Self Management and Telehealth: Lessons Learnt from the Evaluation of a Dorset Telehealth Program

Dorset Clinical Commissioning Group

Exploring the use of strategic frameworks in dental practice

This paper explores the use of strategic frameworks in NHS and private dental practice. It reviews the policy context of dentistry and suggests the challenges in this context will require dental practices to prioritise understanding and engagement with a strategic approach. A strategic approach will be required in order to enhance and improve performance. Two specific strategic frameworks will be explored in terms of their relevance to NHS and private dental practic

Place matters: but does local leadership?

The arrival of New Labour into Government witnessed the prominent re-emergence of place onto the policy agenda. This heralded a range of area-based-initiatives designed to both tackle neighbourhood forms of deprivation and to re-establish a sense of identity and connection between individuals and their local community. In terms of place-making, effective and inclusive participation, representation and leadership were all identified as prerequisites for the creation of sustainable communities . But how important is local leadership and strategic vision within local public service organisations in achieving the desired place-making outcomes? This paper examines the extent to which local leadership and strategic vision represents a significant factor in promoting higher levels of satisfaction, belonging, cohesion and participation across single tier councils in England. The ensuing empirical evidence raises significant questions not only about the importance of local leadership in place-making, but also the environmental and organizational factors that shape local places

New development: strategic user orientation in public services delivery—the missing link in the strategic trinity?

This paper explores the application of strategic planning and management to Public Service Organisations (PSOs). It argues that the impact of these approaches has been limited by the absence of an underlying strategic orientation that would provide a value-base upon which to embed these approaches within PSOs. It argues further for such an orientation to privelege the need for public services to add value to the lives of citizens and service users and not to focus solely upon internal measures of efficiency and performance

Re-imagining the Borders of US Security after 9/11: Securitisation, Risk, and the Creation of the Department of Homeland Security

The articulation of international and transnational terrorism as a key issue in US security policy, as a result of the 9/11 attacks, has not only led to a policy rethink, it has also included a bureaucratic shift within the US, showing a re-thinking of the role of borders within US security policy. Drawing substantively on the 'securitisation' approach to security studies, the article analyses the discourse of US security in order to examine the founding of the Department of Homeland Security, noting that its mission provides a new way of conceptualising 'borders' for US national security. The securitisation of terrorism is, therefore, not only represented by marking terrorism as a security issue, it is also solidified in the organisation of security policy-making within the US state. As such, the impact of a 'war on terror' provides an important moment for analysing the re-articulation of what security is in the US, and, in theoretical terms, for reaffirming the importance of a relationship between the production of threat and the institutionalisation of threat response. © 2007 Taylor & Francis

Microscope and microâ camera assessment of Schneiderian membrane perforation via transcrestal sinus floor elevation: A randomized ex vivo study

ObjectiveWe sought to assess the effectiveness of using a microscope and nonâ invasive camera for assessing sinus membrane perforations during transcrestal sinus floor elevation (TSFE).Materials and methodsFive fresh human cadaver heads corresponding to eight maxillary sinuses (six bilateral and two unilateral) underwent 4 TSFEs per sinus (a total of 32 single site elevations). Each elevation was randomly assigned to receive a three or six mm membrane elevation height (MEH). A microscope and microâ camera were used to assess the sinus membrane perforation. Afterwards, radiological and clinical membrane perforation assessments were performed. The statistical analysis results are expressed using the means, standard deviations, range values of the residual ridge height (RRH), residual ridge width (RRW), sinus membrane thickness (SMT) and incidence of perforation (IoP). Generalized linear methods were used to test for the correlation of RRH and MEH to the microscope and microâ camera perforation assessments and the correlation of microscope and microâ camera assessments with the postâ operative CBCT and crestal liquid evaluation.ResultsThe cumulative percentage of IoP was 40.62%, (23.07% with 3 mm MEH, and 76.92% with 6 mm MEH, p < 0.05). The perforation assessed using either the microscope or microâ camera coincided with the postâ operative CBCT and crestal liquid assessment in 87.55% sites. No significant correlation was found between the microscope or microâ camera assessments with RRH or MEH.ConclusionApplication of a microscope and microâ camera during transcrestal sinus floor elevation may allow the detection of the integrity of the Schneiderian membrane with greater than 85% accuracy in this ex vivo model.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149727/1/clr13453.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149727/2/clr13453_am.pd

Developmental contributions to macronutrient selection: A randomized controlled trial in adult survivors of malnutrition

Background and objectives: Birthweight differences between kwashiorkor and marasmus suggest that intrauterine factors influence the development of these syndromes of malnutrition and may modulate risk of obesity through dietary intake. We tested the hypotheses that the target protein intake in adulthood is associated with birthweight, and that protein leveraging to maintain this target protein intake would influence energy intake (EI) and body weight in adult survivors of malnutrition.Methodology: Sixty-three adult survivors of marasmus and kwashiorkor could freely compose a diet from foods containing 10, 15 and 25 percentage energy from protein (percentage of energy derived from protein (PEP); Phase 1) for 3 days. Participants were then randomized in Phase 2 (5 days) to diets with PEP fixed at 10%, 15% or 25%.Results: Self-selected PEP was similar in both groups. In the groups combined, selected PEP was 14.7, which differed significantly (P &lt; 0.0001) from the null expectation (16.7%) of no selection. Self-selected PEP was inversely related to birthweight, the effect disappearing after adjusting for sex and current body weight. In Phase 2, PEP correlated inversely with EI (P = 0.002) and weight change from Phase 1 to 2 (P = 0.002). Protein intake increased with increasing PEP, but to a lesser extent than energy increased with decreasing PEP.Conclusions and implications: Macronutrient intakes were not independently related to birthweight or diagnosis. In a free-choice situation (Phase 1), subjects selected a dietary PEP significantly lower than random. Lower PEP diets induce increased energy and decreased protein intake, and are associated with weight gain

Leadership and decision-making practices in public versus private universities in Pakistan

The goal of this study is to examine differences in leadership and decision-making practices in public and private universities in Pakistan, with a focus on transformational leadership (TL) and participative decision-making (PDM). We conducted semi-structured interviews with 46 deans and heads of department from two public and two private universities in Pakistan. Our findings indicate that leadership and decision-making practices are different in public and private universities. While differences were observed in all six types of TL-behaviour, the following three approaches emerged to be crucial in both public and private universities: (1) articulating a vision, (2) fostering the acceptance of group goals, and (3) high-performance expectations. In terms of PDM, deans and heads of department in public and private universities adopt a collaborative approach. However, on a practical level this approach is limited to teacher- and student-related matters. Overall, our findings suggest that the leadership and decision-making practices in Pakistani public and private universities are transformational and participative in nature