Joint purchasers and the presumption of joint beneficial ownership:a matter of informed choice?

This paper examines the ruling of Jones v Kernott and shows the results of an empirical survey of conveyancing solicitors and their practices where so affected by the ruling. In particular the paper considers how conveyancing practitioners deal with the issue of organising trusts of land and giving advice to clients in relation to the co-purchase of land.

Using patient knowledge for better health systems

Purpose – This paper describes a “work in progress” research project being carried out with a public health care provider in the UK, a large NHS hospital Trust. Enhanced engagement with patients is one of the Trust’s core principles, but it is recognised that much more needs to be done to achieve this, and that ICT systems may be able to provide some support. The project is intended to find ways to better capture and evaluate the “voice of the patient” in order to lead to improvements in health care quality, safety and effectiveness. Design/methodology/approach – We propose to investigate the use of a patient-orientated knowledge management system (KMS) in managing knowledge about and from patients. The study is a mixed methods (quantitative and qualitative) investigation based on traditional action research, intended to answer the following three research questions: (1) How can a KMS be used as a mechanism to capture and evaluate patient experiences to provoke patient service change (2) How can the KMS assist in providing a mechanism for systematising patient engagement? (3) How can patient feedback be used to stimulate improvements in care, quality and safety? Originality/value –This methodology aims to involve patients at all phases of the study from its initial design onwards, thus leading to an understanding of the issues associated with using a KMS to manage knowledge about and for patients that is driven by the patients themselves. Practical implications – The outcomes of the project for the collaborating hospital will be firstly, a system for capturing and evaluating knowledge about and from patients, and then as a consequence, improved outcomes for both the patients and the service provider. More generally, it will produce a set of guidelines for managing patient knowledge in an NHS hospital that have been tested in one case example.

"I'm a better manager":A biographic narrative study of the impact of personal trauma on the professional lives of managers in the UK

This doctoral study aims to understand how experiences of critical illness or bereavement affect the way managers view and approach their work and their relationships at work. This is an interpretative phenomenological study examining the subjective meanings of personal experience and is underpinned by biographic narratives from four participants and interviews with their nominated workplace witnesses (i.e. colleagues who worked alongside the individual at the time of their trauma). As a consequence of the findings that have emerged across this study, three contributions to theory are presented. All four participants described their traumas as a professional growth experience for themselves as managers, which resulted in self-reported and observed behaviour change at work. Consequently, the first area of theoretical contribution is a suggested extension to the post-traumatic growth (PTG) framework (Calhoun & Tedeschi, 2006) with the addition of a new behavioural dimension called ‘managerial growth’, when applied to the context of ‘ordinary’ organizations. The second area of theoretical contribution arose through the reflexive process that was created during data collection where participants and their witnesses remembered episodes of compassion interaction at work. The second area of contribution thus seeks to extend the existing model of compassion at work (Dutton, Worline, Frost and Lilius, 2006), by conceptualising compassion as a dyadic process between a compassion ‘giver’ and a compassion ‘receiver’ in which the compassion receiver ‘trusts or ‘mistrusts’; ‘discloses’ or ‘withholds’; ‘connects’ or ‘disconnects’ with the compassion giver. The third area of contribution is a new conceptualisation of reflexivity, ‘three-dimensional reflexivity’ (3DR) (Armstrong, Butler and Shaw, 2013). 3DR brings together three of the elements that have been missing from critically reflexive management research; by working with multiple variants of reflexivity in the same study; surfacing different reflexive voices to guard against the researcher’s (potentially) solipsistic own; and remaining sensitive to the concept of reflexive time. In doing so, 3DR not only provides a deeper understanding of individual lived experience; it is also a vehicle in which self-insight is gained. Furthermore, by engaging in its practice, those involved in this study have developed both personally and professionally as a result.

What makes an effective PCT pharmacist? A study of training and development needs

This research was commissioned by the Shropshire and Staffordshire Workforce Development Confederation, to undertake a review of the education and training needs of pharmacists working at a strategic level within primary care trusts.

