The Chinese Inquisition: Xi Jinping\u27s War on Corruption

An integral part of Chinese political life is the rampant corruption that infests every level of Chinese government. China\u27s current leader, Xi Jinping, has initiated a hardline anti-corruption campaign that, for the first time in history, has targeted both low-level officials (small flies) and high-level officials (big tigers). This thesis is concerned with the factors that have motivated Xi to initiate these unprecedented reforms. I have identified three potential motivations: office, policy, and legitimacy. The office motivation refers to Xi\u27s attempt to consolidate his own power as leader of China, as well as the power of his political faction, represented by how many positions of power they hold. Xi may also be trying to achieve a policy goal in one of three areas: monetary policy, policy concerning economic development, or policies to bolster legitimacy. Finally, legitimacy is concerned with the legitimacy of the Chinese Communist Party, which has deteriorated with the spread of corruption. I posit that Xi is driven by all three motivations, which I seek to prove by doing a survey of the media concerning the general situation surrounding the swatting of little flies, as well as a series of case studies, one for each of the big tigers that have been caught in Xi\u27s campaign. Through this analysis, I have arrived at two conclusions. First, based on the evidence collected, Xi is driven by all three motivations, as they are all interconnected. Secondly, as to the specific kind of policy Xi is trying to adopt, there is evidence for the initiation of economic development policies and legitimacy policies, although there was no mention of monetary policy. Unfortunately, these results are only speculation at best. The study of corruption is notorious for its inherent lack of transparency; this fact, coupled with the Chinese government\u27s lack of transparency, make Chinese corruption particularly difficult to study with any measure of certainty. Thus, we cannot discern what has motivated Xi to initiate his anti-corruption campaign, and may never know

Characteristics and costs of individuals experiencing severe hypoglycaemia requiring emergency ambulance assistance in the community

Background and aims: Hypoglycaemia causes considerable a burden to individuals the healthcare providers. The aim of this study was to examine clinical characteristics of individuals requiring emergency medical assistance by ambulance services for an episode of severe hypoglycaemia and to estimate provider costs of hypoglycaemia. Materials and methods: Routinely collected information was retrieved for all episodes of severe hypoglycaemia attended to by the emergency ambulance services for a population of 367,051 people, including 75,603 people with diabetes, in Nottinghamshire and Derbyshire, UK, between 01/11/10 to 28/02/11. A total of 90,435 emergency calls were received in the study period, of which 523 (0.6%) were recorded as severe hypoglycaemia. The time to response, on-site treatment and hospitalisation were recorded along with standard clinical and blood glucose (BG) measures. Ambulance services costs were calculated. Results: The mean (SD) [proportion <= 3.2 mmol/L] pre and post-treatment BG levels were 1.9 (0.9) mmol/L [92%] and 6.5 (3.1) mmol/L [3%] respectively, 74% were under insulin treatment, 28% had nocturnal hypoglycaemia, and 153 (32%) individuals were transported to hospital. Lower pre-treatment BG (p<0.01) and Glasgow Coma Scale scores (p=0.05) were observed in insulin treated individuals in comparison to non-insulin treated individuals. No significant differences in individual characteristics were observed for other clinical measurements: post-treatment blood glucose (p=0.39), systolic blood pressure (p=0.28), diastolic blood pressure (p=0.64) and heart rate (p=0.93). Non insulin treatment was an independent predictor of transportation to hospital (p<0.01). Median time from allocation of call to departure of scene by ambulance services was 39 and 59 minutes for those transported and not transported to hospital respectively, translating to costs of £92 and £139 respectively. The median time from allocation to handing over patients to emergency staff was 75 minutes, equating to a cost of £176. Conclusion: The majority of cases of severe hypoglycaemia are successfully treated at the scene by the emergency ambulance services. Insulin treated and non insulin treated individuals do not differ by clinical characteristics, however non insulin treated individuals were more likely to be transported to hospital. Further studies are needed into the effect of prehospital ambulance care by treatment type on subsequent outcomes

Adolescents' experiences of isolation in cystic fibrosis

Cystic fibrosis (CF) infectious isolation guidelines and clinical recommendations exist in standards of CF care to reduce the risk of cross-infection between individuals with CF. Chronic infection is associated with deterioration in lung function and increased rates of morbidity and mortality, thus preventing and reducing cross-infection is a concern for individuals with CF. Understanding the bio-psychosocial implications of isolation is vital to developing and providing holistic approaches to CF care. This study aimed to make sense of how adolescents with CF understand and experience infectious isolation during their care. Qualitative, semistructured interviews were conducted with 9 adolescents, aged 12 to 19 years old, with a diagnosis of CF who had experienced isolation. Interviews were analyzed using inductive thematic analysis. Participants experienced difficulty adjusting to living with isolation and attempted to integrate their isolation experiences. Isolation highlighted a sense of threat posed by cross-infection, a threat which participants experienced as originating from others and from themselves to others. Participants described striving to protect themselves and others from this threat. Isolation also appeared to exacerbate differences participants noticed between themselves and others without CF. For adolescents with CF, isolation is not a neutral experience. Adolescents reported difficulty understanding isolation and challenges associated with this experience across settings. Given these difficulties, multidisciplinary teams should increase awareness, understanding and discussion about the psychosocial impact of isolation among those with CF, their families and wider systems, to promote optimal bio-psychosocial outcomes. Future research could explore experiences of isolation from children, family and staff perspectives

