Evaluation study of the IHM project on the evaluation of the accreditation of health and social care managers: a pilot.

This evaluation report was commissioned by the Institute of Healthcare Management (IHM) in March 2009 and is based on the accredited manager pilot project that started in May 2009. The IHM pilot project was funded by the Department of Health (Estates). The pilot project aimed to offer managers for the health and social care sectors the opportunity to gain accredited manager status based upon their previous performance and achievements towards nine core manager behaviours1. The pilot project was intended to develop and implement materials that would support the managers in completion of a portfolio of achievement to demonstrate competence in the behaviours (Sugden, 2009). The evaluation study of the pilot project has aimed to include the experiences of the main stakeholders, namely; the candidates (Healthcare and Social), the pilot project team, a representative from the Department of Health (Estates), representing the commissioning body for the project, and the assessors of the candidate portfolios and viva voce examinations. The candidates were drawn mainly from the field of estates and facilities managers within the healthcare sector, with two participants for the social care sector. The project was prompted by the recognition that many managers in the health and social care sector may encounter difficulties in finding the time to attend conventionally delivered training and development programmes. There was also recognition of the need for experienced managers to be able to demonstrate their competence towards good practice behaviours rather than have to undertake taught delivery

Power, participation and partnership: methodological reflection on researching professional doctorate candidates' experiences of researching in the workplace

This study aimed to explore the candidate experience in order to understand more deeply aspects of the development in work based research. Delphi technique was chosen as an approach in order to capture a range of experience and data, to inform how we may best support candidates on practice based doctorates. Many such programmes include a stakeholder learning agreement between the candidate, the university and the employer organisation with the common aim to bring about transformational and sustainable change. Our research to date indicates a disparity within the agreement in the level of stakeholder participation. Where the organisation stakeholder is not fully engaged and involved in supporting the research, there is a potential threat to the effectiveness of any change outcome. Current practice based doctoral research participants were invited to relate to a range of temporal themes in their research project cycle, for example: setting up the project; implementing the project; changes/ contingency planning within the project; project completion and post completion. Of particular interest in relation to the above was the availability of resources and how they were used within the project life cycle. In this respect, resources are deemed to include, human, material, time, personal and organisational culture influence. The allocation, manipulation and distribution of such resources can be understood in terms of power relationships. The paper presents our experience and reflections from two iterative Delphi cycles and proposes a final stage of greater integration with existing academic resources within the professional doctorate programme. The study has enabled the researchers to gain a new understanding of how power may operate in a work based research project through the experience of undertaking the Delphi approach. Furthermore, by thinking about affordances of the project life cycle, it may help us to better understand needs and strategy for the curriculum in order to more effectively support candidates through their transformational learning experience. The consequences of such change might have implications for participation and power distribution within the management and leadership of doctoral work base research projects

Responding to the risk of reducing resource: a study of the evolution of English environmental health services

Environmental Health services in the UK have been subject to significant resource reduction over the last 3 years. It is suggested that services risk becoming unsustainable unless efficient and effective ways of working are employed. With this in mind this paper presents the findings of research into the experience of practitioners who are developing and delivering evolving environmental health services in English local authorities in the context of deep cutting budget reductions. The research aims to explore the experience of change and identify lessons learnt in the development and execution of new models of environmental health service delivery to mitigate against risks of unsustainable or undeliverable services. Participants were chosen from a range of local authority officers, managers, commissioners and leading members of the professional body who have been closely involved in the planning and delivery stages of environmental health service changes. Interviews were carried out with the participants to capture their experience of change and the impact on service delivery. A range of service delivery models have been examined including outsourcing, shared services, regional delivery models and discussion of mutual arrangements and at various stages of development from planning through to full transformation. Field work was undertaken between June 2014 and November 2015. Thematic analysis of interview transcripts has identified six emergent themes of the experience of change: managing changes effectively; understanding the reasons for change; understanding the nature of environmental health; meaningful consultation; viability of the proposal; planning and timeliness. Environmental health services undergoing transformation may benefit from taking into account the lessons learnt by organisations that have previously undergone significant change in their response to the risk of a reducing resource. The emergent themes are being developed to provide a framework of lessons learnt for environmental health services to consider when making changes to their model of service delivery

