Media and information technologies and the changing relationship to public and private space

SIGLEAvailable from British Library Document Supply Centre-DSC:9349.2355(2) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Pressure points: learning from Serious Case Reviews of failures of care and pressure ulcer problems in care homes

Purpose – Serious Case Reviews (SCRs, now Safeguarding Adults Reviews (SARs)) may be held at local level inEngland when a vulnerable adult dies or is harmed, and abuse or neglect is suspected, and there is cause forconcern about multi-agency safeguarding practice. There has been no analysis of SCRs focussing on pressure ulcers. The purpose of this paper is to present findings from a documentary analysis of SCRs/SARs to investigate what recommendations are made about pressure ulcer prevention and treatment in a care home setting in the context of safeguarding. This analysis is presented in cognisance of the prevalence and risks of pressure ulcers among care home residents; and debates about the interface of care quality and safeguarding systems.Design/methodology/approach – Identification of SCRs and SARs from England where the person whodied or who was harmed had a pressure ulcer or its synonym. Narrative and textual analysis of documentssummarising the reports was used to explore the Reviews’ observations and recommendations. The mainthemes were identified.Findings – The authors located 18 relevant SCRs and 1 SAR covering pressure ulcer care in a care homesetting. Most of these inquiries into practice, service communications and the events leading up to the deathor harm of care home residents with pressure ulcers observed that there were failings in the care home, butalso in the wider health and care systems. Overall, the reports reveal specific failings in multi-agencycommunication and in quality of care. Pressure ulcers featured in several SCRs, but it is problems andinadequacies with care and treatment that moved them to the safeguarding arena. The value of examiningpressure ulcers as a key line of inquiry is that they are “visible” in the system, with consensus about what theyare, how to measure them and what constitutes optimal care and treatment. In the new Care Act 2014context they may continue to feature in safeguarding enquiries and investigations as they may be possiblesymptoms of system failures.Research limitations/implications – Reviews vary in content, structure and accessibility making it hard tocompare their approach, findings and recommendations. There are risks in drawing too many conclusionsfrom the corpus of Reviews since these are not published in full and contexts have subsequently changed.However, this is the first analysis of these documents to take pressure ulcers as the focus and it offersvaluable insights into care home practices amid other systems and professional activity.Practical implications – This analysis highlights that it is not inevitably poor quality care in a care home thatgives rise to pressure ulcers among residents. Several SCRs note problems in wider communications withhealthcare providers and their engagement. Nonetheless, poor care quality and negligence were reported insome cases. Various policies have commented on the potential overlap between the raising of concernsabout poor quality care and about safeguarding. These were highlighted prior to the Care Act 2014 althoughcurrent policy views problems with pressure ulcers more as care quality and clinical concerns.Social implications – The value of this documentary analysis is that it rests on real case examples andscrutiny at local level. Future research could consider the findings of SARs, similar documents from the rest ofthe UK, and international perspectives.Originality/value – The value of having a set of documents about adult safeguarding is that they lendthemselves to analysis and comparison. This first analysis to focus on pressure ulcers addresses widerconsiderations related to safeguarding policy and practic

How long does biomedical research take? Studying the time taken between biomedical and health research and its translation into products, policy and practice

This article has been made available through the Brunel Open Access Publishing Fund.Background: The time taken, or ‘time lags’, between biomedical/health research and its translation into health improvements is receiving growing attention. Reducing time lags should increase rates of return to such research. However, ways to measure time lags are under-developed, with little attention on where time lags arise within overall timelines. The process marker model has been proposed as a better way forward than the current focus on an increasingly complex series of translation ‘gaps’. Starting from that model, we aimed to develop better methods to measure and understand time lags and develop ways to identify policy options and produce recommendations for future studies. Methods: Following reviews of the literature on time lags and of relevant policy documents, we developed a new approach to conduct case studies of time lags. We built on the process marker model, including developing a matrix with a series of overlapping tracks to allow us to present and measure elements within any overall time lag. We identified a reduced number of key markers or calibration points and tested our new approach in seven case studies of research leading to interventions in cardiovascular disease and mental health. Finally, we analysed the data to address our study’s key aims. Results: The literature review illustrated the lack of agreement on starting points for measuring time lags. We mapped points from policy documents onto our matrix and thus highlighted key areas of concern, for example around delays before new therapies become widely available. Our seven completed case studies demonstrate we have made considerable progress in developing methods to measure and understand time lags. The matrix of overlapping tracks of activity in the research and implementation processes facilitated analysis of time lags along each track, and at the cross-over points where the next track started. We identified some factors that speed up translation through the actions of companies, researchers, funders, policymakers, and regulators. Recommendations for further work are built on progress made, limitations identified and revised terminology. Conclusions: Our advances identify complexities, provide a firm basis for further methodological work along and between tracks, and begin to indicate potential ways of reducing lags

Fourth European stroke science workshop

Lake Eibsee, Garmisch-Partenkirchen, 16 to 18 November, 2017: The European Stroke Organisation convened >120 stroke experts from 21 countries to discuss latest results and hot topics in clinical, translational and basic stroke research. Since its inception in 2011, the European Stroke Science Workshop has become a cornerstone of European Stroke Organisation’s academic activities and a major highlight for researchers in the field. Participants include stroke researchers at all career stages and with different backgrounds, who convene for plenary lectures and discussions. The workshop was organised in seven scientific sessions focusing on the following topics: (1) acute stroke treatment and endovascular therapy; (2) small vessel disease; (3) opportunities for stroke research in the omics era; (4) vascular cognitive impairment; (5) intracerebral and subarachnoid haemorrhage; (6) alternative treatment concepts and (7) neural circuits, recovery and rehabilitation. All sessions started with a keynote lecture providing an overview on current developments, followed by focused talks on a timely topic with the most recent findings, including unpublished data. In the following, we summarise the key contents of the meeting. The program is provided in the online only Data Supplement. The workshop started with a key note lecture on how to improve the efficiency of clinical trial endpoints in stroke, which was delivered by Craig Anderson (Sydney, Australia) and set the scene for the following discussions