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2. Contributors

Author

Aranda, Jamie, primary, Balasubramani, Goundappa K, additional, Banerjee, Ritu, additional, Barahimi, Behin, additional, Binari, Laura A., additional, Brooks, David M., additional, Burgner, Anna, additional, Castro-Abeger, Alexander De, additional, Chinn, Matthew, additional, de la Peña, Amparo, additional, Esch, Ally, additional, Garcia, Mark E., additional, A.S., Ben Geoffrey, additional, George, Pravin, additional, Giles, Karen E., additional, Goverdhan, Aarthi, additional, Griffin, Daniel, additional, Groth, Sylvia, additional, Hepburn, Madihah, additional, Jacobson, Nancy, additional, Kim, Sarah, additional, Knirsch, Charles A., additional, Krishnaswami, Srinivasan, additional, Krishnaswami, Sriram, additional, Lal, Pooja, additional, Lopata, Susan M., additional, Mani, Subramani, additional, McCall, Natalie N., additional, McDonald, William M., additional, Menon, Sujatha S., additional, Moran, Cullen P., additional, Nagaraju, Sivakumar, additional, Newey, Christopher, additional, Nowalk, Mary Patricia, additional, Patel, Dhyanesh A., additional, Pham, Amelie, additional, Prasad, Krishna Ramakrishnamenon, additional, Ramalingam, Sathishkumar, additional, Ray, John C., additional, Srinivasan, Mythily, additional, Srivastava, Amit K., additional, Thompson, Jennifer L., additional, Thyvalikakath, Thankam, additional, Vaezi, Michael F., additional, Wack, Andreas, additional, Wallis, Robert S., additional, Nemeroff, Charles B., additional, and Weitkamp, Jörn-Hendrik, additional

Published
2024
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4. An Alternative Approach for Detecting Hearing Loss in Adults with Learning Disabilities

Author

McShea, Lynzee, Giles, Karen, Murphy, Ashley, and Ling, Jonathan

Abstract

Background: Annual health checks in primary care include hearing assessment, though current guidance recommends subjective assessment only. Previous studies suggest this is inadequate and recommend objective alternatives such as hearing screening. This study aimed to assess the feasibility of hearing screening and examine the last recorded annual health check outcome for hearing, for those diagnosed with hearing loss as a result of the screening process. Method: Hearing screening took place in four locations and 75 people with learning disabilities participated. Contact was made with each individual's GP to share results and to request onward referral where indicated. Findings: Wax occlusion prevented screening for 23%. Fifty-seven people completed the screen, and 25 had suspected hearing loss. Of these, 22 people required referral to Audiology to verify their hearing thresholds. Only 13 were actually referred, and 11 individuals underwent assessment in Audiology, resulting in 10 being diagnosed with hearing loss. The most recent annual health check outcomes for hearing were examined for those diagnosed with hearing loss. Of the records we accessed, hearing loss had not been identified or actioned in every case. Conclusions: Hearing screening is shown here to be a suitable method for detecting hearing loss. We recommend changing current annual health check practice to incorporate objective screening. Only 12% of those with suspected hearing loss were known to Audiology services, suggesting a substantial proportion of undetected hearing loss in the community. We found evidence of apparent reluctance around referral and hearing aid fitting and make suggestions for improvement.

Published
2022
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6. Can Point-of-Care Testing Improve Access to Diagnostic Screening and Testing for People with Learning Disabilities? Exploring Perspectives to Improve Access and Equity

