Management of long-term sickness absence: a systematic realist review

Purpose
The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors.

Method
A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review.

Results
We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff.

Conclusions
Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.

Events: Temporal and Eternal (in preparation)

This monograph develops a theory of events which provides the foundation for a plausible and coherent account of God’s relation to time, and which has independent appeal (independent, that is, of theological considerations). The book is divided into three parts. The first part involves an investigation of those fundamental aspects of time which have important implications for the nature of events, such as whether time is substantival or relational, and whether time is continuous, dense, or discrete. This part also includes a chapter on how these issues relate to different interpretations of the special theory of relativity. The second part involves a defense of the fundamentality of events, and the development of a theory of events in time. The third part considers ways in which we might plausibly conceive of events as eternal entities. This involves an investigation of different ways of characterizing divine eternity, and then an analysis of the possible relations these ways bear to the antecedently developed theory of temporal events. The thought here is that there are certain characteristics of temporal events which can be assimilated to eternity, and that by evaluating the extent to which different theories of divine eternity allow for this assimilation, we will be able to determine which of those theories is most plausible, and therefore which conception of God’s relation to time is most plausible. The basis of this evaluation will be the theory’s ability to coherently account for God’s knowledge of, and interaction with, the created temporal world. One specific issue here is how to account for God’s knowledge of the future free actions of humans (an issue that I address in 'Eternity, Knowledge, and Freedom'), but there are many other difficulties associated with God’s relation to time, such as God’s creation of contingent time, God’s knowledge of what is happening now, God’s dialogue with humans, and God’s causally interacting with the temporal world in general. A successful theory of eternal events, and, in particular, divine events, will provide a framework for dealing with these difficulties.

I have not yet sough a publisher for this work, but intend to do so in 2013, with a target publication date of 2014.

Moments of Recognition:The Four Semester Studio in QUB

It is a legitimate assertion that the common ground of work of worth in architecture, whether theoretical or built comes from a firmly held position on the part of the author. In addition to delivery key competencies architectural education should act to support the formation of such a position in the student, or to make students aware of the possibility of holding such a position.

It is with this in mind perhaps that intensive unit-based diploma and masters structures are increasingly becoming the standard structure for for schools of architecture across the UK. The strengths of such a structure are most evident when the school, either by virtue of financial strength or geographic location is able to attract a diverse range of contrasting positions to bear in the formation of these units. In effect the offering to the student is a short, intensive immersion into a clear line of thought based on the position of those running the unit. Research is channeled by those running the unit to the work of the students. A single cohort of students therefore is able to observe and understand a wide range of ways of thinking about the subject whether or not they are participants in a unit or not. It is axiomatic that where this structure is applied in the absence of these resources the result can be less helpful, individual units are differentiated not to reflect the interests of those running the unit but for the sake of difference as its own end.

In structuring the M.Arch programme in Queens University Belfast the reality of our somewhat peripheral location was placed at the forefront of our considerations. A single 4 semester studio is offered. The first three semesters are carefully structured to offer a range of directed and self directed projects to the students. By interrogation of these projects, and work undertaken at undergraduate level the aim is to assist the students to identify a personal position on architecture, which is then developed in the thesis in semester four. Research and design outputs are emergent from the interest of the student body, cultivated by staff who have the time over the four semesters to get to know all aspects of a students interests.

This paper will lay out this structure and some of the projects run within it. Now having delivered two graduating years the successes and challenges of the system will be laid out by reference to several case studies of individual student experiences of the structure.

Accountability for Responsibility: An assessment of the Transnational Capitalist Class' role in driving a Global CSR Agenda

Globalisation has led to the establishment of a new hierarchy of leadership. At the helm is the Transnational Capitalist Class (TCC) , which oversees the direction of Multi National Corporations (MNCs) at a global level. Can the TCC, as leaders in the governance agenda, drive a global CSR agenda, or, perhaps, the question should be: do they want to drive a CSR agenda?
The hypothesis of this article is that, as the structure of global leadership and governance has changed, so too has the potential for aligning national CSR agendas to a globally accepted standard. This is unlikely due to systematic limitations inherent in a transitional structural realignment of global leadership. Whereas the design of global leadership has changed due to processes of globalization, the bodies that can regulate this leadership have not developed at the same pace. Regulation on issues such as CSR remains at national, federal and supra-­-national levels suggesting that TCCs have a free reign in dictating agenda. This new class (TCC) may bear a responsibility for CSR but there is a lack of accountability if it is not fulfilled.

