Evaluation of the effectiveness of the new local safeguarding children boards (LSCBS)

Introduction Local Safeguarding Children Boards (LSCBs) were implemented in April 2006 to replace Area Child Protection Committees (ACPCs). The Boards have a statutory responsibility to co-ordinate and ensure the effectiveness of the work of partner bodies to safeguard and promote the welfare of children. LSCB functions include: the development of policies and procedures for safeguarding and promoting the welfare of children; communicating and raising awareness; participating in planning and commissioning children’s services; collecting and analysing information about child deaths; undertaking serious case reviews and monitoring and evaluating the effectiveness of what is done. The Centre for Research in Social Policy (CRSP), in partnership with the Centre for Children and Family Research (CCFR) (both based at Loughborough University) are undertaking an evaluation to explore the structures and processes adopted by LSCBs to fulfil their core functions. The study will also examine whether these new structures and processes have overcome identified weaknesses of Area Child Protection Committees (ACPCs) and promoted co-operation between services responsible for safeguarding and promoting the welfare of children

Effects of self-monitoring of heart rate and additional sprint running on exercise intensity and technical performance during small-sided games in soccer.

The purpose of this study was to assess whether relatively simple interventions including self monitoring of heart rate and the use of targeted sprints for those with the lowest relative HR values (%HRmax) could be used to increase exercise intensity during small sided games (SSGs) in soccer. A secondary aim of the study was to assess the effect of these interventions on overall gameplay. Fourteen male semi-professional players performed SSGs (6 vs. 6) under four conditions including a control, a self-monitoring approach where players monitored their own HR via a wristwatch, and two sprint conditions where players with HR values below 90%HRmax performed sprints either during the game or during the recovery period between games. A linear mixed effects model was used to test for main effects whilst accounting for covariances between observations made on the same player. The results identified relatively small but significant differences in average %HRmax (p<0.001) and RPE values (p<0.001) between the three modified conditions and the control. No significant differences were found between any of the modified conditions for measures of exercise intensity. On average, the modified conditions resulted in a 3.7% increase in %HRmax values and a 9.3% increase in RPE. The results from this study demonstrate that exercise intensity of SSGs in soccer can be increased by relatively simple and practical manipulations, the most basic of which requires only the use of inexpensive HR monitors

The impact of co-located NHS walk-in centres on emergency departments

Objectives: To determine the impact of establishing walk-in centres alongside emergency departments on attendance rates, visit duration, process, costs and outcome of care. Methods: Eight hospitals with co-located emergency departments and walk-in centres were compared with eight matched emergency departments without walk-in centres. Site visits were conducted. Routine data about attendance numbers and use of resources were analysed. A random sample of records of patients attending before and after walk-in centres opened were also assessed. Patients who had not been admitted to hospital were sent a postal questionnaire. Results: In most sites, the walk-in centres did not have a distinct identity and there were few differences in the way services were provided compared with control sites. Overall, there was no evidence of an increase in attendance at sites with walk-in centres, but considerable variability across sites. The proportion of patients managed within the four-hour NHS target improved at sites both with and without walk-in centres. There was no evidence of any difference in re-consultation rates, costs of care or patient outcomes at sites with or without walk-in centres. Conclusions: Most hospitals in this study implemented the walk-in centre concept to a very limited extent. Consequently there was no evidence of any impact on attendance rates, process, costs or outcome of care

The evaluation of arrangements for effective operation of the new Local Safeguarding Children Boards in England - Brief

Introduction and Background: Both the statutory inquiry into the tragic death of Victoria Climbié (2003) and the first joint Chief Inspectors’ Report on Safeguarding (Chief Inspector of Social Services et al., 2002) emphasise the importance of effective joint working between agencies and professionals to safeguard children from harm and to promote their welfare. Subsequent policy developments, underpinned by the Children Act 2004, are intended to ensure an integrated approach to service provision and that children achieve their potential in terms of being healthy, staying safe, enjoying and achieving, making a positive contribution and achieving economic well-being (HM Government, 2004). Working Together to Safeguard Children (HM Government, 2006: p.10) identifies one of the most important developments in this context as the establishment of Local Safeguarding Children Boards (LSCBs). The Boards put former Area Child Protection Committees (ACPCs) on a statutory footing. Research had found that ACPCs’ lack of statutory power had limited their effectiveness (Chief Inspector of Social Services et al., 2002). A series of other weaknesses were also identified including: variations in levels of representation and membership, structure and practice, poor leadership and insufficient resources (Chief Inspector of Social Services et al., 2002; Horwath and Glennie, 1999; Narducci, 2003; Ward et al., 2004)

Comparing care at walk-in centres and at accident and emergency departments: an exploration of patient choice, preference and satisfaction

Objectives: To explore the impact of establishing walk-in centres alongside emergency departments on patient choice, preference and satisfaction. Methods: A controlled, mixed-method study comparing eight emergency departments with co-located walk-in centres with the same number of ‘traditional’ emergency departments. This paper focuses on the results of a cross-sectional questionnaire survey of users. Results: Survey data demonstrated that patients were frequently unable to distinguish between being treated at a walk-in centre or an A&E department, and even where this was the case, opportunities to exercise choice about their preferred care provider were often limited. Few made an active choice to attend a co-located walk-in centre. Patients attending walk-in centres were just as likely to be satisfied overall with the care they received as their counterparts who were treated in the co-located A&E facility, although a small proportion of walk-in centre users did report greater satisfaction with some specific aspects of their care and consultation. Conclusions: Whilst one of the key policy goals underpinning the co-location of walk-in centres next to an A&E department was to provide patients with more options for accessing healthcare and greater choice, leading in turn to increased satisfaction, this evaluation was able to provide little evidence to support this. The high percentage of patients expressing a preference for care in an established emergency department compared to a new walk-in centre facility raises questions for future policy development. Further consideration should therefore be given to the role that A&E focused walk-in centres play in the Department of Health’s current policy agenda, as far as patient choice is concerned

Modelling extreme concentration from a source in a turbulent flow over rough wall

The concentration fluctuations in passive plumes from an elevated and a groundlevel source in a turbulent boundary layer over a rough wall were studied using large eddy simulation and wind tunnel experiment. The predictions of statistics up to second order moments were thereby validated. In addition, the trend of relative fluctuations far downstream for a ground level source was estimated using dimensional analysis. The techniques of extreme value theory were then applied to predict extreme concentrations by modelling the upper tail of the probability density function of the concentration time series by the Generalised Pareto Distribution. Data obtained from both the simulations and experiments were analysed in this manner. The predicted maximum concentration (?0) normalized by the local mean concentration (Cm) or by the local r.m.s of concentration fluctuation (crms), was extensively investigated. Values for ?0/Cm and ?0/crms as large as 50 and 20 respectively were found for the elevated source and 10 and 15 respectively for the ground-level source

Scotland Registry for Ankylosing Spondylitis (SIRAS) – Protocol

Funding SIRAS was funded by unrestricted grants from Pfizer and AbbVie. The project was reviewed by both companies, during the award process, for Scientific merit, to ensure that the design did not compromise patient safety, and to assess the global regulatory implications and any impact on regulatory strategy.Publisher PD