Current practice and opinion in special schools for the maladjusted in England and Wales

This study seeks to describe current practice and opinion in schools for the maladjusted in England and Wales and to exarnlne how far this coincides with earlier descriptions. A review of the literature provides an account of this earlier work, and data accrued from questionnaires completed by 114 schools describe current practice and opinion. The study represents the most extensive empirical enquiry into the work of these schools since 1955 and provides a wide data basis for future research and assessment of progress and change. The data suggest that there is much communality of practice and opinion within the schools, with most schools emphasising their therapeutic rather than their educational purpose. The work is characterised by the wide use and perceived efficacy of warm, caring adult to child relationships, improvement of pupil self-image through success, and individual counselling and discussion, which permeate a structure of routine, discipline and educational concern. Specialised treatments are not used widely and involve only a minority of pupils. Practice tends to be in reference to conduct disordered pupils who are now perceived as the largest single disorder group within the schools, whereas previously neurotic disorders formed the largest single group. The majority of pupils are perceived as underachieving on entry and requiring remedial help: consequently the educational programme has a remedial bias. For staff, qualities of personality are considered to be more valuable than professional skills. The schools differ in the emphasis they allocate to one or more of four identified areas of treatment described as concern for pupils' needs; degree of pupil participation; theoretical orientation: and the use of external controls. There is a diminished reference to psychoanalytical theory and an increased reference to behaviourist theory relative to previous practice. Similarly, the use and perceived importance and effectiveness of pupil participation and unconditional affection has diminished.

Grading and disease management in national screening for diabetic retinopathy in England and Wales

Aims - A National Screening Programme for diabetic eye disease in the UK is in development. We propose a grading and early disease management protocol to detect sight-threatening diabetic retinopathy and any retinopathy, which will allow precise quality assurance at all steps while minimizing false-positive referral to the hospital eye service. Methods - Expert panel structured discussions between 2000 and 2002 with review of existing evidence and grading classifications. Proposals - Principles of the protocol include: separate grading of retinopathy and maculopathy, minimum number of steps, compatible with central monitoring, expandable for established more complex systems and for research, no lesion counting, no ‘questionable’ lesions, attempt to detect focal exudative, diffuse and ischaemic maculopathy and fast track referral from primary or secondary graders. Sight-threatening diabetic retinopathy is defined as: preproliferative retinopathy or worse, sight-threatening maculopathy and/or the presence of photocoagulation. In the centrally reported minimum data set retinopathy is graded into four levels: none (R0), background (R1), preproliferative (R2), proliferative (R3). Maculopathy and photocoagulation are graded as absent (M0, P0) or present (M1, P1). Discussion - The protocol developed by the Diabetic Retinopathy Grading and Disease Management Working Party represents a new consensus upon which national guidelines can be based leading to the introduction of quality-assured screening for people with diabetes.

Profit, productivity and price performance changes in the water and sewerage industry:an empirical application for England and Wales

This paper aims to analyse the impact of regulation in the financial performance of the Water and Sewerage companies (WaSCs) in England and Wales over the period 1991–2008. In doing so, a panel index approach is applied across WaSCs over time to decompose unit-specific index number-based profitability growth as a function of the profitability, productivity and price performance growth achieved by benchmark firms, and the catch up to the benchmark firm achieved by less productive firms. The results indicated that after 2000 there is a steady decline in average price performance, while productivity improves resulting in a relatively stable economic profitability. It is suggested that the English and Welsh water regulator is now more focused on passing productivity benefits to consumers, and maintaining stable profitability than it was in earlier regulatory periods. This technique is of great interest for regulators to evaluate the effectiveness of regulation and companies to identify the determinants of profit change and improve future performance, even if sample sizes are limited.

Sewers and water mains in England and Wales; materials, manufacture and capital expenditure

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

"Comparing the incomparable":hospital costing and the art of medicine in post-war Britain

This paper examines the relationship between medical and hospital accounting discourses during the two decades after the 1946 National Health Service (NHS) Act for England and Wales. It argues that the departmental costing system introduced into the NHS in 1957 was concerned with the administrative aspects of hospital costliness as contemporary hospital accountants suggested that the perceived incomparability, immeasurability and uncontrollability of medical practice precluded the application of cost accounting to the clinical functions of hospitals. The paper links these suggestions to medical discourses which portrayed the practice of medicine as an intuitive and experience-based art and argues that post-war conceptions of clinical medicine represented this domain in a manner that was neither susceptible to the calculations of cost accountants nor to calculating and normalising intervention more generally. The paper concludes by suggesting that a closer engagement with medical discourses may enhance our understanding of historical as well as present day attempts to make medicine calculable.

Redefining 'media' using a 'media-as-a-constitutional-component' concept:an evaluation of the need for the European Court of Human Rights to alter its understanding of 'media' within a new media landscape

This paper considers the impact of new media on freedom of expression and media freedom within the context of the European Convention on Human Rights and European Court of Human Rights jurisprudence. Through comparative analysis of US jurisprudence and scholarship, this paper deals with the following three issues. First, it explores the traditional purpose of the media, and how media freedom, as opposed to freedom of expression, has been subject to privileged protection, within an ECHR context at least. Secondly, it considers the emergence of new media, and how it can be differentiated from the traditional media. Finally, it analyses the philosophical justifications for freedom of expression, and how they enable a workable definition of the media based upon the concept of the media-as-a-constitutional-component.

Audience design in the police interview:the interactional and judicial consequences of audience orientation

Police-suspect interviews in England & Wales are a multi-audience, multi-purpose, transcontextual mode of discourse. They are conducted as part of the initial investigation into a crime, but are subsequently recontextualised through the judicial process, ultimately being presented in court as evidence against the interviewee. The communicative challenges posed by multiple future audiences are investigated by applying Bell’s (1984) audience design model to the police interview, and the resulting "poor fit" demonstrates why this context is discursively counter-intuitive to participants. Further, data analysis indicates that interviewer and interviewee, although ostensibly addressing each other, may orientate to different audiences, with potentially serious consequences. As well as providing new insight into police-suspect interview interaction, this article seeks to extend understanding of the influence of audience on interaction at the discourse level, and to contribute to the development of theoretical models for contexts with multiple or asynchronous audiences.