Beyond the Academy: Applying Anthropological Research, A Case Study of Demonstrating Impact in the U.K. 2014 REF

The 2014 Research Excellence Framework sought for the first time to assess the impact that research was having beyond the boundaries of the university and the wider academic sphere. While the REF continued the approach of previous research assessment exercises in attempting to measure the overall quality of research and teaching within the higher-education sector, it also expected institutions to evidence how some of their research had had ‘an effect on, change or benefit to the economy, society, culture, public policy or services, health, the environment or quality of life, beyond academia’ (REF 2012: 48). This article provides a case study in how researchers in one U.K. anthropology department were able to demonstrate the impact of their work in the public sphere successfully as part of this major audit exercise.

Homogenization and analysis of an expanded long-term monthly rainfall network for the Island of Ireland (1850–2010)

Long-term precipitation series are critical for understanding emerging changes to the hydrological cycle. To this end we construct a homogenized Island of Ireland Precipitation (IIP) network comprising 25 stations and a composite series covering the period 1850–2010, providing the second-longest regional precipitation archive in the British-Irish Isles. We expand the existing catalogue of long-term precipitation records for the island by recovering archived data for an additional eight stations. Following bridging and updating of stations HOMogenisation softwarE in R (HOMER) homogenization software is used to detect breaks using pairwise and joint detection. A total of 25 breakpoints are detected across 14 stations, and the majority (20) are corroborated by metadata. Assessment of variability and change in homogenized and extended precipitation records reveal positive (winter) and negative (summer) trends. Trends in records covering the typical period of digitization (1941 onwards) are not always representative of longer records. Furthermore, trends in post-homogenization series change magnitude and even direction at some stations. While cautionary flags are raised for some series, confidence in the derived network is high given attention paid to metadata, coherence of behaviour across the network and consistency of findings with other long-term climatic series such as England and Wales precipitation. As far as we are aware, this work represents the first application of HOMER to a long-term precipitation network and bodes well for use in other regions. It is expected that the homogenized IIP network will find wider utility in benchmarking and supporting climate services across the Island of Ireland, a sentinel location in the North Atlantic.

Sharing services, saving money? Five risks to cost saving when organizations share administrative services

Shared services are a popular reform for governments under financial pressure. The hope is to reduce overheads and increase efficiency by providing support services like HR, finance and procurement once to multiple agencies. Drawing on insights from organization theory and political science, we identify five risks that shared services won’t live up to current expectations. We illustrate each with empirical evidence from the UK, Ireland and further afield, and conclude with suggestions on how to manage these risks.

School-based approaches to the correction of refractive error in children.

The World Health Organization estimates that 13 million children aged 5-15 years worldwide are visually impaired from uncorrected refractive error. School vision screening programs can identify and treat or refer children with refractive error. We concentrate on the findings of various screening studies and attempt to identify key factors in the success and sustainability of such programs in the developing world. We reviewed original and review articles describing children's vision and refractive error screening programs published in English and listed in PubMed, Medline OVID, Google Scholar, and Oxford University Electronic Resources databases. Data were abstracted on study objective, design, setting, participants, and outcomes, including accuracy of screening, quality of refractive services, barriers to uptake, impact on quality of life, and cost-effectiveness of programs. Inadequately corrected refractive error is an important global cause of visual impairment in childhood. School-based vision screening carried out by teachers and other ancillary personnel may be an effective means of detecting affected children and improving their visual function with spectacles. The need for services and potential impact of school-based programs varies widely between areas, depending on prevalence of refractive error and competing conditions and rates of school attendance. Barriers to acceptance of services include the cost and quality of available refractive care and mistaken beliefs that glasses will harm children's eyes. Further research is needed in areas such as the cost-effectiveness of different screening approaches and impact of education to promote acceptance of spectacle-wear. School vision programs should be integrated into comprehensive efforts to promote healthy children and their families.

