City governance and visual impression management: visual semiotics and the Biccherna panels of Siena

A major preoccupation in the contemporary organizational landscape is governance and how to cope with conflict and uncertainty. These challenges are particularly evident in the governance of cities, with their complex histories, politics and administrative processes. We argue that visual artefacts can form powerful visual impression management, constituting ‘visual governance’, for dealing with such complexities. We construct a framework from the visual semiotics of Umberto Eco, extended by medieval aesthetics. We analyse the pre-modern case of the Sienese Biccherna panels (painted covers and paintings linked to the city accounts) to show how their calligraphy, heraldry and pictures convey idealized reassuring images of orderly administration, in times of complicated, disordered underlying realities. In demonstrating how art and accounting are intertwined as tools of governance, and that there are contemporary resonances in corporate annual reporting, we add both to research in governance and to visual organizational research, and pave the way for further interdisciplinary work on the relationship between art and organizations

The art of writing: the influence of Spanish literary culture on the work of Kate O'Brien

This thesis examines the influence that Spanish literary culture had on Kate O'Brien's work. There are overt Spanish elements in a number of O'Brien's writings; however upon a closer inspection of both her fiction and her non-fiction, this research reveals how a more subtle influence of Spain runs through the core of all her work and that her experimental writing style is inextricably linked to Spanish literary culture. As such, this thesis illuminates the way in which O'Brien's engagement with the writings of Concha Espina, Jacinto Benavente, Miguel Cervantes and Teresa of Avila provided her with a model with which to negotiate the social, religious and familial restraints faced by a female Catholic novelist in post-independence Ireland. The thesis is structured in four parts with a chapter devoted to the unique influence of each writer on O'Brien. Importantly, the thesis confronts some received critical assumptions about O'Brien. More specifically, it challenges the idea that O'Brien was a conservative writer whose work was stylistically timid and outdated in tone. In doing so, this re-assessment of O'Brien's work offers a new approach to her writing, as it situates her in both an Irish and an international context of writers who are regarded as modernist novelists

The role of the school nurse in protecting children and young people from maltreatment: An integrative review of the literature

Objectives. This review aims to describe the role of the school nurse in protecting children and young people from maltreatment by examining the international literature. Child maltreatment is a prevalent issue in global society today and includes physical, emotional and sexual abuse, neglect and exploitation. School nurses are ideally placed to identify and work with children and young people who are at risk of maltreatment through their regular contact with the school community. Design. Integrative literature review incorporating thematic analysis. Data Sources. Electronic databases British Nursing Database, Cumulative Index of Nursing and Allied Health Literature, Medline, PsycInfo, Cochrane Library Database for Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL). Search Terms: Role, School Nurse, Child Maltreatment. Review Methods. Initial title and abstract review of 444 studies resulted in 78 studies for full text review. Additional search strategies identified one relevant study. Inclusion and exclusion criteria were employed as follows; (1) study published in the English language, (2) peer-reviewed, (3) primary research, (4) inclusion of school nurses (or equivalent role internationally) in the study sample, and (5) a focus on the role of school nurses in preventing child maltreatment. Studies were appraised using the Critical Appraisal Skills Programme tool for qualitative studies and the Strengthening the Reporting of Observational Studies in Epidemiology checklist for mixed-methods and quantitative studies. Findings from the studies were identified, summarised and organised into a summary table, before being analysed thematically. Results. 21 studies met inclusion and quality criteria and were included in the review. Key themes that emerged from the analysis were; supporting the child and family, detective work, working with other professionals, training and supervision, barriers to protecting children and young people from maltreatment and trust. Conclusion. International literature highlights the variety of activities that school nurses may undertake in daily practice to protect children and young people from maltreatment. Several challenges to this role are identified, including time management and building relationships with children and young people. Recommendations for practice and further research are made

Using the TIDieR checklist to describe health visitor support for mothers with mental health problems: analysis of a cross-sectional survey

At least half of the 20% of mothers who experience mental health problems (MHPs) during pregnancy or after birth are not receiving the help they need that will lead to recovery. In order to identify where improvements need to be made it is necessary to describe exactly what is being done and the barriers and facilitators that compromise or enhance optimal care. The majority of mothers experience mild to moderate anxiety or depression. The expectation is that primary care professionals, such as health visitors (HVs), can provide the support they need that will lead to recovery. The aim of this study was explore the views of HVs regarding the content and purpose of an intervention to support mothers with MHPs, described as ‘listening visits’ (LVs). A link to an on-line survey was offered to the members and champions of the Institute of Health Visiting (n=9,474) March – May 2016. The survey was completed by 1599 (17%) of the target population, of whom 85% were offering LVs. The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a framework to describe commonalities and variations in practice. There appeared to be a shared understanding of the rationale for LVs but a lack of agreement about what the intervention should be called, the techniques that should be used and the duration, frequency and expected outcomes of the intervention. Contextual factors such as staff shortages; conflicting priorities; the needs and circumstances of mothers; the capability and motivation of HVs; inadequate training and supervision; and absence of clear guidance contributed to variations in perceptions and practice. There are many ways in which the HV contribution to the assessment and management of mothers with MHPs could be improved. The intervention delivered by HVs needs to be more clearly articulated. The contextual factors influencing competent and consistent practice also need to be addressed