A comparison of real catching with catching using stereoscopic visual displays

To date, the usefulness of stereoscopic visual displays in research on manual interceptive actions has never been examined. In this study, we compared the catching movements of 8 right-handed participants (6 men, 2 women) in a real environment (with suspended balls swinging past the participant, requiring lateral hand movements for interception) with those in a situation in which similar virtual ball trajectories were displayed stereoscopically in a virtual reality system (Cave Automated Virtual Environment [CAVE]; Cruz-Neira, Sandin, DeFranti, Kenyon, & Hart, 1992) with the head fixated. Catching the virtual ball involved grasping a lightweight ball attached to the palm of the hand. The results showed that, compared to real catching, hand movements in the CAVE were (a) initiated later, (b) less accurate, (c) smoother, and (d) aimed more directly at the interception point. Although the latter 3 observations might be attributable to the delayed movement initiation observed in the CAVE, this delayed initiation might have resulted from the use of visual displays. This suggests that stereoscopic visual displays such as present in many virtual reality systems should be used circumspectly in the experimental study of catching and should be used only to address research questions requiring no detailed analysis of the information-based online control of the catching movements.

“Boundary-setting as a core activity in complex public systems”

Title: Boundary-setting as a core activity in complex public systems
Authors: Joanne Murphy & Mary Lee Rhodes

The definition of the boundary of a system is at the core of any systems approach (Midgley 2000; 2003). By defining boundaries we enable – and delimit – the range of outcomes sought and the actions and resources that can be brought to bear. In complex adaptive systems (CAS) analysis, the conceptualisaion and definition of boundaries is particularly challenging as they are constantly undergoing redefinition through agent action, interaction and entry/exit. (Rhodes et al 2011). The concept of ‘boundaries’ appears regularly in a wide range of literature around public management, administration, geopolitics, regeneration and organisational development. Discussions around boundaries focus on many things from concrete physical manifestations and barriers, to virtual interfaces between one organisational unit and another, or even entirely theoretical demarcations between different schools of thought (Kaboolian, 1998, Levi-Faur, 2004, Agranoff & McGuire, 2004).

However, managing ‘beyond’ such boundaries is a routinely recurring aspiration that transcends sectors and local concerns. Unsurprisingly then, there is an increasing understanding of the need to acknowledge and manage such boundaries (whether they be physical, social or organisational) within public management as a discipline (Currie et al 2007, Fitzsimmons and White, 1997, Murtagh, 2002). This paper explores the impact of boundaries on public management strategic decision-making in the sectors of urban regeneration and healthcare. In particular, it focuses on demarcations to physical space, communal identity and within professional relationships in these sectors.

The first section describes the research that gave rise to the paper and the cases examined. Next we briefly define what we mean by boundaries. We explore issues that have emerged from our analysis of urban regeneration and health care singularly, before looking at how the concept of boundaries is a recurrent concern across the sectors. The main contribution of the paper is an exploration of how a CAS lens can bring a new insight into the concept of boundaries and decision-making in the two sets of case studies. This discussion will concentrate on initial conditions, bifurcation and adaptation as key CAS factors in relation to boundaries. We conclude with a brief discussion on the benefits of a CAS lens to an analysis of boundaries in public management decision-making.
References:

Agranoff, R. and McGuire, M. (2003) Collaborative Public Management: Strategies for Local Government. Washington, DC: Georgetown Univ. Press.

Currie, G., Lockett, A. (2007) “A critique of transformational leadership: moral, professional & contingent dimensions of leadership within public services organizations”. Human Relations 60: 341-370.

Fitzsimmons and White, (1997) "Crossing boundaries: communication between professional groups", Journal of Management in Medicine, Vol. 11 Iss: 2, pp.96 – 101

Kaboolian, L. (1998) “The New Public Management: Challenging the Boundaries of the Management vs. Administration Debate” Public Administration Review Vol. 58, No. 3 pp.189-193

Levi-Faur D. and Vigoda-Gadot Eran (eds) (2004) International Public Policy and Management: Policy Learning Beyond Regional, Cultural and Political Boundaries, Marcel Dekker,
Midgley, G. (ed) (2003) Systems Thinking. London: Sage Publications

Midgley, G. (2000) Systemic Intervention: Philosophy, Methodology and Practice. New York, NY: Kluwer.

Murtagh, B. (2002). The Politics of Territory: Policy and Segregation in Northern Ireland. Basingstoke, Palgrave.

