Disjointed Service: An English Case Study of Multi-Agency Provision in Tackling Child Trafficking

This paper examines the issue of child trafficking in the United Kingdom and of multi-agency responses in tackling it. The UK, as a signatory to the recent trafficking protocols, is required to implement measures to identify and support potential victims of trafficking - via the National Referral Mechanism. Effective support for child victims is reliant on cooperation between agencies. Our regional case-study contends that fragmented agency understandings of protocols and disjointed partnership approaches in service delivery means the trafficking of vulnerable children continues across the region. This paper asserts that child-trafficking in the UK, previously viewed as an isolated localised phenomenon, maybe far more widespread, revealing deficiencies in child protection services for vulnerable children

Inside youth justice : conflict and contradiction in the remand management of young offenders

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Relative Impact of Highway Construction on Wetland Hydrology in Environmentally Sensitive Areas in Southeast Louisiana

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Simplifying External Load Data in NCAA Division-I Men\u27s Basketball Competitions: A Principal Component Analysis

The primary purpose was to simplify external load data obtained during Division-I (DI) basketball competitions via principal component analysis (PCA). A secondary purpose was to determine if the PCA results were sensitive to load demands of different positional groups (POS). Data comprised 229 observations obtained from 10 men\u27s basketball athletes participating in NCAA DI competitions. Each athlete donned an inertial measurement unit that was affixed to the same location on their shorts prior to competition. The PCA revealed two factors that possessed eigenvalues \u3e1.0 and explained 81.42% of the total variance. The first factor comprised total decelerations (totDEC, 0.94), average speed (avgSPD, 0.90), total accelerations (totACC, 0.85), total mechanical load (totMECH, 0.84), and total jump load (totJUMP, 0.78). Maximum speed (maxSPD, 0.94) was the lone contributor to the second factor. Based on the PCA, external load variables were included in a multinomial logistic regression that predicted POS (Overall model, p \u3c 0.0001; AUCcenters = 0.93, AUCguards = 0.88, AUCforwards = 0.80), but only maxSPD, totDEC, totJUMP, and totMECH were significant contributors to the model\u27s success (p \u3c 0.0001 for each). Even with the high significance, the model still had some issues differentiating between guards and forwards, as in-game demands often overlap between the two positions. Nevertheless, the PCA was effective at simplifying a large external load dataset collected on NCAA DI men\u27s basketball athletes. These data revealed that maxSPD, totDEC, totJUMP, and totMECH were the most sensitive to positional differences during competitions. To best characterize competition demands, such variables may be used to individualize training and recovery regimens most effectively

New speakers: Challenges and opportunities for variationist sociolinguistics

While the field of variationist sociolinguistics has advanced rapidly since Labov (1966), it remains the case that a socially informed theory of language change continues to be influenced by only very few languages, typically English and a handful other dominant European languages. This article considers recent work on the emergence of new speakers in (severely) endangered or minority language communities, and what they might have to offer variationist theory. Although definitions can vary, it has become convention to describe new speakers as individuals ‘with little or no home or community exposure to a minority language but who instead acquire it through immersion or bilingual education programs, revitalization projects or as adult language learners’ (O'Rourke, Pujolar, & Ramallo, 2015: 1). There is now a wealth of literature available on new speakers in typologically dissimilar language contexts, though, so far, very little work has adopted the variationist paradigm. This article will argue that new speakers can figure prominently in variationist models of diffusion and change, taking the classic sociolinguistic factor of social networks as an example. The article ends by proposing a manifesto of potential research trajectories, based on current gaps in the literature

Ablation of paroxysmal atrial fibrillation using a second‐generation cryoballoon catheter or contact‐force sensing radiofrequency ablation catheter: A comparison of costs and long‐term clinical outcomes

IntroductionAlthough noninferiority of cryoballoon ablation (CBA) and radiofrequency catheter ablation for antral pulmonary vein isolation (APVI) has been reported in patients with paroxysmal atrial fibrillation (PAF), it is not clear whether contact force sensing (CF‐RFA) and CBA with the second‐generation catheter have similar procedural costs and long‐term outcomes. The objective of this study is to compare the long‐term efficacy and cost implications of CBA and CF‐RFA in patients with PAF.Methods and resultsA first APVI was performed in 146 consecutive patients (age: 63 ± 10 years, men: 95 [65%], left atrial diameter: 42 ± 6 mm) with PAF using CBA (71) or CF‐RFA (75). Clinical outcomes and procedural costs were compared. The mean procedure time was significantly shorter with CBA than with CF‐RFA (98 ± 39 vs. 158 ± 47 minutes, P < 0.0001). Despite a higher equipment cost in the CBA than the CF‐RFA group, the total procedure cost was similar between the two groups (P = 0.26), primarily driven by a shorter procedure duration that resulted in a lower anesthesia cost. At 25 ± 5 months after a single ablation procedure, 51 patients (72%) in the CBA, and 55 patients (73%) in the CF‐RFA groups remained free from atrial arrhythmias without antiarrhythmic drug therapy (P = 0.84).ConclusionsThe procedure duration was approximately 60 minutes shorter with CBA than CF‐RFA. The procedural costs were similar with both approaches. At 2 years after a single procedure, CBA and CF‐RFA have similar single‐procedure efficacies of 72–73%.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142442/1/jce13378_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142442/2/jce13378.pd

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine