Changing Landscapes in Safeguarding Babies and Young Children in England

ERIC Educational Resources Information Center

Lumsden, Eunice

2014-01-01

The importance of safeguarding children from violence is internationally recognised. However, detecting, intervening and protecting children from abuse both within the family and in institutions is complex. This paper specifically focuses on safeguarding in England and how workforce reform in the early years offers the opportunity to forge new…

Development of priority based statewide scour monitoring systems in New England (PDF file)

DOT National Transportation Integrated Search

2001-08-02

A project was funded by the New England Transportation Consortium to research the creation of a scour monitoring system : that would assist in the allocation of resources during potentially destructive flood events in New England. Emphasis was placed...

New England Colleges under Stress: Presidential Voices from the Region's Smaller Colleges

ERIC Educational Resources Information Center

Halfond, Jay A.; Stokes, Peter

2013-01-01

Shifting demography, rising operating expenses, plummeting state and federal support, intensified competition, broken financial models… these are just a few of the complex challenges facing New England higher education institutions. Given these tensions, who would be surprised if college presidents in the region weren't occasionally plagued by…

Remodeling Headteachers in England: Is It the End of Educational Leadership?

ERIC Educational Resources Information Center

Gunter, Helen M.; Rayner, Steve

2007-01-01

We examine the contemporary relationship between headship and leadership in England. This speaks to the current globalizing agenda promoting generic leadership within a modernizing agenda of restructuring and reculturing in public education. Thinking based on several research studies is used to stimulate perspectives on a range of complex tensions…

76 FR 18505 - Fisheries of the Northeastern United States; Northeast Skate Complex Fishery; Framework Adjustment 1

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-04

... alternatives for each of three principal management measures: (1) The primary possession limit affecting the... Management Plan (Skate FMP). Framework Adjustment 1 was developed by the New England Fishery Management... (IRFA), are available on request from Paul J. Howard, Executive Director, New England Fishery Management...

The Shape of Things to Come: A Photo Essay

ERIC Educational Resources Information Center

Connection: The Journal of the New England Board of Higher Education, 2002

2002-01-01

Think of New England higher education and one probably thinks of ivy-covered brick or perhaps 1950s concrete, but the environment of New England's college campuses is far more diverse, more complex, more daring, and more educational than the stereotype. It is changing fast, thanks to profound forces such as consumerization among students,…

The Complex Determinants of School Intake Characteristics and Segregation, England 1989 to 2014

ERIC Educational Resources Information Center

Gorard, Stephen

2016-01-01

The extent of between-school segregation, or clustering of disadvantaged students within schools, in England varies depending on the indicator of interest. For example, the trend over time for segregation by student poverty differs from those for ethnicity or special educational need. Additionally the causes of the level of segregation for any…

School Autonomy and Government Control: School Leaders' Views on a Changing Policy Landscape in England

ERIC Educational Resources Information Center

Higham, Rob; Earley, Peter

2013-01-01

The Conservative-Liberal Democrat Coalition government elected in 2010 has argued contemporary reform will increase the autonomy of schools in England. Given the complexities that exist, however, in the balance between autonomy and control, we explore how school leaders view autonomy as it exists within the wider policy framework. The article…

Defining geo-habitats for groundwater ecosystem assessments: an example from England and Wales (UK)

NASA Astrophysics Data System (ADS)

Weitowitz, Damiano C.; Maurice, Louise; Lewis, Melinda; Bloomfield, John P.; Reiss, Julia; Robertson, Anne L.

2017-12-01

Groundwater ecosystems comprising micro-organisms and metazoans provide an important contribution to global biodiversity. Their complexity depends on geology, which determines the physical habitat available, and the chemical conditions within it. Despite this, methods of classifying groundwater habitats using geological data are not well established and researchers have called for higher resolution habitat frameworks. A novel habitat typology for England and Wales (UK) is proposed, which distinguishes 11 geological habitats (geo-habitats) on hydrogeological principles and maps their distribution. Hydrogeological and hydrochemical data are used to determine the characteristics of each geo-habitat, and demonstrate their differences. Using these abiotic parameters, a new method to determine abiotic habitat quality is then developed. The geo-habitats had significantly different characteristics, validating the classification system. All geo-habitats were highly heterogeneous, containing both high quality habitat patches that are likely to be suitable for fauna, and areas of low quality that may limit faunal distributions. Karstic and porous habitats generally were higher quality than fractured habitats. Overall, 70% of England and Wales are covered by lower quality fractured habitats, with only 13% covered by higher quality habitats. The main areas of high quality habitats occur in central England as north-south trending belts, possibly facilitating dispersal along this axis. They are separated by low quality geo-habitats that may prevent east-west dispersal of fauna. In south-west England and Wales suitable geo-habitats occur as small isolated patches. Overall, this paper provides a new national-scale typology that is adaptable for studies in other geographic areas.

Accountability in the UK Healthcare System: An Overview

PubMed Central

Peckham, Stephen

2014-01-01

Recent changes in the English National Health Service (NHS) have introduced new complexities into the accountability arrangements for healthcare services. This commentary describes how the new organizational structures have challenged the traditional centralized accountability structures by creating a more dispersed system of governance for local health-care commissioners. It sets the context of discussions about accountability in the UK NHS and then describes the key changes in England following the implementation of the NHS reforms in April 2013. The commentary concludes that while there is increased complexity of accountability within a more decentralized and fragmented healthcare system, the government's goal of achieving increased local autonomy and greater control by general practitioners (GPs) will probably not be realized. In particular, the system will continue to have strongly centralized aspects, with increased regulation and central political responsibility. PMID:25305399

The Pleistocene rivers of the English Channel region

NASA Astrophysics Data System (ADS)

Antoine, Pierre; Coutard, Jean-Pierre; Gibbard, Philip; Hallegouet, Bernard; Lautridou, Jean-Pierre; Ozouf, Jean-Claude

2003-02-01

The Pleistocene history of river systems that enter the English Channel from northern France and southern England is reviewed. During periods of low sea-level (cold stages) these streams were tributaries of the Channel River. In southern England the largest, the River Solent, is an axial stream that has drained the Hampshire Basin from the Early Pleistocene or late Pliocene. Other streams of southern England may be of similar antiquity but their records are generally short and their sedimentary history have been destroyed, as in northern Brittany, by coastal erosion and valley deepening as a consequence of tectonic uplift. In northern France, the Seine and Somme rivers have very well developed terrace systems recording incision that began at around 1 Ma. The uplift rate, deduced from the study of these terrace systems, is of 55 to 60 m myr-1 since the end of the Early Pleistocene. Generally the facies and sedimentary structures indicate that the bulk of the deposits in these rivers accumulated in braided river environments under periglacial climates in all the area around the Channel. Evolution of the rivers reflects their responses to climatic change, local geological structure and long-term tectonic activity. In this context the Middle Somme valley is characterised by a regular pattern in which incision occurs at the beginning of each glacial period within a general background of uplift. Nevertheless the response of the different rivers to climatic variations, uplift and sea-level changes is complex and variable according to the different parts of the river courses.

78 FR 18330 - Notice of Commission Staff Attendance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-26

... activities of PJM Interconnection, L.L.C. (PJM), Independent System Operator New England, Inc. (ISO-NE), and..., New York Independent System Operator, Inc. Docket No. ER13-193-000, ISO New England Inc. Docket No. ER13-195, Indicated PJM Transmission Owners Docket No. ER13-196-000, ISO New England Inc. Docket No...

Performance over Professional Learning and the Complexity Puzzle: Lesson Observation in England's Further Education Sector

ERIC Educational Resources Information Center

O'Leary, Matt; Wood, Phil

2017-01-01

Attempts to measure the quality of teaching and learning have resulted in an overreliance on quantitative performance data and the normalisation of a set of reductionist practices in England's further education sector in recent years. Focusing on lesson observation as an illustrative example and drawing on data from a national study, this article…

The Dark Figure of Infanticide in England and Wales: Complexities of Diagnosis

ERIC Educational Resources Information Center

Brookman, Fiona; Nolan, Jane

2006-01-01

Infants aged younger than 12 months have the highest homicide victimization rate of any single age group in England and Wales. In addition, there are good grounds for believing that the official homicide statistics for this particular age group are an underestimate and subject to distortion. At the same time there is evidence mounting in the…

Researching and Developing Music Provision in Special Schools in England for Children and Young People with Complex Needs

ERIC Educational Resources Information Center

Cheng, Evangeline; Ockelford, Adam; Welch, Graham

2009-01-01

The House of Commons Select Committee on Education (2006) estimated that around 18% of all pupils in England were categorised as having Special Educational Needs (SEN). "Around 3% of all children (250,000) had a statement of SEN and around 1% of all children were in special schools (90,000) which represent approximately one third of children…

Tectono-metamorphic evolution of high-P/T and low-P/T metamorphic rocks in the Tia Complex, southern New England Fold Belt, eastern Australia: Insights from K-Ar chronology

NASA Astrophysics Data System (ADS)

Fukui, Shiro; Tsujimori, Tatsuki; Watanabe, Teruo; Itaya, Tetsumaru

2012-10-01

The Tia Complex in the southern New England Fold Belt is a poly-metamorphosed Late Paleozoic accretionary complex. It consists mainly of high-P/low-T type pumpellyite-actinolite facies (rare blueschist facies) schists, phyllite and serpentinite (T = 300 °C and P = 5 kbar), and low-P/high-T type amphibolite facies schist and gneiss (T = 600 °C and P < 5 kbar) associated with granodioritic plutons (Tia granodiorite). White mica and biotite K-Ar ages distinguish Carboniferous subduction zone metamorphism and Permian granitic intrusions, respectively. The systematic K-Ar age mapping along a N-S traverse of the Tia Complex exhibits a gradual change. The white mica ages become younger from the lowest-grade zone (339 Ma) to the highest-grade zone (259 Ma). In contrast, Si content of muscovite changes drastically only in the highest-grade zone. The regional changes of white mica K-Ar ages and chemical compositions of micas indicate argon depletion from precursor high-P/low-T type phengitic white mica during the thermal overprinting and recrystallization by granitoids intrusions. Our new K-Ar ages and available geological data postulate a model of the eastward rollback of a subduction zone in Early Permian. The eastward shift of a subduction zone system and subsequent magmatic activities of high-Mg andesite and adakite might explain formation of S-type granitoids (Hillgrove suite) and coeval low-P/high-T type metamorphism in the Tia Complex.

Developing care pathways--lessons from the Steele Review implementation in England.

PubMed

Rooney, Eric

2014-02-01

This paper sets out to discuss the concept of care pathways, review their definition, features and implementation and using an example from the NHS dental system in England guide the development of an elder care pathway. Care pathways have developed from quality management approaches in industry and focus on a number of steps which are intended to lead to expected outcomes. The existing definition and descriptors of care pathways serve well, but miss the complex process underlying the development of pathways, their structure, implementation and evaluation. The literature identifies key features of clinical pathways and from the developing field of implementation science, the factors likely to support pathway implementation. Pathways must be generic enough to enable them to be applicable broadly, but specific enough for them to be locally relevant and population specific. The development of care pathways in the National Health Service (NHS) Dental Service in England is described and when compared with the implementation science literature exhibits features identified as positive factors for implementation. As a result a contribution to the pathway definition literature is offered. Learning from the literature and the practical experience described from England, the process for developing dental care pathways for dependent elders should begin with the creation of a high level pathway, which is cognisant of the clinical and implementation science evidence base. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Paat-Ahi, Gerli; Aaviksoo, Ain; Swiderek, Maria

2014-12-01

As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries' DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

Towards a Totalitarian Education System in England: Looking at the Academy Question in a Longer Policy Context

ERIC Educational Resources Information Center

Newsam, Peter

2013-01-01

In this opinion piece, the author writes that England is now well on the way to having the most totalitarian as well as one of the most inefficiently managed schools system in Europe. He states that in the much maligned 1960s, people came from all over the world to learn from what was being achieved in the best of England's publicly-funded, local…

Diagnosis-related groups for stroke in Europe: patient classification and hospital reimbursement in 11 countries.

PubMed

Peltola, Mikko; Quentin, Wilm

2013-01-01

Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems in the care of stroke. As part of the EuroDRG project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Sweden and Spain) compared how their DRG systems deal with stroke patients. The study aims to assist clinicians and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of stroke. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually represent at least 1% of stroke cases. In addition, standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify stroke patients according to different sets of variables (between 1 and 7 classification variables) into diverging numbers of DRGs (between 1 and 10 DRGs). In 6 of the countries more than half of the patients are concentrated within a single DRG. The countries' systems also vary with respect to the evaluation of different kinds of stroke patients. The most complex DRG is considered 3.8 times more resource intensive than an index case in Finland. By contrast, in England, the DRG system does not account for complex cases. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only EUR 907 in Poland but to EUR 7,881 in Ireland. Large variations in the classification of stroke patients raise concerns whether all systems rely on the most appropriate classification variables and whether the DRGs adequately reflect differences in the complexity of treating different groups of patients. Learning from other DRG systems may help in improving the national systems. Clinicians and national DRG authorities should consider how other countries' DRG systems classify stroke patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement. In future, quantitative research is needed to verify whether the most important determinants of cost are considered in different patient classification systems, and whether differences between systems reflect country-specific differences in treatment patterns and, most importantly, what influence they have on patient outcomes. Copyright © 2013 S. Karger AG, Basel.

School Nurses' perspectives on the role of the school nurse in health education and health promotion in England: a qualitative study.

PubMed

Hoekstra, Beverley A; Young, Vicki L; Eley, Charlotte V; Hawking, Meredith K D; McNulty, Cliodna A M

2016-01-01

The role of the school nurse is complex with many possible elements identified by previous research. The aim of this study is to understand perceptions of the role of the school nurse in order to support school nurses in the delivery of health education. The study used an inductive, qualitative research design involving semi-structured interviews and focus groups. Participants were recruited from four NHS trusts across England and final sample size was thirty one school nurses. Three focus groups and two interviews took place in person, and three interviews were over the phone. Data was thematically analysed. School nurses described six main themes. Four themes directly related to the school nurse role: the main roles of a school nurse, school nurses' role in health education, prioritisation of workload and activities, and community work. A further two other themes related to the delivery of health education: the school nursing system and educational resources. The role of the school nurse in England is very diverse and the school nurse role in health education is primarily to advise and support schools, rather than to directly deliver education. The study identified that tailored public health educational resources are needed to support school nurses.

Confusion in the Ranks: How Good Are England's Schools?

ERIC Educational Resources Information Center

Smithers, Alan

2013-01-01

Understanding how well English education performs compared with other countries is a valuable exercise, particularly because the information can help England and other countries learn from successful systems. The most recent international league tables of pupil performance differ considerably. England languishes well down the list in PISA 2009,…

Education Reform in England: Quality and Equity in the Performative School

ERIC Educational Resources Information Center

Wilkins, Chris

2015-01-01

This article argues that contradictory forces affect teachers' work in the neo-liberal school system in England, with a diversity of governance models alongside increasingly dominant orthodoxies of what constitutes 'effective practice and leadership'. School reforms in England have focused on increasing overall attainment and on closing the…

Factors Affecting Completion of Apprenticeship Training in England

ERIC Educational Resources Information Center

Gambin, Lynn; Hogarth, Terence

2016-01-01

This paper examines factors that are associated with the probability of completion of apprenticeship programmes by individual learners in England. Data are from the 2008/2009 academic year Individualised Learner Record--the administrative database containing information on all learners in the Further Education system in England. The analysis…

Satellite Shows Difficult Eastern U.S. Thanksgiving Travel

NASA Image and Video Library

2013-11-27

This true color image of the Continental United States was taken on Nov. 25, 2013 by the Suomi NPP satellite and shows the system as it moves through the South and Midwest. The National Weather Service noted that a complex and powerful storm system continues to generate widespread moderate to heavy rainfall and snows in various parts of the eastern United States as travelers make their way to destinations to celebrate Thanksgiving and Hanukkah on Nov. 28. There are two low-pressure areas working together. One was centered near New Jersey while the other was located over the Carolinas. From the Southeast to New England widespread moderate to heavy rainfall is expected. The rains will also affect the Mid-Atlantic and Southeastern United States, although those regions are not expected to get as much of a soaking. The Appalachians and interior New England are expected to receive snowfall. Areas of heavy snow are forecast for northwestern Indiana and northwestern Pennsylvania on Nov. 27. Snows will blanket the north central United States from the Dakotas to Minnesota, Iowa, Wisconsin, Michigan, the Ohio and Tennessee Valleys, upstate New York and parts of northern New England. The National Weather Service noted that cold air is moving in behind the storm and drop temperatures along the eastern U.S. making for a chilly Thanksgiving. Credit: NASA/NOAA NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Racialised Norms in Apprenticeship Systems in England and Germany

ERIC Educational Resources Information Center

Chadderton, Charlotte; Wischmann, Anke

2014-01-01

In this paper, we consider the issue of the under-representation of young people from minority ethnic/migrant backgrounds in apprenticeships in England and Germany. Whilst there are many studies on apprenticeships in England and Germany, few focus on under-representation or discrimination, even fewer on ethnic under-representation, and there are…

Performance Management in Education: Improving Practice. British Educational Management Series.

ERIC Educational Resources Information Center

Reeves, Jenny; Forde, Christine; O'Brien, Jim; Smith, Pauline; Tomlinson, Harry

This book explores managing the performance of education staff in England and Wales and in Scotland. It compares the different policies of performance management as practiced in England and Wales and in Scotland. (The Scottish system of education is independent of that of England and Wales.) Chapter 1 provides an introduction to performance…

75 FR 29530 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

...: ER07-397-005. Applicants: ISO New England Inc. and New England Power Pool. Description: ISO New England Inc et. al submit revision to Section III.13 of the ISO Tariff in response to the compliance... Independent System Operator Corporation submits amendments to the ISO's amendment to the ISO Tariff filed on 3...

Educational Reform and Curriculum Implementation in England: An Historical Perspective.

ERIC Educational Resources Information Center

Aldrich, Richard

This paper provides a historical perspective on the implementation of educational reform by the Thatcher government in England. Since 1979, and particularly since the Education Reform Act of 1988, the state educational system in England has undergone massive reform in the form of a national curriculum, increased school-based management, and the…

Pain and Surgery in England, circa 1620–circa 1740

PubMed Central

Walker, Katherine A.

2015-01-01

The scholarship on the discussion and role of pain in early modern English surgery is limited. Scholars have given little consideration to how surgeons described and comprehended pain in their patients’ bodies in early modern England, including how these understandings connected to notions of the humours, nerves and sex difference. This article focuses on the attention that surgeons paid to pain in their published and manuscript casebooks and manuals available in English, circa 1620–circa 1740. Pain was an important component of surgery in early modern England, influencing diagnosis, treatment and technique. Surgeons portrayed a complex and multi-dimensional understanding of their patients’ bodies in pain, which was further connected to their portrayals of their professional ability. PMID:25766543

Clinical outcomes and costs for people with complex psychosis; a naturalistic prospective cohort study of mental health rehabilitation service users in England.

PubMed

Killaspy, Helen; Marston, Louise; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; Arbuthnott, Maurice; Koeser, Leonardo; McCrone, Paul; Omar, Rumana Z; King, Michael

2016-04-07

Mental health rehabilitation services in England focus on people with complex psychosis. This group tend to have lengthy hospital admissions due to the severity of their problems and, despite representing only 10-20 % of all those with psychosis, they absorb 25-50 % of the total mental health budget. Few studies have investigated the effectiveness of these services and there is little evidence available to guide clinicians working in this area. As part of a programme of research into inpatient mental health rehabilitation services, we carried out a prospective study to investigate longitudinal outcomes and costs for patients of these services and the predictors of better outcome. Inpatient mental health rehabilitation services across England that scored above average (median) on a standardised quality assessment tool used in a previous national survey were eligible for the study. Unit quality was reassessed and costs of care and patient characteristics rated using standardised tools at recruitment. Multivariable regression modelling was used to investigate the relationship between service quality, patient characteristics and the following clinical outcomes at 12 month follow-up: social function; length of admission in the rehabiliation unit; successful community discharge (without readmission or community placement breakdown) and costs of care. Across England, 50 units participated and 329 patients were followed over 12 months (94 % of those recruited). Service quality was not associated with patients' social function or length of admission (median 16 months) at 12 months but most patients were successfully discharged (56 %) or ready for discharge (14 %), with associated reductions in the costs of care. Factors associated with successful discharge were the recovery orientation of the service (OR 1.04, 95 % CI 1.00-1.08), and patients' activity (OR 1.03, 95 % CI 1.01-1.05) and social skills (OR 1.13, 95 % CI 1.04-1.24) at recruitment. Inpatient mental health rehabilitation services in England are able to successfully discharge over half their patients within 18 months, reducing the costs of care for this complex group. Provision of recovery orientated practice that promotes patients' social skills and activities may further enhance the effectiveness of these services.

Up or Down and Out? A Systemic Analysis of Young People's Educational Pathways in the Youth Justice System in England and Wales

ERIC Educational Resources Information Center

Lanskey, Caroline

2015-01-01

Many young people in the youth justice system in England and Wales are educationally marginalised and systemic barriers to their engagement with education persist. This article presents an analytical framework for understanding how education and youth justice practices shape young people's educational pathways during their time in the youth…

Future Apprenticeships in England: The Role of Mediation in the New Model

ERIC Educational Resources Information Center

Hodgson, Ann; Spours, Ken; Smith, David

2017-01-01

Apprenticeship systems across the globe are having to adapt to changing international economic and social trends. England is no exception. This article examines the latest model of apprenticeship in England from the perspective of the "mediators" who work at local and regional level with employers to construct and deliver the majority of…

78 FR 24193 - Notice of Commission Staff Attendance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... activities of PJM Interconnection, L.L.C. (PJM), Independent System Operator New England, Inc. (ISO-NE), and... Operator, Inc. Docket No. ER13-193-000, ISO New England Inc. Docket No. ER13-195, Indicated PJM Transmission Owners Docket No. ER13-196-000, ISO New England Inc. Docket No. ER13-198, PJM Interconnection, L.L...

78 FR 20312 - Notice of Commission Staff Attendance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... activities of PJM Interconnection, L.L.C. (PJM), Independent System Operator New England, Inc. (ISO-NE), and... Operator, Inc. Docket No. ER13-193-000, ISO New England Inc. Docket No. ER13-195, Indicated PJM Transmission Owners Docket No. ER13-196-000, ISO New England Inc. Docket No. ER13-198, PJM Interconnection, L.L...

Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries

PubMed Central

Paat-Ahi, Gerli; Aaviksoo, Ain; Świderek, Maria

2014-01-01

Background: As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods: National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. Results: European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Conclusion: Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries’ DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement. PMID:25489596

Current Scientific Approaches to Decision Making in Complex Systems: 3. Volume 1. Conference Proceedings. Third Conference, Richmond, Surrey, England, 6-8 August 1978

DTIC Science & Technology

1980-01-01

filter and select out. You use your nose - or heuristics. That is just maturity. The only thing we can do is help people discuss possible models of their...Decision models / Conversation Theory Decision training Team decisions Man-computer interaction Learning strategies 2& ANTAACT (Cme1 revere le N nneesmod...paper by Maria Novakowska on a new model of decision under risk. , /V TI I~ 4 A SECURITY CLASSIFICATION OF TIS PAOUI(Ves Date EntetQ ii ,ln 1 to hi

How Effective Is the Research and Development Ecosystem for England's Schools?

ERIC Educational Resources Information Center

Godfrey, David; Brown, Chris

2018-01-01

This article examines the role of research and development within England's school system. From a range of literature past and present we argue that six features (three dimensions) should form the focus for action at the institutional, systemic and policy levels. Applying these stress tests to the current system, we suggest that an effective…

RAINE Public Communities

EPA Pesticide Factsheets

The file geodatabase (fgdb) contains the New England Town Boundaries and information related specifically to the Resilience and Adaptation in New England (RAINE) web application. This includes data tables relating to particular aspects of towns notably features, funding, impacts, partners, plans, and programs (refer to V_MAP_STATIC tables). New England Town Boundary coverage is a compilation of coverages received from the six New England State GIS Offices. The EPA New England GIS Center appended the coverages together into a single file and generated attrributes to link to the Facility Identification Online system. These feature class points represent the communities (Communities in gdb) and featured RAINE communities (RAINE_Communities_201609), which contain more detailed information that is contained within the included data tables.

A New England Land-Grant Network; A Study of the Feasibility of Establishing Educational Information Links Between the Six Land-Grant Universities in New England.

ERIC Educational Resources Information Center

Bardwell, John D.

This study sought to identify physical facilities needed to connect the six New England land-grant universities. Criteria were time (use of current technology), cost (regular operating budgets of participating institutions), minimal personnel requirements, flexibility, and compatibility. The telephone system, an existing microwave network, a…

Surveillance of sexually transmitted infections in England and Wales.

PubMed

Hughes, G; Paine, T; Thomas, D

2001-05-01

Surveillance of sexually transmitted infections (STIs) in England and Wales has, in the past, relied principally on aggregated statistical data submitted by all genitourinary medicine clinics to the Communicable Disease Surveillance Centre, supplemented by various laboratory reporting systems. Although these systems provide comparatively robust surveillance data, they do not provide sufficient information on risk factors to target STI control and prevention programmes appropriately. Over recent years, substantial rises in STIs, the emergence of numerous outbreaks of STIs, and changes in gonococcal resistance patterns have necessitated the introduction of more sophisticated surveillance mechanisms. This article describes current STI surveillance systems in England and Wales, including new systems that have recently been introduced or are currently being developed to meet the need for enhanced STI surveillance data.

Religion, Schooling, Community, and Security: Exploring Transitions and Transformations in England

ERIC Educational Resources Information Center

Lundie, David

2017-01-01

Education is a complex social practice. In the United Kingdom context, schooling is further nested within the complex social practices of community governance, quasi-market public choice, and religion. This essay explores the shifting definitions of community and education in the context of the Counter Terrorism and Security Act 2015, which places…

76 FR 28328 - Fisheries of the Northeastern United States; Northeast Skate Complex Fishery; Framework Adjustment 1

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-17

... alternatives for each of three principal management measures: (1) The primary possession limit affecting the... measures in Framework Adjustment 1 to the Northeast Skate Complex Fishery Management Plan (Skate FMP). Framework Adjustment 1 was developed by the New England Fishery Management Council (Council) to adjust the...

Addressing water resources risk in England and Wales: Long term infrastructure planning in a private, regulated industry

NASA Astrophysics Data System (ADS)

Turner, Sean

2015-04-01

Water resources planning is a complex and challenging discipline in which decision makers must deal with conflicting objectives, contested socio-economic values and vast uncertainties, including long term hydrological variability. The task is arguably more demanding in England and Wales, where private water companies must adhere to a rigid set of regulatory planning guidelines in order to justify new infrastructural investments. These guidelines prescribe a "capacity expansion" approach to planning: ensure that a deterministic measure of supply, known as "Deployable Output," meets projected demand over a 25-year planning horizon. Deployable Output is derived using a method akin to yield analysis and is commensurate with the maximum rate of supply that a water resources system can sustain without incurring failure under a simulation of historical recorded hydrological conditions. This study examines whether Deployable Output analysis is fit to serve an industry in which: water companies are seeking to invest in cross-company water transfer schemes to deal with loss of water availability brought about by European environmental legislation and an increase in demand driven by population growth; water companies are expected address potential climate change impacts through their planning activities; and regulators wish to benchmark water resource system performance across the separate companies. Of particular interest, then, is the adequacy of Deployable Output analysis as a means to measuring current and future water shortage risk and comparing across supply systems. Data from the UK National River Flow Archive are used to develop a series of hypothetical reservoir systems in two hydrologically contrasting regions -- northwest England/north Wales and Southeast England. The systems are varied by adjusting the draft ratio (ratio of target annual demand to mean annual inflow), the inflow diversity (covariance of streamflow sequences supplying the system), the strength of interconnectivity in the system (water transfer capability as proportion of demand), and the proportion of the target demand that can be drafted from climate-independent supply sources (such as plentiful groundwater supplies or desalination). The reservoir capacities are then adjusted such that all systems are perfectly and equally balanced under current design standards (Deployable Output equals demand) before being subjected to comprehensive reliability, resilience, vulnerability analysis using stochastically-derived replicates of the inflow sequences. Results indicate significant discrepancies in performance, highlighting major deficiencies with the currently-accepted planning metrics as a means to measuring and comparing water shortage risk across supply systems. These discrepancies are evident in both regions examined. The work highlights a need for a reassessment of the prescribed planning methodology to better reflect aspects of water shortage risk, particularly resilience and vulnerability.

National Program for Inspection of Non-Federal Dams. Murphy Dam (NH 00185), Connecticut River Basin, Pittsburg, New Hampshire. Phase I Inspection Report.

DTIC Science & Technology

1981-08-01

dam is coordinated with the needs of the both the New England Electric System and Public Service Company of New Hampshire. 2.4 Evaluation of Data a...England Electric System and the Public Service Company of New Hampshire. The 174 sq. mi. drainage abea tributary to Lake Francis consists of two major...Board 8-24 thru B-291 9 October 1974 New Hampshire Water Resources Board and New England Power Company B-30 ttiru B-41I28 November 1977 Chas. T. Main

Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013.

PubMed

Savage, E J; Mohammed, H; Leong, G; Duffell, S; Hughes, G

2014-12-04

A new electronic surveillance system for sexually transmitted infections (STIs) was introduced in England in 2009. The genitourinary medicine clinic activity dataset (GUMCAD) is a mandatory, disaggregated, pseudo-anonymised data return submitted by all STI clinics across England. The dataset includes information on all STI diagnoses made and services provided alongside demographic characteristics for every patient attendance at a clinic. The new system enables the timely analysis and publication of routine STI data, detailed analyses of risk groups and longitudinal analyses of clinic attendees. The system offers flexibility so new codes can be introduced to help monitor outbreaks or unusual STI activity. From January 2009 to December 2013 inclusive, over twenty-five million records from a total of 6,668,648 patients of STI clinics have been submitted. This article describes the successful implementation of this new surveillance system and the types of epidemiological outputs and analyses that GUMCAD enables. The challenges faced are discussed and forthcoming developments in STI surveillance in England are described.

Schisms in the church: National Health Service systems and institutional divergence in England and Wales.

PubMed

Hughes, David; Vincent-Jones, Peter

2008-12-01

Since devolution, the four countries of the United Kingdom have pursued strikingly different National Health Service (NHS) reforms. While England created a supply-side market more radical than the previous internal market system, Wales moved to a softer version of the purchaser/provider split emphasizing localism. This article deploys institutional theory to analyze the forces shaping change, and describes the hybrid forms of economic organization emerging, including the economic regulation model implemented in England. The schism that has resulted in separate NHS subsystems warrants a different analysis from the more familiar phenomenon of infield divergence. We argue that schism was triggered by political-regulatory influences rather than economic or other social institutional forces, and predict that other decentralized public health care systems may follow a similar path. While political-regulatory, normative, and cognitive institutional influences push in the same direction in Wales, the misalignment of political-regulatory and normative elements in England looks set to result in a period of organizational turbulence.

76 FR 543 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... England Fishery Management Council, 50 Water Street, Mill 2, Newburyport, MA 01950; telephone: (978) 465... representative will present an outline of their project--a networked sensor system array proposed for offshore...

Innovation Is Possible, It's Just Not Easy: Improvement, Innovation and Legitimacy in England's Autonomous and Accountable School System

ERIC Educational Resources Information Center

Greany, Toby

2018-01-01

This article reviews the literature and explores the institutional and systemic factors that help and/or hinder change and innovation across school systems, with a focus on evidence from England. A number of authors have argued that schools and school systems need to become more innovative and adaptive if they are to meet the needs of 21st-century…

Is New England Ready for P-20?: A Report Card on Efforts to Expand the K-12 Notion from Preschool to Grade 20

ERIC Educational Resources Information Center

Cronin, Joseph M.; Goodman, Richard H.

2008-01-01

These authors state that, while New England schools serve the children of the affluent very well, many children from low-income backgrounds are left behind at key points in the "non-system" that is perpetuated from preschool through college and beyond. They suggest that all segments of New England education should work more closely…

Building a Lattice for School Leadership: The Top-to-Bottom Rethinking of Leadership Development in England and What It Might Mean for American Education. Research Report #RR-83

ERIC Educational Resources Information Center

Supovitz, Jonathan

2014-01-01

This report examines the educational leadership development system in England over the last 15 years to identify ideas American leaders and policymakers might learn from looking cross-nationally. The report describes the rise of the National College for School Leadership in England, which spearheaded much of the early policy development and…

Is Tolerance of Faiths Helpful in English School Policy? Reification, Complexity, and Values Education

ERIC Educational Resources Information Center

Bowie, Robert

2017-01-01

Government policies for teachers and schools in England promote values including tolerance of faiths and beliefs alongside law keeping, democracy, and respect. Tolerance of faiths has been highlighted as a key value but complexities around tolerance make interpretations and applications of the policy difficult. Policy documents in this area are…

Science in the Scottish Primary School Curriculum

ERIC Educational Resources Information Center

Peacock, Alan

2005-01-01

When one begins to look at science in primary schools elsewhere, one is immediately struck by the fact that those in England are the odd-ones-out. Hence this is the second in a series of articles looking at how science is dealt with in other systems, beginning with England's immediate neighbours and then looking outwards towards school systems in…

78 FR 28839 - Notice of Commission Staff Attendance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... activities of PJM Interconnection, L.L.C., ISO New England, Inc., and New York Independent System Operator... Interconnection, L.L.C. Docket No. ER13-102, New York Independent System Operator, Inc. Docket No. ER13-193, ISO New England Inc. Docket No. ER13-195, Indicated PJM Transmission Owners Docket No. ER13-196, ISO New...

The Evidence Informed School System in England: Where Should School Leaders Be Focusing Their Efforts?

ERIC Educational Resources Information Center

Greany, Toby; Brown, Chris

2017-01-01

This article examines the impetus for schools to engage both in and with evidence in England's self-improving school system. It begins with an examination of how the education policy environment has changed, shifting from predominantly top down approaches to school improvement to the current government's focus on schools themselves sourcing and…

The Evidence-Informed School System in England: Where Should School Leaders Be Focusing Their Efforts?

