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Historically, there has been less research carried out on earwitness than eyewitness testimony. However, in some cases, earwitness evidence might play an important role in securing a conviction. This paper focuses on accent which is a central characteristic of voices in a forensic linguistic context. The paper focuses on two experiments (Experiment 1, n = 41; Experiment 2, n = 57) carried out with participants from a wide range of various locations around the United Kingdom to rate the accuracy and confidence in recognizing accents from voices from England, Scotland, Wales, Northern Ireland, and Ireland as well as looking at specificity of answers given and how this varies for these regions. Our findings show that accuracy is variable and that participants are more likely to be accurate when using vaguer descriptions (such as "Scottish") than being more specific. Furthermore, although participants lack the meta-linguistic ability to describe the features of accents, they are able to name particular words and pronunciations which helped them make their decision. [ABSTRACT FROM AUTHOR]

Objective: To conduct a systematic review of the evidence for when a hospital admission for an older person can be avoided in subacute settings. We examined the definition of admission avoidance and the evidence for the factors that are required to avoid admission to hospital in this setting. Methods: Using defined PICOD criteria, we conducted searches in three databases (Medline, Embase and Cinahl) from January 2006 to February 2018. References were screened by title and abstract followed by full paper screening by two reviewers. Additional studies were searched from the grey literature, experts in the field and forward and backward referencing. Data were narratively described, and concept analysis was used to investigate the definition of admission avoidance. Results: A total of 17 studies were considered eligible for review; eight provided a definition of admission avoidance and 10 described admission avoidance criteria. We identified three factors which play a key role in admission avoidance in the subacute setting: (1) ambulatory care sensitive conditions and common medical scenarios for the older person, which included respiratory infections or pneumonia, urinary tract infections and catheter care, dehydration and associated symptoms, falls and behavioural management, and managing ongoing chronic conditions; (2) criteria/tools, referring to interventions that have used clinical expertise in conjunction with a range of general and geriatric triage tools; in condition-specific interventions, the decision whether to admit or not was based on level of risk determined by defined clinical tools; and (3) personnel and resources, referring to the need for experts to make the initial decision to avoid an admission. Supervision by nurses or physicians was still needed at subacute level, requiring resources such as short-stay beds, intravenous antibiotic treatment or fluids for rehydration and rapid access to laboratory tests. Conclusion: The review identified a set of criteria for ambulatory care sensitive conditions and common medical scenarios for the older person that can be treated in the subacute setting with appropriate tools and resources. This information can help commissioners and care providers to take on these important elements and deliver them in a locally designed way. [ABSTRACT FROM AUTHOR]

Objectives: While the presence of publication bias in clinical research is well documented, little is known about its role in the reporting of health services research. This paper explores stakeholder perceptions and experiences with regard to the role of publication and related biases in quantitative research relating to the quality, accessibility and organization of health services. Methods: We present findings from semi-structured interviews with those responsible for the funding, publishing and/or conduct of quantitative health services research, primarily in the UK. Additional data collection includes interviews with health care decision makers as 'end users' of health services research, and a focus group with patient and service user representatives. The final sample comprised 24 interviews and eight focus group participants. Results: Many study participants felt unable to say with any degree of certainty whether publication bias represents a significant problem in quantitative health services research. Participants drew broad contrasts between externally funded and peer reviewed research on the one hand, and end user funded quality improvement projects on the other, with the latter perceived as more vulnerable to selective publication and author over-claiming. Multiple study objectives, and a general acceptance of 'mess and noise' in the data and its interpretation was seen to reduce the importance attached to replicable estimates of effect sizes in health services research. The relative absence of external scrutiny, either from manufacturers of interventions or health system decision makers, added to this general sense of 'low stakes' of health services research. As a result, while many participants advocated study pre-registration and using protocols to pre-identify outcomes, others saw this as an unwarranted imposition. Conclusions: This study finds that incentives towards publication and related bias are likely to be present, but not to the same degree as in clinical research. In health services research, these were seen as being offset by other forms of 'novelty' bias in the reporting and publishing of research findings. [ABSTRACT FROM AUTHOR]

