The golden circle: A way of arguing and acting about technology in the London ambulance service

This paper analyses the way in which the London Ambulance Service recovered from the events of October 1992, when it implemented a computer-aided despatch system (LASCAD) that remained in service for less than two weeks. It examines the enactment of a programme of long-term organizational change, focusing on the implementation of an alternative computer system in 1996. The analysis in this paper is informed by actor-network theory, both by an early statement of this approach developed by Callon in the sociology of translation, and also by concepts and ideas from Latour’s more recent restatement of his own position. The paper examines how alternative interests emerged and were stabilized over time, in a way of arguing and acting among key players in the change programme, christened the Golden Circle. The story traces four years in the history of the London Ambulance Service, from the aftermath of October 1992 through the birth of the Golden Circle to the achievement of National Health Service (NHS) trust status. LASCAD was the beginning of the story, this is the middle, an end lies in the future, when the remaining elements of the change programme are enacted beyond the Golden Circle

An assessment of threats to terrestrial protected areas

Protected areas (PAs) represent a cornerstone of efforts to safeguard biodiversity, and if effective should reduce threats to biodiversity. We present the most comprehensive assessment of threats to terrestrial PAs, based on in-situ data from 1,961 PAs across 149 countries, assessed by PA managers and local stakeholders. Unsustainable hunting was the most commonly reported threat and occurred in 61% of all PAs, followed by disturbance from recreational activities occurring in 55%, and natural system modifications from fire or its suppression in 49%. The number of reported threats was lower in PAs with greater remoteness, higher control of corruption and lower human development scores. The main reported threats in developing countries were linked to overexploitation for resource extraction, while negative impacts from recreational activities dominated in developed countries. Our results show that many of the most serious threats to PAs are difficult to monitor with remote sensing, and highlight the importance of in situ threat data to inform the implementation of more effective biodiversity conservation in the global protected area estate

Scaling factors for the in vitro-in vivo extrapolation (IV-IVE) of renal drug and xenobiotic glucuronidation clearance.

AIM: To determine the scaling factors required for inclusion of renal drug glucuronidation clearance in the prediction of total clearance via glucuronidation (CLUGT ). METHODS: Microsomal protein per gram of kidney (MPPGK) was determined for human 'mixed' kidney (n = 5) microsomes (MKM). The glucuronidation activities of deferiprone (DEF), propofol (PRO) and zidovudine (AZT) by MKM and paired cortical (KCM) and medullary (KMM) microsomes were measured, along with the UGT 1A6, 1A9 and 2B7 protein contents of each enzyme source. Unbound intrinsic clearances (CLint,u,UGT ) for PRO and morphine (MOR; 3- and 6-) glucuronidation by MKM, human liver microsomes (HLM) and recombinant UGT1A9 and 2B7 were additionally determined. Data were scaled using in vitro-in vivo extrapolation (IV-IVE) approaches to assess the influence of renal CLint,u,UGT on the prediction accuracy of the calculated CLUGT values of PRO and MOR. RESULTS: MPPGK was 9.3 ± 2.0 mg g(-1) (mean ± SD). The respective rates of DEF (UGT1A6), PRO (UGT1A9) and AZT (UGT2B7) glucuronidation by KCM were 1.4-, 5.2- and 10.5-fold higher than those for KMM. UGT 1A6, 1A9 and 2B7 were the only enzymes expressed in kidney. Consistent with the activity data, the abundance of each of these enzymes was greater in KCM than in KMM. The abundance of UGT1A9 in MKM (61.3 pmol mg(-1) ) was 2.7 fold higher than that reported for HLM. CONCLUSIONS: Scaled renal PRO glucuronidation CLint,u,UGT was double that of liver. Renal CLint,u,UGT should be accounted for in the IV-IVE of UGT1A9 and considered for UGT1A6 and 2B7 substrates

Magnetic resonance imaging findings in children with Parry-Romberg syndrome and en coup de sabre