A comparison of antibiotic prescribing indicators and medicines management scoring in secondary care

Poster: - Robust prescribing indicators analogous to those used in primary care are not available currently in NHS hospital trusts - The Department of Health has recently implemented a scheme for self-assessment scoring medicines management processes (maximum 23) in NHS hospitals - There is no clear relationship between average values for two antibiotic prescribing indicators obtained in ten NHS hospital trusts in the West Midlands - There is no clear relationship between either indicator value and the corresponding self-assessment medicines management score - This study highlights the difficulties involved in assessing the medicines management processes in NHS hospitals; better medicines management evaluation systems are needed

Investigating mental health risk assessment in primary care and the potential role of a structured decision support tool, GRiST

Aim: To explore current risk assessment processes in general practice and Improving Access to Psychological Therapies (IAPT) services, and to consider whether the Galatean Risk and Safety Tool (GRiST) can help support improved patient care. Background: Much has been written about risk assessment practice in secondary mental health care, but little is known about how it is undertaken at the beginning of patients' care pathways, within general practice and IAPT services. Methods: Interviews with eight general practice and eight IAPT clinicians from two primary care trusts in the West Midlands, UK, and eight service users from the same region. Interviews explored current practice and participants' views and experiences of mental health risk assessment. Two focus groups were also carried out, one with general practice and one with IAPT clinicians, to review interview findings and to elicit views about GRiST from a demonstration of its functionality. Data were analysed using thematic analysis. Findings Variable approaches to mental health risk assessment were observed. Clinicians were anxious that important risk information was being missed, and risk communication was undermined. Patients felt uninvolved in the process, and both clinicians and patients expressed anxiety about risk assessment skills. Clinicians were positive about the potential for GRiST to provide solutions to these problems. Conclusions: A more structured and systematic approach to risk assessment in general practice and IAPT services is needed, to ensure important risk information is captured and communicated across the care pathway. GRiST has the functionality to support this aspect of practice.

Development and psychometric evaluation of a new team effectiveness scale for all types of community adult mental health teams:a mixed-methods approach

Defining 'effectiveness' in the context of community mental health teams (CMHTs) has become increasingly difficult under the current pattern of provision required in National Health Service mental health services in England. The aim of this study was to establish the characteristics of multi-professional team working effectiveness in adult CMHTs to develop a new measure of CMHT effectiveness. The study was conducted between May and November 2010 and comprised two stages. Stage 1 used a formative evaluative approach based on the Productivity Measurement and Enhancement System to develop the scale with multiple stakeholder groups over a series of qualitative workshops held in various locations across England. Stage 2 analysed responses from a cross-sectional survey of 1500 members in 135 CMHTs from 11 Mental Health Trusts in England to determine the scale's psychometric properties. Based on an analysis of its structural validity and reliability, the resultant 20-item scale demonstrated good psychometric properties and captured one overall latent factor of CMHT effectiveness comprising seven dimensions: improved service user well-being, creative problem-solving, continuous care, inter-team working, respect between professionals, engagement with carers and therapeutic relationships with service users. The scale will be of significant value to CMHTs and healthcare commissioners both nationally and internationally for monitoring, evaluating and improving team functioning in practice.

Enjoying the third age! Discourse, identity and liminality in extra-care communities

Extra-care housing has been an important and growing element of housing and care for older people in the United Kingdom since the 1990s. Previous studies have examined specific features and programmes within extra-care locations, but few have studied how residents negotiate social life and identity. Those that have, have noted that while extra care brings many health-related and social benefits, extra-care communities can also be difficult affective terrain. Given that many residents are now ‘ageing in place’ in extra care, it is timely to revisit these questions of identity and affect. Here we draw on the qualitative element of a three-year, mixed-method study of 14 extra-care villages and schemes run by the ExtraCare Charitable Trust. We follow Alemàn in regarding residents' ambivalent accounts of life in ExtraCare as important windows on the way in which liminal residents negotiate the dialectics of dependence and independence. However, we suggest that the dialectic of interest here is that of the third and fourth age, as described by Gilleard and Higgs. We set that dialectic within a post-structuralist/Lacanian framework in order to examine the different modes of enjoyment that liminal residents procure in ExtraCare's third age public spaces and ideals, and suggest that their complaints can be read in three ways: as statements about altered material conditions; as inter-subjective bolstering of group identity; and as fantasmatic support for liminal identities. Finally, we examine the implications that this latter psycho-social reading of residents' complaints has for enhancing and supporting residents' wellbeing.

