Empowering Young People: Multi-Disciplinary Expressive Interventions Utilising Diamond9 Evaluative Methods to Encourage Agency in Youth Justice

The article adopts a mixed method approach to evaluating sports and arts-based interventions within Secure Children’s Homes in England and Wales; an under-researched area of the criminal justice system. The research adopts the innovative Diamond9 model and semi-structured interviews to evaluate the study. This is the first time the model has been adopted within a Secure Children’s Home. The results provide an original insight into the voice of this currently underrepresented demographic of the Secure Estate, and highlight future approaches to evaluating rehabilitative models for this hard to reach group.Keywords: Dance interventions; Diamond9; Secure Children’s Homes; Sports interventions; Young People

Legislative approaches to recognising the vulnerability of young people and preventing their criminalisation

Discusses the introduction by the Modern Slavery Act 2015 s.45 of a specific defence for children over the minimum age of criminal responsibility, (MACR) but under 18, which recognises their vulnerability, and considers its wider implications. Reviews the politicisation of youth crime, the role of the media, the position in Scotland and Wales, and the arguments for raising the MACR and introducing a further defence of developmental immaturity. Legislation cited Modern Slavery Act 2015 (c.30)s.4

A virtual patient educational programme to teach anticoagulant counselling to pharmacists: A qualitative evaluation

Introduction: Integrated undergraduate health professions curricula aim to produce graduates who are prepared to meet current and future healthcare needs. Integration is advocated by pharmacy regulators as the perceived optimum way of preparing students for first registration as pharmacists. Integration can be described by model of integration; horizontal, vertical or spiral, themes for integration or by integrative teaching and learning approaches. Harden's integration ladder has been operationalised by the General Pharmaceutical Council as three levels: “fully”, “partially” and “not integrated” curricula1. Aim: This scoping review aimed to explore health professions education literature to inform the design of integrated pharmacy curricula. This review asks: what is meant by integration in health professions curricula? Method: The Arksey and O'Malley scoping review framework was utilised2. Ovid MEDLINE, Embase, Scopus, Web of Science and ERIC were searched for studies published up to May 2018. Research papers were eligible for inclusion if they described curriculum integration in undergraduate health professions curricula. Models of integration, themes for integration, teaching and learning approaches and level of integration were defined to support data extraction. Results: 9345 studies were identified and 136 were included. 12.5% of included studies included a definition of integration. The majority of studies described horizontal integration (n = 87). Various teaching and learning approaches were described, including experiential (n = 43), case‐based (n = 42) and problem‐based (n = 38) learning. Systems‐based teaching (n = 56) was the most common theme reported. The majority of curricula were classified as “partially integrated” i.e. levels 5–7 on Harden's ladder (n = 101). 81 studies reported perception outcomes. Only three studies reported outcomes beyond perception. Reported outcomes were mostly positive and included knowledge gains, increased appreciation of relevance, increased motivation and improved communication. Increased stress, difficulty understanding basic concepts and time constraints were also reported. Conclusions: Various themes for integration and integrative teaching and learning approaches are used. A lack of evidence for integration remains due to reliance on perception data. There is a need for integration to be explicitly defined by curriculum developers and researchers. Attention should be given to model, theme, teaching and learning approach, level of integration and outcomes

Exploration of prescribing error reporting across primary care: a qualitative study

Objectives To explore barriers and facilitators to prescribing error reporting across primary care. Design Qualitative semi-structured face-to-face and telephone interviews were conducted to explore facilitators and barriers to reporting prescribing errors. Data collection and thematic analysis were informed by the COM-B model of behaviour change. Framework analysis was used for coding and charting the data with the assistance of NVivo software (V.12). General and context specific influences on prescribing error reporting were mapped to constructs from the COM-B model (ie, capability, opportunity and motivation). Setting Primary care organisations, including community pharmacy, general practice and community care from North East England. Participants We interviewed a maximal variation purposive sample of 25 participants, including prescribers, community pharmacists and key stakeholders with primary care or medicines safety roles at local, regional and national levels. Results Our findings describe a range of factors that influence the capability, opportunity and motivation to report prescribing errors in primary care. Three key contextual factors are also highlighted that were found to underpin many of the behavioural influences on reporting in this setting: the nature of prescribing; heterogeneous priorities for error reporting across and within different primary care organisations; and the complex infrastructure of reporting and learning pathways across primary care. Findings suggest that there is a lack of consistency in how, when and by whom, prescribing errors are reported across primary care. Conclusions Further research is needed to identify cross-organisational and interprofessional consensus on agreed reporting thresholds and how best to facilitate a more collaborative approach to reporting and learning, that is, sensitive to the needs and priorities of disparate organisations across primary care. Despite acknowledged challenges, there may be potential for an increased role of community pharmacy in prescribing error reporting to support future learning