Author

Giles, Karen, Ling, Jonathan, and Gordon, Isabel

Abstract

Background: People with learning disabilities have an increased risk of diabetes, cardiovascular disease and hearing loss. This study explored service users' and health professionals' perspectives and experiences of adopting minimally invasive diagnostic and screening devices, known as point-of-care testing (POCT) as a means of improving access and engagement. Materials and Methods: Focus groups and semi-structured interviews were undertaken with attendees at a nonhealthcare day centre, specialist learning disability clinical network and national leads as well as researchers into learning disability and point-of-care issues. Thematic analysis of the data was undertaken. Results: There was a lack of awareness and experience of POCT across the users and health professionals. Despite this, on seeing the devices and discussing application there was strong support and acceptability across all participants for their use so long as individual needs were addressed. There was no consistent sense of where this testing should be done but support for the flexibility this could provide in terms of nonmedicalised locations and individual needs. Strategies for success included the use of specific adjustments such as the presence of a known carer, pre-testing information in an appropriate format and taking into account each individual's preferences. Conclusions: POCT is considered a viable and useful method for improving access to testing for people with learning disabilities. Adoption barriers in implementation identified as specific to the field of learning disabilities included lack of POCT awareness and diagnostic overshadowing concerns, and adjusting for individualised needs is essential.

Published
2020
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11. Repurposing existing medications as cancer therapy: design and feasibility of a randomized pilot investigating propranolol administration in patients receiving hematopoietic cell transplantation

Author

Knight, Jennifer M., Kerswill, Stephanie A., Hari, Parameswaran, Cole, Steve W., Logan, Brent R., D’Souza, Anita, Shah, Nirav N., Horowitz, Mary M., Stolley, Melinda R., Sloan, Erica K., Giles, Karen E., Costanzo, Erin S., Hamadani, Mehdi, Chhabra, Saurabh, Dhakal, Binod, and Rizzo, J. Douglas

Published
2018
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13. Educating Air Force Mortuary Officers: Confronting Death Anxiety.

Author

Giles, Karen

Abstract

Instructor at Air Force Institute of Technology describes role in preparing officers and noncommissioned officers to care for Air Force's dead, thus making them mortuary officers. Notes that officers possess no special skills, are not tested for psychological aptitude, and are not given any initial special/additional training. Describes psychological aspects of this profession. (Author/NB)

Published
1993

17. Age of enlightenment

Author

Staunton, Mike and Giles, Karen

Subjects
Management development programs -- Analysis, Business, Human resources and labor relations
Abstract

UK businesses face significant challenges as they seek to draw up management development strategies. They are aware of the need to bring about business change, rather than simply educate managers, and must also promote organizational learning.

Published
2001

19. Sex Education for Pupils with Severe Learning Difficulties: Research Supplement.

Author

Giles, Karen

Abstract

Eight British special schools for students (aged 2-19) with severe learning difficulties were surveyed for information on treatment of various aspects of sex education, teaching methods, and resources used. The findings were applied to the issues of curriculum, resources, staff development, parent involvement, school policy, and local authority policy. (JDD)

Published
1987

20. Indian High School Dropout: A Perspective.

Author

Wisconsin Univ., Milwaukee. Midwest National Origin Desegregation Assistance Center. and Giles, Karen NoLand

Abstract

A research study of American Indian high school students and dropouts in the Milwaukee Public Schools explored cultural factors which affect Indian students' decisions to remain in or drop out of urban, middle-class American schools. Enculturation, i.e. acquisition of Indian culture, and its effect on acculturation, i.e. adopting traits of another culture, was investigated using Kluckhohn's theory of cultural value orientations variation. The origin and manifestation of values and attitudes of Indian students concerning school were explored. Intensive interviews focussed on general values/attitudes concerning peers, school curriculum, teachers, administration, and community; parental/familial influence; attitude toward dropping out; extent of enculturation; and social commitment to school and community. Students assimilated into American middle-class values regarding man and nature, time orientation, and relations with others were found to be more likely to finish high school than those enculturated into Native American values. Cultural perspectives of Native American students were examined as they related to classroom situations. Recommendations for educators of Native American students included employing counselors and teachers knowledgeable about Indian culture, community, and parents; incorporating Indian cultural values into the curriculum; and providing social/cultural outlets for students. References and recommended readings are appended. (LFL)

