Developing a best practice model for partnership practice between specialist palliative care and intellectual disability services: a mixed methods study

Background: The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature. In response, more partnership practice in end-of-life care is proposed. 
Aim: This study aimed to develop a best practice model to guide and promote partnership practice between specialist palliative care and intellectual disability services. 
Design: A mixed methods research design involving two phases was used, underpinned by a conceptual model for partnership practice. 
Setting/participants: Phase 1 involved scoping end-of-life care to people with intellectual disability, based on self-completed questionnaires. In all, 47 of 66 (71.2%) services responded. In Phase 2, semi-structured interviews were undertaken with a purposive sample recruited of 30 health and social care professionals working in intellectual disability and palliative care services, who had provided palliative care to someone with intellectual disability. For both phases, data were collected from primary and secondary care in one region of the United Kingdom. 
Results: In Phase 1, examples of good practice were apparent. However, partnership practice was infrequent and unmet educational needs were identified. Four themes emerged from the interviews in Phase 2: challenges and issues in end-of-life care, sharing and learning, supporting and empowering and partnership in practice. 
Conclusion: Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.

Instructional Methods For Optimal Learning For An Aerospace Assembly Task: digital animation v pictogram-based instructions

Previous studies on work instruction delivery for complex assembly tasks have shown that the mode and delivery method for the instructions in an engineering context can influence both build time and product quality. The benefits of digital, animated instructional formats when compared to static pictures and text only formats have already been demonstrated. Although pictograms have found applications for relatively straight forward operations and activities, their applicability to relatively complex assembly tasks has yet to be demonstrated. This study compares animated instructions and pictograms for the assembly of an aircraft panel. Based around a series of build experiments, the work records build time as well as the number of media references to measure and compare build efficiency. The number of build errors and the time required to correct them is also recorded. The experiments included five participants completing five builds over five consecutive days for each media type. Results showed that on average the total build time was 13.1% lower for the group using animated instructions. The benefit of animated instructions on build time was most prominent in the first three builds, by build four this benefit had disappeared. There were a similar number of instructional references for the two groups over the five builds but the pictogram users required a lot more references during build 1. There were more errors among the group using pictograms requiring more time for corrections during the build.

Changing the intellectual climate

Calls for more broad-based, integrated, useful knowledge now abound in the world of global environmental change science. They evidence many scientists' desire to help humanity confront the momentous biophysical implications of its own actions. But they also reveal a limited conception of social science and virtually ignore the humanities. They thereby endorse a stunted conception of 'human dimensions' at a time when the challenges posed by global environmental change are increasing in magnitude, scale and scope. Here, we make the case for a richer conception predicated on broader intellectual engagement and identify some preconditions for its practical fulfilment. Interdisciplinary dialogue, we suggest, should engender plural representations of Earth's present and future that are reflective of divergent human values and aspirations. In turn, this might insure publics and decision-makers against overly narrow conceptions of what is possible and desirable as they consider the profound questions raised by global environmental change.

Improving parameter learning of Bayesian nets from incomplete data

This paper addresses the estimation of parameters of a Bayesian network from incomplete data. The task is usually tackled by running the Expectation-Maximization (EM) algorithm several times in order to obtain a high log-likelihood estimate. We argue that choosing the maximum log-likelihood estimate (as well as the maximum penalized log-likelihood and the maximum a posteriori estimate) has severe drawbacks, being affected both by overfitting and model uncertainty. Two ideas are discussed to overcome these issues: a maximum entropy approach and a Bayesian model averaging approach. Both ideas can be easily applied on top of EM, while the entropy idea can be also implemented in a more sophisticated way, through a dedicated non-linear solver. A vast set of experiments shows that these ideas produce significantly better estimates and inferences than the traditional and widely used maximum (penalized) log-likelihood and maximum a posteriori estimates. In particular, if EM is adopted as optimization engine, the model averaging approach is the best performing one; its performance is matched by the entropy approach when implemented using the non-linear solver. The results suggest that the applicability of these ideas is immediate (they are easy to implement and to integrate in currently available inference engines) and that they constitute a better way to learn Bayesian network parameters.

Efficiently Scheduling Task Dataflow Parallelism: A Comparison Between Swan and QUARK

Increased system variability and irregularity of parallelism in applications put increasing demands on the ef- ficiency of dynamic task schedulers. This paper presents a new design for a work-stealing scheduler supporting both Cilk- style recursively parallel code and parallelism deduced from dataflow dependences. Initial evaluation on a set of linear algebra kernels demonstrates that our scheduler outperforms PLASMA’s QUARK scheduler by up to 12% on a 16-thread Intel Xeon and by up to 50% on a 32-thread AMD Bulldozer.

The importance of understanding the behavioural phenotypes of genetic syndromes associated with intellectual disability

Behavioural phenotype research is of benefit to a large number of children with genetic syndromes and associated developmental delay. This article presents an overview of this research area and demonstrates how understanding pathways between gene disorders and behaviour can inform our understanding of the difficulties individuals with genetic syndromes and developmental delay experience, including self-injurious behaviour, social exploitation, social anxiety, social skills deficits, sensory differences, temper outbursts and repetitive behaviours. In addition, physical health difficulties and their interaction with behaviour are considered. The article demonstrates the complexity involved in assessing a child with a rare genetic syndrome.

Olefin / Paraffin separation using Task-Specific Materials based on Ionic Liquids: Advances in Gas Processing

In this work, 1-hexene was extracted from its mixtures with n-hexane in varying ratios using a task specific ionic liquid. Herein, the ionic liquid (IL) 1-butyl-3-methylimidazolium nitrate, [BMIM][NO3], was used and examined with and without the addition of a metal salt. The impact of water on both selectivity and distribution coefficient was also tested. Four potential metal salts were investigated, the results of which demonstrate that the dissolution of transition-metal salts in the IL improves the separation of 1-hexene from n-hexane through metal-olefin complexation. Additionally, the presence of water in IL solutions containing metal salt enhances this selectivity. Finally, UNIFAC was used to correlate the experimental LLE data with good accuracy.

Reviewing the Literature on the Breakdown of Foster Care Placements for Young People: Complexity and the Social Work Task

Young people in long-term foster care are at risk of experiencing poor social, emotional, behavioural and educational outcomes. Moreover, these placements have a significantly greater chance of breaking down compared to those involving children. This article critically evaluates the factors associated with this particular outcome. It was carried out through a literature review conducted by a social work practitioner in one Health and Social Care Trust in Northern Ireland. The findings evidenced that, apart from overriding safety concerns, placement breakdown was not a one-off event but rather a complex process involving the interplay between a range of dynamic risk and protective factors over time, operating in the wider context of the young person’s history and life experiences. The significance of these findings for social work practitioners is finally considered by identifying key theories to inform understanding and intervention.