Fluid strategies and outcomes in patients with acute respiratory distress syndrome, systemic inflammatory response syndrome and sepsis: a protocol for a systematic review and meta-analysis

Background
Fluid administration to critically ill patients remains the subject of considerable controversy. While intravenous fluid given for resuscitation may be life-saving, a positive fluid balance over time is associated with worse outcomes in critical illness. The aim of this systematic review is to summarise the existing evidence regarding the relationship between fluid administration or balance and clinically important patient outcomes in critical illness.

Methods
We will search Medline, EMBASE, the Cochrane Central Register of Controlled Trials from 1980 to the present and key conference proceedings from 2009 to the present. We will include studies of critically ill adults and children with acute respiratory distress syndrome (ARDS), sepsis and systemic inflammatory response syndrome (SIRS). We will include randomised controlled trials comparing two or more fluid regimens of different volumes of fluid and observational studies reporting the relationship between volume of fluid administered or fluid balance and outcomes including mortality, lengths of intensive care unit and hospital stay and organ dysfunction. Two independent reviewers will assess articles for eligibility, data extraction and quality appraisal. We will conduct a narrative and/or meta-analysis as appropriate.

Discussion
While fluid management has been extensively studied and discussed in the critical care literature, no systematic review has attempted to summarise the evidence for post-resuscitation fluid strategies in critical illness. Results of the proposed systematic review will inform practice and the design of future clinical trials.

Systematic review registration
PROSPERO CRD42013005608. (http://​www.​crd.​york.​ac.​uk/​PROSPERO/​)

How to promote professional competence and identity in social work students

Background: Field placement experiences are frequently cited in the literature as having most impact on a student social worker’s learning as they emerge into the profession. Placements are integral to the development of practice competence and in acquiring a sense of social work identity. However research on the effectiveness of educational strategies used to deliver learning and assess competence during placement are scarce. Internationally, pressures to meet increasing numbers of student enrolments have raised concerns about the potential impact on the quality of placements and practice teaching provided. These pressures may also impact on the appropriate transfer and application of learning to the student’s practice.
Aim: To identify learning activities rated most useful for developing professional practice competence and professional identity of social work students.
Method: Data were collected from 396 students who successfully completed their first or final placement during 2013-2014 and were registered at one of two Universities in Northern Ireland. Students completed a self-administered questionnaire which covered: placement setting and service user group; type of supervision model; frequency of undertaking specific learning activities; who provided the learning; which activities contributed to their developing professional competence and identity and their overall satisfaction.
Our findings confirmed the centrality of the supervisory relationship as the vehicle to enable quality student learning. Shadowing others, receiving regular supervision and receiving constructive feedback were the tasks that students reported as ‘most useful’ to developing professional identity, competence and readiness to practice. Disturbingly over 50% of students reported that linking practice to the professional codes, practice foci and key roles were not valued as ‘useful’ in terms of readiness to practice, feeling competent and developing professional social work identity. These results offer strong insights into how both the University and the practice placement environment needs to better prepare, assess and support students during practice placements in the field.

Mismatches and matches in address information from the Census and the BSO: A longitudinal perspective 2001-2011

Accurate address information from health service providers is fundamental for the effective delivery of health care and population monitoring and screening. While it is currently used in the production of key statistics such as internal migration estimates, it will become even more important over time with the 2021 Census of UK constituent countries integrating administrative data to enhance the quality of statistical outputs. Therefore, it is beneficial to improve understanding of the accuracy of address information held by health service providers and factors that influence this. This paper builds upon previous research on the social geography of address mismatch between census and health service records in Northern Ireland. It is based on the Northern Ireland Longitudinal Study; this is a large data linkage study including about 28 per cent of the Northern Ireland population, which is matched between the census (2001, 2011) and Health Card Registration System maintained by the Health and Social Care Business Service Organisation (BSO). This research compares address information from the Spring 2011 BSO download (Unique Property Reference Number, Super Output Area) with comparable geographic information from the 2011 Census. Multivariate and multilevel analyses are used to assess the individual and ecological determinants of match/mismatch between geographical information in both data sources to determine if the characteristics of the associated people and places are the same as the position observed in 2001. It is important to understand if the same people are being inaccurately geographically referenced in both Census years or if the situation is more variable.

