An evaluation of professional networks, co-ordination, cooperation and collaboration in the West Midlands Paediatric Palliative Care Network

Introduction: This is a report on Strand 3 of the Big Study, which studied the West Midlands Paediatric Palliative Care Network. The Big Study was funded by The Big Lottery Fund and Strand 3 of the Big Study was researched by the Centre for Nursing and Healthcare Research in the School of Health and Social Care at the University of Greenwich. 1.1 Background: The West Midlands Paediatric Palliative Care Network began as an interest group which started in the year 2000, with 6 to 10 members and grew. At one stage it was allied to the Birmingham Cancer Network and funded by the NHS Strategic Health Authority and at this stage it became more representative of services and West Midlands geography. It has existed in its current format, as a voluntary clinical network to promote paediatric palliative care and share best practice since 2009. The membership is wide and inclusive which means 30 to 40 people may attend the meetings which are held on a bimonthly basis and are hosted and supported charitably. Subgroups are now used to manage work in specific areas e.g. transition or clinical standards. There are links to other related networks with reciprocal membership and informal links to NHS commissioners who may seek advice. 1.2 Scope: This strand of the Big Study focused on the West Midlands Paediatric Palliative Care Network. The geographical area of the West Midlands Paediatric Palliative Care Network includes Birmingham, Coventry, The Black Country, Herefordshire, Shropshire, Solihull, Staffordshire, Stoke-on-Trent, Telford and Wrekin, Warwickshire and Worcestershire. All members of the WMPCCN and the organisations they represent were included in the study. Both NHS and non-NHS organisations offering clinical services to any children requiring palliative care were represented. Excluded from this study was the detailed examination of any of the other networks, e.g. children’s speciality networks or networks covering smaller geographical areas, to which members belonged. 1.3 Report: This report will present the results of an analysis of the responses to an online questionnaire and Social Network data from semi structured telephone interviews. This data was collected during the period February to June 2012. The approach included analysing the online survey data in order to understand the benefits and constraints of the network for individual members and Social Network Analysis of data derived from telephone interviews to explore the flow of knowledge, communication and information within the network. This report will consist of 3 different sections, with Section 1 focusing on children’s palliative care policy, the development of clinical networks and social network analysis concepts. Section 2 will focus on the research design and methods. Section 3 presents the results of the study and the final section provides a summary and conclusions of the analysis

Life events and acute cardiovascular reactions to mental stress: a cohort study

Objective: This study addressed the issue of whether frequent exposure to life events is associated with aggravation or blunting of cardiovascular reactions to acute mental stress. Methods: In a substantial cohort of 585 healthy young adults, systolic and diastolic blood pressure and pulse rate were recorded at rest and in response to a mental arithmetic stress task. Participants indicated, from a list of 50 events, those they had experienced in the last year. Results: There was an overall association between life events and blunted cardiovascular reactivity that was driven by variations in the frequency of exposure to desirable events. The total number of events and the number of personal events were negatively associated with systolic blood pressure and pulse rate reactions to acute stress, whereas the number of work-related events was negatively associated with diastolic blood pressure and pulse rate reactivity. The negative association between total events and systolic blood pressure reactivity was stronger for women than men, whereas men exposed to frequent undesirable events showed enhanced diastolic blood pressure reactivity. The blunting of pulse rate reactivity associated with frequent personal life events was evident particularly for those who had a relatively large number of close friends. Conclusions: The nature and extent of the association between life events exposure and stress reactivity in young adults depends on the valence of the events together with the sex of the individual and their social network size

