10,514 results
Search Results
2. Living Standards and Material Culture in English Rural Households 1300-1600. Data Paper
- Author
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Chris Briggs, Alice Forward, and Ben Jervis
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archaeology ,medieval ,post-medieval ,material culture ,records ,inventory ,england ,Archaeology ,CC1-960 - Abstract
The data in the related digital archive was collected to examine the archaeological and historical evidence for material culture in English medieval rural households, with the aim of gaining a fuller picture than what might be attainable by looking only at objects or documents in isolation. The digital archive provides a starting point for anyone wishing to research aspects of medieval rural settlement.
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- 2021
- Full Text
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3. Silencing the “other” Black Paper contributors
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Limond, David
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- 2012
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4. Supporting aspirations – or not? Recent reforms on equality, the green paper on Special Educational Needs and the potential of a neurodiversity spectrum statement
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Mackenzie, Robin, Watts, John, and Howe, Lati
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- 2012
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5. Findings from the Making Every Adult Matter (MEAM) service pilots: a summary paper
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Battrick, Tim, Hilbery, Oliver, and Holloway, Sue
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- 2013
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6. Turning the Tide: A Vision Paper for multiple needs and exclusions
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Page, Anna
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- 2011
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7. Richter transformation of chronic lymphocytic leukaemia: a British Society for Haematology Good Practice Paper
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Toby A. Eyre, John Riches, Peter Hillmen, George A Follows, Piers E.M. Patten, Renata Walewska, Helen Marr, and Anna Schuh
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Male ,medicine.medical_specialty ,Hematology ,Lymphocytic leukaemia ,Richter transformation ,business.industry ,Prognosis ,Leukemia, Lymphocytic, Chronic, B-Cell ,Dermatology ,England ,Internal medicine ,medicine ,Humans ,Female ,business ,Good practice - Published
- 2021
8. Enforcing the Nationally Described Space Standard: the regulation of “Sub-standard” English housing
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Hubbard, Phil
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- 2023
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9. Analysis and critique of 'Transforming children and young people's mental health provision: A green paper': Some implications for refugee children and young people
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Pat Cox and Jane March McDonald
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Mental Health Services ,Adolescent ,Service delivery framework ,Refugee ,media_common.quotation_subject ,Social Stigma ,B760 ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Humans ,Sociology ,Child ,media_common ,Government ,Refugees ,Wales ,030504 nursing ,business.industry ,Green paper ,B730 ,Public relations ,Mental health ,Culturally Competent Care ,England ,Paradigm shift ,Scale (social sciences) ,Pediatrics, Perinatology and Child Health ,Wounds and Injuries ,0305 other medical science ,business ,Diversity (politics) - Abstract
Adopting a children’s rights perspective, a critique and analysis underpinned by documentary research methodology was undertaken in order to assess the extent to which the government’s Green Paper (Department of Health and Social Care and Department of Education, 2017. Transforming children and young people’s mental health provision: a green paper. Available at: https://www.gov.uk/government/consultations/transforming-children-and-young-peoples-mental-health-provision-a-green-paper (accessed 7 December 2017)) addresses the mental health and well-being needs of refugee children and young people in England and Wales, identifying strengths, limitations and challenges for future policy and practice. Findings suggest that there is much of potential benefit to refugee children and young people’s future mental health and well-being. However, a paradigm shift, explicit in implications, scale and time frame, will be required, if the Green Paper is to achieve those changes in attitudes, practice and service delivery which it anticipates. We argue that this Green Paper’s overarching challenge is that it is premised on Western-centric models in its understanding of the experiences of refugee children and young people, and management of trauma and mental health. It fails to recognize the meanings and significance of culture, and of diversity and difference, and the need to invest in all communities in facilitating engagement and support for children and young people’s mental health issues.
- Published
- 2018
10. A performance-driving model for public-sector construction framework procurement in England
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Lam, Terence Y.M. and Gale, Keith S.
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- 2023
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11. The role of the Mental Health Act 1983 in safeguarding adults at risk of abuse and neglect: a thematic analysis of safeguarding adults reviews
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Foss, Deborah
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- 2023
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12. A comparative study on the perceptions of Dutch and British Muslim leadership regarding social-political challenges
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Gökçekuyu, Ertuğrul
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- 2023
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13. From big solutions to small practices: bringing back the active consumer [Paper in: Justice and Governance in Water. Baldwin, Claudia (ed).]
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Chappells, Heather and Medd, Will
- Published
- 2008
14. The Top 100 Most-Cited Papers in Erosive Tooth Wear: A Bibliometric Analysis
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Aurélio de Oliveira Rocha, Pablo Silveira Santos, Bárbara Azevedo Machado, Michele Bolan, Mariane Cardoso, Paulo Antônio Martins-Júnior, and Carla Miranda Santana
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England ,Bibliometrics ,Research Design ,Germany ,Humans ,Tooth Wear ,General Dentistry - Abstract
Citation rates can be used as an indicator of the influence and relevance of scientific papers. The present study analyzed the 100 most-cited articles related to erosive tooth wear (ETW). The top 100 most-cited papers focusing on ETW topics were collected from the Web of Science database on November 11, 2020. The following bibliometric data were extracted from papers: title, authorship, institutions, countries, number of citations, year of publication, journal title, study design, topic, and keywords. Scopus and Google Scholar were searched to compare the number of citations. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations of the 100 most-cited papers ranged from 71 to 330 (average: 97.44). The papers were published between 1949 and 2015. Caries Research (28%) and The Journal of Dentistry (16%) presented the majority of papers. Laboratorial (44%) and observational studies (33%) were the most common study designs. The most studied topics were epidemiology (31%) and the erosive potential of substances (drinks, foods, or medicines) (22%). The countries with the highest number of most-cited papers were England (32%), Germany (18%), and Switzerland (10%). The University of Bern was the institution with the most papers (10%). Lussi A was the author with the highest number of papers in the top 100 (14%). The most common keyword was “dental erosion” with 64 occurrences. The top 100 most-cited papers related to ETW were composed mainly of laboratorial and observational studies focusing on epidemiology and the erosive potential of substances.