Prescribing error reporting: Facilitating learning and patient safety across primary care [Conference abstract]

Background: In the UK, prescribing errors originating from general practice and other community services are often identified and rectified within community pharmacy. Organisational structures withinNHS primary care mean that boundaries between these independentorganisations may act a barrier to supporting error reporting and potential learning. Aim: This study aimed to identify key facilitators and barriers to facilitating cross-organisational reporting and learning across primary care and to explore the potential role of community pharmacy within this. Methods: Qualitative semi-structured face to face and telephone interviews (n = 16) were conducted with a purposive sample of pharmacists, primary care prescribers, and other key stakeholdersfrom across North East England. Interviews explored: facilitators and barriers to prescribing error reporting in primary care; the influence of decision-making processes and healthcare context; and the potential of community pharmacy in optimising prescribing error reporting and learning. Data collection and analysis were underpinned by the Theoretical Domains Framework. Framework analysis was used for coding and charting the data with the assistance of NVivo software. Results: Decision-making processes, practices, and beliefs around which prescribing errors are deemed to be “significant” in relation toreporting and associated learning were found to differ significantly across and within different primary care settings. It was acknowledged that primary care organisations hold different approaches to risk and risk management and that community pharmacy could play a larger role in the identification of wider prescribing error patterns. Within general practice, the focus on prescribing errors reporting and learningwas mainly described within “significant event” and quality improvement paradigms. In community pharmacy, there was a focus on “prescribing interventions” (i.e. checking prescriptions and rectifying errors with the prescriber) rather than reporting and a clear distinction between the usual reporting processes for dispensing and prescribing errors. This was due to regulatory processes and contractual frameworks as well as beliefs, often based on organisational boundaries, about who “owned” and was responsible for the error. Community prescribers that sit under the remit of secondary care followed standard trust procedures in relation to error reporting. Key barriers to prescribing error reporting and learning include organisation culture and beliefs relating to stigma and blame; concerns about the potential impact on working relationships; heterogeneous regulatory and reporting processes and responsibility for the identification of error patterns; lack of feedback from standard reporting systems; beliefs about the significance and learning potential associated with different error types; and a lack of time and resources. Conclusion: There seems to be a lack of clarity and consistency across primary care in relation to beliefs about whose responsibility it is to report prescribing errors, which errors should be reported, how, when,and to where. There is acknowledged potential to facilitate learning and improve the quality of prescribing by sharing cross-organisational knowledge on prescribing errors and significant events, as well as patterns of inappropriate prescribing. Feedback and learning needs to have a local focus, be perceived to have positive and significant potential to change practice, and be tailored appropriately to each setting

Cryoprecipitate transfusion in trauma patients attenuates hyperfibrinolysis and restores normal clot structure and stability : Results from a laboratory sub-study of the FEISTY trial

Acknowledgements We acknowledge the Aberdeen Microscopy and Histology Core Facility and thank Judith de Vries for her guidance in analysing the confocal images. We thank Megan Simpson for measuring PAI-1 and uPA antigen levels in the fibrinogen preparations. We thank all of the FEISTY research staff who collected and processed the patient samples. Funding This work was supported by research grants from CSL Behring and Tenovus Scotland.Peer reviewedPublisher PD

Re-imagining secure children’s home design to improve outcomes for children

Executive Summary: This policy brief provides policy recommendations on the internal design of new Secure Children’s Homes (SCHs). These policy recommendations are developed from findings from focus group discussions with academics, practitioners, frontline workers, and leaders in child protection services

Keep Safe: collaborative practice development and research with people with learning disabilities

Purpose: This collaborative paper (working together) describes collaborative practice development and research by and with people from the learning disabilities community. This paper aims to show some of the activities which supported the collaborative practice development and research to show and encourage others to do more collaboration. The paper format is based on a previous collaborative paper published in the Tizard Learning Disability Review (Chapman et al., 2013). Design/methodology/approach: The collaborative practice development and feasibility study [1] focuses on an intervention called Keep Safe. This is an intervention for young people with learning disabilities who are 12 years and older and have shown “out-of-control” or harmful sexual behaviour. Findings: The paper gives examples of activities of the Keep Safe Advisory Group in planning, doing and thinking about Keep Safe development and feasibility. The authors list some good things and some difficulties in collaborating. They look at which parts of Frankena et al.’s (2019a) Consensus Statement on how to do inclusive research were done, which ones were not, and why. Social implications The paper ends with some thoughts about collaborating with people from the learning disabilities community: for people with learning disabilities, practitioners and researchers. Originality/value: The paper is original in its illustration of collaborative practice development and research and measuring the activities against the inclusive research consensus statement