Signalling changes to individuals who show resistance to change can reduce challenging behaviour

Background & objectives Several neurodevelopmental disorders are associated with resistance to change and challenging behaviours – including temper outbursts – that ensue following changes to routines, plans or expectations (here, collectively: expectations). Here, a change signalling intervention was tested for proof of concept and potential practical effectiveness. Methods Twelve individuals with Prader-Willi syndrome participated in researcher- and caregiver-led pairing of a distinctive visual-verbal signal with subsequent changes to expectations. Specific expectations for a planned subset of five participants were systematically observed in minimally manipulated natural environments. Nine caregivers completed a temper outburst diary during a four week baseline period and a two week signalling evaluation period. Results Participants demonstrated consistently less temper outburst behaviour in the systematic observations when changes imposed to expectations were signalled, compared to when changes were not signalled. Four of the nine participants whose caregivers completed the behaviour diary demonstrated reliable reductions in temper outbursts between baseline and signalling evaluation. Limitations An active control group for the present initial evaluation of the signalling strategy using evidence from caregiver behaviour diaries was outside the scope of the present pilot study. Thus, findings cannot support the clinical efficacy of the present signalling approach. Conclusions Proof of concept evidence that reliable pairing of a distinctive cue with a subsequent change to expectation can reduce associated challenging behaviour is provided. Data provide additional support for the importance of specific practical steps in further evaluations of the change signalling approach.

Policy Transfer and the Sustainability of Public Private Partnership in Ireland::A conceptual analysis

There has been private sector involvement in the delivery of public services in the Irish State since its foundation. This involvement was formalised in 1998 when Public Private Partnership (PPP) was officially introduced. Ireland is a latecomer to PPP and, prior to the credit crisis, was seen as a ‘rapid follower’ relying primarily on the UK PPP model in the procurement of infrastructure in transport, education, housing/urban regeneration and water/wastewater.  PPP activity in Ireland stalled during the credit crisis, and some projects were cancelled, but it has taken off again recently with part of the Infrastructure and Capital Investment Plan 2016 – 2021 to be delivered through PPP showing continuing political commitment to PPP.  Ireland’s interest in PPP cannot be explained by economic rationale alone, as PPP was initiated during a period of prosperity. We consider three alternative explanations: voluntary adoption – where the UK model was closely followed; coercive adoption – where PPP policy was forced upon Ireland; and institutional isomorphism – where institutional creation and change was promoted to aid public sector organisations in gaining institutional legitimacy. We find evidence of all three patterns, with coercive adoption becoming more relevant in recent years. Ireland’s rapid uptake of PPP differs from other European countries, mostly because when PPP was introduced in 1998, the Irish State was in an economic position where it could have directly procured necessary infrastructure. This paper therefore asks why PPP was adopted and how this adoption pattern has affected the sustainability of PPP in Ireland.  This paper defines PPP; examines the background to the PPP approach adopted in Ireland; outlines the theoretical framework of the paper: transfer theory and institutional theory; discusses the methodology; reports on findings and gives conclusions.   

Combining histology, stable isotope analysis and ZooMS collagen fingerprinting to investigate the taphonomic history and dietary behaviour of extinct giant tortoises from the Mare aux Songes deposit on Mauritius

Taphonomic research of bones can provide additional insight into a site's formation and development, the burial environment and ongoing post-mortem processes. A total of 30 tortoise (Cylindraspis) femur bone samples from the Mare aux Songes site (Mauritius)were studied histologically, assessing parameters such as presence and type of microbial alteration, inclusions, staining/infiltrations, the degree of microcracking and birefringence. The absence of microbial attack in the 4200 year old Mare aux Songes bones suggests the animals rapidly entered the soil whole-bodied and were sealed anoxically, although they suffered frombiological and chemical degradation (i.e. pyrite formation/oxidation, mineral dissolution and staining) related to changes in the site's hydrology. Additionally, carbon and nitrogen stable isotopeswere analysed to obtain information on the animals' feeding behaviour. The results show narrowly distributed δ13C ratios, indicating a terrestrial C3 plant-based diet, combined with a wide range in δ15N ratios. This is most likely related to the tortoises' drought-adaptive ability to change their metabolic processes, which can affect the δ15N ratios. Furthermore, ZooMS collagen fingerprinting analysis successfully identified two tortoise species (C. triserrata and C. inepta) in the bone assemblage,which,when combined with stable isotope data, revealed significantly different δ15N ratios between the two tortoise species. As climatic changes around this period resulted in increased aridity in the Mascarene Islands, this could explain the extremely elevated δ15N ratio in our dataset. The endemic fauna was able to endure the climatic changes 4200 years ago, although human arrival in the 17th century changed the original habitat to such an extent that it resulted in the extinction of several species. Fortunately we are still able to study these extinct tortoises due to the beneficial conditions of their burial environment, resulting in excellent bone preservation.