ERIC Educational Resources Information Center

Brown, Chris; Greany, Toby

2018-01-01

This article examines the impetus for schools to engage in and with evidence in England's self-improving school system. It begins with an examination of how the education policy environment has changed, shifting from predominantly top-down approaches to school improvement to the current government's focus on schools themselves sourcing and sharing…

Deconstructing the Carter Review: Competing Conceptions of Quality in England's "School-Led" System of Initial Teacher Education

ERIC Educational Resources Information Center

Mutton, Trevor; Burn, Katharine; Menter, Ian

2017-01-01

The commitment to establish a "school-led" system of teacher education in England, announced by the Coalition Government in 2011 and relentlessly pursued thereafter, represented a radical departure from previous kinds of initial teacher education partnership. While it is entirely consistent with a neoliberal agenda, with its strong…

Imagining School Autonomy in High-Performing Education Systems: East Asia as a Source of Policy Referencing in England

ERIC Educational Resources Information Center

You, Yun; Morris, Paul

2016-01-01

Education reform is increasingly based on emulating the features of "world-class" systems that top international attainment surveys and, in England specifically, East Asia is referenced as the "inspiration" for their education reforms. However, the extent to which the features identified by the UK Government accord with the…

Developing and validating a new national remote health advice syndromic surveillance system in England.

PubMed

Harcourt, S E; Morbey, R A; Loveridge, P; Carrilho, L; Baynham, D; Povey, E; Fox, P; Rutter, J; Moores, P; Tiffen, J; Bellerby, S; McIntosh, P; Large, S; McMenamin, J; Reynolds, A; Ibbotson, S; Smith, G E; Elliot, A J

2017-03-01

Public Health England (PHE) coordinates a suite of real-time national syndromic surveillance systems monitoring general practice, emergency department and remote health advice data. We describe the development and informal evaluation of a new syndromic surveillance system using NHS 111 remote health advice data. NHS 111 syndromic indicators were monitored daily at national and local level. Statistical models were applied to daily data to identify significant exceedances; statistical baselines were developed for each syndrome and area using a multi-level hierarchical mixed effects model. Between November 2013 and October 2014, there were on average 19 095 NHS 111 calls each weekday and 43 084 each weekend day in the PHE dataset. There was a predominance of females using the service (57%); highest percentage of calls received was in the age group 1-4 years (14%). This system was used to monitor respiratory and gastrointestinal infections over the winter of 2013-14, the potential public health impact of severe flooding across parts of southern England and poor air quality episodes across England in April 2014. This new system complements and supplements the existing PHE syndromic surveillance systems and is now integrated into the routine daily processes that form this national syndromic surveillance service. © Crown copyright 2016.

Leadership of education psychological services: fit for purpose?

PubMed

Booker, Roger

2013-06-01

At a time of great change for educational psychology services in England, this paper reviews current theories of leadership and proposes how an integration of key aspects of these can be applied to support a self review of leadership practice, both by individual leaders and by services. The message from current theory is that in the midst of complexity and rapid change, a primary focus on the head of service is outdated; there should instead be a focus to develop the leadership capacity of the service as a whole. Key constructs considered are systems thinking, social identity, authenticity, and leadership as social construction.

Changing Policy and Legislation and Its Effects on Inclusive and Special Education: A Perspective from England

ERIC Educational Resources Information Center

Norwich, Brahm

2014-01-01

This article, by Brahm Norwich of the Graduate School of Education, University of Exeter, sets the recent legislative changes in the special education system in England, the Children and Families Act (2014), in the context of wider changes in the school system, such as changes in curriculum-assessment, the governance of schools and inspection…

An Analysis of Shaker Education: The Life and Death of an Alternative Educational System, 1774-1950.

ERIC Educational Resources Information Center

Taylor, Frank G.; Roberts, Arthur D.

This study investigates the Shaker educational system, analyzes the development of Shaker schools, and examines the innovative practices that the Shakers used to ready children for the world of their time. Originating in England among illiterate working class people, the movement was established in New England in 1774. Basic characteristics of the…

Demonstration and Evaluation of the Effects of Incentives on Resource Sharing Using a Computerized Interlibrary Communications System.

ERIC Educational Resources Information Center

New England Board of Higher Education, Wellesley, MA. New England Library Information Network.

The potential for using a computerized communication system to facilitate resource sharing in New England has been investigated by the staff of the New England Information Network (NELINET). The central purpose of their research was to determine whether a strategy for load leveling of interlibrary loan (ILL) requests could be implemented online as…

Bayesian conditional-independence modeling of the AIDS epidemic in England and Wales

NASA Astrophysics Data System (ADS)

Gilks, Walter R.; De Angelis, Daniela; Day, Nicholas E.

We describe the use of conditional-independence modeling, Bayesian inference and Markov chain Monte Carlo, to model and project the HIV-AIDS epidemic in homosexual/bisexual males in England and Wales. Complexity in this analysis arises through selectively missing data, indirectly observed underlying processes, and measurement error. Our emphasis is on presentation and discussion of the concepts, not on the technicalities of this analysis, which can be found elsewhere [D. De Angelis, W.R. Gilks, N.E. Day, Bayesian projection of the the acquired immune deficiency syndrome epidemic (with discussion), Applied Statistics, in press].

An audit of clinical resources available for the care of head and neck cancer patients in England.

PubMed

Bradley, P J; Zutshi, B; Nutting, C M

2005-08-01

To undertake a postal survey of cancer networks to define the services available for the diagnosis, treatment and support of patients with head and neck cancer in England. Thirty-four cancer networks are now responsible for the delivery of head and neck cancer services in England and 52 cancer units responded to our questionnaire. Multidisciplinary team working was evident in all centres. However such team working was not always fully staffed, especially in areas of national staff shortages such as pathology, radiology, dietetics and speech therapy. Rapid referral pathways were present for initial assessment of patients but clinically significant delays were identified in the provision of complex investigations, in access to intensive care beds and for oncological care--especially radiotherapy. Major changes in service configuration are likely to be required if the current national targets of time to diagnosis and treatment are to be met.

Impact of mercury from the Canadian boreal forest widfires to New England

NASA Astrophysics Data System (ADS)

Hwang, G.; Talbot, R. W.

2010-12-01

Canadian Boreal forest fires release significant amounts of mercury and constitute several air quality episodes every year in New England, especially during summer. With continuous monitoring of mercury in two New England sites in both rural and elevated area from 2004 to date, several events of the wildfire transport was screened out using ensembles of backward trajectories to ensure the air parcels sampled spent substantial residence time within the box of burned area defined by the the Fire Information for Resource Management System(FIRMS) MODIS hotspot/fires data. Other biomass burning tracers, (such as HCN), were also used as criteria if they are were available during the events period. The mercury to CO ratios during the events were calculated as the input to the Sparse Matrix Operator Kernel Emissions System (SMOKE) model to simulate the high and low ranges of mercury emissions frorm the burned area. We are now using the Community Multiscale Air Quality Modeling System (CMAQ) to study the impact of the mercury emission from the Canadian boreal forest wildfires to the New England region in more details.

Detection and assessment of secondary sonic booms in New England

DOT National Transportation Integrated Search

1980-05-01

This report documents the results of a secondary sonic boom detection and assessment program conducted by the U.S. Dept. of Transportation, Transportation Systems Center in New England during the summer of 1979. Measurements of both acoustic and infr...

Postgraduate Clinical Training at the New England School of Optometry.

ERIC Educational Resources Information Center

Hoffman, Douglas J.

1989-01-01

The New England College of Optometry's two separate but integrated clinical postgraduate programs, one providing Veterans' Administration residencies and the other, college-based fellowships, are described. The shared curriculum components, exchange process, and evaluation system are highlighted. (MSE)

Prison prescribing practice: practitioners' perspectives on why prison is different.

PubMed

Bartlett, A; Dholakia, N; England, R; Hales, H; van Horn, E; McGeorge, T; Moss, B; Ovaisi, S; Tukmachi, E; Patel, S

2014-04-01

The current prison population in England and Wales has multiple, complex healthcare needs, presenting unique challenges to those caring for prisoners. Prison numbers have increased dramatically in the last 10 years. There are now approximately 84,000 prisoners in England and Wales and 120,000 new episodes of imprisonment each year . The authors all contribute to prison healthcare. Below, we discuss a key issue arising from first-hand experience of prisoners' health and social care needs, the prescription of psycho-active drugs by primary and secondary care practitioners. This is a core medical task, but beset with difficulties. These difficulties are not necessarily encountered in other areas of prison healthcare. However, they do illustrate how providing healthcare to prisoners is complex, often lacking a research base and can have pitfalls that are not obvious to the outsider. © 2014 John Wiley & Sons Ltd.

Looking behind the bars: emerging health issues for people in prison.

PubMed

Stürup-Toft, S; O'Moore, E J; Plugge, E H

2018-03-01

There are more than 10 million people imprisoned worldwide. These individuals experience a higher burden of communicable and non-communicable disease, mental health and substance misuse problems than the general population and often come from marginalized and underserved groups in the community. Prisons offer an important opportunity for tackling health problems in a way that can deliver benefits to the individual and to the community. This paper focuses specifically on emerging health issues for prisons across the world. This paper uses sources of international data from published systematic reviews and research studies, the Ministry of Justice for England and Wales, the Prisons and Probations Ombudsmen Review and other United Kingdom government briefing papers. Deaths in custody are a key concern for the justice system as well as the health system. Suicide is the leading cause of mortality in prisons worldwide but non-communicable diseases, such as cardiovascular disease, are increasing in importance in high-income countries and are now the leading cause of mortality in prisons in England and Wales. The prison population is ageing in most high-income countries. Older people in prison typically have multiple and complex medical and social care needs including reduced mobility and personal care needs as well as poor health. Further research is needed to understand the complex relationship between sentencing patterns, the ageing prison population and deaths in custody; to model its impact on prisons and healthcare provision in the future and to determine effective and cost-effective models of care. Research into the health of prisoners is important in improving the health of prisoners but there is considerable variation in quantity and quality between countries. Recent innovations seek to address this disparity and facilitate the sharing of good practice.

Development of a Fuel Spill/Vapor Migration Modeling System.

DTIC Science & Technology

1985-12-01

transforms resulting in a direct solution of the differential equation. A second order finite * difference approximation to the Poisson equation A2*j is...7 O-A64 043 DEVELOPMENT OF A FUEL SPILL/VPOR MIGRATION MODELING 1/2 SYSTEM(U) TRACER TECHNOLOGIES ESCONDIDO Cflo IL 0 ENGLAND ET AL. DEC 85 RFURL...AFWAL-TR-85-2089 DEVELOPMENT OF A FUEL SPILL/VAPOR MIGRATION MODELING SYSTEM W.G. England * L.H. Teuscher TRACER TECHNOLOGIES DTIC *2120 WEST MISSION

Salt Marsh Sustainability in New England: Progress and Remaining Challenges

EPA Science Inventory

Natural resource managers, conservationists, and scientists described marsh loss and degradation in many New England coastal systems at the 2014 “Effects of Sea Level Rise on Rhode Island’s Salt Marshes” workshop, organized by the Narragansett Bay National Estua...

Hazard and risk in the New England fishing fleet

DOT National Transportation Integrated Search

1998-10-29

The United States Coast Guard and the Volpe National Transportation Systems Center studied the 102 serious fishing vessel accidents (1993-1997) in Coast Guard District 1 (New England and Long Island, New York), U.S national fleet accident data, and i...

A comparison of substance dependence treatment information system in America, England, and Iran.

PubMed

Ajami, Sima; Mellat-Karkevandi, Zahra; Saghaeiannejad-Isfahani, Sakineh; Salehi, Mehrdad; Jahanbakhsh, Maryam

2014-01-01

Addiction, as a social problem, is a phenomenon that causes structural changes in cultural, social, political, and economic system in society. Prevention of this problem means decrease of risk factors and increase of protective factors; and recognition of these factors is possible with the help of update, accurate, and complete information in information systems. The aim of this study was to compare substance dependence treatment information system (SDTIS) in America, England, and Iran. This research was an applied and comparison-descriptive study, in which SDTIS was compared in America, England, and Iran. These countries were chosen based on available information on the Internet and also on the development of these countries in the health information management field. Information resources included library resources, electronic resources, and expert people (Health Information Management, Medical Records Education, Psychologist, Psychiatrist, and Medical Informatics). The data collection tool was the data raw form, whose reliability was proved by expert people. Findings were analyzed by theory and descriptive method. America and England had the SDTIS. Their systems had special characteristics such as goals, scope, special method for collecting, processing, reporting, quality and validity control, and confidentiality principles. However, there was no such system in Iran and the present situation in Iran has many differences with similar situations in the studied countries. Presence of an information system in the substance dependence treatment field helps to prevent, control, and treat addicted people. Hence, we try to submit a suitable model for implementing this system.

Acute myocardial infarction and diagnosis-related groups: patient classification and hospital reimbursement in 11 European countries.

PubMed

Quentin, Wilm; Rätto, Hanna; Peltola, Mikko; Busse, Reinhard; Häkkinen, Unto

2013-07-01

As part of the diagnosis related groups in Europe (EuroDRG) project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with patients admitted to hospital for acute myocardial infarction (AMI). The study aims to assist cardiologists and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a primary diagnosis of AMI. Diagnosis-related group classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify AMI patients according to different sets of variables into diverging numbers of DRGs (between 4 DRGs in Estonia and 16 DRGs in France). The most complex DRG is valued 11 times more resource intensive than an index case in Estonia but only 1.38 times more resource intensive than an index case in England. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only €420 in Poland but to €7930 in Ireland. Large variation exists in the classification of AMI patients across Europe. Cardiologists and national DRG authorities should consider how other countries' DRG systems classify AMI patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement.

Acute myocardial infarction and diagnosis-related groups: patient classification and hospital reimbursement in 11 European countries

PubMed Central

Quentin, Wilm; Rätto, Hanna; Peltola, Mikko; Busse, Reinhard; Häkkinen, Unto

2013-01-01

Aims As part of the diagnosis related groups in Europe (EuroDRG) project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with patients admitted to hospital for acute myocardial infarction (AMI). The study aims to assist cardiologists and national authorities to optimize their DRG systems. Methods and results National or regional databases were used to identify hospital cases with a primary diagnosis of AMI. Diagnosis-related group classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify AMI patients according to different sets of variables into diverging numbers of DRGs (between 4 DRGs in Estonia and 16 DRGs in France). The most complex DRG is valued 11 times more resource intensive than an index case in Estonia but only 1.38 times more resource intensive than an index case in England. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only €420 in Poland but to €7930 in Ireland. Conclusions Large variation exists in the classification of AMI patients across Europe. Cardiologists and national DRG authorities should consider how other countries' DRG systems classify AMI patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement. PMID:23364755

Envisioning an Ecologically Sustainable Campus At New England College

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paula Amato; Gregory Palmer

Appropriation funding for our project Ecologically Sustainable Campus - New England College (NH). 67.09. supported five environmental initiatives: (1) a wood pellet boiler for our Science Building, (2) solar hot water panels and systems for five campus buildings, (3) campus-wide energy lighting efficiency project, (4) new efficiency boiler system in Colby Residence Hall, and (5) energy efficient lighting system for the new artificial athletic turf field. (1) New England College purchased and installed a new wood pellet boiler in the Science Building. This new boiler serves as the primary heating source for this building. Our boiler was purchased through Newmore » England Wood Pellet, LLC, located in Jaffrey, New Hampshire. The boiler selected was a Swebo, P500. 300KW wood pellet boiler. The primary goals, objectives, and outcomes of this initiative include the installation of a wood pellet boiler system that is environmentally friendly, highly efficient, and represents a sustainable and renewable resource for New England College. This project was completed on December 15, 2010. (2) New England College purchased and installed solar hot water panels and systems for the Science Building, the Simon Center (student center), the H. Raymond Danforth Library, Gilmore Dining Hall, and Bridges Gymnasium. The College worked with Granite State Plumbing & Heating, LLC, located in Weare, New Hampshire on this project. The solar panels are manufactured by Heat Transfer; the product is Heat Transfer 30-tube collector panels (Evacuated Tube Type) with stainless steel hardware. The interior equipment includes Super Stor Ultra stainless steel super insulated storage tank, Taco 009 Bronze circulator pump, Solar Relay Control Pack, and a Taco Thermal Expansion Tank. The primary goals, objectives, and outcomes of this initiative will allow the College to utilize the sun as an energy resource. These solar hot water panels and systems will alleviate our dependency on fossil fuel as our primary fuel resource and provide a reliable energy source that supplies the hot water needs for sanitation, dishwashing at our dining facilities, and shower facilities for our athletes. This project initiative was completed on June 30, 2010. (3) New England College has completed energy efficiency lighting projects throughout campus, which included upgrades and new systems throughout our buildings. This project also installed efficiency controls for the Lee Clement Arena and refrigeration equipment in the Gilmore Dining Hall. The College worked with Atlantic Energy Solutions, located in Foxboro, Massachusetts on our 50/50 energy efficiency lighting project and campus-wide audit. The actual implementation of the project was completed by D. Poole Electrical Services, located in Center Barnstead, New Hampshire. The primary goals, objectives, and outcomes of this initiative were to install energy efficient lighting systems throughout our campus buildings, which ultimately will provide New England College with a more efficient way to manage and control its energy use. This project initiative was completed on February 15, 2010. (4) New England College purchased and installed a high efficiency and clean burning system for the Colby Residence Hall, which is the primary housing for our freshman. We purchased and installed two Buderus Boilers, model number G515/10 with two Riello Burners, model number RL 38/2. The College worked with Granite State Plumbing & Heating, LLS, located in Weare, New Hampshire on the installation of this high efficiency and clean burning system for the Colby Residence Hall. The primary goals, objectives, and outcomes for this initiative included the installation of a designed system of two boilers to provide redundancy for backup measures. This new system will provide New England College the flexibility to utilize just one smaller boiler to provide heat and hot water during non-peak periods thus continued reduction in energy use and our carbon footprint. This project initiative was completed on September 18, 2009. (5) New England College purchased and installed energy efficient lighting for our new artificial athletic turf field. The College selected Light-Structure Green lighting systems and worked with Musco Lighting, located in Oskaloosa. Iowa. The primary goals, objectives, and outcomes of this initiative were to install innovative lighting systems that significantly reduce energy costs and provide a high level of efficiency, resulting in overall utility savings to the College. This lighting technology combines the energy efficient equipment along with a focused lighting objective (field playing surface) to reduce the number of lighting heads needed to illuminate the playing surface to NCAA standards while reducing energy consumption by 50%. This project was completed on October 15, 2009.« less

Associations between air pollution and socioeconomic characteristics, ethnicity and age profile of neighbourhoods in England and the Netherlands.

PubMed

Fecht, Daniela; Fischer, Paul; Fortunato, Léa; Hoek, Gerard; de Hoogh, Kees; Marra, Marten; Kruize, Hanneke; Vienneau, Danielle; Beelen, Rob; Hansell, Anna

2015-03-01

Air pollution levels are generally believed to be higher in deprived areas but associations are complex especially between sensitive population subgroups. We explore air pollution inequalities at national, regional and city level in England and the Netherlands comparing particulate matter (PM10) and nitrogen dioxide (NO2) concentrations and publicly available population characteristics (deprivation, ethnicity, proportion of children and elderly). We saw higher concentrations in the most deprived 20% of neighbourhoods in England (1.5 μg/m(3) higher PM10 and 4.4 μg/m(3) NO2). Concentrations in both countries were higher in neighbourhoods with >20% non-White (England: 3.0 μg/m(3) higher PM10 and 10.1 μg/m(3) NO2; the Netherlands: 1.1 μg/m(3) higher PM10 and 4.5 μg/m(3) NO2) after adjustment for urbanisation and other variables. Associations for some areas differed from the national results. Air pollution inequalities were mainly an urban problem suggesting measures to reduce environmental air pollution inequality should include a focus on city transport. Copyright © 2014 Elsevier Ltd. All rights reserved.

Modeling the probability of arsenic in groundwater in New England as a tool for exposure assessment.

PubMed

Ayotte, Joseph D; Nolan, Bernard T; Nuckols, John R; Cantor, Kenneth P; Robinson, Gilpin R; Baris, Dalsu; Hayes, Laura; Karagas, Margaret; Bress, William; Silverman, Debra T; Lubin, Jay H

2006-06-01

We developed a process-based model to predict the probability of arsenic exceeding 5 microg/L in drinking water wells in New England bedrock aquifers. The model is being used for exposure assessment in an epidemiologic study of bladder cancer. One important study hypothesis that may explain increased bladder cancer risk is elevated concentrations of inorganic arsenic in drinking water. In eastern New England, 20-30% of private wells exceed the arsenic drinking water standard of 10 micrograms per liter. Our predictive model significantly improves the understanding of factors associated with arsenic contamination in New England. Specific rock types, high arsenic concentrations in stream sediments, geochemical factors related to areas of Pleistocene marine inundation and proximity to intrusive granitic plutons, and hydrologic and landscape variables relating to groundwater residence time increase the probability of arsenic occurrence in groundwater. Previous studies suggest that arsenic in bedrock groundwater may be partly from past arsenical pesticide use. Variables representing historic agricultural inputs do not improve the model, indicating that this source does not significantly contribute to current arsenic concentrations. Due to the complexity of the fractured bedrock aquifers in the region, well depth and related variables also are not significant predictors.

Salt Marsh Sustainability in New England: Progress and Remaining Challenges

EPA Science Inventory

Natural resource managers, conservationists, and scientists described marsh loss and degradation in many New England coastal systems at the 2014 “Effects of Sea Level Rise on Rhode Island’s Salt Marshes” workshop, organized by the Narragansett Bay National Estuarine Research Rese...

Whither Headship?

ERIC Educational Resources Information Center

Male, Trevor

2006-01-01

Headship in England was radically altered in nature in 1988 by the Education Reform Act which introduced the principle of local management of schools. Despite this legislative intervention, however, the model of headship in England remained virtually unchanged, rather it was headteacher behaviour that changed. The maintained school system is still…

Successful multi-technology NO{sub x} reduction project experience at New England Power Company - Salem Harbor station

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fynan, G.A.; Sload, A.; Adamson, E.J.

This paper presents the successes and lessons learned during recent low NOx burner and SNCR projects on generating units at New England Power`s Salem Harbor Generating Station. The principals involved in the project were New England Power Company, New England Power Service Company, Stone and Webster Engineering Corp. and Deutsche-Babcock Riley Inc. One unit was retrofitted with 16 Riley CCV burners with an OFA system, the other with 12 low NOx burners only. In addition to the burners, a SNCR system was also installed on three units. Since each of the burner systems are interdependent (SNCR was treated separately duringmore » design phases and optimized along with the burner systems), close cooperation during the design stages was essential to ensuring a successful installation, startup and optimization. This paper will present the coordinated effort put forth by each company toward this goal with the hope of assisting others who may be planning a similar effort. A summary of the operating results will also be presented. The up front teamwork and advance planning that went into the design stages of the project resulted in a number of successful outcomes e.g. scanner reliability, properly operating oil supply system, compatibility of burners and burner front oil system with new Burner Management System (BMS), reliable first attempt burner ignition and more. Advance planning facilitated pre-outage work and factored into keeping schedules and budgets on track.« less

Does co-payment for inhaler devices affect therapy adherence and disease outcomes? A historical, matched cohort study.

PubMed

Voorham, Jaco; Vrijens, Bernard; van Boven, Job Fm; Ryan, Dermot; Miravitlles, Marc; Law, Lisa M; Price, David B

2017-01-01

Adherence to asthma and chronic obstructive pulmonary disease (COPD) treatment has been shown to depend on patient-level factors, such as disease severity, and medication-level factors, such as complexity. However, little is known about the impact of prescription charges - a factor at the health care system level. This study used real-life data to investigate whether co-payment affects adherence (implementation and persistence) and disease outcomes in patients with asthma or COPD. A matched, historical cohort study was carried out using two UK primary care databases. The exposure was co-payment for prescriptions, which is required for most patients in England but not in Scotland. Two comparison cohorts were formed: one comprising patients registered at general practices in England and the other comprising patients registered in Scotland. Patients aged 20-59 years with asthma, or 40-59 years with COPD, who were initiated on fluticasone propionate/salmeterol xinafoate, were included, matched to patients in the opposite cohort, and followed up for 1 year following fluticasone propionate/salmeterol xinafoate initiation. The primary outcome was good adherence, defined as medication possession ratio ≥80%, and was analyzed using conditional logistic regression. Secondary outcomes included exacerbation rate. There were 1,640 patients in the payment cohort, ie, England (1,378 patients with asthma and 262 patients with COPD) and 619 patients in the no-payment cohort, ie, Scotland (512 patients with asthma and 107 patients with COPD). The proportion of patients with good adherence was 34.3% and 34.9% in the payment and no-payment cohorts, respectively, across both disease groups. In a multivariable model, no difference in odds of good adherence was found between the cohorts (odds ratio, 1.04; 95% confidence interval, 0.85-1.27). There was also no difference in exacerbation rate. There was no difference in adherence between matched patients registered in England and Scotland, suggesting that prescription charges do not have an impact on adherence to treatment.

England's New Market Based System of Student Education: An Initial Report. Research & Occasional Paper Series: CSHE.7.13

ERIC Educational Resources Information Center

Brown, Roger

2013-01-01

In 2012 the Conservative-Liberal Democrat Government introduced a number of reforms to the higher education system in England. The main change was to abolish direct state subsidies for the teaching of most subjects, and replace them with a state-subsidised tuition fee of up to $9,000 (US $13,700). A number of other changes were also made, all with…

Integrated care: theory to practice.

PubMed

Stokes, Jonathan; Checkland, Kath; Kristensen, Søren Rud

2016-10-01

'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical application of integrated care in the NHS in England to exemplify the prevalence of the case management focus. We look at the evidence for effectiveness of multi-disciplinary team case management, for the focus on high-risk groups and for integrated care more generally. We suggest realistic expectations of what integration of care alone can achieve and additional research questions. © The Author(s) 2016.

Leadership of education psychological services: fit for purpose?

PubMed Central

Booker, Roger

2013-01-01

At a time of great change for educational psychology services in England, this paper reviews current theories of leadership and proposes how an integration of key aspects of these can be applied to support a self review of leadership practice, both by individual leaders and by services. The message from current theory is that in the midst of complexity and rapid change, a primary focus on the head of service is outdated; there should instead be a focus to develop the leadership capacity of the service as a whole. Key constructs considered are systems thinking, social identity, authenticity, and leadership as social construction. PMID:26157196

Status of exotic grasses and grass-like vegetation and potential impacts on wildlife in New England

USGS Publications Warehouse

DeStefano, Stephen

2013-01-01

The Northeastern section of the United States, known as New England, has seen vast changes in land cover and human population over the past 3 centuries. Much of the region is forested; grasslands and other open-land cover types are less common, but provide habitat for many species that are currently declining in abundance and distribution. New England also consists of some of the most densely populated and developed states in the country. The origin, distribution, and spread of exotic species are highly correlated with human development. As such, exotics are common throughout much of New England, including several species of graminoids (grasses and grass-like plants such as sedges and rushes). Several of the more invasive grass species can form expansive dense mats that exclude native plants, alter ecosystem structure and functions, and are perceived to provide little-to-no value as wildlife food or cover. Although little research has been conducted on direct impacts of exotic graminoids on wildlife populations in New England, several studies on the common reed (Phragmites australis) in salt marshes have shown this species to have variable effects as cover for birds and other wildlife, depending on the distribution of the plant (e.g., patches and borders of reeds are used more by wildlife than expansive densely growing stands). Direct impacts of other grasses on wildlife populations are largely unknown. However, many of the invasive graminoid species that are present in New England have the capability of outcompeting native plants and thereby potentially affecting associated fauna. Preservation, protection, and restoration of grassland and open-land cover types are complex but necessary challenges in the region to maintain biological and genetic diversity of grassland, wetland, and other open-land obligate species.

77 FR 42677 - Special Conditions: General Electric CT7-2E1 Turboshaft Engine

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... Mihail, ANE-111, Engine and Propeller Directorate, Aircraft Certification Service, 12 New England..., ANE-7 Engine and Propeller Directorate, Aircraft Certification Service, 12 New England Executive Park... additional requirements for the rating's definition, overspeed, controls system, and endurance test because...

Public health in England in 2016-the health of the public and the public health system: a review.

PubMed

Middleton, John

2017-01-01

This article describes the current state of the health of the public in England and the state of the public health professional service and systems. Data sources are wide ranging including the Global Burden of Disease, the Commonwealth Fund and Public Health England reports. There is a high burden of preventable disease and unacceptable inequalities in England. There is considerable expectation that there are gains to be made in preventing ill health and disability and so relieving demand on healthcare. Despite agreement on the need for prevention, the Government has cut public health budgets by a cumulative 10% to 2020. Public health professionals broadly supportive of remaining in the EU face an uphill battle to retain health, workplace and environmental protections following the 'Leave' vote. There is revitalized interest in air pollution. Extreme weather events are testing response and organizational skills of public health professionals and indicating the need for greater advocacy around climate change, biodiversity and protection of ecological systems. Planetary health and ecological public health are ideas whose time has certainly come. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Electronic patient information systems and care pathways: the organisational challenges of implementation and integration.

PubMed

Dent, Mike; Tutt, Dylan

2014-09-01

Our interest here is with the 'marriage' of e-patient information systems with care pathways in order to deliver integrated care. We report on the development and implementation of four such pathways within two National Health Service primary care trusts in England: (a) frail elderly care, (b) stroke care, (c) diabetic retinopathy screening and (d) intermediate care. The pathways were selected because each represents a different type of information and data 'couplings', in terms of task interdependency with some pathways/systems reflecting more complex coordinating patterns than others. Our aim here is identify and explain how health professionals and information specialists in two organisational National Health Service primary care trusts organisationally construct and use such systems and, in particular, the implications this has for issues of professional and managerial control and autonomy. The article is informed by an institutionalist analysis. © The Author(s) 2013.

Uncertainty in macroeconomic policy-making: art or science?

PubMed

Aikman, David; Barrett, Philip; Kapadia, Sujit; King, Mervyn; Proudman, James; Taylor, Tim; de Weymarn, Iain; Yates, Tony

2011-12-13

Uncertainty is pervasive in economic policy-making. Modern economies share similarities with other complex systems in their unpredictability. But economic systems also differ from those in the natural sciences because outcomes are affected by the state of beliefs of the systems' participants. The dynamics of beliefs and how they interact with economic outcomes can be rich and unpredictable. This paper relates these ideas to the recent crisis, which has reminded us that we need a financial system that is resilient in the face of the unpredictable and extreme. It also highlights how such uncertainty puts a premium on sound communication strategies by policy-makers. This creates challenges in informing others about the uncertainties in the economy, and how policy is set in the face of those uncertainties. We show how the Bank of England tries to deal with some of these challenges in its communications about monetary policy.

Modeling the complex activity of sickle cell and thalassemia specialist nurses in England.

PubMed

Leary, Alison; Anionwu, Elizabeth N

2014-01-01

Specialist advanced practice nursing in hemoglobinopathies has a rich historical and descriptive literature. Subsequent work has shown that the role is valued by patients and families and also by other professionals. However, there is little empirical research on the complexity of activity of these services in terms of interventions offered. In addition, the work of clinical nurse specialists in England has been devalued through a perception of oversimplification. The purpose of this study was to understand the complexity of expert nursing practice in sickle cell and thalassemia. The approach taken to modeling complexity was used from common methods in mathematical modeling and computational mathematics. Knowledge discovery through data was the underpinning framework used in this study using a priori mined data. This allowed categorization of activity and articulation of complexity. In total, 8966 nursing events were captured over 1639 hours from a total of 22.8 whole time equivalents, and several data sources were mined. The work of specialist nurses in this area is complex in terms of the physical and psychosocial care they provide. The nurses also undertook case management activity such as utilizing a very large network of professionals, and others participated in admission avoidance work and education of patients' families and other staff. The work of nurses specializing in hemoglobinopathy care is complex and multidimensional and is likely to contribute to the quality of care in a cost-effective way. An understanding of this complexity can be used as an underpinning to establishing key performance indicators, optimum caseload calculations, and economic evaluation.

Restructuring Teachers' Work-Lives and Knowledge in England and Spain

ERIC Educational Resources Information Center

Muller, Jorg; Norrie, Caroline; Hernandez, Fernando; Goodson, Ivor

2010-01-01

This article explores the restructuring of education in England and Spain. Against a presumably homogeneous global streamlining of educational systems according to competition-driven goals, the comparison of teachers' work-lives and professional knowledge evidences a variety of experiences under-represented in discourses on global restructuring.…

Wastewater Collection System Toolbox | Eliminating Sanitary ...

EPA Pesticide Factsheets

2017-04-10

Communities across the United States are working to find cost-effective, long-term approaches to managing their aging wastewater infrastructure and preventing the problems that lead to sanitary sewer overflows. The Toolbox is an effort by EPA New England to provide examples of programs and educational efforts from New England and beyond.

Links Between Watershed Activities and the Degradation of Coastal, Tidal Salt Marshes in Southern New England USA

EPA Science Inventory

Human activities (e.g., land development, wastewater) in coastal watersheds in New England USA are linked with community- and system-level changes in tidal, organic-rich salt marshes. Significant relationships between various indicators of watershed activities and ecosystem stru...

Policy Perspective: School Turnaround in England. Utilizing the Private Sector

ERIC Educational Resources Information Center

Corbett, Julie

2014-01-01

This paper, written by strategic partner of the Center on School Turnaround (CST), Julie Corbett, provides research and examples on England's approach to turning around its lowest performing schools. The English education system utilizes private vendors to support chronically low-performing schools and districts. The introduction is followed by…

The Current Brouhaha about Standards in England

ERIC Educational Resources Information Center

Brown, Roger

2010-01-01

Following a report by a Parliamentary Committee, the Higher Education Funding Council for England is consulting the sector about a strengthened national quality assurance system, with an enhanced role for information about quality and a closer focus on academic standards. This article provides a critical review of the main proposals.