Published
1985

22. Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Author

Green, Robert C., primary, Goddard, Katrina A.B., additional, Jarvik, Gail P., additional, Amendola, Laura M., additional, Appelbaum, Paul S., additional, Berg, Jonathan S., additional, Bernhardt, Barbara A., additional, Biesecker, Leslie G., additional, Biswas, Sawona, additional, Blout, Carrie L., additional, Bowling, Kevin M., additional, Brothers, Kyle B., additional, Burke, Wylie, additional, Caga-anan, Charlisse F., additional, Chinnaiyan, Arul M., additional, Chung, Wendy K., additional, Clayton, Ellen W., additional, Cooper, Gregory M., additional, East, Kelly, additional, Evans, James P., additional, Fullerton, Stephanie M., additional, Garraway, Levi A., additional, Garrett, Jeremy R., additional, Gray, Stacy W., additional, Henderson, Gail E., additional, Hindorff, Lucia A., additional, Holm, Ingrid A., additional, Lewis, Michelle Huckaby, additional, Hutter, Carolyn M., additional, Janne, Pasi A., additional, Joffe, Steven, additional, Kaufman, David, additional, Knoppers, Bartha M., additional, Koenig, Barbara A., additional, Krantz, Ian D., additional, Manolio, Teri A., additional, McCullough, Laurence, additional, McEwen, Jean, additional, McGuire, Amy, additional, Muzny, Donna, additional, Myers, Richard M., additional, Nickerson, Deborah A., additional, Ou, Jeffrey, additional, Parsons, Donald W., additional, Petersen, Gloria M., additional, Plon, Sharon E., additional, Rehm, Heidi L., additional, Roberts, J. Scott, additional, Robinson, Dan, additional, Salama, Joseph S., additional, Scollon, Sarah, additional, Sharp, Richard R., additional, Shirts, Brian, additional, Spinner, Nancy B., additional, Tabor, Holly K., additional, Tarczy-Hornoch, Peter, additional, Veenstra, David L., additional, Wagle, Nikhil, additional, Weck, Karen, additional, Wilfond, Benjamin S., additional, Wilhelmsen, Kirk, additional, Wolf, Susan M., additional, Wynn, Julia, additional, Yu, Joon-Ho, additional, Amaral, Michelle, additional, Amendola, Laura, additional, Aronson, Samuel J., additional, Arora, Shubhangi, additional, Azzariti, Danielle R., additional, Barsh, Greg S., additional, Bebin, E.M., additional, Biesecker, Barbara B., additional, Brown, Brian L., additional, Burt, Amber A., additional, Byers, Peter H., additional, Calikoglu, Muge G., additional, Carlson, Sara J., additional, Chahin, Nizar, additional, Christensen, Kurt D., additional, Chung, Wendy, additional, Cirino, Allison L., additional, Clayton, Ellen, additional, Conlin, Laura K., additional, Cooper, Greg M., additional, Crosslin, David R., additional, Davis, James V., additional, Davis, Kelly, additional, Deardorff, Matthew A., additional, Devkota, Batsal, additional, De Vries, Raymond, additional, Diamond, Pamela, additional, Dorschner, Michael O., additional, Dugan, Noreen P., additional, Dukhovny, Dmitry, additional, Dulik, Matthew C., additional, East, Kelly M., additional, Rivera-Munoz, Edgar A., additional, Evans, Barbara, additional, Everett, Jessica, additional, Exe, Nicole, additional, Fan, Zheng, additional, Feuerman, Lindsay Z., additional, Filipski, Kelly, additional, Finnila, Candice R., additional, Fishler, Kristen, additional, Ghrundmeier, Bob, additional, Giles, Karen, additional, Gilmore, Marian J., additional, Girnary, Zahra S., additional, Goddard, Katrina, additional, Gonsalves, Steven, additional, Gordon, Adam S., additional, Gornick, Michele C., additional, Grady, William M., additional, Gray, David E., additional, Green, Robert, additional, Greenwood, Robert S., additional, Gutierrez, Amanda M., additional, Han, Paul, additional, Hart, Ragan, additional, Heagerty, Patrick, additional, Hensman, Naomi, additional, Hiatt, Susan M., additional, Himes, Patricia, additional, Hisama, Fuki M., additional, Ho, Carolyn Y., additional, Hoffman-Andrews, Lily