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’)

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

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

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

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

UK Food Standards Agency workshop report: diet and immune function

The UK Food Standards Agency convened a workshop on 13 May 2009 to discuss recently completed research on diet and immune function. The objective of the workshop was to review this research and to establish priorities for future research. Several of the trials presented at the workshop showed some effect of nutritional interventions (e.g. vitamin D, Zn, Se) on immune parameters. One trial found that increased fruit and vegetable intake may improve the antibody response to pneumococcal vaccination in older people. The workshop highlighted the need to further clarify the potential public health relevance of observed nutrition-related changes in immune function, e.g. susceptibility to infections and infectious morbidity.<br/