Towards Mentoring as Feminist Praxis in Early Childhood Education and Care in England

ERIC Educational Resources Information Center

Hammond, Sue; Powell, Sacha; Smith, Kate

2015-01-01

Following our contribution to a study of mentoring in seven European countries, we explored epistemological and ontological inconsistencies within mainstream mentoring systems and their regulated practice in England. We considered how feminist mentoring praxis can unsettle conceptualisations of mentoring relationships and challenge inequity in the…

THE NEW ENGLAND AIR QUALITY FORECASTING PILOT PROGRAM: DEVELOPMENT OF AN EVALUATION PROTOCOL AND PERFORMANCE BENCHMARK

EPA Science Inventory

The National Oceanic and Atmospheric Administration recently sponsored the New England Forecasting Pilot Program to serve as a "test bed" for chemical forecasting by providing all of the elements of a National Air Quality Forecasting System, including the development and implemen...

An American knowledge base in England - Alternate implementations of an expert system flight status monitor

NASA Technical Reports Server (NTRS)

Butler, G. F.; Graves, A. T.; Disbrow, J. D.; Duke, E. L.

1989-01-01

A joint activity between the Dryden Flight Research Facility of the NASA Ames Research Center (Ames-Dryden) and the Royal Aerospace Establishment (RAE) on knowledge-based systems has been agreed. Under the agreement, a flight status monitor knowledge base developed at Ames-Dryden has been implemented using the real-time AI (artificial intelligence) toolkit MUSE, which was developed in the UK. Here, the background to the cooperation is described and the details of the flight status monitor and a prototype MUSE implementation are presented. It is noted that the capabilities of the expert-system flight status monitor to monitor data downlinked from the flight test aircraft and to generate information on the state and health of the system for the test engineers provides increased safety during flight testing of new systems. Furthermore, the expert-system flight status monitor provides the systems engineers with ready access to the large amount of information required to describe a complex aircraft system.

Some employment and earnings implications of regional biomass energy utilization: New England and the Cornbelt States

NASA Astrophysics Data System (ADS)

Stevenson, W.; Bell, S. E.; Blair, L. M.; Gove, R. M.; Little, J. R.

1981-08-01

Because of their abundant forest and agricultural biomass resources, New England and the Cornbelt are likely to grow considerably in the development of biomass energy systems during the next decade or two. Forty thousand or more permanent jobs might be created in New England's wood energy industry by the end of the century. If alcohol-fuel use continues to grow, even greater potential for employment in biomass energy exists in the Cornbelt states. The associated earnings would be quite substantial for both regions. The direct combustion of wood and activities related to alcohol-fuel production are expected to be the major contributors to biomass energy production, employment, and earnings; but other biomass systems show potential as well. Energy extraction from municipal waste, anaerobic digestion of animal manure, and other biomass conversion systems will all generate employment as they grow in use.

Gove's Curriculum and the GERM

ERIC Educational Resources Information Center

Wrigley, Terry

2015-01-01

This article examines the complex relationship between England's new National Curriculum and the neoliberal reform of education known as GERM. It explores contradictions between economic functionality and Gove's nostalgic traditionalism. It critiques the new curriculum as narrow, age-inappropriate, obsessed with abstract rules, and poorly focused…

Rationale for the new GP deprivation payment scheme in England: effects of moving from electoral ward to enumeration district underprivileged area scores.

PubMed Central

Bajekal, M; Alves, B; Jarman, B; Hurwitz, B

2001-01-01

BACKGROUND: The Department of Health introduced a new deprivation payments system for general practitioners (GPs) on 1 April 1999. Following a three-year phasing-in process, registered patients will attract deprivation payments based on the underprivileged area (UPA) score of their enumeration district (ED) of residence, rather than their electoral ward, changing the pattern and distribution of payments throughout England. AIM: To assess the rationale behind the changed deprivation payments system for GPs in England and to examine its impact on GP and practice payments. DESIGN OF STUDY: A quantitative study modelling practice-based deprivation payments. SETTING: A total of 25,450 unrestricted principal GPs in 8919 practices in England. METHOD: The effect of three new components in the system were examined: changes in the ED score ranges attracting payment, the percentage increase in the size of successive payment bands, and the total budget. The relationship between consultation rates (used as a proxy for workload) and UPA score was examined, together with changes in GP payments calculated nationally and by geographical area. RESULTS: A total of 11.6% of the population of England live in wards with a UPA score of 30 or more, qualifying for deprivation payments, and a similar proportion (11.4%) live in EDs with a UPA score of 20 or more. The larger percentage increases in the size of payments in successive ED UPA bands is supported by the modelled relationship between consultation rate and UPA score. Financially, under the new deprivations payment system, entitlement widens with 88% of practices receiving a payment. Overall, 74% of GPs gain and 13% lose (3% losing more than 1500 Pounds), with 13% receiving no payment. CONCLUSION: The new ED system maps onto the previous system well. Moreover, it more finely discriminates between smaller areas of different relative deprivation and, thereby, targets payments more accurately. PMID:11407049

Rationale for the new GP deprivation payment scheme in England: effects of moving from electoral ward to enumeration district underprivileged area scores.

PubMed

Bajekal, M; Alves, B; Jarman, B; Hurwitz, B

2001-06-01

The Department of Health introduced a new deprivation payments system for general practitioners (GPs) on 1 April 1999. Following a three-year phasing-in process, registered patients will attract deprivation payments based on the underprivileged area (UPA) score of their enumeration district (ED) of residence, rather than their electoral ward, changing the pattern and distribution of payments throughout England. To assess the rationale behind the changed deprivation payments system for GPs in England and to examine its impact on GP and practice payments. A quantitative study modelling practice-based deprivation payments. A total of 25,450 unrestricted principal GPs in 8919 practices in England. The effect of three new components in the system were examined: changes in the ED score ranges attracting payment, the percentage increase in the size of successive payment bands, and the total budget. The relationship between consultation rates (used as a proxy for workload) and UPA score was examined, together with changes in GP payments calculated nationally and by geographical area. A total of 11.6% of the population of England live in wards with a UPA score of 30 or more, qualifying for deprivation payments, and a similar proportion (11.4%) live in EDs with a UPA score of 20 or more. The larger percentage increases in the size of payments in successive ED UPA bands is supported by the modelled relationship between consultation rate and UPA score. Financially, under the new deprivations payment system, entitlement widens with 88% of practices receiving a payment. Overall, 74% of GPs gain and 13% lose (3% losing more than 1500 Pounds), with 13% receiving no payment. The new ED system maps onto the previous system well. Moreover, it more finely discriminates between smaller areas of different relative deprivation and, thereby, targets payments more accurately.

Implementing personalisation for people with mental health problems: a comparative case study of four local authorities in England.

PubMed

Larsen, John; Ainsworth, Emily; Harrop, Clare; Patterson, Sue; Hamilton, Sarah; Szymczynska, Paulina; Tew, Jerry; Manthorpe, Jill; Pinfold, Vanessa

2013-04-01

Enhancing choice and control for people using services is a mental health and social-care service priority in England. Personalisation is a new policy and practice for delivery of social-care services where eligible adults are allocated a personal budget to spend to meet their agreed support needs. To describe approaches to introducing personal budgets to people with severe and enduring mental health needs, and to identify facilitators or barriers encountered. Within four English local authority (LA) areas, purposively selected to provide maximum variation, semi-structured interviews were undertaken with 58 participants from LAs, NHS trusts and third-sector organisations. An Interpretive Framework analysis considered within- and across-site insights. Issues arising from the implementation of personalisation for people with mental health needs are presented under two general themes: "responsibility and power" and "vision and leadership". Key challenges identified were complexities of working across NHS and LAs, the importance of effective leadership and engagement with service user representatives. Implementing personal budgets in mental health requires effective engagement of health and social-care systems. Change processes need strong leadership, clear vision and personal commitment, with ownership by all key stakeholders, including front-line practitioners.

Modeling the probability of arsenic in groundwater in New England as a tool for exposure assessment

USGS Publications Warehouse

Ayotte, J.D.; Nolan, B.T.; Nuckols, J.R.; Cantor, K.P.; Robinson, G.R.; Baris, D.; Hayes, L.; Karagas, M.; Bress, W.; Silverman, D.T.; Lubin, J.H.

2006-01-01

We developed a process-based model to predict the probability of arsenic exceeding 5 ??g/L in drinking water wells in New England bedrock aquifers. The model is being used for exposure assessment in an epidemiologic study of bladder cancer. One important study hypothesis that may explain increased bladder cancer risk is elevated concentrations of inorganic arsenic in drinking water. In eastern New England, 20-30% of private wells exceed the arsenic drinking water standard of 10 micrograms per liter. Our predictive model significantly improves the understanding of factors associated with arsenic contamination in New England. Specific rock types, high arsenic concentrations in stream sediments, geochemical factors related to areas of Pleistocene marine inundation and proximity to intrusive granitic plutons, and hydrologic and landscape variables relating to groundwater residence time increase the probability of arsenic occurrence in groundwater. Previous studies suggest that arsenic in bedrock groundwater may be partly from past arsenical pesticide use. Variables representing historic agricultural inputs do not improve the model, indicating that this source does not significantly contribute to current arsenic concentrations. Due to the complexity of the fractured bedrock aquifers in the region, well depth and related variables also are not significant predictors. ?? 2006 American Chemical Society.

75 FR 10759 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-09

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... exclusive economic zone (EEZ). Recommendations from this group will be brought to the full Council for... complex using updated survey data; review the Ecosystem-Based Fishery Management draft policy paper and...

Education for Democracy: Reasons and Strategies

ERIC Educational Resources Information Center

Edelstein, Wolfgang

2011-01-01

According to social scientists Herfried Munkler in Germany and Colin Crouch in England, major developments in Western industrial societies--individualism, increasing social complexity, globalisation--present serious threats to basic requirements of stable societies and expose democracy to the corrosion of its socio-moral resources such as social…

Recent Developments in Assessment Procedures in England and Wales.

ERIC Educational Resources Information Center

Goldstein, Harvey; Nuttall, Desmond

Focusing on technical issues, this paper critiques proposed changes in assessment procedures at the further educational level (ages 16 through 18) in England and Wales. Major structural changes are taking place at this educational level, partly because of large scale youth unemployment. The two current examination systems for the final year of…

Re-Making the Middle: Dis-Intermediation in International Context

ERIC Educational Resources Information Center

Lubienski, Christopher

2014-01-01

Recent reforms in England's education system have been justified on the grounds that other countries have pursued similar approaches to education reform. Many such policies that by-pass or otherwise diminish meso-level institutions demonstrate a commitment to the idea of devolving authority to local actors. The current reforms in England and…

Primary Teacher Education in England: 40 Years On

ERIC Educational Resources Information Center

Murray, Jean; Passy, Rowena

2014-01-01

This article examines the relationship between pre-service teacher education (ITE) for primary schooling and primary teaching in England between 1974 and 2014, and explores the "fitness of purpose" of the current system of preparing teachers for the classrooms of the twenty-first century. Our historical analysis suggests that, despite 40…

Youth Justice in England and Wales: A Risky Business

ERIC Educational Resources Information Center

Paylor, Ian

2011-01-01

Risk factor research dominates explanatory models of youth offending and "evidence-based" policy and practice with young people in the youth justice system in England and Wales. Asset is the product of these actuarial ideas and has put the risk factor prevention paradigm into practice. This article evaluates the impact that an actuarial…

Neoliberal Globalisation, Managerialism and Higher Education in England: Challenging the Imposed "Order of Things"

ERIC Educational Resources Information Center

Beckmann, Andrea; Cooper, Charlie

2013-01-01

This article critically explores the consequences of the imposition of neoliberal ideology on a transnational scale on the higher education system. Its particular focus is England where the context of the "new managerialism" continues to dominate the "lifeworlds" of educators and the educated, despite strong concerns about its…

Threshold Assessment and Performance Management: Modernizing or Masculinizing Teaching in England?

ERIC Educational Resources Information Center

Mahony, Pat; Hextall, Ian; Menter, Ian

2004-01-01

The paper reports on aspects of an ESRC project, "The impact of Performance 'Threshold Assessment' on teachers' work" (ESRC R000239286). The paper begins by explaining the nature and technology of "Threshold Assessment," and its location nationally within the performance management system recently introduced into schools in England. We review the…

78 FR 26361 - Notice of Commission Staff Attendance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-06

... Commission's staff may attend the following meetings related to the transmission planning activities of ISO...-000, New York Independent System Operator, Inc. Docket No. ER13-193-000, ISO New England Inc. Docket No. ER13-195, Indicated PJM Transmission Owners Docket No. ER13-196-000, ISO New England Inc. Docket...

National Curriculum Reform in China and England: Origins, Character and Comparison

ERIC Educational Resources Information Center

Halpin, David

2010-01-01

Both China and England require state-funded schools to teach a national curriculum. While policy congruence in terms of overall intention is apparent, there are major differences between each country's approach to systemic curriculum reform which highlight contrasting attitudes to how best to effect change in schools and widely differing views on…

Fatal Child Maltreatment in England, 2005-2009

ERIC Educational Resources Information Center

Sidebotham, Peter; Bailey, Sue; Belderson, Pippa; Brandon, Marian

2011-01-01

Objective: This paper presents comprehensive and up-to-date data covering 4 years of Serious Case Reviews into fatal child maltreatment in England. Methods: Information on all notified cases of fatal maltreatment between April 2005 and March 2009 was examined to obtain case characteristics related to a systemic classification of 5 broad groups of…

Spotlight of a Century of Educational Reform in England.

ERIC Educational Resources Information Center

Henry, Thomas B.

During the past 100 years, there has been an evolution in publicly funded education in England. This report provides a historical perspective for recent reforms and spotlights three related areas. The first section describes the early 19th-century Newcastle Commission's efforts to design a system of sound and cheap elementary education for…

PISA, Policymaking and Political Pantomime: Education Policy Referencing between England and Hong Kong

ERIC Educational Resources Information Center

Adamson, Bob; Forestier, Katherine; Morris, Paul; Han, Christine

2017-01-01

Since the mid-1980s, a number of East Asian societies have consistently performed well in international tests, and their education systems have emerged as models of "best practice", including Hong Kong, which has been extensively referenced by politicians and their advisers in England. In parallel, local dissatisfaction with the…

Polish Complementary Schools in Iceland and England

ERIC Educational Resources Information Center

Zielinska, Malgorzata; Kowzan, Piotr; Ragnarsdóttir, Hanna

2014-01-01

Since 2004, the opening of labour markets has spurred a considerable number of Poles to emigrate e.g. to Iceland and England. Families with school age children have had the challenge of adapting to foreign environments and school systems. Polish complementary schools have played an important, albeit ambivalent, role in this process. Through focus…

Product Diversity and Spectrum of Choice in Hospital ePrescribing Systems in England

PubMed Central

Mozaffar, Hajar; Williams, Robin; Cresswell, Kathrin; Morison, Zoe; Slee, Ann; Team, Aziz Sheikh; Coleman, Jamie; Bates, David W.; Robertson, Ann; Avery, Tony; Blake, Laurence; Chuter, Antony; Slight, Sarah P.; Girling, Alan; Lee, Lisa; Lilford, Richard; McCloughan, Lucy; Schofield, Jill

2014-01-01

Background ePrescribing systems have considerable potential for improving healthcare quality and safety. With growing expectations about the benefits of such systems, there is evidence of widespread plans to implement these systems in hospitals in England where hitherto they have had a low uptake. Given the international drive away from developing home-grown to systems to procuring commercial applications, we aimed to identify available ePrescribing systems in England and to use the findings to develop a taxonomy of the systems offered by suppliers. Methods and Findings We undertook a scoping review of the published and grey literature, and conducted expert interviews with vendors, healthcare organisations and national ePrescribing experts in order to identify the spectrum of available systems, identify and map their key features, and then iteratively develop and validate a taxonomy of commercial ePrescribing systems available to English hospitals. There is a wide range of available systems including 13 hospital-wide applications and a range of specialty systems. These commercial applications can be grouped into four sub-categories: standalone systems, modules within integrated systems, functionalities spread over several modules, and specialty systems. The findings also reveal that apart from four packaged applications (two of which are specialty systems), all other systems have none or less than two live implementations across England. Conclusions The wide range of products developed in the last few years by different national and international suppliers, and the low uptake of these products by English hospitals indicate that the English ePrescribing market is still in its infancy. This market is undergoing rapid cycles of change, both with respect to the number of suppliers and their diversity of offerings. Constant renewal of knowledge is needed on the status of this evolving market, encompassing the products development and adoption, to assist implementation decisions and facilitate market maturity. PMID:24691517

Taking hospital treatments home: a mixed methods case study looking at the barriers and success factors for home dialysis treatment and the influence of a target on uptake rates.

PubMed

Combes, Gill; Allen, Kerry; Sein, Kim; Girling, Alan; Lilford, Richard

2015-10-27

Despite healthcare policies and evidence which promote home dialysis, uptake rates have been falling for over 10 years in England. A target introduced by commissioners in the West Midlands provided a unique opportunity to study how hospitals can increase home-based treatment for a group of patients with complex life-threatening conditions. Quantitative changes in home treatment uptake rates in seven hospitals in the West Midlands were compared with the rest of England for 3 years pre and post the introduction of the target in 2010, using a logistic regression model. Qualitative interviews in four hospitals with 96 clinical and managerial staff and 93 dialysis patients explored the barriers and facilitators to increasing the uptake of home treatment and the impact of the target. Home treatment uptake rates increased significantly in the seven study hospitals compared with the 3 years prior to the introduction of the target and compared with the rest of England where rates remained static. The four main factors facilitating increased uptake were as follows: the commissioner's target, linked to financial penalties; additional funding for specialist staff and equipment; committed, visible clinical champions and good systems for patient training and ongoing healthcare support at home. The three main barriers were as follows: lack of training for non-specialist staff, poorly developed patient education and considerable unrecognised and unmet emotional and psychological patient needs. This study shows the impact of using targets with financial penalties to achieve change and how hospitals can increase significantly the uptake of home-based self-care for a group of patients with complex medical needs. It provides useful pointers to the main barriers and facilitators, which are likely to be relevant to other groups of patients who could be treated at home. It also highlights two neglected areas which need to improve if patients with life-threatening long-term conditions are to be encouraged to take up home treatment: individualised patient education which allows exploration of the impacts of treatment options and the provision of ongoing emotional support.

The relationship between employees' perceptions of human resource systems and organizational performance: examining mediating mechanisms and temporal dynamics.

PubMed

Piening, Erk P; Baluch, Alina M; Salge, Torsten Oliver

2013-11-01

Given the limited understanding of temporal issues in extant theorizing about the link between human resource management (HRM) and performance, in this study we aim to shed light on how, when, and why HR interventions affect organizational performance. On the basis of longitudinal, multi-informant and multisource data from public hospital services in England, we provide new insights into the complex interplay between employees' perceptions of HR systems, job satisfaction, and performance outcomes over time. The dynamic panel data analyses provide support for changes in employees' experience of an HR system being related to subsequent changes in customer satisfaction, as mediated by changes in job satisfaction, albeit these effects decrease over time. Moreover, our longitudinal analyses highlight the importance of feedback effects in the HRM-performance chain, which otherwise appears to evolve in a cyclical manner. (c) 2013 APA, all rights reserved.

Innovations in major system reconfiguration in England: a study of the effectiveness, acceptability and processes of implementation of two models of stroke care.

PubMed

Fulop, Naomi; Boaden, Ruth; Hunter, Rachael; McKevitt, Christopher; Morris, Steve; Pursani, Nanik; Ramsay, Angus Ig; Rudd, Anthony G; Tyrrell, Pippa J; DA Wolfe, Charles

2013-01-05

Significant changes in provision of clinical care within the English National Health Service (NHS) have been discussed in recent years, with proposals to concentrate specialist services in fewer centres. Stroke is a major public health issue, accounting for over 10% of deaths in England and Wales, and much disability among survivors. Variations have been highlighted in stroke care, with many patients not receiving evidence-based care. To address these concerns, stroke services in London and Greater Manchester were reorganised, although different models were implemented. This study will analyse processes involved in making significant changes to stroke care services over a short time period, and the factors influencing these processes. We will examine whether the changes have delivered improvements in quality of care and patient outcomes; and, in light of this, whether the significant extra financial investment represented good value for money. This study brings together quantitative data on 'what works and at what cost?' with qualitative data on 'understanding implementation and sustainability' to understand major system change in two large conurbations in England. Data on processes of care and their outcomes (e.g. morbidity, mortality, and cost) will be analysed to evidence services' performance before and after reconfiguration. The evaluation draws on theories related to the dissemination and sustainability of innovations and the 'social matrix' underlying processes of innovation. We will conduct a series of case studies based on stakeholder interviews and documentary analysis. These will identify drivers for change, how the reconfigurations were governed, developed, and implemented, and how they influenced service quality. The research faces challenges due to: the different timings of the reconfigurations; the retrospective nature of the evaluation; and the current organisational turbulence in the English NHS. However, these issues reflect the realities of major systems change and its evaluation. The methods applied in the study have been selected to account for and learn from these complexities, and will provide useful lessons for future reconfigurations, both in stroke care and other specialties.

Evaluating the Benefits of Adaptation of Critical Infrastructures to Hydrometeorological Risks.

PubMed

Thacker, Scott; Kelly, Scott; Pant, Raghav; Hall, Jim W

2018-01-01

Infrastructure adaptation measures provide a practical way to reduce the risk from extreme hydrometeorological hazards, such as floods and windstorms. The benefit of adapting infrastructure assets is evaluated as the reduction in risk relative to the "do nothing" case. However, evaluating the full benefits of risk reduction is challenging because of the complexity of the systems, the scarcity of data, and the uncertainty of future climatic changes. We address this challenge by integrating methods from the study of climate adaptation, infrastructure systems, and complex networks. In doing so, we outline an infrastructure risk assessment that incorporates interdependence, user demands, and potential failure-related economic losses. Individual infrastructure assets are intersected with probabilistic hazard maps to calculate expected annual damages. Protection measure costs are integrated to calculate risk reduction and associated discounted benefits, which are used to explore the business case for investment in adaptation. A demonstration of the methodology is provided for flood protection of major electricity substations in England and Wales. We conclude that the ongoing adaptation program for major electricity assets is highly cost beneficial. © 2017 Society for Risk Analysis.

The Organisation of 14-19 Education and Training in England: Beyond Weakly Collaborative Arrangements

ERIC Educational Resources Information Center

Hodgson, Ann; Spours, Ken

2006-01-01

As a result of reforms over the past two decades, institutional arrangements for upper secondary education in England are both marketised and competitive compared with other European systems. Since 1997, the Labour Government has broadly sustained this position. However, recent policy documents recognise that 14-19 education and training will…

Professional Development and the Teaching Schools Experiment in England: Leadership Challenges in an Alliance's First Year

ERIC Educational Resources Information Center

Dowling, Simon

2016-01-01

This article reports findings from the first year of a longitudinal, mixed-methods case study of a large teaching school alliance in England. This national initiative is intended to drive improvement at system level by grouping schools around formally designated teaching schools. These "alliances" work collaboratively to share learning,…

Overseas Trained Teachers in England: A Policy Framework for Social and Professional Integration

ERIC Educational Resources Information Center

Miller, Paul Washington

2008-01-01

Overseas trained teachers (OTTs) have become an important part of the make-up of England's primary and secondary education system. Through inadequate, and in some cases a lack of, initial induction and support for professional development, many are at risk of performing sub-optimally and some have become an endangered species. Failure to integrate…

Technology Skills in Demand: A Survey of Job Advertisements in New England.

ERIC Educational Resources Information Center

Papp, Raymond

In order to identify the IS (Information Systems) skills in greatest demand in Connecticut and the New England region, classified ads for business-oriented IS positions appearing in the region's major newspapers during the summer of 1998 were analyzed. This paper highlights these findings and compares them to the skills employers from other…

University Enrollment Patterns in England and the United States.

ERIC Educational Resources Information Center

Fairweather, Malcolm

Factors that influence college choice and enrollment patterns in both the United States and England were identified, based on a comparative literature review. It was found that the reasons given by students for attending universities in the two countries are very similar, in spite of the fact that the systems of higher education in these countries…

The Role of Higher Education within Broader Skills Policies, a Comparison of Emerging Scottish and English Approaches

ERIC Educational Resources Information Center

Keep, Ewart

2014-01-01

This article explores the important role played by higher education in broader skills and economic development policies in England and Scotland. It places the often divergent policy experiments and structural developments in these two countries' higher education systems within an international policy context and explains why England and Scotland…

Pixie-Dust and Privacy: What's Happening to Children's Rights in England?

ERIC Educational Resources Information Center

Dowty, Terri

2008-01-01

Increasingly, Information Technology is being used to identify, record and track children in England under the banners of child protection, reducing risk and improving outcomes. Discussions about the importance of a child's right to privacy have been sidelined in the rush to embrace systems that seek to expand the amount and types of information…

The Uncertain Future of Comprehensive Schooling in England

ERIC Educational Resources Information Center

Gorard, Stephen

2015-01-01

This is an article about secondary schools in England, and what type of school is fair and efficient for a national education system. It discusses what "fair" could mean in this context, summarises some key policy revisions since 1944 in this light, and reminds readers of the damage caused by unfairness within education. Most notably it…

Further Education outside the Jurisdiction of Local Education Authorities in Post-War England

ERIC Educational Resources Information Center

Simmons, Robin

2014-01-01

This article revisits the three decades following the end of World War Two--a time when, following the 1944 Education Act, local education authorities (LEAs) were the key agencies responsible for running the education system across England. For the first time, there was a statutory requirement for LEAs to secure adequate facilities for further…

Negative Effect of the British Poor Vocational Education on Its Economic Development after the Second World War

ERIC Educational Resources Information Center

Li, Yong

2007-01-01

England is the oldest nation of industry revolution and the earliest industrialized country in the world. With the colonization system breakdown and economic giants, the United States, Germany, Japan, etc. rising, today England has already lost former days of elegant appearance. The disadvantageous vocational education is one of essential factor…

Neoliberalization and Managerialization of "Education" in England and Wales--A Case for Reconstructing Education

ERIC Educational Resources Information Center

Beckmann, Andrea; Cooper, Charlie; Hill, Dave

2009-01-01

This paper argues that the neoliberalization of education in England, begun in the 1980s, is having profoundly harmful effects on the lives of individuals and society. Neoliberalism represents a shift away from the post-war social democratic notion of universal "citizenship" rights/identities toward a system of individual consumer…

Redesign and commissioning of sexual health services in England - a qualitative study.

PubMed

Walker, I F; Leigh-Hunt, N; Lee, A C K

2016-10-01

Responsibility for the commissioning of sexual and reproductive health (SRH) services transferred from the National Health Service to local authorities in England in 2013. This transfer prompted many local authorities to undertake new procurements of these SRH services. This study was undertaken to capture some of the lessons learnt in order to inform future commissioning and system redesign. A qualitative study was carried out involving semi-structured interviews. Interviews were conducted with 13 local authority sexual health commissioners in Yorkshire and the Humber from 11 interviews. Thematic analysis was used to identify themes from transcripts of the interviews with the 13 participants. Key themes identified were as follows: the challenge and complexity to those new to clinical commissioning; the prerequisites of robust infrastructural inputs to undertake the process, including technical expertise, a dependable project team, with clarity over the timescales and the budget; the requirement for good governance, stakeholder engagement and successful management of relationships with the latter; and the need to focus on the outcomes, aiming for value for money and improved system performance. Several key issues emerged from our study that significantly influenced the outcome of the redesign and commissioning process for sexual health services. An adapted model of the Donabedian evaluation framework was developed to provide a tool to inform future system redesign. Our model helps identify the key determinants for successful redesign in this context which is essential to both mitigate potential risks and maximize the likelihood of successful outcomes. Our model may have wider applications. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Feminist Thinking on Education in Victorian England

ERIC Educational Resources Information Center

Schwartz, Laura

2011-01-01

This article examines some of the conversations that took place between women's rights advocates on the subject of female education. The relationship between Victorian feminism and educational reform was a complex one, and historians have long argued over whether campaigns for women's schools and colleges can be termed "feminist". This article…

Complex Pathways for Young Mothers outside Employment, Education and Training

ERIC Educational Resources Information Center

Russell, Lisa

2016-01-01

This article explores young mothers' experiences of turbulent pathways in and out of education and work in Northern England. Data are drawn from an ethnography conducted between 2010 and 2013 that incorporated participant observation, life-story maps, photographs and interviews carried out in young mothers' homes, parenting classes and…

Contextual Admissions and Affirmative Action: Developments in Higher Education Policy in England

ERIC Educational Resources Information Center

Lane, Laura; Birds, Rachel

2013-01-01

This paper explores the value of explaining contextual admissions policy directives through the conceptual lenses of meritocracy and social reproduction. It is suggested that examining these concepts can assist in highlighting some of the ideological and practical complexities associated with contextual admissions whilst providing opportunities to…

Language Impairment and Comorbid Vulnerabilities among Young People in Custody

ERIC Educational Resources Information Center

Hughes, Nathan; Chitsabesan, Prathiba; Bryan, Karen; Borschmann, Rohan; Swain, Nathaniel; Lennox, Charlotte; Shaw, Jennifer

2017-01-01

Background: While the prevalence of language and communication difficulties among young people in custody is well established, holistic understanding of the complexity and co-occurrence of additional vulnerabilities among this population are rare. Methods: Ninety-three young people in a young offenders institution in England were assessed using…

Circle and Lines: Complexities of Learning in Community

ERIC Educational Resources Information Center

Schupack, Sara

2013-01-01

Following is a study that explores learning in community in a fully-integrated, team taught course at a community college in New England. These classes, Learning Communities (LCs) represent rich opportunities for exploring and practicing democratic education. From a theoretical grounding in social learning theories and an exploration into learning…

User's Manual for the New England Water-Use Data System (NEWUDS)

USGS Publications Warehouse

Horn, Marilee A.

2003-01-01

Water is used in a variety of ways that need to be understood for effective management of water resources. Water-use activities need to be categorized and included in a database management system to understand current water uses and to provide information to water-resource management policy decisionmakers. The New England Water-Use Data System (NEWUDS) is a complex database developed to store water-use information that allows water to be tracked from a point of water-use activity (called a 'Site'), such as withdrawal from a resource (reservoir or aquifer), to a second Site, such as distribution to a user (business or irrigator). NEWUDS conceptual model consists of 10 core entities: system, owner, address, location, site, data source, resource, conveyance, transaction/rate, and alias, with tables available to store user-defined details. Three components--site (with both a From Site and a To Site), a conveyance that connects them, and a transaction/rate associated with the movement of water over a specific time interval form the core of the basic NEWUDS network model. The most important step in correctly translating real-world water-use activities into a storable format in NEWUDS depends on choosing the appropriate sites and linking them correctly in a network to model the flow of water from the initial From Site to the final To Site. Ten water-use networks representing real-world activities are described--three withdrawal networks, three return networks, two user networks, two complex community-system networks. Ten case studies of water use, one for each network, also are included in this manual to illustrate how to compile, store, and retrieve the appropriate data. The sequence of data entry into tables is critical because there are many foreign keys. The recommended core entity sequence is (1) system, (2) owner, (3) address, (4) location, (5) site, (6) data source, (7) resource, (8) conveyance, (9) transaction, and (10) rate; with (11) alias and (12) user-defined detail subject areas populated as needed. After each step in data entry, quality-assurance queries should be run to ensure the data are correctly entered so that it can be retrieved accurately. The point of data storage is retrieval. Several retrieval queries that focus on retrieving only relevant data to specific questions are presented in this manual as examples for the NEWUDS user.

Power to the people? An international review of the democratizing effects of direct elections to healthcare organizations.

PubMed

Stewart, Ellen A; Greer, Scott L; Wilson, Iain; Donnelly, Peter D

2016-04-01

Ensuring that publicly funded health systems are democratically accountable is an enduring challenge in policy and practice. One strategy for enhancing public officials' accountability is to elect members of the public to oversee their performance. Several countries have experimented with direct elections to healthcare organizations. The most directly comparable examples involve some Canadian regional health authorities, New Zealand district health boards, foundation trusts in England and health boards in Scotland. We propose three aspects of the process by which the democratizing effects of elections should be judged: authorization, accountability and influence. Evidence from these countries suggests that the democratization of health systems is a complex task, which cannot be completed simply by introducing elections. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Approaches to appropriate care delivery from a policy perspective: A case study of Australia, England and Switzerland.

PubMed

Robertson-Preidler, Joelle; Anstey, Matthew; Biller-Andorno, Nikola; Norrish, Alexandra

2017-07-01

Appropriateness is a conceptual way for health systems to balance Triple Aim priorities for improving population health, containing per capita cost, and improving the patient experience of care. Comparing system approaches to appropriate care delivery can help health systems establish priorities and facilitate appropriate care practices. We conceptualized system appropriateness by identifying policies that aim to achieve the Triple Aim and their consequent trade-offs for financing, clinical practice, and the individual patient. We used secondary data sources to compare the appropriate care approaches of Australia, England, and Switzerland according to financial, clinical, and individual appropriateness policies. Health system approaches to appropriate care delivery varied. England prioritizes public health, equity and efficiency at the expense of individual choice, while Switzerland focuses on individual patient preferences, but has higher per capita and out of pocket costs. Australia provides equity in public care access and private health care options that allows for more patient choice, with health care costs falling between the two. Integrating the Triple Aim into health system design and policy can facilitate appropriate care delivery at the system, clinical, and individual levels. Approaches will vary and require countries to negotiate and justify priorities and trade-offs within the context of thehealth system. Copyright © 2017 Elsevier B.V. All rights reserved.

Understanding School Leadership and Management Development in England: Retrospect and Prospect

ERIC Educational Resources Information Center

Simkins, Tim

2012-01-01

This article explores the ways in which leadership and management development (LMD) in England has been researched and analysed over the past 40 years. The article is in two parts. The first analyses the ways in which patterns of provision have evolved in response to changing conceptions of how the school system should be organized and how,…

75 FR 5779 - Notice Providing Agenda for Technical Conference on RTO/ISO Responsiveness

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

.... Southwest Power Pool, Inc Docket Nos. ER09-1050-000, ER09- 1192-000. ISO New England, Inc. and New England Docket No. ER09-1051-000. Power Pool. PJM Interconnection, LLC Docket No. ER09-1063-000. New York Independent System Operator, Docket No. ER09-1142-000. Inc. On November 13, 2009, the Commission issued a...

