The RAMSI Legacy for Policing in the Pacific Region

For the past 14 years, approximately one-fifth of the Regional Assistance Mission to Solomon Islands (RAMSI) Participating Police Force (PPF) has comprised police from 13 Pacific Island countries, referred to as the Pacific Islands contingent. As RAMSI was drawing to a close, it was timely to assess the impact of their involvement on police and policing in the region. Supported by the Australian Federal Police (AFP), the research project was undertaken in 2017 by a team from the Australian National University’s Department of Pacific Affairs. This report draws from more than 100 interviews with key stakeholders and former Pacific Islands contingent members, and a short written survey of 37 former Pacific Islands contingent members. The focus was on the views and experiences of Pacific Islands contingent members concerning the impact of their deployment on them individually, their home police organisations and policing in the region. Funded by the Australian Federal Police (AFP) and supported by the Pacific Islands Forum and the Pacific Islands Chiefs of Police (PICP), the research project commenced at the end of 2016. With RAMSI ending in mid-2017 it was seen as a good time to review its effect and impact on the individual members of the Pacific Islands contingent police, their home police organisations, and, broadly, on regional policing. The research had two main goals. Firstly, to capture and describe the experiences and views of Pacific Islands contingent members and, secondly, to provide a more strategic and analytical assessment of the lessons learnt from this multi-country police-led mission.AusAI

Pacific Policing : RAMSI: Lessons, Impacts and Recommendations

This Policy Brief is in two parts. First, it summarises findings on five key questions that underpinned the research into the Regional Assistance Mission to Solo-mon Islands (RAMSI), drawing directly on our interviews with many of RAMSI's leadership figures, from both the policing and diplomatic sides, and from all periods of RAMSI's existence starting in 2003 and continuing through to 2017. Second, this paper makes a short set of recommenda-tions aimed at capturing best practice from the involve-ment of Pacific Islands personnel in RAMSI, and at sus-taining and consolidating the gains made for policing both in individual police forces in the Pacific, and for relationships between police forces in the region. These recommendations are largely addressed to the AFP although some of them may have broader relevanceThis report was commisioned by Department of Pacific Affair

The RAMSI Legacy for Pacific Policing

While most aspects of the Regional Assistance Mission to Solomon Islands (RAMSI) have been well documented, less has been said about the significant contribution of the Pacific Island police who served with it. Pacific Islanders undertook important civilian roles, but the largest numbers were deployed to RAMSI’s Participating Police Force (PPF). Although the bulk of the PPF were from Australia and New Zealand, approximately one-fifth were Pacific Island police — referred to as the Pacific Island contingent (PI contingent) — from 13 countries: Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Papua New Guinea, Samoa, Tonga, Tuvalu, and Vanuatu. Their contribution underscored the mission’s regional nature and sustained support for RAMSI. Drawing on more than 100 interviews, this In Brief summarises preliminary findings from a research project supported by the Australian Federal Police (AFP) that has been examining the experience and impact of RAMSI’s PI contingent on its individual participants, their home police organisations, and on regional policing more broadly.AusAI

The effects of interoperable information technology networks on patient safety: a realist synthesis

Background Interoperable networks connect information technology systems of different organisations, allowing professionals in one organisation to access patient data held in another one. Health policy-makers in many countries believe that they will improve the co-ordination of services and, hence, the quality of services and patient safety. To the best of our knowledge, there have not been any previous systematic reviews of the effects of these networks on patient safety. Objectives The aim of the study was to establish how, why and in what circumstances interoperable information technology networks improved patient safety, failed to do so or increased safety risks. The objectives of the study were to (1) identify programme theories and prioritise theories to review; (2) search systematically for evidence to test the theories; (3) undertake quality appraisal, and use included texts to support, refine or reject programme theories; (4) synthesise the findings; and (5) disseminate the findings to a range of audiences. Design Realist synthesis, including consultation with stakeholders in nominal groups and semistructured interviews. Settings and participants Following a stakeholder prioritisation process, several domains were reviewed: older people living at home requiring co-ordinated care, at-risk children living at home and medicines reconciliation services for any patients living at home. The effects of networks on services in health economies were also investigated. Intervention An interoperable network that linked at least two organisations, including a maximum of one hospital, in a city or region. Outcomes Increase, reduction or no change in patients’ risks, such as a change in the risk of taking an inappropriate medication. Results We did not find any detailed accounts of the ways in which interoperable networks are intended to work and improve patient safety. Theory fragments were identified and used to develop programme and mid-range theories. There is good evidence that there are problems with the co-ordination of services in each of the domains studied. The implicit hypothesis about interoperable networks is that they help to solve co-ordination problems, but evidence across the domains showed that professionals found interoperable networks difficult to use. There is insufficient evidence about the effectiveness of interoperable networks to allow us to establish how and why they affect patient safety. Limitations The lack of evidence about patient-specific measures of effectiveness meant that we were not able to determine ‘what works’, nor any variations in what works, when interoperable networks are deployed and used by health and social care professionals. Conclusions There is a dearth of evidence about the effects of interoperable networks on patient safety. It is not clear if the networks are associated with safer treatment and care, have no effects or increase clinical risks. Future work Possible future research includes primary studies of the effectiveness of interoperable networks, of economies of scope and scale and, more generally, on the value of information infrastructures. Study registration This study is registered as PROSPERO CRD42017073004. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 40. See the NIHR Journals Library website for further project information

