Studies towards a description of the development and functioning of children's awareness of linguistic variability

PhD ThesisChildren's language acquisition does not consist solely of the mastery,, of linguistic form and structure, children must also acquire the rules for appropriate use of that form and structure. To become competent speaker-hearers children must learn how to handle linguistic variability. Almost nothing is knoýnabout how children acquire the' sociolinguistic skills'and patterns of sociolinguistic variability which have been reported for adult speakers. This thesis therefore investigates some aspects of'the structure and functioning of linguistic variability in children's speech. It is shown that non-segmental variability-in children's speech constitutes an area of primý, importance for study. Children systematically employ the resources of non-segmental variability for a variety of social and affective purposes. The structured nature of this non-segmental variability is revealed by a quantitative analysis of the prosodic and-paralinguistic features in children's speech

IFITM3 restricts the morbidity and mortality associated with influenza

The 2009 H1N1 influenza pandemic showed the speed with which a novel respiratory virus can spread and the ability of a generally mild infection to induce severe morbidity and mortality in a subset of the population. Recent in vitro studies show that the interferon-inducible transmembrane (IFITM) protein family members potently restrict the replication of multiple pathogenic viruses1, 2, 3, 4, 5, 6, 7. Both the magnitude and breadth of the IFITM proteins’ in vitro effects suggest that they are critical for intrinsic resistance to such viruses, including influenza viruses. Using a knockout mouse model8, we now test this hypothesis directly and find that IFITM3 is essential for defending the host against influenza A virus in vivo. Mice lacking Ifitm3 display fulminant viral pneumonia when challenged with a normally low-pathogenicity influenza virus, mirroring the destruction inflicted by the highly pathogenic 1918 ‘Spanish’ influenza9, 10. Similar increased viral replication is seen in vitro, with protection rescued by the re-introduction of Ifitm3. To test the role of IFITM3 in human influenza virus infection, we assessed the IFITM3 alleles of individuals hospitalized with seasonal or pandemic influenza H1N1/09 viruses. We find that a statistically significant number of hospitalized subjects show enrichment for a minor IFITM3 allele (SNP rs12252-C) that alters a splice acceptor site, and functional assays show the minor CC genotype IFITM3 has reduced influenza virus restriction in vitro. Together these data reveal that the action of a single intrinsic immune effector, IFITM3, profoundly alters the course of influenza virus infection in mouse and human

A survey of people with foot problems related to rheumatoid arthritis and their educational needs

Background Up to 50% of people with rheumatoid arthritis (RA) have foot symptoms at diagnosis, hence early foot health intervention is recommended and this should include patient education. This study identifies, for the first time, the foot health education (FHE) needs of people with RA. Methods An online survey of people with RA (n = 543) captured quantitative data in relation to the aims, methods of delivery, content, timing and accessibility of FHE. Results The majority concurred about the aims of FHE. Verbal delivery and websites were the most common methods. Written and verbal FHE were perceived to be the most effective methods. The point of diagnosis was the preferred time to receive it. Lack of access to FHE included minimal focus on foot health during consultations by both health practitioners and patients with RA. Participant gender, age, disease duration and living situation had a statistically significant influence on the results. Conclusion Foot health education is rarely considered within the medical consultation. There is a lack of patient and/or health professional awareness of this need with a detrimental impact on foot health. Patients require health professionals to identify their foot education health needs. Tailored foot health education should begin at initial diagnosis

Life after Regions? The Evolution of City-regionalism in England

This item was accepted for publication in the journal, Regional Studies [© Regional Studies Association]. The definitive version is available at http://dx.doi.org/10.1080/00343404.2010.521148].This paper examines the evolving pattern of city-regional governance in England. Following the demise of English regional policy in 2004, city-regions have come to represent the in vogue spatial scale amongst policy elites. The result has been a proliferation of actual and proposed policies and institutions designed to operate at a, variously defined, city-regional scale in England. Nevertheless, attempts to build a city-regional tier of governance have been tentative and lacking coherence. Alongside this city-regions are to be found emerging alongside existing tiers of economic governance and spatial planning. Arguing that what we are witnessing is not ‘life after regions’ but life with (or alongside) regions, the analysis presented argues that to understand why contemporary state reorganisation results in a multiplication of the scales economic governance and spatial planning we must recognise how the state shapes policies in such a way as to protect its legitimacy for maintain regulatory control and management of the economy. The final section relates these findings to wider debates on state rescaling and speculates on the future role of transition models in sociospatial theory