The Challenges Facing Further Education College Governors in England: A Time for Caution or Creativity?

ERIC Educational Resources Information Center

Hill, Ron; James, Chris; Forrest, Colin

2016-01-01

"Further education" (FE) is a substantial sector in the education system in England. It has funding of approximately £8 billion annually and educates close to three million students. Within the sector are 231 FE colleges which provide a range of courses that are typically vocational/skills-based. They vary in scale and scope with the…

75 FR 3230 - Sunshine Act Meeting Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

...-1051-000 ISO New England Inc. and New England Power Pool. E-8 RM08-7-002 Modification of Interchange... Systems Power Pool Inc. E-14 EL09-40-000 Southwest Power Pool, Inc. E-15 EL10-7-000 Power and Water... Section 23 of the Natural Gas Act. G-2 RP06-569-000, RP07-376-000 Transcontinental Gas Pipe Line...

Rebels against the System: Leadership Agency and Curriculum Innovation in the Context of School Autonomy and Accountability in England

ERIC Educational Resources Information Center

Greany, Toby; Waterhouse, Joanne

2016-01-01

Purpose: The purpose of this paper is to describe and analyse the development of school autonomy, school leadership and curriculum innovation in England over the past 40 years. It provides a baseline picture for the wider international study on school autonomy and curriculum innovation. Design/methodology/approach: An initial literature review was…

Electronic News Delivery Needs Only FCC Encouragement for Invasion of U.S.A.

ERIC Educational Resources Information Center

Edwards, Kenneth

The electronic newspaper, using a television screen and a small keying mechanism to call for specific pages of interest, currently exists in England and may soon be common in the United States. Three systems of electronic information delivery (teletext) now operate in England: CEEFAX, ORACLE, and VIEWDATA. The first two make use of two television…

Policy and Ideologies in Schooling and Early Years Education in England: Implications for and Impacts on Leadership, Management and Equality

ERIC Educational Resources Information Center

Robertson, Leena Helavaara; Hill, Dave

2014-01-01

In this article we begin by discussing "ideology" as a theoretical construct, and the interconnections between policy and ideology in the education system in England. We analyse the main principles of education policies that can be broadly defined from Left to Right, according to the following ideologies: Marxism/Socialism/Radical…

The Influence of Overseas Examples on DES Policy-Making for the School System in England, 1985-1995

ERIC Educational Resources Information Center

Smith, George; Exley, Sonia

2006-01-01

Claims are often made in British education about the extent to which policy reforms have been "borrowed" from overseas. Based on interviews with senior civil servants and HMI, this paper addresses the extent to which such claims apply to central government educational policy-making at school level in England between 1985 and 1995. This…

Labour Market Developments and Their Significance for VET in England: Current Concerns and Debates

ERIC Educational Resources Information Center

Laczik, Andrea; Mayhew, Ken

2015-01-01

This chapter discusses the relationship between the labour market and vocational education and training in England. For decades British governments have emphasised the need for more people to stay longer in the formal education system and at the same time have attempted to improve work-based training. They have also emphasised the centrality of…

Diverging or Converging Trends: An Investigation of Education Policies Concerning the Incorporation of Ethnic Minority Children in England, France and Germany

ERIC Educational Resources Information Center

Qureshi, Yasmeen F.; Janmaat, Jan Germen

2014-01-01

This article focuses specifically on the incorporation of ethnic minority children within the education systems of England, France and Germany. The trends in policy development after World War II in these countries are examined through the prism of three ideal-typical incorporation strategies--integration, assimilation and separation. This is done…

The "Shape" of Teacher Professionalism in England: Professional Standards, Performance Management, Professional Development and the Changes Proposed in the 2010 White Paper

ERIC Educational Resources Information Center

Evans, Linda

2011-01-01

Teacher professionalism in England may be considered to have been shaped by the set of professional standards, and the accompanying statutory performance management system, introduced by the Labour government in 2007. More recently the coalition government's 2010 White Paper, "The Importance of Teaching", announced reforms that will…

A Population-Based Cohort Study of Emergency Appendectomy Performed in England and New York State.

PubMed

Al-Khyatt, Waleed; Mytton, Jemma; Tan, Benjamin H L; Aquina, Christopher T; Evison, Felicity; Fleming, Fergal J; Pasquali, Sandro; Griffiths, Ewen A; Vohra, Ravinder S

2017-08-01

To compare selected outcomes (30-day reoperation and total length of hospital stay) following emergency appendectomy between populations from New York State and England. This retrospective cohort study used demographic and in-hospital outcome data from Hospital Episode Statistics (HES) and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients aged 18+ years undergoing appendectomy between April 2009 and March 2014. Univariate and adjusted multivariable logistic regression were used to test significant factors. A one-to-one propensity score matched dataset was created to compare odd ratios (OR) of reoperations between the two populations. A total of 188,418 patient records, 121,428 (64.4%) from England and 66,990 (35.6%) from NYS, were extracted. Appendectomy was completed laparoscopically in 77.7% of patients in New York State compared to 53.6% in England (P < 0.001). The median lengths of hospital stay for patients undergoing appendectomy were 3 (interquartile range, IQR 2-4) days versus 2 (IQR 1-3) days (P < 0.001) in England and New York State, respectively. All 30-day reoperation rates were higher in England compared to New York State (1.2 vs. 0.6%, P < 0.001), representing nearly a twofold higher risk of 30-day reoperation (OR 1.88, 95% CI 1.64-2.14, P < 0.001). As the proportion of appendectomy completed laparoscopically increased, there was a reduction in the reoperation rate in England (correlation coefficient -0.170, P = 0.036). Reoperations and total length of hospital stay is significantly higher following appendectomy in England compared to New York State. Increasing the numbers of appendectomy completed laparoscopically may decrease length of stay and reoperations.

A Comparison of Mortality Following Emergency Laparotomy Between Populations From New York State and England.

PubMed

Tan, Benjamin H L; Mytton, Jemma; Al-Khyatt, Waleed; Aquina, Christopher T; Evison, Felicity; Fleming, Fergal J; Griffiths, Ewen; Vohra, Ravinder S

2017-08-01

The aim of this study was to compare mortality following emergency laparotomy between populations from New York State and England. Mortality following emergency surgery is a key quality improvement metric in both the United States and UK. Comparison of the all-cause 30-day mortality following emergency laparotomy between populations from New York State and England might identify factors that could improve care. Patient demographics, in-hospital, and 30-day outcomes data were extracted from Hospital Episode Statistics (HES) in England and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients older than 18 years undergoing laparotomy for emergency open bowel surgery between April 2009 and March 2014. The primary outcome measure was all-cause mortality within 30 days of the index laparotomy. Mixed-effects logistic regression was performed to model independent demographic variables against mortality. A one-to-one propensity score matched dataset was created to compare the odd ratios of mortality between the 2 populations. Overall, 137,869 patient records, 85,286 (61.9%) from England and 52,583 (38.1%) from New York State, were extracted. Crude 30-day mortality for patients was significantly higher in the England compared with New York State [11,604 (13.6%) vs 3633 (6.9%) patients, P < 0.001]. Patients undergoing emergency laparotomy in England had significantly higher risk of mortality compared with those in New York State (odds ratio 2.35, confidence interval 2.24-2.46, P < 0.001). The risk of mortality at 30 days is higher following emergency laparotomy in England as compared with New York State despite similar patient groups.

Exploring Geochemical Markers of the Anthropocene in River Sediments: Southern New England

NASA Astrophysics Data System (ADS)

Tran, J.

2015-12-01

The sedimentary record of New England is complex. From glacial till to colonial land use to the industrial revolution, any sediment preserved is intertwined and muddled by humans. Recent studies support the idea that any anthropogenic markers in the sediment record are site specific. Southern New England is marked by a myriad of practices including farming, charcoal kilns, hatting, mill dams, and iron furnaces. While specific markers of the anthropocene have been identified, little work has been done to correlate and quantify these noted markers across multiple basins. Specifically, a combination of x-ray fluorescence (XRF), x-ray diffraction (XRD), and grain size analysis were done on sediment cores taken within Southern New England across various watersheds. We present a combination of geochemical analysis and detrital zircon geochronology in order identify and account for basin differences. This in turn results in a more comprehensive trans-basin understanding of the anthropocene in this region. We observe strong evidence that supports the idea of geochemical markers anthropocene which include an increase in Mercury and Lead content in the sediments. Additionally, in basins where mill dams are present we observe sediment records consistent with flood events and dam degradation. While still fairly novel and understudied, our results provide insight to the much often question topic of the anthropocene in relation to this particular region and the potential pitfalls of doing large scale anthropogenic dating.

From Shakespeare to Defoe: malaria in England in the Little Ice Age.

PubMed

Reiter, P

2000-01-01

Present global temperatures are in a warming phase that began 200 to 300 years ago. Some climate models suggest that human activities may have exacerbated this phase by raising the atmospheric concentration of carbon dioxide and other greenhouse gases. Discussions of the potential effects of the weather include predictions that malaria will emerge from the tropics and become established in Europe and North America. The complex ecology and transmission dynamics of the disease, as well as accounts of its early history, refute such predictions. Until the second half of the 20th century, malaria was endemic and widespread in many temperate regions, with major epidemics as far north as the Arctic Circle. From 1564 to the 1730s the coldest period of the Little Ice Age malaria was an important cause of illness and death in several parts of England. Transmission began to decline only in the 19th century, when the present warming trend was well under way. The history of the disease in England underscores the role of factors other than temperature in malaria transmission.

From Shakespeare to Defoe: malaria in England in the Little Ice Age.

PubMed Central

Reiter, P.

2000-01-01

Present global temperatures are in a warming phase that began 200 to 300 years ago. Some climate models suggest that human activities may have exacerbated this phase by raising the atmospheric concentration of carbon dioxide and other greenhouse gases. Discussions of the potential effects of the weather include predictions that malaria will emerge from the tropics and become established in Europe and North America. The complex ecology and transmission dynamics of the disease, as well as accounts of its early history, refute such predictions. Until the second half of the 20th century, malaria was endemic and widespread in many temperate regions, with major epidemics as far north as the Arctic Circle. From 1564 to the 1730s the coldest period of the Little Ice Age malaria was an important cause of illness and death in several parts of England. Transmission began to decline only in the 19th century, when the present warming trend was well under way. The history of the disease in England underscores the role of factors other than temperature in malaria transmission. PMID:10653562

Spatial distribution of clinical computer systems in primary care in England in 2016 and implications for primary care electronic medical record databases: a cross-sectional population study.

PubMed

Kontopantelis, Evangelos; Stevens, Richard John; Helms, Peter J; Edwards, Duncan; Doran, Tim; Ashcroft, Darren M

2018-02-28

UK primary care databases (PCDs) are used by researchers worldwide to inform clinical practice. These databases have been primarily tied to single clinical computer systems, but little is known about the adoption of these systems by primary care practices or their geographical representativeness. We explore the spatial distribution of clinical computing systems and discuss the implications for the longevity and regional representativeness of these resources. Cross-sectional study. English primary care clinical computer systems. 7526 general practices in August 2016. Spatial mapping of family practices in England in 2016 by clinical computer system at two geographical levels, the lower Clinical Commissioning Group (CCG, 209 units) and the higher National Health Service regions (14 units). Data for practices included numbers of doctors, nurses and patients, and area deprivation. Of 7526 practices, Egton Medical Information Systems (EMIS) was used in 4199 (56%), SystmOne in 2552 (34%) and Vision in 636 (9%). Great regional variability was observed for all systems, with EMIS having a stronger presence in the West of England, London and the South; SystmOne in the East and some regions in the South; and Vision in London, the South, Greater Manchester and Birmingham. PCDs based on single clinical computer systems are geographically clustered in England. For example, Clinical Practice Research Datalink and The Health Improvement Network, the most popular primary care databases in terms of research outputs, are based on the Vision clinical computer system, used by <10% of practices and heavily concentrated in three major conurbations and the South. Researchers need to be aware of the analytical challenges posed by clustering, and barriers to accessing alternative PCDs need to be removed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Systemic Amyloidosis in England: an epidemiological study

PubMed Central

Pinney, Jennifer H; Smith, Colette J; Taube, Jessi B; Lachmann, Helen J; Venner, Christopher P; Gibbs, Simon D J; Dungu, Jason; Banypersad, Sanjay M; Wechalekar, Ashutosh D; Whelan, Carol J; Hawkins, Philip N; Gillmore, Julian D

2013-01-01

Epidemiological studies of systemic amyloidosis are scarce and the burden of disease in England has not previously been estimated. In 1999, the National Health Service commissioned the National Amyloidosis Centre (NAC) to provide a national clinical service for all patients with amyloidosis. Data for all individuals referred to the NAC is held on a comprehensive central database, and these were compared with English death certificate data for amyloidosis from 2000 to 2008, obtained from the Office of National Statistics. Amyloidosis was stated on death certificates of 2543 individuals, representing 0·58/1000 recorded deaths. During the same period, 1143 amyloidosis patients followed at the NAC died, 903 (79%) of whom had amyloidosis recorded on their death certificates. The estimated minimum incidence of systemic amyloidosis in the English population in 2008, based on new referrals to the NAC, was 0·4/100 000 population. The incidence peaked at age 60–79 years. Systemic AL amyloidosis was the most common type with an estimated minimum incidence of 0·3/100 000 population. Although there are various limitations to this study, the available data suggest the incidence of systemic amyloidosis in England exceeds 0·8/100 000 of the population. PMID:23480608

Can the Accountable Care Organization model facilitate integrated care in England?

PubMed

Ahmed, Faheem; Mays, Nicholas; Ahmed, Naeem; Bisognano, Maureen; Gottlieb, Gary

2015-10-01

Following the global economic recession, health care systems have experienced intense political pressure to contain costs without compromising quality. One response is to focus on improving the continuity and coordination of care, which is seen as beneficial for both patients and providers. However, cultural and structural barriers have proved difficult to overcome in the quest to provide integrated care for entire populations. By holding groups of providers responsible for the health outcomes of a designated population, in the United States, Accountable Care Organizations are regarded as having the potential to foster collaboration across the continuum of care. They could have a similar role in England's National Health Service. However, it is important to consider the difference in context before implementing a similar model, adapted to suit the system's strengths. Working together, general practice federations and the Academic Health Science Networks could form the basis of accountable care in England. © The Author(s) 2015.

Geographic Information Systems for Assessing Existing and Potential Bio-energy Resources: Their Use in Determining Land Use and Management Options which Minimize Ecological and Landscape Impacts in Rural Areas

NASA Technical Reports Server (NTRS)

Jackman, A. E.; Fabos, J. G.; Carlozzi, C. C.

1982-01-01

A management construct is described which forms part of an overall landscape ecological planning model which has as a principal objective the extension of the traditional descriptive land use mapping capabilities of geographic information systems into land management realms. It is noted that geographic information systems appear to be moving to more comprehensive methods of data handling and storage, such as relational and hierarchical data management systems, and a clear need has simultaneously arisen therefore for planning assessment techniques and methodologies which can actually use such complex levels of data in a systematic, yet flexible and scenario dependent way. The descriptive of mapping method proposed broaches such issues and utilizes a current New England bioenergy scenario, stimulated by the use of hardwoods for household heating purposes established in the post oil crisis era and the increased awareness of the possible landscape and ecological ramifications of the continued increasing use of the resource.

Using real-time syndromic surveillance systems to help explore the acute impact of the air pollution incident of March/April 2014 in England.

PubMed

Smith, Gillian E; Bawa, Zharain; Macklin, Yolande; Morbey, Roger; Dobney, Alec; Vardoulakis, Sotiris; Elliot, Alex J

2015-01-01

During March and early April 2014 there was widespread poor air quality across the United Kingdom. Public Health England used existing syndromic surveillance systems to monitor community health during the period. Short lived statistically significant rises in a variety of respiratory conditions, including asthma and wheeze, were detected. This incident has demonstrated the value of real-time syndromic surveillance systems, during an air pollution episode, for helping to explore the impact of poor air quality on community health in real-time. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

What Einstein Can Teach Us about Education

ERIC Educational Resources Information Center

Hayes, Denis

2007-01-01

People are more likely to associate Einstein with complex scientific theories and mathematical calculations than with education theory. In fact, Einstein's own experiences of schooling and his reflections on the meaning of life and the significance of education are profound and oddly relevant to the situation that pertains in England today. It is…

Facilitating Primary Head Teacher Succession in England: The Role of the School Business Manager

ERIC Educational Resources Information Center

Woods, Charlotte; Armstrong, Paul; Pearson, Diana

2012-01-01

School leadership is significant for student learning, but increased workload and complexity are believed to be in part responsible for the difficulties internationally in managing succession, with experienced leaders leaving the profession prematurely and potential future leaders reluctant to take on the role. This article draws on a national…

The Open College of the North West, Distance Learning, and the "Open Tech" Programme.

ERIC Educational Resources Information Center

Percy, Keith; Saunders, Murray

1982-01-01

A regional program of pre-university courses in northwestern England open to adults with no entry qualifications is discussed. It uses some distance learning techniques but is investigating expansion to technical education through distance learning. The complexities and potential costs of such a substantial directional change are examined. (MSE)

Mission Impossible? Leadership Responsibility without Authority for Initiatives To Reorganise Schools.

ERIC Educational Resources Information Center

Wallace, Mike

This paper explores how characteristics of complex educational change may virtually dictate the leadership strategies adopted by those charged with bringing about change. The change in question here is the large-scale reorganization of local education authorities (LEAs) across England. The article focuses on how across-the-board initiatives to…

Prison Education in England and Wales. (2nd Revised Edition). Mendip Papers MP 022.

ERIC Educational Resources Information Center

Ripley, Paul

In response to prison disturbances in England and Wales in the late 1980s, the education program for prisoners was improved and more prisoners were given access to educational services. Although education is a relatively new phenomenon in the English and Welsh penal system, by the 20th century, education had become an integral part of prison life.…

Farewell to the Tick Box Inspector? Ofsted and the Changing Regime of School Inspection in England

ERIC Educational Resources Information Center

Baxter, Jacqueline; Clarke, John

2013-01-01

Since its inception in 1992 Ofsted (The Office for Standards in Education, Children's Services and Skills) has inspected schools under Section 9 of the Education (Schools) Act 1992; Section 10 of the School Inspections Act 1996; and Section 5 of the Education Act 2005. Pressure on England to improve its system of education has not only emerged…

The Utilization of PBTE by the Rhode Island Teacher Center and the New England Program in Teacher Education.

ERIC Educational Resources Information Center

Pitman, John C.

The primary purposes of this paper are (a) to describe how the Performance Based Teacher Education (PBTE) Component of the New England Program in Teacher Education (NEPTE) and Rhode Island Teacher Center (RITC) are currently operating, and (b) to project how the NEPTE and RITC delivery systems might be further utilized to diffuse PBTE. Both NEPTE…

Using a Catholic Model: The Consequences of the Changing Strategic Purpose of Anglican Faith Schools and the Contrasting Interpretations within Liberalism

ERIC Educational Resources Information Center

Johnson, Helen

2003-01-01

Until comparatively recently, the survival and success of Church of England and Roman Catholic schools within the English dual system was not given much attention by liberal commentators. However, the general popularity of faith schools among parents and their particular role within current government policy has encouraged the Church of England to…

Comparison of hypertension healthcare outcomes among older people in the USA and England

PubMed Central

Marshall, Alan; Nazroo, James; Feeney, Kevin; Lee, Jinkook; Vanhoutte, Bram; Pendleton, Neil

2016-01-01

Background The USA and England have very different health systems. Comparing hypertension care outcomes in each country enables an evaluation of the effectiveness of each system. Method The English Longitudinal Study of Ageing and the Health and Retirement Survey are used to compare the prevalence of controlled, uncontrolled and undiagnosed hypertension within the hypertensive population (diagnosed or measured within the survey data used) aged 50 years and above in the USA and in England. Results Controlled hypertension is more prevalent within the hypertensive population in the USA (age 50–64: 0.53 (0.50 to 0.57) and age 65+: 0.51 (0.49 to 0.53)) than in England (age 50–64: 0.45 (0.42 to 0.48) and age 65+: 0.42 (0.40 to 0.45)). This difference is driven by lower undiagnosed hypertension in the USA (age 50–64: 0.18 (0.15–0.21) and age 65+: 0.13 (0.12 to 0.14)) relative to England (age 50–64: 0.26 (0.24 to 0.29) and age 65+: 0.22 (0.20 to 0.24)). The prevalence of uncontrolled hypertension within the hypertensive population is very similar in the USA (age 50–64: 0.29 (0.26 to 0.32) and age 65+: 0.36 (0.34 to 0.38)) and England (age 50–64: 0.29 (0.26 to 0.32) and age 65+: 0.36 (0.34 to 0.39)). Hypertension care outcomes are comparable across US insurance categories. In both countries, undiagnosed hypertension is positively correlated with wealth (ages 50–64). Uncontrolled hypertension declines with rising wealth in the USA. Conclusions Different diagnostic practices are likely to drive the cross-country differences in undiagnosed hypertension. US government health systems perform at least as well as private healthcare and are more equitable in the distribution of care outcomes. Higher undiagnosed hypertension among the affluent may reflect less frequent medical contact. PMID:26598759

Comparison of hypertension healthcare outcomes among older people in the USA and England.

PubMed

Marshall, Alan; Nazroo, James; Feeney, Kevin; Lee, Jinkook; Vanhoutte, Bram; Pendleton, Neil

2016-03-01

The USA and England have very different health systems. Comparing hypertension care outcomes in each country enables an evaluation of the effectiveness of each system. The English Longitudinal Study of Ageing and the Health and Retirement Survey are used to compare the prevalence of controlled, uncontrolled and undiagnosed hypertension within the hypertensive population (diagnosed or measured within the survey data used) aged 50 years and above in the USA and in England. Controlled hypertension is more prevalent within the hypertensive population in the USA (age 50-64: 0.53 (0.50 to 0.57) and age 65+: 0.51 (0.49 to 0.53)) than in England (age 50-64: 0.45 (0.42 to 0.48) and age 65+: 0.42 (0.40 to 0.45)). This difference is driven by lower undiagnosed hypertension in the USA (age 50-64: 0.18 (0.15-0.21) and age 65+: 0.13 (0.12 to 0.14)) relative to England (age 50-64: 0.26 (0.24 to 0.29) and age 65+: 0.22 (0.20 to 0.24)). The prevalence of uncontrolled hypertension within the hypertensive population is very similar in the USA (age 50-64: 0.29 (0.26 to 0.32) and age 65+: 0.36 (0.34 to 0.38)) and England (age 50-64: 0.29 (0.26 to 0.32) and age 65+: 0.36 (0.34 to 0.39)). Hypertension care outcomes are comparable across US insurance categories. In both countries, undiagnosed hypertension is positively correlated with wealth (ages 50-64). Uncontrolled hypertension declines with rising wealth in the USA. Different diagnostic practices are likely to drive the cross-country differences in undiagnosed hypertension. US government health systems perform at least as well as private healthcare and are more equitable in the distribution of care outcomes. Higher undiagnosed hypertension among the affluent may reflect less frequent medical contact. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Regional variation in hospitalisation and mortality in heart failure: comparison of England and Lombardy using multistate modelling.

PubMed

Bottle, Alex; Ventura, Chiara Maria; Dharmarajan, Kumar; Aylin, Paul; Ieva, Francesca; Paganoni, Anna Maria

2018-06-01

Heart failure (HF) is a common, serious chronic condition with high morbidity, hospitalisation and mortality. The healthcare systems of England and the northern Italian region of Lombardy share important similarities and have comprehensive hospital administrative databases linked to the death register. We used them to compare admission for HF and mortality for patients between 2006 and 2012 (n = 37,185 for Lombardy, 234,719 for England) with multistate models. Despite close similarities in age, sex and common comorbidities of the two sets of patients, in Lombardy, HF admissions were longer and more frequent per patient than in England, but short- and medium-term mortality was much lower. English patients had more very short stays, but their very elderly also had longer stays than their Lombardy counterparts. Using a three-state model, the predicted total time spent in hospital showed large differences between the countries: women in England spent an average of 24 days if aged 65 at first admission and 19 days if aged 85; in Lombardy these figures were 68 and 27 days respectively. Eight-state models suggested disease progression that appeared similar in each country. Differences by region within England were modest, with London patients spending more time in hospital and having lower mortality than the rest of England. Whilst clinical practice differences plausibly explain these patterns, we cannot confidently disentangle the impact of alternatives such as coding, casemix, and the availability and use of non-hospital settings. We need to better understand the links between rehospitalisation frequency and mortality.

Examination of England's New Medicine Service (NMS) of complex health care interventions in community pharmacy.

PubMed

Latif, Asam; Waring, Justin; Watmough, Deborah; Barber, Nick; Chuter, Anthony; Davies, James; Salema, Nde-Eshimuni; Boyd, Matthew J; Elliott, Rachel A

Community pharmacies are increasingly commissioned to deliver new, complex health interventions in response to the growing demands on family doctors and secondary health care services. Little is known about how these complex interventions are being accommodated and translated into the community pharmacy setting and whether their aims and objectives are realized in practice. The New Medicine Service (NMS) is a complex medicine management intervention that aims to support patients' adherence to newly prescribed medicines for a long-term condition. This study explores the recent implementation of the NMS in community pharmacies across England. It also seeks to understand how the service is becoming manifest in practice and what lessons can be learned for future service implementation. Structured, organizational ethnographic observations and in situ workplace interviews with pharmacists and support staff were undertaken within 23 English community pharmacies. Additionally, one-to-one, semi-structured interviews were carried out with 47 community pharmacists and 11 general practitioners (GPs). Observational and interview data were transcribed and analyzed thematically and guided by Damschroder's consolidated framework for implementation research. The NMS workload had been implemented and absorbed into pharmacists' daily routines alongside existing responsibilities with no extra resources and little evidence of reduction in other responsibilities. Pharmacists were pragmatic, simplifying, and adapting the NMS to facilitate its delivery and using discretion to circumvent perceived non-essential paperwork. Pharmacist understanding of the NMS was found to impact on what they believed should be achieved from the service. Despite pharmacists holding positive views about the value of the NMS, not all were convinced of its perceived benefits and necessity, with reports that many consultations did not identify any problems with the patients' medicines. GPs were generally supportive of the initiative but were unaware of the service or potential benefits. Poorly developed existing pharmacist-GP relationships impeded implementation. This study identifies the multifaceted and complex processes involved in implementing a new community pharmacy service in England. Community pharmacy workflow, infrastructure, and public and professional relationships all affect NMS implementation. Greater prior engagement with the pharmacy workforce and GPs, robust piloting and a phased rollout together with ongoing support and updates, are potentials strategies to ensure future implementation of pharmacy services meet their intended aims in practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Quantifying the need for enhanced case management for TB patients as part of TB cohort audit in the North West of England: a descriptive study.

PubMed

Tucker, Angela; Mithoo, Jeniffer; Cleary, Paul; Woodhead, Mark; MacPherson, Peter; Wingfield, Tom; Davies, Stefanie; Wake, Carolyn; McMaster, Paddy; Bertel Squire, S

2017-11-15

Patients with TB have diverse and often challenging clinical and social needs that may hamper successful treatment outcomes. Understanding the need for additional support during treatment (enhanced case management, or ECM) is important for workforce capacity planning. North West England TB Cohort Audit (TBCA) has introduced a 4-level ECM classification system (ECM 0-3) to quantify the need for ECM in the region. This study describes the data from the first 2 years of ECM classification. Data collected between April 2013 and July 2015 were used to analyse the proportions of patients allocated to each ECM level and the prevalence of social and clinical factors indicating need for ECM. Single variable and multivariable logistic regression models were constructed to examine the association between ECM level and treatment outcome. Of 1714 notified cases 99.8% were assigned an ECM level: 31% ECM1, 19% ECM2 and 14% ECM3. The most common factors indicating need for ECM were language barriers (20.3%) and clinical complexity (16.9%). 1342/1493 (89.9%) of drug-sensitive, non-CNS cases completed treatment within 12 months. Patients in ECM2 and 3 were less likely to complete treatment at 12 months than patients in ECM0 (adjusted OR 0.47 [95% CI 0.27-0.84] and 0.23 [0.13-0.41] respectively). Use of TBCA to quantify different levels of need for ECM is feasible and has demonstrated that social and clinical complexity is common in the region. Results will inform regional workforce planning and assist development of innovative methods to improve treatment outcomes in these vulnerable groups.

Selected water-resources activities of the U.S. Geological Survey in New England in 2017

USGS Publications Warehouse

Weiskel, Peter K.

2017-06-22

The New England Water Science Center of the U.S. Geological Survey (USGS) is headquartered in Pembroke, New Hampshire, with offices in East Hartford, Connecticut; Augusta, Maine; Northborough, Massachusetts; and Montpelier, Vermont. The areas of expertise covered by the water science center’s staff of 130 include aquatic biology, chemistry, geographic information systems, geology, hydrologic sciences and engineering, and water use.

Building a Social Movement for Education in England: Responses to Richard Hatcher

ERIC Educational Resources Information Center

Harris, Richard; Little, Gawain

2016-01-01

In "FORUM" 57(3), 2015, Richard Hatcher outlined how it was necessary to build a social movement against government education policy and in support of an alternative reform agenda. We, the editors, believe this is an important, and complex, debate. As a contribution to developing further discussion around Richard's ideas we present two…

Best density and structure for uneven-aged northern hardwood management in New England

Treesearch

William B. Leak

2003-01-01

Choice of the best residual density (basal area per acre) and structure (diameter distribution) for uneven-aged management of northern hardwoods is a complex decision that depends on the manager's decision rules, product objectives, site conditions, and - perhaps most important - current stand conditions. In contrast to other recommendations on residual density...

Asserting "Needs" and Claiming "Rights": The Cultural Politics of Community Language Education in England.

ERIC Educational Resources Information Center

Hall, Kathleen

2002-01-01

Discusses the paradox involved in constructing a language policy: language is invoked as a reified object associated with essentialist constructs of identity to stand for much more complex and changing patterns of language use. Considers this paradox from the perspective of a campaign led by Sikh parents to have Punjabi introduced into curriculum…

The Aquarium: A Marine Education Infusion Unit. Northern New England Marine Education Project.

ERIC Educational Resources Information Center

Maine Univ., Orono. Coll. of Education.

This interdisciplinary unit is intended for use in second grade classes; however, it can be used K-8 with modifications. The unit seeks to demonstrate that aquatic organisms interact in complex ecosystems and that these organisms react to their environment in different ways. Specific directions are given for setting up an aquarium and populating…

One stop or full stop? The continuing challenges for researchers despite the new streamlined NHS research governance process.

PubMed

Thompson, Andrew G H; France, Emma F

2010-05-13

Obtaining the necessary approvals and permission for clinical research requires successful negotiation of the ethical and R&D layers of the NHS. Differences in structure and governance frameworks feature between the constituent nations of the UK (England, Scotland, Wales and Northern Ireland), which adds complexity to cross-national studies. Difficulties in carrying out research in the NHS in the UK due to bureaucratic and time-consuming governance processes have led to the development of a new system of application and co-ordination from 2009. This paper illustrates how this new system fails to be consistent and streamlined and is unlikely to become so unless changes are made to the implementation and management of the governance processes. We present a case study of the research governance process at the survey stage of an investigation into the use, preferences and need for information by people making choices or decisions about health care. The method involved home-based, face-to-face interviewing in a questionnaire survey in relation to decisions about lymphoma treatment, Down's syndrome screening in pregnancy, and caring for people with dementia. Our experience of the ethics stage was very positive, noting an efficient process of application and a speedy decision, both in relation to the initial application and to subsequent substantial amendments. By contrast, the R&D stages were very slow, most with unexplained delays, but some offering contradictory advice and exhibiting a lack of clear guidance and training for NHS staff. The R&D arrangements in Scotland were far quicker and more likely to be successful than in England. Overall, the delays were so severe that substantial parts of the research could not be delivered as planned within the funding timescale. If high-quality research in the NHS, particularly in England, is to be delivered in a timely and cost-effective way, R&D processes for gaining research governance approval need improvement. Attention is needed in process implementation and management, particularly in relation to staff training, as well as clarity in guidance and communication within and between organisations.

Prioritising public health: a qualitative study of decision making to reduce health inequalities.

PubMed

Orton, Lois C; Lloyd-Williams, Ffion; Taylor-Robinson, David C; Moonan, May; O'Flaherty, Martin; Capewell, Simon

2011-10-20

The public health system in England is currently facing dramatic change. Renewed attention has recently been paid to the best approaches for tackling the health inequalities which remain entrenched within British society and across the globe. In order to consider the opportunities and challenges facing the new public health system in England, we explored the current experiences of those involved in decision making to reduce health inequalities, taking cardiovascular disease (CVD) as a case study. We conducted an in-depth qualitative study employing 40 semi-structured interviews and three focus group discussions. Participants were public health policy makers and planners in CVD in the UK, including: Primary Care Trust and Local Authority staff (in various roles); General Practice commissioners; public health academics; consultant cardiologists; national guideline managers; members of guideline development groups, civil servants; and CVD third sector staff. The short term target- and outcome-led culture of the NHS and the drive to achieve "more for less", combined with the need to address public demand for acute services often lead to investment in "downstream" public health intervention, rather than the "upstream" approaches that are most effective at reducing inequalities. Despite most public health decision makers wishing to redress this imbalance, they felt constrained due to difficulties in partnership working and the over-riding influence of other stakeholders in decision making processes. The proposed public health reforms in England present an opportunity for public health to move away from the medical paradigm of the NHS. However, they also reveal a reluctance of central government to contribute to shifting social norms. It is vital that the effectiveness and cost effectiveness of all new and existing policies and services affecting public health are measured in terms of their impact on the social determinants of health and health inequalities. Researchers have a vital role to play in providing the complex evidence required to compare different models of prevention and service delivery. Those working in public health must develop leadership to raise the profile of health inequalities as an issue that merits attention, resources and workforce capacity; and advocate for central government to play a key role in shifting social norms.

