Search

Infants with Down syndrome are more likely to experience feeding problems and mothers are likely to require more feeding support than mothers of typically developing infants. During the COVID-19 pandemic, many feeding support services changed from face-to-face to online, which impacted some maternal feeding experiences negatively, but no studies to date have explored the impact for mothers of infants with Down syndrome. Thematic analysis was conducted on semi-structured interviews from thirteen new mothers of infants (aged 8-17 months) with Down syndrome in the UK. Three superordinate themes were generated: (1) Every baby with Down syndrome has a unique journey; (2) There's no point asking, they won't know; and (3) Lack of in-person support. Many mothers expressed frustrations over health professionals' lack of Down syndrome specific knowledge resulting in unmet needs, further magnified due to the nature of the virtual support being offered. Moreover, mothers struggled with reduced social support from other mothers when encountering feeding problems. These results hold real-world implications for health professionals who could provide more specialised face-to-face feeding support to mothers of infants with Down syndrome. This should be prioritised for children's overall development and mothers' wellbeing.

Inclusive practices mean many children with autism spectrum disorders (ASD) attend mainstream education settings. To manage the stressors involved and access its benefits, support can be critical. Indeed, insufficient support can detrimentally impact wellbeing, longer-term development, and the inclusivity agenda. Expanding a limited evidence-base on educational support after diagnosis, focus groups and interviews were conducted for eight parent/carers of children with ASD, twelve special education needs (SEN) school staff, and four children with ASD attending mainstream school. An inductive thematic analysis on the data elicited three themes: a system overwhelmed by unmet needs, the impact on quality of life, and hope for the future. The overwhelming finding was a significant lack of education support for parent/carers and school staff, with the mainstream education system poorly designed and insufficiently resourced to facilitate the inclusion of children with ASD, particularly for those impacted by historic difficulties with access. The tireless work of parent/carers and frontline SEN educators fostered a sense of hope and engendered inclusivity for the children who participated, who felt supported. Given their buffering role, protecting and supporting parent/carer and SEN teacher wellbeing requires a policy shift supporting longer term inclusivity alongside improvements in funding streams and accessibility in provision.

Whilst attendance in mainstream school helps encourage inclusivity, these environments are recognised as being particularly challenging for young people with an autism spectrum disorder (ASD). The COVID-19 pandemic brought a novel transition as young people moved from school to home-learning. This study compared the experiences of parents of children with ASD and co-occurring health difficulties of school-learning environments with their home-learning environments during COVID-19 lockdown. An interpretative phenomenological analysis was conducted on semi-structured interviews from six parents of children (aged 8-15 years old) with ASD. Four superordinate themes were generated: Interactions between Health, ASD and Learning Environments; School Support and Managing Health Needs; Seeking Solutions; and Learning from COVID-19 Lockdown. The study highlighted the impact of ASD and co-occurring health difficulties on learning where parents found ways to provide positive home-learning environments which could be used and/or transferred back into school environments. These results hold real-world implications where educators could treat sensory and ASD friendly environments as standard and include genuine adjustments for children with ASD and additional needs. A flexible home-learning approach using parental knowledge around environmental adjustments that support learning, wellbeing and a sense of inclusion should be prioritised for children's overall development and wellbeing in these unprecedented times, and beyond.

Mainstream primary and secondary schools are increasingly committed to the inclusion of students with Tourette Syndrome (TS). This qualitative study explores teachers' perceptions of factors that have contributed to, or hindered, their success in creating an inclusive environment for children with Tourette Syndrome (TS). Eight teachers (two males, six females) from mainstream primary and secondary schools in the United Kingdom (UK) took part in semi-structured interviews to ascertain their knowledge, training and experience of TS during their professional careers in the UK. Thematic analysis of the transcripts revealed three main themes: teachers' lack of real knowledge and awareness of TS; training provision and marginalisation of TS; and finding solutions and building alliances. Although many of the teachers described their mainstream school as an inclusive environment, many still believed they lacked the professional training to adequately understand the disorder. By enhancing teacher training related to TS, improvements may be seen in the communications between the teachers and parents, and opportunities to educate children and the wider community will also result in a more inclusive environment, reducing specific and generic stressors for children with TS.

