Exploring Innovative Methodologies in time and place to analyze child protection documents as elements of practice

This paper aims to demonstrate how a derived approach to case file analysis, influenced by the work of Michel Foucault and Dorothy E.Smith, can offer innovative means by which to study the relations between discourse and practices in child welfare. The article explores text-based forms of organization in histories of child protection in Finland and in Northern Ireland. It is focused on case file records in different organizational child protection contexts in two jurisdictions. Building on a previous article (Author 1 & 2: 2011), we attempt to demonstrate the potential of how the relations between practices and discourses –a majorly important theme for understanding child welfare social work – can be effectively analysed using a combination of two approaches This article is based on three different empirical studies from our two jurisdictions Northern Ireland (UK) and Finland; one study used Foucault; the other Smith and the third study sought to combine the methods. This article seeks to report on ongoing work in developing, for child welfare studies, ‘a history that speaks back’ as we have described it.

Does first aid have a place in the medical curriculum? A survey of medical students

Introduction: When a medical emergency occurs in the prehospital environment, there is an expectation from the general public for medical students to offer assistance with a similar level of competence as qualified doctors. However, the question is raised; do medical students have sufficient training in first aid skills to fulfil the role expected of them?

Prior to the publication of the latest version of Tomorrow’s Doctors by the UK General Medical Council, a student selected component (SSC) in first aid was delivered at the medical school in Queen’s University Belfast (QUB), Northern Ireland. The overwhelming popularity of this SSC prompted a desire to investigate and understand students’ experiences of first aid.

Aim: To identify first and second year medical students’ knowledge of, and attitudes towards, first aid and their expectations of the medical curriculum.

Methods: A questionnaire was delivered using TurningPoint Audience Response System® during the second semester of the 2008 - 2009 academic year to all first and second year medical students at QUB.

Results: Less than half of the students felt that they had a good level of first aid knowledge, a third would feel confident helping in an emergency and only 10% would be confident leading an emergency situation. The vast majority of students believed first aid is beneficial, that the general public expect medical students to have the knowledge to handle an emergency situation, and that a full first aid course should be included in the core medical curriculum at an early stage. They did not believe it should be a pre-requisite for medical school.

Conclusion: Only a small proportion believed their first aid knowledge adequate. An overwhelming proportion believed that first aid training is beneficial and that the public expect competency in managing emergencies. This study clearly demonstrates students’ need and desire for first aid training in the core medical curriculum at an early stage and to the highest training level possible.

Preferences for a third-trimester ultrasound scan in a low-risk obstetric population: a discrete choice experiment

Objective: Establish maternal preferences for a third-trimester ultrasound scan in a healthy, low-risk pregnant population.

Design: Cross-sectional study incorporating a discrete choice experiment.

Setting: A large, urban maternity hospital in Northern Ireland.

Participants: One hundred and forty-six women in their second trimester of pregnancy.

Methods: A discrete choice experiment was designed to elicit preferences for four attributes of a third-trimester ultrasound scan: health-care professional conducting the scan, detection rate for abnormal foetal growth, provision of non-medical information, cost. Additional data collected included age, marital status, socio-economic status, obstetric history, pregnancy-specific stress levels, perceived health and whether pregnancy was planned. Analysis was undertaken using a mixed logit model with interaction effects.

Main outcome measures: Women's preferences for, and trade-offs between, the attributes of a hypothetical scan and indirect willingness-to-pay estimates.

Results: Women had significant positive preference for higher rate of detection, lower cost and provision of non-medical information, with no significant value placed on scan operator. Interaction effects revealed subgroups that valued the scan most: women experiencing their first pregnancy, women reporting higher levels of stress, an adverse obstetric history and older women.

Conclusions: Women were able to trade on aspects of care and place relative importance on clinical, non-clinical outcomes and processes of service delivery, thus highlighting the potential of using health utilities in the development of services from a clinical, economic and social perspective. Specifically, maternal preferences exhibited provide valuable information for designing a randomized trial of effectiveness and insight for clinical and policy decision makers to inform woman-centred care.

