Reviewing child deaths - Learning from the American experience

Current systems for investigating child deaths in England, Wales and Northern Ireland have come under intense scrutiny in recent years and questions have been raised about the accuracy of child death investigations and resulting statistics. Research has highlighted the ways in which multidisciplinary input can contribute to investigative and review processes, a perspective which is further supported by recent UK policy developments. The experience of creating multidisciplinary child death review teams (CDRTs) in America highlights the potential benefits the introduction of a similar system might have. These benefits include improved multi-agency working and communication, more effective identification of suspicious cases, a decrease in inadequate death certification and a broader and more in-depth understanding of the causes of child deaths through the systematic collection and analysis of data. While a lack of funding, regional coordination and evaluation limit the impact of American CDRTs, the positive aspects of this process make it worthwhile, and timely, to consider how such a model might fit within our own context. Current policy developments such as the Home Office review of coroner services, the Children Bill and related Department for Education and Skills (DfES) work on developing screening groups demonstrate that strides have been made in respect of introducing a multidisciplinary process. Similarly, the development of local protocols for the investigation and/or review of child deaths in England, Wales and Northern Ireland highlights an increased focus on multidisciplinary processes. However, key issues from the American experience, such as the remit of CDRTs/screening panels, the need for national coordination and the importance of rigorous evaluation, can inform the development of a similar process in the UK. Copyright ©2005 John Wiley & Sons, Ltd.

Still Fighting the "War for Talent''? Bridging the Science Versus Practice Gap

The purpose of this article is to identify some the most critical outstanding issues faced by practitioners in undertaking effective talent management. In spite of the global financial crisis, talent management will continue being one of the most important challenges faced by organizations in the coming decade. Workforce demographics and skills shortages are likely to make the "war for talent'' fiercer than ever before making effective talent management a competitive necessity. While talent management is rapidly developing as a research field, there are many areas and questions that need to be explored. These questions are likely to have a particularly important applied benefit as they represent some of the key challenges organizations are grappling with in effectively managing their talent. The article asks researchers in the field to consider the questions proposed in developing future research agendas.

Community asset transfer in Northern Ireland

Community Asset Transfer (CAT), introduced by the New Labour administration and strengthened by the Coalition, aims to provide local groups with the opportunity to own public sector facilities and related services. It is a contested concept, with critics seeing it as another strategy in welfare displacement and state disinvestment, while for others it offers communities an opportunity to acquire collateral and take control over services affecting their lives. This paper explores CAT in Northern Ireland and suggests that while there are important practices, the region lacks the policies, legislative framework and skills to develop it in more progressive and inclusive ways.

A framework for challenging deficits in compression bandaging techniques

Northern Irish (and all UK-based) health care is facing major challenges. This article uses a specific theory to recommend and construct a framework to address challenges faced by the author, such as deficits in compression bandaging techniques in healing venous leg ulcers and resistance found when using evidence-based research within this practice. The article investigates the challenges faced by a newly formed community nursing team. It explores how specialist knowledge and skills are employed in tissue viability and how they enhance the management of venous leg ulceration by the community nursing team. To address these challenges and following a process of reflection, Lewin's forcefield analysis model of change management can be used as a framework for some recommendations made.

An accelerated method of developing DBT projects using CDIO partner institutions as parallel processors

The cycle of the academic year impacts on efforts to refine and improve major group design-build-test (DBT) projects since the time to run and evaluate projects is generally a full calendar year. By definition these major projects have a high degree of complexity since they act as the vehicle for the application of a range of technical knowledge and skills. There is also often an extensive list of desired learning outcomes which extends to include professional skills and attributes such as communication and team working. It is contended that student project definition and operation, like any other designed product, requires a number of iterations to achieve optimisation. The problem however is that if this cycle takes four or more years then by the time a project’s operational structure is fine tuned it is quite possible that the project theme is no longer relevant. The majority of the students will also inevitably experience a sub-optimal project experience over the 5 year development period. It would be much better if the ratio were flipped so that in 1 year an optimised project definition could be achieved which had sufficient longevity that it could run in the same efficient manner for 4 further years. An increased number of parallel investigators would also enable more varied and adventurous project concepts to be examined than a single institution could undertake alone in the same time frame.
This work-in-progress paper describes a parallel processing methodology for the accelerated definition of new student DBT project concepts. This methodology has been devised and implemented by a number of CDIO partner institutions in the UK & Ireland region. An agreed project theme was operated in parallel in one academic year with the objective of replacing a multi-year iterative cycle. Additionally the close collaboration and peer learning derived from the interaction between the coordinating academics facilitated the development of faculty teaching skills in line with CDIO standard 10.