How trust affects the use of information obtained through intra- and extraorganizational relationships?

We have limited knowledge on the potential pattern similarities/differences of trust’s role that may exist in information use obtained through intra- and extra-organizational relationships. This study addresses this question by investigating how trust leads to information use. Data from 338 intra-organizational and a sub-ample of 158 interorganizational dyadic information exchange-relationships showed that trust is an important driver of the utilization of market information in both cases. Trust has no direct relationship to information use, instead has a strong indirect effect through a mediator, perceived quality of information. The effects of trust on the use of information obtained through inter- and extra-organizational dyadic relationships proved to be similar.

Bizalom és vállalati teljesítmény. A bizalom szerepe az aszimmetrikus információk minőségének vállalati észlelésében és azok vezetői döntéshozatalban való felhasználásában = Trust and corporate performance

A kutatás azt a kérdéskört vizsgálja, hogyan járul hozzá a bizalom a vállalatok piaci teljesítményéhez. A vállalatok azon képessége, hogy felhasználják a rendelkezésükre álló piaci információkat nehezen másolható, tartós versenyelőnyt biztosít. A marketingmenedzserek a piaci információk hitelességét nehezen tudják objektív módon megítélni, mivel azokat jellemzően mások gyűjtik és rendszerezik számukra. A szerző kutatásában a menedzserek vállalaton belüli és vállalaton kívüli piaci informálódást célzó kapcsolatai esetén modellezte és empirikusan tesztelte a bizalom hatásait. Eredményei szerint a bizalom a vállalaton belüli és vállalaton kívüli kapcsolatok esetében is fontos mozgatórugója az információfelhasználásnak, jóllehet közvetlenül nincs hatással arra. Minél jobban bízik a döntéshozó az információ forrásában, annál jobb minőségűnek fogja észlelni a tőle származó információt. Az információ észlelt minősége meghatározza, hogy arra támaszkodnak-e a vezetők a döntések meghozatalánál. Azok a marketingmenedzserek, akik képesek bizalmi kapcsolatok kiépítésére, szélesebb körű, hiteles piaci információkra támaszkodhatnak a döntéshozatal során, amely hozzájárul a vállalat piaci teljesítményéhez. ____ We have limited knowledge on the potential pattern similarities/differences of trust’s role that may exist in information use obtained through intra- and extra-organizational relationships. This study addresses this question by investigating how trust leads to information use. Data from 338 intra-organizational and a sub-ample of 158 inter-organizationaldyadic information exchange relationships showed that trust is an important driver of the utilization of market information in both cases. Trust has no direct relationship to information use, instead has a strong indirect effect through a mediator, perceived quality of information. The effects of trustontheuse of information obtained throughinter- and extra-organizational dyadic relationships proved to be similar.

Determinants of resource development strategies in nonprofit organizations: An analysis of children, youth and family services

