Pre-conception care : current practice and methods of provision

This thesis examines the present provisions for pre-conception care and the views of the providers of services. Pre-conception care is seen by some clinicians and health educators as a means of making any necessary changes in life style, corrections to imbalances in the nutritional status of the prospective mother (and father) and the assessment of any medical problems, thus maximizing the likelihood of the normal development of the baby. Pre-conception care may be described as a service to bridge the gap between the family planning clinic and the first ante-natal booking appointment. There were three separate foci for the empirical research - the Foresight organisation (a charity which has pioneered pre-conception care in Britain); the pre-conception care clinic at the West London Hospital, Hammersmith; and the West Midlands Regional Health Authority. The six main sources of data were: twenty five clinicians operating Foresight pre-conception clinics, couples attending pre-conception clinics, committee members of the Foresight organisation, staff of the West London Hospital pre-conception clinic, Hammersmith, District Health Education Officers working in the West Midlands Regional Health Authority and the members of the Ante-Natal Care Action Group, a sub-group of the Regional Health Advisory Group on Health Promotion and Preventive Medicine. A range of research methods were adopted. These were as follows: questionnaires and report forms used in co-operation with the Foresight clinicians, interviews, participant observation discussions and informal meetings and, finally, literature and official documentation. The research findings illustrated that pre-conception care services provided at the predominantly private Foresight clinics were of a rather `ad hoc' nature. The type of provision varied considerably and clearly reflected the views held by its providers. The protocol which had been developed to assist in the standardization of results was not followed by the clinicians. The pre-conception service provided at the West London Hospital shared some similarities in its approach with the Foresight provision; a major difference was that it did not advocate the use of routine hair trace metal analysis. Interviews with District Health Education Officers and with members of the Ante Natal Care Action Group revealed a tentative and cautious approach to pre-conception care generally and to the Foresight approach in particular. The thesis concludes with a consideration of the future of pre-conception care and the prospects for the establishment of a comprehensive pre-conception care service.

Black and minority ethnic graduate entrepreneurs: motivations, characteristics and access to finance

This paper draws upon four case studies to examine characteristics, entrepreneurial motivations and access to finance of black and minority ethnic (BME) graduates in the UK. We find that BME graduates starting a business are motivated by a desire to “do better”, and rely heavily on personal savings and family sources for start-up capital. In addition: • There is no conclusive evidence that suggests in this study that BME graduates entered entrepreneurship because of unemployment; with the exception of a few, all had jobs prior to entering self employment. • “Glass ceilings” were often cited by participants of the case studies as a kind of barrier, but there was reluctance to specify exactly what that meant. • Also, lack of satisfaction from working for others is considered to be a strong motivator for entering self-employment but other reasons, to be one’s own boss and the prospect of higher earnings, are also strong motivators. There is, therefore, a need for support agencies and universities to recognise the distinctive nature of BME graduate enterprise in order to provide effective solutions for different groups. This might include a) work experience, b) advice on an adequate capital structure at start up, c) adequate funding and training, and d) appropriate training for all graduates in basic business education.

West Midlands English:Birmingham and the Black Country

This volume focuses on the closely allied yet differing linguistic varieties of Birmingham and its immediate neighbour to the west, the industrial heartland of the Black Country. Both of these areas rose to economic prominence and success during the Industrial Revolution, and both have suffered economically and socially as a result of post-war industrial decline. The industrial heritage of both areas has meant that tight knit and socially homogeneous individual areas in each region have demonstrated in many respects little linguistic change over time, and have continued to exhibit linguistic features, especially morphological constructions, peculiar to these areas or now restricted to these areas. At the same time, immigration from other areas of the British Isles over time, from Commonwealth countries and later from EU member states, together with increased social mobility, have meant that newly developing structures and more widespread UK linguistic phenomena have spread into these varieties. This volume provides a clear description of the structure of the linguistic varieties spoken in the two areas. Following the structure of the Dialects of English volumes, it provides: •A comprehensive overview of the phonological, grammatical and lexical structure of both varieties, as well as similarities between the two varieties and distinguishing features •Thorough discussion of the historical and social factors behind the development of the varieties and the stigma attached to these varieties •Discussion of the unusual situation of the Black Country as an area undefined in geographical and administrative terms, existing only in the imagination •Examples of the variety from native speakers of differing ethnicities, ages and genders •An annotated bibliography for further consultation

Ties that bind:understanding why and how diversity management relates to black and ethnic minority employees’ experience of organisational life