Patterns and predictors of help-seeking contacts with health services and general practitioner detection of suicidality prior to suicide: a cohort analysis of suicides occurring over a two-year period

Background: Contact with primary care and psychiatric services prior to suicide may be considerable, presenting
opportunities for intervention. However, there is scant knowledge on the frequency, nature and determinants of
contact.
Method: Retrospective cohort study-an analysis of deaths recorded as suicide by the Northern Ireland Coroner’s
Office linked with data from General Practice patient records over a 2 year period
Results: Eighty-seven per cent of suicides were in contact with General Practice services in the 12 months before
suicide. The frequency of contact with services was considerable, particularly among patients with a common
mental disorder or substance misuse problems. A diagnosis of psychiatric problems was absent in 40 % of suicides.
Excluding suicide attempts, the main predictors of a noted general practitioner concern for patient suicidality are
male gender, frequency of consultations, diagnosis of mental illness and substance misuse.
Conclusions: Despite widespread and frequent contact, a substantial proportion of suicidal people were
undiagnosed and untreated for mental health problems. General Practitioner alertness to suicidality may be too
narrowly focused.

Acute care teaching in the undergraduate nursing curriculum

AIM: To incorporate basic aspects of acute care into the undergraduate nursing programme by providing an opportunity for the development of knowledge and skills in the early recognition and assessment of deteriorating patients on general hospital wards.
BACKGROUND: Acute care initiatives implemented in the hospital setting to improve the identification and management of 'at risk' patients have focused on the provision of education for trained or qualified staff. However, to ensure student nurses are 'fit to practice' at the point of registration, it has been recommended that acute care theory and skills are incorporated into the undergraduate nursing curriculum.
PRACTICE DEVELOPMENT INITIATIVE: An 'Integrated Nursing Care' module was incorporated into year 3 of the undergraduate nursing programme to introduce students to acute care theory and practice. Module content focuses on the early detection and management of acute deterioration in patients with respiratory, cardiac, neurological or renal insufficiencies. We used a competency-based framework to ensure the application of theory to practice through the use of group seminars. High-fidelity patient-simulated clinical scenarios were a key feature. The United Kingdom Resuscitation Council Intermediate Life Support course is also an important component of the module.
CONCLUSIONS: Incorporating the Integrated Nursing Care module into the undergraduate nursing curriculum provides pre-registration students the opportunity to develop their knowledge and skills in acute care.
RELEVANCE TO CLINICAL PRACTICE: The provision of undergraduate education in care of the acutely ill patient in hospital is essential to improve nurses' competence and confidence in assessing and managing deteriorating patients in general wards at the point of registration.

Multilayer optimization in radio resource allocation for the packet transmission in wireless networks