Recruiting faith and non-faith based schools, adolescents and parents to a cluster randomised sexual-health trial: experiences, challenges and lessons from the mixed-methods Jack Feasibility Trial

Background: The move toward evidence-based education has led to increasing numbers of randomised trials in schools. However, the literature on recruitment to non-clinical trials is relatively underdeveloped, when compared to that of clinical trials. Recruitment to school-based randomised trials is, however, challenging; even more so when the focus of the study is a sensitive issue such as sexual health. This article reflects on the challenges of recruiting post-primary schools, adolescent pupils and parents to a cluster randomised feasibility trial of a sexual health intervention, and the strategies employed to address them.
Methods: The Jack Trial was funded by the UK National Institute for Health Research (NIHR). It comprised a feasibility study of an interactive film-based sexual health intervention entitled If I Were Jack, recruiting over 800 adolescents from eight socio-demographically diverse post-primary schools in Northern Ireland. It aimed to determine the facilitators and barriers to recruitment and retention to a school-based sexual health trial and identify optimal multi-level strategies for an effectiveness study. As part of an embedded process evaluation, we conducted semi-structured interviews and focus groups with principals, vice-principals, teachers, pupils and parents recruited to the study as well as classroom observations and a parents’ survey.
Results: With reference to Social Learning Theory, we identified a number of individual, behavioural and environmental level factors which influenced recruitment. Commonly identified facilitators included perceptions of the relevance and potential benefit of the intervention to adolescents, the credibility of the organisation and individuals running the study, support offered by trial staff, and financial incentives. Key barriers were prior commitment to other research, lack of time and resources, and perceptions that the intervention was incompatible with pupil or parent needs or the school ethos.
Conclusions: Reflecting on the methodological challenges of recruiting to a school-based sexual health feasibility trial, this study highlights pertinent general and trial-specific facilitators and barriers to recruitment, which will prove useful for future trials with schools, adolescent pupils and parents.

From teaching clinician to research academic- changing focus within UK nurse education; a discussion paper

The focus of this discussion paper is the need for effective professional socialisation of student nurses and the degree to which core values and culture are transferred through University schools of nursing, the academic teaching staff and to the student nurses.
UK schools of nursing had progressively transferred into university institutions more than two decades ago. Schools of nursing and the teaching academics within them, to a greater or lesser extent, impact on and help to professionally socialize student nurses. Professed core values of universities whilst including a focus on excellence and innovation, perhaps also include, collegiality, integrity and social commitment to care. These are all qualities, which should be core values and elements
of the transferable professional culture to student nurses. Notwithstanding the professed core values, at least in some areas of UK universities there is some evidence of increasing competition and a disproportionate research market driven focus. This can reflect back into schools of nursing and is inconsistent with nursing professional values.

This paper explores the degree to which the professed core values of universities and the institutional culture are necessarily enacted, and the degree to which
any dissonance in the institutions professed/enacted core values and culture reflect through the schools of nursing and impact in the professional socialisation of student nurses. The paper also explores the degree to which effective leadership in schools of nursing can help to maintain professional core values and a culture of nursing professional

We need to talk about managerialism: On the Importance of values dialogue and renewal within Catholic schools

Whilst reports of value tensions between new managerialism and Catholic education have emerged as a key theme in the academic literature there remains little empirical understanding of how teachers negotiate these complex terrains in Catholic schools. Drawing on qualitative data from teachers in two Catholic post-primary schools in Northern Ireland, this paper sought to explore how Catholic teachers developed a distinctively Catholic ethos against a culture of ‘creeping managerialism’. The paper has shown that despite the predominance of managerial practices, tensions between managerialist values and the ‘Catholic ethos’ did not emerge in either context: in one school managerialism permeated the school and the Catholic ethos was constructed within this context. In the other school a staff process of spiritual renewal had consolidated a commitment to the Catholic faith and social inclusion. It was argued that the dialogical engagement around Catholic values may help Catholic schools defend against the harsher manifestations of managerialism without compromising the pupils’ capacity to realise their academic potential

Basalt Fibre Reinforced Polymer Strengthening of Normal Strength Reinforced Concrete Floor Slabs Subject to Arching Effects

With ever increasing demands to strengthen existing reinforced concrete structures to facilitate higher loading due to change of use and to extend service lifetime, the use of fibre reinforced polymers (FRPs) in structural retrofitting offers an opportunity to achieve these aims. To date, most research in this area has focussed on the use of glass fibre reinforced polymer (GFRP) and carbon fibre reinforced polymer (CFRP), with relatively little on the use of basalt fibre reinforced polymer (BFRP) as a suitable strengthening material. In addition, most previous research has been carried out using simply supported elements, which have not considered the beneficial influence of in-plane lateral restraint, as experienced within a framed building structure. Furthermore, by installing FRPs using the near surface mounted (NSM) technique, disturbance to the existing structure can be minimised.
This paper outlines BFRP NSM strengthening of one third scale laterally restrained floor slabs which reflect the inherent insitu compressive membrane action (CMA) in such slabs. The span-to-depth ratios of the test slabs were 20 and 15 and all were constructed with normal strength concrete (~40N/mm2) and 0.15% steel reinforcement. 0.10% BFRP was used in the retrofitted samples, which were compared with unretrofitted control samples. In addition, the bond strength of BFRP bars bonded into concrete was investigated over a range of bond lengths with two different adhesive thicknesses. This involved using an articulated beam arrangement in order to establish optimum bond characteristics for use in strengthening slab samples.