Objectives: The paper reports on an empirical study of Health and Wellbeing Boards (HWBs) in England. Established by the Health and Social Care Act 2012, HWBs act as place-based hubs for leaders in health, social care, local government and other sectors to come together to address health improvement and the wider determinants of health. Methods: We conducted a three-year study of HWBs (2015–2017) in five localities across England. This involved collecting qualitative data from semi-structured interviews with key actors in the HWBs at strategic and operational levels, and focus group sessions with voluntary-sector participants at each HWB. Results: HWBs have largely followed the path of previous partnerships in terms of a lack of clear aims and objectives, lack of ownership and accountability by partners, and an absence of any significant impact on health outcomes. Conclusions: Many of the features of unsuccessful partnership working were largely displayed by HWBs. Boards require more executive power and ownership from the bottom up if they are to have any real impact. [ABSTRACT FROM AUTHOR]

This paper considers the origins and traces the history of the Social Fund, an ideologically-motivated social policy departure of the Thatcher era. It identifies the controversy, in research communities amongst others, which surrounded the establishment of the Fund, and considers the evidence of recurring difficulties in its practical operation over a thirty-year period. It then turns to the Coalition administration in Westminster’s decision to divest itself of responsibility for key parts of the Fund, devolving such obligations to local authorities in England, the Parliament in Scotland and the Assembly in Wales. The paper sets out a comparison of the approaches being developed to discharge the Fund’s prior responsibilities in the three nations. It concludes that the essential policy thrust lies in a determination to roll back central state obligations in poverty relief and income maintenance which had hitherto been accepted by all post-war administrations. [ABSTRACT FROM PUBLISHER]

Despite the term 'never events' these events continue to happen in the NHS. This paper considers the findings from a review of the causes of nine surgical 'never events'; looking at the learning from the investigations to provide 'a window on the system' and considering the multiple issues that need to be addressed to reduce future risk. The paper discusses why many of the causes described in investigation reports cannot be adequately addressed by the action plans that target each individual cause - things are never that simple - instead the causes should be seen as a reflection of the current state of safety within an organization, showing the underlying cultural and systems issues that need to be addressed at a wider level than that of the incident itself. [ABSTRACT FROM AUTHOR]

Empirical evidence suggests that planning policies significantly impact on investment property market performance in the UK. It is less clear, however, how information about the planning policy environment feeds into investment decision-making. This paper seeks to explore this issue. It reports on interviews with the property investment community and focuses on the decision to invest in the retail sector. The paper uses a six-stage model of the investment decision-making process as a framework for analysing the way in which concerns about policy impact on behaviour. The results suggest that an understanding of the policy environment and the development of a relationship with local planning authorities are most important in the post-acquisition asset management stage of the investment process. The research also reveals variations in access to policy intelligence and that approaches to analysis of the likely effects of planning regimes vary with fund type and strategy. [ABSTRACT FROM PUBLISHER]

This paper discusses how we have improved patient handover by implementing an electronic system for weekend handover. We discuss the process of changing handover methods and the results of an audit comparing our old paper based book versus our new 'e-handover' system. [ABSTRACT FROM AUTHOR]

In the United Kingdom, individuals requiring inpatient care for mental health purposes can be admitted to hospital with their consent as informal patients, or formally through procedure(s) prescribed by law. There are, however, instances where individuals otherwise referred to as informal patients are on admission without their consent or in circumstances that amount to deprivation of their liberty as defined by the United Kingdom Supreme Court and without recourse to lawful procedures by their clinical team as stipulated by the European Convention on Human Rights. Such instances might be without the awareness of the individuals or their clinical teams or the clinical teams might be unclear as to which statute applies to patient care. This paper has been written to help clinicians define the legal status of patients at the point of admission, during their stay on the inpatient unit and the statute(s) that apply to different in-patient situations. [ABSTRACT FROM AUTHOR]