One stop or full stop? The continuing challenges for researchers despite the new streamlined NHS research governance process

PubMed Central

2010-01-01

Background Obtaining the necessary approvals and permission for clinical research requires successful negotiation of the ethical and R&D layers of the NHS. Differences in structure and governance frameworks feature between the constituent nations of the UK (England, Scotland, Wales and Northern Ireland), which adds complexity to cross-national studies. Difficulties in carrying out research in the NHS in the UK due to bureaucratic and time-consuming governance processes have led to the development of a new system of application and co-ordination from 2009. This paper illustrates how this new system fails to be consistent and streamlined and is unlikely to become so unless changes are made to the implementation and management of the governance processes. Methods We present a case study of the research governance process at the survey stage of an investigation into the use, preferences and need for information by people making choices or decisions about health care. The method involved home-based, face-to-face interviewing in a questionnaire survey in relation to decisions about lymphoma treatment, Down's syndrome screening in pregnancy, and caring for people with dementia. Results Our experience of the ethics stage was very positive, noting an efficient process of application and a speedy decision, both in relation to the initial application and to subsequent substantial amendments. By contrast, the R&D stages were very slow, most with unexplained delays, but some offering contradictory advice and exhibiting a lack of clear guidance and training for NHS staff. The R&D arrangements in Scotland were far quicker and more likely to be successful than in England. Overall, the delays were so severe that substantial parts of the research could not be delivered as planned within the funding timescale. Conclusions If high-quality research in the NHS, particularly in England, is to be delivered in a timely and cost-effective way, R&D processes for gaining research governance approval need improvement. Attention is needed in process implementation and management, particularly in relation to staff training, as well as clarity in guidance and communication within and between organisations. PMID:20465819

Mortality from ruptured abdominal aortic aneurysms: clinical lessons from a comparison of outcomes in England and the USA.

PubMed

Karthikesalingam, Alan; Holt, Peter J; Vidal-Diez, Alberto; Ozdemir, Baris A; Poloniecki, Jan D; Hinchliffe, Robert J; Thompson, Matthew M

2014-03-15

The outcome of patients with ruptured abdominal aortic aneurysm (rAAA) varies by country. Study of practice differences might allow the formulation of pathways to improve care. We compared data from the Hospital Episode Statistics for England and the Nationwide Inpatient Sample for the USA for patients admitted to hospital with rAAA from 2005 to 2010. Primary outcomes were in-hospital mortality, mortality after intervention, and decision to follow non-corrective treatment. In-hospital mortality and the rate of non-corrective treatment were analysed by binary logistic regression for each health-care system, after adjustment for age, sex, year, and Charlson comorbidity index. The study included 11,799 patients with rAAA in England and 23,838 patients with rAAA in the USA. In-hospital mortality was lower in the USA than in England (53·05% [95% CI 51·26-54·85] vs 65·90%; p<0·0001). Intervention (open or endovascular repair) was offered to a greater proportion of cases in the USA than in England (19,174 [80·43%] vs 6897 [58·45%]; p<0·0001) and endovascular repair was more common in the USA than in England (4003 [20·88%] vs 589 [8·54%]; p<0·0001). Postintervention mortality was similar in both countries (41·77% for England and 41·65% for USA). These observations persisted in age-matched and sex-matched comparisons. In both countries, reduced mortality was associated with increased use of endovascular repair, increased hospital caseload (volume) for rAAA, high hospital bed capacity, hospitals with teaching status, and admission on a weekday. In-hospital survival from rAAA, intervention rates, and uptake of endovascular repair are lower in England than in the USA. In England and the USA, the lowest mortality for rAAA was seen in teaching hospitals with larger bed capacities and doing a greater proportion of cases with endovascular repair. These common factors suggest strategies for improving outcomes for patients with rAAA. None. Copyright © 2014 Elsevier Ltd. All rights reserved.

Small Drinking Water System Initiative | Drinking Water in New ...

EPA Pesticide Factsheets

2017-07-06

Reliable, safe, high quality drinking water is essential to sustaining our communities. Approximately 90% of New England's drinking water systems - about 10,000 systems - are small and most use ground water sources.

75 FR 16096 - New England Power Generators Association Inc., Complainant v. ISO New England Inc., Respondent...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-31

...-787-000] New England Power Generators Association Inc., Complainant v. ISO New England Inc., Respondent; ISO New England Inc. and New England Power Pool; Notice of Complaint March 24, 2010. Take notice... Inc. (Complainant) filed a formal complaint against ISO New England Inc. (Respondent) alleging that...

Uncertainty-based Estimation of the Secure Range for ISO New England Dynamic Interchange Adjustment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Etingov, Pavel V.; Makarov, Yuri V.; Wu, Di

2014-04-14

The paper proposes an approach to estimate the secure range for dynamic interchange adjustment, which assists system operators in scheduling the interchange with neighboring control areas. Uncertainties associated with various sources are incorporated. The proposed method is implemented in the dynamic interchange adjustment (DINA) tool developed by Pacific Northwest National Laboratory (PNNL) for ISO New England. Simulation results are used to validate the effectiveness of the proposed method.

Prospective pilots of routine data capture by paediatricians in clinics and validation of the Disabilities Complexity Scale.

PubMed

Horridge, Karen A; Mcgarry, Kenneth; Williams, Jane; Whitlingum, Gabriel

2016-06-01

To pilot prospective data collection by paediatricians at the point of care across England using a defined terminology set; demonstrate feasibility of data collection and utility of data outputs; and confirm that counting the number of needs per child is valid for quantifying complexity. Paediatricians in 16 hospital and community settings collected and anonymized data. Participants completed a survey regarding the process. Data were analysed using R version 3.1.2. Overall, 8117 needs captured from 1224 consultations were recorded. Sixteen clinicians responded positively about the process and utility of data collection. The sum of needs varied significantly (p<0.01) by level of gross motor function ascertained using the Gross Motor Function Classification System for children with cerebral palsy; epilepsy severity as defined by level of expertise required to manage it; and by severity of intellectual disability. Prospective data collection at the point of clinical care proved possible without disrupting clinics, even for those with the most complex needs, and took the least time when done electronically. Counting the number of needs was easy to do, and quantified complexity in a way that informed clinical care for individuals and related directly to validated scales of functioning. Data outputs could inform more appropriate design and commissioning of quality services. © 2016 Mac Keith Press.

Challenges Facing Healthwatch, a New Consumer Champion in England.

PubMed

Carter, Pam; Martin, Graham

2016-01-21

This article engages with debates about the conceptualisation and practical challenges of patient and public involvement (PPI) in health and social care services. Policy in this area in England has shifted numerous times but increasingly a consumerist discourse seems to override more democratic ideas concerning the relationship between citizens and public services. Recent policy change in England has seen the creation of new consumer champion bodies in the form of local Healthwatch. The article describes these new organisational structures for PPI and shows how those who seek to influence planning and delivery of services or comment or complain about aspects of their care face considerable complexity. This is due, in part, to the ambiguous remit set out for newly instigated Healthwatch organisations by government. Drawing on governance theory, we show that it can also be understood as a function of an increasingly polycentric governance arena. Challenges that flow from this include problems of specifying jurisdictional responsibility, accountability, and legitimacy. We review Healthwatch progress to date, then we set out four challenges facing local Healthwatch organisations before discussing the implications of these for patients and the public. The first challenge relates to non-coterminous boundaries and jurisdictional integrity. Secondly, establishing the unique features of Healthwatch is problematic in the crowded PPI arena. The third challenge arises from limited resources as well as the fact that resources flow to Healthwatch from the local authorities that Healthwatch are expected to hold to account. The fourth challenge we identify is how local Healthwatch organisations negotiate the complexity of being a partner to statutory and other organisations, while at the same time being expected to champion local people's views. © 2016 by Kerman University of Medical Sciences.

Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

PubMed

Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

2018-04-01

Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

Qualitative interviews with healthcare staff in four European countries to inform adaptation of an intervention to increase chlamydia testing

PubMed Central

McNulty, Cliodna; Ricketts, Ellie J; Fredlund, Hans; Uusküla, Anneli; Town, Katy; Rugman, Claire; Tisler-Sala, Anna; Mani, Alix; Dunais, Brigitte; Folkard, Kate; Allison, Rosalie; Touboul, Pia

2017-01-01

Objective To determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England. Design Qualitative interviews. Setting European primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013. Participants 45 GP staff, 13 trainers and 18 stakeholders. Interviews The iterative interview schedule explored participants’ personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis. Results Findings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country’s health services. Conclusions A common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu. PMID:28951413

Annuity choices and income drawdown: evidence from the decumulation phase of defined contribution pensions in England.

PubMed

Banks, James; Crawford, Rowena; Tetlow, Gemma

2015-10-01

We provide new empirical evidence on the importance of defined contribution pension wealth in England, and the nature of annuitization decisions taken by older adults who retire with such sources of wealth. Other things equal, financial literacy, and numeracy in particular, are important factors governing individuals' choices over whether to shop around for an annuity as opposed to taking the 'path of least resistance' option and purchasing from their original pension fund provider. This has important policy and welfare implications given that buying an annuity on the open market has significant financial benefits for most people. In the context of the increasing reliance on private provision for retirement, the importance of individuals having the financial literacy to successfully navigate complex financial decisions late in life should not be underestimated.

Academisation, School Collaboration and the Primary School Sector in England: A Story of Six School Leaders

ERIC Educational Resources Information Center

Keddie, Amanda

2016-01-01

This paper presents data from a study of five English primary schools. It examines some of the challenges associated with school autonomy and collaboration for state primary schools amid the uncertainty and complexity of governance in the present English education context. The paper features the voices of six leaders gathered from interviews that…

The Micro-Politics of Micro-Leadership: Exploring the Role of Programme Leader in English Universities

ERIC Educational Resources Information Center

Murphy, Mark; Curtis, Will

2013-01-01

This study is based on interviews with 25 programme leaders at two universities in England. Programme leadership is ubiquitous and essential to effective university operations, yet there is surprisingly little research on the role. It is an ambiguous and complex form of leadership, existing as it does in the space between standard academic and…

Comparison as Curriculum Governance: Dynamics of the European-Wide Governance Technology of Comparison within England's National Curriculum Reforms

ERIC Educational Resources Information Center

Papanastasiou, Natalie

2012-01-01

The curriculum is a governance technology of knowledge production and is also itself governed by complex dynamics within European education policy space. This article focuses on how the curriculum is governed by comparative knowledge; in particular, it identifies how this facet of governance has manifested itself within the policy space of…

Beginning Primary School Principals in Belgium: How They Deal with External Influences and Develop Professionally.

ERIC Educational Resources Information Center

Vandenberghe, Roland

To understand the realities and complexities faced by beginning primary school principals, a group of researchers from Belgium, Canada, England, the Netherlands, and the United States launched a collaborative study in 2000. This report describes the Belgium arm of the study. The study set out to answer the following: What are similarities and…

A Flexible Approach to Quantifying Various Dimensions of Environmental Complexity

DTIC Science & Technology

2004-08-01

dissertation, Cambridge University, Cambridge, England, 1989. [15] C. J. C. H. Watkins and P. Dayan, “Q-learning,” Machine Learning , vol. 8, pp. 279–292, 1992...16] I. Szita, B. Takács, and A. Lörincz, “²-MDPs: Learning in varying environments,” Journal of Machine Learning Research, vol. 3, pp. 145–174, 2002

Equity Issues in Performance Assessment. Undermining Gender Stereotypes: Examination Performance in the UK at 16.

ERIC Educational Resources Information Center

Elwood, Jannette

Since its introduction in 1988 the General Certificate of Secondary Education (GCSE), the main public examination for pupils at age 16 in England, Wales, and Northern Ireland, has become an obvious area in which to investigate gender-related differences in performance. As a complex attainment test, the GCSE is largely made up of a coursework…

Bullying, "Cussing" and "Mucking About": Complexities in Tackling Homophobia in Three Secondary Schools in South London, UK

ERIC Educational Resources Information Center

Warwick, Ian; Aggleton, Peter

2014-01-01

In countries such as the UK, schools have a responsibility to prevent all forms of bullying, including those related to sexual orientation. However, relatively little is known about how schools go about this work successfully. This study aimed to identify how three secondary schools in south London, England, were addressing homophobia. Three…

"Emboldened Bodies": Social Class, School Health Policy and Obesity Discourse

ERIC Educational Resources Information Center

De Pian, Laura

2012-01-01

This paper examines the multiple ways in which health policy relating to obesity, diet and exercise is recontextualised and mediated by teachers and pupils in the context of social class in the UK. Drawing on a case study of a middle-class primary school in central England, the paper documents the complexity of the policy process, its uncertainty,…

The Repercussions of Reporting Bullying: Some Experiences of Students at an Independent Secondary School

ERIC Educational Resources Information Center

O'Brien, Niamh; Munn-Giddings, Carol; Moules, Tina

2018-01-01

This article reports on the complex web experienced by young people when making decisions to report bullying in school. The study was conducted in the secondary school of an independent day and boarding school in the east of England. A Participatory Action Research approach was used with student voice and perspective at its core. This study…

Whale Multi-Disciplinary Studies: A Marine Education Infusion Unit. Northern New England Marine Education Project.

ERIC Educational Resources Information Center

Maine Univ., Orono. Coll. of Education.

This multidisciplinary unit deals with whales, whaling lore and history, and the interaction of the whale with the complex marine ecosystem. It seeks to teach adaptation of marine organisms. It portrays the concept that man is part of the marine ecosystem and man's activities can deplete and degrade marine ecosystems, endangering the survival of…

Language Brokering as Young People's Work: Evidence from Chinese Adolescents in England

ERIC Educational Resources Information Center

Hall, Nigel; Sham, Sylvia

2007-01-01

Language brokering describes the task in an intercultural language event undertaken by children in families with one or two non-national languages parents or caregivers. This paper examines the complex issues involved in being a language broker and explores these as they apply to a group of adolescents in Chinese families in the UK. The findings…

Agency and Female Teachers' Career Decisions: A Life History Study of 40 Women

ERIC Educational Resources Information Center

Smith, Joan

2011-01-01

This article reports on some of the findings of a wider, life history study on the factors affecting the career decisions of 40 female secondary school teachers in England. By using life history interviews, it was possible to gain rich and nuanced insights into the complexity of factors influencing women's career decisions. While acknowledging the…

Have You Been to the Shore Before? A Marine Education Infusion Unit on Seashore and Aquarium Life. Revised Edition.

ERIC Educational Resources Information Center

Butzow, John W.; And Others

Classroom and field activities for fifth- through ninth-grade students comprise this teaching guide for the northern New England shore. Teacher background information contains an introduction to life at the shore and the animal classification of marine invertebrates. Activities stress two major concepts: (1) the diversity and complex interactions…

The Undergraduate Education Studies Dissertation: Philosophical Reflections upon Tacit Empiricism in Textbook Guidance and the Latent Capacity of Argumentation

ERIC Educational Resources Information Center

Gibson, Howard; Garside, Darren

2017-01-01

The final-year undergraduate dissertation is commonplace in Education Studies programmes across the world and yet its philosophical assumptions are complex and not always questioned. In England there is evidence to suggest a tacit preference for empiricism in textbooks designed to support early researchers. This brings, we suggest, problems…

Integrated agricultural energy system

NASA Astrophysics Data System (ADS)

Taylor, R. M.

1985-08-01

The purpose of this program is to show New England farmers and other New England energy users how they can use alternative energy sources to reduce their energy cost and dependency on conventional sources. The project demonstrates alternative energy technologies in solar, alcohol and methane. Dissemination is planned through tours to be conducted by the Worcester County Extension Service. Most of these goals were completed as planned. A few things have yet to be completed. The solar panels and solar hot water tanks have to be installed. The fermenter's agitating and cooling system have to be secured inside the fermenter. Once these items are complete tours will begin early in the spring.

Utilizing a 'systems' approach to improve the management of waste from healthcare facilities: best practice case studies from England and Wales.

PubMed

Tudor, Terry L; Woolridge, Anne C; Bates, Margaret P; Phillips, Paul S; Butler, Sharon; Jones, Keith

2008-06-01

Changes in environmental legislation and standards governing healthcare waste, such as the Hazardous Waste Regulations are expected to have a significant impact on healthcare waste quantities and costs in England and Wales. This paper presents findings from two award winning case study organizations, the Cardiff and Vale NHS Trust and the Cornwall NHS Trust on 'systems' they have employed for minimizing waste. The results suggest the need for the development and implementation of a holistic range of systems in order to develop best practice, including waste minimization strategies, key performance indicators, and staff training and awareness. The implications for the sharing of best practice from the two case studies are also discussed.

A case of isolation by distance and short-term temporal stability of population structure in brown trout (Salmo trutta) within the River Dart, southwest England

PubMed Central

Griffiths, Andrew M; Koizumi, Itsuro; Bright, Dylan; Stevens, Jamie R

2009-01-01

Salmonid fishes exhibit high levels of population differentiation. In particular, the brown trout (Salmo trutta L.) demonstrates complex within river drainage genetic structure. Increasingly, these patterns can be related to the underlying evolutionary models, of which three scenarios (member-vagrant hypothesis, metapopulation model and panmixia) facilitate testable predictions for investigations into population structure. We analysed 1225 trout collected from the River Dart, a 75 km long river located in southwest England. Specimens were collected from 22 sample sites across three consecutive summers (2001–2003) and genetic variation was examined at nine microsatellite loci. A hierarchical analysis of molecular variance revealed that negligible genetic variation was attributed among temporal samples. The highest levels of differentiation occurred among samples isolated above barriers to fish movement, and once these samples were removed, a significant effect of isolation-by-distance was observed. These results suggest that, at least in the short-term, ecological events are more important in shaping the population structure of Dart trout than stochastic extinction events, and certainly do not contradict the expectations of a member-vagrant hypothesis. Furthermore, individual-level spatial autocorrelation analyses support previous recommendations for the preservation of a number of spawning sites spaced throughout the tributary system to conserve the high levels of genetic variation identified in salmonid species. PMID:25567897

Specification Technology Guidebook.

DTIC Science & Technology

1985-08-01

1. General Aspects A. Identification JSD - Jackson System Development -. Michael Jackson Systems Limited 17 Conduit Street London, England WIROTD Tel...USER MANAGER ORGANIZATION ə X _ _ _ _ 1-3__ 3-6 X > 6 _ _ D. Primary Source of Document ation Michael Jackson Systems Limited Also see: References

Systems Design and Pilot Operation of a Regional Center for Technical Processing for the Libraries of the New England State Universities. NELINET, New England Library Information Network. Progress Report, July 1, 1967 - March 30, 1968, Volume II, Appendices.

ERIC Educational Resources Information Center

Agenbroad, James E.; And Others

Included in this volume of appendices to LI 000 979 are acquisitions flow charts; a current operations questionnaire; an algorithm for splitting the Library of Congress call number; analysis of the Machine-Readable Cataloging (MARC II) format; production problems and decisions; operating procedures for information transmittal in the New England…

Actor-Network Theory and its role in understanding the implementation of information technology developments in healthcare.

PubMed

Cresswell, Kathrin M; Worth, Allison; Sheikh, Aziz

2010-11-01

Actor-Network Theory (ANT) is an increasingly influential, but still deeply contested, approach to understand humans and their interactions with inanimate objects. We argue that health services research, and in particular evaluations of complex IT systems in health service organisations, may benefit from being informed by Actor-Network Theory perspectives. Despite some limitations, an Actor-Network Theory-based approach is conceptually useful in helping to appreciate the complexity of reality (including the complexity of organisations) and the active role of technology in this context. This can prove helpful in understanding how social effects are generated as a result of associations between different actors in a network. Of central importance in this respect is that Actor-Network Theory provides a lens through which to view the role of technology in shaping social processes. Attention to this shaping role can contribute to a more holistic appreciation of the complexity of technology introduction in healthcare settings. It can also prove practically useful in providing a theoretically informed approach to sampling (by drawing on informants that are related to the technology in question) and analysis (by providing a conceptual tool and vocabulary that can form the basis for interpretations). We draw on existing empirical work in this area and our ongoing work investigating the integration of electronic health record systems introduced as part of England's National Programme for Information Technology to illustrate salient points. Actor-Network Theory needs to be used pragmatically with an appreciation of its shortcomings. Our experiences suggest it can be helpful in investigating technology implementations in healthcare settings.

A methodology to assess groundwater risk from hydraulic fracturing and other hydrocarbon activities in 3D

NASA Astrophysics Data System (ADS)

Loveless, S.; Lewis, M.; Bloomfield, J.; Ward, R.; Davey, I.; Hart, A.

2017-12-01

The shale gas boom of the US has prompted a renewed interest in onshore oil and gas in England. Shale gas has received most public attention, but exploration licences have also been granted for coal bed methane and conventional hydrocarbon resources. Hydraulic fracturing, both from vertical and lateral wells, is a significant contributing factor to the recent successes of hydrocarbon activities in the US. However, there are concerns in England regarding potential environmental impacts of subsurface pathways which may connect the hydrocarbon rocks (and injected fluids) with exploitable groundwater. In England groundwater is an important resource, providing 31% (locally up to 100% in the southeast) of water resources. The British Geological Survey has been working with the Environment Agency in England to understand the hazards and risks to overlying groundwater from onshore hydrocarbon exploitation. In the US, contrasting evidence for stray gas migration from shale targets to drinking water shows that differences in geological conditions contribute to a variation in risk between sites. These geological factors include proximity of the hydrocarbon rock to the groundwater receptor, pre-existing geological pathways, low permeability units, and a driving force (e.g. hydraulic head). Due to substantial geological variation across England, a generic approach to risk assessment that can be applied to specific sites has been developed. A methodology has been developed based on DRASTIC principles, whereby a risk score is attributed to formations within a volume of interest, based on a rank and weighting system for each geological factor, multiplied by a hazard score for a given hydrocarbon activity. This score is compared with an assessment of the importance of the receptor. Scores are relative and enable comparison between different activities and sites. Uncertainty is explicitly assessed and factors with a high degree of uncertainty to be systematically identified and addressed. Rankings should be amended as additional data is obtained. Tests on areas identified for potential hydrocarbon exploration in England show that whilst geological scenarios with very high and low risks are theoretically possible, the majority of proposed locations would have similar risks under the current categorisation system.

Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

2012-02-01

As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure of appendectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that together comprised at least 97% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify appendectomy patients according to different sets of variables (between two and six classification variables) into diverging numbers of DRGs (between two and 11 DRGs). The most complex DRG is valued 5.1 times more resource intensive than an index case in France but only 1.1 times more resource intensive than an index case in Finland. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the most complex case vignette amount to only 1,005 in Poland but to 12,304 in France. Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries' DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement.

Childbirth and Diagnosis Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Bellanger, Martine M; Quentin, Wilm; Tan, Siok Swan

2013-05-01

The study compares how Diagnosis-Related Group (DRG) based hospital payment systems in eleven European countries (Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) deal with women giving birth in hospitals. It aims to assist gynaecologists and national authorities in optimizing their DRG systems. National or regional databases were used to identify childbirth cases. DRG grouping algorithms and indicators of resource consumption were compared for those DRGs which account for at least 1% of all childbirth cases in the respective database. Five standardized case vignettes were defined and quasi prices (i.e. administrative prices or tariffs) of hospital deliveries according to national DRG-based hospital payment systems were ascertained. European DRG systems classify childbirth cases according to different sets of variables (between one and eight variables) into diverging numbers of DRGs (between three and eight DRGs). The most complex DRG is valued 3.5 times more resource intensive than an index case in Ireland but only 1.1 times more resource intensive than an index case in The Netherlands. Comparisons of quasi prices for the vignettes show that hypothetical payments for the most complex case amount to only € 479 in Poland but to € 5532 in Ireland. Differences in the classification of hospital childbirth cases into DRGs raise concerns whether European systems rely on the most appropriate classification variables. Physicians, hospitals and national DRG authorities should consider how other countries' DRG systems classify cases to optimize their system and to ensure fair and appropriate reimbursement. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Transportation and dynamic networks: Models, theory, and applications to supply chains, electric power, and financial networks

NASA Astrophysics Data System (ADS)

Liu, Zugang

Network systems, including transportation and logistic systems, electric power generation and distribution networks as well as financial networks, provide the critical infrastructure for the functioning of our societies and economies. The understanding of the dynamic behavior of such systems is also crucial to national security and prosperity. The identification of new connections between distinct network systems is the inspiration for the research in this dissertation. In particular, I answer two questions raised by Beckmann, McGuire, and Winsten (1956) and Copeland (1952) over half a century ago, which are, respectively, how are electric power flows related to transportation flows and does money flow like water or electricity? In addition, in this dissertation, I achieve the following: (1) I establish the relationships between transportation networks and three other classes of complex network systems: supply chain networks, electric power generation and transmission networks, and financial networks with intermediation. The establishment of such connections provides novel theoretical insights as well as new pricing mechanisms, and efficient computational methods. (2) I develop new modeling frameworks based on evolutionary variational inequality theory that capture the dynamics of such network systems in terms of the time-varying flows and incurred costs, prices, and, where applicable, profits. This dissertation studies the dynamics of such network systems by addressing both internal competition and/or cooperation, and external changes, such as varying costs and demands. (3) I focus, in depth, on electric power supply chains. By exploiting the relationships between transportation networks and electric power supply chains, I develop a large-scale network model that integrates electric power supply chains and fuel supply markets. The model captures both the economic transactions as well as the physical transmission constraints. The model is then applied to the New England electric power supply chain consisting of 6 states, 5 fuel types, 82 power generators, with a total of 573 generating units, and 10 demand markets. The empirical case study demonstrates that the regional electricity prices simulated by the model match very well the actual electricity prices in New England. I also utilize the model to study interactions between electric power supply chains and energy fuel markets.

Teaching Particle Physics in Secondary Schools: Why Do Physicists Want to Smash Matter to Bits?

ERIC Educational Resources Information Center

Young, Clive

2017-01-01

Matter can be described and explained in a number of ways, using models of increasing complexity depending on the intended audience. Under the current National Curriculum for England, the kinetic theory of matter is taught to 11- and 12-year-olds in secondary schools to explain the structure of solids, liquids and gases and their behaviour when…

Barriers to Non-Residential Respite Care for Adults with Moderate to Complex Needs: A UK Perspective

ERIC Educational Resources Information Center

Southby, Kris

2017-01-01

Respite aims to alleviate the stress and burden of caring for someone with an intellectual disability and/or autism. Respite can take place in a number of different ways, but most commonly occurs in a residential setting. Based on survey and interview data with carers (CAs), service users and stakeholders (STs) in a northern city in England, this…

School Food Politics: The Complex Ecology of Hunger and Feeding in Schools around the World. Global Studies in Education, Volume 6

ERIC Educational Resources Information Center

Robert, Sarah A., Ed.; Weaver-Hightower, Marcus B., Ed.

2011-01-01

The essays in "School Food Politics" explore the intersections of food and politics on all six of the inhabited continents of the world. Including electoral fights over universally free school meals in Korea, nutritional reforms to school dinners in England and canteens in Australia, teachers' and doctors' work on school feeding in…

Hard to Reach and Hard to Teach: Supporting the Self-Regulation of Learning in an Alternative Provision Secondary School

ERIC Educational Resources Information Center

Putwain, David W.; Nicholson, Laura J.; Edwards, Jenna L.

2016-01-01

Since 2010, new types of state-funded schools have opened in England with a focus on providing alternative education provision. Very little is known about these schools, partly due to their novelty, and how they are attempting to re-engage those students who for various, and often complex, reasons have become disconnected from education. We…

An Ecological Analysis of the Dynamics of Localities: A 14+ Low Opportunity Progression Equilibrium in Action

ERIC Educational Resources Information Center

Hodgson, Ann; Spours, Ken

2015-01-01

This article uses a multi-level ecological model to explore the dynamics of localities in England and their effects on the 14+ participation, progression and transition (14+ PPT) of young people at a time when nationally and internationally there is a recognition that transitions from education to employment are both more complex and take longer.…

Climate Change and Everyday Life: Repertoires Children Use to Negotiate a Socio-Scientific Issue

ERIC Educational Resources Information Center

Byrne, Jenny; Ideland, Malin; Malmberg, Claes; Grace, Marcus

2014-01-01

There are only a few studies about how primary school students engage in socio-scientific discussions. This study aims to add to this field of research by focusing on how 9-10-year-olds in Sweden and England handle climate change as a complex environmental socio-scientific issue (SSI), within the context of their own lives and in relation to…

A New Education Scheme for Japan: Importing Education PPP Structures from England and Scotland (Part 2)

ERIC Educational Resources Information Center

Tachioka, Hiroshi; Campbell, Joel R.

2006-01-01

There are very few PFI projects in Japan that are specifically designed for education, but there are a few hybrid or complex PFIs that includes education in their facilities and services. In this article, the authors discuss the Ichikawa City Seventh District Junior High School building (an education PFI), which includes a school lunch room,…

Forest cover type analysis of New England forests using innovative WorldView-2 imagery

NASA Astrophysics Data System (ADS)

Kovacs, Jenna M.

For many years, remote sensing has been used to generate land cover type maps to create a visual representation of what is occurring on the ground. One significant use of remote sensing is the identification of forest cover types. New England forests are notorious for their especially complex forest structure and as a result have been, and continue to be, a challenge when classifying forest cover types. To most accurately depict forest cover types occurring on the ground, it is essential to utilize image data that have a suitable combination of both spectral and spatial resolution. The WorldView-2 (WV2) commercial satellite, launched in 2009, is the first of its kind, having both high spectral and spatial resolutions. WV2 records eight bands of multispectral imagery, four more than the usual high spatial resolution sensors, and has a pixel size of 1.85 meters at the nadir. These additional bands have the potential to improve classification detail and classification accuracy of forest cover type maps. For this reason, WV2 imagery was utilized on its own, and in combination with Landsat 5 TM (LS5) multispectral imagery, to evaluate whether these image data could more accurately classify forest cover types. In keeping with recent developments in image analysis, an Object-Based Image Analysis (OBIA) approach was used to segment images of Pawtuckaway State Park and nearby private lands, an area representative of the typical complex forest structure found in the New England region. A Classification and Regression Tree (CART) analysis was then used to classify image segments at two levels of classification detail. Accuracies for each forest cover type map produced were generated using traditional and area-based error matrices, and additional standard accuracy measures (i.e., KAPPA) were generated. The results from this study show that there is value in analyzing imagery with both high spectral and spatial resolutions, and that WV2's new and innovative bands can be useful for the classification of complex forest structures.

Preventing violence-related injuries in England and Wales: a panel study examining the impact of on-trade and off-trade alcohol prices.

PubMed

Page, Nicholas; Sivarajasingam, Vaseekaran; Matthews, Kent; Heravi, Saeed; Morgan, Peter; Shepherd, Jonathan

2017-02-01

To examine the influence of real on-trade and off-trade alcohol prices and socioeconomic and environmental factors on rates of violence-related emergency department (ED) attendances in England and Wales over an 8-year period. Anonymised injury data which included attendance date, age and gender of patients aged over 18 years who reported injury in violence were collected from a structured sample of 100 EDs across England and Wales between 1 January 2005 and 31 December 2012. Alcohol prices and socioeconomic measures were obtained from the UK Office for National Statistics. Panel techniques were used to derive a statistical model. Real on-trade (β=-0.661, p<0.01) and off-trade (β=-0.277, p<0.05) alcohol prices were negatively related with rates of violence-related ED attendance among the adult population of England and Wales, after accounting for the effects of regional poverty, income inequality, youth spending power and seasonal effects. It is estimated that over 6000 fewer violence-related ED attendances per year in England and Wales would result from a 1% increase in both on-trade and off-trade alcohol prices above inflation. Of the variables studied, changes in regional poverty and income inequality had the greatest effect on violence-related ED attendances in England and Wales. Small increases in the price of alcohol, above inflation, in both markets, would substantially reduce the number of patients attending EDs for treatment of violence-related injuries in England and Wales. Reforming the current alcohol taxation system may be more effective at reducing violence-related injury than minimum unit pricing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Blood Stocks Management Scheme, a partnership venture between the National Blood Service of England and North Wales and participating hospitals for maximizing blood supply chain management.

PubMed

Chapman, J F; Cook, R

2002-10-01

The Blood Stocks Management Scheme (BSMS) has been established as a joint venture between the National Blood Service (NBS) in England and North Wales and participating hospitals to monitor the blood supply chain. Stock and wastage data are submitted to a web-based data-management system, facilitating continuous and complete red cell data collection and 'real time' data extraction. The data-management system enables peer review of performance in respect of stock holding levels and red cell wastage. The BSMS has developed an innovative web-based data-management system that enables data collection and benchmarking of practice, which should drive changes in stock management practice, therefore optimizing the use of donated blood.

Service quality and clinical outcomes: an example from mental health rehabilitation services in England.

PubMed

Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael

2013-01-01

Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

The study of anatomy in England from 1700 to the early 20th century

PubMed Central

Mitchell, Piers D; Boston, Ceridwen; Chamberlain, Andrew T; Chaplin, Simon; Chauhan, Vin; Evans, Jonathan; Fowler, Louise; Powers, Natasha; Walker, Don; Webb, Helen; Witkin, Annsofie

2011-01-01

The study of anatomy in England during the 18th and 19th century has become infamous for bodysnatching from graveyards to provide a sufficient supply of cadavers. However, recent discoveries have improved our understanding of how and why anatomy was studied during the enlightenment, and allow us to see the context in which dissection of the human body took place. Excavations of infirmary burial grounds and medical school cemeteries, study of hospital archives, and analysis of the content of surviving anatomical collections in medical museums enables us to re-evaluate the field from a fresh perspective. The pathway from a death in poverty, sale of the corpse to body dealer, dissection by anatomist or medical student, and either the disposal and burial of the remains or preservation of teaching specimens that survive today in medical museums is a complex and fascinating one. PMID:21496014

Operational Earthquake Forecasting of Aftershocks for New England

NASA Astrophysics Data System (ADS)

Ebel, J.; Fadugba, O. I.

