40 research outputs found
A collation of the Gospel texts contained in Durham Cathedral mss. A.II.10, A.II.16 and A.II.17, and some provisional conclusions therefrom regarding the type of Vulgate text employed in Northumbria in the 8th century, together with a full description of each ms.
Part I. A description of the types of Latin Gospel texts in use in the Celtic and Anglo-Saxon Churches: (a) The Latin Gospels in the Celtic Church - the evidence of Patrick, Gildas and Columbanus; the early, seventh century, MSS.; the text of the "Celtic mixed family": a discussion of the reputed characteristics of that family and the conclusion that those characteristics indicate a common editorial tradition rather than a common textual tradition. (b) The Latin Gospels in England - in the south; in Northumbria; the conclusion that the Gospel texts in the early Ango-Saxon Gospel Books show a continuing influence of Italian text-types.
Part II. The early history of Durham A.II.10, A.II.16 and A.II.17 - conclusion that both parts of A.II.17 (foll. 2-102, Majuscule, and foll. 103 - 111, Uncial) came from Lindisfarne with the community of St. Cuthbert and that A.II.17, Uncial, is part of the exemplar of the Lindisfarne Gospels; earliest eveidence for A.II.16 being at Durham is twelfth century; the fourteenth century catalogues; Rud and the loan of A.II.16 and A.II.17 to Richard Bentley; earliest eveidence for A.II.10 not until the nineteenth century.
Part III. Full collation of the texts of A.II.10, A.II.16 and A.II.17 (excluding John in A.II.16 and the Uncial leaves in A.II.17) against the text of Wordsworth and White, Novum Testamentum Domini Nostri Iesu Christi Latine, pars prior - Quattuor Evangelia, Oxford 1889-1898, and description of the individual mss.
(a) A.II.10 (and C.II.13 and E.III.20) contains an Old Latin section (MK.II:12 - VI:6) with a text very close to the of Dublin, Trinity College Ms. 55; the rest of the text appears to be Old Latin corrected against the Vulgate.
(b) A.II.17 (foll 2-102) belongs textually to the OXZ, mixed Italian, tradition; also certain points of contact with the text of the Book of Kells.
(c) A.II.16 (foll. 1-102) - the text of Mark is very close to that in A.II.17; the text of Matthew is similar to that found in the Echternach Gospels (Paris lat. 9389), with certain "Celtic" readings; Luke presents a mixed text with many points of contact with the texts of the "Celtic" Vulgate
Putting guidelines into practice: Using co-design to develop a complex intervention based on NG48 to enable care staff to provide daily oral care to older people living in care homes
OBJECTIVES: (1) Explore the challenges of providing daily oral care in care homes; (2) understand oral care practices provided by care home staff; (3) co-design practical resources supporting care home staff in these activities. METHODS: Three Sheffield care homes were identified via the "ENRICH Research Ready Care Home Network," and three to six staff per site were recruited as co-design partners. Design researchers led three co-design workshops exploring care home staff's experiences of providing daily oral care, including challenges, coping strategies and the role of current guidelines. New resources were prototyped to support the use of guidelines in practice. The design researchers developed final resources to enable the use of these guidelines in-practice-in-context. FINDINGS: Care home staff operate under time and resource constraints. The proportion of residents with dementia and other neurodegenerative conditions is rapidly increasing. Care home staff face challenges when residents adopt "refusal behaviours" and balancing daily oral care needs with resident and carer safety becomes complex. Care home staff have developed many coping strategies to navigate "refusal behaviours." Supporting resources need to "fit" within the complexities of practice-in-context. CONCLUSIONS: The provision of daily oral care practices in care homes is complex and challenging. The co-design process revealed care home staff have a "library" of context-specific practical knowledge and coping strategies. This study offers insights into the process of making guidelines usable for professionals in their contexts of practice, exploring the agenda of implementing evidence-based guidelines
Associations between paternal PTSD or depression, adolescent mental health, and family functioning:A cross-sectional study of UK military families