The aim of the paper is to assess open disclosure in Ireland following clinical adverse events in healthcare. A number of areas were examined from the patient's and healthcare team's perspectives. The barriers/constraints to open disclosure, the extent of policies, procedures or guidelines that are available for staff to consult with, inclusive of how they are implemented, harvested valuable insight. The supports available for healthcare staff following an adverse event and patients' expectations after such an event are also encompassed to include the relationship open disclosure has on concerns regarding litigious intent. The questionnaire was disseminated to a multidisciplinary healthcare group. The questions were numbered 1-9, with a mixture of open and closed questions. A five-point Likert format was used with three questions in attitudinal/ opinion statements, regarding supports available for staff following an adverse event. A Statistical Package for Social Sciences was used to assist with the interpretation of data. This study was directed at the multidisciplinary healthcare team and senior management within the Health Service Executive (HSE) and Voluntary sectors. The oldest hospitals in Ireland are voluntary public hospitals some of them originating from the 18th century, having been established by charities and religious orders. Voluntary hospitals are partly funded by the HSE, specifically having their own governance structure. There was a response rate of 67% (n ¼ 192). A total 56.5% of respondents stated their organization did not have an open disclosure policy, procedure or guideline in place however, 16% of the attendees stated there was one in place. A total of 54.4% (104) acknowledged barriers/concerns surrounding open disclosure, with fear of litigious intent noted by 24% of respondents. A total of 52.3% (101) identified support availability to staff following an adverse event, 38.9% (10) felt there was little/no follow-up support, with 11.1.% (2) stating they were made to feel guilty, and associated it with being "on trial". Findings demonstrate an unstructured approach to disclosure of adverse events in Ireland, with fear of litigation a major concern for healthcare professionals. Error awareness among the general public, the introduction of protective legislation and implementation of a national standard on open disclosure in conjunction with practical training and education will all positively and practically influence open disclosure of adverse events in Ireland. [ABSTRACT FROM AUTHOR]

While trust is seen as central to most social relations, most writers, including sociologists of science, assume that modern trust relations – especially those in regulatory relationships – tend towards the impersonal. Drawing on ethnographic material from one kind of scientific oversight body – research ethics committees based in the UK NHS – this paper argues that interpersonal trust is crucial to regulatory decision-making and intimately bound up with the way in which these oversight bodies work, and that as such they build on, rather than challenge, the trust-based nature of the scientific community. [ABSTRACT FROM PUBLISHER]

This paper tests the theory of Relative Risk Aversion (RRA), which argues that educational decisions are intended to minimize the risk of downward social class mobility. We propose a structural model which distinguishes the instantaneous utility of educational decisions from the future utility of these decisions with respect to reproducing one’s parents’ social class position. We analyse British data and find that RRA accounts for some of the observed social class differences in educational decisions. We also find that while more than 90% of individuals derive utility from reproducing their parents’ social class position (RRA ‘conformists’), a small group of individuals experience disutility from reaching their parents’ social class position (RRA ‘rebels’). Individuals who experience disutility from reproducing their parents’ social class position are characterized by low cognitive ability and a high incidence of behavioural problems in childhood. [ABSTRACT FROM AUTHOR]

As subjects of the parental right to choose (DES, 1988), parents are called upon to fulfil certain duties and responsibilities when choosing a secondary school for their child, with the expectation that they might navigate the school system ‘successfully’ and become ‘better informed consumers’ (DCSF, 2008). To comply with these rules of citizenship parents are encouraged to make use of a variety of information on schools as part of a realistic and informed choice, one that is consummate with their role as consumer-citizens. Such ‘cognitive mapping’ is evident in school brochures and websites where choice is assembled on the basis of visual iconography and narrative terrains. This leads to a consideration of how choice is visually mediated and communicated through the circulation of symbols and the structure of narratives. To explain these phenomena, I analyse and compare the ways in which two all-girls faith secondary schools attempt to (further) define themselves, culturally, historically and pedagogically, in a crowded field of choice. I conclude the paper with a discussion of the benefits and insights generated through a visually orientated approach to the study of school choice. [ABSTRACT FROM PUBLISHER]

From time to time regulators are required by new legislation to radically alter the normative basis of their decisions. Their ability to do so can, however, be undermined both by a lack of appropriate resources and the self-referential nature of regulatory systems. Some aids to adaptation already exist, but, as this paper demonstrates, these either take the forms of reactions to failure, or are inadequate to ensure certainty of result, as they are themselves reliant on the adoption of new norms of behaviour by regulatory agencies. We therefore propose a novel mechanism building on a proven research methodology to break out of this circularity in adaptation: a modified form of Participatory Action Research embedded within regulatory systems. [ABSTRACT FROM AUTHOR]

Healthcare is a highly regulated environment. This has driven what could be characterized as a papersafe approach, whereby organizations are required to demonstrate to a multiplicity of regulators, inspectorates and accrediting bodies that they are paper safe. However, for many organizations, this has not produced a system which is actually patient safe; rather it has in practice operated as a parallel system that does not reflect the true state of safety. This project looks at a quality improvement and patient safety programme and critically asks the question of whether it is flawed because of failure to address issues surrounding Doctors and cultural change. We used Johnson & Schole's cultural web framework to explore the attitudes of junior doctors towards a patient safety and quality improvement programme. Data collection was through the use of focus groups backed up with quantitative data from a web based questionnaire survey. It has been demonstrated that Doctors represent a dominant sub-culture within the NHS and their beliefs, attitudes and value are often at odds or unrecognized by senior healthcare managers. Unless the cultural differences are adequately addressed then transformational change projects such as 'Best and Safest Care' are unlikely to succeed. A better understanding of the organizational context allows for more appropriate change interventions to be developed. [ABSTRACT FROM AUTHOR]

