Diffusion theory and multi-disciplinary working in children’s services

Purpose The purpose of this paper is to explore how innovation in children’s services is adopted and developed by staff within new multi-disciplinary children’s safeguarding teams. It draws on diffusion of innovations (DOI) theory to help us better understand the mechanisms by which the successful implementation of multi-disciplinary working can be best achieved. Design/methodology/approach It is based on interviews with 61 frontline safeguarding staff, including social workers, substance misuse workers, mental health workers and domestic abuse workers. Thematic analysis identified the enablers and barriers to implementation. Findings DOI defines five innovation attributes as essential for rapid diffusion: relative advantage over current practice; compatibility with existing values and practices; complexity or simplicity of implementation; trialability or piloting of new ideas; and observability or seeing results swiftly. Staff identified multi-disciplinary team working and group supervision as advantageous, in line with social work values and improved their service to children and families. Motivational interviewing and new ways of case recordings were less readily accepted because of the complexity of practicing confidently and concerns about the risks of moving away from exhaustive case recording which workers felt provided professional accountability. Practical implications DOI is a useful reflective tool for senior managers to plan and review change programmes, and to identify any emerging barriers to successful implementation. Originality/value The paper provides insights into what children’s services staff value about multi-disciplinary working and why some aspects of innovation are adopted more readily than others, depending on the perception of diffusion attributes.

The synthesis, spectroscopic and electrochemical characterisation of Ru(II) polypyridyl complexes containing hydroquinone

A range of mononuclear and dinuclear [Ru(bpy)2L]+ and [Ru(bpy)2(L)Ru(bpy)2]2+ complexes where L is 3(2’,5,-dimethoxyphenyl)-5-(pyndm-2’’-yl)-lH-r,2’,4’-tnazole, 3 (2 \ 5 ’ -dimethoxyphenyl)-5-(pyrazin-2”-yl)-1H-1’ ,25,4 ’ -tnazole, l,4-bis(5’-(pyndin-2”- yl)-1H-1’ ,2 ’ ,4’ ,-tnazol-35 -yl)-2,5-dimethoxyphenyl, l,4-bis(5’-(pyrazin-2,,-yl)-lHr ,2 ,,4,r tnazol-3’-yl)-2,5-dimethoxyphenyl and their hydroquinone and qumone analogues are reported in this thesis. Chapter one is an introductory chapter, which provides relevant background information and assists in placing the ideas and data contained in the main body of this thesis in context, while chapter two denotes the methods and procedures employed during the synthesis and characterisation of the complexes presented in the subsequent chapters. In chapter three the first group of ruthenium (II) polypyndyl complexes are described. These complexes are characterised by the presence of tnazole moieties and a dimethoxyphenyl group. These dimethoxyphenyl compounds represent model complexes for examination of the ensuing hydroquinone and qumone complexes. Synthesis of the hydroquinone and qumone complexes was also achieved via these dimethoxyphenyl counterparts. Chapter four pertains to the synthesis and charactensation of the mononuclear and dinuclear hydroquinone complexes, which differ only from the dimethoxyphenyl complexes by the presence of a dihydroxyphenyl group. These complexes exhibit behaviour comparable in a number of ways to their dimethoxy analogues except for additional redox processes in the anodic region of their cyclic voltammograms. These dihydroxyphenyl complexes also display interesting spectroelectrochemical behaviour, which was not noted in the spectra of the protected analogues, and that hence may be indicative of proton transfer between the hydroquinone and tnazole moieties. The synthesis and charactensation of the qumone complexes, which contain qumone moieties in place of the dihydroxy groups, is descnbed in chapter five. There is no quenching of the excited state noted for these complexes. All of the compounds obtained have been charactensed using [HNMR, IR, UV/Vis and emission spectroscopies both at room and low temperatures and in neutral and acidic media. The acid-base properties of each of the complexes have also been investigated in aqueous solutions. The electronic structures of the mononuclear pyndine containing qumone and hydroquinone complexes have been examined using Gausssum and DOS spectra have hence been generated in order to ascertain the nature of the HOMO and LUMO levels. In the final chapter, chapter six, a comprehensive examination of the behaviour of the range of complexes is provided and a number of observations and conclusions are proffered along with suggestions for future work. Generally, the behaviour of each of the complexes was found to differ depending both on whether the complex contained a pyrazyl or a pyndyl group and on the nature of the pendant phenyl moiety Emission, lifetime, electrochemical and spectroelectrochemical analyses of the pyrazine containing complexes suggest that switching of the excited states of these complexes from the bipyndyl moiety to the ligand occurs upon protonation of the complex. Three appendices are also provided the first of which, appendix I, contains additional NMR data Appendix II contains in-depth electrochemical studies exploring solvent conditions and identifying the optimum working-electrode Finally, appendix III compnses of additional syntheses undertaken dunng these studies, which have not been included in the mam body of the thesi

