Crossing the Ferry / words by Bobby Newcomb

https://egrove.olemiss.edu/sharris_a/1009/thumbnail.jp

Smoking cessation and tobacco prevention in Indigenous populations

This article systematically reviews 91 smoking cessation and tobacco prevention studies tailored for Indigenous populations around the world, with a particular focus on Aboriginal and Torres Strait Islander populations in Australia. We identified several components of effective interventions, including the use of multifaceted programs that simultaneously address the behavioural, psychological and biochemical aspects of addiction, using resources culturally tailored for the needs of individual Indigenous populations. Pharmacotherapy for smoking cessation was effective when combined with culturally tailored behavioural interventions and health professional support, though it is generally underused in clinical practice. From a policy perspective, interventions of greater intensity, with more components, were more likely to be effective than those of lower intensity and shorter duration. For any new policy it is important to consider community capacity building, development of knowledge, and sustainability of the policy beyond guided implementation. Future research should address how the intervention can be supported into standard practice, policy, or translation into the front-line of clinical care. Investigations are also required to determine the efficacy of emerging therapies (such as e-cigarettes and the use of social media to tackle youth smoking), and under-researched interventions that hold promise based on non-Indigenous studies, such as the use of Champix. We conclude that more methodologically rigorous investigations are required to determine components of the less-successful interventions to aid future policy, practice and research initiatives. Evidence Base, issue 3, 201

‘Being Yourself’ in the Electronic Sweatshop: New Forms of Normative Control

This article extends research about high-commitment management practices in tightly controlled work environments typified by the call centre. One promising research avenue suggests that normative management systems in such contexts, involving ‘fun’ exercises and culture programmes, etc., are more about distracting employee attention away from other, more taxing controls. This article develops such an approach by exploring the specific nature and conditions of such distraction. An empirical study of a call centre in which employees were encouraged to ‘just be themselves’ (in relation to lifestyle differences, sexuality, diverse identities, etc.) reveals how the distractions are partly informed by the dysfunctions of existing technical, bureaucratic and conventional cultural controls, all of which homogenize workers. Furthermore, the new regime not only serves to distract employees, but proves instrumental in capturing their sociality, energy and ‘authentic’ or ‘non-work’ personalities as emotional labour. At the same time, it gives rise to some contestation and less individualistic forms of authenticity. These outcomes have wider implications for our understanding of worker autonomy in and around hybrid control systems

Communitarian perspectives on social enterprise

Concepts of social enterprise have been debated repeatedly, and continue to cause confusion. In this paper, a meta-theoretical framework is developed through discussion of individualist and communitarian philosophy. Philosophers from both traditions build social theories that emphasise either consensus (a unitarist outlook) or diversity (a pluralist outlook). The various discourses in corporate governance reflect these assumptions and create four distinct approaches that impact on the relationship between capital and labour. In rejecting the traditional discourse of private enterprise, social enterprises have adopted other approaches to tackle social exclusion, each derived from different underlying beliefs about the purpose of enterprise and the nature of governance. The theoretical framework offers a way to understand the diversity found within the sector, including the newly constituted Community Interest Company (CIC).</p

A Practical Approach to Genetic Hypokalemia

Mutations in genes encoding ion channels, transporters, exchangers, and pumps in human tissues have been increasingly reported to cause hypokalemia. Assessment of history and blood pressure as well as the K+ excretion rate and blood acid-base status can help differentiate between acquired and inherited causes of hypokalemia. Familial periodic paralysis, Andersen's syndrome, congenital chloride-losing diarrhea, and cystic fibrosis are genetic causes of hypokalemia with low urine K+ excretion. With respect to a high rate of K+ excretion associated with faster Na+ disorders (mineralocorticoid excess states), glucoricoid-remediable aldosteronism and congenital adrenal hyperplasia due to either 11β-hydroxylase and 17α-hydroxylase deficiencies in the adrenal gland, and Liddle's syndrome and apparent mineralocorticoid excess in the kidney form the genetic causes. Among slow Cl- disorders (normal blood pressure, low extracellular fluid volume), Bartter's and Gitelman's syndrome are most common with hypochloremic metabolic alkalosis. Renal tubular acidosis caused by mutations in the basolateral Na+/HCO3- cotransporter (NBC1) in the proximal tubules, apical H+-ATPase pump, and basolateral Cl-/HCO3- exchanger (anion exchanger 1, AE1) in the distal tubules and carbonic anhydroase II in both are genetic causes with hyperchloremic metabolic acidosis. Further work on genetic causes of hypokalemia will not only provide a much better understanding of the underlying mechanisms, but also set the stage for development of novel therapies in the future

Historical institutionalism and the politics of sustainable energy transitions: a research agenda