Serving Multiple Masters: Exploring HRD in the Context of Third Sector Partnerships for Public Service Delivery

Organisations in the Non-Profit and Voluntary (NPV) sector increasingly face challenging and uncertain times with an increasing shift from public grant funding towards contract funding. As a result many of these changes employees in such organisations have often found themselves working more closely under contract with colleagues in public sector organisations in order to provide public services. Using a multiple case study methodology and in-depth interviewing of a range of stakeholders form two large Northern Irish based Non Profit Organisations in the social care sector, the purpose of this research was to
investigate HRD and people management issues and how a turbulent environment can affect how organisations approach HRD strategy and implementation.

The research identifies the importance placed upon NPOs adopting HRD strategies and addressing the development of unique and specialised skills in order to claw back power within the relationships they serve with statutory funding bodies. However this research also notes that the manner in which HRD and its associated issues are considered within NPOs can have an impact on the loyalty and commitment of the workforce which serves them. What is of concern is that the context for the delivery of public services under contract is putting increasing strain on NPOs and this has been felt markedly by their respective workforces, and unless strong values-led leadership and managerial practice is in
place in NPOs, the voluntary-centred ethos of those who work in the sector may be significantly damaged.

Economic evaluation and its place in dentistry

Objective: This review intends to examine current research surrounding economic assessment in the delivery of dental care. Economic evaluation is an acknowledged method of analysing dental care systems by means of efficiency, effectiveness, efficacy and availability. Though this is a widely used method in medicine, it is underappreciated in dentistry. As the delivery of health care changes there has been recent demand by the public, the profession, and those funding dental treatment to investigate current practices regarding programs themselves and resource allocation.
Methods: A meta-analysis was conducted regarding health economics. The initial search was carried out using Pubmed, Google Scholar, Science Direct, and The Cochrane Library with search terms “health AND economics AND dentistry”. A secondary search was conducted with the terms “heath care AND dentistry AND”. The third part of the entry was changed to address the aims and included the following terms: “cost benefit analysis”, “efficiency criteria”, “supply & demand”, “cost-effectiveness”, “cost minimisation”, “cost utility”, “resource allocation”, “QALY”, and “delivery and economics”. Limits were applied to all searches to only include papers published in English within the last eight years.
Results: Preliminary results demonstrated a limited number of economic evaluations conducted in dentistry. Those that were carried out were mainly confined to the United Kingdom. Furthermore analysis was mainly restricted to restorative dentistry, followed by orthodontics, and maxillofacial surgery, thereby demonstrating a need for investigation in all fields of dentistry.
Conclusion: Health economics has been overlooked in the past regarding delivery of dental care and resource allocation. Economic appraisal is a crucial part of generating an effective and efficient dental care system. It is becoming increasingly evident that there is a need for economic evaluation in all dental fields.

Conflicts in the Middle East since 1945, (London: Routledge, 2007, Third Edition).

This third edition of Conflicts in the Middle East since 1945 analyzes the nature of conflict in the Middle East, with its racial, ethnic, political, cultural, religious and economic factors. Throughout the book Peter Hinchcliffe and Beverley Milton-Edwards put the main conflicts into their wider context, with thematic debates on issues such as the emergence of radical Islam, the resolution of conflicts, diplomacy and peace-making, and the role of the superpowers.

The book is brought fully up to date with events in the Middle East, covering, for instance, developments in Iraq in 2006 where a democratically elected government is in place but the insurgency show no sign of coming under control. The analysis of the Palestinian/Israeli conflict is also brought up to the present day, to include the election of the Hamas government and the 2006 conflict between Israel and Lebanon’s Hizballah.

Including a newly updated bibliography and maps of the area, this is the perfect introduction for all students wishing to understand the complex situation in the Middle East, in its historical context.

Feasibility, normative heuristics and the proper place of historical responsibility – a reply to Ohndorf et al.

In this comment, we pick up three points raised by Ohndorf et al. (2015) in their reply to our ethical assessment of the German Advisory Council’s Budget Approach (WBGUBA). First, we discuss and clarify the relationship between ethics and political feasibility, highlighting that the way Ohndorf et el. use feasibility creates an unwarranted status quo bias. Second, we explain the proper place historical responsibility should have within the WBGUBA, stressing the fact that the reasons why we choose one policy proposal over another matter. Third, we analyze the limited extent to which a normative heuristic should motivate an ethically ambitious policy proposal like the WBGUBA.