Responding to the risk of reducing resources: development of a framework for future change programmes in environmental health services

Environmental Health services in the UK have been subject to significant resource reduction over the last 5 years. It is suggested that services risk becoming unsustainable unless efficient and effective ways of working are employed. With this in mind this paper presents the findings of research into the experience of practitioners who are developing and delivering evolving Environmental Health services in English local authorities in the context of deep cutting budget reductions. The research explores the experience of change and identifies lessons learnt in the development and execution of new models of Environmental Health service delivery to mitigate against risks of unsustainable or undeliverable services. Interviews were carried out with the participants to capture their experience of change and the impact on service delivery. A range of service delivery models have been examined including outsourcing, shared services, regional delivery models and discussion of mutual arrangements and at various stages of development from planning through to full transformation. Field work was undertaken between 2014 and 2016. Thematic analysis of interview transcripts has identified six emergent themes of the experience of change: managing changes effectively; understanding the reasons for change; understanding the nature of Environmental Health; meaningful consultation; viability of the proposal; planning and timeliness. Environmental Health services undergoing transformation may benefit from taking into account the lessons learnt by organisations that have previously undergone significant change in their response to the risk of a reducing resource. Keywords: Environmental Health; austerity; regulation; emerging risk; outsourcing; managing change

Concurrent Carbon Capture and Biocementation through the Carbonic Anhydrase (CA) activity of microorganisms ‑ a review and outlook

Biocementation, i.e., the production of biomimetic cement through the metabolic activity of microorganisms, offers exciting new prospects for various civil and environmental engineering applications. This paper presents a systematic literature review on a biocementation pathway, which uses the carbonic anhydrase (CA) activity of microorganisms that sequester CO2 to produce biocement. The aim is the future development of this technique for civil and (geo-)environmental engineering applications towards CO2-neutral or negative processes. After screening 248 potentially relevant peer-reviewed journal papers published between 2002 and 2023, 38 publications studying CA-biocementation were considered in the review. Some of these studies used pure CA enzyme rather than bacteria-produced CA. Of these studies, 7 used biocementation for self-healing concrete, 6 for CO2 sequestration, 10 for geotechnical applications, and 15 for (geo-)environmental applications. A total of 34 bacterial strains were studied, and optimal conditions for their growth and enzymatic activity were identified. The review concluded that the topic is little researched; more studies are required both in the laboratory and field (particularly long-term field experiments, which are totally lacking). No studies on the numerical modelling of CA-biocementation and the required kinetic parameters were found. The paper thus consulted the more widely researched field of CO2 sequestration using the CA-pathway, to identify other microorganisms recommended for further research and reaction kinetic parameters for numerical modelling. Finally, challenges to be addressed and future research needs were discussed

Combining phytoremediation with bioenergy production: developing a multi‑criteria decision matrix for plant species selection

The use of plants to extract metal contaminants from soils has been proposed as a cost-effective means of remediation, and utilizing energy crops for this phytoextraction process is a useful way of attaining added value from the process. To simultaneously attain both these objectives successfully, selection of an appropriate plant species is crucial to satisfy a number of important criteria including translocation index, metal and drought tolerance, fast growth rate, high lignocellulosic content, good biomass production, adequate calorific value, second generation attribute, and a good rooting system. In this study, we proposed a multi-criteria decision analysis (MCDA) to aid decision-making on plant species based on information generated from a systematic review survey. Eight species Helianthus annuus (sunflower), Brassica juncea (Indian mustard), Glycine max (soybean), Salix spp. (willow), Populus spp. (poplar), Panicum virgatum (switchgrass), Typha latifolia (cattails), and Miscanthus sinensis (silvergrass) were examined based on the amount of hits on a number of scientific search databases. The data was normalized by estimating their min–max values and their suitability. These criteria/indicators were weighted based on stipulated research objectives/priorities to form the basis of a final overall utility scoring. Using the MCDA, sunflower and silvergrass emerged as the top two candidates for both phytoremediation and bioenergy production. The multi-criteria matrix scores assist the process of making decisions because they compile plant species options quantitatively for all relevant criteria and key performance indicators (KPIs) and its weighing process helps incorporate stakeholder priorities to the selection process