An evaluation of multi-station Objective Structured Clinical Examination (OSCE) in clinical psychology training

This evaluation explored first year clinical psychology trainees’ and assessors’ experiences of Observed Structured Clinical Examination (OSCE). Changes to the OSCE based on their feedback helped reduce trainees’ anxiety, promoted trainees’ favourability of the OSCE and increased preparedness for placements

Birdwatching

Birdwatching is a practice-based project in which Carter and Fisher work in association to produce a suite of monotypes. The authorship of the works is shared where no aspect of the work belongs to either of the participating artists. Each artist contributed imagery, drawn from their independent research, then devised a methodology informed by antiphonal birdsong. Carter uses gesture, drawn from birdsong, transcribed in the landscape. Fisher uses images of birds as a recurring metaphor- a cipher for ideas to do with flight, freedom and love

Secondary analyses to test the impact on inequalities and uptake of the schools-based human papillomavirus (HPV) vaccination programme by stage of implementation of a new consent policy in the south-west of England

Objectives To test the impact on inequalities and uptake of the schools-based human papillomavirus (HPV) vaccination programme by stage of implementation of a new policy providing additional opportunities to consent.Setting Two local authorities in the south-west of England.Participants Young women (n=7129) routinely eligible for HPV vaccination aged 12–13 years during the intervention period (2017/2018 to 2018/2019 programme years).Interventions Local policy change that included additional opportunities to provide consent (parental verbal consent and adolescent self-consent).Outcomes Secondary analyses of cross-sectional intervention data were undertaken to examine uptake by: (1) receipt of parental written consent forms and; (2) percentage of unvaccinated young women by stage of implementation.Results During the intervention period, 6341 (89.0%) eligible young women initiated the HPV vaccination series. Parental written consent forms were less likely to be returned where young women attended alternative education provider settings (p&lt;0.001), belonged to non-white British ethnic groups (p&lt;0.01) or more deprived quintiles (p&lt;0.001). Implementation of parental verbal consent and adolescent self-consent reduced the percentage of unvaccinated young women from 21.3% to 16.5% (risk difference: 4.8%). The effect was greater for young women belonging to the most deprived compared with the least deprived quintile (risk difference: 7.4% vs 2.3%, p&lt;0.001), and for young women classified as Unknown ethnic category compared with white British young women (6.7% vs 4.2%, p&lt;0.001). No difference was found for non-white British young women (5.4%, p&lt;0.21).Conclusions Local policy change to consent procedures that allowed parents to consent verbally and adolescents to self-consent overcame some of the barriers to vaccination of young women belonging to families less likely to respond to paper-based methods of gaining consent and at greater risk of developing cervical cancer.Trial registration number 49 086 105

Impact of new consent procedures on uptake of the schools-based Human Papillomavirus (HPV) vaccination programme

BACKGROUND: Local policy change initiating new consent procedures was introduced during 2017–2018 for the human papillomavirus (HPV) vaccination programme year in two local authorities in the south–west of England. This study aims to assess impact on uptake and inequalities. METHODS: Publicly available aggregate and individual-level routine data were retrieved for the programme years 2015–2016 to 2018–2019. Statistical analyses were undertaken to show: (i) change in uptake in intervention local authorities in comparison to matched local authorities and (ii) change in uptake overall, and by local authority, school type, ethnicity and deprivation. RESULTS: Aggregate data showed uptake in Local Authority One increased from 76.3% to 82.5% in the post-intervention period (risk difference: 6.2% P = 0.17), with a difference-in-differences effect of 11.5% (P = 0.03). There was no evidence for a difference-in-differences effect in Local Authority Two (P = 0.76). Individual-level data showed overall uptake increased post-intervention (risk difference: +1.1%, P = 0.05), and for young women attending school in Local Authority One (risk difference: 2.3%, P < 0.01). No strong evidence for change by school category, ethnic group and deprivation was found. CONCLUSION: Implementation of new consent procedures can improve and overcome trends for decreasing uptake among matched local authorities. However, no evidence for reduction in inequalities was found. IMPLICATIONS AND DISCUSSION: The new consent procedures increased uptake in one of the intervention sites and appeared to overcome trends for decreasing uptake in matched sites. There are issues in relation to the quality of data which require addressing