Preventing child pedestrian injuries and deaths arising from vehicle-child accidents in domestic driveways: An action research project

This research was a three-fold investigation into the viability of previous recommendations for vehicle-related child driveway accident safety . Firstly, the groups most at risk of these types of accidents were determined in order that they could be specifically considered when reviewing the practicalities of previous recommendations . Secondly, the feasibility of previous recommendations was systematically examined through both an extensive literature review and key and expert informant interviews . Based on these, the likelihood of implementation of previous safety recommendations for the identified high risk groups was ascertained, providing a basis on which to abandon some previous recommendations, remove obstacles to others which would enhance practicability and generate further recommendations that would be tenable for the at-risk groups in particular. The key findings of this research were, foremost, that there is a noticeable lack of specific reference to vehicle-related child driveway accidents in any legislation or safety guidelines, as well as a shortage of official data that deal expressly with this type of accident. Further, it was found that the major obstacles to the implementation of previous recommendations - particularly the environmental ones - were cost, autonomy, and spatial constraints. While several recommendations were abandoned due to factors such as unproven or dubious effectiveness and/or prohibitive cost, it was found that the most viable recommendations were characterised by their relatively low cost for the families involved. These recommendations were typically environmental or educational in nature. Thus, the recommendations in this report include some moderate regulatory changes to facilitate greater uptake of environmental and behaviour-modifying recommendations as well as practical ideas that all need to be part of a cohesive campaign to address the issue of vehicle-related child driveway accidents in New Zealand

How Do Companies Act? Annual reports, Strategic reports, Director's reports and Sustainability reports

Existing legislation on inclusion of information on social and environmental issues in Company reporting does notprovide an adequate guarantee that the information reported is material or complete. This legislation is presentin the Companies Act 2006, and was recently updated in the Companies Act (Strategic Report and Directors ReportRegulations) 2013.This means that investors will find it difficult to use existing data to inform decisions, even as the demand for this typeof information is increasing. The solution is to amend the Companies Act to incorporate a necessary requirement forassurance of non financial impact information. Directors are currently required to provide a statement asserting that shareholders have the information necessary to assess company performance, business and strategy. The scope of the financial audit is to report on whether these statements are inconsistent with the information that theauditors have acquired in the course of performing the audit. This scope should be extended to requiring assuranceon the materiality and completeness of the information regarding the wider impact of the company's operations.Shareholders and other stakeholders would then be able to use this information in their investment decisions. In themeantime, examples of discrepancies in Company reporting can be raised with the Financial Reporting Council (FRC).The first section explores issues arising from current approaches to reporting on social and environmentalissues. The second focuses on related current legislation in the Companies Act and how limitations create challengesfor reporting useful information. The third section sets out the increasing demand for information on social andenvironmental issues as evidence of how important this social and environmental information really is. The fourthsection highlights the importance of audit in standardising information and ensuring it is useful, and examines thecurrent provision for auditing the social and environmental information. It concludes that there is a critical gap incurrent legislation which will restrict the use of information despite its growing importance. The options for addressing this gap are limited but we believe that the statutory audit requirements should be extended to cover materiality decisions relating to social and environmental information

Self-management of musculoskeletal hand pain and hand problems in community-dwelling adults aged 50 years and older: results from a cross-sectional study in a UK population

BACKGROUND: Musculoskeletal pain is common in adults, with the hand being frequently affected. Healthcare services have the potential to be of benefit to adults with hand pain and problems, through promotion and facilitation of self-management. METHODS: This paper explores existing self-management in a UK population of community-dwelling adults aged 50 years and over using data from surveys and a nested clinical cohort study. Self-management of hand problems was considered in three ways: self-directed treatment approaches used, adaptation behaviours adopted and choice to consult with a healthcare professional. RESULTS: The treatment approaches most commonly used were 'exercise/movement' (n = 151, 69 %) and 'resting' the hands (n = 139, 69 %). The use of adaptation behaviour was widespread: 217 (99 %) people reported using one or more adaptation behaviours. Under half of survey respondents who reported hand pain (n = 783, 43 %) had consulted a healthcare professional about their problem during the last year: the lowest rate of consultation was for occupational therapy (n = 60, 3 %). CONCLUSIONS: Self-directed treatment and adaptation behaviours were widespread in adults aged 50 years and over with hand problems, but consultation with a healthcare professional was low

