Not just ticking the box: an investigation into safeguarding adults training transfer in Cornwall, UK

Two published journal articles are included in the appendices.Safeguarding adults is a priority in adult social care, and training is one of the main ways in which policy and guidance around it is implemented. Training transfer refers to the use of new learning on the job, and while the transfer literature is well developed, it does not extend to safeguarding adults training. This research aimed to identify, develop and refine a programme theory of safeguarding adults training transfer by identifying factors that facilitate or inhibit the use of safeguarding adults training in practice, and the impact that the training has. A cross sectional mixed methods realist synthesis approach was used to evaluate two safeguarding adults training programmes provided in Cornwall, UK between 2009 and 2011. Realist synthesis aims to uncover what works, for whom, in which circumstances and how, and develops policy makers’ programme theories of interventions using evidence. A systematic review of training transfer generally, and then of health and social care transfer specifically led to a revision of the policy makers’ programme theory of training. Empirical research in the form of a factorial survey and narrative analysis of qualitative interviews was then undertaken, to further revise the programme theory to be specific to safeguarding adults training. Findings emphasise the importance of considering the effect of the training culture and transfer climate on safeguarding adults training effectiveness. Factors such as opportunity to use learning and supervisor support are important to transfer and the conflict between adult learning principles and mandatory training was explored. Safeguarding adults-specific supports were also highlighted, emphasising the importance of supporting practice using mechanisms other than training. Recommendations are provided regarding how the safeguarding related transfer climate can be improved. Limitations of the study include a high likelihood of sampling bias. The limitations of individual methods and problem of generalising findings obtained from a case study of Cornwall were reduced using the realist synthesis approach

Preservice Teacher Intersectional Awareness: A Qualitative Inquiry

The purpose of this dissertation was to investigate the intersectional awareness of preservice general education teachers as experienced through an internship in an urban, Title 1 funded school. Intersectionality Theory (Boveda, 2016; Crenshaw, 1990; Dill & Zambrana, 2009; Jones & Wijeyesinghe, 2011) was used as a theoretical framework to inform this study. A descriptive phenomenological design (Creswell, 2013; Moustakas, 1994) was used to examine preservice teachers\u27 (PSTs)lived experiences within their teacher preparation program courses and internship. Data were collected through individual semi-structured interviews with preservice general education teachers. Data analysis was completed using Colaizzi\u27s (1978) seven-step process as outlined by Sanders (2003). Thematic analysis resulted in three primary themes around how participants experienced intersectionality in their internship experiences. The primary themes included: (a) Understanding my role and identity as an intern and teacher in an urban, Title 1 funded school; (b) Acknowledging the context of my students and my school; and (c) Serving all students through my knowledge, skills, and dispositions. Data and results from this study inform research, practice, and policy related to intersectionality and its application to teacher education to advance educational equity. This research builds upon the work of scholars committed to enhancing teacher education to develop teachers with the knowledge, skills, and dispositions needed to serve all students

"Cutting through": overcoming the barriers to academic engagement with policy processes

A lack of access and poor communication are often cited as reasons why academic research is not widely used by policymakers. But what about the challenges for researchers engaging with decision-makers such as parliaments? Lindsay Walker, Lindsey Pike, Marsha Wood and Hannah Durrant have surveyed more than 400 research professionals and identified some clear barriers, with heavy workloads and a lack of transparency around how research will be used among the most prominent. In order to promote better engagement between academia and policy such initiatives should provide guidance for academics on the different opportunities to submit research evidence, be transparent about why and how that evidence will be used, and provide clear acknowledgement of the research contribution by academic sources

Supporting evidence-informed policy and scrutiny: A consultation of UK research professionals

Access to reliable and timely information ensures that decision-makers can operate effectively. The motivations and challenges of parliamentarians and policy-makers in accessing evidence have been well documented in the policy literature. However, there has been little focus on research-providers. Understanding both the demand- and the supply-side of research engagement is imperative to enhancing impactful interactions. Here, we examine the broader experiences, motivations and challenges of UK-based research professionals engaging with research-users relevant to policy-making and scrutiny in the UK using a nationwide online questionnaire. The context of the survey partly involved contributing to the UK Evidence Information Service (EIS), a proposed rapid match-making service to facilitate interaction between parliamentary arenas that use evidence and research-providers. Our findings reveal, at least for this sub-sample who responded, that there are gender-related differences in policy-related experience, motivations, incentives and challenges for research professionals to contribute to evidence-informed decision-making through initiatives such as the EIS. Male and female participants were equally likely to have policy experience; however, males reported both significantly broader engagement with the research-users included in the survey and significantly higher levels of engagement with each research-user. Reported incentives for engagement included understanding what the evidence will be used for, guidance on style and content of contribution, and acknowledgement of contributions by the policymaker or elected official. Female participants were significantly more likely to select the guidance-related options. The main reported barrier was workload. We discuss how academia-policy engagement initiatives can best address these issues in ways that enhance the integration of research evidence with policy and practice across the UK

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Peer Toy Play as a Gateway to Children’s Gender Flexibility: The Effect of (Counter)Stereotypic Portrayals of Peers in Children’s Magazines

