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Discusses the theme of prostitution, in the first pornographic novel `Memoirs of a Woman of Pleasure,' by John Cleland with the prostitute's body resembling as that of a place to be colonized and a colonizer, reflecting London's preeminence in colonization during the 17th century. Sexual division of labor; Metaphor of a woman's body; Analogy between trade and prostitution.

Objective: A major issue facing all health systems is improving population health while at the same time responding to both growing patient numbers and needs and developing and retaining the health care workforce. One policy response to workforce shortages has been the development of advanced clinical practice roles. In the context of an English national policy promoting such roles in the health service, we explored senior managers' and senior clinicians' perceptions of factors at the organization level that support or inhibit the introduction of advanced clinical practice roles. The investigation was framed by theories of the diffusion of innovation and the system of professions. Methods: We conducted a qualitative interview study of 39 senior manager and clinicians in 19 National Health Service acute, community, mental health and ambulance organizations across a metropolitan area in 2019. Results: Small numbers of advanced clinical practice roles were reported, often in single services. Four main influences were identified in the development of advanced clinical practice roles: staff shortages (particularly of doctors in training grades) combined with rising patient demand, the desire to retain individual experienced staff, external commissioners or purchasers of services looking to shape services in line with national policy, and commissioner-funded new roles in new ambulatory care services and primary care. Three factors were reported as enabling the roles: finance for substantive posts, evidence of value of the posts, and structural support within the organization. Three factors were perceived as inhibiting developing the roles: confusion and lack of knowledge amongst clinicians and managers, the availability of finance for the roles, and a nervousness (sometimes resistance) to introducing the new roles. Conclusions: While the national policy was to promote advanced clinical practice roles, the evidence suggested there was and would continue to be limited implementation at the operational level. Development scenarios that introduced new monies for such roles reduced some of the inhibiting factors. However, where the introduction of roles required funding to move from one part of a service to another, and potentially from one staff group to another, the growth of these roles was and is likely to be contested. In such scenarios, research and business evidence of relative advantage will be important, as too will be supporters in powerful positions. The paucity of publicly available evidence on the effectiveness of advanced clinical practice roles across the specialties and professions in different contexts requires urgent attention. [ABSTRACT FROM AUTHOR]

In 2016, the Children's Commissioner for England reported that the most frequent provision for young carers (YCs) comes from dedicated YC services. This study formed one part of a three-year evaluation of support for YCs and their families provided by the Hampshire YCs Alliance (HYCA), a county-wide collaboration of ten YC services in the UK. It set out to explore the following primary questions; (a) what are the most important changes that the YC services made to YCs and their families? (b) what is it about the services that creates those changes? Semi-structured interviews were carried out in 2017, with YCs aged 9–17 (n = 8), their parents (n = 5), HYCA staff (n = 6) and professionals from other stakeholder organisations (n = 5) and a thematic analysis was undertaken. Reflecting previous research that YCs and their families have a broad range of needs, findings also reveal how YC services support them through a diverse range of interventions. Support led to a diverse range of positive changes for YCs and their families. A number of service features that facilitate change for YCs, as well as 'key dynamics' important in facilitating change were identified. These findings have led to a conceptual framework of how YC services facilitate change for YCs and are important for understanding the impact these dedicated services can make to the lives of YCs and how they facilitate change. Together they have implications for the development and commissioning of interventions for YCs and families and how service providers promote their support provision. [ABSTRACT FROM AUTHOR]

This paper is based on a research study which explores Social Workers' feelings about professionals touching children during statutory child protection visits to clients' homes in one part of a southern English county. The study focussed on Social Worker visits to children aged between two and ten years who were subject to child protection plans following Section 47 enquiries of the Children Act 1989. A convenience sample of ten completed questionnaires recorded the types of touch, which were reported during the last visit made by the social worker. Semi-structured interviews followed with a further ten Social Workers. Analysis of the data revealed that most of the Social Workers in the study did touch children in a range of ways and for a variety of reasons during visits. 'Touch' was a term which some found uncomfortable and this paper considers whether terminology obstructs open reflection on the topic. Practitioners were keen to discuss the subject more amongst their peers in order to share best practice. [ABSTRACT FROM AUTHOR]

