Networks of support: factors contributing to successful inter-agency work with young people

This study examines how agencies might work together more effectively to improve the life chances of young people who fall `through the net' of agency provision. Whatever the situation, the failure to co-operate challenges a democratic society and basic human rights. The problem occurs when individual primary care agencies either: • try to do on their own what can only be achieved by co-operation, or • fail to do anything because, in their view, the client's needs should be met by some other agency, or • only do what they can do on their own. The purpose of this study is to establish: • to what extent improvements in inter-agency co-operation would help agencies work more effectively with young people variously described as falling through the net, or on the margins of an agency's responsibility • what factors contribute to these improvements • what characterises effective models of inter-agency practice. The study finds that over the last thirty years, the legislative framework surrounding inter-agency co-operation for young people provides few examples of structures or procedures requiring agencies to co-operate. Where these exist, they have been set up in response to needs or crises of pressing concern at the time. Research into the practice of inter-agency work shows that successful inter-agency projects set up to meet the needs of those at risk of falling through the net follow a characteristic pattern. This led to the construction of a model based on the idea that successful inter-agency practice depends on the existence of collaborative activity at three interconnected levels: policy and planning; implementation, case work, research and training; networking/liaison. Projects supported at all three levels are more likely to be successful and survive than those which are not. This pattern can be replicated in different contexts and with different client groups to ensure effective co-ordination and redistribution of resources, and that a balance is held between preventative and proactive work. The model's key elements enable it to structure communication pathways within and between agencies, to co-ordinate activity in relation to a particular issue, to develop the interpersonal skills of participants and to provide feedback to policy makers. The research concludes that: • formal structures promoting inter-agency collaboration encourage agencies to innovate and to provide co-ordinated services for young people needing more support than can be provided by any one of them • inter-agency work has become a new area of professional and para professional expertise • models designed to help agencies meet the needs of people at risk can be applied to other projects set up to solve complex problems involving more than one department

Histomorphological study of the spinal growth plates from the convex side and the concave side in adolescent idiopathic scoliosis

Asymmetrical growth of the vertebrae has been implicated as one possible etiologic factor in the pathogenesis of adolescent idiopathic scoliosis. The longitudinal vertebral growth derives from the endochondral ossification of the vertebral growth plate. In the present study, the growth plates from the convex and concave side of the vertebrae were characterized by the method of histology and immunohistochemistry to evaluate the growth activity, cell proliferation, and apoptosis. Normal zoned architectures were observed in the convex side of the growth plate and disorganized architectures in the concave side. The histological grades were significantly different between the convex and the concave side of the growth plate in the apex vertebrae (P < 0.05). The histological difference was also found significant statistically between end vertebrae and apex vertebrae in the concave side of vertebral growth plates (P < 0.05). The proliferative potential indexes and apoptosis indexes of chondrocytes in the proliferative and hypertrophic zone in the convex side were significantly higher than that in the concave side in the apex vertebral growth plate (P < 0.05). There was a significant difference of the proliferative potential index (proliferating cell nuclear antigen, PCNA index) between convex side and concave side at the upper end vertebra (P < 0.05). The difference of the proliferative potential index and apoptosis index were found significant statistically in the concave side of the vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). The same result was also found for the apoptosis index (terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate biotin nick end labeling assay, TUNEL index) in the convex side of vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). Some correlation were found between radiographic measurements and proliferation and apoptosis indexes. The difference in histological grades and cellular activity between the convex and concave side indicated that the bilateral growth plate of the vertebrae in AIS patients have different growth kinetics which may affect the curve progression

The word as a unit of meaning. The role of context in words meaning

A unit of meaning is a word plus all those words within its contextual context that are needed to disambiguate this word to make it monosemous. A lot of research were made to study the influence of the context. They testify that there is usually in each word a hard core of relatively stable meaning and can be modified by the context within certain limits

Statutory Assessment of the class? Supporting the additional needs of the learning context

This paper considers issues of funding of support for students facing difficulties in learning, and the role of assessment and labelling within this process. It explores the tensions within this process using a Foucauldian framework, and from the key perspectives of social justice and rights. Drawing on a range of literature it identifies the focus upon the individual within assessment processes around the world, and then considers in detail the strengths and weaknesses of the current form of Statutory Assessment of Special Educational Needs within England. The paper proposes an alternative funding system that resolves shortcomings within the individual approach and the English system. It suggests that a Class Funding Approach could build on a notion of justice for all, reduce the opportunities for wide variations in provision, and minimise the negative impact of current dividing practices

