Reflections on Practice Learning in Northern Ireland and the Republic of Ireland: Lessons from Student Experiences

Practice learning is viewed as one of the most important components of social work education wherever in the world social work is practised. Northern Ireland and the Republic of Ireland provide an interesting case example of the educational impact on students resulting from their experience of different models of practice learning. Although sharing a common historical legacy, recent developments in policy in both jurisdictions have tended to engender greater divergences in how programmes organise and deliver social work education and practice learning. Drawing on findings from a joint-research project with students in Queen’s University, Belfast and Trinity College, Dublin, the authors highlight significant cross-border similarities as well as differences in the way practice learning is conceptualised, organised and delivered. Through comparing and contrasting student experiences, the authors reflect on how the findings might help to inform the future development of practice learning standards in both jurisdictions.

Establishing ex ante public construction supply chain guidelines in the public procurement of Schools' estate

Purpose – The purpose of this study is to explore the formative development of construction supply chain guidelines or proposals in a UK region’s schools’ estates procurement process to more effectively address a forthcoming increase in investment.

Design/methodology/approach – The research approach is interpretive. Using an action research approach, repeated semi-structured interviews and focus groups with a range of stakeholders are conducted.

Findings – The current construction supply chain in schools’ estate procurement has many difficulties, not least given the highly fragmented and disconnected nature of the projects. Synergies are being missed and there is little or no continuous improvement. Drawing on these findings, the research iteratively develops a range of proposals and guidelines to address this situation.

Research limitations/implications – This research adds weight to the current focus on pressing for change in the construction industry. It presents potentially valuable insights into the benefits of partnering arrangements and how these might usefully be incorporated into schools’ estate supply chain.

Practical implications – A set of guidelines is developed to guide the public procurement of schools’ estate in a UK region. These guidelines are set within the context of the Modernising and Rethinking Construction agenda.

Originality/value – The action research approach enabled the researchers to gain a unique insight into how public procurement and contractor personnel interact and to establish effective practical guidelines.

Impaired endothelium-dependent vasodilatation is a novel predictor of mortality in intensive care

Objective: Endothelial function may be impaired in critical illness. We hypothesized that impaired endothelium-dependent vasodilatation is a predictor of mortality in critically ill patients.
Design: Prospective observational cohort study.
Setting: Seventeen-bed adult intensive care unit in a tertiary referral university teaching hospital. Patients: Patients were recruited within 24 hrs of admission to the intensive care unit.
Interventions: The SphygmoCor Mx system was used to derive the aortic augmentation index from radial artery pulse pressure waveforms. Endothelium-dependent vasodilatation was calculated as the change in augmentation index in response to an endothelium-dependent vasodilator (salbutamol).
Measurements and Main Results: Demographics, severity of illness scores, and physiological parameters were collected. Statistically significant predictors of mortality identified using single regressor analysis were entered into a multiple logistic regression model. Receiver operator characteristic curves were generated. Ninety-four patients completed the study. There were 80 survivors and 14 nonsurvivors. The Simplified Acute Physiology Score II, the Sequential Organ Failure Assessment score, leukocyte count, and endothelium-dependent vasodilatation conferred an increased risk of mortality. In logistic regression analysis, endothelium-dependent vasodilatation was the only predictor of mortality with an adjusted odds ratio of 26.1 (95% confidence interval [CI], 4.3-159.5). An endothelium-dependent vasodilatation value of 0.5% or less predicted intensive care unit mortality with a sensitivity of 79% (CI, 59-88%) and specificity of 98% (CI, 94-99%).
Conclusions: In vivo bedside assessment of endothelium-dependent vasodilatation is an independent predictor of mortality in the critically ill. We have shown it to be superior to other validated severity of illness scores with high sensitivity and specificity.