Whose outcomes are they anyway? Report of the pilot evaluation of a joint service\ud

Health and social care partnership working is often predicated on the notion that it improves outcomes for service users. Yet there is a lack of evidence linking partnerships to changes in outcomes. Against this background, the Health Services Management Centre at the University of Birmingham designed the Partnership Outcomes Evaluation Toolkit (POET) specifically to evaluate health and social care partnerships in terms of service user outcomes. This paper reports on the field testing of POET with Sandwell Integrated Support Service. This research provided a number of interesting insights into this service, and indicated some dissonance between staff and service user and carer expectations

No heir apparent? Exploring the workers' co-operative model as a solution to the continuity of family businesses

Family businesses, with no apparent heir, face the risk of discontinuity. While a number of family businesses rely heavily on non-family employees, the role of non-family employees in the continuity of family businesses is under-researched. The workers’ co-operative model offers one way to address this gap as it represents a model whereby non-family employees gain a stake in ownership whilst the family remains involved. In practice, conversion to ensure continuity is actively promoted in a number of countries. In this paper, the authors explore the role of the workers’ co-operative model as one possible solution to succession difficulties facing family firms. Based on the reported experiences in a number of countries, we identify the motivations behind conversion, the barriers faced and the benefits accruing. We find that, in theory, the worker co-operative model merits the attention of family business scholars as a means of securing continuity and survival of family business. We explore the factors that appear to aid or hinder successful conversions in practice and we make recommendations to policy-makers surrounding the supports required to encourage and facilitate successful conversion

Does woman + a network = career progression?

Question: I am an ambitious and talented junior manager who has recently been hired by FAB plc, a large multinational company. I am also a woman and, as part of my induction pack, have received an invitation to join FABFemmes - the in-company women's network. I don't think my gender has been an obstacle to my success thus far and so I don't really feel the need to join. But on the other hand I don't want to turn my back on something that might offer me a useful source of contacts to help me advance up the career ladder. What would be the best thing to do? - Ms Ambitious, UK

Milwaukee’s Swing Park: Guerrilla Urbanism at the Intersection of Public Space, Community, and Urban Planning

Guerrilla urbanism involves citizen-led bottom-up unsanctioned temporary efforts. This kind of temporary urbanism may offer unique opportunities not possible through traditional planning approaches. This paper is a case study of the Swing Park in Milwaukee, Wisconsin, USA. It began as an effort to temporarily enliven an area at one end of a pedestrian walkway – the Marsupial Bridge – suspended under a viaduct across the Milwaukee River. What started as an illegal temporary installation of swings made of used tires was embraced physically and emotionally as part of the everyday life of the pedestrian bridge by the local community who wanted the swings to stay. The guerrilla urbanism group found itself in conflict with the City’s Department of Public Works over concerns about safety and legal liability, aside from budgetary constraints on permanently upgrading and maintaining the swings. This paper conceptualizes the case study within a three-part framework of public space, community, and urban planning. It examines how the Swing Park has been seen to have both succeeded and failed, while problematizing it within the context of the interdisciplinary literature on temporary urbanism

The GALEX Arecibo SDSS Survey. I. Gas Fraction Scaling Relations of Massive Galaxies and First Data Release

We introduce the GALEX Arecibo SDSS Survey (GASS), an on-going large program that is gathering high quality HI-line spectra using the Arecibo radio telescope for an unbiased sample of ~1000 galaxies with stellar masses greater than 10^10 Msun and redshifts 0.025<z<0.05, selected from the SDSS spectroscopic and GALEX imaging surveys. The galaxies are observed until detected or until a low gas mass fraction limit (1.5-5%) is reached. This paper presents the first Data Release, consisting of ~20% of the final GASS sample. We use this data set to explore the main scaling relations of HI gas fraction with galaxy structure and NUV-r colour. A large fraction (~60%) of the galaxies in our sample are detected in HI. We find that the atomic gas fraction decreases strongly with stellar mass, stellar surface mass density and NUV-r colour, but is only weakly correlated with galaxy bulge-to-disk ratio (as measured by the concentration index of the r-band light). We also find that the fraction of galaxies with significant (more than a few percent) HI decreases sharply above a characteristic stellar surface mass density of 10^8.5 Msun kpc^-2. The fraction of gas-rich galaxies decreases much more smoothly with stellar mass. One of the key goals of GASS is to identify and quantify the incidence of galaxies that are transitioning between the blue, star-forming cloud and the red sequence of passively-evolving galaxies. Likely transition candidates can be identified as outliers from the mean scaling relations between gas fraction and other galaxy properties. [abridged]Comment: 25 pages, 12 figures. Accepted for publication in MNRAS. Version with high resolution figures available at http://www.mpa-garching.mpg.de/GASS/pubs.ph