Challenges in mercury speciation and fractionation in soil and sediment

This investigation focused on the development, test and validation of methodologies for mercury fractionation and speciation in soil and sediment. After an exhaustive review of the literature, several methods were chosen and tested in well characterised soil and sediment samples. Sequential extraction procedures that divide mercury fractions according to their mobility and potential availability in the environment were investigated. The efficiency of different solvents for fractionation of mercury was evaluated, as well as the adequacy of different analytical instruments for quantification of mercury in the extracts. Kinetic experiments to establish the equilibrium time for mercury release from soil or sediment were also performed. It was found that in the studied areas, only a very small percentage of mercury is present as mobile species and that mobility is associated to higher aluminium and manganese contents, and that high contents of organic matter and sulfur result in mercury tightly bound to the matrix. Sandy soils tend to release mercury faster that clayey soils, and therefore, texture of soil or sediment has a strong influence on the mobility of mercury. It was also understood that analytical techniques for quantification of mercury need to be further developed, with lower quantification limits, particularly for mercury quantification of less concentrated fractions: water-soluble e exchangeable. Although the results provided a better understanding of the distribution of mercury in the sample, the complexity of the procedure limits its applicability and robustness. A proficiency-testing scheme targeting total mercury determination in soil, sediment, fish and human hair was organised in order to evaluate the consistency of results obtained by different laboratories, applying their routine methods to the same test samples. Additionally, single extractions by 1 mol L-1 ammonium acetate solution, 0.1 mol L-1 HCl and 0.1 mol L-1 CaCl2, as well as extraction of the organometallic fraction were proposed for soil; the last was also suggested for sediment and fish. This study was important to update the knowledge on analytical techniques that are being used for mercury quantification, the associated problems and sources of error, and to improve and standardize mercury extraction techniques, as well as to implement effective strategies for quality control in mercury determination. A different, “non chemical-like” method for mercury species identification was developed, optimised and validated, based on the thermo-desorption of the different mercury species. Compared to conventional extraction procedures, this method has advantages: it requires little to no sample treatment; a complete identification of species present is obtained in less than two hours; mercury losses are almost neglectable; can be considered “clean”, as no residues are produced; the worldwide comparison of results obtained is easier and reliable, an important step towards the validation of the method. Therefore, the main deliverables of this PhD thesis are an improved knowledge on analytical procedures for identification and quantification of mercury species in soils and sediments, as well as a better understanding of the factors controlling the behaviour of mercury in these matrices.

Cross-readings and ecoliteracy in children's pop-up books

The purpose of this text is to analyse two recently been published pop-up books aimed at children, by Anouck Boisrobert e Louis Rigaud, Popville (2009) and Dans la forêt du paresseux [Wake up, Sloth!, En el bosque del perezoso] (first published in 2009 and 2012, accompanied with texts by Joy Sorman and Sophie Strady, respectively). These books were published originally in France by Hélium Editions, but they can now be found in several western countries and in many languages (Catalan, French, Dutch, English, German, Italian, Portuguese and Spanish, at least). The objective is to analyse their verbal text and their visual aspects produced by a sophisticated paper engineered to question how they achieve what seems to be one of their goals, the promotion of the readers' ecoliteracy (Orr, 1992) by his involvement in the reading process. This issue seems to be one of the main trends on children's literature in western societies nowadays, transcending the traditional and almost omnipresent role of scenario that nature plays in many children's narratives.

The work of memory: embodiment, materiality and home in Jeanne Bouvier’s autobiographical writings

In this paper I follow trails in the memory of work by reading the books and papers of Jeanne Bouvier, a French seamstress, ardent trade-unionist and passionate writer, who left a rich body of labour literature including four published historical studies, as well as the memoirs of her life, work and struggles. Work, action and creativity are three interrelated planes on which Bouvier situates herself, while memory and imagination are interwoven in the way she seeks to understand herself in the world with others. What emerges as a particularly striking theme from Bouvier’s papers is a material matrix of mnemonic and imaginary practices, wherein bodies, places and objects are entangled in the narrative constitution of the self of the woman worker/writer.

