Preventative Social Care and Community Development in Wales: "New" Legislation, "Old" Tensions?

Prevention is becoming ever more central in UK care policy for older people, though precisely what this entails, and how it works most effectively in social care and support, remains ambiguous. Set against the "newness" of recent social care legislation in Wales, this article explores the perspectives of professionals on prevention and community development, particularly for older people. This draws on qualitative data collected from 11 Welsh local authorities, four NHS Wales health boards, and eight regional third-sector organisations, incorporating 64 interviews with directors, executives, and senior managers. Recent research has highlighted concerns over the slipperiness of prevention as a concept, resulting in multiple interpretations and activities operating under its banner. Consistent with this, our data suggested a kaleidoscopic picture of variously named community-based initiatives working to support the intricate web of connections that sustain older people, as well as provide practical or material help. Similarly, professionals highlighted varied agendas of community resilience, individual independence, and reducing the need for state-funded health and social care, as well as a range of viewpoints on the roles of the state, private sector, and the third sector. Analysis revealed fragments of familiar themes in community development; positive hopes for community initiatives, tensions between the mixed agendas of state-instigated activities, and the practical challenges arising from systems imbued with neo-liberal ideas. Realising the promise of prevention will require deft steering through these challenges

A Question of Life and Death : The Aesopic Animal Fables on Why Not to Kill

This article belongs to the Special Issue "Animal Narratology".This article deals with Greek animal fables, traditionally attributed to a former slave, Aesop, who lived during the sixth century BCE. As a genre, the Aesopic fables, or the Aesopica, has had a significant impact on the Western fable tradition and modern Western children’s literature. The Aesopica owes much to the Mesopotamian fables and has parallels in other Near Eastern cultures. Modern research has concentrated on tracing the oriental roots of the fable tradition and the dating of the different parts of the Aesopica, as well as defining the fable as a genre. The traditional reading of fables has, however, excluded animals qua animals, supposing that fables are mainly allegories of the human condition. The moral of the story (included in the epimythia or promythia) certainly guides one to read the stories anthropocentrically, but the original fables did not necessarily include this positioning element. Many fables address the situation when a prey animal, like a lamb, negotiates with a predator animal, like a wolf, by giving reasons why she should not be killed. In this article, I will concentrate on these fables and analyse them from the point of view of their structure and content. Comparing these fables with some animal similes in Homer’s Iliad, I suggest that these fables deal not only with the ethical problem of ‘might makes right’ as a human condition, but also the broader philosophical question of killing other living creatures and the problem of cruelty.Peer reviewe

Evaluation of the Social Services and Well-being (Wales) Act 2014 Literature Review

This document is a summary of the extensive review of the literature to inform the evaluation of the Social Services and Well-being (Wales) Act 2014 (hereafter referred to as ‘the Act’)

Prevention and social care for older people in Wales: reflections from a research study

Prevention has increasingly become a central principle for health and care services across the UK. Legislatively this is evident in The Care Act 2014 in England or the Social Services and Well-being (Wales) Act 2014; each making prevention a statutory obligation for governments to enact. Yet, recent research has highlighted how this legislative drive incorporates a ‘definitional slipperiness’[1] that sees prevention linked to multiple agendas all at once: individual well-being; system partnership working; community development and resilience; statutory cost-saving, and financial imperatives, to name a few. Not all these agendas sit easily alongside one another, though, meaning that there is scope for multiple parallel interpretations of prevention[2] particularly in the social care context, and for older people

Evaluation of the Social Services and Well-being (Wales) Act 2014: Literature Review

The author list for the literature review is provided below: Evaluation of the Social Services and Well-being (Wales) Act 2014: Literature Review Chapter authors: Introduction and methods Verity, F., Wallace, S., Llewellyn, M., Anderson, P. and Lyttleton-Smith, J. Well-being Anderson, P., Lyttleton-Smith, J., Kosnes, L., Read, S., Blackmore, H. and Williams, Z. Prevention and early intervention Verity, F., Read, S. and Richards, J. Co-production Andrews, N., Calder, G., Blanluet, N., Tetlow, S. and Wallace, S. Multi-agency Wallace, C., Orrell, A., Garthwaite, T., Tetlow, S. and Wallace, S. Voice and control Llewellyn, M., Saltus, R., Blackmore, H., Tetlow, S., Williams, Z. and Wallace, S. Financial and economic Phillips, C., Prowle, M., Tetlow, S. and Williams, Z. Service user and carer experiences under the Act Wallace, S.This report is a summary of the extensive review of the literature to inform the evaluation of the Social Services and Well-being (Wales) Act 2014. This document is a summary of the extensive review of the literature undertaken to inform the evaluation of the Social Services and Well-being (Wales) Act 2014 (hereafter referred to as ‘the Act’).1 The Welsh Government has commissioned a partnership between academics across four universities in Wales and expert advisers to deliver the evaluation. The Act sets out a government vision to produce ‘transformative changes’ in social service public policy, regulations, and delivery arrangements across Wales. It has 11 parts and is informed by five principles that set out a vision to produce transformative changes in public policy, regulations, and service delivery. Aligned to it are structures, processes, and codes of practice. The Evaluation of the Act – a study called IMPACT – is organised around each of the five principles together with a focus on the financial and economic aspects of the Act’s implementation. The approach to undertaking this evaluation research is to structure the evaluation by using the fundamental principles of the Act as the scaffolding. These principles are: • Well-being • Prevention • Co-Production • Multi-agency working • Voice and control There is also a focus on the financial and economic considerations of the implementation of the Act and this area constitutes the sixth evaluation study theme