Na última década tem-se assistido a um crescimento exponencial das redes de comunicações sem fios, nomeadamente no que se refere a taxa de penetração do serviço prestado e na implementação de novas infra-estruturas em todo o globo. É ponto assente neste momento que esta tendência irá não só continuar como se fortalecer devido à convergência que é esperada entre as redes móveis sem fio e a disponibilização de serviços de banda larga para a rede Internet fixa, numa evolução para um paradigma de uma arquitectura integrada e baseada em serviços e aplicações IP. Por este motivo, as comunicações móveis sem fios irão ter um papel fundamental no desenvolvimento da sociedade de informação a médio e longo prazos. A estratégia seguida no projecto e implementação das redes móveis celulares da actual geração (2G e 3G) foi a da estratificação da sua arquitectura protocolar numa estrutura modular em camadas estanques, onde cada camada do modelo é responsável pela implementação de um conjunto de funcionalidades. Neste modelo a comunicação dá-se apenas entre camadas adjacentes através de primitivas de comunicação pré-estabelecidas. Este modelo de arquitectura resulta numa mais fácil implementação e introdução de novas funcionalidades na rede. Entretanto, o facto das camadas inferiores do modelo protocolar não utilizarem informação disponibilizada pelas camadas superiores, e vice-versa acarreta uma degradação no desempenho do sistema. Este paradigma é particularmente importante quando sistemas de antenas múltiplas são implementados (sistemas MIMO). Sistemas de antenas múltiplas introduzem um grau adicional de liberdade no que respeita a atribuição de recursos rádio: o domínio espacial. Contrariamente a atribuição de recursos no domínio do tempo e da frequência, no domínio espacial os recursos rádio mapeados no domínio espacial não podem ser assumidos como sendo completamente ortogonais, devido a interferência resultante do facto de vários terminais transmitirem no mesmo canal e/ou slots temporais mas em feixes espaciais diferentes. Sendo assim, a disponibilidade de informação relativa ao estado dos recursos rádio às camadas superiores do modelo protocolar é de fundamental importância na satisfação dos critérios de qualidade de serviço exigidos. Uma forma eficiente de gestão dos recursos rádio exige a implementação de algoritmos de agendamento de pacotes de baixo grau de complexidade, que definem os níveis de prioridade no acesso a esses recursos por base dos utilizadores com base na informação disponibilizada quer pelas camadas inferiores quer pelas camadas superiores do modelo. Este novo paradigma de comunicação, designado por cross-layer resulta na maximização da capacidade de transporte de dados por parte do canal rádio móvel, bem como a satisfação dos requisitos de qualidade de serviço derivados a partir da camada de aplicação do modelo. Na sua elaboração, procurou-se que o standard IEEE 802.16e, conhecido por Mobile WiMAX respeitasse as especificações associadas aos sistemas móveis celulares de quarta geração. A arquitectura escalonável, o baixo custo de implementação e as elevadas taxas de transmissão de dados resultam num processo de multiplexagem de dados e valores baixos no atraso decorrente da transmissão de pacotes, os quais são atributos fundamentais para a disponibilização de serviços de banda larga. Da mesma forma a comunicação orientada à comutação de pacotes, inenente na camada de acesso ao meio, é totalmente compatível com as exigências em termos da qualidade de serviço dessas aplicações. Sendo assim, o Mobile WiMAX parece satisfazer os requisitos exigentes das redes móveis de quarta geração. Nesta tese procede-se à investigação, projecto e implementação de algoritmos de encaminhamento de pacotes tendo em vista a eficiente gestão do conjunto de recursos rádio nos domínios do tempo, frequência e espacial das redes móveis celulares, tendo como caso prático as redes móveis celulares suportadas no standard IEEE802.16e. Os algoritmos propostos combinam métricas provenientes da camada física bem como os requisitos de qualidade de serviço das camadas superiores, de acordo com a arquitectura de redes baseadas no paradigma do cross-layer. O desempenho desses algoritmos é analisado a partir de simulações efectuadas por um simulador de sistema, numa plataforma que implementa as camadas física e de acesso ao meio do standard IEEE802.16e.

Cooperative positioning for heterogeneous wireless systems

Future emerging market trends head towards positioning based services placing a new perspective on the way we obtain and exploit positioning information. On one hand, innovations in information technology and wireless communication systems enabled the development of numerous location based applications such as vehicle navigation and tracking, sensor networks applications, home automation, asset management, security and context aware location services. On the other hand, wireless networks themselves may bene t from localization information to improve the performances of di erent network layers. Location based routing, synchronization, interference cancellation are prime examples of applications where location information can be useful. Typical positioning solutions rely on measurements and exploitation of distance dependent signal metrics, such as the received signal strength, time of arrival or angle of arrival. They are cheaper and easier to implement than the dedicated positioning systems based on ngerprinting, but at the cost of accuracy. Therefore intelligent localization algorithms and signal processing techniques have to be applied to mitigate the lack of accuracy in distance estimates. Cooperation between nodes is used in cases where conventional positioning techniques do not perform well due to lack of existing infrastructure, or obstructed indoor environment. The objective is to concentrate on hybrid architecture where some nodes have points of attachment to an infrastructure, and simultaneously are interconnected via short-range ad hoc links. The availability of more capable handsets enables more innovative scenarios that take advantage of multiple radio access networks as well as peer-to-peer links for positioning. Link selection is used to optimize the tradeo between the power consumption of participating nodes and the quality of target localization. The Geometric Dilution of Precision and the Cramer-Rao Lower Bound can be used as criteria for choosing the appropriate set of anchor nodes and corresponding measurements before attempting location estimation itself. This work analyzes the existing solutions for node selection in order to improve localization performance, and proposes a novel method based on utility functions. The proposed method is then extended to mobile and heterogeneous environments. Simulations have been carried out, as well as evaluation with real measurement data. In addition, some speci c cases have been considered, such as localization in ill-conditioned scenarios and the use of negative information. The proposed approaches have shown to enhance estimation accuracy, whilst signi cantly reducing complexity, power consumption and signalling overhead.