Rational Thinking and Belief in Psychic Abilities: It Depends on Level of Involvement

Previous research has shown that lay believers in psychic abilities are more prone to intuitive thinking, less inclined to rational thinking, and have an external locus of control, compared to non-believers. Psychic practitioners, however, may have different characteristics. Psychic practitioners (N=31; mean age = 42.7 years, s.d.=13.1), lay believers (N=33; mean age = 33.0 years, s.d.=10.3), and non-believers (N=31; mean age = 34.4 years, s.d.=15.4) completed questionnaires measuring thinking styles, locus of control, and psychic belief. Comparisons of lay believers with non-believers confirmed previous observations; believers had a higher propensity for intuitive thinking, lower propensity for rational thinking, and more external locus of control. In contrast, practitioners were equivalent to non-believers in rational thinking and had the highest internal locus of control. This highlights the importance of considering level of involvement with psychic practice in understanding the thinking styles of believers. Results suggested that practitioners may have rationalised their beliefs and constructed a coherent model of psychic phenomena that satisfies a propensity for rational thinking within a community of belief.

Antimicrobial resistance and synergy in herbal medicine

Antimicrobial resistance (AMR) is a serious and growing threat to human health. The development of new antibiotics is limited and slow. The tradition of synergy in herbal medicine is being used as a source of research ideas. A literature review of antimicrobial research and plant synergy published in a five year period was carried out using online databases. The in vitro findings were that most of the research reported synergy both within plants and between plants and antibiotics. Whole plant extracts and combinations of compounds were shown to be more effective antimicrobials than isolated constituents. The discussion highlights that the in vitro herbal research findings are difficult to apply to practice and aren’t progressing to clinical trials. Collaborative, innovative, inter-disciplinary clinical research is recommended.

Children’s Friendships and Learning in School: Cognitive Enhancement Through Social Interaction?

Background. Recent literature has identified that children's performance on cognitive (or problem-solving) tasks can be enhanced when undertaken as a joint activity among pairs of pupils. Performance on this ‘social’ activity will require quality relationships between pupils, leading some researchers to argue that friendships are characterized by these quality relationships and, therefore, that friendship grouping should be used more frequently within classrooms. Aims. Children's friendship grouping may appear to be a reasonable basis for cognitive development in classrooms, although there is only inconsistent evidence to support this argument. The inconsistency may be explained by the various bases for friendship, and how friendship is affected by cultural contexts of gender and schooling. This study questions whether classroom-based friendship pairings will perform consistently better on a cognitive task than acquaintance pairings, taking into account gender, age, and ability level of children. The study also explores the nature of school-based friendship described by young children. Sample. 72 children were paired to undertake science reasoning tasks (SRTs). Pairings represented friendship (versus acquaintance), sex (male and female pairings), ability (teacher-assessed high, medium, and low), and age (children in Years 1, 3, and 5 in a primary school). Method. A small-scale quasi-experimental design was used to assess (friendship- or acquaintance-based) paired performance on SRTs. Friendship pairs were later interviewed about qualities and activities that characterized their friendships. Results. Girls' friendship pairings were found to perform at the highest SRT levels and boys' friendship pairing performed at the lowest levels. Both boy and girl acquaintance pairings performed at mid-SRT levels. These findings were consistent across Year (in school) levels and ability levels. Interviews revealed that male and female friendship pairs were likely to participate in different types of activity, with girls being school-inclusive and boys being school-exclusive. Conclusion. Recommendations to use friendship as a basis for classroom grouping for cognitive tasks may facilitate performance of some pairings, but may also inhibit the performance of others. This is shown very clearly with regard to gender. Some of the difference in cognitive task performance may be explained by distinct, cultural (and social capital) orientations to friendship activities, with girls integrating school and educational considerations into friendship, and boys excluding school and educational considerations.

Development of Social Relationships, Interactions and Behaviours in Early Education Settings

Recent research and policy regarding the advantages of early years provision has focused largely on the enhancement and development of cognitive skills for preschoolers. This study, based in the United Kingdom, focuses on a range of cognitive and social skills and identifies beneficial characteristics of a government pilot scheme for 2-year-olds in areas of social disadvantage. Data were collected from nursery managers and parents across six early years settings using a combination of qualitative and quantitative methods centred around in-depth observational techniques focused on children. Results indicate that in addition to the development of cognitive skills, children showed increased confidence and modes of communication and interaction and that these were associated with the varied activities and routines established within the early years settings. Some variations in terms of frequency and quality of interactions, activities and practice were identified in settings; however, interpersonal support for learning and development was consistent across settings.