Extensive evidence has documented the gender stereotypic content of children’s media, and media is recognized as an important socializing agent for young children. Yet, the precise impact of children’s media on the endorsement of gender-typed attitudes and behaviors has received less scholarly attention. We investigated the impact of stereotypic and counter-stereotypic peers pictured in children’s magazines on children’s gender flexibility around toy play and preferences, playmate choice, and social exclusion behavior (n = 82, age 4–7 years-old). British children were randomly assigned to view a picture of a peer-age boy and girl in a magazine playing with either a gender stereotypic or counter-stereotypic toy. In the stereotypic condition, the pictured girl was shown with a toy pony and the pictured boy was shown with a toy car; these toys were reversed in the counter-stereotypic condition. Results revealed significantly greater gender flexibility around toy play and playmate choices among children in the counterstereotypic condition compared to the stereotypic condition, and boys in the stereotypic condition were more accepting of gender-based exclusion than were girls. However, there was no difference in children’s own toy preferences between the stereotypic and counter-stereotypic condition, with children preferring more gender-typed toys overall. Implications of the findings for media, education, and parenting practices are discussed, and the potential for counterstereotypic media portrayals of toy play to shape the gender socialization of young children is explored

Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial.

BACKGROUND: Studies evaluating titration of antihypertensive medication using self-monitoring give contradictory findings and the precise place of telemonitoring over self-monitoring alone is unclear. The TASMINH4 trial aimed to assess the efficacy of self-monitored blood pressure, with or without telemonitoring, for antihypertensive titration in primary care, compared with usual care. METHODS: This study was a parallel randomised controlled trial done in 142 general practices in the UK, and included hypertensive patients older than 35 years, with blood pressure higher than 140/90 mm Hg, who were willing to self-monitor their blood pressure. Patients were randomly assigned (1:1:1) to self-monitoring blood pressure (self-montoring group), to self-monitoring blood pressure with telemonitoring (telemonitoring group), or to usual care (clinic blood pressure; usual care group). Randomisation was by a secure web-based system. Neither participants nor investigators were masked to group assignment. The primary outcome was clinic measured systolic blood pressure at 12 months from randomisation. Primary analysis was of available cases. The trial is registered with ISRCTN, number ISRCTN 83571366. FINDINGS: 1182 participants were randomly assigned to the self-monitoring group (n=395), the telemonitoring group (n=393), or the usual care group (n=394), of whom 1003 (85%) were included in the primary analysis. After 12 months, systolic blood pressure was lower in both intervention groups compared with usual care (self-monitoring, 137·0 [SD 16·7] mm Hg and telemonitoring, 136·0 [16·1] mm Hg vs usual care, 140·4 [16·5]; adjusted mean differences vs usual care: self-monitoring alone, -3·5 mm Hg [95% CI -5·8 to -1·2]; telemonitoring, -4·7 mm Hg [-7·0 to -2·4]). No difference between the self-monitoring and telemonitoring groups was recorded (adjusted mean difference -1·2 mm Hg [95% CI -3·5 to 1·2]). Results were similar in sensitivity analyses including multiple imputation. Adverse events were similar between all three groups. INTERPRETATION: Self-monitoring, with or without telemonitoring, when used by general practitioners to titrate antihypertensive medication in individuals with poorly controlled blood pressure, leads to significantly lower blood pressure than titration guided by clinic readings. With most general practitioners and many patients using self-monitoring, it could become the cornerstone of hypertension management in primary care. FUNDING: National Institute for Health Research via Programme Grant for Applied Health Research (RP-PG-1209-10051), Professorship to RJM (NIHR-RP-R2-12-015), Oxford Collaboration for Leadership in Applied Health Research and Care, and Omron Healthcare UK

Not just ticking the box : an investigation into safeguarding adults training transfer in Cornwall, UK

Safeguarding adults is a priority in adult social care, and training is one of the main ways in which policy and guidance around it is implemented. Training transfer refers to the use of new learning on the job, and while the transfer literature is well developed, it does not extend to safeguarding adults training. This research aimed to identify, develop and refine a programme theory of safeguarding adults training transfer by identifying factors that facilitate or inhibit the use of safeguarding adults training in practice, and the impact that the training has. A cross sectional mixed methods realist synthesis approach was used to evaluate two safeguarding adults training programmes provided in Cornwall, UK between 2009 and 2011. Realist synthesis aims to uncover what works, for whom, in which circumstances and how, and develops policy makers’ programme theories of interventions using evidence. A systematic review of training transfer generally, and then of health and social care transfer specifically led to a revision of the policy makers’ programme theory of training. Empirical research in the form of a factorial survey and narrative analysis of qualitative interviews was then undertaken, to further revise the programme theory to be specific to safeguarding adults training. Findings emphasise the importance of considering the effect of the training culture and transfer climate on safeguarding adults training effectiveness. Factors such as opportunity to use learning and supervisor support are important to transfer and the conflict between adult learning principles and mandatory training was explored. Safeguarding adults-specific supports were also highlighted, emphasising the importance of supporting practice using mechanisms other than training. Recommendations are provided regarding how the safeguarding related transfer climate can be improved. Limitations of the study include a high likelihood of sampling bias. The limitations of individual methods and problem of generalising findings obtained from a case study of Cornwall were reduced using the realist synthesis approach.EThOS - Electronic Theses Online ServiceGBUnited Kingdo