A critical analysis of Child and Adolescent Mental Health Services policy in England, 2000‐2015

Policy in Child and Adolescent Mental Health (CAMH) in England has undergone radical changes in the last 15 years, with far reaching implications for funding models, access to services and service delivery. Using corpus analysis and critical discourse analysis, we explore how childhood, mental health, and CAMHS are constituted in 15 policy documents, 9 pre‐2010, and 6 post 2010. We trace how these constructions have changed over time, and consider the practice implications of these changes. We identify how children’s distress is individualised, through medicalising discourses and shifting understandings of the relationship between socioeconomic context and mental health. This is evidenced in a shift from seeing children’s mental health challenges as produced by social and economic inequities, to a view that children’s mental health must be addressed early to prevent future socio‐economic burden. We consider the implications CAMHS policies for the relationship between children, families, mental health services and the state. The paper concludes by exploring how concepts of ‘parity of esteem’ and ‘stigma reduction’ may inadvertently exacerbate the individualisation of children’s mental health.

The Impacts of Variety on the Costs and Profits of a Hotel Chain’s Properties

In the hotel industry, undistributed operating expenses represent a significant portion of the operating costs for a hotel. Exactly how most of these expenses arise is not well understood. Using data from more than 40 hotels operated by a major chain, the authors examine the links between the variety of a hotel’s products and customers and its undistributed operating expenses and revenues. Their findings show that undistributed operating expenses are related to the extent of the property’s business and product-services mix. The results suggest that although increasing a property's product-service mix results in higher undistributed operating expenses, the incremental costs are compensated for by higher revenues. However, increasing business mix while increasing undistributed operating expenses does not result in higher revenues.

Comportamentos autolesivos em adolescentes : características epidemiológicas e análise de fatores psicopatológicos, temperamento efetivo e estratégias de coping

Tese de doutoramento, Medicina (Psiquiatria e Saúde Mental), Universidade de Lisboa, Faculdade de Medicina, 2014

How has the Personalisation of Social Care Impacted on Service Users with Dementia?

The personalisation agenda is a government initiative aimed at transforming adult social care through giving service users choice and control over the care they receive. A key part of this agenda is the provision of direct payments; cash payments made to individuals eligible for social care services which allow them to manage their own care. Research suggests that direct payments can enable people with dementia to stay in their own home for longer and experience greater choice, flexibility and an improved social life. However very few people with dementia currently access direct payments. The objective of this research was to explore the social care experiences of people with dementia in relation to their access to and use of direct payments. 26 semi-structured interviews were conducted with people with dementia in receipt of social care services in the community, and their carers and social workers, and focus groups held with two community social work teams. It was found that direct payments tended to be seen as a fall-back option, for example as the only alternative to residential care, or as a solution to problems with traditional services. Direct payments appeared to afford particular benefits to people with dementia in terms of flexibility, continuity of care and access to local facilities. It is therefore important that this group are enabled to access direct payments. The second (ongoing) phase of this research comprises the design and pilot testing of an intervention aimed at improving access to direct payments by people with dementia.

Risk under performance-based contracting in the UK construction sector

As a method of procuring the services of the built environment, performance-based contracting (PBC) seeks to link the building supplier to longer term commitments than has traditionally been the case in the construction sector. By rewarding the building producer according to the way that building or structure delivers the users' requirements, rather than according to a list of assembled parts, a number of additional risks are taken by contractors, including fitness for purpose, costs and briefing. The extent to which contractors recognize these risks and their methods of dealing with them vary considerably and are influenced by their attitudes towards risk. As the risks associated with PBC are seen as large, uninsurable, and vulnerable to changing client requirements, the majority of respondents would reject the use of PBC as a method of contracting. Nevertheless, PBC may be used under particular conditions, where rewards are deemed sufficient to compensate for the additional risk to the contractor of undertaking work on the basis of a stream of payments paid over the life of a structure depending on the satisfactory performance of the building or as part of a private finance initiative.