Evaluation of the Social Services and Well-being (Wales) Act 2014: Literature Review

Evaluation of the Social Services and Well-being (Wales) Act 2014: Literature Review Edited by: Llewellyn, M., Verity, F. and Wallace, S. Chapter authors: Chapter 1: Evaluation Overview and Literature Methodology Verity, F., Wallace, S., Llewellyn, M., Anderson, P. and Lyttleton-Smith, J. Chapter 2: Well-being literature review Anderson, P., Lyttleton-Smith, J., Kosnes, L., Read, S., Blackmore, H. and Williams, Z. Chapter 3: Prevention and early intervention literature review Verity, F., Read, S. and Richards, J. Chapter 4: Co-production literature review Andrews, N., Calder, G., Blanluet, N., Tetlow, S. and Wallace, S. Chapter 5: Multi-agency literature review Wallace, C., Orrell, A., Garthwaite, T., Tetlow, S. and Wallace, S. Chapter 6: Voice and control literature review Llewellyn, M., Saltus, R., Blackmore, H., Tetlow, S., Williams, Z. and Wallace, S. Chapter 7: Financial and economic literature review Phillips, C., Prowle, M., Tetlow S. and Williams Z.Mae’r ddogfen yma hefyd ar gael yn Gymraeg. This document is also available in Welsh. OGL © Crown Copyright Digital ISBN 978-1-80038-948-9.This document is a summary of the extensive review of the literature to inform the evaluation of the Social Services and Well-being (Wales) Act 2014 (hereafter referred to as ‘the Act’).Welsh Governmen

SLCO5A1 and synaptic assembly genes contribute to impulsivity in juvenile myoclonic epilepsy

Elevated impulsivity is a key component of attention-deficit hyperactivity disorder (ADHD), bipolar disorder and juvenile myoclonic epilepsy (JME). We performed a genome-wide association, colocalization, polygenic risk score, and pathway analysis of impulsivity in JME (n = 381). Results were followed up with functional characterisation using a drosophila model. We identified genome-wide associated SNPs at 8q13.3 (P = 7.5 × 10−9) and 10p11.21 (P = 3.6 × 10−8). The 8q13.3 locus colocalizes with SLCO5A1 expression quantitative trait loci in cerebral cortex (P = 9.5 × 10−3). SLCO5A1 codes for an organic anion transporter and upregulates synapse assembly/organisation genes. Pathway analysis demonstrates 12.7-fold enrichment for presynaptic membrane assembly genes (P = 0.0005) and 14.3-fold enrichment for presynaptic organisation genes (P = 0.0005) including NLGN1 and PTPRD. RNAi knockdown of Oatp30B, the Drosophila polypeptide with the highest homology to SLCO5A1, causes over-reactive startling behaviour (P = 8.7 × 10−3) and increased seizure-like events (P = 6.8 × 10−7). Polygenic risk score for ADHD genetically correlates with impulsivity scores in JME (P = 1.60 × 10−3). SLCO5A1 loss-of-function represents an impulsivity and seizure mechanism. Synaptic assembly genes may inform the aetiology of impulsivity in health and disease

An immune dysfunction score for stratification of patients with acute infection based on whole-blood gene expression

Dysregulated host responses to infection can lead to organ dysfunction and sepsis, causing millions of global deaths each year. To alleviate this burden, improved prognostication and biomarkers of response are urgently needed. We investigated the use of whole-blood transcriptomics for stratification of patients with severe infection by integrating data from 3149 samples from patients with sepsis due to community-acquired pneumonia or fecal peritonitis admitted to intensive care and healthy individuals into a gene expression reference map. We used this map to derive a quantitative sepsis response signature (SRSq) score reflective of immune dysfunction and predictive of clinical outcomes, which can be estimated using a 7- or 12-gene signature. Last, we built a machine learning framework, SepstratifieR, to deploy SRSq in adult and pediatric bacterial and viral sepsis, H1N1 influenza, and COVID-19, demonstrating clinically relevant stratification across diseases and revealing some of the physiological alterations linking immune dysregulation to mortality. Our method enables early identification of individuals with dysfunctional immune profiles, bringing us closer to precision medicine in infection.peer-reviewe