Evidence of Effective Child Protection Systems in Practice

HelpdeskThis rapid review synthesise evidence of effective child protection systems in practice and in low resource setting. It drew largely on evaluative papers, academic papers and some grey literature. The reviewed evidence was frequently produced as part of programme assessments commissioned and published by international agencies, but undertaken by external researchers using mixed-method approaches. While the evidence reviewed was of good quality, there were also certain limitations to the content provided. The review found major challenges in assessing the impact of a national systems-based approach to child protection are the current limitations in both the availability and quality of evidence (Krueger et al. 2014; Krueger 2014: 30; Combaz 2013: 1). Firstly, in terms of availability of evidence, in many state-based contexts, there is ‘almost non-existent data’ available on the effectiveness of systems in delivering outcomes for children (Stuckenbruck 2018: 19). It is due to the relatively recent establishment of a systems approach to child protection limiting the amount of data available (Wessells, 2014; Krueger et al., 2014) and the low capacity of existing national systems to gather and process data (UNICEF 2015a: 15; UNICEF 2015c: 16; Combaz 2013: 3; Stuckenbruck 2018: 21; De Sas Kropiwnicki, 2012). Secondly, in terms of quality, there are a number of underpinning challenges, including variable definitions of systemic approaches to child protection and an inadequate consideration of contextual factors as part of programme design. Further to this, where evidence is available, the bulk of evaluative documentation focusses on programme effectiveness in terms of establishing necessary child protection mechanisms rather than in terms of impact on child protection outcomes (Wessells 2014; Combaz 2013: 4). In general, available evidence on effectiveness of child protection systems in low resource settings does not provide substantial information on the links between given systemic development practices and improved outcomes and impact for children (Combaz 2013: 1-2). Given the lack of consistency and comparability in both systematic approaches and the evidence base, it is difficult to generalise on what is effective and what is not in child protection programmes (Davis et al., 2012: 9; De Sas Kropiwnicki, 2012). In this context, it is difficult to definitively point to a specific national system that could be defined as effective. Instead, it may be more useful to focus on specific strategies that have been found to be effective in limited resource contexts (Crispin 2018). A 2012 UNICEF meta-synthesis points to a range of programme-specific factors that contribute to or shape effectiveness in child protection systems in low-resource settings (De Sas Kropiwnicki, 2012)

Alien Registration- Maslen, Helen L. (Madison, Somerset County)

https://digitalmaine.com/alien_docs/7096/thumbnail.jp

Child Domestic Work

The definition of Child Domestic Work (CDW) is contested. Whilst international law defines children as any person under the age of 18 years old, in some countries, the national minimum age to work can be as low as 14 years old. Furthermore, socio-cultural patterns and national level policies add an additional dimension to how CDW is viewed, measured and reported. Despite these variations, as an overview, child domestic work is a general reference to children’s work in the domestic work sector in the home of a third-party or employer. The International Labour Organisation’s (ILO) and UNICEF conventions provide the main framework for definitions. This Helpdesk Report discusses the following questions: What different approaches exist to defining child labour in domestic work? What data is available regarding the numbers of children and households that are involved in domestic child labour? How does the prevalence of domestic child labour differ across countries? What approaches of data collection methods have been used and what are the data limitations

A longitudinal study of alcohol use and antisocial behaviour in young people

Aims: To examine the direction of causation between young people's antisocial behaviour and alcohol (mis)use in the longer and shorter term, together with their joint effects on alcohol-related trouble. Methods: A longitudinal study (2586 pupils) supplied data, allowing exploration of the causal effects of alcohol (mis)use and antisocial behaviour between ages 11 and 15, using structural equation models of longer and shorter-term relationships and joint-effects models in respect of alcohol-related trouble at age 15. This method allowed us to evaluate which of three hypotheses, described as ‘disinhibition’ [alcohol (mis)use causes or facilitates antisocial behaviour], ‘susceptibility’ [antisocial behaviour causes alcohol (mis)use] or ‘reciprocal’ [alcohol (mis)use causes antisocial behaviour and the reverse] receives most support, both overall and by gender, social class, and drinking context. Results: Overall, the results support the susceptibility hypothesis, particularly in the longer-term models. There is no support for ‘pure’ disinhibition. However, in the shorter-term and joint-effects models (i.e. as the time lag becomes shorter), there is evidence that in some gender, social class, or drinking contexts, in addition to antisocial behaviour causing alcohol (mis)use, the reverse also applies. Conclusions: Antisocial behaviour is the main predictor of alcohol (mis)use and alcohol-related trouble, with alcohol (mis)use impacting only modestly on antisocial behaviour and alcohol-related trouble in the shorter term

Teams, HRM and innovation:an organisation-level analysis

For organizations to survive and prosper they have to develop new and improved products, services and ways of working. Innovation is vital for organizational survival. Much research and managerial attention is therefore devoted to understanding the factors that predict innovation in organizations. This paper describes a research study of product innovation in manufacturing organizations and explores the extent to which team based working and team working effectiveness in these organizations predict product innovation. It also considers whether combinations of good HRM systems and practices, extensive team based working and effective team working are associated with product innovation

