A systematic review of evidence-based assessment practices by allied health practitioners for children with cerebral palsy

AIM: The routine use of psychometrically robust assessment tools is integral to best practice. This systematic review aims to determine the extent to which evidence-based assessment tools were used by allied health practitioners for children with cerebral palsy (CP).

METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols 2015 was employed. A search strategy applied the free text terms: 'allied health practitioner', 'assessment', and 'cerebral palsy', and related subject headings to seven databases. Included articles reported assessment practices of occupational therapists, physiotherapists, or speech pathologists working with children with CP aged 0 to 18 years, published from the year 2000.

RESULTS: Fourteen articles met the inclusion criteria. Eighty-eight assessment tools were reported, of which 23 were in high use. Of these, three tools focused on gross motor function and had acceptable validity for use with children with CP: Gross Motor Function Measure, Gross Motor Function Classification System, and goniometry. Validated tools to assess other activity components, participation, quality of life, and pain were used infrequently or not at all.

INTERPRETATION: Allied health practitioners used only a few of the available evidence-based assessment tools. Assessment findings in many areas considered important by children and families were rarely documented using validated assessment tools.

Paramountcy, family rights and contested adoption: does contact with birth relatives balance the scales?

This article combines practitioner insight and research evidence to chart how principles of partnership and paramountcy have led to birth family contact becoming the expected norm following contested adoption from care in Northern Ireland. The article highlights how practice has adapted to the delay in proposed reforms to adoption legislation resulting in the evolution of increasingly open adoption practices. Adoption represents an irrevocable transfer of parental responsibility from birth to adoptive parents and achieves permanence and legal security for children in care who cannot return to their birth family. Its enduring effect, however, makes public adoption a contentious field of child welfare practice, particularly when contested by birth parents. This article explores how post-adoption contact may be viewed as reconciling the uneasy interface between paramountcy principles and parental rights to respect for family life. The article highlights the complexity of adoptive kinship relationships following contested adoption from care, and how contact presents unique challenges that mitigate against meaningful and sustainable connections between the child and their birth relatives. In conclusion, a call is made for sensitive negotiation and support of contact arrangements, and the development of practice models that are informed by an understanding of the workings of adoptive kinship.

Low-Dose Aspirin Use After Diagnosis of Colorectal Cancer Does Not Increase Survival: A Case–Control Analysis of a Population-Based Cohort

BACKGROUND & AIMS: Individuals who began taking low-dose aspirin before they were diagnosed with colorectal cancer were reported to have longer survival times than patients who did not take this drug. We investigated survival times of patients who begin taking low-dose aspirin after a diagnosis of colorectal cancer in a large population-based cohort study.

METHODS: We performed a nested case-control analysis using a cohort of 4794 patients diagnosed with colorectal cancer from 1998 through 2007, identified from the UK Clinical Practice Research Datalink and confirmed by cancer registries. There were 1559 colorectal cancer-specific deaths, recorded by the Office of National Statistics; these were each matched with up to 5 risk-set controls. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI), based on practitioner-recorded aspirin usage.

RESULTS: Overall, low-dose aspirin use after a diagnosis of colorectal cancer was not associated with colorectal cancer-specific mortality (adjusted OR = 1.06; 95% CI: 0.92-1.24) or all-cause mortality (adjusted OR = 1.06; 95% CI: 0.94-1.19). A dose-response association was not apparent; for example, low-dose aspirin use for more than 1 year after diagnosis was not associated with colorectal cancer-specific mortality (adjusted OR = 0.98; 95% CI: 0.82-1.19). There was also no association between low-dose aspirin usage and colon cancer-specific mortality (adjusted OR = 1.02; 95% CI: 0.83-1.25) or rectal cancer-specific mortality (adjusted OR = 1.10; 95% CI: 0.88-1.38).

CONCLUSIONS: In a large population-based cohort, low-dose aspirin usage after diagnosis of colorectal cancer did not increase survival time.

