Improving child protection : a systematic review of training and procedural interventions

Aim: To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals. Methods: Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome measures were learning achievement, attitudinal change, and clinical behaviour. Results: Seven papers that examined the effectiveness of procedural interventions and 15 papers that evaluated training programmes met the inclusion criteria. Critical appraisal showed that evaluation of interventions was on the whole poor. It was found that certain procedural interventions (such as the use of checklists and structured forms) can result in improved recording of important clinical information and may also alert clinical staff to the possibility of abuse. While a variety of innovative training programmes were identified, there was an absence of rigorous evaluation of their impact. However a small number of onegroup pre- and post-studies suggest improvements in a range of attitudes necessary for successful engagement in the child protection process. Conclusion: Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective

Disease Incidence and Results of Extremity Lesion Treatment: Mersey Region Soft Tissue Sarcomas (1975–1985)

Purpose. The incidence and treatment results of extremity soft tissue sarcoma (STS) in the Mersey Region, in the absence of a Multi-Disciplinary Unit, for the period 1975–1985, have been analysed

Process Variation: Demonstrating Responsibility

W. Edwards Deming preached that understanding variation is of paramount importance. He created the Red Bead Experiment (DRBE) to illustrate that variation is present in all processes and that utimately, management, not the willing worker, is responsible for the variability that is inherent in a process. We modify DRBE to demonstrate these lessons to undergraduate management and accounting students. Our results indicate that DRBE is a successful way for these students to I cam how variation applies to their respective studies

Suppressing sensorimotor activity modulates the discrimination of auditory emotions but not speaker identity

Our ability to recognize the emotions of others is a crucial feature of human social cognition. Functional neuroimaging studies indicate that activity in sensorimotor cortices is evoked during the perception of emotion. In the visual domain, right somatosensory cortex activity has been shown to be critical for facial emotion recognition. However, the importance of sensorimotor representations in modalities outside of vision remains unknown. Here we use continuous theta-burst transcranial magnetic stimulation (cTBS) to investigate whether neural activity in the right postcentral gyrus (rPoG) and right lateral premotor cortex (rPM) is involved in nonverbal auditory emotion recognition. Three groups of participants completed same-different tasks on auditory stimuli, discriminating between the emotion expressed and the speakers' identities, before and following cTBS targeted at rPoG, rPM, or the vertex (control site). A task-selective deficit in auditory emotion discrimination was observed. Stimulation to rPoG and rPM resulted in a disruption of participants' abilities to discriminate emotion, but not identity, from vocal signals. These findings suggest that sensorimotor activity may be a modality-independent mechanism which aids emotion discrimination. Copyright © 2010 the authors

Carbon Free Boston: Transportation Technical Report

Part of a series of reports that includes: Carbon Free Boston: Summary Report; Carbon Free Boston: Social Equity Report; Carbon Free Boston: Technical Summary; Carbon Free Boston: Buildings Technical Report; Carbon Free Boston: Waste Technical Report; Carbon Free Boston: Energy Technical Report; Carbon Free Boston: Offsets Technical ReportOVERVIEW: Transportation connects Boston’s workers, residents and tourists to their livelihoods, health care, education, recreation, culture, and other aspects of life quality. In cities, transit access is a critical factor determining upward mobility. Yet many urban transportation systems, including Boston’s, underserve some populations along one or more of those dimensions. Boston has the opportunity and means to expand mobility access to all residents, and at the same time reduce GHG emissions from transportation. This requires the transformation of the automobile-centric system that is fueled predominantly by gasoline and diesel fuel. The near elimination of fossil fuels—combined with more transit, walking, and biking—will curtail air pollution and crashes, and dramatically reduce the public health impact of transportation. The City embarks on this transition from a position of strength. Boston is consistently ranked as one of the most walkable and bikeable cities in the nation, and one in three commuters already take public transportation. There are three general strategies to reaching a carbon-neutral transportation system: • Shift trips out of automobiles to transit, biking, and walking;1 • Reduce automobile trips via land use planning that encourages denser development and affordable housing in transit-rich neighborhoods; • Shift most automobiles, trucks, buses, and trains to zero-GHG electricity. Even with Boston’s strong transit foundation, a carbon-neutral transportation system requires a wholesale change in Boston’s transportation culture. Success depends on the intelligent adoption of new technologies, influencing behavior with strong, equitable, and clearly articulated planning and investment, and effective collaboration with state and regional partners.Published versio

Two-path subsets: Efficient counting and applications to performability analysis

The problem of computing performability probabilities in stochastic PERT and flow networks is studied when the network is minimally designed to withstand any two component failures. Polynomial-time algorithms to compute performability when the network is planar - the nonplanar versions being NP-hard - solve related two-path subset problems. Given an acyclic graph with weights on the arcs, the algorithms compute the total weight of all subsets of arcs that are contained in (1) two source-sink paths, or (2) two are-disjoint source-sink paths. A polynomial algorithm is given for (1), and for (2) in the case where the graph is a source-sink planar k-flow graph, that is, cdge-minimal with respect to supporting k units of flow

The robustness and restoration of a network of ecological networks

Understanding species' interactions and the robustness of interaction networks to species loss is essential to understand the effects of species' declines and extinctions. In most studies, different types of networks (such as food webs, parasitoid webs, seed dispersal networks, and pollination networks) have been studied separately. We sampled such multiple networks simultaneously in an agroecosystem. We show that the networks varied in their robustness; networks including pollinators appeared to be particularly fragile. We show that, overall, networks did not strongly covary in their robustness, which suggests that ecological restoration (for example, through agri-environment schemes) benefitting one functional group will not inevitably benefit others. Some individual plant species were disproportionately well linked to many other species. This type of information can be used in restoration management, because it identifies the plant taxa that can potentially lead to disproportionate gains in biodiversity

Fetid Dogweed (Dyssodia papposa; Asteraceae) and Slender Russian Thistle (Salsola collina; Amaranthaceae), New to Alberta, Canada

Two non-native vascular plants, Fetid Dogweed (Dyssodia papposa; Asteraceae) and Slender Russian Thistle (Salsola collina; Amaranthaceae), are added to the flora of Alberta, Canada, based on collections and sight records made in 2011. Fetid Dogweed was found along roadsides at eight sites in southern Alberta, and Slender Russian Thistle was found along a hiking trail in Dinosaur Provincial Park near Drumheller. Both species are weedy and are probably expanding their range in North America

Declines in the Lethality of Suicide Attempts Explain the Decline in Suicide Deaths in Australia

Background: To investigate the epidemiology of a steep decrease in the incidence of suicide deaths in Australia. Methods: National data on suicide deaths and deliberate self-harm for the period 1994–2007 were obtained from the Australian Institute of Health and Welfare. We calculated attempt and death rates for five major methods and the lethality of these methods. Negative binomial regression was used to estimate the size and significance of method-specific time-trends in attempts and lethality. Results: Hanging, motor vehicle exhaust and firearms were the most lethal methods, and together accounted for 72% of all deaths. The lethality of motor vehicle exhaust attempts decreased sharply (RR = 0.94 per year, 95% CI 0.93–0.95) while the motor vehicle exhaust attempt rate changed little; this combination of motor vehicle exhaust trends explained nearly half of the overall decline in suicide deaths. Hanging lethality also decreased sharply (RR = 0.96 per year, 95% CI 0.956–0.965) but large increases in hanging attempts negated the effect on death rates. Firearm lethality changed little while attempts decreased. Conclusion: Declines in the lethality of suicide attempts–especially attempts by motor vehicle exhaust and hanging–explain the remarkable decline in deaths by suicide in Australia since 1997