This paper engages with challenges of localism, collaboration and reflexivity in thinking about the conceptualisation and development of partnership learning communities between higher education and criminal justice institutions. Grounded in experiences of partnership working in the UK and Australia, our arguments are twofold: First, drawing on missions, policy and practice challenges, that there is a case to be made for partnership--working between higher education and criminal justice institutions; and second that, although there is a need to think about collaborative international structures, there is also a need to reflect critically on how different socio-political and cultural realities (both within and beyond national borders) might shape the particular nature of partnership working. Therefore, while warmly welcoming international collaboration in this field, we urge caution in importing or exporting different "models" of partnership working. We make the case, instead, for open-textured theoretical and empirical reflexivity.

A Therapy Outcome Measure (TOM) is a practical tool for measuring outcomes of care, providing a quick and simple measure which can be used over time in a routine clinical setting. The TOM allows therapists to reflect on the dimensions of impairment, activity, participation, and well-being on an 11-point ordinal scale. Currently there are no therapy outcome measures for Inducible Laryngeal Obstruction (ILO) and Chronic Cough (CC). The purpose of this study was to develop two TOMs, one for ILO (TOM ILO) and one for CC (TOM CC), and to test the reliability and validity of each. Respiratory professionals working with patients with ILO and CC from eight UK locations received training in the use of TOM ILO and TOM CC. Face validity, inter-rater reliability and test-retest reliability were tested and analysed. TOM ILO and TOM CC both have strong face validity. The TOM ILO had strong intra-rater reliability and inter-rater reliability. The TOM CC had poor intra-rater but strong inter-rater reliability. TOM ILO and TOM CC have readily been adapted by those who received training. TOM ILO and TOM CC can now be used as a validated outcome measure. [ABSTRACT FROM AUTHOR]

Infants with Down syndrome are more likely to experience feeding problems and mothers are likely to require more feeding support than mothers of typically developing infants. During the COVID-19 pandemic, many feeding support services changed from face-to-face to online, which impacted some maternal feeding experiences negatively, but no studies to date have explored the impact for mothers of infants with Down syndrome. Thematic analysis was conducted on semi-structured interviews from thirteen new mothers of infants (aged 8–17 months) with Down syndrome in the UK. Three superordinate themes were generated: (1) Every baby with Down syndrome has a unique journey, (2) There's no point asking, they won't know, (3) Lack of in-person support. Many mothers expressed frustrations over health professionals' lack of Down syndrome specific knowledge resulting in unmet needs, further magnified due to the nature of the virtual support being offered. Moreover, mothers struggled with reduced social support from other mothers when encountering feeding problems. These results hold real-world implications for health professionals who could provide more specialised face-to-face feeding support to mothers of infants with Down syndrome. This should be prioritised for children's overall development and mothers' wellbeing. [ABSTRACT FROM AUTHOR]

Researchers, practitioners, and policy-makers in many countries are grappling with ways to address the persistent problem of inequitable educational outcomes between advantaged and disadvantaged students. This paper reports the results of a unique cross-country, cross-cultural analysis undertaken to provide insights into teaching practices that promote equity, drawing on programmes of empirical research or syntheses of major programmes of research that worked from a complex, non-linear view of teaching and its outcomes. We analysed international evidence about teaching practices that have a positive influence on diverse students' learning outcomes and opportunities and then compared and contrasted the results of these analyses. From the commonalities we identified, we derived six interconnected "facets of practice for equity," which are general principles of practice rather than specific teaching strategies or behaviours. Building on these facets, we developed a conceptual framework that can inform an equity-centred teacher education curriculum that specifically addresses the task of preparing teachers who can make a positive difference to the learning opportunities and outcomes of diverse students, particularly those historically disadvantaged by the education system.

Objective: This is the first study to systematically explore the lived experiences of sudden and new onset of severe functional tics from the perspective of the mother's experiences and describes their attempts to access support services in the United Kingdom. Method: Twenty-One mothers of young people aged between 12 to 17 years with functional tic-like behaviour (FTLB) took part in semi-structured interviews. Thematic analysis of the transcribed interviews revealed gaps and inconsistencies within the process of gaining access to professional services and a lack of support for the management of tics and functional tic-like movements, in addition to highlighting the impact it had on daily family life. Results: The themes generated included the occurrence and development of tics, the severity and intensity of symptoms, the psychological impact on the family and the need to make recommendations for a clear care pathway. Managing the impact of the FTLB and co-occurring conditions such as suicidal ideation and self-harm, as well as the physical and emotional trauma, commonly contributed to feelings of isolation and helplessness, which impacted negatively on the family's ability to function and participate in society. Conclusions: The findings emphasize the urgent need to create a clear management pathway for those experiencing FTLB, including the need for more professionals with relevant knowledge, to improve the dialogue with families during the referral process, whilst prioritising the treatment of anxiety and other identified mental health concerns. [ABSTRACT FROM AUTHOR]