Public awareness of the link between alcohol and cancer in England in 2015: A population-based survey

Background: Public knowledge of the association between alcohol and cancer is reported to be low. We aimed to provide up-to-date evidence for England regarding awareness of the link between alcohol and different cancers and to determine whether awareness differs by demographic characteristics, alcohol use, and geographic region. Methods: A representative sample of 2100 adults completed an online survey in July 2015. Respondents were asked to identify which health outcomes, including specific cancers, may be caused by alcohol consumption. Logistic regressions explored whether demographic, alcohol use, and geographic characteristics predicted correctly identifying alcohol-related cancer risk. Results: Unprompted, 12.9% of respondents identified cancer as a potential health outcome of alcohol consumption. This rose to 47% when prompted (compared to 95% for liver disease and 73% for heart disease). Knowledge of the link between alcohol and specific cancers varied between 18% (breast) and 80% (liver). Respondents identified the following cancers as alcohol-related where no such evidence exists: bladder (54%), brain (32%), ovarian (17%). Significant predictors of awareness of the link between alcohol and cancer were being female, more highly educated, and living in North-East England. Conclusion: There is generally low awareness of the relationship between alcohol consumption and cancer, particularly breast cancer. Greater awareness of the relationship between alcohol and breast cancer in NorthEast England, where a mass media campaign highlighted this relationship, suggests that population awareness can be influenced by social marketing

Understanding changing housing aspirations: A review of the evidence

This article reviews the literature on changing housing aspirations and expectations in contemporary housing systems. It argues that there is a conceptual and definitional gap in relation to the term ‘housing aspirations’, as distinct from expectations, preferences, choices and needs. The article sets out working definitions of these terms, before discussing the evidence on changing housing (and related) systems. Emerging research has begun to consider whether trends such as declining homeownership, affordability concerns and precarious labour systems across a range of countries are fundamentally changing individuals’ aspirations for the forms of housing they aim to access at different stages of their lives. Whilst much of the research into housing aspirations has been considered in terms of tenure, and homeownership in particular, this article suggests that research needs to move beyond tenure and choice frameworks, to consider the range of dimensions that shape aspirations, from the political economy and the State to socialization and individuals’ dispositions for housing

Primary health care delivery models in rural and remote Australia – a systematic review

© 2008 Wakerman et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background One third of all Australians live outside of its major cities. Access to health services and health outcomes are generally poorer in rural and remote areas relative to metropolitan areas. In order to improve access to services, many new programs and models of service delivery have been trialled since the first National Rural Health Strategy in 1994. Inadequate evaluation of these initiatives has resulted in failure to garner knowledge, which would facilitate the establishment of evidence-based service models, sustain and systematise them over time and facilitate transfer of successful programs. This is the first study to systematically review the available published literature describing innovative models of comprehensive primary health care (PHC) in rural and remote Australia since the development of the first National Rural Health Strategy (1993–2006). The study aimed to describe what health service models were reported to work, where they worked and why. Methods A reference group of experts in rural health assisted in the development and implementation of the study. Peer-reviewed publications were identified from the relevant electronic databases. 'Grey' literature was identified pragmatically from works known to the researchers, reference lists and from relevant websites. Data were extracted and synthesised from papers meeting inclusion criteria. Results A total of 5391 abstracts were reviewed. Data were extracted finally from 76 'rural' and 17 'remote' papers. Synthesis of extracted data resulted in a typology of models with five broad groupings: discrete services, integrated services, comprehensive PHC, outreach models and virtual outreach models. Different model types assume prominence with increasing remoteness and decreasing population density. Whilst different models suit different locations, a number of 'environmental enablers' and 'essential service requirements' are common across all model types. Conclusion Synthesised data suggest that, moving away from Australian coastal population centres, sustainable models are able to address diseconomies of scale which result from large distances and small dispersed populations. Based on the service requirements and enablers derived from analysis of reported successful PHC service models, we have developed a conceptual framework that is particularly useful in underpinning the development of sustainable PHC models in rural and remote communities