Despite much anecdotal and oftentimes empirical evidence that black and ethnic minority employees do not feel integrated into organisational life and the implications of this lack of integration for their career progression, there is a dearth of research on the nature of the relationship black and ethnic minority employees have with their employing organisations. Additionally, research examining the relationship between diversity management and work outcomes has returned mixed findings. Scholars have attributed this to the lack of an empirically validated measure of workforce diversity management. Accordingly, I sought to address these gaps in the extant literature in a two-part study grounded in social exchange theory. In Study 1, I developed and validated a measure of workforce diversity management practices. Data obtained from a sample of ethnic minority employees from a cross section of organisations provided support for the validity of the scale. In Study 2, I proposed and tested a social-exchange-based model of the relationship between black and ethnic minority employees’ and their employing organisations, as well as assessed the implications of this relationship for their work outcomes. Specifically, I hypothesised: (i) perception of support for diversity, perception of overall justice, and developmental experiences (indicators of integration into organisational life) as mediators of the relationship between diversity management and social exchange with organisation; (ii) the moderating influence of diversity climate on the relationship between diversity management and these indicators of integration; and (iii) the work outcomes of social exchange with organisation defined in terms of career satisfaction, turnover intention and strain. SEM results provide support for most of the hypothesised relationships. The findings of the study contribute to the literature on workforce diversity management in a number of ways. First, the development and validation of a diversity management practice scale constitutes a first step in resolving the difficulty in operationalising and measuring the diversity management construct. Second, it explicates how and why diversity management practices influence a social exchange relationship with an employing organisation, and the implications of this relationship for the work outcomes of black and ethnic minority employees. My study’s focus on employee work outcomes is an important corrective to the predominant focus on organisational-level outcomes of diversity management. Lastly, by focusing on ethno-racial diversity my research complements the extant research on such workforce diversity indicators as age and gender.

Novel b-lactams, their antibacterial and pharmacokinetic properties and pre-clinical evaluation

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Higher-order aberrations in amblyopia:an analysis of pre- and post-wavefront-guided laser refractive correction

For more than a century it has been known that the eye is not a perfect optical system, but rather a system that suffers from aberrations beyond conventional prescriptive descriptions of defocus and astigmatism. Whereas traditional refraction attempts to describe the error of the eye with only two parameters, namely sphere and cylinder, measurements of wavefront aberrations depict the optical error with many more parameters. What remains questionable is the impact these additional parameters have on visual function. Some authors have argued that higher-order aberrations have a considerable effect on visual function and in certain cases this effect is significant enough to induce amblyopia. This has been referred to as ‘higher-order aberration-associated amblyopia’. In such cases, correction of higher-order aberrations would not restore visual function. Others have reported that patients with binocular asymmetric aberrations display an associated unilateral decrease in visual acuity and, if the decline in acuity results from the aberrations alone, such subjects may have been erroneously diagnosed as amblyopes. In these cases, correction of higher-order aberrations would restore visual function. This refractive entity has been termed ‘aberropia’. In order to investigate these hypotheses, the distribution of higher-order aberrations in strabismic, anisometropic and idiopathic amblyopes, and in a group of visual normals, was analysed both before and after wavefront-guided laser refractive correction. The results show: (i) there is no significant asymmetry in higher-order aberrations between amblyopic and fixing eyes prior to laser refractive treatment; (ii) the mean magnitude of higher-order aberrations is similar within the amblyopic and visually normal populations; (iii) a significant improvement in visual acuity can be realised for adult amblyopic patients utilising wavefront-guided laser refractive surgery and a modest increase in contrast sensitivity was observed for the amblyopic eye of anisometropes following treatment (iv) an overall trend towards increased higher-order aberrations following wavefront-guided laser refractive treatment was observed for both visually normal and amblyopic eyes. In conclusion, while the data do not provide any direct evidence for the concepts of either ‘aberropia’ or ‘higher-order aberration-associated amblyopia’, it is clear that gains in visual acuity and contrast sensitivity may be realised following laser refractive treatment of the amblyopic adult eye. Possible mechanisms by which these gains are realised are discussed.

McKinney, Mark. Redrawing French Empire Comics. Columbus, The Ohio State University Press, 2013. 304 pages. 9780814212202