Old conflicts, new rivals? Airline competition in the European market

Christoph Franz of Lufthansa recently identified Ryanair, easyJet, Air Berlin and Emirates as the company’s main competitors – gone are the days when it could benchmark itself against BA or Air France-KLM! This paper probes behind the headlines to assess the extent to which different airlines are in competition, using evidence from the UK and mainland European markets. The issue of route versus network competition is addressed. Many regulators have put an emphasis on the former whereas the latter, although less obvious, can be more relevant. For example, BA and American will cease to compete between London and Dallas Fort Worth if their alliance obtains anti-trust immunity but 80% of the passengers on this route are connecting at one or both ends and hence arguably belong to different markets (e.g. London-San Francisco, Zurich-Dallas, Edinburgh-New Orleans) which may be highly contested. The remaining 20% of local traffic is actually insufficient to support a single point to point service in its own right. Estimates are made of the seat capacity major airlines are offering to the local market as distinct from feeding other routes. On a sector such as Manchester–Amsterdam, 60% of KLM’s passengers are transferring at Schiphol as against only 1% of bmibaby’s. Thus although KLM operates 5 flights and 630 seats per day against bmibaby’s 2 flights and 298 seats, in the point to point market bmibaby offers more seats than KLM. The growth of the Low Cost Carriers (LCCs) means that competition increasingly needs to be viewed on city pair markets (e.g. London-Rome) rather than airport pair markets (e.g. Heathrow-Fiumicino). As the stronger LCCs drive out weaker rivals and mainline carriers retrench to their major hubs, some markets now have fewer direct options than existed prior to the low cost boom. Timings and frequencies are considered, in particular the extent to which services are a true alternative especially for business travellers. LCCs typically offer lower frequencies and more unsociable timings (e.g. late evening arrivals at remote airports) as they are more focused on providing the cheapest service rather than the most convenient schedule. Interesting findings on ‘monopoly’ services are presented (including alliances) - certain airlines have many more of these than others. Lufthansa has a significant number of sectors to itself whereas at the other extreme British Airways has direct competition on almost every route in its network. Ryanair and flybe have a higher proportion of monopoly routes than easyJet or Air Berlin. In the domestic US market it has become apparent since deregulation that better financial returns can come from dominating a large number of smaller markets rather than being heavily exposed in the major markets - which are hotly fought over. Regional niches that appear too thin for Ryanair to serve (with its all 189 seat 737-800 fleet) are identified. Fare comparisons in contrasting markets provide some insights to marketing and pricing strategies. Data sources used include OAG (schedules and capacity), AEA (traditional European airlines traffic by region), the UK CAA (airport, airline and route traffic plus survey information of passenger types) and ICAO (international route traffic and capacity by carrier). It is concluded that airlines often have different competitors depending on the context but in surprisingly many cases there are actually few or no direct substitutes. The competitive process set in train by deregulation of European air services in the 1990s is leading back to one of natural monopolies and oblique alternatives. It is the names of the main participants that have changed however!

The potential for neighbourhood regeneration in a period of austerity: changing forms of neighbourhood governance in two cities

Localism is an active political strategy, developed in a period of austerity by the UK's coalition government as a justification for the restructuring of state-civil society relationships. The deprived neighbourhood has long been a site for service delivery and a scale for intervention and action, giving rise to a variety of forms of neighbourhood governance. Prior international comparative research indicated convergence with the US given the rise of the self-help conjuncture and the decline of neighbourhood governance as a medium of regeneration. The subsequent shift in the UK paradigm from ‘big’ to ‘small state’ localism and deficit-reducing cuts to public expenditure confirm these trends, raising questions about the forms of neighbourhood governance currently being established, the role being played by local and central government, and the implications for neighbourhood regeneration. Two emerging forms of neighbourhood governance are examined in two urban local authorities and compared with prior forms examined in earlier research in the case study sites. The emerging forms differ significantly in their design and purpose, but as both are voluntary and receive no additional funding, better organised and more affluent communities are more likely to pursue their development. While it is still rather early to assess the capacity of these forms to promote neighbourhood regeneration, the potential in a period of austerity appears limited. Reduced funding for local services increases the imperative to self-help, while rights to local voice remain limited and the emerging forms provide little scope to influence (declining) local services and (still centralised) planning decisions, especially in neighbourhoods with regeneration needs which are likely to lack the requisite capacities, particularly stores of linking social capital. Initial conclusions suggest greater polarity and the further containment of deprived neighbourhoods.