556 research outputs found

    Satisfactory Progress? Keywords in English School Inspection

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    In this paper, we explore some of the keywords around which the practice of school inspection is ordered in England. As part of a project that explores the role of inspection in governing schooling in England, Scotland and Sweden, we have examined some of the key sources through which Ofsted (The Office for Standards in Education, Children’s Services and Skills) publicly announces its role and purpose. In considering these texts we have turned to Raymond Williams’ conception of ‘keywords’ (1988) to frame our analysis. We suggest that these sources are marked by the presence of a series of such keywords that underpin and legitimize the practice of school inspection by Ofsted. We conclude by considering some of the changing terminology that followed from the Coalition Government that took office in the UK in 2010 and which made education reform a centre piece of its first period in power

    Dying to be Mommy: Using Intentional Parenthood as a Proxy for Consent in Posthumous Egg Retrieval Cases

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    Article published in the Michigan State Law Review

    Russian Information Warfare: Policy Recommendations

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    This final article on Russian information warfare presents policy recommendations that can be adopted to combat and respond to information warfare. Each case study exhibits unique circumstances that illuminate potential policy options for counteracting Russian disinformation campaigns. After analyzing both the successes and failures in each case study, the following policy recommendations emerged: transparency, preemptive information-sharing, media literacy campaigns, private-sector engagement, and multilateral cooperation. These policy recommendations provide a broad framework for all countries facing a similar threat

    Clonal expansion within pneumococcal serotype 6C after use of seven-valent vaccine

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    Streptococcus pneumoniae causes invasive infections, primarily at the extremes of life. A seven-valent conjugate vaccine (PCV7) is used to protect against invasive pneumococcal disease in children. Within three years of PCV7 introduction, we observed a fourfold increase in serotype 6C carriage, predominantly due to a single clone. We determined the whole-genome sequences of nineteen S. pneumoniae serotype 6C isolates, from both carriage (n = 15) and disease (n = 4) states, to investigate the emergence of serotype 6C in our population, focusing on a single multi-locus sequence type (MLST) clonal complex 395 (CC395). A phylogenetic network was constructed to identify different lineages, followed by analysis of variability in gene sets and sequences. Serotype 6C isolates from this single geographical site fell into four broad phylogenetically distinct lineages. Variation was seen in the 6C capsular locus and in sequences of genes encoding surface proteins. The largest clonal complex was characterised by the presence of lantibiotic synthesis locus. In our population, the 6C capsular locus has been introduced into multiple lineages by independent capsular switching events. However, rapid clonal expansion has occurred within a single MLST clonal complex. Worryingly, plasticity exists within current and potential vaccine-associated loci, a consideration for future vaccine use, target selection and design

    Neonates living with enterostomy following necrotising enterocolitis are at high risk of becoming severely underweight

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    Necrotising enterocolitis (NEC) is often managed with a temporary enterostomy. Neonates with enterostomy are at risk of growth retardation during critical neurodevelopment. We examined their growth using z-score. We identified all patients with enterostomy from NEC in two neonatal surgical units (NSU) during January 2012–December 2016. Weight-for-age z-score was calculated at birth, stoma formation and closure, noting severely underweight as z < − 3. We compared those kept in NSU until stoma closure with those discharged to local units or home (LU/H) with a stoma. A total of 74 patients were included. By stoma closure, 66 (89%) had deteriorated in z-score with 31 (42%) being severely underweight. There was no difference in z-score at stoma closure between NSU and LU/H despite babies sent to LU/H having a more distal stoma, higher birth weight and gestational age. Babies in LU/H spent a much shorter period on parenteral nutrition while living with their stoma for longer, many needing readmission. Conclusion: Growth failure is a common and severe problem in babies living with enterostomy following NEC. z-score allowed growth trajectory to be accounted for in nutrition prescription and timing of stoma closure. Care during this period should be focused on minimising harm.What is Known:• Necrotising enterocolitis (NEC) is a life-threatening condition affecting predominately premature and very low birth weight neonates. Emergency treatment with temporary enterostomy often leads to growth failure.• There is no consensus on the optimal timing for stoma reversal, hence prolonging impact on growth during crucial developmental periods. Both malnutrition and surgical NEC are independently associated with poor neurodevelopment outcome.What is New:• Our study found growth in 89% of babies deteriorated while living with a stoma, with 42% having a weight-for-age z-score < − 3, meeting the WHO criteria of being severely underweight, despite judicial use of parenteral nutrition. Applying z-score to weight measurements will allow growth trajectory to be accounted for in clinical decisions, including nutrition prescription (both enteral and parenteral), and guide timing of stoma closure.• Surgeons who target stoma closure at a certain weight risk waiting for an indefinite period of time, during which babies’ growth may falter

    Improving Patient Safety: Engaging Students in Interprofessional Team-Based Learning (TBL)

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    Complex healthcare systems and ambiguous clinical decisions can result in medical errors which threaten patient safety. There is a need for improved awareness of medical errors across healthcare disciplines. We utilised team-based learning (TBL) to pilot an interprofessional patient safety module for senior health professional students. We evaluated the use of TBL within the interprofessional context to achieve student learning outcomes. Twenty-seven students from pharmacy (n=11), nursing (n=8) and medicine (n=8) faculties participated. Data were collected via questionnaires, focus groups, class observation and student test scores. Quantitative data were analysed using descriptive statistics. Framework analysis was used to code qualitative data using social capital as a conceptual framework. In total, 26/27 (96%) of participants completed the questionnaire and 20/27 (70%) attended focus groups. There was no significant difference in prior knowledge between the disciplines. The TBL module enriched the learning environment and enabled students to prepare, problem-solve and interact with facilitators. The TBL pedagogy and interprofessional framework enabled the development of social capital among students. The module demonstrated the potential of interprofessional education to shift knowledge and attitudes towards a greater appreciation of patient safety issues and better prepare health professional students for the workforce. The TBL pedagogy strengthened knowledge sharing and fostered collaboration across disciplines
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