Explaining party cohesion and discipline in democratic legislatures: purposiveness and contexts

Legislative party discipline and cohesion are important phenomena in the study of political systems. Unless assumptions are made that parties are cohesive and act as unified collectivities with reasonably well-defined goals, it is really difficult, if not impossible, to consider their electoral and legislative roles usefully. But levels of legislative party cohesiveness are also important because they provide us with crucial information about how legislatures/ parliaments function and how they interact with executives/governments. Without cohesive (or disciplined) parties,1 government survival in parliamentary systems is threatened because executive and legislative powers are fused while in separated systems presidents' bases of legislative support become less stable. How do we explain varying levels of legislative party cohesion? The first part of this article draws on the purposive literature to explore the benefits and costs to legislators in democratic legislatures of joining and acting collectively and individualistically within political parties. This leads on to a discussion of various conceptual and empirical problems encountered in analysing intra-party cohesion and discipline in democratic legislatures on plenary votes. Finally, the article reviews the extant empirical evidence on how a multiplicity of systemic, party-levels and situational factors supposedly impact cohesion/discipline levels. The article ends with a discussion of the possibilities and limitations of building comparative models of cohesion/discipline.

Perceived Social Pressures and the Internalization of the Mesomorphic Ideal: the Role of Drive for Muscularity and Autonomy in Physically Active Men

BACKGROUND: Researchers have tested the beliefs of sportspeople and sports medicine specialists that cognitive strategies influence strength performance. Few investigators have synthesised the literature. OBJECTIVES: The specific objectives were to review evidence regarding (a) the cognitive strategy-strength performance relationship; (b) participant skill level as a moderator; and (c) cognitive, motivational, biomechanical/physiological, and emotional mediators. METHOD: Studies were sourced via electronic databases, reference lists of retrieved articles, and manual searches of relevant journals. Studies had to be randomised or counterbalanced experiments with a control group or condition, repeated measures, and a quality control score above 0.5 (out of 1). Cognitive strategies included goal setting, imagery, self-talk, preparatory arousal, and free choice. Dependent variables included maximal strength, local muscular endurance, or muscular power. RESULTS: Globally, cognitive strategies were reliability associated with increased strength performance (results ranged from 61 to 65 %). Results were mixed when examining the effects of specific strategies on particular dependent variables, although no intervention had an overall negative influence. Indeterminate relationships emerged regarding hypothesised mediators (except cognitive variables) and participant skill level as a moderator. CONCLUSIONS: Although cognitive strategies influence strength performance, there are knowledge gaps regarding specific types of strength, especially muscular power. Cognitive variables, such as concentration, show promise as possible mediators.

Teaching Toward Utopia: Promise, Provocation, and Pain in Pedagogies of Radical Imagination

Thesis (Ph.D.)--University of Washington, 2014

Using official data sources to analyse the light goods vehicle fleet and operations in Britain

Report produced as part of the Green Logistics project (EPSRC and Department for Transport funded). Light goods vehicles play a key role in providing goods and services to businesses and other organisations in Britain. In order to better understand the relationship between costs and benefits of LGV operations it is necessary to gain a more detailed appreciation of the roles that these vehicles are fulfilling. This report aims to provide a better understanding of this sector by examining LGV fleet and operations in terms of their characteristics, utilisation and efficiency and purpose. Important potential external impacts of LGVs are also considered.

Understanding community empowerment in urban regeneration and planning in England: putting policy and practice in context

Community involvement in the fields of town planning and urban regeneration includes a wide range of opportunities for residents and service users to engage with networks, partnerships and centres of power. Both the terminology and degree of the transfer of power to citizens varies in different policy areas and contexts but five core objectives can be identified. This article approaches the subject of community empowerment by exploring the theoretical literature; reviewing recent policy pronouncements relating to community involvement in England and by discussing a recent case study of an Urban II project in London. The conclusions suggest that community empowerment is always likely to be partial and contingent on local circumstances and the wider context.