Expert international trauma clinicians’ views on the definition, composition and delivery of reintegration interventions for complex PTSD

Background: Research has previously distinguished between complex post-traumatic stress disorder (CPTSD) and PTSD, with the former including a range of disturbances in self-regulatory capacities in addition to difficulties associated with PTSD. Clinical guidelines have previously recommended a phase-based approach for the treatment of CPTSD, yet the final ‘reintegration’ phase of treatment has been overlooked in research, with limited evidence into its value and effectiveness, and inconsistencies in its definitions and understanding. Objective: We set out to define and determine the key principles of ‘reintegration’ and to specify the components and method of delivery of treatment. Method: Leading national and international clinical and academic experts in CPTSD were interviewed and asked about their views of how ‘reintegration’ should be defined, its role in the treatment of CPTSD, what it should be composed of, the key principles of its delivery, and how it should be evaluated. We analysed transcripts of the interviews following the principles of Codebook Thematic Analysis. Results: We conducted 16 interviews with leading national and international experts with at least 10 years’ experience of treating people with CPTSD. Themes derived from our analysis demonstrated that while the definition and composition of reintegration varied greatly between experts, the key principles in its delivery were consistent across all experts. Conclusions: The results of this study lay the foundation for a framework of what reintegration is and how it can be used in, but also highlight the need for more research to be conducted on the role of reintegration in the treatment of CPTSD. Consensus for the definition and composition of reintegration is still yet to be reached. Possible measures for evaluating reintegration should also be explored in the future

Book reviews

Teaching/Communication/Extension/Profession,

The Ursinus Weekly, March 7, 1949

Bruins place second in mat tourney • Cheating committee sets up new rules to stop offenders • Bullets take first; Helfferich and Cox gain Ursinus wins • Lantern lists Howard S. Lee for program of varied ballads • Hallelujah!!! Gaff gets highest rating in poll of readers • Arnold D. Graeffe to address forum audience on Thursday • Business group nears disaster; meeting called • Juniors to pick Ruby officers on Wednesday • Sophs planning week-end with hop as feature event • Sororities extending bids as week of rushing begins • Should Ursinus subsidize its athletes? • Hardworking publicity staff keeps Ursinus in limelight • Doggie roast, talk on China highlight week\u27s Y activities • Benefactors donate volumes and money to growing library • Ursinus grapplers pin PMC opponents to loss sheet 35-3 • Matmen, hoopsters force intramurals to sidelines • Cindermen to face \u27Fords on April 23 in season\u27s opener • Drexel swamps local mermaids, 42-15; Jay Vee team matches opponents, 27-27 • Bearettes nose out Garnet team 36-33, trim Beaver 26-20 • Court season closes with pair of defeats • Cox, Helfferich outstanding in MA tourney • Garnet, PMC to vie for league honors in Friday play-off • Powell, Pleet, Peterson receive honors on \u2748 MA soccer team • MSGA topics cover cheating, placement at Tuesday session • Orchestra and television highlight junior class affair • Curtain Club selects spring playhttps://digitalcommons.ursinus.edu/weekly/1610/thumbnail.jp

High basal melting forming a channel at the grounding line of Ross Ice Shelf, Antarctica