Control of fungal plant disease using inhibitors of polyamine biosynthesis

The effects of a number of inhibitors of polyamine biosynthesis on the growth of two species of biotrophic fungi, five species of necrotrophic fungi and one hemibiotroph were studied. The fungi used were: 1. Erysiphe qraminis DC. ex Merat f.sp. hordei Marchal 2. Ustilago maydis (DC.) Corda 3. Pythium ultimum Trow 4. Septoria nodorum (Berk.) Berk, apud and Br. 5. Pyrenophora teres Drechsler 5. Gaeumannomyces qraminis (Sacc.) v. Arx and Olivier f.sp. tritici Walker 7. Fusarium culmorum (W.G.Sm.) Sacc. 8. Phytophthora infestans (Montague) de Bary. The work carried out involved the following inhibitors: 1. 2-difluoromethylornithine (DFMO) 2. (E)-2-(fluoromethyl) dehydroornithine (Delta-MFM) 3. (E)-2-(fluoromethyl) dehydroornithine methyl ester (Delta-MFMO.Me) 4. (2R, 5R)-6-heptyne-2, 5-diamine (RR-MAP) 5. 2-hydrazinoornithine 6. 2-difluoromethylarginine (DFMA) 7. Methylglyoxal-bis (guanylhydrazone) (MGBG) 8. Cyclohexylamine (CHA) Compounds 1-5 are inhibitors of ornithine decarboxylase, 6 inhibits arginine decarboxylase, 7 is an inhibitor of S-adenosylmethionine decarboxylase and 8 inhibits spermidine synthase. The effects of each of these inhibitors on infection of barley leaves by mildew were examined. Leaves of barley cv. Golden Promise were sprayed with various concentrations of the inhibitors as post-inoculation treatments. DFMO, MGBG and a combination of the two were also applied as pre-inoculation treatments. All of the inhibitors significantly reduced mildew infection. With the exception of the DFMA treatments, post-inoculation sprays were more effective than pre-inoculation ones. When DFMO, MGBG and DFMA were sprayed onto leaves at different time intervals, DFMO and MGBG most effectively controlled mildew when sprayed on the third day after inoculation. DFMA was more efficient as a pre-inoculation treatment. Addition of polyamines to DFMO sprays increased mildew infection compared to that resulting from the DFMO treatment alone, although infection was less than in the control. Whereas pre-inoculation sprays of putrescine and spermidine resulted in an increase in mildew infection by the final day of measuring, the post-inoculation treatments of polyamines reduced mildew growth. Several of the inhibitors (1-4 and 5-8) were used to examine their effects on growth of the remaining fungi in vitro. This was achieved by supplementing growth media with the inhibitors and also with polyamines, both alone and in combination with DFMO. Species-dependent responses to the inhibitors were observed and although growth of some fungi (notably G. graminis) was reduced by various inhibitors, some increases in growth were noted after treatment. This was possibly a result of secondary enzyme production or overproduction of the target enzyme, leading to an initial surge of polyamine synthesis and enhanced growth. The effects of DFMO were reversed by the addition of polyamines to the growth medium. Once it had been established that the inhibitors did have an effect on fungal growth, an attempt was made to understand the processes involved in uptake of polyamines, precursors and DFMO by the fungi. F. culmorum and G. graminis were selected for this work because of their different responses to the inhibitors. Uptake of the polyamines, ornithine and arginine appeared to be biphasic, with one system operating at low substrate concentrations and another at high substrate concentrations. DFMO was taken up linearly and was non-saturable over the concentrations studied. Uptake of the amino acids and polyamines by F. culmorum was pH dependent and competition work suggests that putrescine, spermidine and ornithine have different uptake systems. However, uptake of DFMO was inhibited in the presence of putrescine, spermidine and ornithine suggesting that its uptake may not be limited to one uptake system. The reduction in uptake of putrescine and DFMO by F. culmorum when sodium azide (a respiratory inhibitor) was added suggests a partial energy requirement. This was not the case for spermidine uptake. The fungi, when grown in the presence of DFMO did not generally show enhanced uptake of polyamines as may have been expected, perhaps because the inhibitor can be rendered relatively ineffective in long term studies by intracellular decarboxylation. Exposure to MGBG, however, resulted in a decrease in uptake, possibly due to mitochondrial damage or non-specific effects of this inhibitor. Cations present within the growth and assay media affected uptake of polyamines by both F. culmorum and G. graminis, with magnesium ions causing the greatest inhibitory effects

Developing self-authorship through participation in student research conferences

Graduate attributes are a framework of skills, attitudes, values and knowledge that graduates should develop by the end of their degree programmes. Such attributes can be integrated into both curricular and extra-curricular activities. Adopting a largely qualitative approach and using semi-structured interviews, we outline the experiences of Geography, Earth and Environmental Science (GEES) students’ experiences at a national undergraduate research conference and provide evidence for the graduate attributes developed. The students demonstrated intellectual autonomy, repurposing their work for presentation to a multi-disciplinary audience through conversation with and benchmarking against their peers. They gained confidence in expressing their identity as researchers and moved towards self-authorship, consciously balancing the contextual nature of their disciplinary knowledge with intra-personally grounded goals and values. The undergraduate research conference thereby offers students an opportunity to begin to construct their professional identities during their studies, potentially helping them to navigate into their working and wider social lives