B., additional, Hong, Celine, additional, Horike-Pyne, Martha J., additional, Hull, Sara, additional, Jamal, Seema, additional, Jensen, Brian C., additional, Joffe, Steve, additional, Johnston, Jennifer, additional, Karavite, Dean, additional, Kauffman, Tia L., additional, Kaufman, Dave, additional, Kelley, Whitley, additional, Kim, Jerry H., additional, Kirby, Christine, additional, Klein, William, additional, Knoppers, Bartha, additional, Kong, Sek Won, additional, Krantz, Ian, additional, Krier, Joel B., additional, Lamb, Neil E., additional, Lambert, Michele P., additional, Le, Lan Q., additional, Lebo, Matthew S., additional, Lee, Alexander, additional, Lee, Kaitlyn B., additional, Lennon, Niall, additional, Leo, Michael C., additional, Leppig, Kathleen A., additional, Lewis, Katie, additional, Lewis, Michelle, additional, Lindeman, Neal I., additional, Lockhart, Nicole, additional, Lonigro, Bob, additional, Lose, Edward J., additional, Lupo, Philip J., additional, Rodriguez, Laura Lyman, additional, Lynch, Frances, additional, Machini, Kalotina, additional, MacRae, Calum, additional, Marchuk, Daniel S., additional, Martinez, Josue N., additional, Masino, Aaron, additional, McLaughlin, Heather M., additional, McMullen, Carmit, additional, Mieczkowski, Piotr A., additional, Miller, Jeff, additional, Miller, Victoria A., additional, Mody, Rajen, additional, Mooney, Sean D., additional, Moore, Elizabeth G., additional, Morris, Elissa, additional, Murray, Michael, additional, Ng, David, additional, Oliver, Nelly M., additional, Parsons, Will, additional, Patrick, Donald L., additional, Pennington, Jeffrey, additional, Perry, Denise L., additional, Petersen, Gloria, additional, Plon, Sharon, additional, Porter, Katie, additional, Powell, Bradford C., additional, Punj, Sumit, additional, Breitkopf, Carmen Radecki, additional, Raesz-Martinez, Robin A., additional, Raskind, Wendy H., additional, Reigar, Dean A., additional, Reiss, Jacob A., additional, Rich, Carla A., additional, Richards, Carolyn Sue, additional, Rini, Christine, additional, Roberts, Scott, additional, Robertson, Peggy D., additional, Robinson, Jill O., additional, Robinson, Marguerite E., additional, Roche, Myra I., additional, Romasko, Edward J., additional, Rosenthal, Elisabeth A., additional, Salama, Joseph, additional, Scarano, Maria I., additional, Schneider, Jennifer, additional, Seidman, Christine E., additional, Seifert, Bryce A., additional, Shirts, Brian H., additional, Sholl, Lynette M., additional, Siddiqui, Javed, additional, Silverman, Elian, additional, Simmons, Shirley, additional, Simons, Janae V., additional, Skinner, Debra, additional, Stoffel, Elena, additional, Strande, Natasha T., additional, Sunyaev, Shamil, additional, Sybert, Virginia P., additional, Taber, Jennifer, additional, Taylor, Deanne M., additional, Tilley, Christian R., additional, Tomlinson, Ashley, additional, Trinidad, Susan, additional, Tsai, Ellen, additional, Ubel, Peter, additional, Van Allen, Eliezer M., additional, Vassy, Jason L., additional, Vats, Pankaj, additional, Vetter, Victoria L., additional, Vries, Raymond D., additional, Walser, Sarah A., additional, Walsh, Rebecca C., additional, Werner-Lin, Allison, additional, Whittle, Jana, additional, Wilfond, Ben, additional, Wilhelmsen, Kirk C., additional, Yang, Yaping, additional, Young, Carol, additional, and Zikmund-Fisher, Brian J., additional

Published
2016
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25. Changing rules

Author

Giles, Karen

Subjects
Workers -- Influence, Corporate reorganizations -- Social aspects, Business, Human resources and labor relations
Abstract

Managing three streams of integrated activity, that is, changes in structure, processes and human capability, is one of the emerging challenges. Reorganizations are typically managed within project disciplines and with clear statement of objectives.