Purpose: The immune checkpoint inhibitors (ICIs) have resulted in subgroups of patients with metastatic melanoma achieving high-quality durable responses. Metastatic melanoma survivors are a new population in the era of cancer survivorship. The aim of this study was to evaluate metastatic melanoma survivors in terms of health-related quality of life (HRQoL), immune-related adverse events (irAEs) and exposure to immunosuppressive agents in a large single centre in the UK.Methods: We defined the survivor population as patients with a diagnosis of metastatic melanoma who achieved a durable response to an ICI and had been followed-up for a minimum of 12 months from initiation of ICI without disease progression. HRQoL was assessed using SF-36. Electronic health records were accessed to collect data on demographics, treatments, irAEs and survival. HRQoL data was compared with two norm-based datasets.Results: Eighty-four metastatic melanoma survivors were eligible and 87% (N = 73) completed the SF-36. ICI-related toxicity of any grade occurred in 92% of patients and 43% had experienced a grade 3 or 4 toxicity. Almost half (49%) of the patients required steroids for the treatment of ICI-related toxicity, whilst 14% required treatment with an immunosuppressive agent beyond steroids. Melanoma survivors had statistically significant lower HRQoL scores with regard to physical, social and physical role functioning and general health compared with the normative population. There was a trend towards inferior scores in patients with previous exposure to ipilimumab compared with those never exposed to ipilimumab.Conclusions: Our results show that metastatic melanoma survivors have potentially experienced significant ICI-related toxicity and experience significant impairments in specific HRQoL domains. Future service planning is required to meet this population's unique survivorship needs. [ABSTRACT FROM AUTHOR]

Objectives: Despite the recognition that a high proportion of individuals with an Autism Spectrum Disorder (ASD) will also reach the diagnostic threshold for at least one other mental health condition, many families struggle to access the appropriate mental health support. This study aimed to systematically explore the lived experiences of raising a child with an Autism Spectrum Disorder (ASD) and comorbid mental health condition and describes their attempts to access support via mental health services in the UK. Methods: Seven mothers of children aged between 11 to 15 years with ASD and who were referred for mental health issues, took part in semi-structured interviews. Interpretative Phenomenological Analysis (IPA) of the transcribed interviews revealed gaps and inconsistencies within the process of gaining access to mental health services, in addition to the impact it had on the mothers' own mental health. Results: The themes generated were psychological impact on caregiver; negative experience accessing mental health services, and breakdown in relationships with professionals. Managing the impact of their child's mental health condition, including suicidal ideation and self-harm, alongside their child's neurological condition, commonly led to feelings of isolation, self-blame, guilt and powerlessness; impacting on the mother's own mental health. Conclusions: The themes emphasised the importance of ensuring appropriate referrals are made, enhancing the therapeutic alliance with both the child and parent during the referral process, and in providing continuity of care. [ABSTRACT FROM AUTHOR]

Research has shown the transition planning of young people with autism spectrum disorders from child to adult-directed services to be both problematic and limited in function. Mothers of children with autism spectrum disorders have been shown to be at an increased risk from maternal mental health problems, and have often taken on the role of care co-coordinator during the transition period. The current study sought to explore the experiences of transition of mothers of young people with autism spectrum disorders in the United Kingdom. Interpretative phenomenological analysis was utilised in the analysis of six semi-structured interviews of mothers. Three superordinate themes were identified: negative experiences, resources to cope, facilitating self-preparation. All mothers had an adverse emotional response to transitioning their children from youth to adult services and all indicated a struggle with regard to their control over the process. In order to manage their negative feelings, some mothers adopted an activist attitude. Almost all mothers acknowledged the importance of support from other parents who had a child with an autism spectrum disorder. This study highlights the perceived lack of support and service provision for families with children with disabilities approaching adulthood. This is the first study to identify the important role parent support groups may have in cultivating resilience during the transition from child to adult services. [ABSTRACT FROM AUTHOR]