Health is only one part of the story - Case and Deaton carefully chart the underlying economic picture, which is no less stark. As well as the death data, Case and Deaton also show deteriorating health in this group, in particular depression, other mental illness and distress, and chronic pain and disability. In dissecting aggregate statistics, Case and Deaton home in on one group where health has deteriorated fastest - middle aged (45-54 years) white Americans. [Extracted from the article]

Bede's preoccupations in the later years of his life have recently come under close scrutiny. This article will set out the argument to this point, then explore how the Ecclesiastical history conforms to more general perceptions of Bede's purposes. It will conclude that this work was designed to address just one part of his wider reform agenda, as that pertained to the Northumbrian king of the day, Ceolwulf. To this end, Bede painted a picture of the current situation within the Church which is far more optimistic than that on offer in the Letter to Ecgberht just a few years later. It must be concluded that his specific purposes as regards any particular work, and the audience at which that work was aimed, exercised a considerable influence over his strategy, which varies enormously from one part of his output to another. [ABSTRACT FROM PUBLISHER]

The Yorkshire Health Study is a longitudinal observational regional health study collecting health information on the residents from the Yorkshire and Humberside region in England. The second wave of data collection is currently under way. The study aims to inform National Health Service (NHS) and local authority health-related decision making in Yorkshire, with wider implications from findings as well. The first wave contains records for 27 806 individuals (2010-12), aged between 16 and 85, from one part of Yorkshire (South Yorkshire), with the second wave expanding data collection to the whole of the Yorkshire and Humberside region. Data were collected on current and long-standing health, health care usage and health-related behaviours, with a particular focus on weight and weight management. The majority of individuals have also given consent for record linkage with routine clinical data, allowing the linking to disease diagnosis, medication use and health care usage. The study encourages researchers to utilize the sample through the embedding of randomized controlled trials, other controlled trials and qualitative studies. To access the anonymized data or use the sample to recruit participants to studies, researchers should contact Clare Relton (c.relton@sheffield.ac.uk). [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to report on a part of a study examining the interrelationships between personalisation and safeguarding practice. Specifically the authors aimed to examine how safeguarding practice is affected by the roll out of personalisation in adult social care, particularly when the adult at risk has a personal budget or is considering this. Design/methodology/approach -- A sample of annual reports from Adult Safeguarding Boards in England was accessed for content analysis covering the period 2009-2011. One part of this sample of local authorities was selected at random; the other authorities selected had been early adopters of personalisation. The reports were analysed using a pro forma to collect salient information on personalisation that was cross-referenced to identify common themes and differences. Findings -- The authors found variable mentions of personalisation as part of the macro policy context reported in the annual reviews, some examples of system or process changes at mezzo level where opportunities to discuss the interface were emerging, and some small reports of training and case accounts relevant to personalisation. Overall these two policy priorities seemed to be more closely related than had been found in earlier research on the interface between adult safeguarding and personalisation. Research limitations/implications -- There was wide variation in the annual reports in terms of detail, size and content, and reports for only one year were collected. Developments may have taken place but might not have been recorded in the annual reports so these should not be relied upon as complete accounts of organisational or practice developments. Practical implications -- Authors of Safeguarding Adults Board reports may benefit from learning that their reports may be read both immediately and potentially in the future. They may wish to ensure their comments on current matters will be intelligible to possible future readers and researchers. Originality/value -- There does not appear to have been any other previous study of Safeguarding Adult Boards' annual reports. Documentary analysis at local level is under-developed in safeguarding studies. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this paper is to take a holistic perspective to explore levels of cycling and opportunities and barriers to increase children’s safer cycling in disadvantaged areas in England. The study was one part of a larger study which explored the factors underlying the high level of road traffic casualties especially among children in the most disadvantaged areas of England and to explore how this impacts on mobility and quality of life. The methods involved a cross sectional survey comprising school based questionnaire surveys with children aged 9–14 and focus groups with parents who had children within this age range. The surveys were conducted in 2007 and the focus groups during 2008. 4286 children completed the survey and eight focus groups were held. Bike ownership (77%) was high, use in previous week moderate (39%) but only 2% cycled to school. Ownership was significantly lower in minority ethnic groups. Despite young children’s strong preference to travel by cycle (30%) than walk or go by car, most parents felt it was too hazardous. It is unlikely that these findings would be any different from the rest of England, however the combination of environmental and social factors may elevate the risks for young cyclists in these areas. This paper concludes that a number of barriers exist to increasing levels of cycling among children living in disadvantaged areas particularly amongst ethnic groups. These barriers could be addressed by environmental modifications to reduce speeds and by reducing the levels of antisocial driving and riding in residential areas and around destinations where children travel, by providing cycle training to improve children’s skills and parent’s confidence, and by providing secure storage facilities for bikes. Until these barriers are addressed it is unlikely that cycling will increase despite the strong preferences children have to travel by bike. Such preferences to cycle provide an opportunity for local authorities to act on. [Copyright &y& Elsevier]