O vidro como material plástico: transparência, luz, cor e expressão

A presente tese de doutoramento procura focar o vidro como material plástico para a concepção de obras de arte. Os seus alicerces caracterizam-se pelo estudo técnico sobre o uso do vidro e a sua aplicação na realização de obras com pressupostos estéticos e artísticos. Hoje a arte em vidro apresenta-se inovadora e contemporânea, procurando uma componente ligada à pesquisa e à experimentação. Portugal possui uma ampla história ligada à tradição do vidro, em especial ao vitral. No que concerne à sua aplicação na arte contemporânea, assistimos a um renovado interesse por parte de vários artistas. No entanto, quando se trabalha com o vidro, é necessário o artista conhecer e dominar a técnica que utiliza, para assim compreender as potencialidades que o material oferece e empregá-las de acordo com o seu modus operandi. Cria-se uma relação entre a ciência e a arte, uma descoberta e utilização de novos conhecimentos, em que se pretende manter uma relação estreita entre o cientista e o artista através do desenvolvimento de novos materiais, nomeadamente os vidros e esmaltes luminescentes e a adição de óxidos de metais de transição 3d na sua composição. Neste sentido foram desenvolvidos estudos minuciosos sobre a técnica de kilncasting onde se utilizou o vidro sonoro superior produzido no CRISFORM (Centro de Formação Profissional para o Sector da Cristalaria), na Marinha Grande. Assim, verifica-se que as premissas desta tese podem ser divididas em três vertentes: a) Uma contextualização histórica e teórica do panorama artístico do vidro em Portugal; b) Uma componente teórica/prática do estudo do vidro: a ciência do vidro, a sua composição, com a preocupação de utilizar esses conhecimentos para a elaboração de amostras práticas, onde a componente técnica é fundamental para a produção de futuras obras de arte; c) A idealização de obras de arte e a utilização do vidro como material plástico para a sua realização. Na elaboração destas obras procurou-se focar a dicotomia entre transparência versus opacidade, os efeitos cromáticos produzidos por diferentes espessuras e texturas do vidro, assim como da monocromia versus policromia, esta última através do vidro e esmaltes luminescentes. Em suma, na complementaridade laboratório/ateliê, os segredos da matéria abrem novas fronteiras à criatividade estética.

‘To me, it's like a little box of tricks’: Breaking the depressive interlock as a programme participant in mindfulness-based cognitive therapy

Objectives. Mindfulness meditation practices have become increasingly popular in clinical therapies, changing patterns of depressogenic thinking for individuals who experience consecutive episodes of depression. We were interested in finding out how Mindfulness Based Cognitive Therapy (MBCT) worked for programme participants by focussing on how meditative practices changed their relationships to their thoughts. Design. Data for the study came from six semi-structured research interviews carried out with individuals who had taken part in an 8 week MBCT programme Methods. We used Interpretative Phenomenological Analysis (IPA) to analyse the experiential accounts. Results. We report on two superordinate themes – Engaging the Neutral Mind (with subordinate themes ‘breaking the paralysis of worry’ and ‘choosing to think differently’) and Experiencing the Neutral Mind (with subordinate themes of ‘reflection on previous thinking styles’ and ‘becoming psychologically self-reliant’). Conclusions. Themes from the present study offer support to the assertion that mindfulness meditation helps facilitate a different mode of meta-cognitive processing with which to handle depression-related cognitions. Practitioner Points Participants reported that they experienced an enhanced capacity to differentiate between their thought processes, experiencing an ability to tolerate some more uncomfortable thoughts and experiencing a/more choice in how to respond to thoughts Participants recognised that ruminating over negative thoughts was related to depressive states and experienced a shift in meta-cognitive processes that actively challenged depressogenic cognitions Participants became more psychologically self-reliant and therapeutically independent following MBCT Integrating mindfulness based practices in therapy may be a mediating factor in sustaining psychological wellbeing and may help clients develop self-compassion Future research looks to examining exit cases to understand elements of MBCT which are experienced as less successful by clients