This study is an exploratory analysis of an operational measure for resource development strategies, and an exploratory analysis of internal organizational contingencies influencing choices of these strategies in charitable nonprofit organizations. The study provides conceptual guidance for advancing understanding about resource development in the nonprofit sector. The statistical findings are, however, inconclusive without further rigorous examination. A three category typology based on organization technology is initially presented to define the strategies. Three dimensions of internal organizational contingencies explored represent organization identity, professional staff, and boards of directors. Based on relevant literature and key informant interviews, an original survey was administered by mail to a national sample of nonprofit organizations. The survey collected data on indicators of the proposed strategy types and selected contingencies. Factor analysis extracted two of the initial categories in the typology. The Building Resource Development Infrastructure Strategy encompasses information technology, personnel, legal structures, and policies facilitating fund development. The Building Resource Development Infrastructure Strategy encompasses the mission, service niche, and type of service delivery forming the basis for seeking financial support. Linear regressions with each strategy type as the dependent variable identified distinct and common contingencies which may partly explain choices of strategies. Discriminant analysis suggests the potential predictive accuracy of the contingencies. Follow-up case studies with survey respondents provide additional criteria for operationalizing future measures of resource development strategies, and support and expand the analysis on contingencies. The typology offers a beginning framework for defining alternative approaches to resource development, and for exploring organization capacity specific to each approach. Contingencies that may be integral components of organization capacity are funding, leadership frame, background and experience, staff and volunteer effort, board member support, and relationships in the external environment. Based on these findings, management questions are offered for nonprofit organization stakeholders to consider in planning for resource development. Lessons learned in designing and conducting this study are also provided to enhance future related research. ^

Análise numérica de dutos enterrados sujeitos a elevação e recalque localizado

Problems associated to longitudinal interactions in buried pipelines are characterized as three-dimensional and can lead to different soil-pipe issues. Despite the progress achieved in research on buried pipelines, little attention has been given to the three-dimensional nature of the problem throughout the last decades. Most of researches simplify the problem by considering it in plane strain condition. This dissertation aims to present a study on the behavior of buried pipelines under local settlement or elevation, using three-dimensional simulations. Finite element code Plaxis 3D was used for the simulations. Particular aspects of the numerical modeling were evaluated and parametric analyzes were performed, was investigated the effects of soil arching in three-dimensional form. The main variables investigated were as follows: relative density, displacement of the elevation or settlement zone, elevated zone size, height of soil cover and pipe diameter/thickness ratio. The simulations were performed in two stages. The first stage was involved the validation of the numerical analysis using the physical models put forward by Costa (2005). In the second stage, numerical analyzes of a full-scale pipeline subjected to a localized elevation were performed. The obtained results allowed a detailed evaluation of the redistribution of stresses in the soil mass and the deflections along the pipe. It was observed the reduction of stresses in the soil mass and pipe deflections when the height of soil cover was decreased on regions of the pipe subjected to elevation. It was also shown for the analyzed situation that longitudinal thrusts were higher than vi circumferential trusts and exceeded the allowable stresses and deflections. Furthermore, the benefits of minimizing stress with technical as the false trench, compressible cradle and a combination of both applied to the simulated pipeline were verified

A randomized trial of specialized versus standard neck physiotherapy in cervical dystonia

We thank: the patients who took part; Monsieur John-Pierre Bleton for training the physiotherapists; Gladys McPherson (Senior IT Manager), Adesoji Adeyemi (programmer) and Diana Collins (data entry) from the Centre for Healthcare Randomised Trials, University of Aberdeen who provided the randomisation and database service; and the funders including The Dystonia Society, the RS Macdonald Charitable Trust, The Sir Halley Stewart Trust, The Foyle Foundation and The Garfield Weston Foundation. The Dystonia Society and other funders had no role in the design, conduct, analysis or writing of the report or the decision to submit the manuscript.

Prior Antithrombotic Use is Associated with Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke

Sources of Funding The GWTG-Stroke program is currently supported in part by a charitable contribution from Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership and the American Heart Association Pharmaceutical Roundtable. GWTG-Stroke has been funded in the past through support from Boehringer-Ingelheim and Merck. These funding agencies did not participate in design or analysis, manuscript preparation, or approval of this study.

Whole-brain patterns of 1H-magnetic resonance spectroscopy imaging in Alzheimer's disease and dementia with Lewy bodies

Acknowledgments We thank Craig Lambert for his help in processing the MRS data. The study was funded by the Sir Jules Thorn Charitable Trust (grant ref: 05/JTA) and was supported by the National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre and the Biomedical Research Unit in Lewy Body Dementia based at Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust and Newcastle University and the NIHR Biomedical Research Centre and Biomedical Research Unit in Dementia based at Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.