Background: Relationships between paternal mental health, adolescent mental health, and family functioning have received limited attention in UK military populations. The aim of this secondary data analysis was to investigate whether post-traumatic stress disorder (PTSD) or depression in military fathers was associated with mental health disorders in adolescent offspring and impaired family functioning. Methods: In total, n=105 serving and ex-serving members of the UK Armed Forces, and n=137 of their adolescent offspring (aged 11 to 17 years), were included in this analysis. Data were collected online and via home visits, using validated questionnaires to assess mental health and family functioning. Results: Families where fathers had probable PTSD or depression experienced more impaired general family functioning compared to families where the father did not have these conditions (unadjusted b=0.21, 95% CI=0.07 to 0.35, p=0.003), and particularly on the communication subscale of the Family Assessment Device. Probable paternal PTSD or depression was also associated with increased likelihood of adolescent mental health disorders (unadjusted OR=2.30, 95% CI=1.10 to 4.81, p=0.027), particularly internalising disorders such as depression or anxiety (unadjusted OR=2.21, 95% CI=1.04 to 4.71, p=0.040). The direction and strength of these associations did not substantially change after adjusting for sociodemographic and military covariates. Conclusions: This study found evidence for associations between probable paternal PTSD or depression, poorer adolescent mental health, and poorer family functioning in military families. This highlights the importance of supporting the wellbeing of both military fathers and their adolescent offspring, and of supporting the whole family when parents are known to be struggling with their mental health
An Evaluation of the Return to Practice Programme (Nursing) at City University of London (2017-2018)
In response to concerns over a predicted chronic nursing shortage recent focus has been placed on Return to Practice (RTP) programmes, which aim to increase the nursing workforce by enabling former nurses to return to the profession. In order to encourage former nurses to return to practice, it is important to understand the motivations, expectations and experiences of current returnees by evaluating RTP programmes.
Aims: To evaluate the RTP programme by exploring the views and experiences of returnees to nursing, and of the nursing staff who support them.
Methods: This was a mixed methods study: an electronic survey of all students currently or recently on the RTP programme at City, University of London; and interviews with a range of stakeholders, including returnees, mentors and senior managers, at North East London Foundation Trust (NELFT). Descriptive statistics were used to summarise quantitative responses to the survey and Framework method was employed to analyse qualitative data.
Results: Seventy-four responses to the survey were received; eight interviews were carried out with returnees, and five with NELFT staff. Overall, data suggests that the programme has been very successful: most views were positive, many were very positive. Though returnees found the course fairly challenging, they also found it largely fit for purpose. There were many useful suggestions about how to improve and promote the programme. There were also some reservations about the organisation of placements and of mentorship arrangements, the latter largely due to the difficulty of arranging for time for returnees and their mentors to work together.
Recommendations: RTP programmes should be continued and if possible expanded. Wider advertising, ideally involving successful RTP returnees, should be used to attract more recruits, and funding for returnees should be maintained or increased.
Higher Education Institutions (HEIs) should offer support to enable RTP nurses to return to study and to achieve their academic objectives as smoothly as possible. This may include responding to the individual learning needs of RTP nurses and allowing flexibility for students who need longer for private study. National Health Service (NHS) Trusts/Boards should ensure that Human Resource (HR) departments are willing and able to deal quickly with arrangements for employed RTP students. Processes for arranging placements should include realistic timetables for Disclosure and Barring Service (DBS) checks to be carried out. NHS providers should consider the suggestion that returnees can arrange their own placements if they wish.
NHS providers should make even greater efforts to ensure that front-line staff understand the position of RTP nursing students, what they can expect from them and what their responsibilities to them are.
Recent RTP graduates should be encouraged and enabled to support future RTP students. As champions of the programme, they should support the Trust in clarifying to existing staff what RTP students need and can be permitted to do
Putting Guidelines into Practice: Using Co-design to Develop a Complex Intervention Based on NG48 to Enable Care Staff to Provide Daily Oral Care to Older People Living in Care Homes
Objectives: 1) Explore the challenges of providing daily oral care in care homes; 2) Understand oral care practices provided by care home staff; 3) Co-design practical resources supporting care home staff in these activities.
Methods: Three Sheffield care homes were identified via the âENRICH Research Ready Care Home Networkâ and three to six staff per site were recruited as co-design partners. Design researchers led three co-design
workshops exploring care home staffâs experiences of providing daily oral care, including challenges, coping strategies and the role of current guidelines. New resources were prototyped to support the use of guidelines
in practice. The design researchers developed final resources to enable the use of these guidelines in-practice-in-context.