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- 2021
15. Osler Centenary Papers: Osler as medical leader
- Author
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Donald R.J. Singer
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Canada ,Modern medicine ,Medical education ,Education, Medical ,business.industry ,education ,Lifelong learning ,History, 19th Century ,General Medicine ,History, 20th Century ,humanities ,Leadership ,England ,Physicians ,Humans ,Medicine ,Leadership style ,Hospital patients ,Bedside teaching ,business ,Societies, Medical - Abstract
The Canadian physician Sir William Osler is a key figure in the history of modern medicine. He encouraged lifelong learning for doctors, starting with bedside teaching. Contemporary with Old World figures such as Pasteur in Paris and Virchow in Berlin, he played a major role in raising awareness among clinicians of the importance of the scientific basis for the practice of medicine. He championed a rational approach to treatment and did much to encourage avoidance of ‘unnecessary drugging’ by prescribers. He is credited with playing a key role in improving education of medical students and postgraduate education of doctors, with important benefits for the care of hospital patients. He also had a major influence on his medical colleagues through founding and leading medical societies. A century on from his death in December 1919, his specific contributions and how he achieved them are not well known. The aim of this article is to consider the evidence that Osler was an influential medical leader and to reflect on the extent to which the achievements which resulted from his leadership are relevant to modern clinical medicine. Questions of interest include his leadership style, what made for his success as a leader, his medical achievements both in North America and in England, his own insight into leadership and how he was viewed by his peers.
- Published
- 2019
16. Taxonomy of the form and function of primary care services in or alongside emergency departments: concepts paper
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Michelle Edwards, Jonathan Benger, Katherine Morton, Janet Brandling, Thomas Hughes, Freya Davies, Adrian Edwards, Sarah Voss, Matthew Cooke, Aloysius Niroshan Siriwardena, Alison Cooper, and Andrew Carson-Stevens
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Emergency Medical Services ,media_common.quotation_subject ,Context (language use) ,Critical Care and Intensive Care Medicine ,emergency departments ,Terminology ,primary care ,Taxonomy (general) ,Medicine ,Function (engineering) ,media_common ,Service (business) ,Wales ,Primary Health Care ,business.industry ,Stakeholder ,emergency care systems, primary care ,General Medicine ,Emergency department ,Public relations ,Service provider ,England ,Models, Organizational ,Emergency Medicine ,Emergency Service, Hospital ,business ,Concepts - Abstract
Primary care services in or alongside emergency\ud departments look and function differently and are\ud described using inconsistent terminology. Research to\ud determine effectiveness of these models is hampered by\ud outdated classification systems, limiting the opportunity\ud for data synthesis to draw conclusions and inform\ud decision-making and policy. We used findings from a\ud literature review, a national survey of Type 1 emergency\ud departments in England and Wales, staff interviews,\ud other routine data sources and discussions from\ud two stakeholder events to inform the taxonomy. We\ud categorised the forms inside or outside the emergency\ud department: inside primary care services may be\ud integrated with emergency department patient flow or\ud may run parallel to that activity; outside services may be\ud offered on site or off site. We then describe a conceptual\ud spectrum of integration: identifying constructs that\ud influence how the services function—from being closer\ud to an emergency medicine service or to usual primary\ud care. This taxonomy provides a basis for future evaluation\ud of service models that will comprise the evidence base\ud to inform policy-making in this domain. Commissioners\ud and service providers can consider these constructs in\ud characterising and designing services depending on local\ud circumstances and context.
- Published
- 2019
17. The influence of national culture on employee voice in small and medium enterprises: a cross-cultural perspective
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McKearney, Aidan, Prouska, Rea, Tungtakanpoung, Monrudee, and Opute, John
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- 2023
- Full Text
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18. A multi-criteria decision analysis assessment of waste paper management options
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Stephen Burnley, David Cooke, and Deirdre Hanan
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Paper ,Engineering ,Waste management ,business.industry ,Decision Making ,Social criteria ,Waste paper ,Incineration ,Environmental economics ,Multiple-criteria decision analysis ,Decision Support Techniques ,England ,Waste Management ,Recycling ,business ,Waste Management and Disposal ,Decision analysis - Abstract
The use of Multi-criteria Decision Analysis (MCDA) was investigated in an exercise using a panel of local residents and stakeholders to assess the options for managing waste paper on the Isle of Wight. Seven recycling, recovery and disposal options were considered by the panel who evaluated each option against seven environmental, financial and social criteria. The panel preferred options where the waste was managed on the island with gasification and recycling achieving the highest scores. Exporting the waste to the English mainland for incineration or landfill proved to be the least preferred options. This research has demonstrated that MCDA is an effective way of involving community groups in waste management decision making.
- Published
- 2013
19. Safe nurse staffing policies for hospitals in England, Ireland, California, Victoria and Queensland: A discussion paper
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Luk Bruyneel, Walter Sermeus, Koen Van den Heede, Justien Cornelis, Carine Van de Voorde, and Nicolas Bouckaert
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Matching (statistics) ,Population ageing ,Victoria ,Staffing ,Personnel Staffing and Scheduling ,Nurses ,Nursing Staff, Hospital ,California ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Humans ,030212 general & internal medicine ,030503 health policy & services ,Health Policy ,Nurse staffing ,Health services research ,Hospitals ,Policy ,England ,Transparency (graphic) ,Workforce ,Job satisfaction ,Business ,Queensland ,0305 other medical science ,Ireland - Abstract
Objective The association between higher registered nurses (RN) staffing (educational level and number) and better patient and nurse outcomes is well-documented. This discussion paper aims to provide an overview of safe staffing policies in various high-income countries to identify reform trends in response to recurring nurse workforce challenges. Methods Based on a scan of the literature five cases were selected: England (UK), Ireland, California (USA), Victoria and Queensland (Australia). Information was gathered via a review of the grey and peer-reviewed literature. Country experts were consulted for additional information and to review country reports. Results The focus of safe staffing policies varies: increasing transparency about staffing decisions (England), matching actual and required staffing levels based on patient acuity measurement (Ireland), mandated patient-to-nurse ratios at the level of the nurse (California) or the ward (Victoria, Queensland). Calibration of the number of patients by the number of nurses varies across cases. Nevertheless, positive effects on the nursing workforce (increased bedside staffing) and staff well-being (increased job satisfaction) have been consistently documented. The impact on patient outcomes is promising but less well evidenced. Conclusion Countries will have to set safe staffing policies to tackle challenges such as the ageing population and workforce shortages. Various approaches may prove effective, but need to be accompanied by a comprehensive policy that enhances bedside nurse staffing in an evidence-based, objective and transparent way.
