The Gosport War Memorial Hospital Panel report and its implications for nursing

Where do we even begin? How do mere words encapsulate the full horror of the Gosport War Memorial Hospital (GWMH) report (Gosport Independent Panel, 2018) and its profound implications for nursing? Many of us thought that in our careers we would never again read anything as damning of health care and health services as the Francis Report; Darbyshire & McKenna, 2013; Hayter, 2013; Nolan, 2013). We were wrong. Politicians, hospitals, health services, educators and regulators at that time were falling over each other to reassure us that ‘lessons had been learned’, ‘things had changed’, ‘new systems were in place’ and that such disasters and failures ‘must never happen again’

Problematising parent–professional partnerships in education

The value of, and need for, parent–professional partnerships is an unchallenged mantra within policy relating to ‘special educational needs’. In spite of this, partnerships continue to be experienced as problematic by both parents and professionals. This paper brings together the different perspectives of two disability researchers: one a parent of a disabled child while the other was a teacher for 20 years of children with the label autism. The paper deconstructs the concept of partnership and then, drawing on the expertise of parents, suggests how enabling and empowering parent–professional relationships might be achieved

Problematising parent–professional partnerships in education

The value of, and need for, parent–professional partnerships is an unchallenged mantra within policy relating to ‘special educational needs’. In spite of this, partnerships continue to be experienced as problematic by both parents and professionals. This paper brings together the different perspectives of two disability researchers: one a parent of a disabled child while the other was a teacher for 20 years of children with the label autism. The paper deconstructs the concept of partnership and then, drawing on the expertise of parents, suggests how enabling and empowering parent–professional relationships might be achieved

The science of clinical practice: disease diagnosis or patient prognosis? Evidence about "what is likely to happen" should shape clinical practice.

BACKGROUND: Diagnosis is the traditional basis for decision-making in clinical practice. Evidence is often lacking about future benefits and harms of these decisions for patients diagnosed with and without disease. We propose that a model of clinical practice focused on patient prognosis and predicting the likelihood of future outcomes may be more useful. DISCUSSION: Disease diagnosis can provide crucial information for clinical decisions that influence outcome in serious acute illness. However, the central role of diagnosis in clinical practice is challenged by evidence that it does not always benefit patients and that factors other than disease are important in determining patient outcome. The concept of disease as a dichotomous 'yes' or 'no' is challenged by the frequent use of diagnostic indicators with continuous distributions, such as blood sugar, which are better understood as contributing information about the probability of a patient's future outcome. Moreover, many illnesses, such as chronic fatigue, cannot usefully be labelled from a disease-diagnosis perspective. In such cases, a prognostic model provides an alternative framework for clinical practice that extends beyond disease and diagnosis and incorporates a wide range of information to predict future patient outcomes and to guide decisions to improve them. Such information embraces non-disease factors and genetic and other biomarkers which influence outcome. SUMMARY: Patient prognosis can provide the framework for modern clinical practice to integrate information from the expanding biological, social, and clinical database for more effective and efficient care

Estimating the returns to UK publicly funded cancer-related research in terms of the net value of improved health outcomes

© 2014 Glover et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background - Building on an approach developed to assess the economic returns to cardiovascular research, we estimated the economic returns from UK public and charitable funded cancer-related research that arise from the net value of the improved health outcomes. Methods - To assess these economic returns from cancer-related research in the UK we estimated: 1) public and charitable expenditure on cancer-related research in the UK from 1970 to 2009; 2) net monetary benefit (NMB), that is, the health benefit measured in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of GB£25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1991 to 2010; 3) the proportion of NMB attributable to UK research; 4) the elapsed time between research funding and health gain; and 5) the internal rate of return (IRR) from cancer-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using sensitivity analyses to illustrate the effect of some key parameters. Results - In 2011/12 prices, total expenditure on cancer-related research from 1970 to 2009 was £15 billion. The NMB of the 5.9 million QALYs gained from the prioritised interventions from 1991 to 2010 was £124 billion. Calculation of the IRR incorporated an estimated elapsed time of 15 years. We related 17% of the annual NMB estimated to be attributable to UK research (for each of the 20 years 1991 to 2010) to 20 years of research investment 15 years earlier (that is, for 1976 to 1995). This produced a best-estimate IRR of 10%, compared with 9% previously estimated for cardiovascular disease research. The sensitivity analysis demonstrated the importance of smoking reduction as a major source of improved cancer-related health outcomes. Conclusions - We have demonstrated a substantive IRR from net health gain to public and charitable funding of cancer-related research in the UK, and further validated the approach that we originally used in assessing the returns from cardiovascular research. In doing so, we have highlighted a number of weaknesses and key assumptions that need strengthening in further investigations. Nevertheless, these cautious estimates demonstrate that the returns from past cancer research have been substantial, and justify the investments made during the period 1976 to 1995.Wellcome Trust, Cancer Research UK, the National Institute of Health Research, and the Academy of Medical Sciences

Text-message reminders increase uptake of routine breast screening appointments : a randomised controlled trial in a hard-to-reach population