Findings: Care home staff operate under time and resource constraints. The proportion of residents with dementia and other neurodegenerative conditions is rapidly increasing. Care home staff face challenges when
residents adopt ârefusal behavioursâ and balancing daily oral care needs with resident and carer safety becomes complex. Care home staff have developed many coping strategies to navigate ârefusal behavioursâ.
Supporting resources need to âfitâ within the complexities of practice-in-context.
Conclusions: The provision of daily oral care practices in care homes is complex and challenging. The co-design process revealed care home staff have a âlibraryâ of context-specific practical knowledge and coping strategies.
This study offers insights into the process of making guidelines usable for professionals in their contexts of practice, exploring the agenda of implementing evidence-based guidelines
Improving the oral health of older people in care homes (TOPIC): a protocol for a feasibility study
BACKGROUND: Evidence for interventions promoting oral health amongst care home residents is weak. The National Institute for Health and Care Excellence (NICE) guideline NG48 aims to maintain and improve the oral health of care home residents. A co-design process that worked with residents and care home staff to understand how the NG48 guideline could be best implemented in practice has been undertaken to refine a complex intervention. The aim of this study is to assess the feasibility of the intervention to inform a future larger scale definitive trial. METHODS: This is a protocol for a pragmatic cluster randomised controlled trial with a 12-month follow-up that will be undertaken in 12 care homes across two sites (six in London, six in Northern Ireland). Care homes randomised to the intervention arm (n = 6) will receive the complex intervention based on the NG48 guideline, whilst care homes randomised to the control arm (n = 6) will continue with routine practice. The intervention will include a training package for care home staff to promote knowledge and skills in oral health promotion, the use of the Oral Health Assessment Tool on residents by trained care home staff, and a 'support worker assisted' daily tooth-brushing regime with toothpaste containing 1500 ppm fluoride. An average of ten residents, aged 65 years or over who have at least one natural tooth, will be recruited in each care home resulting in a recruited sample of 120 participants. Assessments will be undertaken at baseline, 6 months and 12 months, and will include a dental examination and questionnaires on general health and oral health administered by a research assistant. A parallel process evaluation involving semi-structured interviews will be undertaken to explore how the intervention could be embedded in standard practice. Rates of recruitment and retention, and intervention fidelity will also be recorded. A cost-consequence model will determine the relevance of different outcome measures in the decision-making context. DISCUSSION: The study will provide valuable information for trialists, policymakers, clinicians and care home staff on the feasibility and associated costs of oral health promotion in UK care homes. TRIAL REGISTRATION: ISRCTN10276613. Registered on 17th April 2020. http://www.isrctn.com/ISRCTN10276613
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Developing and testing a principle-based fidelity index for peer support in mental health services
Purpose
Evidence suggests that the distinctive relational qualities of peer supportâcompared to clinical-patient relationshipsâcan be eroded in regulated healthcare environments. Measurement of fidelity in trials of peer support is lacking. This paper reports the development and testing of a fidelity index for one-to-one peer support in mental health services, designed to assess fidelity to principles that characterise the distinctiveness of peer support.
Methods
A draft index was developed using expert panels of service user researchers and people doing peer support, informed by an evidence-based, peer support principles framework. Two rounds of testing took place in 24 mental health services providing peer support in a range of settings. Fidelity was assessed through interviews with peer workers, their supervisors and people receiving peer support. Responses were tested for spread and internal consistency, independently double rated for inter-rater reliability, with feedback from interviewees and service user researchers used to refine the index.
Results
A fidelity index for one-to-one peer support in mental health services was produced with good psychometric properties. Fidelity is assessed in four principle-based domains; building trusting relationships based on shared lived experience; reciprocity and mutuality; leadership, choice and control; building strengths and making connections to community.
Conclusions
The index offers potential to improve the evidence base for peer support in mental health services, enabling future trials to assess fidelity of interventions to peer support principles, and service providers a means of ensuring that peer support retains its distinctive qualities as it is introduced into mental health services
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Peer support for discharge from inpatient mental health care versus care as usual in England (ENRICH): a parallel, two-group, individually randomised controlled trial.