A well-educated and trained workforce is undoubtedly crucial to the development of quality care for people with learning disabilities. Notwithstanding this, and unsure as to the need to continue to commission educational programmes for one part of this workforce--pre-registration learning disability nursing--South Central Strategic Health Authority commissioned the Valued People Project to undertake a detailed strategic review of educational commissioning, along with a review of the specialist learning disability health workforce more generally. This project has recently been completed, and provides a unique evidence-based expert evaluation of the future strategic direction of education commissioning and leadership for workforce issues in specialist learning disability services, as well as the wider NHS workforce. This is the first in a series of articles that reports on one aspect of the project: the focus group work undertaken with parents and relatives of people with learning disabilities, and people with learning disabilities themselves, as to the need and type of health workforce needed to support them in the future. The article concludes by identifying the key messages of importance from parents and people with learning disabilities concerning the future specialist and wider NHS workforce. [ABSTRACT FROM AUTHOR]

Background: The BioMedical Admissions Test (BMAT) forms part of the undergraduate medical admission process at the University of Cambridge. The fairness of admissions tests is an important issue. Aims: Aims were to investigate the relationships between applicants' background variables and BMAT scores, whether they were offered a place or rejected and, for those admitted, performance on the first year course examinations. Method: Multilevel regression models were employed with data from three combined applicant cohorts. Admission rates for different groups were investigated with and without controlling for BMAT performance. The fairness of the BMAT was investigated by determining, for those admitted, whether scores predicted examination performance equitably. Results: Despite some differences in applicants' BMAT performance (e.g. by school type and gender), BMAT scores predicted mean examination marks equitably for all background variables considered. The probability of achieving a 1st class examination result, however, was slightly under-predicted for those admitted from schools and colleges entering relatively few applicants. Not all differences in admission rates were accounted for by BMAT performance. However, the test constitutes only one part of a compensatory admission system in which other factors, such as interview performance, are important considerations. Conclusion: Results are in support of the equity of the BMAT. [ABSTRACT FROM AUTHOR]

Reported here is one part of the nationally representative, Schools and Continuing Professional Development in England - State of the Nation research study which was funded by the Training and Development Agency for Schools (TDA). This paper sets out to understand how teachers and school leaders in England perceive the benefits and effectiveness of CPD activity. The investigation of benefits and effectiveness of CPD presented in the paper focuses on the various impacts that could result from participation, the forms and features of activities, as well as the conditions that make effectiveness more or less likely to occur. [ABSTRACT FROM AUTHOR]