Background: There is a need for interventions to promote uptake of breast screening throughout Europe. Methods: We performed a single-blind randomised controlled trial to test whether text-message reminders were effective. Two thousand two hundred and forty women receiving their first breast screening invitation were included in the study and randomly assigned in a 1 : 1 ratio to receive either a normal invitation only (n=1118) or a normal invitation plus a text-message reminder 48 h before their appointment (n=1122). Findings: In the intention-to-treat analysis, uptake of breast screening was 59.1% among women in the normal invitation group and 64.4% in the text-message reminder group (χ2=6.47, odds ratio (OR): 1.26, 95% confidence intervals (CI): 1.05–1.48, P=0.01). Of the 1122 women assigned to the text-message reminder group, only 456 (41%) had a mobile number recorded by their GP and were thereby sent a text. In the per-protocol analysis, uptake by those in the control group who had a mobile number recorded on the GP system was 59.77% and by those in the intervention group who were sent a reminder 71.7% (χ2=14.12, OR=1.71, 95% CI=1.29–2.26, P<0.01). Interpretation: Sending women a text-message reminder before their first routine breast screening appointment significantly increased attendance. This information can be used to allocate resources efficiently to improve uptake without exacerbating social inequalities

Sport development and physical activity promotion : an integrated model to encourage collaboration and enhance understanding

As inactivity and obesity levels continue to rise, calls are being made for sport development action to be further directed towards capitalising on the value of community participation for health and social benefits. This paper seeks to highlight a current disconnect between physical activity and sport management research, and identify opportunities for collaboration. To date, the sport management literature has predominantly focused on sport as a form of entertainment with spectatorship outcomes, where professional codes are a commonly used setting of research inquiry. There has been less focus on organisational issues related to participation in sport and recreation. This is identified as a gap, given the current push towards increasing focus on sport and recreation promotion for community wellbeing. The present paper sought to examine physical activity and sport management research, to identify commonalities and potential for integration and co-operation. The outcome of this review is a conceptual framework, integrating socio-ecological models, taken from physical activity research, and sport development concepts derived from sport management theory. The proposed conceptual framework seeks to provide sport management researchers with direction in their efforts to promote participation in sport, recreation and physically active leisure domains, particularly for community wellbeing purposes. Furthermore, such direction may also enhance the capacity of researchers to capitalise on opportunities for collaboration and integration across domains of inquiry

Muddy waters: critiquing the historical criminology method in the investigation of the Smiley Face murders theory

As an emerging trans-disciplinary field, the operational use of historical criminology is a largely under-studied area. Examination of the use of archival research in studying cases connected to Gannon and Gilbertson’s Smiley Face murders theory indicates that there is clear potential for historical criminology to be used to revisit closed or cold investigations to determine if the official findings of the case are consistent with the evidence. In the case of the Smiley Face murders theory, taking a historical criminology approach has failed to prove the hypothesis of researchers; nevertheless, use of historical research methods has had some success in forcing a re-evaluation of several cases, and should be considered an important tool in future investigations of this nature

Are medical procedures that induce coughing or involve respiratory suctioning associated with increased generation of aerosols and risk of SARS-CoV-2 infection? A rapid systematic review.

BACKGROUND: The risk of transmission of SARS-CoV-2 from aerosols generated by medical procedures is a cause for concern. AIM: To evaluate the evidence for aerosol production and transmission of respiratory infection associated with procedures that involve airway suctioning or induce coughing/sneezing. METHODS: The review was informed by PRISMA guidelines. Searches were conducted in PubMed for studies published between January 1st, 2003 and October 6th, 2020. Included studies examined whether nasogastric tube insertion, lung function tests, nasendoscopy, dysphagia assessment, or suctioning for airway clearance result in aerosol generation or transmission of SARS-CoV-2, SARS-CoV, MERS, or influenza. Risk of bias assessment focused on robustness of measurement, control for confounding, and applicability to clinical practice. FINDINGS: Eighteen primary studies and two systematic reviews were included. Three epidemiological studies found no association between nasogastric tube insertion and acquisition of respiratory infections. One simulation study found low/very low production of aerosols associated with pulmonary lung function tests. Seven simulation studies of endoscopic sinus surgery suggested significant increases in aerosols but findings were inconsistent; two clinical studies found airborne particles associated with the use of microdebriders/drills. Some simulation studies did not use robust measures to detect particles and are difficult to equate to clinical conditions. CONCLUSION: There was an absence of evidence to suggest that the procedures included in the review were associated with an increased risk of transmission of respiratory infection. In order to better target precautions to mitigate risk, more research is required to determine the characteristics of medical procedures and patients that increase the risk of transmission of SARS-CoV-2

Hired Guns: Local Government Mergers in New South Wales and the KPMG Modelling Report

© 2017 CPA Australia Across the developed world, including Australia, public policymaking now rests heavily on commissioned reports generated by for-profit consultants, contrasting starkly with the earlier customary reliance on the civil service to provide informed policy advice to political decision makers. Dependence on commercial consultants is problematic, especially given the moral hazards involved in ‘hired guns’ providing support for policy ‘solutions’ desired by their political paymasters. This paper provides a vivid illustration of some of the dangers flowing from the use of consultants by examining the methodology employed by KPMG in its empirical analysis of the pecuniary consequences of proposed municipal mergers as part of the New South Wales’ (NSW) Government's Fit for the Future local government reform program. We show that the KPMG (2016) modelling methodology is awash with errors which render its conclusions on the financial viability of the NSW merger proposals fatally flawed