The history of France and its empires is one that has been well trodden, particularly the French occupation, and subsequent war, in Algeria. In this companion to his earlier work, 2011’s The Colonial Heritage of French Comics,McKinney attempts to examine the reconstruction of French national identity in the wake of decolonisation through the medium of Francophonecomics. He endeavours to study the colonial affrontier (3), the space in which France and its colonies are connected and divided, where they seek to confront each other, or to seek peace and the removal of the division. McKinney argues this affrontier can be found most strongly in the Francophone comics produced dealing with the French colonial experience in Algeria, as well as that of Indochina,and does so from both sides of each conflict. McKinney examines in detail the French colonisation of Algeria (1830sonwards), the French war in Indochina (1946–54) and the Algerian war (1954–62), and his work is the first to approach these well-covered areas of research through the medium of comics. The resulting work takes the form of an investigation into the five forms of genealogical inquiry utilised in comics regarding these conflicts. His approach investigates the familial, ethnic, national, artistic and critical forms of genealogy relating to colonialism and imperialism from a variety of viewpoints, including the previously overlooked perspective of the pieds noirs. He aims to highlight both those cartoonists that critique the colonial ideology, as well as those cartoonists who to some extent attempt to gloss over or even romanticise the French empire, strengthening the affrontier. He positions himself alongside Foucault in seeing genealogy as a useful means of establishing ‘historical knowledge of struggles’ (Foucault1980, 85), but McKinney looks at the colonial representation in a popular medium,including the recent increase in comics produced which consider the French colonial experience. He argues that this consideration of the present, as well as European imperialism, is absent in the work of Foucault. The text is accompanied by a number of black and white facsimiles of pages from the comics he analyses to illustrate the different and often conflicting positions of cartoonists on these issues. Overall, McKinney’s work is a welcome addition to the study of the French colonial experience, which separates its elf from the rest by using Francophonecomics as lenses through which to look at these already well-trodden areas of study. He succeeds in determining if and how cartoonists critique colonial ideology and representations on both sides of the conflicts, a task in which he is unarguably successful. McKinney’s work, however, is unfortunately let down by typo graphicerrors, which occur throughout the text.Nevertheless, McKinney’s work is another important work in the field of Bande Dessine ́e scholarship, and useful for anyone interested in the representations of colonialism and imperialism in French comics, accompanied by anencyclopaedic bibliography of comics produced on this topic.

West Midlands English:Birmingham and the Black Country

This chapter provides an overview, discussing firstly the boundaries of the West Midlands area today within which Birmingham and the Black Country are situated, taking account of how they have changed across time. It includes a section on the demographic make-up of the region across time, before moving on to consider issues relating to language, culture and identity in section 1.5 on the theoretical underpinnings of the research upon which much of this book is based, particularly in relation to Chapters 2, 3 and 4 is also included. Section 1.6 then considers issues relating to research design, and the different methodologies adopted in research design and data collection and analysis by three separate projects which inform the chapters of this book. The Geographical Limits of the west Midlands: Where does it begin and where does it end? The Local Government Boundary Commission for England (2010: http://www.lgbce.org.uk/) gives the geographical range of the west Midlands as the five counties of Herefordshire, Shropshire, Staffordshire, Warwickshire and Worcestershire. The boundaries of these five shire counties date back to at least the twelfth century, being ancient subdivisions established by the Normans for administration purposes after the 1066 conquest. The shire counties were, in most cases, based on earlier Anglo-Saxon divisions. In 1974, as a result of population density concentrated in parts of the shire counties, a sixth county, that of the West Midlands, was carved out from parts of the three shire counties of Staffordshire, Warwickshire and Worcestershire.

A multi-organisational approach for disaster preparedness and response:the use of optimisation and GIS for facility location, stock pre-positioning, resource allocation and relief distribution

From 1992 to 2012 4.4 billion people were affected by disasters with almost 2 trillion USD in damages and 1.3 million people killed worldwide. The increasing threat of disasters stresses the need to provide solutions for the challenges faced by disaster managers, such as the logistical deployment of resources required to provide relief to victims. The location of emergency facilities, stock prepositioning, evacuation, inventory management, resource allocation, and relief distribution have been identified to directly impact the relief provided to victims during the disaster. Managing appropriately these factors is critical to reduce suffering. Disaster management commonly attracts several organisations working alongside each other and sharing resources to cope with the emergency. Coordinating these agencies is a complex task but there is little research considering multiple organisations, and none actually optimising the number of actors required to avoid shortages and convergence. The aim of the this research is to develop a system for disaster management based on a combination of optimisation techniques and geographical information systems (GIS) to aid multi-organisational decision-making. An integrated decision system was created comprising a cartographic model implemented in GIS to discard floodable facilities, combined with two models focused on optimising the decisions regarding location of emergency facilities, stock prepositioning, the allocation of resources and relief distribution, along with the number of actors required to perform these activities. Three in-depth case studies in Mexico were studied gathering information from different organisations. The cartographic model proved to reduce the risk to select unsuitable facilities. The preparedness and response models showed the capacity to optimise the decisions and the number of organisations required for logistical activities, pointing towards an excess of actors involved in all cases. The system as a whole demonstrated its capacity to provide integrated support for disaster preparedness and response, along with the existence of room for improvement for Mexican organisations in flood management.