BACKGROUND: High numbers of patients discharged from psychiatric hospital care are readmitted within a year. Peer support for discharge has been suggested as an approach to reducing readmission post-discharge. Implementation has been called for in policy, however, evidence of effectiveness from large rigorous trials is missing. We aimed to establish whether peer support for discharge reduces readmissions in the year post-discharge. METHODS: We report a parallel, two-group, individually randomised, controlled superiority trial, with trial personnel masked to allocation. Patients were adult psychiatric inpatients (age â„18 years) with at least one previous admission in the preceding 2 years, excluding those who had a diagnosis of any organic mental disorder, or a primary diagnosis of learning disability, an eating disorder, or drug or alcohol dependency, recruited from seven state-funded mental health services in England. Patients were randomly assigned (1:1) to the intervention (peer support plus care as usual) or control (care as usual) groups by an in-house, online randomisation service, stratified by site and diagnostic group (psychotic disorders, personality disorders, and other eligible non-psychotic disorders) with randomly permuted blocks of randomly varying length to conceal the allocation sequence and achieve the allocation ratio. The peer support group received manual-based, one-to-one peer support, focused on building individual strengths and engaging with activities in the community, beginning during the index admission and continuing for 4 months after discharge, plus care as usual. Care as usual consisted of follow-up by community mental health services within 7 days of discharge. The primary outcome was psychiatric readmission 12 months after discharge (number of patients readmitted at least once), analysed on an intention-to-treat basis. All patients were included in a safety analysis, excluding those who withdrew consent for use of their data. The trial is registered with the ISRCTN registry, ISRCTN10043328. The trial was complete at the time of reporting. FINDINGS: Between Dec 1, 2016, and Feb 8, 2019, 590 patients were recruited and randomly assigned, with 294 allocated to peer support (287 included in the analysis after withdrawals and loss to follow-up), and 296 to care as usual (291 in the analysis). Mean age was 39·7 years (SD 13·7; range 18-75). 306 patients were women, 267 were men, three were transgender, and two preferred not to say. 353 patients were White, 94 were Black, African, Caribbean, or Black British, 68 were Asian or Asian British, 48 were of mixed or multiple ethnic groups, and 13 were of other ethnic groups. In the peer support group, 136 (47%) of 287 patients were readmitted at least once within 12 months of discharge. 146 (50%) of 291 were readmitted in the care as usual group. The adjusted risk ratio of readmission was 0·97 (95% CI 0·82-1·14; p=0·68), and the adjusted odds ratio for readmission was 0·93 (95% CI 0·66-1·30; p=0·68). The unadjusted risk difference was 0·03 (95% CI -0·11 to 0·05; p=0·51) in favour of the peer support group. Serious adverse events were infrequent (67 events) and similar between groups (34 in the peer support group, 33 in the care as usual group). Threat to life (self-harm) was the most common serious adverse event (35 [52%] of 67 serious adverse events). 391 other adverse events were reported, with self-harm (not life threatening) the most common (189 [48%] of 391). INTERPRETATION: One-to-one peer support for discharge from inpatient psychiatric care, plus care as usual, was not superior to care as usual alone in the 12 months after discharge. This definitive, high-quality trial addresses uncertainty in the evidence base and suggests that peer support should not be implemented to reduce readmission post-discharge for patients at risk of readmission. Further research needs to be done to improve engagement with peer support in high-need groups, and to explore differential effects of peer support for people from different ethnic communities. FUNDING: UK National Institute for Health Research
« Mines de diamant de Kimberley. Afrique australe » ⹠1881
Ăpreuve sur papier albuminĂ©, 56 x 45,7 cmLa dĂ©couverte de diamants dans la rĂ©gion de Kimberley en 1867 va profondĂ©ment modifier le visage de l'Afrique du Sud et attirer en quelques annĂ©es de nombreuses compagnies Ă©trangĂšres. Adrien Auguste Moulle, ingĂ©nieur des Mines et membre de la SociĂ©tĂ© de gĂ©ographie a travaillĂ©, pour la Compagnie française des mines de diamants du Cap, Ă la mine de Kimberley dans les annĂ©es 1880. Il est l'auteur d'un MĂ©moire sur la gĂ©ologie gĂ©nĂ©rale et sur les mines de diamants de l'Afrique du Sud et le donateur de cette photographie Ă la SociĂ©tĂ© de gĂ©ographie