2015-12-01

Although the forecasting of mainshocks is not possible, recent research demonstrates that probabilistic forecasts of expected aftershock activity following moderate and strong earthquakes is possible. Previous work has shown that aftershock sequences in intraplate regions behave similarly to those in California, and thus the operational aftershocks forecasting methods that are currently employed in California can be adopted for use in areas of the eastern U.S. such as New England. In our application, immediately after a felt earthquake in New England, a forecast of expected aftershock activity for the next 7 days will be generated based on a generic aftershock activity model. Approximately 24 hours after the mainshock, the parameters of the aftershock model will be updated using the observed aftershock activity observed to that point in time, and a new forecast of expected aftershock activity for the next 7 days will be issued. The forecast will estimate the average number of weak, felt aftershocks and the average expected number of aftershocks based on the aftershock statistics of past New England earthquakes. The forecast also will estimate the probability that an earthquake that is stronger than the mainshock will take place during the next 7 days. The aftershock forecast will specify the expected aftershocks locations as well as the areas over which aftershocks of different magnitudes could be felt. The system will use web pages, email and text messages to distribute the aftershock forecasts. For protracted aftershock sequences, new forecasts will be issued on a regular basis, such as weekly. Initially, the distribution system of the aftershock forecasts will be limited, but later it will be expanded as experience with and confidence in the system grows.

Co-operation and conflict under hard and soft contracting regimes: case studies from England and Wales.

PubMed

Hughes, David; Allen, Pauline; Doheny, Shane; Petsoulas, Christina; Vincent-Jones, Peter

2013-01-01

This paper examines NHS secondary care contracting in England and Wales in a period which saw increasing policy divergence between the two systems. At face value, England was making greater use of market levers and utilising harder-edged service contracts incorporating financial penalties and incentives, while Wales was retreating from the 1990 s internal market and emphasising cooperation and flexibility in the contracting process. But there were also cross-border spill-overs involving common contracting technologies and management cultures that meant that differences in on-the-ground contracting practices might be smaller than headline policy differences suggested. The nature of real-world contracting behaviour was investigated by undertaking two qualitative case studies in England and two in Wales, each based on a local purchaser/provider network. The case studies involved ethnographic observations and interviews with staff in primary care trusts (PCTs) or local health boards (LHBs), NHS or Foundation trusts, and the overseeing Strategic Health Authority or NHS Wales regional office, as well as scrutiny of relevant documents. Wider policy differences between the two NHS systems were reflected in differing contracting frameworks, involving regional commissioning in Wales and commissioning by either a PCT, or co-operating pair of PCTs in our English case studies, and also in different oversight arrangements by higher tiers of the service. However, long-term relationships and trust between purchasers and providers had an important role in both systems when the financial viability of organisations was at risk. In England, the study found examples where both PCTs and trusts relaxed contractual requirements to assist partners faced with deficits. In Wales, news of plans to end the purchaser/provider split meant a return to less precisely-specified block contracts and a renewed concern to build cooperation between LHB and trust staff. The interdependency of local purchasers and providers fostered long-term relationships and co-operation that shaped contracting behaviour, just as much as the design of contracts and the presence or absence of contractual penalties and incentives. Although conflict and tensions between contracting partners sometimes surfaced in both the English and Welsh case studies, cooperative behaviour became crucial in times of trouble.

Energy performance of net-zero and near net-zero energy homes in New England

NASA Astrophysics Data System (ADS)

Thomas, Walter D.

Net-Zero Energy Homes (NZEHs) are homes that consume no more energy than they produce on site during the course of a year. They are well insulated and sealed, use energy efficient appliances, lighting, and mechanical equipment, are designed to maximize the benefits from day lighting, and most often use a combination of solar hot water, passive solar and photovoltaic (PV) panels to produce their on-site energy. To date, NZEHs make up a miniscule percentage of homes in the United States, and of those, few have had their actual performance measured and analyzed once built and occupied. This research focused on 19 NZEHs and near net-zero energy homes (NNZEHs) built in New England. This set of homes had varying designs, numbers of occupants, and installed technologies for energy production, space heating and cooling, and domestic hot water systems. The author worked with participating homeowners to collect construction and systems specifications, occupancy information, and twelve months of energy consumption, production and cost measurements, in order to determine whether the homes reached their respective energy performance design goals. The author found that six out of ten NZEHs achieved net-zero energy or better, while all nine of the NNZEHs achieved an energy density (kWh/ft 2/person) at least half as low as the control house, also built in New England. The median construction cost for the 19 homes was 155/ft 2 vs. 110/ft2 for the US average, their average monthly energy cost was 84% below the average for homes in New England, and their estimated CO2 emissions averaged 90% below estimated CO2 emissions from the control house. Measured energy consumption averaged 14% below predictions for the NZEHs and 38% above predictions for the NNZEHs, while generated energy was within +/- 10% of predicted for 17 out of 18 on-site PV systems. Based on these results, the author concludes that these types of homes can meet or exceed their designed energy performance (depending on occupant behavior), can be affordably built, and will have very low energy costs and CO2 emissions compared to conventional homes. In short, they are very suitable for New England.

STAF: A Powerful and Sophisticated CAI System.

ERIC Educational Resources Information Center

Loach, Ken

1982-01-01

Describes the STAF (Science Teacher's Authoring Facility) computer-assisted instruction system developed at Leeds University (England), focusing on STAF language and major program features. Although programs for the system emphasize physical chemistry and organic spectroscopy, the system and language are general purpose and can be used in any…

The impact of endovascular aneurysm repair on mortality for elective abdominal aortic aneurysm repair in England and the United States.

PubMed

Karthikesalingam, Alan; Holt, Peter J; Vidal-Diez, Alberto; Bahia, Sandeep S; Patterson, Benjamin O; Hinchliffe, Robert J; Thompson, Matthew M

2016-08-01

Procedural mortality is of paramount importance for patients undergoing elective abdominal aortic aneurysm (AAA) repair. Previous comparative studies have demonstrated international differences in the care of ruptured AAA. This study compared the use of endovascular aneurysm repair (EVAR) and in-hospital mortality for elective AAA repair in England and the United States. The English Hospital Episode Statistics and the U.S. Nationwide Inpatient Sample (NIS) were interrogated for elective AAA repair from 2005 to 2010. In-hospital mortality and the use of EVAR were analyzed separately for each health care system, after within-country risk adjustment for age, gender, year, and an accepted national comorbidity index. The study included 21,272 patients with AAA in England, of whom 86.61% were male, with median (interquartile range) age of 74 (69-79) years. There were 196,113 AAA patients in the United States, of whom 76.14% were male, with median (interquartile range) age of 73 (67-78) years. In-hospital mortality was greater in England (4.09% vs 1.96 %; P < .01) and EVAR less common (37.33% vs 64.36%; P < .01). These observations persisted in age- and gender-matched comparison. In both countries, lower mortality and greater use of EVAR were seen in centers performing greater numbers of AAA repairs per annum. In England, lower mortality and greater use of EVAR were seen in teaching hospitals with larger bed capacity. In-hospital survival and the uptake of EVAR are lower in England than in the United States. In both countries, mortality was lowest in high-caseload centers performing a greater proportion of cases with endovascular repair. These common factors suggest strategies for improving outcomes for patients requiring elective AAA repair. Copyright © 2016. Published by Elsevier Inc.

Cost calculator methods for estimating casework time in child welfare services: A promising approach for use in implementation of evidence-based practices and other service innovations.

PubMed

Holmes, Lisa; Landsverk, John; Ward, Harriet; Rolls-Reutz, Jennifer; Saldana, Lisa; Wulczyn, Fred; Chamberlain, Patricia

2014-04-01

Estimating costs in child welfare services is critical as new service models are incorporated into routine practice. This paper describes a unit costing estimation system developed in England (cost calculator) together with a pilot test of its utility in the United States where unit costs are routinely available for health services but not for child welfare services. The cost calculator approach uses a unified conceptual model that focuses on eight core child welfare processes. Comparison of these core processes in England and in four counties in the United States suggests that the underlying child welfare processes generated from England were perceived as very similar by child welfare staff in California county systems with some exceptions in the review and legal processes. Overall, the adaptation of the cost calculator for use in the United States child welfare systems appears promising. The paper also compares the cost calculator approach to the workload approach widely used in the United States and concludes that there are distinct differences between the two approaches with some possible advantages to the use of the cost calculator approach, especially in the use of this method for estimating child welfare costs in relation to the incorporation of evidence-based interventions into routine practice.

Child survival in England: Strengthening governance for health.

PubMed

Wolfe, Ingrid; Mandeville, Kate; Harrison, Katherine; Lingam, Raghu

2017-11-01

The United Kingdom, like all European countries, is struggling to strengthen health systems and improve conditions for child health and survival. Child mortality in the UK has failed to improve in line with other countries. Securing optimal conditions for child health requires a healthy society, strong health system, and effective health care. We examine inter-sectoral and intra-sectoral policy and governance for child health and survival in England. Literature reviews and universally applicable clinical scenarios were used to examine child health problems and English policy and governance responses for improving child health through integrating care and strengthening health systems, over the past 15 years. We applied the TAPIC framework for analysing policy governance: transparency, accountability, participation, integrity, and capacity. We identified strengths and weaknesses in child health governance in all the five domains. However there remain policy failures that are not fully explained by the TAPIC framework. Other problems with successfully translating policy to improved health that we identified include policy flux; policies insufficiently supported by delivery mechanisms, measurable targets, and sufficient budgets; and policies with unintended or contradictory aspects. We make recommendations for inter-sectoral and intra-sectoral child health governance, policy, and action to improve child health in England with relevant lessons for other countries. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Airborne simulation of Shuttle/Spacelab management and operation

NASA Technical Reports Server (NTRS)

Mulholland, D. R.; Neel, C. B.

1976-01-01

The ASSESS (Airborne Science/Spacelab Experiments System Simulation) program is discussed. A simulated Spacelab operation was carried out aboard the CV-990 airborne laboratory at Ames Research Center. A scientific payload was selected to conduct studies in upper atmospheric physics and infrared astronomy with principal investigators from France, the Netherlands, England and the U.S. Two experiment operators (EOs) from the U.S. and two from Europe were trained to function as proxies for the principal investigators in operating, maintaining, and repairing the scientific instruments. The simulated mission, in which the EOs and a Mission Manager were confined to the aircraft and living quarters for a 1-week period while making scientific observations during nightly flights, provided experience in the overall management of a complex international payload, experiment preparation, testing, and integration, the training and selection of proxy operators, and data handling.

Bedform development and morphodynamics in mixed cohesive sediment substrates: the importance of winnowing and flocculation

NASA Astrophysics Data System (ADS)

Ye, Leiping; Parsons, Daniel; Manning, Andrew

2016-04-01

There remains a lack of process-based knowledge of sediment dynamics within flows over bedforms generated in complex mixtures of cohesionless sand and biologically-active cohesive muds in natural estuarine flow systems. The work to be presented forms a part of the UK NERC "COHesive BEDforms (COHBED)" project which aims to fill this gap in knowledge. Herein results from a field survey in sub-tidal zone of Dee estuary (NW, England) and a set of large-scale laboratory experiments, conducted using mixtures of non-cohesive sands, cohesive muds and Xanthan gum (as a proxy for the biological stickiness of Extracellular Polymeric Substances (EPS)) will be presented. The results indicate the significance of biological-active cohesive sediments in controlling winnowing rates and flocculation dynamics, which contributes significantly to rates of bedform evolution.

The Complex Challenges of Remotely Removing Redundant Pipework and Cleaning/Remediation of Aging Civil Structures at Sellafield - 12446

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farran, Paul

This paper identifies how a joint Sellafield Ltd/Nuclear Management Partners Tactical Review Team and main contractor, SA Robotics, developed and successfully deployed a solution to clean and coat the wall surface of an aging structure on the Sellafield Site. This involved removal of redundant pipework from the wall, cleaning and coating of the surface using a bespoke designed robotic manipulator with various end effectors. This system was able to safely and in a controlled manner remove the pipework, clean down the wall and prime and coat it within the required programme duration which was 5 months earlier than a previousmore » shielding only option. This was done in a high radiation field and in the challenging conditions of winter in Northern England. (authors)« less

Changing choices in health care: implications for equity, efficiency and cost.

PubMed

Bevan, Gwyn; Helderman, Jan-Kees; Wilsford, David

2010-07-01

Although choice may be seen as an end in itself, the papers included in this special issue of Health Economics, Policy and Law, examine choice policies in European systems of health care, which aim to be effective instruments for ameliorating the systemic pressures from the iron triangle of equity, efficiency, and cost. Three papers consider the nature of differences between and within countries following the Beveridge and Bismarck models of financing and organising the delivery of care, and how choices are changing within different systems. Within countries following the Beveridge model, current policies in England, Denmark and Sweden emphasise increasing patient choice of provider. Within countries following the Bismarck model, current policies in France and Germany seek to restrict choice of specialists by introducing 'soft' gatekeeping; and in the Netherlands there is a system of managed competition with choice of insurer that, in principle, allows insurers to contract selectively with providers. A fourth paper considers how government policies that seek to restrict choice within systems of universal coverage have been subject to challenges in the courts. A commentary explores the implications of the fraught and complex nature of choices between insurers and providers of health care for designing effective choice policies.

Mandatory implementation of NICE Guidelines for the care of bipolar disorder and other conditions in England and Wales.

PubMed

Morriss, Richard

2015-09-30

Bipolar disorder is a common long-term mental health condition characterised by episodes of mania or hypomania and depression resulting in disability, early death, and high health and society costs. Public money funds the National Institute of Healthcare and Clinical Excellence (NICE) to produce clinical guidelines by systematically identifying the most up to date research evidence and costing its main recommendations for healthcare organisations and professionals to follow in England and Wales. Most governments, including those of England and Wales, need to improve healthcare but at reduced cost. There is evidence, particularly in bipolar disorder, that systematically following clinical guidelines achieves these outcomes. NICE clinical guidelines, including those regarding bipolar disorder, remain variably implemented. They give clinicians and patients a non-prescriptive basis for deciding their care. Despite the passing of the Health and Social Care Act in 2012 in England requiring all healthcare organisations to consider NICE clinical guidelines in commissioning, delivering, and inspecting healthcare services, healthcare organisations in the National Health Service may ignore them with little accountability and few consequences. There is no mechanism to ensure that healthcare professionals know or consider them. Barriers to their implementation include the lack of political and professional leadership, the complexity of the organisation of care and policy, mistrust of some processes and recommendations of clinical guidelines, and a lack of a clear implementation model, strategy, responsibility, or accountability. Mitigation to these barriers is presented herein. The variability, safety, and quality of healthcare might be improved and its cost reduced if the implementation of NICE clinical guidelines, such as those for bipolar disorder, were made the minimum starting point for clinical decision-making and mandatory responsibilities of all healthcare organisations and professionals.

Mortality in England during the 1783 4 Laki Craters eruption

NASA Astrophysics Data System (ADS)

Witham, C. S.; Oppenheimer, C.

2004-12-01

1783/4 has been recognised as a mortality “crisis year” in the population history of England. This demographic incident coincides with the Laki Craters eruption, Iceland, which began in June 1783 and fumigated many parts of Europe with volcanic gases and particles. Many reports and proxy climate records implicate the volcanic cloud in meteorological anomalies, including notably hot 1783 summer conditions in England and a severe subsequent winter. We present here a detailed analysis of the geographical and temporal trends in English mortality data, and interpret them in the light of the climatological records and observations of the pollutant cloud. We show that there were two distinct crisis periods: in August-September 1783, and January-February 1784, which together accounted for ~20,000 extra deaths. In both cases, the East of England was the worst affected region. Possible causes for the two crisis periods are considered and we conclude that the timing and magnitude of the winter mortality peak can be explained by the severe cold of January 1784. The late summer mortality followed 1 2 months after the very hot July of 1783 and may also have been related to the weather, with the time lag reflecting the relatively slow spread of enteric disease or the contraction of malaria. However, it is hard to explain the entire late summer anomaly by these high temperature causes. We therefore consider that fine acid aerosol and/or gases in the volcanic haze may also have contributed to the unusual August-September mortality. Given that complex radiative and dynamical effects of the volcanic cloud are implicated in the climatic anomalies in 1783 4, it is likely that the Laki Craters eruption did play a role in the English mortality crises of the same period.

Outcome of cardiac surgery in patients with congenital heart disease in England between 1997 and 2015

PubMed Central

Dimopoulos, Konstantinos; Uebing, Anselm; Diller, Gerhard-Paul; Rosendahl, Ulrich; Belitsis, George

2017-01-01

Background The number of patients with congenital heart disease (CHD) is increasing worldwide and most of them will require cardiac surgery, once or more, during their lifetime. The total volume of cardiac surgery in CHD patients at a national level and the associated mortality and predictors of death associated with surgery are not known. We aimed to investigate the surgical volume and associated mortality in CHD patients in England. Methods Using a national hospital episode statistics database, we identified all CHD patients undergoing cardiac surgery in England between 1997 and 2015. Results We evaluated 57,293 patients (median age 11.9years, 46.7% being adult, 56.7% female). There was a linear increase in the number of operations performed per year from 1,717 in 1997 to 5,299 performed in 2014. The most common intervention at the last surgical event was an aortic valve procedure (9,276; 16.2%), followed by repair of atrial septal defect (9,154; 16.0%), ventricular septal defect (7,746; 13.5%), tetralogy of Fallot (3,523; 6.1%) and atrioventricular septal defect (3,330; 5.8%) repair. Associated mortality remained raised up to six months following cardiac surgery. Several parameters were predictive of post-operative mortality, including age, complexity of surgery, need for emergency surgery and socioeconomic status. The relationship of age with mortality was “U”-shaped, and mortality was highest amongst youngest children and adults above 60 years of age. Conclusions The number of cardiac operations performed in CHD patients in England has been increasing, particularly in adults. Mortality remains raised up to 6-months after surgery and was highest amongst young children and seniors. PMID:28628610

Counting on commitment; the quality of primary care-led diabetes management in a system with minimal incentives.

PubMed

Mc Hugh, Sheena; Marsden, Paul; Brennan, Carmel; Murphy, Katie; Croarkin, Celine; Moran, Joe; Harkins, Velma; Perry, Ivan J

2011-12-28

The aim of the present study was to assess the performance of three primary care-led initiatives providing structured care to patients with Type 2 diabetes in Ireland, a country with minimal incentives to promote the quality of care. Data, from three primary care initiatives, were available for 3010 adult patients with Type 2 diabetes. Results were benchmarked against the national guidelines for the management of Type 2 diabetes in the community and results from the National Diabetes Audit (NDA) for England (2008/2009) and the Scottish Diabetes Survey (2009). The recording of clinical processes of care was similar to results in the UK however the recording of lifestyle factors was markedly lower. Recording of HbA1c, blood pressure and lipids exceeded 85%. Recording of retinopathy screening (71%) was also comparable to England (77%) and Scotland (90%). Only 63% of patients had smoking status recorded compared to 99% in Scotland while 70% had BMI recorded compared to 89% in England. A similar proportion of patients in this initiative and the UK achieved clinical targets. Thirty-five percent of patients achieved a target HbA1c of < 6.5% (< 48 mmol/mol) compared to 25% in England. Applying the NICE target for blood pressure (≤ 140/80 mmHg), 54% of patients reached this target comparable to 60% in England. Slightly less patients were categorised as obese (> 30 kg/m²) in Ireland (50%, n = 1060) compared to Scotland (54%). This study has demonstrated what can be achieved by proactive and interested health professionals in the absence of national infrastructure to support high quality diabetes care. The quality of primary care-led diabetes management in the three initiatives studied appears broadly consistent with results from the UK with the exception of recording lifestyle factors. The challenge facing health systems is to establish quality assurance a responsibility for all health care professionals rather than the subject of special interest for a few.

Detection and Assessment of Secondary Sonic Booms in New England.

DTIC Science & Technology

1980-05-01

MEASUREMENT DATA During the period May 3, 1979 to September 14, 1979, infra - sonic measurements were made at Malden MA, at six other sites in the Greater...D-AO8O 160 TRANSPORTATION SYSTEMS CENTER CAMBRIDGE MA F/ 20/1 DETECTION AND ASSESSMENT OF SECONDARY SONIC BOOMS IN NEW ENGLAN--ETC(U) MAY 80 E J...CHART F AA-AEE-8O-22 DETECTION AND ASSESSMENT OF SECONDARY SONIC BOOMS IN NEW ENGLAND AD A088 160 MAY 1980 Q4 = Ci OF T R, 4 This document has been

Using real-time syndromic surveillance to assess the health impact of the 2013 heatwave in England.

PubMed

Elliot, Alex J; Bone, Angie; Morbey, Roger; Hughes, Helen E; Harcourt, Sally; Smith, Sue; Loveridge, Paul; Green, Helen K; Pebody, Richard; Andrews, Nick; Murray, Virginia; Catchpole, Mike; Bickler, Graham; McCloskey, Brian; Smith, Gillian

2014-11-01

Heatwaves are a seasonal threat to public health. During July 2013 England experienced a heatwave; we used a suite of syndromic surveillance systems to monitor the impact of the heatwave. Significant increases in heatstroke and sunstroke were observed during 7-10 July 2013. Syndromic surveillance provided an innovative and effective service, supporting heatwave planning and providing early warning of the impact of extreme heat thereby improving the public health response to heatwaves. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Connecting large-scale atmospheric circulation, river flow and groundwater levels in a chalk catchment in southern England

NASA Astrophysics Data System (ADS)

Lavers, David A.; Hannah, David M.; Bradley, Chris

2015-04-01

Groundwater is an important water resource and globally it represents the largest distributed store of freshwater. In southern England, groundwater is a major source for public water supply, and many aquifers have recently experienced both extreme low and high groundwater levels. In this paper, we use observations of precipitation, river discharge and groundwater levels (1964-2010) and an atmospheric reanalysis to explore the large-scale climate patterns preceding the nine highest and lowest March river discharge and groundwater levels in the chalk catchment of the River Lambourn (Berkshire Downs, southern England). Peak monthly precipitation is shown to occur from October to January, while the highest river discharge and groundwater levels are found from February to April. For high discharge/groundwater levels, composite anomaly patterns of the mean sea level pressure show a stronger than average pressure gradient across the North Atlantic Ocean, with enhanced water vapour transport across southern England. For the lowest discharge/groundwater levels, a blocking high pressure system is found across the British Isles deflecting storms and precipitation to the north. Significantly, the intra-composite variability suggests that different sequences of atmospheric states may lead to high and low discharge/groundwater events.

What is the utility of using syndromic surveillance systems during large subnational infectious gastrointestinal disease outbreaks? An observational study using case studies from the past 5 years in England.

PubMed

Todkill, D; Elliot, A J; Morbey, R; Harris, J; Hawker, J; Edeghere, O; Smith, G E

2016-08-01

Syndromic surveillance systems in England have demonstrated utility in the early identification of seasonal gastrointestinal illness (GI) tracking its spatio-temporal distribution and enabling early public health action. There would be additional public health utility if syndromic surveillance systems could detect or track subnational infectious disease outbreaks. To investigate using syndromic surveillance for this purpose we retrospectively identified eight large GI outbreaks between 2009 and 2014 (four randomly and four purposively sampled). We then examined syndromic surveillance information prospectively collected by the Real-time Syndromic Surveillance team within Public Health England for evidence of possible outbreak-related changes. None of the outbreaks were identified contemporaneously and no alerts were made to relevant public health teams. Retrospectively, two of the outbreaks - which happened at similar times and in proximal geographical locations - demonstrated changes in the local trends of relevant syndromic indicators and exhibited a clustering of statistical alarms, but did not warrant alerting local health protection teams. Our suite of syndromic surveillance systems may be more suited to their original purposes than as means of detecting or monitoring localized, subnational GI outbreaks. This should, however, be considered in the context of this study's limitations; further prospective work is needed to fully explore the use of syndromic surveillance for this purpose. Provided geographical coverage is sufficient, syndromic surveillance systems could be able to provide reassurance of no or minor excess healthcare systems usage during localized GI incidents.

Prioritising public health: a qualitative study of decision making to reduce health inequalities

PubMed Central

2011-01-01

Background The public health system in England is currently facing dramatic change. Renewed attention has recently been paid to the best approaches for tackling the health inequalities which remain entrenched within British society and across the globe. In order to consider the opportunities and challenges facing the new public health system in England, we explored the current experiences of those involved in decision making to reduce health inequalities, taking cardiovascular disease (CVD) as a case study. Methods We conducted an in-depth qualitative study employing 40 semi-structured interviews and three focus group discussions. Participants were public health policy makers and planners in CVD in the UK, including: Primary Care Trust and Local Authority staff (in various roles); General Practice commissioners; public health academics; consultant cardiologists; national guideline managers; members of guideline development groups, civil servants; and CVD third sector staff. Results The short term target- and outcome-led culture of the NHS and the drive to achieve "more for less", combined with the need to address public demand for acute services often lead to investment in "downstream" public health intervention, rather than the "upstream" approaches that are most effective at reducing inequalities. Despite most public health decision makers wishing to redress this imbalance, they felt constrained due to difficulties in partnership working and the over-riding influence of other stakeholders in decision making processes. The proposed public health reforms in England present an opportunity for public health to move away from the medical paradigm of the NHS. However, they also reveal a reluctance of central government to contribute to shifting social norms. Conclusions It is vital that the effectiveness and cost effectiveness of all new and existing policies and services affecting public health are measured in terms of their impact on the social determinants of health and health inequalities. Researchers have a vital role to play in providing the complex evidence required to compare different models of prevention and service delivery. Those working in public health must develop leadership to raise the profile of health inequalities as an issue that merits attention, resources and workforce capacity; and advocate for central government to play a key role in shifting social norms. PMID:22014291

Why do GPs leave direct patient care and what might help to retain them? A qualitative study of GPs in South West England

PubMed Central

Sansom, Anna; Terry, Rohini; Fletcher, Emily; Salisbury, Chris; Long, Linda; Richards, Suzanne H; Aylward, Alex; Welsman, Jo; Sims, Laura; Campbell, John L; Dean, Sarah G

2018-01-01

Objective To identify factors influencing general practitioners’ (GPs’) decisions about whether or not to remain in direct patient care in general practice and what might help to retain them in that role. Design Qualitative, in-depth, individual interviews exploring factors related to GPs leaving, remaining in and returning to direct patient care. Setting South West England, UK. Participants 41 GPs: 7 retired; 8 intending to take early retirement; 11 who were on or intending to take a career break; 9 aged under 50 years who had left or were intending to leave direct patient care and 6 who were not intending to leave or to take a career break. Plus 19 stakeholders from a range of primary care-related professional organisations and roles. Results Reasons for leaving direct patient care were complex and based on a range of job-related and individual factors. Three key themes underpinned the interviewed GPs’ thinking and rationale: issues relating to their personal and professional identity and the perceived value of general practice-based care within the healthcare system; concerns regarding fear and risk, for example, in respect of medical litigation and managing administrative challenges within the context of increasingly complex care pathways and environments; and issues around choice and volition in respect of personal social, financial, domestic and professional considerations. These themes provide increased understanding of the lived experiences of working in today’s National Health Service for this group of GPs. Conclusion Future policies and strategies aimed at retaining GPs in direct patient care should clarify the role and expectations of general practice and align with GPs’ perception of their own roles and identity; demonstrate to GPs that they are valued and listened to in planning delivery of the UK healthcare; target GPs’ concerns regarding fear and risk, seeking to reduce these to manageable levels and give GPs viable options to support them to remain in direct patient care. PMID:29326195

"It was the whole picture" a mixed methods study of successful components in an integrated wellness service in North East England.

PubMed

Cheetham, M; Van der Graaf, P; Khazaeli, B; Gibson, E; Wiseman, A; Rushmer, R

2018-03-22

A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of 'active ingredients' at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.

Ages and origins of rocks of the Killingworth dome, south-central Connecticut: Implications for the tectonic evolution of southern New England

USGS Publications Warehouse

Aleinikoff, J.N.; Wintsch, R.P.; Tollo, R.P.; Unruh, D.M.; Fanning, C.M.; Schmitz, M.D.

2007-01-01

The Killingworth dome of south-central Connecticut occurs at the southern end of the Bronson Hill belt. It is composed of tonalitic and trondhjemitic orthogneisses (Killingworth complex) and bimodal metavolcanic rocks (Middletown complex) that display calc-alkaline affinities. Orthogneisses of the Killingworth complex (Boulder Lake gneiss, 456 ?? 6 Ma; Pond Meadow gneiss, ???460 Ma) were emplaced at about the same time as eruption and deposition of volcanic-sedimentary rocks of the Middletown complex (Middletown Formation, 449 ?? 4 Ma; Higganum gneiss, 459 ?? 4 Ma). Hidden Lake gneiss (339 ?? 3 Ma) occurs as a pluton in the core of the Killingworth dome, and, on the basis of geochemical and isotopic data, is included in the Killingworth complex. Pb and Nd isotopic data suggest that the Pond Meadow, Boulder Lake, and Hidden Lake gneisses (Killingworth complex) resulted from mixing of Neoproterozoic Gander terrane sources (high 207Pb/204Pb and intermediate ??Nd) and less radiogenic (low 207Pb/204Pb and low ??Nd) components, whereas Middletown Formation and Higganum gneiss (Middletown complex) were derived from mixtures of Gander basement and primitive (low 207Pb/204Pb and high ??Nd) sources. The less radiogenic component for the Killingworth complex is similar in isotopic composition to material from Laurentian (Grenville) crust. However, because published paleomagnetic and paleontologic data indicate that the Gander terrane is peri-Gondwanan in origin, the isotopic signature of Killingworth complex rocks probably was derived from Gander basement that contained detritus from non-Laurentian sources such as Amazonia, Baltica, or Oaxaquia. We suggest that the Killingworth complex formed above an east-dipping subduction zone on the west margin of the Gander terrane, whereas the Middletown complex formed to the east in a back-arc rift environment. Subsequent shortening, associated with the assembly of Pangea in the Carboniferous, resulted in Gander cover terranes over the Avalon terrane in the west; and in the Middletown complex over the Killingworth complex in the east. Despite similarities of emplacement age, structural setting, and geographic continuity of the Killingworth dome with Oliverian domes in central and northern New England, new and published isotopic data suggest that the Killingworth and Middletown complexes were derived from Gander crust, and are not part of the Bronson Hill arc that was derived from Laurentian crust. The trace of the Ordovician Iapetan suture (the Red Indian line) between rocks of Laurentian and Ganderian origin probably extends from Southwestern New Hampshire west of the Pelham dome of northcentral Massachusetts and is coverd by Mesozoic rocks of the Hartford basin.

Building a house on shifting sand: methodological considerations when evaluating the implementation and adoption of national electronic health record systems.

PubMed

Takian, Amirhossein; Petrakaki, Dimitra; Cornford, Tony; Sheikh, Aziz; Barber, Nicholas

2012-04-30

A commitment to Electronic Health Record (EHR) systems now constitutes a core part of many governments' healthcare reform strategies. The resulting politically-initiated large-scale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively) short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England's National Health Service's Care Records Service (NHS CRS). We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations → intervention → changed operations (outcome). Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT) projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within multiple specific settings and reflecting a constantly changing milieu of policies, strategies and software, with constant interactions across such boundaries.

78 FR 1851 - New England States Committee on Electricity v. ISO New England Inc.; Notice of Complaint

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-09

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-34-000] New England States Committee on Electricity v. ISO New England Inc.; Notice of Complaint Take notice that on December... sections 206 of the Federal Power Act, 16 U.S.C. 824(e), New England States Committee on Electricity...

The UNH Earth Systems Observatory: A Regional Application in Support of GEOSS Global-Scale Objectives

NASA Astrophysics Data System (ADS)

Vorosmarty, C. J.; Braswell, B.; Fekete, B.; Glidden, S.; Hartmann, H.; Magill, A.; Prusevich, A.; Wollheim, W.; Blaha, D.; Justice, D.; Hurtt, G.; Jacobs, J.; Ollinger, S.; McDowell, W.; Rock, B.; Rubin, F.; Schloss, A.

2006-12-01

The Northeast corridor of the US is emblematic of the many changes taking place across the nation's and indeed the world's watersheds. Because ecosystem and watershed change occurs over many scales and is so multifaceted, transferring scientific knowledge to applications as diverse as remediation of local ground water pollution, setting State-wide best practices for non-point source pollution control, enforcing regional carbon sequestration treaties, or creating public/private partnerships for protecting ecosystem services requires a new generation of integrative environmental surveillance systems, information technology, and information transfer to the user community. Geographically complex ecosystem interactions justify moving toward more integrative, regionally-based management strategies to deal with issues affecting land, inland waterways, and coastal waterways. A unified perspective that considers the full continuum of processes which link atmospheric forcings, terrestrial responses, watershed exports along drainage networks, and the final delivery to the coastal zone, nearshore, and off shore waters is required to adequately support the management challenge. A recent inventory of NOAA-supported environmental surveillance systems, IT resources, new sensor technologies, and management-relevant decision support systems shows the community poised to formulate an integrated and operational picture of the environment of New England. This paper presents the conceptual framework and early products of the newly-created UNH Earth Systems Observatory. The goal of the UNH Observatory is to serve as a regionally-focused yet nationally-prominent platform for observation-based, integrative science and management of the New England/Gulf of Maine's land, air, and ocean environmental systems. Development of the UNH Observatory is being guided by the principles set forth under the Global Earth Observation System of Systems and is cast as an end-to-end prototype for GEOSS, targeting the monitoring in near real time of regional ecosystem state. The UNH Earth Systems Observatory consists of five interacting components. These "pillars" include (1) the Observatory data holdings themselves, (2) IT informatics backbone with standards-compliant data and map services, (3) community engagement through User Working Groups (UWGs), (4) an Advisory Board (drawn from local, regional, and national entities), and (5) education and public outreach. The structure is designed to capitalize on "operations-ready" capabilities, to identify emerging opportunities for new data integration, and to use the Observatory as a regional "launchpad" from which data-intensive science and management activities can be tested and implemented operationally.