This paper discusses the early implementation of the Mental Capacity Act 2005 in health and social care in England. The author examines the research evidence to date, particularly monitoring data from the Department of Health, in order to review the progress made in implementation. The extent to which the Act is achieving its overall aim of facilitating decision-making by people lacking capacity is discussed, focusing on people with dementia. The author concludes that the initial implementation of the Act (and the related Deprivation of Liberty Safeguards) has had only limited effectiveness in facilitating decision-making by people lacking capacity, promoting their best interests and protecting their liberty. Future implementation needs to ensure that the rights of people lacking capacity, particularly people with dementia, are taken more seriously in health and social care and are better protected. [ABSTRACT FROM PUBLISHER]

Recent years have seen an expansion in the work on the attitudes, beliefs and preferences of those middle-class groups that have accompanied the return of capital to many North American and western European city centres and their surrounding urban suburbs. Yet despite this, it is argued that there is little research linking gentrification to wider processes of social transformation, particularly debates over housing market decision-making, the balancing of work and life, and the gender division of labour within the household. It is to examining the interaction of these aspects of everyday life in a gentrifying area that this paper turns, using the example of Chorlton, a southern urban suburb of Manchester. [ABSTRACT FROM AUTHOR]

This paper discusses the role of gender dynamics in the experiences of credit and debt in low income families in the UK, drawing on a qualitative longitudinal study funded by the Joseph Rowntree Foundation. It builds on earlier work on: the household economy; the gendered distribution of income specifically within low income families in receipt of benefits; and the extent of credit and debt in the UK currently. Following critiques of traditional sociological and social psychological analyses of the household economy, it takes a more discursive approach, which enables identification of gender dynamics as one of the mechanisms through which decision-making in relation to this area of practice is accomplished. [ABSTRACT FROM AUTHOR]

The use of area-based deprivation indices is now a firmly established means of assessing which areas ought to be the focus of government policy, with separate indices of deprivation established for each constituent part of the UK. In England, the Index of Multiple Deprivation 2004 has been widely used to support decision-making for key urban policies and in more local assessments of deprivation. Implicit in the development and use of these indicators is the notion that area matters and that it can be an important influence on a whole range of different activities. However, there is also a sense in which contemporary measures of deprivation are spatially short-sighted since they are not able to account formally for the spatial context of individual locations. This paper therefore offers an alternative approach to the measurement of local conditions by combining spatial statistical approaches with a much-used deprivation index. [ABSTRACT FROM AUTHOR]

Do UK community pharmacists encounter the high drama dilemmas of the medical ethics literature or is a 'morality of the mundane' more appropriate? This paper presents the findings of a qualitative study that asked a sample of UK pharmacists to describe their ethical issues and to establish whether these were ethical dilemmas as understood philosophically or ethical problems of a more legal or emotional nature. It emerged that although many pharmacists referred to 'dilemmas', these were often problems involving a conflict between an ethical value and a legal or procedural issue and often arose in the routine minutiae of dispensing prescriptions and selling medicines. Such ethical problems remained of concern for pharmacists and the commercial environment, corporate pharmacy ownership and pharmacists' subordination to doctors, all precipitated ethical problems. Law and ethics appeared to be understood synonymously but this may reflect a modernity that increasingly brackets out ethical experiences by encouraging reliance upon law and procedure. [ABSTRACT FROM AUTHOR]

The UK Genethics Club was established in November 2001 in order to provide a national forum of ethics support for the profession of clinical genetics in the UK. The forum brings together health professionals, medical ethicists and lawyers and support is provided through detailed discussion of cases and sharing of good practice. Clinical genetics professionals had previously voiced concerns about making extremely difficult ethical decisions, with profound implications, in something of a vacuum. Professionals saw a lack of guidance in the area and lack of time for discussion of difficult cases as reasons for this. This paper describes the origins of the group and gives (anonymized) examples of some of the types of issues discussed. [ABSTRACT FROM AUTHOR]