Evidence for the outcomes and impact of clinical pharmacy: context of UK hospital pharmacy practice

Objectives: The role of clinical pharmacists in hospitals has evolved and continues to expand. In the UK, outside of a few national policy drivers, there are no agreed priorities, measures or defined outcomes for hospital clinical pharmacy (CP). This paper aims to (1) highlight the need to identify and prioritise specific CP roles, responsibilities and practices that will bring the greatest benefit to patients and health systems and (2) describe systematic weaknesses in current research methodologies for evaluating CP services and propose a different approach. Method: Published reviews of CP services are discussed using the Economic, Clinical and Humanistic Outcomes framework. Recurring themes regarding study methodologies, measurements and outcomes are used to highlight current weaknesses in studies evaluating CP. Results: Published studies aiming to demonstrate the economic, clinical or humanistic outcomes of CP often suffer from poor research design and inconsistencies in interventions, measurements and outcomes. This has caused difficulties in drawing meaningful conclusions regarding CP’s definitive contribution to patient outcomes. Conclusion: There is a need for more research work in National Health Service (NHS) hospitals, employing a different paradigm to address some of the weaknesses of existing research on CP practice. We propose a mixed-methods approach, including qualitative research designs, and with emphasis on cost-consequence analyses for economic evaluations. This approach will provide more meaningful data to inform policy and demonstrate the contribution of hospital CP activities to patient care and the NHS

Chemistry and the environment

A report on three symposia in the ‘Energy, Water and Environmental Science’ programme at the International Union of Pure and Applied Chemistry (IUPAC) 46th World Chemistry Congress (in Sao Paulo, Brazil, 9-14 July, 2017). The symposia presented the latest advances concerning the environmental impact of emerging technologies and the fate of pollutants in the environment

Which doctors and with what problems contact a specialist service for doctors? A cross sectional investigation

Background: In the United Kingdom, specialist treatment and intervention services for doctors are underdeveloped. The MedNet programme, created in 1997 and funded by the London Deanery, aims to fill this gap by providing a self-referral, face-to-face, psychotherapeutic assessment service for doctors in London and South-East England. MedNet was designed to be a low-threshold service, targeting doctors without formal psychiatric problems. The aim of this study was to delineate the characteristics of doctors utilising the service, to describe their psychological morbidity, and to determine if early intervention is achieved. Methods: A cross-sectional study including all consecutive self-referred doctors (n = 121, 50% male) presenting in 2002–2004 was conducted. Measures included standardised and bespoke questionnaires both self-report and clinician completed. The multi-dimensional evaluation included: demographics, CORE (CORE-OM, CORE-Workplace and CORE-A) an instrument designed to evaluate the psychological difficulties of patients referred to outpatient services, Brief Symptom Inventory to quantify caseness and formal psychiatric illness, and Maslach Burnout Inventory. Results: The most prevalent presenting problems included depression, anxiety, interpersonal, self-esteem and work-related issues. However, only 9% of the cohort were identified as severely distressed psychiatrically using this measure. In approximately 50% of the sample, problems first presented in the preceding year. About 25% were on sick leave at the time of consultation, while 50% took little or no leave in the prior 12 months. A total of 42% were considered to be at some risk of suicide, with more than 25% considered to have a moderate to severe risk. There were no significant gender differences in type of morbidity, severity or days off sick. Conclusion: Doctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of suicide; however, low rates of severe psychiatric illness were detected. These findings suggest that MedNet clients represent both ends of the spectrum of severity, enabling early clinical engagement for a significant proportion of cases that is of importance both in terms of personal health and protecting patient care, and providing a timely intervention for those who are at risk, a group for whom rapid intervention services are in need and an area that requires further investigation in the UK