“I just can’t, I am frightened for my safety, I don’t know how to work with her” Practitioners’ experiences of client violence and recommendations for future practice

To what extent is the therapist-client relationship damaged following client perpetuated violence and what steps can we take to diminish its impact? Much of the information we have on client violence comes from multiple mental health disciplines in the US and the UK over the last 20-30 years and has formed a useful, though sometimes dated and sporadic, quantitative baseline to delineate a range of issues. However, there is limited systematic research on how practitioner psychologists process the violence in the course of their everyday practice and how this impacts the therapist-client dynamic. Using Interpretative Phenomenological Analysis (IPA), we explored seven therapists’ experiences of client violence across a range of work sites – acute psychiatric hospital wards, forensic hospital wards and community mental health teams. Three main themes were documented: processing the moment-to-moment experience of client violence; professional vulnerabilities and needs as a result of client violence; and the ruptured therapeutic relationship. Strategies for supporting practicing psychologists and providing continuing professional care for clients include challenging self-doubt and re-energizing professional competencies as well as repairing ourselves and repairing the therapeutic relationship. Recommendations for credentialing and regulatory bodies in relation to client violence are also highlighted.

‘Running with the Fox and Hunting with the Hounds’: Social Work Tutors' Experiences of Managing Failing Social Work Students in Practice Learning Settings

The paper explores the issues raised by social work students failing in practice learning settings from the perspective of university tutors, by drawing on existing literature in this area from social work and nursing, as well as findings from a small‐scale empirical qualitative study. The qualitative study was influenced by practitioner‐researcher and practice‐near paradigms; and is based on interviews with twelve social work tutors in England. The findings reveal that tutors are able to articulate the important tasks and functions of their roles when issues of failing students in practice learning settings arise, although the process can be challenging. The challenges include: supporting practice educator and student, concerns about other tutors’ practices, the difficulties in promoting appropriate professional standards and values within higher education contexts and frustrations with practice educators and placements. Only a third of the respondents (four) however, articulated their gate keeping roles and responsibilities although this was not without its difficulties. Given the current reforms in social work education in England at this present time, with greater emphasis on threshold standards at entry level, and at key stages throughout the programme of study, the research is timely in terms of the critical consideration of the tutor role and challenges inherent in promoting appropriate standards.

Squaric acid/4-aminoquinoline conjugates: novel potent antiplasmodial agents

We report the synthesis and structure–activity relationship (SAR) analysis of a series of hybrid compounds containing a squaric moiety conjugated with heterocyclic moieties from well-known antimalarials. This novel series of compounds presents improved antiplasmodial activity compared with the squaric derivatives described in our previous work. Three compounds, 8b (IC50 = 99 nM), 8c (IC50 = 95 nM), and 8d (IC50 = 105 nM) had greater in vitro potency than chloroquine 1 (IC50 = 140 nM) against chloroquine resistant Plasmodium falciparum. In addition, they were noncytotoxic against NIH 3T3 and Hek 293T cells.

A moral, mural! : as ideias nos mapas e quadros parietais

Tese de doutoramento, Educação (História da Educação), Universidade de Lisboa, Instituto de Educação, 2014

A Reflective Encounter With the Fine Sand Area in a Nursery School Setting

This article draws on a model of reflection that involves creating meanings through repeated encounters with evocative objects. Responses to one such evocative object, a 20-second video clip of children playing in the fine sand area, illustrates the “turning toward” and then “turning away” from the object to engage with broader themes. Parten’s play types are used when analyzing children’s play in the fine sand area (the evocative object). The focus then turns away to themes of English as a second language, messy play, energies of childhood, and Foucault’s docile bodies. The intention was to integrate loosely formulated research aims relating to quality of the physical environment within the evolving life of the nursery setting to encourage a developing research orientation and reflective dis-position. This way of approaching practitioner research is well adapted to a longer-term engagement with enduring areas of interest, such as developing the potential of the physical environment.