This paper forms part of an exploration of assessment on one part-time higher education (HE) course: an in-service, professional qualification for teachers and trainers in the learning and skills sector which is delivered on a franchise basis across a network of further education colleges in the north of England. This paper proposes that the validity and reliability of portfolio-based assessment, a key component of many HE programmes in addition to the course being researched here, is contestable. Analysis of the processes of compiling portfolios for assessment, through the conceptual framework of the New Literacy Studies, suggests that the ways in which portfolios are assessed and the ways in which the crucial requisites of validity and reliability are assigned to them, mask complexities and contradictions in their creation by the student. This paper argues for a new, critical analysis of portfolio production and raises a number of questions about the validity, reliability and authenticity of the assessment process that the portfolios reify. [ABSTRACT FROM AUTHOR]

This study sought to explore the early implementation of cluster-based learning (CBL) pilots in one part of the UK. A qualitative study using semi-structured one-to-one interviews was conducted with 10 key informants responsible for managing and delivering local training programmes across 14 general practice specialty training schemes. Data were analysed using thematic content analysis using the constant comparative method. Wide variation existed in the running of CBL pilots between different schemes. The principal reasons for trialling CBL were the high numbers of general practitioner trainees, resulting in extra pressure placed on postgraduate education facilities. Training programme directors (TPDs) managed and facilitated the current pilots. Effective facilitation of the groups was considered essential, along with good organisation and planning, and enthusiastic facilitators. Having a mixture of specialist trainees from different stages of training promoted shared learning in the group. The cluster-based approach was also judged to enable the targeting of training to meet the needs of learners and to address specific local needs. Responders considered that CBL should ultimately comprise learner-led sessions facilitated by educational supervisors, with TPDs being responsible for leading the improvement of the quality of educational and clinical supervision. The main reasons why CBL was not implemented were anxieties about the risks of losing the perceived benefits of the current training format in the absence of evidence of the added value of CBL. The reluctance of trainers to get involved was a major barrier - this resulted mainly from a lack of confidence with facilitating small groups and funding for their time. [ABSTRACT FROM AUTHOR]

In the wake of proposals in the 2002 Planning and Compulsory Purchase Bill to replace the current system of development plans with a new generation of planning policy tools, this is an appropriate moment to reconsider the role of design policies within English planning practice. As the era of local plans, structure plans, and unitary development plans (UDPs) comes to a close, the author looks at one part of the remit that development plans aim to address—design. In doing so, he revisits the practice of a range of local planning authorities originally examined for research undertaken between 1992 and 1994. The author's aim is to gauge how the design-policy approaches of these authorities have fared: (a) twelve years after they were first required to prepare them by the 1990 Town and Country Planning Act, and (b) eight/nine years after they were initially examined in research undertaken for the then Department of the Environment and the Economic and Social Research Council. The research confirmed the benefits of a long-term commitment to better design, grounded within a well-established policy framework that is, nevertheless, responsive to lessons from local implementation experience. It revealed that there is no one right way to achieve this objective, and that the more flexible approaches to plan-making envisaged in forthcoming national legislation should encourage the best of local practice to spread beyond the limited number of local authorities that have so far made such a commitment. [ABSTRACT FROM AUTHOR]

Abstract As one part of a larger study of the integration of mental health and social care, the present paper explores the role of the Joint Commissioning Board in the governance arrangements for health and social partnership in Somerset, UK. A short review of the literature on joint planning and joint commissioning revealed that such partnership has proved problematic, and that the role of non-executive directors and councillors is usually overlooked. Furthermore, the research on corporate boards suggests that their performance does not match the prescriptions made for them. Following a description of the methodology of the study, the present paper reports the findings of the activity of the Joint Commissioning Board from three data sources: (1) observation of meetings; (2) analysis of documentation; and (3) participant interviews. All three sources support the view, put forward in the Discussion section, that the Board does not play a proactive role in the setting and monitoring of policy and priorities. Nonetheless, it is argued, the Board plays a central and constructive role in the governance of partnership: as the symbol of interagency partnership; as the vehicle for sustaining commitment to mental health; and as the method of bringing additional elements of public accountability to the commissioning and providing of health and social care. Locating this ritual function of the Board within the broader sociological literature, the Discussion section goes on to suggest the implications both for the future of governance of partnership and for further research in this area. [ABSTRACT FROM AUTHOR]

