The Iwakura Mission in Britain, 1872

In London, at the Suntory and Toyota International Centres for Economics and Related Disciplines (LSE), a symposium was held on 6 December 1997 - the anniversary of the day when the members of Iwakura's delegation were received by Queen Victoria. Comprising four lectures the symposium was attended by a packed audience of some 75 people including the Joint Chairman and many members of the Japan Society, several senior representatives of the Japanese Embassy, as well as staff and students. Each lecturer focused sharply on a particular aspect of the Mission's work in Britain that fell within his or her special field and each prompted numerous questions and much discussion. It is some measure of the great range of subjects that the Mission was attempting to cover that there was no real overlap between any of the four papers. They are now included in their entirety in this volume.Iwakura misson, Victorian London, Kume Kunitake, Iwakura Tomomi, Ito Hirobumi, education, industry, exports, religion, Kairan Jikki chronicle, Meiji government, unequal treaties, embassy, 1872, Britain, Japan, America.

Oralism: a sign of the times? The contest for deaf communication in education provision in late nineteenth-century Scotland

Disability history is a diverse field. In focussing upon children within deaf education in late nineteenth-century Scotland, this essay reflects some of that diversity. In 1880, the International Congress on the Education of the Deaf in Milan stipulated that speech should have ‘preference’ over signs in the education of deaf children. The mode of achieving this, however, effectively banned sign language. Endeavours to teach deaf children to articulate were not new, but this decision placed pressures on deaf institutions to favour the oral system of deaf communication over other methods. In Scotland efforts were made to adopt oralism, and yet educators were faced with the reality that this was not good educational practice for most pupils. This article will consider responses of Scottish educators of deaf children from the 1870s until the beginning of the twentieth century

High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement.

BACKGROUND: High performing hospitals attain excellence across multiple measures of performance and multiple departments. Studying high performing hospitals can be valuable if factors associated with high performance can be identified and applied. Factors leading to high performance are complex and an exclusive quantitative approach may fail to identify richly descriptive or relevant contextual factors. The objective of this study was to undertake a systematic review of qualitative literature to identify methods used to identify high performing hospitals, the factors associated with high performers, and practical strategies for improvement. METHODS: Methods used to collect and summarise the evidence contributing to this review followed the 'enhancing transparency in reporting the synthesis of qualitative research' protocol. Peer reviewed studies were identified through Medline, Embase and Cinahl (Jan 2000-Feb 2014) using specified key words, subject terms, and medical subject headings. Eligible studies required the use of a quantitative method to identify high performing hospitals, and qualitative methods or tools to identify factors associated with high performing hospitals or hospital departments. Title, abstract, and full text screening was undertaken by four reviewers, and inter-rater reliability statistics were calculated for each review phase. Risk of bias was assessed. Following data extraction, thematic syntheses identified contextual factors important for explaining success. Practical strategies for achieving high performance were then mapped against the identified themes. RESULTS: A total of 19 studies from a possible 11,428 were included in the review. A range of process, output, outcome and other indicators were used to identify high performing hospitals. Seven themes representing factors associated with high performance (and 25 sub-themes) emerged from the thematic syntheses: positive organisational culture, senior management support, effective performance monitoring, building and maintaining a proficient workforce, effective leaders across the organisation, expertise-driven practice, and interdisciplinary teamwork. Fifty six practical strategies for achieving high performance were catalogued. CONCLUSIONS: This review provides insights into methods used to identify high performing hospitals, and yields ideas about the factors important for success. It highlights the need to advance approaches for understanding what constitutes high performance and how to harness factors associated with high performance

The facilitators and barriers to implementing patient reported outcome measures in organisations delivering health related services: a systematic review of reviews

Background There is increasing interest in using Patient Reported Outcome Measures (PROMs) within organisations delivering health related services. However, organisations have had mixed success in implementing PROMs and there is little understanding about why this may be. Thus, the purpose of this study was to identify the facilitators and barriers to implementing PROMs in organisations. Method A systematic review of reviews was undertaken. Searches were conducted of five electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO and the Cochrane Database of Systematic Reviews, during the week of the 20th February 2017. Additional search methods included website searching and reference checking. To be included, a publication had to be a review of the literature, describe its methods and include information related to implementing PROMs. The reviews were extracted using a standardised form and assessed for their risk of bias using the Risk of Bias in Systematic Reviews tool. The findings were synthesised using the Consolidated Framework for Implementation Research. The protocol was registered on the International Prospective Register of Systematic Reviews database (PROSPERO) (CRD42017057491). Results Initially 2047 records were identified. After assessing eligibility, six reviews were included. These reviews varied in their review type and focus. Different issues arose at distinct stages of the implementation process. Organisations needed to invest time and resources in two key stages early in the implementation process: ‘designing’ the processes for using PROMs within an organisation; and ‘preparing’ an organisation and its staff. The ‘designing’ stage involved organisations planning not just which PROMs to use and how to administer them, but also how the data would be used for clinical purposes. The ‘preparing’ stage involved getting an organisation and its staff ready to use PROMs, particularly persuading clinicians of the validity and value of PROMs, delivering training, and developing electronic systems. Having an implementation lead overseeing the process and developing the process based on feedback were also identified as facilitating implementation. Conclusion Organisations implementing PROMs need to invest time and resources in ‘designing’ the PROMs strategy and ‘preparing’ the organisation to use PROMs. Focusing on these earlier stages may prevent problems arising when PROMs are used in practice