Judith Weir\u27s King Harald\u27s Saga: innovations of character and virtuosity in contemporary opera

In 1979, Scottish-born composer Judith Weir wrote King Harald’s Saga for the soprano Jane Manning. Although an opera in three acts, the cast consists of one performer unaccompanied, interpreting various characters, including the protagonist, King Harald, two of his wives, and the entire Norwegian Army. The opera presented in its entirety is ten minutes in duration. The scope of this paper is intended to assist the performer as well as those who are interested in contemporary opera. I have provided a brief overview of Weir’s compositional style in opera, chamber opera and song. As King Harald’s Saga was Weir’s first opera, I have also observed ways in which it influenced these subsequent vocal works. After my interview with Weir, she provided two inspirations for King Harald’s Saga: Grand Opera of Verdi and Wagner, and Icelandic Saga. Although disparate in nature, further investigations in my analysis show many striking similarities. Both evoke a detached aesthetic stance, as in telling a story, and both are filled with grandiose characterizations. This analysis also discusses how the format of the literature influenced the format of the operatic structure. Background information regarding Icelandic Saga is provided to clarify the explanations and observations of the composer. In addition, I have also provided a thorough analysis of the musical score, including many musical examples to clarify my observations. As each character is given one movement or number in the score (except for Harald), the overall format of the analysis is organized by character. Issues of tonality are addressed with reference to the intentions of the composer, and information as to pitch center, meter, and vocal expression are derived solely from composer’s notes and the vocal line itself

Coming to grips with student mobility and policy implications: a case study from regional Queensland

In 2008, in what could be considered a significant shift in Australian education policy, Rudd and Gillard stated that,"'business as usual' in Australian schools will not, by itself, substantially lift educational outcomes, particularly in low SES communities" (2008, p.26). They highlighted the need for schools to not only "commit to excellence in teaching and learning within the classroom, but . . . be prepared to address the range of external factors that impact on students' ability to engage in learning"(ibid). This paper summarises some of the issues exposed through a collaborative research project with schools related to one set of external factors in lower socio-economic communities - student mobility or movement of students between schools. Taking a policy research perspective, informed by Dale(1989), Rist (2005) and Ball (1994), the paper examines the relationship between 'wider policies of the state' in particular marketisation and considers how mobility plays out in school sites, specifically school sites marked by poverty. The paper firstly presents an overview of the issues related to the measurement of mobility outlining the various ways stability within school populations has been measured. The paper argues for a measurement tool that reflects both the transactional pressure student mobility creates for schools and teachers but also the complexity conferred by poverty, suggesting that current metrics effectively mask issues of mobility within such communities. The paper then presents research findings on the work of schools and teachers in relation to mobile students. Through a detailed analysis of this work, actions are located as serving the interests of the state - technical transactions related to the Education (General Provisions) Act 2006, practical requirements related to inducting students to a new school and, most importantly, critical actions related to student learning and support needs. The use of this framework to examine the work of teachers exposes the 'complex interplay of interests' (Ball, 1997) that require visibility within any policy reform. Using Rist's (2005) notion of research as having an 'enlightenment function' the paper argues that sustained collaborative research with schools can expose the complexities of such phenomena as student mobility. In the context of renewed commitment to 'needs based funding', the paper concludes with suggested directions to support individual case management of mobile students within a social justice framework and a call for the reconsideration of the role of the state in order to reduce mobility in low SES communities

Use of Patient Diaries in pAediatric inTensive carE: UPDATE Study. A Constructivist Grounded Theory Study exploring the child, parents, and healthcare professionals’ perspectives.

