Exploring the impact of user involvement on health and social care services for cancer in the UK.

This report presents the findings from a study of cancer network partnership groups in the UK. Cancer network partnership groups are regional organisations set up to enable joint working between people affected by cancer and health professionals, with the aim of improving cancer care

Active Living : Transforming the Organization of Retirement and Housing in the U.S.

We examine the transformation of the social institutions of retirement and housing in the US in the latter part of the 20th century. Using institutional ethnography we explicate a woman\u27s experience relocating to an age segregated community. Her relocation is predicated upon ideological practices that reconceptualize retirement as active living and the construction of a setting in which retirees engage in this new lifestyle. We demonstrate the textual mediation of this ideological and organizational reformation through an examination of an advertising campaign undertaken by the Del Webb Development Corporation in the marketing of Sun City, Arizona. The advertising texts provide an ideological code to manage and reorganize at multiple sites the social relations of one segment of the housing industry under late capitalism

Introduction to the Special Issue: New Scholarship in Institutional Ethnography

Twelve years ago the Journal of Sociology and Social Welfare (JSSW) published a special issue devoted to institutional ethnography, “Institutional Ethnography: Theory and Practice” (Winfield, 2003). This alternative sociology, founded by Dorothy E. Smith, begins from the standpoint of the experiences of particular, active subjects and sets out to discover and describe the social relations shaping those experiences (Smith, 1987, 2005, 2006). JSSW, dedicated to publishing new, cutting-edge theoretical and methodological articles, was the first academic journal to devote a special issue to this new mode of inquiry used to investigate the social world. Over the ensuing years, the number of international practitioners of institutional ethnography has increased across a diverse array of disciplines, opening up new areas of investigation and methodological strategies, and in the process increasing our knowledge of “ruling relations,” that “expansive, historically specific apparatus of management and control that arose with the development of corporate capitalism and supports it operation” (DeVault, 2006, p. 295)

Impact of ethanol on continuous inline diafiltration of liposomal drug products

Liposomal drug products are playing an increasing role in the field of drug delivery. With this increased demand comes the need to increase the capabilities and capacity of manufacturing options. Continuous manufacturing techniques present a significant opportunity to address these needs for liposomal manufacturing processes. Liposomal formulations have unique considerations that impact translation from batch to continuous process designs. This article examines aspects of converting to a continuous design that were previously viewed as inconsequential in a batch process. The batch process involves the removal of ethanol (EtOH) through tangential flow filtration (TFF). EtOH was found to reduce the permeability of the hollow fibers used for TFF. This effect was determined to have minimal impact on the overall batch process design but considerable influence on the design of continuous TFF such as inline diafiltration (ILDF). Using a pilot scale setup, EtOH was found to decrease permeability in an inverse manner to EtOH concentration. Further assessment found that dilution of the EtOH levels prior to diafiltration can significantly reduce the amount of ILDF stages needed and that a continuous design requires less buffer to the commensurate batch design

Mandated Collaboration as a Strategy of Environmental Governance? A Case Study of the Niagara Peninsula Source Protection Area in Ontario

Government (state) command and control strategies for addressing the complexities, uncertainties, and conflicts associated with ecological issues are no longer adequate. This is particularly true when addressing water resources. Water resources are inherently complex as a result of demands related to (1) competition between multiple users of water resources; (2) multiple scales at which water is managed; and (3) the mismatch between administrative and hydrological boundaries. Collaborative strategies for environmental governance are increasingly essential for addressing water resource issues. New legislation in Ontario has specifically mandated that collaboration be used as a strategy for source water protection. Government involvement is important for successful collaboration. However, little research has been undertaken to understand what impact mandating collaboration has on the process and outcomes. This thesis explores the relationship between mandated collaboration, the process of collaboration, and its outcomes in order to critically assess the potential impacts of government-mandated collaboration. The research was guided by a conceptual framework developed from the literature concerning government involvement in collaboration. Evaluative criteria were used to assess processes and outcomes. The empirical work explored a case study of the Niagara Source Protection Area in Ontario. The case draws attention to how government affects the collaborative process and outcomes

Women seafarers’ health and welfare survey

Background: This is a collaborative study from the International Maritime Health Association, International Seafarers’ Welfare and Assistance Network, International Transport Workers’ Federation and the Seafarers Hospital Society. The aim of the study was to look at the health and welfare needs of women seafarers and how organisations can best make or campaign for improvements to the health information and services available to women seafarers. Materials and methods: A pilot study was conducted in July 2014 and following review of the data and revision of the questionnaire the study was launched in December 2014, running until the middle of March 2015. Results collected from the survey are also supported by qualitative data obtained from two focus groups run during February and March. Results: 595 responses were received from a range of nationalities, ages and positions on board ships. The findings suggest that joint/back pain, stress/depression/anxiety and headache seem to be the most common symptoms reported by women seafarers and that 55% felt that they are related to their work. 48% state that they have problems with seeking medical care and offer suggestions to improve this. Routine wellness checks, nutrition and information on joint and back pain are the main areas that women seafarers stated health screening/services/information would be most useful to improve their health and wellbeing. They suggested this could best be received directly from health professionals, or alternatively by reading leaflets or from online websites/an app. Significantly 37% of women seafarers also stated that they do not have access to sanitary bins within the toilet and 18% say that sexual harassment is an issue. Conclusions: The responses received highlight a small number of areas where relatively simple and low-cost interventions might improve the health and welfare of women seafarers. Specifically these include the production and appropriate, distribution of gender — specific information on back pain, mental health and nutrition in addition to gynaecological complaints, to all women seafarers; the introduction of means for disposing of sanitary waste for all female crew on all ships and the improved availability of female specific products e.g. sanitary products in port shops and welfare centres worldwide. Additional work is needed to investigate these areas more fully and to look at the issue of confidence in medically trained staff, medical confidentiality and sexual harassment. Any further work and interventions will require the support of all of the main stakeholders and we plan a briefing meeting to publicise the findings to date and to identify support for further work in this area