Antarctica's ice shelves are thinning at an increasing rate, affecting their buttressing ability. Channels in the ice shelf base unevenly distribute melting, and their evolution provides insight into changing subglacial and oceanic conditions. Here we used phase-sensitive radar measurements to estimate basal melt rates in a channel beneath the currently stable Ross Ice Shelf. Melt rates of 22.2 ± 0.2 m a−1 (>2500% the overall background rate) were observed 1.7 km seaward of Mercer/Whillans Ice Stream grounding line, close to where subglacial water discharge is expected. Laser altimetry shows a corresponding, steadily deepening surface channel. Two relict channels to the north suggest recent subglacial drainage reorganization beneath Whillans Ice Stream approximately coincident with the shutdown of Kamb Ice Stream. This rapid channel formation implies that shifts in subglacial hydrology may impact ice shelf stability

Cost-effectiveness of specialist eating disorders services for children and adolescents with anorexia nervosa: a national surveillance study.

BACKGROUND: Evidence suggests specialist eating disorders services for children and adolescents with anorexia nervosa have the potential to improve outcomes and reduce costs through reduced hospital admissions. This study aimed to evaluate the cost-effectiveness of assessment and diagnosis in community-based specialist child and adolescent mental health services (CAMHS) compared to generic CAMHS for children and adolescents with anorexia nervosa. METHOD: Observational, surveillance study of children and adolescents aged 8 to 17, in contact with community-based CAMHS in the UK or Republic of Ireland for a first episode of anorexia nervosa. Data were reported by clinicians at baseline, 6 and 12-months follow-up. Outcomes included the Children's Global Assessment Scale (CGAS) and percentage of median expected body mass for age and sex (%mBMI). Service use data included paediatric and psychiatric inpatient admissions, outpatient and day-patient attendances. A joint distribution of incremental mean costs and effects for each group was generated using bootstrapping to explore the probability that each service is the optimal choice, subject to a range of values a decision-maker might be willing to pay for outcome improvements. Uncertainty was explored using cost-effectiveness acceptability curves. RESULTS: Two hundred ninety-eight children and adolescents met inclusion criteria. At 12-month follow-up, there were no significant differences in total costs or outcomes between specialist eating disorders services and generic CAMHS. However, adjustment for pre-specified baseline covariates resulted in observed differences favouring specialist services, due to significantly poorer clinical status of the specialist group at baseline. Cost-effectiveness analysis using CGAS suggests that the probability of assessment in a specialist service being cost-effective compared to generic CAMHS ranges from 90 to 50%, dependent on willingness to pay for improvements in outcome. CONCLUSIONS: Assessment in a specialist eating disorders service for children and adolescents with anorexia nervosa may have a higher probability of being cost-effective than assessment in generic CAMHS. TRIAL REGISTRATION: ISRCTN12676087 . Date of registration 07/01/2014

Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for healthcare professionals

Background: Antibiotic overuse has contributed to antimicrobial resistance, which is a global public health problem. In the UK, despite the fall in rates of antibiotic prescription since 2013, prescribing levels remain high in comparison with other European countries. Prescribing in out-of-hours (OOH) care provides unique challenges for prudent prescribing, for which professionals may not be prepared. Aim: To explore the guidance available to professionals on prescribing antibiotics for common infections in OOH primary care within the UK, with a focus on training resources, guidelines, and clinical recommendations. Design & setting: A realist-informed scoping review of peer-reviewed articles and grey literature. Method: The review focused on antibiotic prescribing OOH (for example, clinical guidelines and training videos). General prescribing guidance was searched whenever OOH-focused resources were unavailable. Electronic databases and websites of national agencies and professional societies were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Findings were organised according to realist review components, that is, mechanisms, contexts, and outcomes. Results: In total, 46 clinical guidelines and eight training resources were identified. Clinical guidelines targeted adults and children, and included recommendations on prescription strategy, spectrum of the antibiotic prescribed, communication with patients, treatment duration, and decision-making processes. No clinical guidelines or training resources focusing specifically on OOH were found. Conclusion: The results highlight a lack of knowledge about whether existing resources address the challenges faced by OOH antibiotic prescribers. Further research is needed to explore the training needs of OOH health professionals, and whether further OOH-focused resources need to be developed given the rates of antibiotic prescribing in this setting