Many EU-8 migrant workers work in low-skilled, low-paid jobs, particularly in sectors such as food processing and agriculture. Our interest lies in the experience of those migrant workers in the UK and specifically what happens when they are denied their employment rights. In earlier work, we have already shown that there was a significant underuse by EU-8 migrant workers of Employment Tribunals (ETs). So the questions for this article are three-fold. First, why do so few EU-8 migrant workers enforce their employment rights before ETs and to what extent do legal, economic, political and cultural landscapes, as they are experienced by migrant workers, constrain or enable enforcement action? Second, if migrant workers do not resort to ETs, what do they do? Do they simply move on, or do they use alternative enforcement mechanisms (such as the Gangmasters' Licensing Authority)? How effective are these other enforcement processes and institutions in protecting the rights of migrant and similarly vulnerable domestic workers? And third, what might be done to improve the enforcement of employment rights for EU-8 migrant workers and for other vulnerable workers on the UK labour market, including non-EU migrants, especially in the light of the new labour market enforcement agency (LMEA)? We argue that the establishment of a Pay and Work Rights Ombudsman might help address some of the problems experienced by EU-8 migrant workers and other vulnerable national workers. [ABSTRACT FROM AUTHOR]

Aim: Speech and language therapists (SLTs) provide intervention for communication and swallowing to patients with life-limiting conditions, such as dementia and head and neck cancer. The role of the SLT in palliative care is difficult to define. Much is known about the clinical aspects of this role; however, little is known about the core values, beliefs and expectations of SLTs working in this sector, particularly with regard to their role in supporting patients' communication. Through a series of semi-structured interviews and a follow-up focus group, this report aimed to form a picture of the experiences and views of SLTs about their communication role in palliative care. Results suggest that SLTs are forging a self-identity in a sector that is itself constantly evolving, which causes difficulties in defining their role. Participants report that other health professionals have a poor understanding of the SLT's role. SLTs may benefit from palliative care-specific guidelines and increased interprofessional awareness of their role in order to become better integrated into the palliative care sector. [ABSTRACT FROM AUTHOR]

There are currently at least 2 million people in the UK living with and following a cancer diagnosis. Typically four out of every ten people with cancer will receive radiotherapy, but a large proportion of people who have pelvic radiotherapy may go on to develop gastrointestinal (GI) symptoms. This includes rectal bleeding and faecal incontinence, which can have a huge impact on quality of life. These problems often go under-reported by patients and are also under-recognised or under-treated by health professionals. Cancer survivorship is a growing topic that is likely to have a major impact on the NHS, with increasing numbers of patients presenting. A late GI effects of pelvic radiotherapy clinic was set up to address these growing needs of patients with GI symptoms following radiotherapy. This article also shares insights from a doctoral study that is underway looking at people’s experiences of living with symptoms following their treatment, in order to improve awareness of the major impact that this can have. [ABSTRACT FROM AUTHOR]

This article will revisit the parliamentary debate in October 1971 which took Britain into the European Economic Community ( EEC). It will show that both sides involved viewed the vote as a great matter of principle and invoked a number of British traditions in order to justify their stance. Opponents of entry sought to portray EEC membership as endangering three great traditions: Cobdenite liberalism, British internationalism and the UK's ability to govern itself. Those on the other side of the argument rejected all three of these claims, viewing the choice for Europe as opting for an exciting future rather than clinging unrealistically to former glories, and claimed that they were acting in line with another central British tradition - that of being a country that mattered and had a say when crucial economic and political decisions were being made. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Forensic mental health care in the UK has undergone a rapid expansion since the late 1990s. In medium secure units (MSUs), there is growing emphasis on developing care pathways without much theoretical underpinning. We developed a concept of 'Milestones to Recovery' (MTR) to measure progress through the MSU pathway. Aims Our aim was to validate the MTR framework. Our hypotheses were that patients scoring higher on the MTR Scale would be more likely to be aggressive to others in the following 6 months and resident in the acute areas of the unit and that those scoring lower would be more likely to be discharged within 6 months of the assessment. Methods An MTR scale was developed to enable the investigation of the validity of the MTR framework and evaluated with staff evaluations of 80 resident patients using a prospective, longitudinal and naturalistic design. Results The results suggest that the MTR framework is valid in discriminating between different stages on the MSU pathway. Therapeutic engagement was particularly important in terms of progress through the MSU, whereas current behaviour was important in predicting future aggression. Conclusions Further research is required to test the MTR framework across different levels of security, with larger samples and within different populations. Implications for practice [ABSTRACT FROM AUTHOR]