- Published
- 2020
20. A protocol paper: community engagement interventions for cardiovascular disease prevention in socially disadvantaged populations in the UK: an implementation research study
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Sibyl Anthierens, Geofrey Musinguzi, Papreen Nahar, Harm W.J. van Marwijk, Elizabeth Ford, Stephen Bremner, Hilde Bastiaens, Mark Bowyer, Jean Yves Le Reste, Linda Gibson, and Tholene Sodi
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Counseling ,medicine.medical_specialty ,Implementation research ,Health (social science) ,Epidemiology ,Psychological intervention ,030204 cardiovascular system & hematology ,Risk Assessment ,Vulnerable Populations ,State Medicine ,03 medical and health sciences ,Study Protocol ,0302 clinical medicine ,Nursing ,Health care ,medicine ,Stakeholder analysis ,030212 general & internal medicine ,Stepped-wedge cluster randomised trial ,Community engagement ,business.industry ,lcsh:Public aspects of medicine ,Health Policy ,Public health ,1. No poverty ,Public Health, Environmental and Occupational Health ,Community Participation ,lcsh:RA1-1270 ,CVD risk prevention ,United Kingdom ,3. Good health ,Disadvantaged ,England ,Cardiovascular Diseases ,Community health ,Human medicine ,business ,Psychology - Abstract
Background Cardiovascular disorders (CVD) are the single greatest cause of mortality worldwide. In the UK, the National Health Service (NHS) has launched an initiative of health checks over and above current care to tackle CVD. However, the uptake of Health Checks is poor in disadvantaged communities. This protocol paper sets out a UK-based study (Sussex and Nottingham) aiming to co-produce a community delivered CVD risk assessment and coaching intervention to support community members to reduce their risk of CVD. The overall aim of the project is to implement a tailored-to-context community engagement (CE) intervention on awareness of CVD risks in vulnerable populations in high, middle and low-income countries. The specific objectives of the study are to enhance stakeholder’ engagement; to implement lifestyle interventions for cardiovascular primary prevention, in disadvantaged populations and motivate uptake of NHS health checks. Methods This study uses both qualitative and quantitative methods in three phases of evaluation, including pre-, per- and post-implementation. To ensure contextual appropriateness the ‘Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research’ (SPICES) project will organize a multi-component community-engagement intervention. For the qualitative component, the pre-implementation phase will involve a contextual assessment and stakeholder mapping, exploring potentials for CVD risk profiling strategies and led by trained Community Health Volunteers (CHV) to identify accessibility and acceptability. The per-implementation phase will involve healthy lifestyle counselling provided by CHVs and evaluation of the outcome to identify fidelity and scalability. The post-implementation phase will involve developing sustainable community-based strategies for CVD risk reduction. All three components will include a process evaluation. A stepped wedge cluster randomised trial of the roll out will focus on implementation outcomes including uptake and engagement and changes in risk profiles. The quantitative component includes pre and post-intervention surveys. The theory of the socio-ecological framework will be applied to analyse the community engagement approach. Discussion Based on the results ultimately a sustainable community engagement-based strategy for the primary prevention of CVD risk will be developed to enhance the performance of NHS health care in the UK. The Trial Registration number is ISRCTN68334579.
- Published
- 2020
21. Response to Correspondence from Kolstoe and colleagues concerning our paper entitled, Research approvals iceberg: How a 'low-key' study in England needed 89 professionals to approve it and how we can do better
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Mila Petrova, Stephen Barclay, Petrova, Mila [0000-0001-7351-6815], and Apollo - University of Cambridge Repository
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Health (social science) ,Biomedical ethics ,Comment [publication type] [MeSH] ,Ethics, Research ,Ethical review [MeSH] ,Political science ,Humans ,Ethics, Medical ,Institutional review boards ,Ethics ,lcsh:R723-726 ,Research ethics ,Scope (project management) ,Health Policy ,Corporate governance ,Research [MeSH] ,Records ,Bioethics ,Conflation ,Issues, ethics and legal aspects ,England ,Philosophy of medicine ,IRB ,Accountability ,Ethics committees ,Engineering ethics ,Bioethics [MeSH] ,lcsh:Medical philosophy. Medical ethics ,Medical ethics ,Ethics Committees, Research - Abstract
In their letter to the Editor in this issue, Kolstoe and Carpenter challenge a core aspect of our recently published case study of research approvals [BMC Medical Ethics 20:7] by arguing that we conflate research ethics with governance and funding processes. Amongst the key concerns of the authors are: 1) that our paper exemplifies a typical conflation of concepts such as governance, integrity and ethics, with significant consequences for claims around the responsibility and accountability of the organisations involved; 2) that, as a consequence of this conflation, we misrepresent the ethics review process, including in fundamental aspects such as the ethics approval-opinion distinction; 3) that it is difficult to see scope for greater integration of processes such as applying for funding, research approvals, Patient and Public Involvement, etc., as suggested by us. Here we present an alternative point of view towards the concerns raised.
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- 2020
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22. Lessons from evaluation of the NHS white paper Our Health, Our Care, Our Say
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Helen Thorp, Ailsa M Cameron, Sarah Purdy, Stephen Peckham, Kate Stewart, Michael .W. Calnan, Chris Salisbury, and Rachel A Lart
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Budgets ,Cost-Benefit Analysis ,Health Services Accessibility ,State Medicine ,Debate & Analysis ,White paper ,Nursing ,Health care ,Humans ,Medicine ,Healthcare Disparities ,Health policy ,HRHIS ,business.industry ,Health Policy ,Social Support ,International health ,Public relations ,Long-Term Care ,Health equity ,Long-term care ,England ,Health Care Reform ,Health care reform ,Patient Participation ,Family Practice ,business - Abstract
The NHS white paper Our Health, Our Care, Our Say was published by the previous UK Labour government in January 2006, describing a new strategic direction for health and social care in the community.1 This had four main goals: (a) better prevention and earlier intervention for improved health, independence, and wellbeing; (b) more choice and a stronger voice for individuals and communities; (c) tackling inequalities and improving access to services; and (d) more support for people with long-term needs. The context for these policy goals was the need, experienced by all developed countries, to remodel their healthcare systems to reflect the changing needs of their populations. In particular, the focus of health care is increasingly to support people to manage long-term health conditions at home and to reduce the number of admissions to hospital. Helping people to get more convenient and faster access to health care, providing them with more information to enable them to care for themselves, and integrating health and social care systems, are all strategies to meet this need. To achieve the policy goals, the white paper promoted a range of initiatives. The government produced a structured framework for ensuing implementation of these initiatives and tracking progress made towards the policy goals.2,3 A series of evaluations of the initiatives were commissioned, including formal programme evaluation, demonstration sites, pilot projects, and formative evaluation. This emphasis on evaluation reflected a commitment, which was increasingly evident from the late 1990s onward, to base policy on evidence about what works.4 What has been learned from this programme of evaluation about the extent to which these initiatives are achieving the policy goals of the white paper? We were commissioned by the Department of Health to review the evaluations of 10 initiatives that were specifically promoted by the …
- Published
- 2011
23. Policy change and policy dilemmas: interpreting the community services White Paper in England
- Author
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Bob Hudson
- Subjects
community services ,integration ,England ,policy dilemmas ,policy implementation ,ambiguity ,conflict ,Medicine (General) ,R5-920 - Abstract
Context: In 2006 the Labour Government in England published its long awaited White Paper on ‘community services’, following on from the 2005 Green Paper on the future of social care. The policy envisages an unprecedented shift of activity and resources from acute care to community settings, along with a much stronger focus on preventive care. Several mechanisms are to be put in place to ensure this shift takes place, most notably practice-based commissioning, payments-by-results and enhanced partnership working. Purpose: This article outlines the intended changes and assesses the extent to which they add up to a coherent strategy. Conclusion: It is argued that although there is widespread support for the overall vision, the strategy contains some difficult policy tensions that are common to other welfare systems. These will have to be addressed if the vision is to be a reality.
