-performance computing, usually via Web and mobile applications. Science gateways, virtual laboratories and virtual research environments are enabling significant contributions to many research domains, facilitating more efficient, open, reproducible research in bold new ways. This paper explores the global impact achieved by the sum effects of these programs in increasing research impact, demonstrates their value in the broader digital landscape and discusses future opportunities. This is evidenced through examination of national and international programs in this field

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Binary Decision Diagram Representations Of Firewall And Router Access Lists

Network firewalls and routers can use a rule database to decide which packets will be allowed from one network onto another. By filtering packets the firewalls and routers can improve security and performance -- by excluding packets which may pose a security risk to a network or are not relevant to it. However, as the size of the rule list increases, it becomes difficult to maintain and validate the rules, and the cost of rule lookup may add significantly to latency. Ordered binary decision diagrams (BDDs) -- a compact method of representing and manipulating boolean expressions -- are a potential method of representing the rules. This paper explores how BDDs can be used to develop methods that help analysis of rules to validate them and changes to them, to improve performance, and facilitate hardware support. 1 Introduction The growth of network and internet communication creates several challenges for network design. Two important issues are security and performance. As the volume o..