Use of Patient Diaries in pAediatric inTensive carE: UPDATE Study. A Constructivist Grounded Theory Study exploring the child, parents, and healthcare professionals’ perspectives. Fiona Lynch Paediatric Intensive Care Units (PICU) are essential to paediatric healthcare, providing high medical and nursing care to children who have become critically ill. PICUs offer prompt and appropriate interventions for children who have developed physiological instability, whether following surgery, from infection, trauma, or deterioration of a chronic condition. A stay in a PICU is not without potential psychological consequences for the child and family. Interventions to support recovery from the psychological impact of critical illness for the child and their family are evolving. Studies undertaken in adult and children’s intensive care have explored interventions that may reduce the psychological impact of critical illness for the patient and their relatives, such as patient diaries. The impact of patient diaries is still emerging in PICUs, and a clear picture of how this intervention is used is the logical next step. Therefore, this study aimed to ascertain how PICU patient diaries are used by critically ill children, their families, and healthcare professionals during and after admission into the PICU. Constructivist grounded theory (Charmaz, 2006) was identified as the most appropriate methodology to study how the child, their family and the teams caring for them used patient diaries. The methods of intensive interviews and focus group interviews were adopted to generate rich data from the participants. Two intensive consecutive interviews were conducted with children and their family. The first interviews were conducted during the admission to the PICU and then repeated approximately five to six months post-discharge from the hospital. In total, 11 interviews were conducted during the admission to the PICU and six interviews post-discharge from the PICU. Only one child was interviewed as a participant in this study. Five separate focus group interviews were conducted with healthcare professionals to ascertain their views on the use and usefulness of the diaries. In total, 95 HCPs were recruited for the five focus group interviews, with four conducted in the PICU and one in the children’s cardiology ward. Two categories evolved from the family participants and three categories from the HCPs, leading to the development of the core category of Making Sense. Findings showed that patient diaries provided a communication tool which strengthened relationships between the parent and their child, the healthcare professionals and other family members by Creating Connections. The relationships fostered through the diaries were viewed as Impacting Emotionally on parents and HCPs. From this emotional involvement, the diary was considered to support the parents’ emotional wellbeing. From the entries made by the family members, the diaries provided insights into how families coped emotionally, allowing HCPs to provide individualised support where needed. In an environment with an imbalance of power and unfamiliar organisational processes and cultures, the diary supported parental autonomy by Empowering Involvement to make decisions. The patient diary is a tool to bridge the knowledge gap between parents and HCPs in the child’s critical illness experience. Through this use, the diary offered a compendium of information about the child’s PICU journey. Providing clear insights and explanations of their child's PICU admission, the patient diary filled any gaps in memory and offered an easily understandable permanent record. Therefore, the diary was a valuable resource supporting Making Sense of the child’s complex critical illness journey. The UPDATE study has explored the uses of PICU patient diaries from the perspective of the families and HCPs. The patient diaries were valued and offered a tool to support the family, the HCP and child in making sense of the critical illness journey. Through CGT this study has provided insights not previously understood and contributes to the evolving evidence and theory about using patient diaries for the survivors of the PICU.  Florence Nightingale FoundationUniversity Hospitals of Susse

Understanding hoarding symptoms in children with comorbid ADHD

This thesis explored the nature of hoarding symptoms in children and adolescents with comorbid ADHD. It was concluded that a correlated liabilities model may be useful in understanding the comorbidity between hoarding symptoms and ADHD, including shared executive functioning difficulties, emotion dysregulation, neurological and genetic vulnerability

Stem cell-derived embryo models: moral advance or moral obfuscation?

Stem cell-derived embryo models (SCEMs) are model embryos used in scientific research to gain a better understanding of early embryonic development. The way humans develop from a single-cell zygote to a complex multicellular organism remains poorly understood. However, research looking at embryo development is difficult because of restrictions on the use of human embryos in research. Stem cell embryo models could reduce the need for human embryos, allowing us to both understand early development and improve assisted reproductive technologies. There have been several rapid advances in creating SCEMs in recent years. These advances potentially provide a new avenue to study early human development. The benefits of SCEMs are predicated on the claim that they are different from embryos and should, therefore, be exempt from existing regulations that apply to embryos (such as the 14-day rule). SCEMs are proposed as offering a model that can capture the inner workings of the embryo but lack its moral sensitivities. However, the ethical basis for making this distinction has not been clearly explained. In this current controversy, we focus on the ethical justification for treating SCEMs differently to embryos, based on considerations of moral status