This paper describes one part of a feasibility study carried out in England which examined the costs, quality and effectiveness of continence services in areas with different approaches to provision. It involved the design of instruments to collect the views and perceptions of patients and an investigation of ways to develop a methodology to implement comparative studies. It is the design and piloting of the questionnaires and the way patients responded that forms the focus of this paper. The main sample group recruited for the study were women who had recently sought formal help with urinary incontinence and were likely to receive conservative treatment or management in the community. They were interviewed and asked to complete four questionnaires at two points in time. A smaller sub-group of disabled women, interviewed only once, were included to compare cost profiles for different client groups. The questionnaires which were developed address the impact of urinary incontinence (using a standard scale), the effectiveness of service provision in terms of patients’ clinical history, expectations and hoped-for outcomes, service receipt and its cost, and patients’ satisfaction with several aspects of service provision. In total 118 women were interviewed, including 28 disabled women. The study generated a set of survey instruments which might be used for a variety of purposes including audit and future research and which could inform purchaser and provider decisions by using patients’ perspectives of quality of life outcomes to enhance service development. [ABSTRACT FROM AUTHOR]

Evaluating local palliative care services and identifying gaps in services for patients are crucial to the development of services which enable people to die at home in a well-supported environment. A review of the local strategy for providing respite and support services for palliative care patients and their carers was carried out in one area of south-east England. The review comprised four elements: identification of services available; interviews with provider `stakeholders'; interviews with patients and carers; questionnaire survey of general practitioners and district nurses. The findings and outcome are described. It is suggested that this approach could be adopted by health authorities to form one part of a comprehensive system of needs assessment. Alternatively, it could be used by groups of providers to evaluate existing services and to identify potential improvements to services. Advantages and disadvantages of the approach for both commissioners of such reviews and those carrying them out are discussed. [ABSTRACT FROM AUTHOR]

Adjacent species-rich and species-poor areas of a limestone outcrop were investigated in a heavy metal mining complex on Grassington Moor, Yorkshire, England, to determine reasons for the differences in their floras. Levels of soil lead, zinc, nitrogen, phosphorus and potassium were determined and the activities of the enzymes urease, acid phosphatase and dehydrogenase in the soil were measured. Soil respiration rates were also determined. The percentages of the variation in species-density accounted for by each factor were determined using a step-wise multiple regression technique. Binding of lead in organic forms resulting in low levels of available lead, together with higher levels of the major plant nutrients, were probably the main factors enabling a species-rich community to occur on one part of the outcrop. Possible ways in which the differences in habitat became established are discussed. [ABSTRACT FROM AUTHOR]

The article presents a study which compares a group of truants living in a disadvantaged part of Sheffield in England, with a group of other unauthorized absentees living in the same area. A sample was identified consisting of all persistent absentees aged 5- 15 from schools in one part of Sheffield plus all children from the same schools or neighboring schools who had been referred to the psychological service over a two-year period for advice about their poor school attendance. The districts selected for study were almost entirely inner-city district, characterized by numerous social problems, run-down council housing estates and few owner-occupied houses. They had exceptionally higher rates. After an interview, parents were asked to complete a Health Questionnaire focusing on psychiatric symptoms. Results show few differences in the social and financial circumstances of the two groups but considerable differences in the children's behavior and in family relationships. Truants' parents were significantly more likely to report conduct disorders such as stealing or lying.