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- 2006
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24. Sterrett, Joseph, and Peter Thomas, eds., Sacred Text—Sacred Space: Architectural, Spiritual, and Literary Convergences in England and Wales. Foreword Richard Chartres. Vol. 4 of Studies in Religion and Arts Series, eds. James Najarian and Eric Ziolkowski. Leiden and Boston: Brill, 2011. Pp. xvi + 372 + illustrations. $166.00 paper
- Author
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Cimadomo, Guido
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Wales ,England ,Sacred space ,Lugares sagrados . Inglaterra y Gales - Abstract
Post-refereed, pre-print version, de acuerdo con consent form. Publicado en: Religion and the Arts 19:1-2(2015). 144-145.DOI: https://doi.org/10.1163/15685292-01901011 Two important concepts underlie this collection of essays edited by Joseph Sterrett and Peter Thomas: sacred space, a place or places where man can find “what is real in the midst of the formless expanse”; and text, considered in its sacred character, as something given to and developed by man in order to guide his own spiritual life. While they seem to proceed from opposite directions, the opposition implicit in these concepts between concrete and spiritual is not so strong when we consider that (according to Helen Wilcox) sacred spaces are everywhere when considered in the general context of the spiritual life. The relations between sacred texts and sacred spaces presented in this volume are the result of research done at Cardiff University, and are limited to England and Wales. Due to the history of the these two countries it is easy for the reader to understand how these concepts are related with the evolution and transformation of religious belief and of society in general during the period under consideration. The book is divided into three temporal sections, focusing on the medieval era, the early modern period, and the nineteenth century. The twelve essays that make up the book look at sacred texts, at sacred spaces, and at both of them in very different ways: ...
- Published
- 2020
25. Teaching history in Japan and England: exchanging ideas and comparing knowledge
- Author
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Fearns-Davies, Matthew, Kubota, Tsutomu, Tachibana, Fumina, Kato, Yuko, and Davies, Ian
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- 2022
- Full Text
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26. Accuracy and Efficiency of Recording Pediatric Early Warning Scores Using an Electronic Physiological Surveillance System Compared With Traditional Paper-Based Documentation
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Steven Lane, Bernie Carter, Gerri Sefton, Roger Killen, Stuart Black, Enitan D. Carrol, Colette Holloway, Caitlin Richards, Pearl Ampah, Dominic Loren-Gosling, Coral Davies, Cathryn Sproule, Max Lyon, Chung Shen Chean, Jean Spinty, and April Wilson
- Subjects
Organizational Behavior and Human Resource Management ,Nursing (miscellaneous) ,Time Factors ,Strategy and Management ,Human error ,MEDLINE ,Vital signs ,Pharmaceutical Science ,Health Informatics ,Observation ,Documentation ,B700 ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,030225 pediatrics ,Surveys and Questionnaires ,Drug Discovery ,Medicine ,Health Status Indicators ,Humans ,030212 general & internal medicine ,Diagnosis, Computer-Assisted ,Prospective Studies ,Reliability (statistics) ,Features ,Monitoring, Physiologic ,Marketing ,Pharmacology ,Pediatric ,Warning system ,business.industry ,Vital Signs ,Reproducibility of Results ,B730 ,medicine.disease ,Early warning score ,e-Observations ,Test (assessment) ,VitalPAC ,England ,Medical emergency ,business - Abstract
Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score. To test this hypothesis, we conducted a controlled study of documentation using five clinical vignettes. We measured the accuracy of vital sign recording, score calculation, and time taken to complete documentation using a handheld electronic physiological surveillance system, VitalPAC Pediatric, compared with traditional paper-based charts. We explored the user acceptability of both methods using a Web-based survey. Twenty-three staff participated in the controlled study. The electronic physiological surveillance system improved the accuracy of vital sign recording, 98.5% versus 85.6%, P < .02, Pediatric Early Warning Score calculation, 94.6% versus 55.7%, P < .02, and saved time, 68 versus 98 seconds, compared with paper-based documentation, P < .002. Twenty-nine staff completed the Web-based survey. They perceived that the electronic physiological surveillance system offered safety benefits by reducing human error while providing instant visibility of recorded data to the entire clinical team.
- Published
- 2017
27. Working paper 1 (statistics update): An overview of statistics on SEN in England and ASN in Scotland
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Gillooly, Amanda and Riddell, Sheila
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children ,Scotland ,England ,Additional support needs ,autonomy and rights - Published
- 2019
28. Spring budget: cash for social care and a green paper on future funding
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Richard Humphries and Chris Ham
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Budgets ,Social Work ,CARE Act ,media_common.quotation_subject ,Commission ,030204 cardiovascular system & hematology ,State Medicine ,Social insurance ,03 medical and health sciences ,0302 clinical medicine ,Financial Support ,Humans ,Medicine ,030212 general & internal medicine ,Publication ,media_common ,Finance ,Government ,Green paper ,business.industry ,General Medicine ,Tipping point (climatology) ,England ,Cash ,Health Expenditures ,business - Abstract
The government has bought some time to find a sustainable solution The spring budget delivered £2bn of new funding for social care over three years from 2017‑18 and a commitment to publish a green paper outlining options for future funding. The government’s decision to find additional resources reflects the huge pressures facing social care in England, which the Care Quality Commission described as near “tipping point,”1 and the effect of these pressures on the NHS. These resources will go some way towards stabilising social care, even though they fall short of the sums independent commentators have argued are needed to bridge the expected funding gap by the end of this parliament.2 The announcement of a green paper, planned for the autumn, fulfils the prime minister’s commitment to explore ways of making the funding of social care sustainable. Several options are likely to be considered, including compulsory social insurance as used in countries such as Germany and Japan; acting on the recommendations of the Dilnot report to introduce a cap on care costs, which was included in the Care Act …
- Published
- 2017
29. Lessons from abroad for funding long-term care in England: a prospective policy transfer perspective on official documents
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Powell, Martin
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- 2022
- Full Text
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30. Comment on the paper “Deep groundwater flow and geochemical processes in limestone aquifers: evidence from thermal waters in Derbyshire, England, UK” by John Gunn, Simon H Bottrell, David J Lowe, Stephen R H Worthington. Hydrogeology Journal (2006), 14 (6), 868–881
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Brassington, F. C.