Assessing mutual accountability to strengthen national WASH systems and achieve the SDG targets for water and sanitation

Abstract Multi-stakeholder engagement is critical for making progress towards Sustainable Development Goal (SDG) 6 ‘Ensure access to water and sanitation for all’, which is currently off track to be achieved by 2030. The aim of this paper was to investigate mutual accountability and multi-stakeholder platforms in the WASH sector in a diverse range of countries. Data were collected by Sanitation and Water for All (SWA) Research and Learning Constituency partners and collaborators in five SWA member countries: Bangladesh, Indonesia, Kenya, Peru and Somalia. Data collection involved document review, key informant interviews and workshops, and an online questionnaire. Across all the case study countries, there were no clear examples of mutual accountability mechanisms being widely used in the WASH sector. However, the findings indicate that some of the case study countries have active WASH multi-stakeholder platforms involving a range of actors from government, civil society and the private sector; however, these typically function as coordination and communication platforms rather than supporting mutual accountability. Other case study countries did not have multi-stakeholder platforms involving a diverse range of actors, and instead had platforms established for single stakeholder groups such as the private sector or civil society, leaving certain groups out of activities. Overall, the study highlights the importance of establishing strong multi-stakeholder processes and platforms that bring together a range of actors including government, civil society, private sector, research actors, and WASH external support organizations. Such platforms could provide a foundation to enable mutual accountability between these actors by providing a space to set commitments and monitor progress and have potential to strengthen WASH systems both nationally and globally.</jats:p

FEM Simulation of Non-Progressive Growth from Asymmetric Loading and Vicious Cycle Theory: Scoliosis Study Proof of Concept

Scoliosis affects about 1-3% of the adolescent population, with 80% of cases being idiopathic. There is currently a lack of understanding regarding the biomechanics of scoliosis, current treatment methods can be further improved with a greater understanding of scoliosis growth patterns. The objective of this study is to develop a finite element model that can respond to loads in a similar fashion as current spine biomechanics models and apply it to scoliosis growth. Using CT images of a non-scoliotic individual, a finite element model of the L3-L4 vertebra was created. By applying asymmetric loading in accordance to the ‘vicious cycle’ theory and through the use of a growth modulation equation it is possible to determine the amount of growth each region of the vertebra will undergo; therefore predict scoliosis growth over a period of time. This study seeks to demonstrate how improved anatomy can expand researchers current knowledge of scoliosis

The vertebral body growth plate in scoliosis: a primary disturbance of growth?

Study Design and Aims: This was an observational pilot study of the vertebral body growth plates in scoliosis involving high-resolution coronal plane magnetic resonance (MR) imaging and histological examination. One aim of this study was to determine whether vertebral body growth plates in scoliosis demonstrated abnormalities on MR imaging. A second aim was to determine if a relationship existed between MR and histological abnormalities in these vertebral body growth plates. Methods: MR imaging sequences of 18 patients demonstrated the vertebralbody growth plates well enough to detect gross abnormalities/ deficient areas/zones. Histological examination of ten vertebral body growth plates removed during routine scoliosis surgery was performed. Observational histological comparison with MR images was possible in four cases. Results: Four of the 18 MR images demonstrated spines with normal curvature and normal vertebral body growth plates. In 13 scoliotic spines, convex and concave side growth plate deficiencies were observed most frequently at or near the apex of the curve. One MR image demonstrated a 55° kyphosis and no convex or concave side deficiencies. The degree of vertebral body wedging was independent of the presence of vertebral body growth plate deficiency. Histological abnormalities of the vertebral body growth plates were demonstrated in four with MR imaging abnormalities. Conclusion: This study demonstrated MR image abnormalities of scoliotic vertebral body growth plates compared to controls. A qualitative relationship was demonstrated between MR imaging and histological abnormalities. The finding that vertebral body growth plate deficiencies occurred both on the convex and concave sides of the spine, closest to the apical vertebra of the scoliosis curve, implied that they are less likely to be the result of adaptive changes to the physical forces involved in the scoliotic deformity. One explanation is that they represent a primary disturbance of growth