Research series (Chicora Foundation) 45

This study provides the results of an archaeological and historical survey of the block in Charleston, South Carolina proposed for the construction of the new Saks Fifth Avenue department store

'White knuckle care work' : violence, gender and new public management in the voluntary sector

Drawing on comparative data from Canada and Scotland, this article explores reasons why violence is tolerated in non-profit care settings. This article will provide insights into how workers' orientations to work, the desire to care and the intrinsic rewards from working in a non-profit context interact with the organization of work and managerially constructed workplace norms and cultures (Burawoy, 1979) to offset the tensions in an environment characterized by scarce resources and poor working conditions. This article will also outline how the same environment of scarce resources causes strains in management's efforts to establish such cultures. Working with highly excluded service users with problems that do not respond to easy interventions, workers find themselves working at the edge of their endurance, hanging on by their fingernails, and beginning to participate in various forms of resistance; suggesting that even among the most highly committed, 'white knuckle care' may be unsustainable

Clinical outcomes in pediatric hemodialysis patients in the USA: lessons from CMS’ ESRD CPM Project

Although prospective randomized trials have provided important information and allowed the development of evidence-based guidelines in adult hemodialysis (HD) patients, with approximately 800 prevalent pediatric HD patients in the United States, such studies are difficult to perform in this population. Observational data obtained through the Center for Medicare & Medicaid Services’ (CMS’) End Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) Project have allowed description of the clinical care provided to pediatric HD patients as well as identification of risk factors for failure to reach adult targets for clinical parameters such as hemoglobin, single-pool Kt/V (spKt/V) and serum albumin. In addition, studies linking data from the ESRD CPM Project and the United States Renal Data System have allowed evaluation of associations between achievement of those targets and the outcomes of hospitalization and death. The results of those studies, while unable to prove cause and effect, suggest that the adult ESRD CPM targets may assist in identifying pediatric HD patients at risk for poor outcomes

Ensuring quality in online career mentoring

This article explores the issue of quality in online career mentoring. It builds on a previous evaluation of Brightside, an online mentoring system in the UK which is primarily aimed at supporting young people's transitions to further learning. The article notes that participants in Brightside's mentoring programmes reported satisfaction with their experiences, with many stating that it helped them to make decisions and to positively change their learning and career behaviours. However, the article argues that there are challenges in ensuring quality and consistency connected to both the voluntary nature of mentoring and the online mode. The article proposes a 10-point quality framework to support quality assurance, initial training and professional development for online mentors

Learning to manage and share data: jump-starting the research methods curriculum

Researchers? responsibilities towards their research data are changing across all domains of social scientific endeavour. Government, funders and publishers expect greater transparency of, open access to, and re-use of research data, and fears over data loss call for more robust information security practices. Researchers must develop, enhance and professionalise their research data management skills to meet these challenges and to deal with a rapidly changing data sharing environment. This paper sets out how we have contributed to jump-starting the research methods training curriculum in this field by translating high-level needs into practical guidance and training activities. Our pedagogical approach involves applicable, easy-to-digest, modules based on best practice guidance for managing and sharing research data. In line with recent findings on successful practices in methods teaching, we work on the principle of embedding grounded learning activities within existing narratives of research design and implementation

Assessing time to pulmonary function benefit following antibiotic treatment of acute cystic fibrosis exacerbations

<p>Abstract</p> <p>Background</p> <p>Cystic Fibrosis (CF) is a life-shortening genetic disease in which ~80% of deaths result from loss of lung function linked to inflammation due to chronic bacterial infection (principally <it>Pseudomonas aeruginosa</it>). Pulmonary exacerbations (intermittent episodes during which symptoms of lung infection increase and lung function decreases) can cause substantial resource utilization, morbidity, and irreversible loss of lung function. Intravenous antibiotic treatment to reduce exacerbation symptoms is standard management practice. However, no prospective studies have identified an optimal antibiotic treatment duration and this lack of objective data has been identified as an area of concern and interest.</p> <p>Methods</p> <p>We have retrospectively analyzed pulmonary function response data (as forced expiratory volume in one second; FEV₁) from a previous blinded controlled CF exacerbation management study of intravenous ceftazidime/tobramycin and meropenem/tobramycin in which spirometry was conducted daily to assess the time course of pulmonary function response.</p> <p>Results</p> <p>Ninety-five patients in the study received antibiotics for at least 4 days and were included in our analyses. Patients received antibiotics for an average of 12.6 days (median = 13, SD = 3.2 days), with a range of 4 to 27 days. No significant differences were observed in mean or median treatment durations as functions of either treatment group or baseline lung disease stage. Average time from initiation of antibiotic treatment to highest observed FEV₁was 8.7 days (median = 10, SD = 4.0 days), with a range of zero to 19 days. Patients were treated an average of 3.9 days beyond the day of peak FEV₁(median = 3, SD = 3.8 days), with 89 patients (93.7%) experiencing their peak FEV₁improvement within 13 days. There were no differences in mean or median times to peak FEV₁as a function of treatment group, although the magnitude of FEV₁improvement differed between groups.</p> <p>Conclusions</p> <p>Our results suggest that antibiotic response to exacerbation as assessed by pulmonary function is essentially complete within 2 weeks of treatment initiation and relatively independent of the magnitude of pulmonary function response observed.</p

Leeway for the loyal: a model of employee discretion

This article examines the factors underlying task discretion from an economist's perspective. It argues that the key axis for understanding discretion is the trade-off between the positive effects of discretion on potential output per employee and the negative effects of greater leeway on work effort. In empirical analysis using matched employer-employee data, it is shown that discretion is strongly affected by the level of employee commitment. In addition, discretion is generally greater in high-skilled jobs, although not without exceptions, and lower where employees are under-skilled. Homeworking and flexitime policies raise employee discretion. The impact of teamworking is mixed. In about half of cases team members do not jointly decide about work matters, and the net effect of teams on task discretion in these cases is negative. In other cases, where team members do decide matters jointly, the impact is found to be neutral according to employees' perceptions, or positive according to managers' perceptions. There are also significant and substantial unobserved establishment-level factors which affect task discretion

Constrained by managerialism : caring as participation in the voluntary social services

The data in this study show that care is a connective process, underlying and motivating participation and as a force that compels involvement in the lives of others, care is at least a micro-participative process. Care or affinity not only persisted in the face of opposition, but it was also used by workers as a counter discourse and set of practices with which to resist the erosion of worker participation and open up less autonomized practices and ways of connecting with fellow staff, clients and the communities they served. The data suggest that while managerialism and taylorised practice models may remove or reduce opportunities for worker participation, care is a theme or storyline that gave workers other ways to understand their work and why they did it, as well as ways they were prepared to resist managerial priorities and directives, including the erosion of various kinds of direct and indirect participation. The degree of resistance possible, even in the highly technocratic worksite in Australia, shows that cracks and fissures exist within managerialism

Work-time underemployment and financial hardship: class inequalities and recession in the UK

The economic crisis that led to recession in the UK in 2008–9 impacted in multiple ways on work and economic life. This article examines changes to the work-time of employees. The UK stood out for its recessionary expansion of work-time underemployment. Working in a job that provides ‘too few’ hours can have serious ramifications for the economic livelihood of workers. Working-class workers are central here. Drawing on analysis of large-scale survey data, the article identifies that workers in lower level occupations experienced the most substantial post-recessionary growth in the proportions working ‘too few’ hours. Did these work-time changes narrow or widen class inequalities in feelings of financial hardship? The article concludes that although middle-class workers also saw their financial positions damaged, this so-called ‘first middle-class recession’ did not erode class inequalities in financial hardship among UK workers