Published
2003

26. Reviews.

Author

Warren, Simon, Giles, Karen, and Coleman, Marianne

Subjects
*EDUCATIONAL planning
Abstract

This article analyzes several books on educational planning. The books mentioned include "Creating a Learning Society? Learning Careers and Policies for Lifelong Learning," by Stephen Gorard and Gareth Rees, "The Information Age: Technology, Learning and Exclusion in Wales," by Neil Selwyn and Stephen Gorard, "World Class Schools: International Perspectives on School Effectiveness," edited by David Reynolds, Bert Creemers, Sam Stringfield, Charles Teddlie and Gene Schaffer and "Diary of a Deputy," by Susan M. Tranter.

Published
2004
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27. The Great Works of Art Project

Author

Giles, Karen

Subjects
Art appreciation -- Study and teaching, Community art projects -- Evaluation -- Study and teaching, Arts, visual and performing, Education, Evaluation, Study and teaching
Abstract

A high school art teacher can play a unique role in helping students become informed about art. The enthusiasm students develop when looking at and discussing art is too important [...]

Published
1995

28. Yorkshire TALES.

Author

GILES, KAREN

Subjects
RUGBY Union football
Abstract

The article offers information on the Wortley Rugby Union club South Yorkshire (RUFC) in England. It mentions the success of the club to achieve the 5,000-pound jackpot at the Royal Bank of Scotland Group (RBS) Rugby Force 2011. It notes the significant contribution of Jason Leonard and Tom Palmer to help the club achieved its goals in the said year. A quick guide for the RBS Rugby Force is also presented.

Published
2011

29. Think you're too old to play rugby? Think again... Meet JOHN GOLDMAN?

Author

Giles, Karen

Subjects
RUGBY football players, OLD age, AGE & sports
Abstract

The article features the 70-year-old rugby football player John Goldman of Mill Hill team in England. Goldman states that he was not able to enjoy rugby in his younger days because of his asthma but, had the chance to play the game at his old age despite his cancer and bad back. He mentions that he stopped playing the game but, after 34 years he decided too make a comeback because he had always passion for it. He adds that age and illness must not prevent one from doing what he wants to do.

Published
2011

30. COMMUNITY CARE.

Author

Giles, Karen

Subjects
RUGBY football teams, CLUBHOUSES, ATHLETIC clubs, SPORTS teams -- Finance, MEMBERSHIP in associations, institutions, etc., MANAGEMENT, MAINTENANCE
Abstract

The article focuses on the Pontycymmer Rugby Football Club (RFC) and the refurbishment of its clubhouse by the RBS Rugby Force. It discusses the problems, successes, and developments that Pontycymmer encountered including their financial problems, bringing young members in the club, and the renovation of their clubhouse. It mentions that the club won a 5, 000 pounds grant to renovate their clubhouse to improve its toilet facilities, ceiling roof, and the garden area.

Published
2010

31. Manchester.

Author

Giles, Karen

Subjects
RUGBY football teams, RUGBY football coaches
Abstract

In this article the author discusses the relegation of the Manchester rugby football club in England. It states that Manchester coach Elaine Vassie is leading the club's fightback and assuring that Manchester will remain a proud, passionate and determined club despite being relegated. It also mentions the people who help in executing the club that include Ian Thompson, James Wade, and John Davis. It notes that Manchester may be playing in National Two North next term.