- Published
- 2008
- Full Text
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31. A discussion paper: Do national maternity policy reviews take account of the education and training of the future midwifery workforce? An example from England
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Jenny Hall and Susan Way
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Nurse Midwives ,Training (civil) ,State Medicine ,National education ,03 medical and health sciences ,0302 clinical medicine ,Political science ,Maternity and Midwifery ,National Policy ,Humans ,030212 general & internal medicine ,Education, Nursing ,book ,Curriculum ,030504 nursing ,business.industry ,Health Policy ,Obstetrics and Gynecology ,Public relations ,Nursing standard ,England ,Order (business) ,Workforce ,book.journal ,0305 other medical science ,business - Abstract
The development and provision of maternity services globally are continuing to receive much attention in order to improve care and safety for women and babies. In the UK national reviews of the maternity services have taken place, with local services taking forward specific pilot projects to support the implementations of policy recommendations. This paper argues that, in order to meet the requirements of change in maternity services, there also needs to be a prompt review of the education of student midwives in order to be confident that the workforce of the future is equipped to implement these changes successfully. Using changes to national policy in England, this paper raises the question of the need for flexible national education standards, to ensure a curriculum can meet the needs of the changing workforce without the need for constant revision of the curriculum.
- Published
- 2017
32. Paper electrocardiograph strips may contain overlooked clinical information in screen-detected type 2 diabetes patients
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Niels Ejskjaer, Annelli Sandbæk, Lise Tarnow, Nygaard H, Jesper Fleischer, Klaus Skovbo Jensen, and Morten Charles
- Subjects
Male ,Paper ,medicine.medical_specialty ,Diabetic Cardiomyopathies ,Endocrinology, Diabetes and Metabolism ,Denmark ,Biomedical Engineering ,Bioengineering ,Type 2 diabetes ,Cohort Studies ,QRS complex ,Electrocardiography ,Diabetic Neuropathies ,Heart Rate ,Internal medicine ,Heart rate ,Internal Medicine ,medicine ,Heart rate variability ,Humans ,Mass Screening ,Diagnostic Errors ,Mass screening ,Aged ,Netherlands ,medicine.diagnostic_test ,Primary Health Care ,business.industry ,Type 2 Diabetes Mellitus ,Middle Aged ,medicine.disease ,Diabetes Mellitus, Type 2 ,England ,Cardiology ,Physical therapy ,Electrocardiography, Ambulatory ,Female ,Original Article ,business ,Cohort study - Abstract
Background: A large number of nondigitized electrocardiograph (ECG) strips are routinely collected in larger cohort studies such as the ADDITION study (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care). These ECG strips are routinely read manually but may contain overlooked information revealing cardiac autonomic dysfunction. The aim of this study was to investigate whether clinical information may be lost using manual R wave to R wave (RR) interval measurements in the calculation of heart rate variability (HRV) in patients with type 2 diabetes mellitus (T2DM). Method: From the Danish part of the ADDITION study, we randomly selected 120 T2DM patients at baseline of the ADDITION study. Analysis of the ECG strips was performed using two different methods: (1) by experienced technicians using rulers and (2) by experienced technicians using a high-resolution computer-assisted method. Calculation of heart rate and time domain HRV [standard deviation of normal-to-normal RR intervals (SDNN) and root mean square of successive differences (RMSSD)] were performed with the same software. Results: When comparing results from the two methods, the following values of Pearson's r are obtained: 0.98 for heart rate, 0.76 for SDNN, and 0.68 for RMSSD. These results indicate that heart rate and HRV measurements by the computer-assisted and manually based methods correlate. However, Bland-Altman plots and Pitman's test of difference in variance revealed poor agreements ( p < .01) for both HRV measurements (SDNN and RMSSD); only heart rate showed substantiated agreement ( p = .54) between the two methods. Low HRV was statistically significantly associated to high heart rate, systolic blood pressure, and diastolic blood pressure in these screen-detected T2DM patients. Conclusions: Paper ECG strips may contain overlooked clinical information on the status of autonomic function in patients with T2DM. In our study, manual measurements of RR intervals were inferior to the computer-assisted method. Based on this study, we recommend cautiousness in the clinical use and interpretation of HRV based on manual or low resolution measurements of RR intervals from ECG strips. High resolution measurements of RR intervals reveal significant associations between low HRV and high heart rate, systolic blood pressure, and diastolic blood pressure among patients with screen-detected T2DM. It is feasible to use a computer-assisted method to determine RR intervals in patients with T2DM.
- Published
- 2012
33. Federated networks in England and Australia cricket: a model of economic dependency and financial insecurity
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Millar, Robbie, Plumley, Daniel, Wilson, Rob, and Dickson, Geoff
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- 2023
- Full Text
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34. Creating pre-conditions for change in clinical practice: the influence of interactions between multiple contexts and human agency
- Author
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Myall, Michelle, May, Carl, Richardson, Alison, Bogle, Sarah, Campling, Natasha, Dace, Sally, and Lund, Susi
- Published
- 2021
- Full Text
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35. Assessment methods in entrepreneurship education, challenges and opportunities in developed and developing nations: a comparative study of Nigeria and England
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Babatunde, Simeon, El-Gohary, Hatem, and Edwards, David
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- 2021
- Full Text
- View/download PDF
36. Understanding the complexity of system-level leadership in the English schooling landscape
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Constantinides, Michalis
- Published
- 2021
- Full Text
- View/download PDF
37. A study to evaluate the effectiveness of Best Beginnings' Baby Buddy phone app in England: a protocol paper
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Sam. Nightingale, Trudy Goodenough, Sally Kendal, Jane Coad, Crispin Day, Samuel Ginja, Toity Deave, Elizabeth Bailey, and Raghu Lingam
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medicine.medical_specialty ,education ,Mothers ,Qualitative property ,HM ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Phone ,Pregnancy ,parenting ,medicine ,Best Beginnings ,Humans ,030212 general & internal medicine ,Centre for Health and Clinical Research ,Care Planning ,app ,Research ethics ,evaluation ,030503 health policy & services ,Research ,Public Health, Environmental and Occupational Health ,Infant ,Focus group ,Mental health ,Mobile Applications ,Self Efficacy ,England ,Health Communication ,Information and Communications Technology ,Research Design ,Family medicine ,H1 ,Best Beginnings, app, evaluation, parenting, pregnancy ,Female ,0305 other medical science ,Psychology ,Cohort study - Abstract
IntroductionDevelopments in information and communication technologies have enabled electronic health and seen a huge expansion over the last decade. This has increased the possibility of self-management of health issues.PurposeTo assess the effectiveness of the Baby Buddy app on maternal self-efficacy and mental well-being three months post-birth in a sample of mothers recruited antenatally. In addition, to explore when, why and how mothers use the app and consider any benefits the app may offer them in relation to their parenting, health, relationships or communication with their child, friends, family members or health professionals.MethodsWe will use a mixed-methods approach, a cohort study, a qualitative element and analysis of in-app data. Participants will be first-time pregnant women, aged 16 years and over, between 12 and 16 weeks of gestation and recruited from five English study sites.Evaluation planWe will compare maternal self-efficacy and mental health at three months post-delivery in mothers who have downloaded the Baby Buddy app compared with those that have not downloaded the app, controlling for confounding factors. Women will be recruited antenatally between 12 and 16 weeks of gestation. Further follow-ups will take place at 35 weeks of gestation and three months post-birth. Data from the cohort study will be supplemented by in-app data that will include, for example, patterns of usage. Qualitative data will assess the impact of the app on the lives of pregnant women and health professionals using both focus groups and interviews.EthicsApproval from the West Midlands-South Birmingham Research Ethics Committee (NRES) (16/WM/0029) and the University of the West of England, Bristol, Research Ethics Committee (HAS.16.08.001).DisseminationFindings of the study will be published in peer reviewed and professional journals, presented locally, nationally and at international conferences. Participants will receive a summary of the findings and the results will be published on Best Beginnings’ website.