Improving the understanding of the politics of sustainable energy transitions has become a major focus for research. This paper builds on recent interest in institutionalist approaches to consider in some depth the agenda arising from a historical institutionalist perspective on such transitions. It is argued that historical institutionalism is a valuable complement to socio-technical systems approaches, offering tools for the explicit analysis of institutional dynamics that are present but implicit in the latter framework, opening up new questions and providing useful empirical material relevant for the study of the wider political contexts within which transitions are emerging. Deploying a number of core concepts including veto players, power, unintended consequences, and positive and negative feedback in a variety of ways, the paper explores research agendas in two broad areas: understanding diversity in transition outcomes in terms of the effects of different institutional arrangements, and the understanding of transitions in terms of institutional development and change. A range of issues are explored, including: the roles of electoral and political institutions, regulatory agencies, the creation of politically credible commitment to transition policies, power and incumbency, institutional systems and varieties of capitalism, sources of regime stability and instability, policy feedback effects, and types of gradual institutional change. The paper concludes with some observations on the potential and limitations of historical institutionalism, and briefly considers the question of whether there may be specific institutional configurations that would facilitate more rapid sustainable energy transitions

School autonomy and educational inclusion of children with special needs: Evidence from England

This is the final version. Available from Wiley via the DOI in this record.In the past few decades, several countries have introduced reforms aimed at increasing school autonomy. We evaluate the effect of the introduction of autonomous academies in England on the educational trajectories of children with special educational needs. This has been done using longitudinal data on all schoolchildren in state schools in England, from the National Pupil Database. The results show that the effects of school autonomy on educational inclusion are not uniform and depend on schools’ previous performance and socio‐economic composition. Schools that obtained autonomy under the control of an external sponsor (sponsored academies) were more likely to decrease the proportion of pupils with special needs and remove additional support for them. We do not observe these effects in the schools that voluntarily applied for the more autonomous status (converter academies).Economic and Social Research Counci

The experiences of student nurses on placements with practice nurses : a pilot study

To prepare the registered nurse of tomorrow in the United Kingdom (UK) to care for patients in general practice (GP)-led services, today's student nurses need to have the opportunity to experience placements with practice nurses to enable them to make positive career choices to become practice nurses in the future. The role of the practice nurse is described in the article. As a pilot project, seventeen students undertook placements with practice nurses in one of seven GP practices selected by the London GP Deanery and the university as having fulfilled the criteria to support student nurses in placements. A mentorship preparation programme was provided to prepare practice nurses for mentoring these students. An evaluation study was undertaken of this pilot project. Findings showed that students were highly positive about the experience; the majority rated this placement as being as good as or better than previous placement experiences. The evaluation also explored the impact on student learning and the value that the placement had. There was a positive impact on students' knowledge and skills in certain clinical areas especially related to health promotion. Students also indicated that they would like to have additional placements with practice nurses and would consider a career as a practice nurse in the future

Modular Approach to Therapy for Anxiety, Depression, Trauma, or Conduct Problems in outpatient child and adolescent mental health services in New Zealand: study protocol for a randomized controlled trial

Background: Mental health disorders are common and disabling for young people because of the potential to disrupt key developmental tasks. Implementation of evidence-based psychosocial therapies in New Zealand is limited, owing to the inaccessibility, length, and cost of training in these therapies. Furthermore, most therapies address one problem area at a time, although comorbidity and changing clinical needs commonly occur in practice. A more flexible approach is needed. The Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH-ADTC) is designed to overcome these challenges; it provides a range of treatment modules addressing different problems, within a single training program. A clinical trial of MATCH-ADTC in the USA showed that MATCH-ADTC outperformed usual care and standard evidence-based treatment on several clinical measures. We aim to replicate these findings and evaluate the impact of providing training and supervision in MATCH-ADTC to: (1) improve clinical outcomes for youth attending mental health services; (2) increase the amount of evidence-based therapy content; (3) increase the efficiency of service delivery. Methods: This is an assessor-blinded multi-site effectiveness randomized controlled trial. Randomization occurs at two levels: (1) clinicians (≥60) are randomized to intervention or usual care; (2) youth participants (7–14 years old) accepted for treatment in child and adolescent mental health services (with a primary disorder that includes anxiety, depression, trauma-related symptoms, or disruptive behavior) are randomly allocated to receive MATCH-ADTC or usual care. Youth participants are recruited from ‘mainstream’, Māori-specific, and Pacific-specific child and adolescent mental health services. We originally planned to recruit 400 youth participants, but this has been revised to 200 participants. Centralized computer randomization ensures allocation concealment. The primary outcome measures are: (i) the difference in trajectory of change of clinical severity between groups (using the parent-rated Brief Problem Monitor); (ii) clinicians’ use of evidence-based treatment procedures during therapy sessions; (iii) total time spent by clinicians delivering therapy. Discussion: If MATCH-ADTC demonstrates effectiveness it could offer a practical efficient method to increase access to evidence-based therapies, and improve outcomes for youth attending secondary care services