Published
2010

32. The Peter Pan OF RUGBY.

Author

Giles, Karen

Subjects
RUGBY football players, CAREER development, RUGBY football records, SPORTS
Abstract

The article provides information on the existing condition of 49-year old rugby football player Graham Dawe. It mentions that Dawe is busy with his farm but is still active in the league. It also offers details on his performance and statistics in playing rugby. According to Dawe's opponents, he is the toughest player. in addition, they call him Peter Pan of the league.

Published
2009

33. Report of the Academy of Consultation-Liaison Psychiatry Task Force on Lessons Learned From the COVID-19 Pandemic, November 19, 2020: Executive Summary

Author

Shapiro, Peter A., Brahmbhatt, Khyati, Caravella, Rachel, Erickson, Jennifer, Everly, George, Giles, Karen, Gopalan, Priya, Greenspan, Heather, Huijón, R. Michael, Key, R. Garrett, Kroll, David, Prince, Elizabeth, Rabinowitz, Terry, Saad-Pendergrass, Dahlia, and Shalev, Daniel

Abstract

The COVID-19 pandemic forced consultation-liaison psychiatrists to adapt to unprecedented circumstances. The Academy of Consultation-Liaison Psychiatry (ACLP) recognized the need and opportunity to assess its response and convened a task force in mid-2020 to review the lessons learned from the initial experience of the COVID-19 pandemic.

Published
2021
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34. CHECKING IN AT HQ.

Author

Giles, Karen

Subjects
RUGBY football tournaments, RUGBY football teams
Abstract

The article reports on the rugby fare "Big Match," to be held at Twickenham in London, England where the rugby football club Harlequins will be featured in the Guinness Premiership on December 27, 2008. According to Harlequins chief executive Mark Evans, bigger ground, average support and players are three things that aid in a club's success. Moreover, the author adds that the fare offers an affordable Christmas treat for familiy members