Complexity in the new NHS: longitudinal case studies of CCGs in England

PubMed Central

Checkland, Katherine; Coleman, Anna; Perkins, Neil

2016-01-01

Objective The reform in the English National Health Services (NHS) under the Health and Social Care Act 2012 is unlike previous NHS reorganisations. The establishment of clinical commissioning groups (CCGs) was intended to be ‘bottom up’ with no central blueprint. This paper sets out to offer evidence about how this process has played out in practice and examines the implications of the complexity and variation which emerged. Design Detailed case studies in CCGs across England, using interviews, observation and documentary analysis. Using realist framework, we unpacked the complexity of CCG structures. Setting/participants In phase 1 of the study (January 2011 to September 2012), we conducted 96 interviews, 439 h of observation in a wide variety of meetings, 2 online surveys and 38 follow-up telephone interviews. In phase 2 (April 2013 to March 2015), we conducted 42 interviews with general practitioners (GPs) and managers and observation of 48 different types of meetings. Results Our study has highlighted the complexity inherent in CCGs, arising out of the relatively permissive environment in which they developed. Not only are they very different from one another in size, but also in structure, functions between different bodies and the roles played by GPs. Conclusions The complexity and lack of uniformity of CCGs is important as it makes it difficult for those who must engage with CCGs to know who to approach at what level. This is of increasing importance as CCGs are moving towards greater integration across health and social care. Our study also suggests that there is little consensus as to what being a ‘membership’ organisation means and how it should operate. The lack of uniformity in CCG structure and lack of clarity over the meaning of ‘membership’ raises questions over accountability, which becomes of greater importance as CCG is taking over responsibility for primary care co-commissioning. PMID:26743708

Complexity in the new NHS: longitudinal case studies of CCGs in England.

PubMed

Checkland, Katherine; McDermott, Imelda; Coleman, Anna; Perkins, Neil

2016-01-07

The reform in the English National Health Services (NHS) under the Health and Social Care Act 2012 is unlike previous NHS reorganisations. The establishment of clinical commissioning groups (CCGs) was intended to be 'bottom up' with no central blueprint. This paper sets out to offer evidence about how this process has played out in practice and examines the implications of the complexity and variation which emerged. Detailed case studies in CCGs across England, using interviews, observation and documentary analysis. Using realist framework, we unpacked the complexity of CCG structures. In phase 1 of the study (January 2011 to September 2012), we conducted 96 interviews, 439 h of observation in a wide variety of meetings, 2 online surveys and 38 follow-up telephone interviews. In phase 2 (April 2013 to March 2015), we conducted 42 interviews with general practitioners (GPs) and managers and observation of 48 different types of meetings. Our study has highlighted the complexity inherent in CCGs, arising out of the relatively permissive environment in which they developed. Not only are they very different from one another in size, but also in structure, functions between different bodies and the roles played by GPs. The complexity and lack of uniformity of CCGs is important as it makes it difficult for those who must engage with CCGs to know who to approach at what level. This is of increasing importance as CCGs are moving towards greater integration across health and social care. Our study also suggests that there is little consensus as to what being a 'membership' organisation means and how it should operate. The lack of uniformity in CCG structure and lack of clarity over the meaning of 'membership' raises questions over accountability, which becomes of greater importance as CCG is taking over responsibility for primary care co-commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Estimating the burden of heat illness in England during the 2013 summer heatwave using syndromic surveillance

PubMed Central

Smith, Sue; Elliot, Alex J; Hajat, Shakoor; Bone, Angie; Smith, Gillian E; Kovats, Sari

2016-01-01

Background The burden of heat illness on health systems is not well described in the UK. Although the UK generally experiences mild summers, the frequency and intensity of hot weather is likely to increase due to climate change, particularly in Southern England. We investigated the impact of the moderate heatwave in 2013 on primary care and emergency department (ED) visits using syndromic surveillance data in England. Methods General practitioner in hours (GPIH), GP out of hours (GPOOH) and ED syndromic surveillance systems were used to monitor the health impact of heat/sun stroke symptoms (heat illness). Data were stratified by age group and compared between heatwave and non-heatwave years. Incidence rate ratios were calculated for GPIH heat illness consultations. Results GP consultations and ED attendances for heat illness increased during the heatwave period; GPIH consultations increased across all age groups, but the highest rates were in school children and those aged ≥75 years, with the latter persisting beyond the end of the heatwave. Extrapolating to the English population, we estimated that the number of GPIH consultations for heat illness during the whole summer (May to September) 2013 was 1166 (95% CI 1064 to 1268). This was double the rate observed during non-heatwave years. Conclusions These findings support the monitoring of heat illness (symptoms of heat/sun stroke) as part of the Heatwave Plan for England, but also suggest that specifically monitoring heat illness in children, especially those of school age, would provide additional early warning of, and situation awareness during heatwaves. PMID:26873949

Innovations in an Accounting Information Systems Course.

ERIC Educational Resources Information Center

Shaoul, Jean

A new approach to teaching an introductory accounting information systems course is outlined and the potential of this approach for integrating computers into the accounting curriculum at Manchester University (England) is demonstrated. Specifically, the use of a small inventory recording system and database in an accounting information course is…

The Education Systems of the United Kingdom. Oxford Studies in Comparative Education.

ERIC Educational Resources Information Center

Phillips, David, Ed.

Little current research focuses on the whole educational systems of England, Wales, Scotland, and Northern Ireland. Chapter 1, "The Educational Systems of the United Kingdom," points to shared cultural influences, broadly similar policy aims, and political, functional, and cultural interdependence to explain relatively modest…

Improving School Leadership. Volume 2: Case Studies on System Leadership

ERIC Educational Resources Information Center

Hopkins, David, Ed.; Nusche, Deborah, Ed.; Pont, Beatriz, Ed.

2008-01-01

This book explores what specialists are saying about system leadership for school improvement. Case studies examine innovative approaches to sharing leadership across schools in Belgium (Flanders), Finland and the United Kingdom (England) and leadership development programmes for system improvement in Australia and Austria. As these are emerging…

Modelling uveal melanoma

PubMed Central

Foss, A.; Cree, I.; Dolin, P.; Hungerford, J.

1999-01-01

BACKGROUND/AIM—There has been no consistent pattern reported on how mortality for uveal melanoma varies with age. This information can be useful to model the complexity of the disease. The authors have examined ocular cancer trends, as an indirect measure for uveal melanoma mortality, to see how rates vary with age and to compare the results with their other studies on predicting metastatic disease.
METHODS—Age specific mortality was examined for England and Wales, the USA, and Canada. A log-log model was fitted to the data. The slopes of the log-log plots were used as measure of disease complexity and compared with the results of previous work on predicting metastatic disease.
RESULTS—The log-log model provided a good fit for the US and Canadian data, but the observed rates deviated for England and Wales among people over the age of 65 years. The log-log model for mortality data suggests that the underlying process depends upon four rate limiting steps, while a similar model for the incidence data suggests between three and four rate limiting steps. Further analysis of previous data on predicting metastatic disease on the basis of tumour size and blood vessel density would indicate a single rate limiting step between developing the primary tumour and developing metastatic disease.
CONCLUSIONS—There is significant underreporting or underdiagnosis of ocular melanoma for England and Wales in those over the age of 65 years. In those under the age of 65, a model is presented for ocular melanoma oncogenesis requiring three rate limiting steps to develop the primary tumour and a fourth rate limiting step to develop metastatic disease. The three steps in the generation of the primary tumour involve two key processes—namely, growth and angiogenesis within the primary tumour. The step from development of the primary to development of metastatic disease is likely to involve a single rate limiting process.

 PMID:10216060

Qualitative interviews with healthcare staff in four European countries to inform adaptation of an intervention to increase chlamydia testing.

PubMed

McNulty, Cliodna; Ricketts, Ellie J; Fredlund, Hans; Uusküla, Anneli; Town, Katy; Rugman, Claire; Tisler-Sala, Anna; Mani, Alix; Dunais, Brigitte; Folkard, Kate; Allison, Rosalie; Touboul, Pia

2017-09-25

To determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England. Qualitative interviews. European primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013. 45 GP staff, 13 trainers and 18 stakeholders. The iterative interview schedule explored participants' personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis. Findings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country's health services. A common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

ANNUAL REPORT For Calendar Year 2011 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2011-12-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States, the six New England state land grant universities and the Federal Highway Administration (FHWA). Through the Consor...

ANNUAL REPORT For Calendar Year 2015 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2018-01-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States, the six New England state land grant universities and the Federal Highway Administration (FHWA). Through the Consor...

New England Transportation Consortium annual report for calendar year 2012.

DOT National Transportation Integrated Search

2013-02-01

The New England Transportation Consortium (NETC) is a cooperative effort of the : transportation agencies of the six New England States, the six New England state land grant universities and the Federal Highway Administration (FHWA). Through the Cons...

ANNUAL REPORT For Calendar Year 2010 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2011-04-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States, the six New England state land grant universities and the Federal Highway Administration (FHWA). Through the Consor...

ANNUAL REPORT For Calendar Year 2013 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2014-02-02

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States, the six New England state land grant universities and the Federal Highway Administration (FHWA). Through the Consor...

ANNUAL REPORT For Calendar Year 2014 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2015-02-02

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States, the six New England state land grant universities and the Federal Highway Administration (FHWA). Through the Consor...

A Comparative Review of Policy and Practice for Education for Sustainable Development/Education for Global Citizenship (ESD/GC) in Teacher Education across the Four Nations of the UK

ERIC Educational Resources Information Center

Bamber, Philip; Bullivant, Andrea; Glover, Alison; King, Betsy; McMcCann, Gerard

2016-01-01

The early 21st century has seen a period of extreme turbulence in education at all levels in the UK. Although education policy was administrated on a territorial basis before 1999, the 1998-1999 devolution settlement has amplified the complexity of education policy and practice across England, Wales, Scotland, and Northern Ireland. Through a…

Moral dilemmas and abortion decision-making: Lessons learnt from abortion research in England and Wales.

PubMed

Hoggart, Lesley

2018-05-21

This paper scrutinises the concepts of moral reasoning and personal reasoning, problematising the binary model by looking at young women's pregnancy decision-making. Data from two UK empirical studies are subjected to theoretically driven qualitative secondary analysis, and illustrative cases show how complex decision-making is characterised by an intertwining of the personal and the moral, and is thus best understood by drawing on moral relativism.

Red oak in southern New England and big-leaf mahogany in the Yucatan Peninsula: can mixed-species forests be sustainably managed for single-species production?

Treesearch

M. Kelty; L. Camara-Cabrales; J. Grogan

2011-01-01

Complex mixed-species forests are the focus of conservation efforts that seek to maintain native biodiversity. However, much of this forestland is privately owned and is managed for timber income as well as for conservation. Management of these high-diversity forests is particularly difficult when only one tree species produces the majority of high-value timber. We...

Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK

PubMed Central

Bevan, Gwyn; Hamblin, Richard

2009-01-01

Following devolution, differences developed between UK countries in systems of measuring performance against a common target that ambulance services ought to respond to 75% of calls for what may be immediately life threatening emergencies (category A calls) within 8 minutes. Only in England was this target integral to a ranking system of ‘star rating’, which inflicted reputational damage on services that failed to hit targets, and only in England has this target been met. In other countries, the target has been missed by such large margins that services would have been publicly reported as failing, if they had been covered by the English system of star ratings. The paper argues that this case-study adds to evidence from comparisons of different systems of hospital performance measurement that, to have an effect, these systems need to be designed to inflict reputational damage on those that have performed poorly; and it explores implications of this hypothesis. The paper also asks questions about the adequacy of systems of performance measurement of ambulance services in UK countries. PMID:19381327

Automated biosurveillance data from England and Wales, 1991-2011.

PubMed

Enki, Doyo G; Noufaily, Angela; Garthwaite, Paul H; Andrews, Nick J; Charlett, André; Lane, Chris; Farrington, C Paddy

2013-01-01

Outbreak detection systems for use with very large multiple surveillance databases must be suited both to the data available and to the requirements of full automation. To inform the development of more effective outbreak detection algorithms, we analyzed 20 years of data (1991-2011) from a large laboratory surveillance database used for outbreak detection in England and Wales. The data relate to 3,303 distinct types of infectious pathogens, with a frequency range spanning 6 orders of magnitude. Several hundred organism types were reported each week. We describe the diversity of seasonal patterns, trends, artifacts, and extra-Poisson variability to which an effective multiple laboratory-based outbreak detection system must adjust. We provide empirical information to guide the selection of simple statistical models for automated surveillance of multiple organisms, in the light of the key requirements of such outbreak detection systems, namely, robustness, flexibility, and sensitivity.

Automated Biosurveillance Data from England and Wales, 1991–2011

PubMed Central

Enki, Doyo G.; Noufaily, Angela; Garthwaite, Paul H.; Andrews, Nick J.; Charlett, André; Lane, Chris

2013-01-01

Outbreak detection systems for use with very large multiple surveillance databases must be suited both to the data available and to the requirements of full automation. To inform the development of more effective outbreak detection algorithms, we analyzed 20 years of data (1991–2011) from a large laboratory surveillance database used for outbreak detection in England and Wales. The data relate to 3,303 distinct types of infectious pathogens, with a frequency range spanning 6 orders of magnitude. Several hundred organism types were reported each week. We describe the diversity of seasonal patterns, trends, artifacts, and extra-Poisson variability to which an effective multiple laboratory-based outbreak detection system must adjust. We provide empirical information to guide the selection of simple statistical models for automated surveillance of multiple organisms, in the light of the key requirements of such outbreak detection systems, namely, robustness, flexibility, and sensitivity. PMID:23260848

New England Lakes & Ponds Project

EPA Science Inventory

The New England Lakes and Ponds Project provides a consistent and first time comprehensive assessment of the ecological and water quality condition of lakes and ponds across the New England region. The project is being conducted by EPA along with the New England Interstate Water...

The Transmutation of Deference in Medicine: An Ethico-Legal Perspective.

PubMed

Devaney, Sarah; Holm, Søren

2018-05-01

This article critically considers the question of whether an increase in legal recognition of patient autonomy culminating in the decision of the Supreme Court in Montgomery v Lanarkshire Health Board in 2015 has led to the death of deference to doctors, not only within the courts and healthcare regulatory arenas in England and Wales but also in the consulting room and the health care system more broadly. We argue that deference has not been eradicated, but that the types of deference paid to doctors and to the medical profession have changed. In addition, whilst traditionally deference was extended towards the medical profession, increasing instances of deference being shown to other parties in the healthcare setting can be identified, allowing wider debate or recognition of the complexity of understandings, interests and aims of all those involved. Finally, we note instances in which deference to the medical profession has become more hidden.

Evaluation of terrain complexity by autocorrelation. [geomorphology and geobotany

NASA Technical Reports Server (NTRS)

Craig, R. G.

1982-01-01

The topographic complexity of various sections of the Ozark, Appalachian, and Interior Low Plateaus, as well as of the New England, Piedmont, Blue Ridge, Ouachita, and Valley and Ridge Provinces of the Eastern United States were characterized. The variability of autocorrelation within a small area (7 1/2-ft quadrangle) to the variability at widely separated and diverse areas within the same physiographic region was compared to measure the degree of uniformity of the processes which can be expected to be encountered within a given physiographic province. The variability of autocorrelation across the eight geomorphic regions was compared and contrasted. The total study area was partitioned into subareas homogeneous in terrain complexity. The relation between the complexity measured, the geomorphic process mix implied, and the way in which geobotanical information is modified into a more or less recognizable entity is demonstrated. Sampling strategy is described.

Co-operation and conflict under hard and soft contracting regimes: case studies from England and Wales

PubMed Central

2013-01-01

Background This paper examines NHS secondary care contracting in England and Wales in a period which saw increasing policy divergence between the two systems. At face value, England was making greater use of market levers and utilising harder-edged service contracts incorporating financial penalties and incentives, while Wales was retreating from the 1990s internal market and emphasising cooperation and flexibility in the contracting process. But there were also cross-border spill-overs involving common contracting technologies and management cultures that meant that differences in on-the-ground contracting practices might be smaller than headline policy differences suggested. Methods The nature of real-world contracting behaviour was investigated by undertaking two qualitative case studies in England and two in Wales, each based on a local purchaser/provider network. The case studies involved ethnographic observations and interviews with staff in primary care trusts (PCTs) or local health boards (LHBs), NHS or Foundation trusts, and the overseeing Strategic Health Authority or NHS Wales regional office, as well as scrutiny of relevant documents. Results Wider policy differences between the two NHS systems were reflected in differing contracting frameworks, involving regional commissioning in Wales and commissioning by either a PCT, or co-operating pair of PCTs in our English case studies, and also in different oversight arrangements by higher tiers of the service. However, long-term relationships and trust between purchasers and providers had an important role in both systems when the financial viability of organisations was at risk. In England, the study found examples where both PCTs and trusts relaxed contractual requirements to assist partners faced with deficits. In Wales, news of plans to end the purchaser/provider split meant a return to less precisely-specified block contracts and a renewed concern to build cooperation between LHB and trust staff. Conclusions The interdependency of local purchasers and providers fostered long-term relationships and co-operation that shaped contracting behaviour, just as much as the design of contracts and the presence or absence of contractual penalties and incentives. Although conflict and tensions between contracting partners sometimes surfaced in both the English and Welsh case studies, cooperative behaviour became crucial in times of trouble. PMID:23734604

Omega Navigation System Course Book. Volume 2

DTIC Science & Technology

1994-07-01

STATION ID LOCATION LATITUDE LONGITUDE FREQUENCY RADIATED (kHz) POWER (kW) GBR§ Rugby , U.K. 52022’N 1011’W 16.0 45 JxZ§ Noviken, Norway 66058’N 13053’E...FREQUENCY RADIATEDIDENTIFICATION LOCATION (o)dg)kz)POWER(dog) (dog) (kHz) (kW) GBR Rugby , England 52.37N 1.19W 16.0 45 JXZ Noviken, Norway 66.97N 13.89E...IDENTIFICATION FREQUENCY RADIATED LOCATION LATITUDE LONGITUDE (kHz) POWER (kW) (deg) (deg) GBR 16.0 45 Rugby , England 52.37 N 1.19W JHZ 16.4 45 Noviken

A Systemless System: Designing the Disarticulation of English State Education

ERIC Educational Resources Information Center

Lawn, Martin

2013-01-01

The idea of a system of education has never been fully accepted in England. A more realistic translation of the realities of English education is that of systems of education, folded inside each other. Although it is possible to outline the building blocks of a national system (primary, secondary, further and higher), the political, spatial and…

77 FR 52137 - Proposed Order and Request for Comment on a Petition From Certain Independent System Operators...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

... New York Independent System Operator, Inc.; and In the Matter of the Petition for an Exemptive Order... Independent System Operator (``CAISO'') and New York Independent System Operator (``NYISO'')), whose central... Commodity Exchange Act by ISO New England Inc.; In the Matter of the Petition for an Exemptive Order Under...

[Origin of animal experimentation legislation in the 19th century].

PubMed

Pocard, M

1999-01-01

The first legislation in the world, designed to protect animals used in research, was passed in England in 1876, and is still in force today. It is one of the strictest in Europe. At the same period, France had no such law, and was the country conducting the greatest amount of animal experimentation. Comparing, these two countries, in the middle of the 19th century, can account for this difference. The most important difference seems to be related to the theological question: are animals endowed with a soul? Saint Augustine, claimed, in the 4th century, perhaps because of an experiment with the centipede, that animals do not have a soul. In the 17th century, René Descartes, using a different philosophical system, reached a similar conclusion, in France. On the other hand, under the influence of Charles Darwin, England rejected the Roman Catholic conclusion, about the soul of animals. The industrial revolution, occurring earlier in England than in France, also changed the society, developing urban areas, where people were cut off from rural life and changing human relationships with animals. The industrial revolution enabled the development of the press, giving impetus to public opinion. These facts, combined with a caution of science, which was more developed in England than in France, brought about the first important "anti-doctor" campaign.

Primary care and health inequality: Difference-in-difference study comparing England and Ontario.

PubMed

Cookson, Richard; Mondor, Luke; Asaria, Miqdad; Kringos, Dionne S; Klazinga, Niek S; Wodchis, Walter P

2017-01-01

It is not known whether equity-oriented primary care investment that seeks to scale up the delivery of effective care in disadvantaged communities can reduce health inequality within high-income settings that have pre-existing universal primary care systems. We provide some non-randomised controlled evidence by comparing health inequality trends between two similar jurisdictions-one of which implemented equity-oriented primary care investment in the mid-to-late 2000s as part of a cross-government strategy for reducing health inequality (England), and one which invested in primary care without any explicit equity objective (Ontario, Canada). We analysed whole-population data on 32,482 neighbourhoods (with mean population size of approximately 1,500 people) in England, and 18,961 neighbourhoods (with mean population size of approximately 700 people) in Ontario. We examined trends in mortality amenable to healthcare by decile groups of neighbourhood deprivation within each jurisdiction. We used linear models to estimate absolute and relative gaps in amenable mortality between most and least deprived groups, considering the gradient between these extremes, and evaluated difference-in-difference comparisons between the two jurisdictions. Inequality trends were comparable in both jurisdictions from 2004-6 but diverged from 2007-11. Compared with Ontario, the absolute gap in amenable mortality in England fell between 2004-6 and 2007-11 by 19.8 per 100,000 population (95% CI: 4.8 to 34.9); and the relative gap in amenable mortality fell by 10 percentage points (95% CI: 1 to 19). The biggest divergence occurred in the most deprived decile group of neighbourhoods. In comparison to Ontario, England succeeded in reducing absolute socioeconomic gaps in mortality amenable to healthcare from 2007 to 2011, and preventing them from growing in relative terms. Equity-oriented primary care reform in England in the mid-to-late 2000s may have helped to reduce socioeconomic inequality in health, though other explanations for this divergence are possible and further research is needed on the specific causal mechanisms.

The use of monitoring data for identifying factors influencing phytoplankton bloom dynamics in the eutrophic Taw Estuary, SW England.

PubMed

Maier, Gerald; Glegg, Gillian A; Tappin, Alan D; Worsfold, Paul J

2009-07-01

Using the Taw Estuary as an example, data routinely collected by the Environment Agency for England and Wales over the period 1990-2004 were interrogated to identify the drivers of excessive algal growth. The estuary was highly productive with chlorophyll concentrations regularly exceeding 100 microg L(-1), mostly during periods of low freshwater input from the River Taw when estuarine water residence times were longest. However, algal growth in mid estuary was often inhibited by ammonia inputs from the adjacent sewage treatment works. The reported approach demonstrates the value of applying conventional statistical analyses in a structured way to existing monitoring data and is recommended as a useful tool for the rapid assessment of eutrophication. However, future estuarine monitoring should include the collection of dissolved organic nutrient data and targeted high temporal resolution data because the drivers of eutrophication are complex and often very specific to a particular estuary.

Suicide after absconding from inpatient care in England: an exploration of mental health professionals' experiences.

PubMed

Hunt, Isabelle M; Clements, Caroline; Saini, Pooja; Rahman, Mohammad Shaiyan; Shaw, Jenny; Appleby, Louis; Kapur, Nav; Windfuhr, Kirsten

2016-06-01

Absconding from inpatient care is associated with suicide risk in psychiatric populations. However, little is known about the real world context of suicide after absconding from a psychiatric ward or the experiences of clinical staff caring for these patients. To identify the characteristics of inpatients who died by suicide after absconding and to explore these and further key issues related to suicide risk from the perspective of clinical staff. A mixed-methods study using quantitative data of all patient suicides in England between 1997 and 2011 and a thematic analysis of semi-structured interviews with 21 clinical staff. Four themes were identified as areas of concern for clinicians: problems with ward design, staffing problems, difficulties in assessing risk, and patient specific factors. Results suggest that inpatients who died by suicide after absconding may have more complex and severe illness along with difficult life events, such as homelessness. Closer monitoring of inpatients and access points, and improved risk assessments are important to reduce suicide in this patient group.

‘Nature Concocts & Expels’: The Agents and Processes of Recovery from Disease in Early Modern England

PubMed Central

Newton, Hannah

2015-01-01

The ‘golden saying’ in early modern medicine was ‘Nature is the healer of disease’. This article uncovers the meaning and significance of this forgotten axiom by investigating perceptions of the agents and physiological processes of recovery from illness in England, c.1580–1720. Drawing on sources such as medical texts and diaries, it shows that doctors and laypeople attributed recovery to three agents—God, Nature and the practitioner. While scholars are familiar with the roles of providence and medicine, the vital agency of Nature has been overlooked. In theory, the agents operated in a hierarchy: Nature was ‘God's instrument’, and the physician, ‘Nature's servant’; but in practice the power balance was more ambivalent. Nature was depicted both as a housewife who cooked and cleaned the humours, and as a warrior who defeated the disease. Through exploring these complex dynamics, the article sheds fresh light on concepts of gender, disease and bodies. PMID:26217069

The transmission dynamics of groups A and B human respiratory syncytial virus (hRSV) in England & Wales and Finland: seasonality and cross-protection.

PubMed

White, L J; Waris, M; Cane, P A; Nokes, D J; Medley, G F

2005-04-01

Human respiratory syncytial virus (hRSV) transmission dynamics are inherently cyclical, and the observed genetic diversity (between groups A and B) also appears to have a repeating pattern. A key unknown is the extent to which genetic variants interact immunologically, and thus impact on epidemiology. We developed a novel mathematical model for hRSV transmission including seasonal forcing of incidence and temporary intra- and inter-group partial immunity. Simultaneous model fits to data from two locations (England & Wales, UK, and Turku, Finland) successfully reproduced the contrasting infection dynamics and group A/B dominance patterns. Parameter estimates are consistent with direct estimates. Differences in the magnitude and seasonal variation in contact rate between the two populations alone could account for the variation in dynamics between these populations. The A/B group dominance patterns are explained by reductions in susceptibility to and infectiousness of secondary homologous and heterologous infections. The consequences of the observed dynamic complexity are discussed.

Can a purchaser be a partner? Nursing education in the English universities.

PubMed

Meerabeau, E

2001-01-01

Since the early 1990s, public sector management in England has been exhorted to follow the example of the private sector, and 'quasi-markets' have been established, for example in the health service. A quasi-market also exists between the NHS and higher education for the purchasing (or procurement) of nursing education. This paper uses policy documents such as the National Health Service Executive Circular (March 1999) on 'Good Contracting Guidelines' for Non-Medical Education and Training, plus other relevant literature on the commodification of higher education, quasi-markets and contract theory to examine this market, and the confusion of two rhetorics, those of competition and partnership. Nursing occupies a marginal place in higher education in England, having only recently become part of it. The emphasis of the quasi-market on the output of a trained 'fit for purpose' labour force combines with professional attempts to create an academic discipline, in complex ways which are as yet underanalysed.

System-Level Barriers and Facilitators for Foregoing or Withdrawing Dialysis: A Qualitative Study of Nephrologists in the United States and England.

PubMed

Grubbs, Vanessa; Tuot, Delphine S; Powe, Neil R; O'Donoghue, Donal; Chesla, Catherine A

2017-11-01

Despite a growing body of literature suggesting that dialysis does not confer morbidity or mortality benefits for all patients with chronic kidney failure, the initiation and continuation of dialysis therapy in patients with poor prognosis is commonplace. Our goal was to elicit nephrologists' perspectives on factors that affect decision making regarding end-stage renal disease. Semistructured, individual, qualitative interviews. Participants were purposively sampled based on age, race, sex, geographic location, and practice type. Each was asked about his or her perspectives and experiences related to foregoing and withdrawing dialysis therapy. Interviews were audiotaped, transcribed, and analyzed using narrative and thematic analysis. We conducted 59 semistructured interviews with nephrologists from the United States (n=41) and England (n=18). Most participants were 45 years or younger, men, and white. Average time since completing nephrology training was 14.2±11.6 (SD) years. Identified system-level facilitators and barriers for foregoing and withdrawing dialysis therapy stemmed from national and institutional policies and structural factors, how providers practice medicine (the culture of medicine), and beliefs and behaviors of the public (societal culture). In both countries, the predominant barriers described included lack of training in end-of-life conversations and expectations for aggressive care among non-nephrologists and the general public. Primary differences included financial incentives to dialyze in the United States and widespread outpatient conservative management programs in England. Participants' views may not fully capture those of all American or English nephrologists. Nephrologists in the United States and England identified several system-level factors that both facilitated and interfered with decision making around foregoing and withdrawing dialysis therapy. Efforts to expand facilitators while reducing barriers could lead to care practices more in keeping with patient prognosis. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Who wants to be involved in health care decisions? Comparing preferences for individual and collective involvement in England and Sweden.

PubMed

Fredriksson, Mio; Eriksson, Max; Tritter, Jonathan

2017-07-14

Patient and public involvement (PPI) is framed as positive for individuals, the health system, public health, as well as for communities and society as a whole. We investigated whether preferences for PPI differed between two countries with Beveridge type health systems-Sweden and England. We measured willingness to be involved in individual treatment decisions and in decisions about the organization and provision of local health and social care services. This was a comparative cross-sectional study of the general population's preferences. Together, the two samples included 3125 respondents; 1625 in England and 1500 in Sweden. Country differences were analysed in a multinomial regression model controlling for gender, age and educational attainment. Overall, 68% of respondents wanted a passive patient role and 44% wanted to be involved in local decisions about organization and provision of services. In comparison with in Sweden, they were in England less likely to want a health professional such as a GP or consultant to make decisions about their treatment and also more likely to want to make their own decisions. They were also less likely to want to be involved in local service development decisions. An increased likelihood of wanting to be involved in organizational decision-making was associated with individuals wanting to make their own treatment decisions. Women were less likely to want health professionals to make decisions and more likely to want to be involved in organizational decisions. An effective health system that ensures public health must integrate an effective approach to PPI both in individual treatment decisions and shaping local health and social care priorities. To be effective, involvement activities must take in to account the variation in the desire for involvement and the implications that this has for equity. More work is needed to understand the relationship between the desire to be involved and actually being involved, but both appear related to judgements of the impact of involvement on health care decisions.

Theoretical study on the photoabsorption in the Herzberg I band system of the O 2 molecule

NASA Astrophysics Data System (ADS)

Takegami, Ryuta; Yabushita, Satoshi

2005-01-01

The Herzberg I band system of the oxygen molecule is electric-dipole forbidden and its absorption strength has been explained by intensity borrowing models which include the spin-orbit (SO) and L-uncoupling (RO) interactions as perturbations. We employed three different levels of theoretical models to evaluate these two interactions, and obtained the rotational and vibronic absorption strengths using the ab initio method. The first model calculates the transition moments induced by the SO interaction variationally with the SO configuration interaction method (SOCI), and uses the first-order perturbation theory for the RO interaction, and is called SOCI. The second is based on the first-order perturbation theory for both the SO and RO interactions, and is called Pert(Full). The last is a limited version of Pert(Full), in that the first-order perturbation wavefunction for the initial and final state is represented by only one dominant basis, namely the 1 3Π g and B3Σu- state, respectively, as originally used by England et al. [Can. J. Phys. 74 (1996) 185], and is called Pert(England). The vibronic oscillator strengths calculated by these three models were in good agreement with the experimental values. As for the integrated rotational linestrengths, the SOCI and Pert(Full) models reproduced the experimental results very well, however the Pert(England) model did not give satisfactory results. Since the Pert(England) model takes only the 1 3Π g and B3Σu- states into consideration, it cannot contain the complicated configuration interactions with highly excited states induced by the SO and RO interaction, which plays an important role for calculating the delicate integrated rotational linestrength. This result suggests that the configuration interaction with highly excited states due to some perturbations cannot be neglected in the case of very weak absorption band systems.

76 FR 56192 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-12

...-000. Applicants: ISO New England Inc. Description: ISO New England Inc. Resource Termination Filing.... Eastern Time on Thursday, September 22, 2011. Docket Numbers: ER11-4420-000. Applicants: ISO New England Inc. Description: ISO New England Inc. Resource Termination Filing-- EnerNOC. Filed Date: 09/01/2011...

Gauging the Health of New England's Lakes and Ponds

EPA Science Inventory

The New England Lakes and Ponds Project provides a consistent and first time comprehensive assessment of the ecological and water quality condition of lakes and ponds across the New England region. The project is being conducted by EPA along with the New England Interstate Water...

Satellites see major winter storm marching toward the U.S. East Coast

NASA Image and Video Library

2017-12-08

NASA and NOAA satellites are providing various views of the major winter storm marching toward the U.S. East coast on March 13. The storm is forecast to merge with another system and is expected to bring large snowfall totals from the Mid-Atlantic to New England. NASA's Aqua satellite gathered infrared data from the storm system and the area ahead of the storm for cloud and ground temperatures. NOAA's GOES-East satellite provided visible and infrared imagery that showed the extent and the movement of the system. Forecasters at the National Weather Service's Weather Prediction Center (WPC) noted that the low pressure system crossing the Midwest states and Ohio Valley is expected to merge with another low off the southeast U.S. coast. WPC stated "This will allow for a strong nor'easter to develop near the coast and cause a late-season snowstorm from the central Appalachians to New England, including many of the big cities in the Northeast U.S." Credits: NASA/NOAA GOES Project

Multi Media Systems. International Compendium. Eleven Project Descriptions of Combined Teaching Systems in Eight Countries.

ERIC Educational Resources Information Center

Gaudray, Francine, Comp.

The demands made by modern technological society on the traditional educational system are briefly discussed. The remainder of the compendium describes 11 projects which are using educational technology, principally televised instruction, with success. Projects from Brazil, Canada, West Germany, France, England, Japan, Poland, and the United…

System Redesign for System Capacity Building

ERIC Educational Resources Information Center

Hargreaves, David H.

2011-01-01

Purpose: A recent development in England is the emergence, under various names, of groups of schools working together in a variety of collaborative ways. Such diversification enjoys broad political support. In this paper, the author aims to argue that the trend is potentially a radical transformation of the school system as a whole. The concepts…

One-to-One Tuition: An Ideal Context for Learning?

ERIC Educational Resources Information Center

Ireson, Judith

2011-01-01

In many parts of the world, the state education system is accompanied by a shadow system that mirrors the school curriculum. In England, most provision in the shadow system is through private, one-to-one tutoring, offered by those working independently and through local, regional and national agencies. International surveys indicate that shadow…

78 FR 53747 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

.... Applicants: ISO New England Inc. Description: ISO New England Inc. Resource Termination-- Constellation... Due: 5 p.m. e.t. 9/11/13. Docket Numbers: ER13-2212-000. Applicants: ISO New England Inc. Description: ISO New England Inc. Resource Termination--Waterbury Generation. Filed Date: 8/21/13. Accession Number...

75 FR 55846 - Draft Re-Evaluation for Environmental Impact Statement: Sikorsky Memorial Airport, Stratford, CT

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-14

..., Environmental Program Manager, Federal Aviation Administration New England, 12 New England Executive Park... Memorial Airport in Stratford, Connecticut. The document will assist the FAA in determining the suitability... following locations: FAA New England Region, 16 New England Executive Park, Burlington, MA, 781-238-7613...