Rhodes, ML, Joanne Murphy, Jenny Muir, John Murray (2011) Public Management & Complexity Theory: Richer Decision Making in Irish Public Services, UK: Routledge

The importance of solid-phase distribution on the oral bioaccessibility of Ni and Cr in soils overlying Palaeogene basalt lavas, Northern Ireland

Potentially toxic elements (PTEs) including nickel and chromium are often present in soils overlying basalt at concentrations above regulatory guidance values due to the presence of these elements in underlying geology. Oral bioaccessibility testing allows the risk posed by PTEs to human health to be assessed; however, bioaccessibility is controlled by factors including mineralogy, particle size, solid-phase speciation and encapsulation. X-ray diffraction was used to characterise the mineralogy of 12 soil samples overlying Palaeogene basalt lavas in Northern Ireland, and non-specific sequential extraction coupled with chemometric analysis was used to determine the distribution of elements amongst soil components in 3 of these samples. The data obtained were related to total concentration and oral bioaccessible concentration to determine whether a relationship exists between the overall concentrations of PTEs, their bioaccessibility and the soils mineralogy and geochemistry. Gastric phase bioaccessible fraction (BAF %) ranged from 0.4 to 5.4 % for chromium in soils overlying basalt and bioaccessible and total chromium concentrations are positively correlated. In contrast, the range of gastric phase BAF for nickel was greater (1.4–43.8 %), while no significant correlation was observed between bioaccessible and total nickel concentrations. However, nickel BAF was inversely correlated with total concentration. Solid-phase fractionation information showed that bioaccessible nickel was associated with calcium carbonate, aluminium oxide, iron oxide and clay-related components, while bioaccessible chromium was associated with clay-related components. This suggests that weathering significantly affects nickel bioaccessibility, but does not have the same effect on the bioaccessibility of chromium.

Taking as Giving, Appropriation as Access: Transfers of Land Development Rights and China’s Recent Experiments

Economic development at both the domestic and global levels is associated with increasing tensions which are inextricably linked to the meaning and allocation of property rights, which has a great impact on appropriation of resources and may lead to different paths of development. “Taking”-- the appropriation of private land for public needs -- is a typical example that exhibits those tensions, posing a challenge to the conventional conception of property as individualistic and exclusive rights of possession, use, and disposition and to the associated neoliberal model of development. Should the individual landowner be left to bear the cost of a regulatory intervention which endures to the wider benefit of the whole community? How to mitigate the tensions between private ownership and public regulation? If we take the liberal concept of property, then private property seems to be in constant conflict with public interests and wider social concerns. Meanwhile, community, situating between the state and the individuals, and community’s relationship to development rights, have not provoked enough discussion. The paper explores the different ways land development rights might be seen both in Western, essentially common law systems, and in China, especially now and in view of two case studies. An empirical example in Wugang, China reveals the importance of integrating the “community lens” proposed by Roger Cotterrell into studies of the transfer of land development rights. Reading through the community lens, taking could be giving and appropriation could also be access. This approach provides a new perspective to re-evaluate the relationship between legal appropriation and development.

Improving the educational achievement of young people in out-of-home care

A strong link between research and practice is essential to ensure
that the best available evidence gets into the hands of child welfare
practitioners, who are faced with the daunting task of making decisions
about vulnerable children on a daily basis. In 2007, a group of
senior child welfare leaders in the province of Ontario (Canada) created
a research dissemination model that replicated the worldrenowned
UK program, Research in Practice (http://www.rip.org.
uk). Practice and Research Together (PART; www.partontario.org) is
an Ontario consortium of 45 child welfare organizations whose mandate
is to disseminate research to its member agencies, which include
85% of the local child welfare organizations in the province. Each
member pays an annual membership-fee that is based on its size
(Dill & Shera, 2011). A key factor in PART's success has been its ability
to link its program offerings (i.e., webinars, literature reviews, conferences,
and publications) to issues of real-world relevance to child
welfare practitioners and senior leaders. A central and highly anticipated
program offering is PART's annual conference (learning
event). These conferences bring evidence to bear on practice in priority
areas in child welfare.
On May 31 and June 1 and 2, 2011, PART, in collaboration with the
Centre for Research on Educational and Community Services (CRECS)
at the University of Ottawa, co-hosted an international conference in
Ottawa that was focused on improving the educational achievement
of young people in out-of-home care (hereafter, in care). Speakers
from five countries – Canada, USA, Germany, Sweden, and UK – presented
the results of their research at the conference. The speakers
addressed three main topic areas: the disadvantaged socio-political
status of young people in care, many of whom do not complete secondary
or post-secondary education; innovative interventions to improve
their educational outcomes; and the effectiveness of tutoring,
which is the most common educational intervention for young people
in care.

Fit to Burst

A single drama for BBC Radio 3 The Wire: Andy has hit a mid-life crisis. His career is a mess, his relationship is falling apart and despite, or perhaps because of this, he seems intent on eating himself into an early grave. The Voice in his head has warned him, clearly, and a nightmarish tour of his inner organs has left him in no doubt that he is headed for, at best, a coronary arrest; at worst, something that he can't bear to think about it.

And yet he persists. Drowning in despair he grasps at crumbs of comfort, ingesting enough food to support a small country and doubling his waist and his weight in just one month, terrifying his wife and his work colleagues and rendering the average doorway inadequate for his desperate attempts at escape.