Black describes industrial relations in the UK prison service as the 'Jurassic Park' of public sector industrial relations. Despite industrial relations being identified as an obstacle to good performance or a contributory factor to a crisis in numerous reports, an industrial relations problem persists. In fact, Black argues that many penal reforms, including prison market testing and privatisation, can be 'construed as aimed more at diversification in order to resolve the industrial relations crisis, than to enhance penal reform and identify levels of accountability'. [ABSTRACT FROM AUTHOR]

This article presents a microhistory built around an Inquiry, in 1854, into the alleged sexual misconduct of John Chapman Golding, the government teacher at Caledon. The events in this village become a means through which to engage with the themes of education, respectability and the workings of rumour in the context of a nineteenth-century rural community. The article locates the Inquiry within the expectations set up by the 'New System' of education, launched under the superintendency of James Rose Innes in 1839. As one of the first experiments in state education within the British Empire, the 'New System' represents a significant moment in the history of South African education. At the same time, the interplay between micro- and macro-histories, between the personal and political, enables the historian to examine the nature of mid-nineteenth Cape society in new ways. [ABSTRACT FROM AUTHOR]

Whilst there are not yet laws specifically relating to nanotechnology and its products in any country, the technology and its products are not unregulated. Regulatory frameworks created for conventional technologies and products will be expected to apply to nanotechnology and its products. For example, new medicines are regulated in Australia by the Therapeutic Goods Administration. If a new medicine incorporates nanotechnology, then it should still be regulated as a medicine. However, whether the expectation that pre-existing regulatory frameworks will apply is correct and, if so, whether the application of such frameworks is adequate are important issues to be answered. This paper considers these questions, drawing on lessons learnt from significant regulatory reviews undertaken in the United Kingdom, United States and Australia. [ABSTRACT FROM AUTHOR]

This article explores the role of the Treasury in the formulation and implementation of Britain's European policy in the period between the Messina conference and the failure of the first membership bid. It points to a strong contrast between the 1955-59 period, during which the Treasury, aided and abetted by the Board of Trade, was the dominant force in British European policy, and the early 1960s when the Cabinet and Foreign Offices successfully challenged for the position as lead department in this policy area. The final section of the article seeks to explain the disappearance of Treasury pre-eminence, suggesting that factors ranging from the personality of the Chancellor to the subject and context of negotiations with Western European interlocutors help explain why the Treasury appeared a waning force in the making of Britain's policy towards the EEC. [ABSTRACT FROM AUTHOR]

Canine kobuvirus (CaKV) is a globally distributed pathogen of dogs and is predominantly associated with infection of the gastrointestinal tract. However, an etiological link to enteric disease has not been established since CaKV has been identified in both asymptomatic dogs and animals with diarrheic symptoms. In this study, an extraintestinal CaKV infection was detected by next-generation sequencing in a fox (Vulpes vulpes) in Germany concomitant with a canine distemper virus (canine morbillivirus; CDV) co-infection. Phylogenetic analysis of the complete coding region sequence showed that this strain was most closely related to a CaKV strain detected in a dog in the United Kingdom in 2008. The tissue and cellular tropism of CaKV was characterized by the detection of viral antigens and RNA. CaKV RNA was detected by in situ hybridization in different tissues, including epithelial cells of the stomach and ependymal cells in the brain. The use of a new RT-qPCR assay for CaKV confirmed the systemic distribution of CaKV with viral RNA also detected in the lymph nodes, bladder, trachea, and brain. The detection of a CDV infection in this fox suggests that immunosuppression should be further investigated as a contributing factor to the enhanced extraintestinal spread of CaKV. [ABSTRACT FROM AUTHOR]

Comments on issues related to health services in Great Britain. Program of BBC 'Panorama' on brain death and transplantation; Changes in the management of persons admitted to hospital with self-poisoning; Vaccination against smallpox.

Focuses on the 1998 United Kingdom (UK) Presidency. Meetings presided by the UK government; Information on Presidency; Assessment of the 1998 Presidency.

Presents the transcript of a speech on the British presidency of the European Communities (EC) Council of Minister, delivered at the Annual Conferences of the University Association for Contemporary European Studies in January 1993 Misconceptions concerning the role of an EC presidency; Organizational shortcomings of the British civil service; Lack of political and economic credibility.