- Published
- 2018
38. MODEM: A comprehensive approach to modelling outcome and costs impacts of interventions for dementia. Protocol paper
- Author
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Emily Grundy, Martin Knapp, Adelina Comas-Herrera, Ann Bowling, Klara Lorenz, Daniel Lombard, David McDaid, Nicolas Farina, Sube Banerjee, Carol Jagger, and Raphael Wittenberg
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Male ,Carers ,Economics ,Cost effectiveness ,Cost-Benefit Analysis ,Microsimulation ,Psychological intervention ,Outcomes ,Health informatics ,HV Social pathology. Social and public welfare. Criminology ,Health administration ,Study Protocol ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,RA0001 ,Humans ,Medicine ,Dementia ,030212 general & internal medicine ,Actuarial science ,030214 geriatrics ,Cost–benefit analysis ,Social care ,business.industry ,Health Policy ,Nursing research ,Treatments ,medicine.disease ,Costs ,Models, Economic ,Caregivers ,England ,RC0521 ,Quality of Life ,Female ,Cost-effectiveness ,Microsimulation model ,business - Abstract
Background\ud \ud The MODEM project (A comprehensive approach to MODelling outcome and costs impacts of interventions for DEMentia) explores how changes in arrangements for the future treatment and care of people living with dementia, and support for family and other unpaid carers, could result in better outcomes and more efficient use of resources.\ud \ud Methods\ud \ud MODEM starts with a systematic mapping of the literature on effective and (potentially) cost-effective interventions in dementia care. Those findings, as well as data from a cohort, will then be used to model the quality of life and cost impacts of making these evidence-based interventions more widely available in England over the period from now to 2040. Modelling will use a suite of models, combining microsimulation and macrosimulation methods, modelling the costs and outcomes of care, both for an individual over the life-course from the point of dementia diagnosis, and for individuals and England as a whole in a particular year.\ud \ud Project outputs will include an online Dementia Evidence Toolkit, making evidence summaries and a literature database available free to anyone, papers in academic journals and other written outputs, and a MODEM Legacy Model, which will enable local commissioners of services to apply the model to their own populations.\ud \ud Discussion\ud \ud Modelling the effects of evidence-based cost-effective interventions and making this information widely available has the potential to improve the health and quality of life both of people with dementia and their carers, while ensuring that resources are used efficiently.
- Published
- 2017
39. Thicker paper and larger font increased response and completeness in a postal survey
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Christian D Mallen, Kate M. Dunn, George Peat, and Elaine Thomas
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Gerontology ,Male ,Paper ,Patients ,Epidemiology ,Primary care ,law.invention ,Postal questionnaire ,Randomized controlled trial ,law ,Surveys and Questionnaires ,Font ,Medicine ,Humans ,Postal Service ,Cooperative Behavior ,Aged ,business.industry ,Hazard ratio ,Middle Aged ,Prognosis ,Arthralgia ,Health Surveys ,Confidence interval ,Postal survey ,England ,Research Design ,Printing ,Female ,business ,Older people ,Family Practice ,Demography - Abstract
Objective To investigate the effect of font size and paper thickness on the response to, and completion of, a self-completion postal questionnaire among older people with joint pain. Study Design and Setting Randomized trial. People aged 50 years and older with joint pain who consulted a general practitioner at one of five general practices in Central Cheshire were sent a postal questionnaire. Questionnaire format (large or small font size, thick or thin paper) was randomly allocated using a 2 × 2 factorial design. Results Questionnaires were received from 502 out of 650 participants (crude response 77%). Response was significantly higher for participants receiving questionnaires with a larger font size (79.3% vs. 75.2%; hazard ratio 1.26, 95% confidence interval: 1.02, 1.56). Paper thickness had no significant effect on response. Completion (measure by assessing double-page turnover error) was increased in participants receiving questionnaires printed on thicker paper (3.2% vs. 7.1%; P = 0.049) but was not affected by font size. Conclusion This study demonstrates that questionnaires in larger font and on thicker paper may produce higher and more complete responses than surveys using standard size font and standard thickness paper, and should therefore be considered in studies among older people.
- Published
- 2007
40. Second-hand smoke levels in UK pubs and bars: do the English Public Health White Paper proposals go far enough?
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Ivan Gee, A.F.R. Watson, Richard Edwards, Joanna Carrington, P. R. Edwards, M van Tongeren, and Patrick McElduff
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Smoke ,Male ,medicine.medical_specialty ,Passive smoking ,Restaurants ,Public health ,Suspended particles ,Public Health, Environmental and Occupational Health ,Public Policy ,General Medicine ,medicine.disease_cause ,Extractor ,Geography ,White paper ,England ,Environmental health ,Air Pollution, Indoor ,Data Interpretation, Statistical ,Occupational Exposure ,medicine ,Humans ,Female ,Tobacco Smoke Pollution ,Public Health ,Second hand smoke - Abstract
Background The English Public Health White Paper proposes introducing smoke-free workplaces except in pubs and bars that do not prepare and serve food. The bar area will be nonsmoking in exempted pubs. Objective To explore the likely impact of these proposals in UK pubs and bars. Methods A total of 59 pubs and bars within Greater Manchester in 2001 were chosen. Thirteen were mechanically ventilated, 12 were naturally ventilated and 34 had extractor fans; 23 provided non-smoking areas. We measured timeweighted average concentrations of respirable suspended particles (RSP), solanesol tobacco-specific particles and vapour-phase nicotine (VPN) over a 4-h sampling period on a Tuesday or Saturday night. Results Second-hand smoke (SHS) levels in smoking areas were high (mean RSP 114.5 μg/m 3 , VPN 88.2 μg/m 3 , solanesol 101.7 μg/m 3 ). There were only small (5–13 per cent) reductions in bar areas. Mean levels were lower in non-smoking areas: by 33 per cent for RSPs, 52 per cent for solanesol particles and 69 per cent for VPN. Compared with other settings (homes and other workplaces) with unrestricted smoking, mean SHS levels were high throughout all areas of the pubs regardless of ventilation strategy. Conclusion Partial measures, like those in the English Public Health White Paper, will leave bar staff in exempted pubs unprotected from the occupational hazard of SHS.