Optimal Time Series Momentum

We develop a continuous-time asset price model to capture the timeseries momentum documented recently. The underlying stochastic delay differentialsystem facilitates the analysis of effects of different time horizons used bymomentum trading. By studying an optimal asset allocation problem, we find thatthe performance of time series momentum strategy can be significantly improvedby combining with market fundamentals and timing opportunity with respect tomarket trend and volatility. Furthermore, the results also hold for different timehorizons, the out-of-sample tests and with short-sale constraints. The outperformanceof the optimal strategy is immune to market states, investor sentiment andmarket volatility.

Nonreciprocal scattering by stacked nonlinear magneto-active semiconductor layers

The combinatorial frequency generation by the periodic stacks of magnetically biased semiconductor layers has been modelled in a self-consistent problem formulation, taking into account the nonlinear dynamics of carriers. It is shown that magnetic bias not only renders nonreciprocity of the three-wave mixing process but also significantly enhances the nonlinear interactions in the stacks, especially at the frequencies close to the intrinsic magneto-plasma resonances of the constituent layers. The main mechanisms and properties of the combinatorial frequency generation and emission from the stacks are illustrated by the simulation results, and the effects of the individual layer parameters and the structure arrangement on the stack nonlinear and nonreciprocal response are discussed. © 2014 Elsevier B.V. All rights reserved.

An evaluation of a critical care course for undergraduate nursing students

AIM:
The aim of this paper was to evaluate a 2-day critical care course (CCC) delivered to a cohort of adult branch nursing students.

BACKGROUND:
In today's health care system there is an increase in the number of critically ill patients being cared for in a ward environment. As a result, nurses require the knowledge and skills to effectively manage this patient group. Skills such as prompt recognition of the sick patient, effective communication and performing basic management care skills are necessary.

METHODS:
The CCC was provided to final year adult branch nursing students (n = 182) within a university in the UK. On completion of the course, participants were invited to undertake a Likert scale questionnaire. The questionnaire also contained a free response section to elicit qualitative information. Quantitative data were analysed using SPSS version 17.0 and descriptive statistics produced. Qualitative responses were analysed thematically.

RESULTS:
There was a 73.7% (n = 135) response rate. Overall, there was a positive evaluation of the course. Students (89.6%; n = 121) reported a perceived increase in confidence when caring for critically ill patients following the course and 88.2% (n = 119) felt that their knowledge and skills had improved at the end of the 2-day course.

CONCLUSION:
This study supports the implementation of critical care training for undergraduate nursing students. There are implications for the development of specific modules, aiming to improve undergraduate nursing students' recognition, assessment and management of the critically ill patient.

UK medical graduates’ preparedness for practice (P4P): A multi-site qualitative study

Introduction Previous research has demonstrated mixed findings in terms of graduates’ P4P in terms of their knowledge and skills, and interpersonal, systemic and technological aspects (Monrouxe et al. 2014). Few studies have included diverse stakeholders from multiple sites and employing longitudinal methods. We therefore aimed to understand the extent to which UK medical graduates are prepared for practice as Foundation doctors. Methods Cross-sectional qualitative narrative interview and longitudinal audio-diary (LAD) studies with participants from England, Scotland, Wales and Northern Ireland. Study 1 comprised 27 group and 84 individual interviews (n=185) with participants representing different stakeholders (F1s, fully registered trainees, clinical educators, undergraduate/postgraduate deans/foundation programme directors, other healthcare professionals, employers, policy makers, government representatives, and patient/public representatives). Study 2 comprised LADs with 26 F1s over 4-months. Results Participants found it hard initially to conceptualise the term ‘preparedness for practice’. We identified 2187 personal incident narratives (i.e. stories of P4P experiences) across our data: 506 (23%) were classed as ‘prepared’, 730 (33%) as ‘unprepared’ and 951 (44%) as ‘unspecified’. We identified factors that facilitated (e.g. supportive supervisors/colleagues, opportunities for shadowing) and hindered (e.g. unsupportive or disrespectful colleagues, poor organization, understaffing) transitions into and through the Foundation programme. The LADs suggested that trainees felt more confident and competent over time, but that such development was not always linear as challenging circumstances (e.g. new rotations) sometimes made trainees feel unprepared for situations where they had previously indicated preparedness. Conclusion Our findings add to the existing evidence on medical graduates’ P4P in the UK (e.g. Goldacre et al. 2008; Illing et al. 2013). Our findings support the role of assistantships and supportive supervisors for smoothing transitions from student to F1. Further longitudinal and action research studies are now needed to follow students through their final-year assistantships and into their F2 year.

Modelling Cohesive-Frictional Particulate Solids for Bulk Handling Applications

Many powders and particulate solids are cohesive in nature and the strength often exhibits dependence on the consolidation stress. As a result, the stress history in the material leading up to a handling scenario needs to be considered when evaluating its handleability. This paper outlines the development of a DEM contact model accounting for plasticity and adhesion force, which is shown to be suitable for modelling the stress history dependent cohesive strength. The model was used to simulate the confined consolidation and the subsequent unconfined loading of iron ore fines with particle sizes up to 1.18mm. The predicted flow function was found to be comparable to the experimental results.