Foundation degrees in biomedical science: the student experience

The first cohort of students on a University of Westminster foundation degree completed the course recently. Here, Chrystalla Ferrier, Kelly Brookwell and Paul Quinn employ some reflective practice.

Visual Approaches to Property Law Pedagogy

Purpose - To consider a more visual approach to property law teaching practices. This will be achieved by exploring the existence of ‘visual learners’ as a student body, evaluating the use of more visual teaching techniques in academic practice, recognising the historic dominance of text in legal education, and examining the potential for heightening visual teaching practices in the teaching of property law. Design/methodology/approach – The paper reviews and analyses some of the available literature on visual pedagogy, and visual approaches to legal education, but also introduces an amount of academic practitioner analysis. Findings – This paper evidences that, rather than focusing on the categorisation of ‘visual learner’, the modern academic practitioner should employ the customary use of more visual stimuli; consequently becoming a more ‘visual teacher’. This paper demonstrates that these practices, if performed effectively, can impact upon the information literacy of the whole student body: It also proffers a number of suggestions as to how this could be achieved within property law teaching practices. Practical implications – The paper will provide support for early-career academic practitioners, who are entering a teaching profession in a period of accelerated and continual change, by presenting an overview of pedagogic practices in the area. It will also provide a stimulus for those currently teaching on property law modules and support their transition to a more visual form of teaching practice. Originality/value – This paper provides a comprehensive overview of visual pedagogy in legal education, and specifically within that of property law, which has not been conducted elsewhere.

The New Instantaneity: How Social Media are Helping us Privilege the (Politically) Correct over the True

The recent sacking of the eminent scientist Tim Hunt from one of the UK’s leading research institutions is only the latest in a series of cases where public individuals have been derided for comments made in jest on social media, with serious consequences for their professional and personal lives. This article discusses the case of Tim Hunt as an example of the extent to which the privileging of the correct over the true which has long pervaded media discourse is taken to the extreme by the instant-response culture of social media. It points to the emergence of a new form of instantaneity enabled by these networked forms of communication that serves to reinforce systemic inaction rather than the change widely associated with these technologies. It draws on philosophy and Critical Theory as useful conceptual frameworks for highlighting the ways in which Twitter & co. increasingly call us to action but crowd out thought, thereby passing over opportunities for real social change.

From the high ground to the swamp: A model for immersive journalism research

This article examines a reflexive, praxis-based methodology for conducting journalism research from a practitioner-academic perspective. Journalism research methods that are interactive, iterative and which rest on a dynamic communicative partnership between academics and practitioners, offer the best way for understanding change in our dynamic field. This permits the researcher to coalesce and strengthen their identity as a practitioner-academic and develop research projects that are mutually beneficial for advancing scholarship and practice. Drawing on reflexive methodologies in the human sciences, such as hermeneutics, cybernetics and constructivism, this article envisions an immersive approach embracing phenomenology and Gestalt as a fully reflexive method of data collection.

A Social Institutionalist Perspective on HR Diffusion: Histrorical and Cultural Receptivity to HRM in a Post-Comminist Context

This research considers cross-national diffusion of international human resource management (IHRM) ideas and practices by applying an emergent frame of sociological conceptualisation – ‘social institutionalism’ (SI). We look at cultural filters to patterns of diffusion, assimilation and adoption of IHRM, using Romania as a case study. The paper considers the former Communist system of employment relations, suggesting that through institutionalisation former ways of thinking continued to influence definitions and practice of people management in post-Communist Eastern Europe. The paper provides a new perspective on HRM by discussing the value of SI as a general model for understanding cross-cultural receptivity to HR ideas, sensitising the HR practitioner and academic to institutionalised culture as a historical legacy influencing receptivity to international management ideas.