Evidence-based primary health care and local research: a necessary but problematic partnership

Background: Front-line NHS staff undertake small research projects to answer questions about local patients and services, but these projects often face considerable challenges. This paper reports on one such project. Aims and methods of study:The study used structured interviews in order to find out about the knowledge of nutrition among Bangladeshis using an NHS Walk-in Centre. Development of the study: Time constraints posed considerable difficulties in progressing and completing the study; flaws in the methodology emerged; and underpinning assumptions about health promotion and ethnic minority health beliefs were open to challenge. Learning from the study: Despite this, some findings were valuable and have considerable potential as a stimulus to critical thinking among practitioners about their own attitudes, as well as raising issues that future research would find it useful to address

Assessing Retirement Needs and Interest in myRa: Findings From the Refund to Savings Initiative

As part of the U.S. Department of the Treasury’s ongoing effort to promote the myRA starter retirement account, we used the Refund to Savings Initiative’s Household Financial Survey to assess low- to moderate-income tax filers’ retirement needs, attitudes towards retirement, and interest in a myRA-type account. We also tested different messaging approaches for promoting myRA. The report found that 32% of survey respondents did not own a retirement account and that lack of money and lack of access to an employer-based account were major impediments to retirement account ownership. The report also found that only 10% to 15% of respondents felt on track to retire comfortably. Several aspects of myRA appealed to respondents including the absence of a minimum balance and the absence of penalties for early withdrawal. Additionally, a simple, direct, informational approach to promotional messaging proved more effective than personal messaging at driving interest in myRA

Effect of α-lipoic acid and exercise training on cardiovascular disease risk in obesity with impaired glucose tolerance

Obese subjects with impaired glucose tolerance (IGT) are more susceptible than healthy individuals to oxidative stress and cardiovascular disease. This randomised controlled investigation was designed to test the hypothesis that α-lipoic acid supplementation and exercise training may elicit favourable clinical changes in obese subjects with IGT. All data were collected from 24 obese (BMI ≥ 30 kg/m2) IGT patients. Following participant randomisation into two groups, fasting venous blood samples were obtained at baseline, and before and following intervention. The first group consisted of 12 participants who completed a 12 week control phase followed by 12 weeks of chronic exercise at 65% HRmax for 30 minutes a day, 5 days per week, while ingesting 1 gram per day of α-lipoic acid for 12 weeks. The second group consisted of 12 participants who completed the same 12 week control phase, but this was followed by 12 weeks of 1 gram per day of α-lipoic acid supplementation only (no exercise). The main findings show a comparatively greater rate of low density lipoprotein (LDL) oxidation in the group consisting of α-lipoic acid only (p < 0.05 vs. pre intervention), although total oxidant status was lower post intervention (p < 0.05 vs. baseline) in this group. However, exercise and α-lipoic acid in combination attenuates LDL oxidation. Furthermore, in the α-lipoic acid supplement plus exercise training group, total antioxidant capacity was significantly increased (p < 0.05 vs. baseline and pre intervention). Body fat percentage and waist and hip circumference decreased following exercise training (p < 0.05 vs. post intervention). There were no selective treatment differences for a range of other clinical outcomes including glycaemic regulation (p > 0.05). These findings report that α-lipoic acid ingestion may increase the atherogenicity of LDL when ingested in isolation of exercise, suggesting that in IGT the use of this antioxidant treatment does not ameliorate metabolic disturbances, but instead may detrimentally contribute to the pathogenesis of atherosclerosis and development of CVD. However, when α-lipoic acid is combined with exercise, this atherogenic effect is abolished

NICE guideline for antenatal and postnatal mental health: the health visitor role

When the NICE guideline for antenatal and postnatal mental health was updated in December 2014, the intervention delivered by health visitors, described as ‘listening visits’, was not included in the recommendations as one of a number of possible, evidence-based options of support. Maternal mental health is one of the six high impact areas designated as a fundamental component of health visiting practice. This review demonstrates how health visitors are uniquely placed to fulfill many of the recommendations in the updated NICE guideline and have a pivotal part to play in prevention, early identification, prompt treatment and improved outcomes for mothers, their partners and their babies. The review also highlights the challenges of delivering the recommended levels of perinatal mental health information, advice and support amidst budget cuts, reorganization of services and conflicting policy priorities