Collaborative Depression Trial (CADET): multi-centre randomised controlled trial of collaborative care for depression - study protocol

<p>Abstract</p> <p>Background</p> <p>Comprising of both organisational and patient level components, collaborative care is a potentially powerful intervention for improving depression treatment in UK primary Care. However, as previous models have been developed and evaluated in the United States, it is necessary to establish the effect of collaborative care in the UK in order to determine whether this innovative treatment model can replicate benefits for patients outside the US. This Phase III trial was preceded by a Phase II patient level RCT, following the MRC Complex Intervention Framework.</p> <p>Methods/Design</p> <p>A multi-centre controlled trial with cluster-randomised allocation of GP practices. GP practices will be randomised to usual care control or to "collaborative care" - a combination of case manager coordinated support and brief psychological treatment, enhanced specialist and GP communication. The primary outcome will be symptoms of depression as assessed by the PHQ-9.</p> <p>Discussion</p> <p>If collaborative care is demonstrated to be effective we will have evidence to enable the NHS to substantially improve the organisation of depressed patients in primary care, and to assist primary care providers to deliver a model of enhanced depression care which is both effective and acceptable to patients.</p> <p>Trial Registration Number</p> <p>ISRCTN32829227</p

Evaluating the quality of social work supervision in UK children's services: comparing self-report and independent observations

Understanding how different forms of supervision support good social work practice and improve outcomes for people who use services is nearly impossible without reliable and valid evaluative measures. Yet the question of how best to evaluate the quality of supervision in different contexts is a complicated and as-yet-unsolved challenge. In this study, we observed 12 social work supervisors in a simulated supervision session offering support and guidance to an actor playing the part of an inexperienced social worker facing a casework-related crisis. A team of researchers analyzed these sessions using a customized skills-based coding framework. In addition, 19 social workers completed a questionnaire about their supervision experiences as provided by the same 12 supervisors. According to the coding framework, the supervisors demonstrated relatively modest skill levels, and we found low correlations among different skills. In contrast, according to the questionnaire data, supervisors had relatively high skill levels, and we found high correlations among different skills. The findings imply that although self-report remains the simplest way to evaluate supervision quality, other approaches are possible and may provide a different perspective. However, developing a reliable independent measure of supervision quality remains a noteworthy challenge

Configuring the New ‘Regional World’: On being Caught between Territory and Networks

This article was accepted for publication in the journal, Regional Studies [© Taylor & Francis].Recent years have witnessed a tremendous appeal in debating the relative decline in ‘territorially embedded’ conceptions of regions vis-à-vis the privileging of ‘relational and unbounded’ conceptions. Nevertheless, the most recent skirmishes see some scholars emphasise how it is not the privileging of one or other that is important, but recognising how it is increasingly different combinations of these elements that seem to be emerging in today’s new ‘regional world’. Here emphasis is being placed on a need to analyse how the different dimensions of socio-spatial relations (e.g. territory, place, network, scale) come together in different ways, at different times, and in different contexts to secure the overall coherence of capitalist, and other, social formations. The purpose of this paper is to make visible the politics of transformation in North West England, uncovering the role and strategies of individual and collective agents, organisations and institutions in orchestrating and steering regional economic development. For it is argued the unanswered question is not which sociospatial relations are dominant, emerging, or residual in any given space-time but understanding how and why they are dominant, emerging, or residual. The paper suggests the answer to this and other questions is to be found at the interface between emergent spatial strategies and inherited sociospatial configurations