Published
2009

35. Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Author

Wilhelmsen, Kirk, Plon, Sharon E., Deardorff, Matthew A., Conlin, Laura K., Appelbaum, Paul S., Berg, Jonathan S., Davis, James V., Ho, Carolyn Y., Vetter, Victoria L., Gornick, Michele C., Biesecker, Leslie G., Jarvik, Gail P., Raskind, Wendy H., Yang, Yaping, Blout, Carrie L., Manolio, Teri A., Goddard, Katrina A.B., Punj, Sumit, Masino, Aaron, Cooper, Greg M., Oliver, Nelly M., Machini, Kalotina, Robinson, Dan, Burt, Amber A., Vassy, Jason L., Roberts, J. Scott, Amaral, Michelle, Ghrundmeier, Bob, Janne, Pasi A., Wilhelmsen, Kirk C., Rehm, Heidi L., Perry, Denise L., Fullerton, Stephanie M., Tsai, Ellen, Tarczy-Hornoch, Peter, Gray, David E., Joffe, Steven, Evans, Barbara, McEwen, Jean, Devkota, Batsal, Scarano, Maria I., Arora, Shubhangi, Lewis, Katie, Lebo, Matthew S., Rivera-Munoz, Edgar A., Richards, Carolyn Sue, Johnston, Jennifer, Lynch, Frances, Werner-Lin, Allison, Veenstra, David L., Patrick, Donald L., Kelley, Whitley, Koenig, Barbara A., Kaufman, Dave, Lambert, Michele P., Mody, Rajen, Dulik, Matthew C., Karavite, Dean, Porter, Katie, Han, Paul, Clayton, Ellen W., Grady, William M., Sharp, Richard R., Rini, Christine, Le, Lan Q., Vats, Pankaj, Filipski, Kelly, Finnila, Candice R., Young, Carol, Skinner, Debra, Martinez, Josue N., Kirby, Christine, Feuerman, Lindsay Z., Mooney, Sean D., Caga-Anan, Charlisse F., Evans, James P., Powell, Bradford C., Taber, Jennifer, Brown, Brian L., Murray, Michael, Bernhardt, Barbara A., Fishler, Kristen, McMullen, Carmit, East, Kelly, Amendola, Laura M., Wolf, Susan M., Stoffel, Elena, Azzariti, Danielle R., Greenwood, Robert S., Garraway, Levi A., Knoppers, Bartha M., Reigar, Dean A., Green, Robert C., Robinson, Marguerite E., Kaufman, David, Parsons, Will, Hong, Celine, Scollon, Sarah, Marchuk, Daniel S., Chung, Wendy K., Sholl, Lynette M., Yu, Joon-Ho, Girnary, Zahra S., Lamb, Neil E., Lee, Alexander, Ng, David, Davis, Kelly, Bebin, Gordon, Adam S., Dorschner, Michael O., Hutter, Carolyn M., Christensen, Kurt D., Henderson, Gail E., Trinidad, Susan, Rich, Carla A., Diamond, Pamela, Lee, Kaitlyn B., Gonsalves, Steven, Hull, Sara, Hisama, Fuki M., Aronson, Samuel J., Kong, Sek Won, Hindorff, Lucia A., Shirts, Brian, Gilmore, Marian J., Carlson, Sara J., Walser, Sarah A., Spinner, Nancy B., Biesecker, Barbara B., Shirts, Brian H., Jamal, Seema, Ou, Jeffrey, Wynn, Julia, Chahin, Nizar, Kauffman, Tia L., Gutierrez, Amanda M., Tabor, Holly K., Siddiqui, Javed, Tomlinson, Ashley, Klein, William, Roberts, Scott, Horike-Pyne, Martha J., Byers, Peter H., Fan, Zheng, Parsons, Donald W., Mieczkowski, Piotr A., Moore, Elizabeth G., Myers, Richard M., Lennon, Niall, Holm, Ingrid A., Miller, Jeff, Silverman, Elian, Kim, Jerry H., Morris, Elissa, Cooper, Gregory M., East, Kelly M., Seifert, Bryce A., Burke, Wylie, Calikoglu, Muge G., Strande, Natasha T., Lupo, Philip J., Lonigro, Bob, Walsh, Rebecca C., Whittle, Jana, Muzny, Donna, Crosslin, David R., Pennington, Jeffrey, Giles, Karen, Cirino, Allison L., Hoffman-Andrews, Lily B., Gray, Stacy W., Chinnaiyan, Arul M., Nickerson, Deborah A., Raesz-Martinez, Robin A., Hart, Ragan, Dugan, Noreen P., Heagerty, Patrick, Macrae, Calum, Leppig, Kathleen A., Roche, Myra I., Rodriguez, Laura Lyman, Van Allen, Eliezer M., Brothers, Kyle B., Himes, Patricia, Breitkopf, Carmen Radecki, De Vries, Raymond, Rosenthal, Elisabeth A., Sybert, Virginia P., Lockhart, Nicole, Exe, Nicole, Krantz, Ian D., Simmons, Shirley, Biswas, Sawona, Simons, Janae V., Lewis, Michelle Huckaby, Romasko, Edward J., Garrett, Jeremy R., Lindeman, Neal I., Sunyaev, Shamil, Krier, Joel B., Seidman, Christine E., Hiatt, Susan M., Bowling, Kevin M., Leo, Michael C., Robinson, Jill O., Salama, Joseph S., Wilfond, Benjamin S., Barsh, Greg S., Reiss, Jacob A., Tilley, Christine R., Zikmund-Fisher, Brian J, McGuire, Amy, Miller, Victoria A., Taylor, Deanne M., Jensen, Brian C., McCullough, Laurence, Dukhovny, Dmitry, Weck, Karen, Everett, Jessica, Robertson, Peggy D., Schneider, Jennifer, Vries, Raymond D., Petersen, Gloria M., Wagle, Nikhil, McLaughlin, Heather M., Lose, Edward J., and Hensman, Naomi

Subjects
3. Good health
Abstract

Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools related to participant preferences and consent, variant classification, disclosure and management of primary and secondary findings, health outcomes, and integration with electronic health records. Future research directions will refine measures of clinical utility of CGES in both germline and somatic testing, evaluate the use of CGES for screening in healthy individuals, explore the penetrance of pathogenic variants through extensive phenotyping, reduce discordances in public databases of genes and variants, examine social and ethnic disparities in the provision of genomics services, explore regulatory issues, and estimate the value and downstream costs of sequencing. The CSER consortium has established a shared community of research sites by using diverse approaches to pursue the evidence-based development of best practices in genomic medicine.