- Published
- 2006
41. How smart is England’s approach to smart specialization? A policy paper.
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Marlow, David and Richardson, Kevin
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- *
PUBLIC investments , *TECHNOLOGICAL innovations , *ECONOMIC development , *LEADERSHIP , *RURAL development , *REGIONAL planning , *ECONOMIC policy - Abstract
A previous paper on RIS3 assessed its potential to influence growth strategies and their delivery. It held that significant further investment work was needed in tools and techniques, data and intelligence, and innovation in leadership capacity and capabilities. It further asserted that such investment was needed to be part of a commitment to a long-run learning and evaluation process. This paper considers synergies and dissonances between these national approaches to development in England. In particular, it explores how far RIS represents a step change from previous approaches to innovation-led growth. Alternatively, is it more accurately an incremental facelift and rebranding of previous orthodoxies? Does it add value to or detract from national policy for England? What roles might the approach play in the so-called ‘devolution revolution’? Can the (small scale, ‘light touch’) Advisory Hub approach support and promote those roles? What, if anything, might the England experience have for other nations and regions of Europe? [ABSTRACT FROM AUTHOR]
- Published
- 2016
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42. The part of justices of the peace in establishing of the English navy in the late 16th – early 17th centuries (by the materials of Norfolk county)
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Vladimir P. Mitrofanov
- Subjects
england ,norfolk ,justice of the peace ,nathaniel bacon ,«papers» ,recruitment of sailors ,earl of nottingam ,History (General) ,D1-2009 - Abstract
Background. The activity of justices of the peace as authorities in the counties of England during the Tudors and the first Stuarts, although considered by historians, have not yet been studied, which is noted in the research. By the materials of Nathaniel Bacon, who was the justice of the peace of the Norfolk county, one of the little-studied aspects of the activity of justices of the peace is considered, namely their part in the formation of marine crews for the Royal Navy. Materials and methods. Using the case-studies method, observing the principle of historicism, and the method of analysis and synthesis, various documentary and narrative sources available in the collection of N. Bacon fore the period 1580–1620 are analyzed. Results. An analysis of the sources showed the degree of participation of the justiceof the peace N. Bacon in the recruitment of sailors in the fifteen hundred of Norfolk county at the end of the 16th century and in 1620. His financial expenses fore these purposes and some other administrative actions are noted. The quantitative and personal date of people recruited into the Royal Navy are also determined. Conclusions. In addition to his participation in the socio-economic issue of local life, N. Bacon Was directly involved in the recruitment of sailors for the Royal Navy, using state’s funds. It was an episodic activity, but it required the justice of peace to personally visit the towns and villages of the county, accounting for state’s funds, maintaining contacts with both the constables of the hundreds and the officials of the Crown. The royal authority was pleased with his work in this regard. Without the participation of justices of peace, it is unlikely that officials of maritime department would be able to quickly recruit marine crews.
- Published
- 2023
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43. Schizophrenia, evolution and the borders of biology: on Huxley et al.'s 1964 paper in Nature
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Raf de Bont
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Canada ,Psychoanalysis ,eugenics ,Schizophrenia (object-oriented programming) ,Abram Hoffer ,History, 21st Century ,Biological determinism ,Thomas Huxley ,Politics ,Ernst Mayr ,Argument ,Germany ,Eugenics ,evolution ,Humans ,Sociology ,Psychoanalytic theory ,Biological Psychiatry ,Publishing ,History, 19th Century ,psychoanalysis ,History, 20th Century ,Humphrey Osmond ,Biological Evolution ,schizophrenia ,Psychiatry and Mental health ,England ,Psychoanalytic Theory ,Close reading ,Periodicals as Topic ,Biological psychiatry - Abstract
In October 1964, Julian Huxley, Ernst Mayr, Humphrey Osmond and Abram Hoffer co-published a controversial paper in Nature, in which they tried to explain the persistence of schizophrenia from an evolutionary perspective. This article will elucidate how the reputed authors composed this paper to make it a strong argument for biological psychiatry. Through a close reading of their correspondence, it will furthermore clarify the elements which remained unspoken in the paper, but which were elementary in its genesis.The first was the dominance of psychoanalytical theory in (American) psychiatry — a dominance which the authors wanted to break. The second was the ongoing discussion on the boundaries of biological determinism and the desirability of a new kind of eugenics. As such, the Huxley et al. paper can be used to study the central issues of psychiatry in a pivotal era of its history.
- Published
- 2010
44. Public spending on adult social care and delayed transfers of care in England
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Iparraguirre, Jose
- Published
- 2020
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45. Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development
- Author
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Catherine Pope, Jonathan Drennan, Alejandra Recio Saucedo, Michael Simon, Chiara Dall'Ora, Peter Griffiths, Jane Ball, Antonello Maruotti, and Jeremy Jones
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Health Planning Guidelines ,media_common.quotation_subject ,Cost-Benefit Analysis ,Control (management) ,Staffing ,Personnel Staffing and Scheduling ,Nursing ,Nursing Staff, Hospital ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,Case mix index ,Excellence ,Medicine ,030212 general & internal medicine ,Endogeneity ,General Nursing ,media_common ,Inpatients ,Actuarial science ,030504 nursing ,Cost–benefit analysis ,business.industry ,Economics, Nursing ,Systematic review ,England ,0305 other medical science ,business - Abstract
A large and increasing number of studies have reported a relationship between low nurse staffing levels and adverse outcomes, including higher mortality rates. Despite the evidence being extensive in size, and having been sometimes described as "compelling" and "overwhelming", there are limitations that existing studies have not yet been able to address. One result of these weaknesses can be observed in the guidelines on safe staffing in acute hospital wards issued by the influential body that sets standards for the National Health Service in England, the National Institute for Health and Care Excellence, which concluded there is insufficient good quality evidence available to fully inform practice. In this paper we explore this apparent contradiction. After summarising the evidence review that informed the National Institute for Health and Care Excellence guideline on safe staffing and related evidence, we move on to discussing the complex challenges that arise when attempting to apply this evidence to practice. Among these, we introduce the concept of endogeneity, a form of bias in the estimation of causal effects. Although current evidence is broadly consistent with a cause and effect relationship, endogeneity means that estimates of the size of effect, essential for building an economic case, may be biased and in some cases qualitatively wrong. We expand on three limitations that are likely to lead to endogeneity in many previous studies: omitted variables, which refers to the absence of control for variables such as medical staffing and patient case mix; simultaneity, which occurs when the outcome can influence the level of staffing just as staffing influences outcome; and common-method variance, which may be present when both outcomes and staffing levels variables are derived from the same survey. Thus while current evidence is important and has influenced policy because it illustrates the potential risks and benefits associated with changes in nurse staffing, it may not provide operational solutions. We conclude by posing a series of questions about design and methods for future researchers who intend to further explore this complex relationship between nurse staffing levels and outcomes. These questions are intended to reflect on the potential added value of new research given what is already known, and to encourage those conducting research to take opportunities to produce research that fills gaps in the existing knowledge for practice. By doing this we hope that future studies can better quantify both the benefits and costs of changes in nurse staffing levels and, therefore, serve as a more useful tool for those delivering services.