Xpert MTB/RIF versus sputum microscopy as the initial diagnostic test for tuberculosis: a cluster-randomised trial embedded in South African roll-out of Xpert MTB/RIF.

BACKGROUND: In South Africa, sputum smear microscopy has been replaced with Xpert MTB/RIF as the initial diagnostic test for tuberculosis. In a pragmatic parallel cluster-randomised trial, we evaluated the effect on patient and programme outcomes. METHODS: We randomly allocated 20 laboratories (clusters) in medium-burden districts of South Africa to either an Xpert (immediate Xpert) or microscopy (Xpert deferred) group (1:1), stratified by province. At two primary care clinics per laboratory, a systematic sample of adults giving sputum for tuberculosis investigation was assessed for eligibility. The primary outcome was mortality at 6 months from enrolment. Masking of participants' group allocation was not possible because of the pragmatic trial design. The trial is registered with the ISRCTN registry (ISRCTN68905568) and the South African Clinical Trial Register (DOH-27-1011-3849). FINDINGS: Between June and November, 2012, 4972 people were screened, and 4656 (93·6%) enrolled (median age 36 years; 2891 [62%] female; 2212 [62%] reported being HIV-positive). There was no difference between the Xpert and microscopy groups with respect to mortality at 6 months (91/2324 [3·9%] vs 116/2332 [5·0%], respectively; adjusted risk ratio [aRR] 1·10, 95% CI 0·75-1·62]). INTERPRETATION: Xpert did not reduce mortality at 6 months compared with sputum microscopy. Improving outcomes in drug-sensitive tuberculosis programmes might require not only better diagnostic tests but also better linkage to care. FUNDING: Bill & Melinda Gates Foundation

A multidisciplinary concept analysis of empowerment : implications for nursing.

According to the Institute of Medicine, nursing has failed to effectively shape the health care system and to advocate successfully for patients. Empowerment may be a potent tool to fulfill these responsibilities, yet nurses have not benefited from considering application of the concept to the continuum of health care advocacy in their communities, in their relationships with clients, and in their professional roles within health care organizations. This paper uses concept analysis to examine the attributes, characteristics, and uses of empowerment within diverse disciplines to clarify its meaning and explore its potential application to nursing\u27s challenges that cross settings, disciplines, and time

Adrenal Corticosteroidogenesis and Hypothyroidsm: Effect of Long-term Treatment with P-Aminobenzoic Acid

The relationship between induced hypothyroidism and adrenal involution has been studied by a variety of approaches in an attempt to elucidate the physiological basis between the events. McCarthy et al. (1959) reported on an investigation of feeding several antithyroidal agents to rats to study adrenal gland involution. While adrenal involution did occur following treatment with several of the goitrogens, only in one case was there a difference in peripheral plasma adrenal corticoid levels. In rats fed p-aminobenzoic acid (PABA) for 12 weeks, peripheral levels of corticosterone (B) decreased and levels of a Porter-Silber positive chromogen increased markedly. Work from the laboratories of Peron (1961) and of Birmingham (1961) established that the Porter-Silber chromogen in rat blood is 18-hydroxy-deoxycorticosterone (18-OH DOC). Cortes and Peron (1964) compared adrenal venous effiuent of normal and PABA-tested rats. These workers concluded that adrenal venous secretion of B and of 18-OH DOC by PABA-treated rats was unchanged from control values. Since the level of PABA fed has been shown to decrease thyroid function (McCarthy and Murphree, 1960), a question arose as to whether adrenal tissue from these hypothyroid rats would show any modification in corticosteroidogenesis. This study was undertaken to examine adrenal corticoid conversion in adrenal glands from rats fed PABA for various periods of time