36. Building workforce capacity and capability for integrated working

Author

Akehurst, Joy, Giles, Karen, and Stronge, Paul

Subjects
sub_healthsciences, sub_nursing
Abstract

1) Introduction \ud Context – The NHS England (NHSE) Five Year Forward View (2015) aims to improve health, the quality of care and the predicted financial gap of 30 billion pounds by 2021. Strategic initiatives include prevention and self-care; enhancing primary care; efficiency measures; technology and innovation; workforce development; ‘local’, ‘joined up' services delivered ‘out of hospital’.\ud In 2015, 29 ‘vanguard’ sites were chosen as part of the NHS New Care Models Programme to develop and test different, innovative, local models of integrated care. These models include ‘multispecialty community provider’, ‘enhanced health in care homes’, ‘acute care collaborations’,’ urgent and emergency care collaborations’ and ‘primary and acute care’ systems. The Sunderland ‘multispecialty community provider’ site is in the northeast of England (high deprivation). Risk stratification shows that 3% of the population account for 50% of the health/social care spend (frail elderly with 2 or more co-morbidities with high risk of hospital admission).\ud Three models have been developed – Enhanced primary care; Community integrated teams (one in each of the 5 areas of the city); a Recovery at home service to facilitate early discharge and prevent re-admission. \ud The problem – Workforce planning ‘across the system’ had not been addressed. Key issues - Historic recruitment challenges, workforce engagement, change management and governance.\ud 2) Practice change implemented\ud Action research to support the development of the workforce to deliver integrated care.\ud 3) Aim and theory of change\ud Research questions:\ud What are the skills, knowledge and behaviours which staff need to work in integrated care to deliver high quality effective care for patients?\ud How can current workforce development and planning approaches be improved and delivered?\ud Action research includes phases of action and evaluation, with findings fed back into the service developmental process. It is useful when there is little evidence of best practice, where new roles/services are being developed, or there is potential for tension across services. It can also support behavioural change. The research includes documentary analysis, semi-structured interviews and focus groups. \ud 4) Targeted population/stakeholders \ud System leaders, frontline health/social care staff, patients/carers \ud 5) Timeline \ud January 2016 - April 2017 (3 phases)\ud \ud 6) Highlights \ud The final phase is focussing on the patient and carer perspective of the new workforce for integrated care. Early themes are indicating the need for a ‘named’ professional, care co-ordination, leadership skills, emotional support, communication skills\ud \ud 7) Sustainability \ud The outputs of the research are being built into the strategic. operational, and workforce planning processes\ud 8) Transferability\ud Research findings are fed back to the New Care Models workstream to share learning across vanguard sites and to develop the evidence base. \ud 9) Conclusions \ud Phase 2 themes/challenges:\ud • The need to develop impact measures for new roles in integrated care to ensure there are no unintended consequences in the ‘system’\ud • To setup a ‘system wide workforce group’\ud • The need to develop an organisational development strategy to ensure staff engagement and leadership skills \ud • A plan for ‘upskilling’ staff \ud • The development of a dataset for the ‘system’ workforce\ud • To develop a compact to support the development of future workforce planning approaches\ud • The workforce group to commence modelling of the future workforce using evidence based tools provided by NHS England\ud • A system wide training needs analysis\ud • Workshops to be held with locality leads to support future workforce modelling\ud • To pilot ‘care co-ordination’ and to agree a local definition

Published
2017

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