Iron Age to Medieval entomogamous vegetation and Rhinolophus hipposideros roost in south-eastern Wales (UK)

Karst cave systems are well developed in Wales (UK) and, in some instances, constitute important bat roosts. Ogof Draenen, near Blaenavon in south-east Wales, is the most recent major cave discovery (1994) with already > 70 km of passages explored spanning a vertical range of 148 m. With the exception of one small chamber (Siambre Ddu) located directly above the main Ogof Draenen system, very few bats have been noticed inside. Extensive accumulations of guano, attributable to Rhinolophus hipposideros, are however found in parts of the Ogof Draenen system. In places covering many square meters and sometimes building heaps > 0.5 m thick, these represent volumes not yet found in any other cave system in the British Isles. Although the date of the abandonment of the main Ogof Draenen system as a bat roost remains unknown, six radiocarbon dates on guano from Ogof Draenen place the occupation in the Iron Age to Medieval period at least. Palynological analysis was undertaken on ten samples distributed through the cave. Comparisons were made with a moss polster and a lake mud sample from the area to provide a first approximation of the regional modern pollen rain and with two modern guano samples, one from Siambre Ddu and one from Agen Allwedd cave (5 km to the north-west) to provide a temporal comparison with the fossil guano. Agen Allwedd cave currently is one of the largest active roosts for Lesser Horseshoe bats in Britain and lies close to the present northern limit of this endangered species in Europe. The main results are that the cave appears to have been used both as a summer and a winter roost; most of the Ogof Draenen guano is formed within c.1600 14C years and, if the largest heap is continuous, it has accumulated within 750 14C years, i. e. 0.16 mm.year-1; the fossil guano samples reflect a relatively closed oak forest with more abundant ivy (Hedera) and holly (Ilex) than at present; insect-pollinated plants such as Ilex, Acer, Hedera and Impatiens glandulifera are over–represented in the guano samples; in addition to the usual causes of bat roost decline (pesticides, pollution), in the case of Ogof Draenen, we may add entrance blocked by rock collapse and decline of the local forest cover as well as change in its composition

Rheumatic heart disease in pregnancy: strategies and lessons learnt implementing a population-based study in Australia

Background The global burden of rheumatic heart disease (RHD) is two-to-four times higher in women, with a heightened risk in pregnancy. In Australia, RHD is found predominantly among Aboriginal and Torres Strait Islander peoples. Methods This paper reviews processes developed to identify pregnant Australian women with RHD during a 2-year population-based study using the Australasian Maternity Outcomes Surveillance System (AMOSS). It evaluates strategies developed to enhance reporting and discusses implications for patient care and public health. Results AMOSS maternity coordinators across 262 Australian sites reported cases. An extended network across cardiac, Aboriginal and primary healthcare strengthened surveillance and awareness. The network notified 495 potential cases, of which 192 were confirmed. Seventy-eight per cent were Aboriginal and/or Torres Strait Islander women, with a prevalence of 22 per 1000 in the Northern Territory. Discussion Effective surveillance was challenged by a lack of diagnostic certainty, incompatible health information systems and varying clinical awareness among health professionals. Optimal outcomes for pregnant women with RHD demand timely diagnosis and access to collaborative care. Conclusion The strategies employed by this study highlight gaps in reporting processes and the opportunity pregnancy provides for diagnosis and re/engagement with health services to support better continuity of care and promote improved outcomes.The authors gratefully acknowledge aid from the Australian National Health and Medical Research Council (NHMRC) project grant #1024206 and NHMRC Postgraduate Scholarship #11332944; University of Technology Sydney Chancellor’s Research Scholarship; and END RHD Centre of Research Excellence, Telethon Kids Institute, University of Western Australia

Sting jets in intense winter North-Atlantic windstorms

Extratropical cyclones dominate autumn and winter weather over western Europe. The strongest cyclones, often termed windstorms, have a large socio-economic impact due to the strong surface winds and associated storm surges in coastal areas. Here we show that sting jets are a common feature of windstorms; up to a third of the 100 most intense North Atlantic winter windstorms over the last two decades satisfy conditions for sting jets. The sting jet is a mesoscale descending airstream that can cause strong near-surface winds in the dry slot of the cyclone, a region not usually associated with strong winds. Despite their localized transient nature these sting jets can cause significant damage, a prominent example being the storm that devastated southeast England on 16 October 1987. We present the first regional climatology of windstorms with sting jets. Previously analysed sting jet cases appear to have been exceptional in their track over northwest Europe rather than in their strength