- Published
- 2016
46. The European positional paper on rhinosinusitis and nasal polyps: has the introduction of guidance on the management of sinus disease affected uptake of surgery and acute admissions for sinusitis?
- Author
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Benjamin Cosway, David R. Owens, and Alun Tomkinson
- Subjects
medicine.medical_specialty ,Subgroup analysis ,Nasal Polyps ,Paranasal Sinuses ,otorhinolaryngologic diseases ,medicine ,Humans ,Nasal polyps ,Sinusitis ,Sinus (anatomy) ,Retrospective Studies ,Rhinitis ,Wales ,business.industry ,Retrospective cohort study ,General Medicine ,medicine.disease ,Otorhinolaryngologic Surgical Procedures ,Surgery ,Hospitalization ,medicine.anatomical_structure ,Paranasal sinuses ,England ,Otorhinolaryngology ,Practice Guidelines as Topic ,Neurosurgery ,business - Abstract
Rhinosinusitis is a common condition with adults experiencing 2-5 episodes per year. The European Positional Paper on Rhinosinusitis and Nasal Polyps (EP3OS) published in 2005 and updated in 2007 provided evidence-based guidelines on the management of sinus disease promoting a conservative approach to treatment. This study examines the effect of EP3OS on sinus surgery uptake and acute admissions for sinusitis in England and Wales. A retrospective study using the national electronic health databases of England (Hospital Episodes Statistics, HES online) and Wales (Patient Episodes Database of Wales, PEDW) was undertaken from 2000 to 2010 using the OPCS-4 codes E12-E17 (sinus surgery) and ICD10 code J01 (acute admission for sinusitis). Data were analysed for effect following the introduction of the EP3OS in 2005 using linear regression and Chi squared analysis. 116,370 sinus procedures and 10,916 acute admissions for sinusitis were made during the study period. No significant decrease in sinus surgery procedures occurred following the introduction of the EP3OS as may have been expected (p0.05), although subgroup analysis suggested a significant increase in Wales (p0.05). In addition, significant increases in acute admissions for sinusitis were observed following the introduction of EP3OS (p0.05). However, subgroup analysis suggested this was not the case in Wales (p0.05). The EP3OS appears to have had little impact on the rates of sinus surgery but more conservative approaches to managing of sinus disease may have led to an increase in acute admissions. Further research is required to investigate whether changes in practice were adopted.
- Published
- 2012
47. Financial resilience of English local government in the aftermath of COVID-19
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Ahrens, Thomas and Ferry, Laurence
- Published
- 2020
- Full Text
- View/download PDF
48. Hospital management of self harm in adults in England: study contains important data not reported in the paper
- Author
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Mitchell, Alex J
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Adult ,Hospitalization ,Mental Health Services ,England ,Risk Factors ,Humans ,Suicide, Attempted ,Letters ,Delivery of Health Care ,Risk Assessment ,Self-Injurious Behavior - Published
- 2016
49. The advent of paper chromatography
- Author
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William J. Whelan
- Subjects
Paper ,Paper chromatography ,Chromatography ,England ,Chemistry ,Chromatography, Paper ,Genetics ,History, 20th Century ,Molecular Biology ,Biochemistry ,Biotechnology - Published
- 1995
50. Paper trials: a qualitative study exploring the place of portfolios in making revalidation recommendations for Responsible Officers
- Author
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Daniel S, Furmedge, Ann, Griffin, Catherine, O'Keeffe, Anju, Verma, Laura-Jane, Smith, and Deborah, Gill
- Subjects
Self-Assessment ,Quality Assurance, Health Care ,Portfolios ,education ,Reflection ,Focus Groups ,Assessment ,Licensure, Medical ,Clinical governance ,Quality ,State Medicine ,Revalidation ,Interviews as Topic ,England ,Physicians ,Learning tools ,London ,Employee Performance Appraisal ,Humans ,Clinical Competence ,Qualitative Research ,Appraisal ,Research Article - Abstract
Background A portfolio of supporting information (SI) reflecting a doctor’s entire medical practice is now a central aspect of UK appraisal for revalidation. Medical revalidation, introduced in 2012, is an assessment of a doctor’s competence and passing results in a five yearly license to practice medicine. It assesses of a doctor’s professional development, workplace performance and reflection and aims to provide assurance that doctors are up-to-date and fit to practice. The dominant assessment mechanism is a portfolio. The content of the revalidation portfolio has been increasingly prescribed and the assessment of the SI is a fundamental aspect of the appraisal process which ultimately allows Responsible Officers (ROs) to make recommendations on revalidation. ROs, themselves doctors, were the first to undergo UK revalidation. This qualitative study explored the perceptions of ROs and their appraisers about the use of this portfolio of evidence in a summative revalidation appraisal. Methods 28 purposefully sampled London ROs were interviewed following their revalidation appraisal and 17 of their appraisers participated in focus groups and interviews. Thematic analysis was used to identify commonalities and differences of experience. Results SI was mostly easy to provide but there were challenges in gathering certain aspects. ROs did not understand in what quantities they should supply SI or what it should look like. Appraisers were concerned about making robust judgements based on the evidence supplied. A lack of reflection from the process of collating SI and preparing for appraisal was noted and learning came more from the appraisal interview itself. Conclusions More explicit guidance must be available to both appraisee and appraiser about what SI is required, how much, how it should be used and, how it will be assessed. The role of SI in professional learning and revalidation must be clarified and further empirical research is required to examine how best to use this evidence to make judgments as part of this type of appraisal.
- Published
- 2015
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