The effects of interoperable information technology networks on patient safety: a realist synthesis

Background Interoperable networks connect information technology systems of different organisations, allowing professionals in one organisation to access patient data held in another one. Health policy-makers in many countries believe that they will improve the co-ordination of services and, hence, the quality of services and patient safety. To the best of our knowledge, there have not been any previous systematic reviews of the effects of these networks on patient safety. Objectives The aim of the study was to establish how, why and in what circumstances interoperable information technology networks improved patient safety, failed to do so or increased safety risks. The objectives of the study were to (1) identify programme theories and prioritise theories to review; (2) search systematically for evidence to test the theories; (3) undertake quality appraisal, and use included texts to support, refine or reject programme theories; (4) synthesise the findings; and (5) disseminate the findings to a range of audiences. Design Realist synthesis, including consultation with stakeholders in nominal groups and semistructured interviews. Settings and participants Following a stakeholder prioritisation process, several domains were reviewed: older people living at home requiring co-ordinated care, at-risk children living at home and medicines reconciliation services for any patients living at home. The effects of networks on services in health economies were also investigated. Intervention An interoperable network that linked at least two organisations, including a maximum of one hospital, in a city or region. Outcomes Increase, reduction or no change in patients’ risks, such as a change in the risk of taking an inappropriate medication. Results We did not find any detailed accounts of the ways in which interoperable networks are intended to work and improve patient safety. Theory fragments were identified and used to develop programme and mid-range theories. There is good evidence that there are problems with the co-ordination of services in each of the domains studied. The implicit hypothesis about interoperable networks is that they help to solve co-ordination problems, but evidence across the domains showed that professionals found interoperable networks difficult to use. There is insufficient evidence about the effectiveness of interoperable networks to allow us to establish how and why they affect patient safety. Limitations The lack of evidence about patient-specific measures of effectiveness meant that we were not able to determine ‘what works’, nor any variations in what works, when interoperable networks are deployed and used by health and social care professionals. Conclusions There is a dearth of evidence about the effects of interoperable networks on patient safety. It is not clear if the networks are associated with safer treatment and care, have no effects or increase clinical risks. Future work Possible future research includes primary studies of the effectiveness of interoperable networks, of economies of scope and scale and, more generally, on the value of information infrastructures. Study registration This study is registered as PROSPERO CRD42017073004. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 40. See the NIHR Journals Library website for further project information

Charles C. Francis Papers, 1911-2013

An article, written by Judy Keen and Jill Lawrence for USA Today, about a campaign meeting between presidential candidate George W. Bush and gay and lesbian Republican supporters. The article includes a picture of Bush with two of these supporters

The Genotype-Tissue Expression (GTEx) Project: Linking Clinical Data with Molecular Analysis to Advance Personalized Medicine

Evaluation of how genetic mutations or variability can directly affect phenotypic outcomes, the development of disease, or determination of a tailored treatment protocol is fundamental to advancing personalized medicine. To understand how a genotype affects gene expression and specific phenotypic traits, as well as the correlative and causative associations between such, the Genotype-Tissue Expression (GTEx) Project was initiated The GTEx collection of biospecimens and associated clinical data links extensive clinical data with genotype and gene expression data to provide a wealth of data and resources to study the underlying genetics of normal physiology. These data will help inform personalized medicine through the identification of normal variation that does not contribute to disease. Additionally, these data can lead to insights into how gene variation affects pharmacodynamics and individualized responses to therapy

Parent stress, parenting competence and family-centered support to young children with an intellectual or developmental disability

A family-centered approach to the support of families with a young child with an intellectual or developmental disability has been widely adopted in the last decade. While some of the foundational assumptions of family-centered theory have been tested, there remain considerable gaps in the research evidence for this approach. While parenting stress and competence have been examined in the general family support literature, these variables have received little attention in the family-centered support literature. This pilot study examined the relationship between parent stress and parenting competence and family-centered support. The results suggest that important components of family-centered practice are significantly associated with parent stress, but that a meaningful association between parenting competence and family-centered practice is yet to be demonstrated.</p

Nutraceuticals: Separating the wheat from the chaff

Foods provide nutrients such as vitamins, minerals, protein, carbohydrate and fat and a host of other nonessential nutrients that may confer health benefits. Some “nutraceuticals” have been found to boost the immune system, enhance memory function and possibly slow the aging process. For example, flavonoids — which are found in red wine, purple grape juice, green tea and cocoa products — exhibit potent antioxidant activity in laboratory experiments and have been postulated to protect against coronary artery disease and reduce the risk of cancer. Recognizing potential health benefits from flavonoids and other plant extracts, some manufacturers are creating “functional” foods by fortifying, bioengineering and otherwise modifying foods so that they contain higher than normal concentrations of these components. With the exception of echinacea, St. John's wort and Ginkgo biloba, there is a paucity of scientific data for the majority of botanicals sold in health food stores and supermarkets. At the same time, adverse reactions to some botanicals have been documented in humans. Many would argue that government regulation of botanicals is inadequate. Further studies and comprehensive databases are needed to establish the safety and efficacy of popular and widely consumed dietary supplements