Later Pleistocene evolution of the Exe valley: A chronstratigraphic model of terrace formation and its implications for Palaeolithic archaeology

This paper presents the ?rst systematic chronostratigraphic study of the river terraces of the Exe catchment in South West England and a new conceptual model for terrace formation in unglaciated basins with applicability to terrace staircase sequences elsewhere. The Exe catchment lay beyond the maximum extent of Pleistocene ice sheets and the drainage pattern evolved from the Tertiary to the Middle Pleistocene, by which time the major valley systems were in place and downcutting began to create a staircase of strath terraces. The higher terraces (8-6) typically exhibit altitudinal overlap or appear to be draped over the landscape, whilst the middle terraces show greater altitudinal separation and the lowest terraces are of a cut and ?ll form. The terrace deposits investigated in this study were deposited in cold phases of the glacial-interglacial Milankovitch climatic cycles with the lowest four being deposited in the Devensian Marine Isotope Stages (MIS) 4-2. A new cascade process-response model is proposed of basin terrace evolution in the Exe valley, which emphasises the role of lateral erosion in the creation of strath terraces and the reworking of inherited resistant lithological components down through the staircase. The resultant emergent valley topography and the reworking of artefacts along with gravel clasts, have important implications for the dating of hominin presence and the local landscapes they inhabited. Whilst the terrace chronology suggested here is still not as detailed as that for the Thames or the Solent System it does indicate a Middle Palaeolithic hominin presence in the region, probably prior to the late Wolstonian Complex or MIS 6. This supports existing data from cave sites in South West England.

Synthesis and characterization of star polymers and cross-linked star polymer model networks with cores based on an asymmetric, hydrolyzable dimethacrylate cross-linker

A hydrolyzable dimethacrylate cross-linker, 2-methyl-2,4-pentanediol dimethacrylate (MPDMA), was synhesized by the reaction of 2-methyl-2,4-pentanediol and methacryloyl chloride in the presence of triethylamine. This cross-linker was used to prepare a neat cross-linker network and three cross-linked star polymer model networks (CSPMNs) of methyl methacrylate (MMA), as well as star-shaped polymers of MMA, by group transfer polymerization (GTP). Gel permeation chromatography (GPC) in tetrahydrofuran (THF) confirmed the narrow molecular weight distributions (MWDs) of the linear polymer precursors, and demonstrated the increase in molecular weight (MW) on each successive addition of cross-linker or monomer. Characterization of the star polymers by static light scattering (SLS) in THF showed that star polymers with MPDMA cores bear a relatively small number of arms, between 7 and 35. All star polymers and polymer networks containing the MPDMA cross-linker were hydrolyzed at room temperature in neat trifluoroacetic acid to yield lower-MW products.

Synthesis and characterization of star polymers and cross-linked star polymer model networks containing a novel, silicon-based, hydrolyzable cross-linker

An acid-labile dimethacrylate cross-linker, dimethyldi(methacryloyloxy-l-ethoxy)silane (DMDMAES), was synthesized by the reaction of 2-hydroxyethyl methacrylate (HEMA) and dichlorodimethylsilane in the presence of triethylamine. Group transfer polymerization (GTP) was employed to use this cross-linker in the preparation of six hydrolyzable polymer structures: one neat cross-linker network, one randomly cross-linked network of methyl methacrylate (MMA), two star-shaped polymers of MMA, and two cross-linked star polymer model networks (CSPMNs) of MMA. A nonhydrolyzable CSPMN of MMA, based on a stable cross-linker, was also synthesized. Gel permeation chromatography (GPC) in tetrahydrofuran (THF) confirmed the narrow molecular weight distributions (MWDs) of the linear polymer precursors and demonstrated the increase in molecular weight (MW) upon each successive addition of cross-linker or monomer. Characterization by static light scattering (SLS) and GPC showed that star polymers with DMDMAES cores bear a relatively small number of arms, around 7. All star polymers and polymer networks were hydrolyzed using hydrochloric acid in THF. While the MWs of the products from the hydrolysis of the star polymers, the neat cross-linker network, and the randomly cross-linked network were as expected, those from the CSPMNs were of a much higher than expected MW, indicating extensive star-star coupling.

A Vector Approach for the Analysis and Synthesis of Directional Modulation Transmitters

In order to formalize and extend on previous ad-hoc analysis and synthesis methods a theoretical treatment using vector representations of directional modulation (DM) systems is introduced and used to achieve DM transmitter characteristics. An orthogonal vector approach is proposed which allows the artificial orthogonal noise concept derived from information theory to be brought to bear on DM analysis and synthesis. The orthogonal vector method is validated and discussed via bit error rate (BER) simulations.