BACKGROUND: The aim of this study was to: (i) describe the abnormalities seen on brain imaging in a group of children with en coup de sabre (EDCS) with/without Parry-Romberg syndrome (PRS); and (ii) identify clinical predictors of brain imaging abnormalities. METHODS: This was a single centre (Great Ormond Street Hospital, London) retrospective case series of patients with ECDS/PRS seen from 2000 to 2018. We identified patients with cutaneous manifestations consistent with the clinical descriptions of ECDS/PRS. Presenting clinical, laboratory, and radiological brain findings are described. Results are expressed as medians and ranges or frequencies and percentages. Fisher's exact test was used to identify clinical associations with magnetic resonance imaging (MRI) abnormalities. RESULTS: Fourteen patients were studied: 6 males and 8 females; median age 14 years (range 3-20). We observed neuroimaging abnormalities in 2/6 ECDS and 5/8 ECDS/PRS patients. White matter signal abnormality, dystrophic calcification, leptomeningeal enhancement, and sulcal crowding were the typical findings on brain imaging. A total of 50% of patients had no MRI abnormality despite some of these patients having neurological symptoms. The presence of seizures was significantly associated with ipsilateral enhanced white matter signalling on MRI (p < 0.05). CONCLUSIONS: In summary, we observed several distinct radiographic patterns associated with ECDS/PRS. Seizure disorder was strongly associated with the presence of ipsilateral enhanced white matter signalling. Improved neuroimaging techniques that combine morphological with functional imaging may improve the detection rate of brain involvement in children with ECDS/PRS in the future

Teleworking practice in small and medium-sized firms: Management style and worker autonomy

In an empirical study of teleworking practices amongst small and medium-sized enterprises (SMEs) in West London, organisational factors such as management attitudes, worker autonomy and employment flexibility were found to be more critical than technological provision in facilitating successful implementation. Consequently, we argue that telework in most SMEs appears as a marginal activity performed mainly by managers and specialist mobile workers

Preparing to work: dramaturgy, cynicism and normative ‘remote’ control in the socialization of graduate recruits in management consulting

online) This paper examines the socialization of graduate recruits into a knowledge intensive labour process and organizational culture. Theoretically the paper draws upon the idea of ‘preparing for work’ to position this early socialization as a crucial moment in the production of subjectivities suited (and booted) for the labour process of management consulting. Empirically the paper reports on a two-day induction session for new graduate recruits joining a global management consultancy and their responses to this training. Particular attention is given to the use of role-play and a dramaturgical workshop used in part of the training process. The paper argues that the utilization of dramaturgy in training is consistent with the overall approach to control developed in the firm in response to the fact that the labour process of consulting is often conducted on client sites, away from any direct supervisory gaze. As such, the consultants were subjected to a form of cultural control that was designed to function independently of direct supervision. This control did not operate directly upon the new employees professed values, however, but at one step removed so that a ‘cynical distance’ from the content of the organization’s culture was accepted so long as a professional ‘ethic of behaviour’ was established. By focusing on an ‘ethic of behaviour’ these young professionals were encouraged to internalize a self-control akin to that of an actor, rather than internalizing the corporate values entirely

Triplet exciton diffusion and phosphorescence quenching in Iridium(III)-Centered dendrimers

A study of triplet-triplet exciton annihilation and nonradiative decay in films of iridium(III)-centered phosphorescent dendrimers is reported. The average separation of the chromophore was tuned by the molecular structure and also by blending with a host material. It was found that triplet exciton hopping is controlled by electron exchange interactions and can be over 600 times faster than phosphorescence quenching. Nonradiative decay occurs by weak dipole-dipole interactions and is independent of exciton diffusion, except in very thin films

The abolition of the General Teaching Council for England and the future of teacher discipline

With the abolition of the General Teaching Council for England in the 2011 Education Act, this article considers the future of teacher discipline in England. It provides a critique of the changes to the regulation of teacher misconduct and incompetence that draws on a Foucauldian framework, especially concerning the issue of public displays of discipline and the concomitant movement to more hidden forms. In addition, the external context of accountability that accompanies the reforms to teacher discipline are considered including the perfection of the panoptic metaphor presented by the changes to Ofsted practices such as the introduction of zero-notice inspections. The article concludes that the reforms will further move teachers from being occupational professionals to being organisational professionals marking them apart from comparable professions in medicine and law

A global analysis of management capacity and ecological outcomes in terrestrial protected areas

Protecting important sites is a key strategy for halting the loss of biodiversity. However, our understanding of the relationship between management inputs and biodiversity outcomes in protected areas (PAs) remains weak. Here, we examine biodiversity outcomes using species population trends in PAs derived from the Living Planet Database in relation to management data derived from the Management Effectiveness Tracking Tool (METT) database for 217 population time‐series from 73 PAs. We found a positive relationship between our METT‐based scores for Capacity and Resources and changes in vertebrate abundance, consistent with the hypothesis that PAs require adequate resourcing to halt biodiversity loss. Additionally, PA age was negatively correlated with trends for the mammal subsets and PA size negatively correlated with population trends in the global subset. Our study highlights the paucity of appropriate data for rigorous testing of the role of management in maintaining species populations across multiple sites, and describes ways to improve our understanding of PA performance