Promoting Recruitment using Information Management Efficiently (PRIME): a stepped-wedge, cluster randomised trial of a complex recruitment intervention embedded within the REstart or Stop Antithrombotics Randomised Trial.

PubMed

Maxwell, Amy E; Parker, Richard A; Drever, Jonathan; Rudd, Anthony; Dennis, Martin S; Weir, Christopher J; Al-Shahi Salman, Rustam

2017-12-28

Few interventions are proven to increase recruitment in clinical trials. Recruitment to RESTART, a randomised controlled trial of secondary prevention after stroke due to intracerebral haemorrhage, has been slower than expected. Therefore, we sought to investigate an intervention to boost recruitment to RESTART. We conducted a stepped-wedge, cluster randomised trial of a complex intervention to increase recruitment, embedded within the RESTART trial. The primary objective was to investigate if the PRIME complex intervention (a recruitment co-ordinator who conducts a recruitment review, provides access to bespoke stroke audit data exports, and conducts a follow-up review after 6 months) increases the recruitment rate to RESTART. We included 72 hospital sites located in England, Wales, or Scotland that were active in RESTART in June 2015. All sites began in the control state and were allocated using block randomisation stratified by hospital location (Scotland versus England/Wales) to start the complex intervention in one of 12 different months. The primary outcome was the number of patients randomised into RESTART per month per site. We quantified the effect of the complex intervention on the primary outcome using a negative binomial, mixed model adjusting for site, December/January months, site location, and background time trends in recruitment rate. We recruited and randomised 72 sites and recorded their monthly recruitment to RESTART over 24 months (March 2015 to February 2017 inclusive), providing 1728 site-months of observations for the primary analysis. The adjusted rate ratio for the number of patients randomised per month after allocation to the PRIME complex intervention versus control time before allocation to the PRIME complex intervention was 1.06 (95% confidence interval 0.55 to 2.03, p = 0.87). Although two thirds of respondents to the 6-month follow-up questionnaire agreed that the audit reports were useful, only six patients were reported to have been randomised using the audit reports. Respondents frequently reported resource and time pressures as being key barriers to running the audit reports. The PRIME complex intervention did not significantly improve the recruitment rate to RESTART. Further research is needed to establish if PRIME might be beneficial at an earlier stage in a prevention trial or for prevention dilemmas that arise more often in clinical practice.

Proceedings of Damping 󈨟, Held in San Diego, California on 13 - 15 February 1991. Volume 2

DTIC Science & Technology

1991-08-01

Efficiency CBC* Dr. L. H. Sperling , J. J. Fay, and Dr. D. A. Thomas The Thermorheologically Complex Material CBD* Lt. Col. Ronald L. Bagley SESSION CC...Andrew S. Bicos. and J. S. Fechter The Need for Passive Damping in Feedback Controlled Flexible Struc- GBB tures Dr. Andreas von Flotow and D. W. Vos...Vibration Research, Southampton, England (R.C. Drew) Lehigh University, Bethlehem, Pennsylvania (L. Sperling ) MrS Corporation, Minneapolis, Minnesota

Direct cost of pars plana vitrectomy for the treatment of macular hole, epiretinal membrane and vitreomacular traction: a bottom-up approach.

PubMed

Nicod, Elena; Jackson, Timothy L; Grimaccia, Federico; Angelis, Aris; Costen, Marc; Haynes, Richard; Hughes, Edward; Pringle, Edward; Zambarakji, Hadi; Kanavos, Panos

2016-11-01

The direct cost to the National Health Service (NHS) in England of pars plana vitrectomy (PPV) is unknown since a bottom-up costing exercise has not been undertaken. Healthcare resource group (HRG) costing relies on a top-down approach. We aimed to quantify the direct cost of intermediate complexity PPV. Five NHS vitreoretinal units prospectively recorded all consumables, equipment and staff salaries during PPV undertaken for vitreomacular traction, epiretinal membrane and macular hole. Out-of-surgery costs between admission and discharge were estimated using a representative accounting method. The average patient time in theatre for 57 PPVs was 72 min. The average in-surgery cost for staff was £297, consumables £619, and equipment £82 (total £997). The average out-of-surgery costs were £260, including nursing and medical staff, other consumables, eye drops and hospitalisation. The total cost was therefore £1634, including 30 % overheads. This cost estimate was an under-estimate because it did not include out-of-theatre consumables or equipment. The average reimbursed HRG tariff was £1701. The cost of undertaking PPV of intermediate complexity is likely to be higher than the reimbursed tariff, except for hospitals with high throughput, where amortisation costs benefit from economies of scale. Although this research was set in England, the methodology may provide a useful template for other countries.

Armorican provenance for the mélange deposits below the Lizard ophiolite (Cornwall, UK): evidence for Devonian obduction of Cadomian and Lower Palaeozoic crust onto the southern margin of Avalonia

NASA Astrophysics Data System (ADS)

Strachan, Rob A.; Linnemann, Ulf; Jeffries, Teresa; Drost, Kerstin; Ulrich, Jens

2014-07-01

Devonian sedimentary rocks of the Meneage Formation within the footwall of the Lizard ophiolite complex in SW England are thought to have been derived from erosion of the over-riding Armorican microplate during collision with Avalonia and the closure of the Rheic Ocean. We further test this hypothesis by comparison of their detrital zircon suites with those of autochthonous Armorican strata. Five samples analysed from SW England (Avalonia) and NW France (Armorica) have a bimodal U-Pb zircon age distribution dominated by late Neoproterozoic to middle Cambrian (c. 710-518 Ma) and Palaeoproterozoic (c. 1,800-2,200 Ma) groupings. Both can be linked with lithologies exposed within the Cadomian belt as well as the West African craton, which is characterized by major tectonothermal events at 2.0-2.4 Ga. The detrital zircon signature of Avalonia is distinct from that of Armorica in that there is a much larger proportion of Mesoproterozoic detritus. The common provenance of the samples is therefore consistent with: (a) derivation of the Meneage Formation mélange deposits from the Armorican plate during Rheic Ocean closure and obduction of the Lizard Complex and (b) previous correlation of quartzite blocks within the Meneage Formation with the Ordovician Grès Armoricain Formation of NW France.

Pressure ulcer and wounds reporting in NHS hospitals in England part 1: Audit of monitoring systems.

PubMed

Smith, Isabelle L; Nixon, Jane; Brown, Sarah; Wilson, Lyn; Coleman, Susanne

2016-02-01

Internationally, health-care systems have attempted to assess the scale of and demonstrate improvement in patient harms. Pressure ulcer (PU) monitoring systems have been introduced across NHS in-patient facilities in England, including the Safety Thermometer (STh) (prevalence), Incident Reporting Systems (IRS) and the Strategic Executive Information System (STEIS) for serious incidents. This is the first of two related papers considering PU monitoring systems across NHS in-patient facilities in England and focusses on a Wound Audit (PUWA) to assess the accuracy of these systems. Part 2 of this work and recommendations are reported pp *-*. The PUWA was undertaken in line with 'gold-standard' PU prevalence methods in a stratified random sample of NHS Trusts; 24/34 (72.7%) invited NHS Trusts participated, from which 121 randomly selected wards and 2239 patients agreed to participate. The PUWA identified 160 (7.1%) patients with an existing PU, compared to 105 (4.7%) on STh. STh had a weighted sensitivity of 48.2% (95%CI 35.4%-56.7%) and weighted specificity of 99.0% (95%CI 98.99%-99.01%). The PUWA identified 189 (8.4%) patients with an existing/healed PU compared to 135 (6.0%) on IRS. IRS had an unweighted sensitivity of 53.4% (95%CI 46.3%-60.4%) and unweighted specificity of 98.3% (95%CI 97.7%-98.8%). 83 patients had one or more potentially serious PU on PUWA and 8 (9.6%) of these patients were reported on STEIS. The results identified high levels of under-reporting for all systems and highlighted data capture challenges, including the use of clinical staff to inform national monitoring systems and the completeness of clinical records for PUs. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

PubMed Central

Osaro, Erhabor; Chima, Njemanze

2014-01-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness. PMID:25182941

How a universal health system reduces inequalities: lessons from England

PubMed Central

Ali, Shehzad; Doran, Tim; Ferguson, Brian; Fleetcroft, Robert; Goddard, Maria; Goldblatt, Peter; Laudicella, Mauro; Raine, Rosalind; Cookson, Richard

2016-01-01

Background Provision of universal coverage is essential for achieving equity in healthcare, but inequalities still exist in universal healthcare systems. Between 2004/2005 and 2011/2012, the National Health Service (NHS) in England, which has provided universal coverage since 1948, made sustained efforts to reduce health inequalities by strengthening primary care. We provide the first comprehensive assessment of trends in socioeconomic inequalities of primary care access, quality and outcomes during this period. Methods Whole-population small area longitudinal study based on 32 482 neighbourhoods of approximately 1500 people in England from 2004/2005 to 2011/2012. We measured slope indices of inequality in four indicators: (1) patients per family doctor, (2) primary care quality, (3) preventable emergency hospital admissions and (4) mortality from conditions considered amenable to healthcare. Results Between 2004/2005 and 2011/2012, there were larger absolute improvements on all indicators in more-deprived neighbourhoods. The modelled gap between the most-deprived and least-deprived neighbourhoods in England decreased by: 193 patients per family doctor (95% CI 173 to 213), 3.29 percentage points of primary care quality (3.13 to 3.45), 0.42 preventable hospitalisations per 1000 people (0.29 to 0.55) and 0.23 amenable deaths per 1000 people (0.15 to 0.31). By 2011/2012, inequalities in primary care supply and quality were almost eliminated, but socioeconomic inequality was still associated with 158 396 preventable hospitalisations and 37 983 deaths amenable to healthcare. Conclusions Between 2004/2005 and 2011/2012, the NHS succeeded in substantially reducing socioeconomic inequalities in primary care access and quality, but made only modest reductions in healthcare outcome inequalities. PMID:26787198

Clinical negligence in hospitals in France and England.

PubMed

Kelly, Michael J; de Bono Q C, John; Métayer, Patrice

2015-12-01

This article arose from the back-to-back presentations by Michael Kelly and Patrice Métayer to the Anglo-French Medical Society in 2013 on the French and English legal systems handling a case of alleged clinical negligence as it proceeds from complaint to settlement or judgment in the two jurisdictions. Both systems have a hospital-based first stage with various avenues being available for amicable resolution, the French version being more regulated and prescribed than the English one. In both jurisdictions fewer than 5% cases go down the criminal route. Before the court is involved, in England there is an elaborate lawyer-controlled phase involving negotiations between the two sides and their experts which is expensive but often leads to pre-trial settlement for significant sums of money. Medical experts are central to all of this. In England they are largely unregulated and entirely advisory in an open market, in France they are both regulated and supervised by judges, being placed on official lists. These experts take a major inquisitorial role in a Debate between the two sides, combining the functions of Single Joint Expert (SJE), arbiter and mentor. If agreement is not reached, a second Debate before a different Expert is arranged. In both countries fewer than 5% cases reach a court for a hearing before a judge. In England a trial is an elaborate lengthy, expensive adversarial contest where all of the issues are rehearsed in full with factual and expert evidence, whereas in France in a contested case the judge reviews the reports of the two Debates with the lawyers who were involved (and not the experts, factual witnesses or parties). © The Author(s) 2015.

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England.

PubMed

Osaro, Erhabor; Chima, Njemanze

2014-06-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

A comparison of HAS & NICE guidelines for the economic evaluation of health technologies in the context of their respective national health care systems and cultural environments

PubMed Central

Massetti, Marc; Aballéa, Samuel; Videau, Yann; Rémuzat, Cécile; Roïz, Julie; Toumi, Mondher

2015-01-01

Background Health technology assessment (HTA) has been reinforced in France, notably with the introduction of economic evaluation in the pricing process for the most innovative and expensive treatments. Similarly to the National Institute for Clinical Excellence (NICE) in England, the National Authority for Health (HAS), which is responsible for economic evaluation of new health technologies in France, has published recommendations on the methods of economic evaluation. Since economic assessment represents a major element of HTA in England, exploring the differences between these methodological guidelines might help to comprehend both the shape and the role economic assessment is intended to have in the French health care system. Methods Methodological guidelines for economic evaluation in France and England have been compared topic-by-topic in order to bring out key differences in the recommended methods for economic evaluation. Results The analysis of both guidelines has revealed multiple similarities between France and England, although a number of differences were also noted regarding the elected methodology of analysis, the comparison of studies’ outcomes with cost-effectiveness thresholds, the study population to consider, the quality of life valuation methods, the perspective on costs, the types of resources considered and their valuation, the discount rates to apply in order to reflect the present value of interventions, etc. To account for these differences, modifications will be required in order to adapt economic models from one country to the other. Conclusions Changes in HTA assessment methods occur in response to different challenges determined by the different philosophical and cultural considerations surrounding health and welfare as well as the political considerations regarding the role of public policies and the importance of their evaluation. PMID:27123190

Fitness to stand trial, human rights and possibilities from England and Wales.

PubMed

Stewart, Jeanette; Woodward, Mary; Hepner, Flana

2015-06-01

The capacity of individuals with disability, including cognitive or mental health impairments, to access justice on an equal basis has been considered recently in several Australian jurisdictions. Impairments can render individuals vulnerable in the legal system, affecting their reliability as a witness or their fitness to be tried, especially when limited support is available to help these individuals meet the test and criteria for fitness to stand trial. This article considers the situation in Australia in light of human rights perspectives and compares it with the England and Wales approach where special support measures have been introduced to help individuals access justice. The article recommends that better support measures be introduced in Australia that would be consistent with a human rights framework calling for support to enable individuals with disability to access justice. In particular, the introduction of intermediaries, as used in England and Wales, would go some way towards helping vulnerable individuals to access justice.

Integrated mental health services in England: a policy paradox

PubMed Central

England, Elizabeth; Lester, Helen

2005-01-01

Abstract Purpose The purpose of this paper is to examine the effects of health care policy on the development of integrated mental health services in England. Data sources Drawing largely from a narrative review of the literature on adult mental health services published between January 1997 and February 2003 undertaken by the authors, we discuss three case studies of integrated care within primary care, secondary care and across the primary/secondary interface for people with serious mental illness. Conclusion We suggest that while the central thrust of a raft of recent Government policies in England has been towards integration of different parts of the health care system, policy waterfalls and implementation failures, the adoption of ideas before they have been thoroughly tried and tested, a lack of clarity over roles and responsibilities and poor communication have led to an integration rhetoric/reality gap in practice. This has particular implications for people with serious mental health problems. Discussion We conclude with suggestions for strategies that may facilitate more integrated working. PMID:16773165

Immigration, Wealth and the ‘Mortality Plateau’ in Emergent Urban-Industrial Towns of Nineteenth-Century Massachusetts

PubMed Central

Beemer, Jeffrey K.; Anderton, Douglas L.

2013-01-01

The mortality transition in Western Europe and the U.S. encompassed a much more complex set of conditions and experiences than earlier thought. Our research addresses the complex set of relationships among growing urban communities, family wealth, immigration and mortality in New England by examining individual-level, socio-demographic mortality correlates during the nineteenth-century mortality plateau and its early twentieth-century decline. In contrast to earlier theories that proposed a more uniform mortality transition, we offer an alternative hypothesis that focuses on the impact of family wealth and immigration on individual-level mortality during the early stages of the mortality transition in Northampton and Holyoke, Massachusetts. PMID:23667286

Neural network based load and price forecasting and confidence interval estimation in deregulated power markets

NASA Astrophysics Data System (ADS)

Zhang, Li

With the deregulation of the electric power market in New England, an independent system operator (ISO) has been separated from the New England Power Pool (NEPOOL). The ISO provides a regional spot market, with bids on various electricity-related products and services submitted by utilities and independent power producers. A utility can bid on the spot market and buy or sell electricity via bilateral transactions. Good estimation of market clearing prices (MCP) will help utilities and independent power producers determine bidding and transaction strategies with low risks, and this is crucial for utilities to compete in the deregulated environment. MCP prediction, however, is difficult since bidding strategies used by participants are complicated and MCP is a non-stationary process. The main objective of this research is to provide efficient short-term load and MCP forecasting and corresponding confidence interval estimation methodologies. In this research, the complexity of load and MCP with other factors is investigated, and neural networks are used to model the complex relationship between input and output. With improved learning algorithm and on-line update features for load forecasting, a neural network based load forecaster was developed, and has been in daily industry use since summer 1998 with good performance. MCP is volatile because of the complexity of market behaviors. In practice, neural network based MCP predictors usually have a cascaded structure, as several key input factors need to be estimated first. In this research, the uncertainties involved in a cascaded neural network structure for MCP prediction are analyzed, and prediction distribution under the Bayesian framework is developed. A fast algorithm to evaluate the confidence intervals by using the memoryless Quasi-Newton method is also developed. The traditional back-propagation algorithm for neural network learning needs to be improved since MCP is a non-stationary process. The extended Kalman filter (EKF) can be used as an integrated adaptive learning and confidence interval estimation algorithm for neural networks, with fast convergence and small confidence intervals. However, EKF learning is computationally expensive because it involves high dimensional matrix manipulations. A modified U-D factorization within the decoupled EKF (DEKF-UD) framework is developed in this research. The computational efficiency and numerical stability are significantly improved.

Grammar Teaching in Secondary School Foreign Language Learning in England: Teachers' Reported Beliefs and Observed Practices

ERIC Educational Resources Information Center

Liviero, Sara

2017-01-01

This study investigates teachers' beliefs relating to grammar teaching in modern foreign language (MFL) learning in England. Focus on grammatical form has been consistently supported by linguistic research and teacher practice, and has progressively been reinstated in England's National Curriculum. However, MFL learning assessment in England has…

Smart Routes: Migration Patterns among New England's College Freshmen

ERIC Educational Resources Information Center

Thomas, Michael K.

2003-01-01

Despite increased competition from other states, New England remains a very popular education destination for both undergraduate and graduate students. As with commerce, New England has a "balance of trade," with students flowing in and out of the region. As a region, New England enjoys a notable "positive" net migration of…

Ezekiel Cheever (1614-1708), New England Colonial Teacher.

ERIC Educational Resources Information Center

Parker, Franklin; Parker, Betty J.

This paper narrates the life of Ezekiel Cheever, the most famous colonial New England Latin grammar teacher of his time. Cheever came from middle class Puritan roots in England, receiving a classical education before emigrating to Boston (Massachusetts). His remarkably long teaching career of 70 years in four New England towns and the esteem shown…

Counting on commitment; the quality of primary care-led diabetes management in a system with minimal incentives

PubMed Central

2011-01-01

Background The aim of the present study was to assess the performance of three primary care-led initiatives providing structured care to patients with Type 2 diabetes in Ireland, a country with minimal incentives to promote the quality of care. Methods Data, from three primary care initiatives, were available for 3010 adult patients with Type 2 diabetes. Results were benchmarked against the national guidelines for the management of Type 2 diabetes in the community and results from the National Diabetes Audit (NDA) for England (2008/2009) and the Scottish Diabetes Survey (2009). Results The recording of clinical processes of care was similar to results in the UK however the recording of lifestyle factors was markedly lower. Recording of HbA1c, blood pressure and lipids exceeded 85%. Recording of retinopathy screening (71%) was also comparable to England (77%) and Scotland (90%). Only 63% of patients had smoking status recorded compared to 99% in Scotland while 70% had BMI recorded compared to 89% in England. A similar proportion of patients in this initiative and the UK achieved clinical targets. Thirty-five percent of patients achieved a target HbA1c of < 6.5% (< 48 mmol/mol) compared to 25% in England. Applying the NICE target for blood pressure (≤ 140/80 mmHg), 54% of patients reached this target comparable to 60% in England. Slightly less patients were categorised as obese (> 30 kg/m2) in Ireland (50%, n = 1060) compared to Scotland (54%). Conclusions This study has demonstrated what can be achieved by proactive and interested health professionals in the absence of national infrastructure to support high quality diabetes care. The quality of primary care-led diabetes management in the three initiatives studied appears broadly consistent with results from the UK with the exception of recording lifestyle factors. The challenge facing health systems is to establish quality assurance a responsibility for all health care professionals rather than the subject of special interest for a few. PMID:22204759

Lessons from Albion: Can Australia learn from England's approach to primary healthcare funding?

PubMed

Norman, Richard; Robinson, Suzanne

2015-01-01

As Australia struggles to meet increased demand for healthcare and contain expenditure there has been a focus on primary care and its role in demand management and keeping people out of expensive secondary care. However, with domestic policy struggling to find a suitable approach consideration of English policy could well be fruitful in the quest to strengthen and develop primary care in Australia. The purpose of this paper is to consider policy developments in England and explores these in relation to the Australian healthcare system. The authors highlight the key changes to policy that have occurred in the English healthcare system in recent years, and discuss whether they have proven successful. The authors discuss the barriers to implementing similar approaches in Australia, particularly the difference in system structure that would necessitate policy adaptation. Whilst there are differences in the structure and organisation of funding and service provision between countries, there are developments in England that are worthy of consideration from an Australian perspective. These include a focus on funding and commissioning that rewards quality not just activity and volume. As Australia sees the development of new primary care organisations that are tasked with commissioning then developments and lessons around the technical and relational aspects will be important to consider. The work highlights that Australia might consider learning from the English experience in this area and the types of incentives that may increase efficiency and quality of health service provision. This is important as it potentially gives greater certainty about those approaches most likely to yield beneficial outcomes for patients and the broader system.

The invertebrate ecology of the Chalk aquifer in England (UK)

NASA Astrophysics Data System (ADS)

Maurice, L.; Robertson, A. R.; White, D.; Knight, L.; Johns, T.; Edwards, F.; Arietti, M.; Sorensen, J. P. R.; Weitowitz, D.; Marchant, B. P.; Bloomfield, J. P.

2016-03-01

The Chalk is an important water supply aquifer, yet ecosystems within it remain poorly understood. Boreholes (198) in seven areas of England (UK) were sampled to determine the importance of the Chalk aquifer as a habitat, and to improve understanding of how species are distributed. Stygobitic macro-invertebrates were remarkably common, and were recorded in 67 % of boreholes in unconcealed Chalk, although they were not recorded in Chalk that is concealed by low-permeability strata and thus likely to be confined. Most species were found in shallow boreholes (<21 m) and boreholes with deep (>50 m) water tables, indicating that the habitat is vertically extensive. Stygobites were present in more boreholes in southern England than northern England (77 % compared to 38 %). Only two species were found in northern England compared to six in southern England, but overall seven of the eight stygobitic macro-invertebrate species found in England were detected in the Chalk. Two species are common in southern England, but absent from northern England despite the presence of a continuous habitat prior to the Devensian glaciation. This suggests that either they did not survive glaciations in the north where glaciers were more extensive, or dispersal rates are slow and they have never colonised northern England. Subsurface ecosystems comprising aquatic macro-invertebrates and meiofauna, as well as the microbial organisms they interact with, are likely to be widespread in the Chalk aquifer. They represent an important contribution to biodiversity, and may influence biogeochemical cycles and provide other ecosystem services.

Evaluating variation in use of definitive therapy and risk-adjusted prostate cancer mortality in England and the USA.

PubMed

Sachdeva, Ashwin; van der Meulen, Jan H; Emberton, Mark; Cathcart, Paul J

2015-02-24

Prostate cancer mortality (PCM) in the USA is among the lowest in the world, whereas PCM in England is among the highest in Europe. This paper aims to assess the association of variation in use of definitive therapy on risk-adjusted PCM in England as compared with the USA. Observational study. Cancer registry data from England and the USA. Men diagnosed with non-metastatic prostate cancer (PCa) in England and the USA between 2004 and 2008. Competing-risks survival analyses to estimate subhazard ratios (SHR) of PCM adjusted for age, ethnicity, year of diagnosis, Gleason score (GS) and clinical tumour (cT) stage. 222,163 men were eligible for inclusion. Compared with American patients, English patients were more likely to present at an older age (70-79 years: England 44.2%, USA 29.3%, p<0.001), with higher tumour stage (cT3-T4: England 25.1%, USA 8.6%, p<0.001) and higher GS (GS 8-10: England 20.7%, USA 11.2%, p<0.001). They were also less likely to receive definitive therapy (England 38%, USA 77%, p<0.001). English patients were more likely to die of PCa (SHR=1.9, 95% CI 1.7 to 2.0, p<0.001). However, this difference was no longer statistically significant when also adjusted for use of definitive therapy (SHR=1.0, 95% CI 1.0 to 1.1, p=0.3). Risk-adjusted PCM is significantly higher in England compared with the USA. This difference may be explained by less frequent use of definitive therapy in England. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The evolution of the market for commercial computerized physician order entry and computerized decision support systems for prescribing.

PubMed

Mozaffar, Hajar; Williams, Robin; Cresswell, Kathrin; Morrison, Zoe; Bates, David W; Sheikh, Aziz

2016-03-01

To understand the evolving market of commercial off-the-shelf Computerized Physician Order Entry (CPOE) and Computerized Decision Support (CDS) applications and its effects on their uptake and implementation in English hospitals. Although CPOE and CDS vendors have been quick to enter the English market, uptake has been slow and uneven. To investigate this, the authors undertook qualitative ethnography of vendors and adopters of hospital CPOE/CDS systems in England. The authors collected data from semi-structured interviews with 11 individuals from 4 vendors, including the 2 most entrenched suppliers, and 6 adopter hospitals, and 21 h of ethnographic observation of 2 user groups, and 1 vendor event. The research and analysis was informed by insights from studies of the evolution of technology fields and the emergence of generic COTS enterprise solutions. Four key themes emerged: (1) adoption of systems that had been developed outside of England, (2) vendors' configuration and customization strategies, (3) localized adopter practices vs generic systems, and (4) unrealistic adopter demands. Evidence for our over-arching finding concerning the current immaturity of the market was derived from vendors' strategies, adopters' reactions to the technology, and policy makers' incomplete insights. The CPOE/CDS market in England is still in an emergent phase. The rapid entrance of diverse products, triggered by federal policy initiatives, has resulted in premature adoption of systems that do not yet adequately meet the needs of hospitals. Vendors and adopters lacked understanding of how to design and implement generic solutions to meet diverse user needs. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

78 FR 32384 - New England Power Generators Association v. ISO New England Inc.; Notice of Complaint

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... Power Generators Association v. ISO New England Inc.; Notice of Complaint Take notice that on May 17... New England Power Generators Association (Complainant) filed a formal complaint against ISO New...., Washington, DC 20426. This filing is accessible on-line at http://www.ferc.gov , using the ``eLibrary'' link...

78 FR 67357 - New England Power Generators Association, Inc. v. ISO New England Inc.; Notice of Complaint

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

... Power Generators Association, Inc. v. ISO New England Inc.; Notice of Complaint Take notice that on...), 18 CFR 385.206 (2013), the New England Power Generators Association, Inc. (NEPGA or Complainant..., 888 First Street NE., Washington, DC 20426. This filing is accessible on-line at http://www.ferc.gov...

75 FR 8321 - Notice of Attendance at Nepool Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

... meeting information, see http://www.iso-ne.com/committees/comm_wkgrps/index.html . The discussions at each.... ER07-397, ISO New England Inc. and the New England Power Pool Participants Committee Docket No. ER08-633, ISO New England Inc. Docket No. ER08-830, ISO New England Inc. Docket No. ER08-1209, ISO New...

The New England travel market: changes in generational travel patterns

Treesearch

Rodney B. Warnick

1995-01-01

The purpose of this study was to examine and explore the New England domestic travel market trends, from 1979 through 1991 within the context of generations. The existing travel markets, who travel to New England, are changing by age cohorts and specifically within different generations. The New England changes in generational travel patterns do not reflect national...

Neo-Liberalism and Change in Higher Education Policy: England and Japan

ERIC Educational Resources Information Center

Yokoyama, Keiko

2008-01-01

The study scrutinizes the rationale behind higher education policy change in England and Japan, giving attention to stakeholders' perspective and legitimacy, policy network, and policy sphere. It argues that change in higher education policy in England and Japan towards being more market-oriented in the 1980s (England) and the 1990s (Japan) can…

77 FR 75612 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-21

..., focusing on the section pertaining to modifications to the current days-at-sea (DAS) trip limit management system, including alternatives for establishing a monkfish DAS leasing program. The recommendations of...

77 FR 42699 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... such, this meeting will focus on potential modifications to the current days-at-sea (DAS) management system, including alternatives to enable DAS leasing, and on approaches to integrate monkfish into the...

The Fees System Is Broken--So Let's Fix It

ERIC Educational Resources Information Center

Banks, Chris

2010-01-01

In England, there is an assumption of "fees" by the government within the further education (FE) system and it ended up in a system in which co-investment contributions from individuals are half what they should be while those from employers are not measured, not cash and not substantial. In this regard, the author examines the many…

Changing Financial Provision Leads to a Radical Reform of the English Education System.

ERIC Educational Resources Information Center

Davies, Brent; Ellison, Linda

This paper discusses the recent implementation in England of school improvement reforms based on school choice and in particular on a system of school-based management whereby total financial control is vested in individual schools. The first section briefly describes the financial structure of the English educational system, followed by an…

A Systems-Based Approach To Integrated Nutrient Management in Narragansett Bay and Its Watershed.

EPA Science Inventory

EPA’s Office of Research and Development is embarking on a project to develop and demonstrate a systems-based management approach that will achieve more integrated and effective management of nutrients in southern New England. The geographic focus of this multi-year research proj...

A Systems-Based Approach to Integrated Nutrient Management in Narragansett Bay and its Watershed

EPA Science Inventory

EPA’s Office of Research and Development is embarking on a project to develop and demonstrate a systems-based management approach that will achieve more integrated and effective management of nutrients in southern New England. The geographic focus of this multi-year research proj...

The Moral Imperative: The Case of the English Education System

ERIC Educational Resources Information Center

Spangenberg, Sabine; McIntosh, Bryan

2014-01-01

In England, social choice in education faces trade-offs between equity and efficiency. The scope of these trade-offs ranges from the introduction of choice to correcting "market failures" to reduce inequalities and restrict social injustices. The article analyses the English school education system and its relationship with social…

Positioning the Values of Early Career Teachers in Norway, Germany and England

ERIC Educational Resources Information Center

Czerniawski, Gerry

2009-01-01

Many countries in the "developed world" are engaging in what has been described as a "systemic" reform of their education systems, due in part to the competitive economic pressures of globalisation. Much literature has been generated about globalisation, exploring the dynamic interrelationship said to exist between economic…

Marine Program Annual Report 1973.

ERIC Educational Resources Information Center

New Hampshire Univ., Durham. Marine Program.

This report describes the activities of a program designed to develop the information and systems necessary for managing the Continental Shelf and Coastal Zone of Northern New England. Ten research areas or projects are discussed: aquaculture, biology and ecology, coastal oceanography, buoy systems studies, man in the sea, marine platforms and…

Exploring Quality Assurance in Sixth Form Colleges

ERIC Educational Resources Information Center

Stoten, David William

2012-01-01

Purpose: This paper aims to focus on the changing nature of quality assurance systems within the sixth form college sector. Design/methodology/approach: Ten sixth form colleges were surveyed across England and staff from varying levels within college hierarchies questioned about how quality assurance systems were implemented. Research involved…

Fleximode: Within Western Australia TAFE.

ERIC Educational Resources Information Center

Toussaint, Dorothy

After fleximode was introduced into the Western Australian TAFE system, its cost and effectiveness compared with traditional delivery systems were evaluated. Fleximode, as practiced in Australia, was adapted from a mode of study pioneered in England. It offered students the independence of off-campus study in combination with access to college…

Impact of cleaning and other interventions on the reduction of hospital-acquired Clostridium difficile infections in two hospitals in England assessed using a breakpoint model.

PubMed

Hughes, G J; Nickerson, E; Enoch, D A; Ahluwalia, J; Wilkinson, C; Ayers, R; Brown, N M

2013-07-01

Clostridium difficile infection remains a major challenge for hospitals. Although targeted infection control initiatives have been shown to be effective in reducing the incidence of hospital-acquired C. difficile infection, there is little evidence available to assess the effectiveness of specific interventions. To use statistical modelling to detect substantial reductions in the incidence of C. difficile from time series data from two hospitals in England, and relate these time points to infection control interventions. A statistical breakpoints model was fitted to likely hospital-acquired C. difficile infection incidence data from a teaching hospital (2002-2009) and a district general hospital (2005-2009) in England. Models with increasing complexity (i.e. increasing the number of breakpoints) were tested for an improved fit to the data. Partitions estimated from breakpoint models were tested for individual stability using statistical process control charts. Major infection control interventions from both hospitals during this time were grouped according to their primary target (antibiotics, cleaning, isolation, other) and mapped to the model-suggested breakpoints. For both hospitals, breakpoints coincided with enhancements to cleaning protocols. Statistical models enabled formal assessment of the impact of different interventions, and showed that enhancements to deep cleaning programmes are the interventions that have most likely led to substantial reductions in hospital-acquired C. difficile infections at the two hospitals studied. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Analysis of the synoptic winter mortality climatology in five regions of England: Searching for evidence of weather signals.

PubMed

Paschalidou, A K; Kassomenos, P A; McGregor, G R

2017-11-15

Although heat-related mortality has received considerable research attention, the impact of cold weather on public health is less well-developed, probably due to the fact that physiological responses to cold weather can vary substantially among individuals, age groups, diseases etc., depending on a number of behavioral and physiological factors. In the current work we use the classification techniques provided by the COST-733 software to link synoptic circulation patterns with excess cold-related mortality in 5 regions of England. We conclude that, regardless of the classification scheme used, the most hazardous conditions for public health in England are associated with the prevalence of the Easterly type of weather, favoring advection of cold air from continental Europe. It is noteworthy that there has been observed little-to-no regional variation with regards to the classification results among the 5 regions, suggestive of a spatially homogenous response of mortality to the atmospheric patterns identified. In general, the 10 different groupings of days used reveal that excess winter mortality is linked with the lowest daily minimum/maximum temperatures in the area. However it is not uncommon to observe high mortality rates during days with higher, in relative terms, temperatures, when rapidly changing weather results in an increase of mortality. Such a finding confirms the complexity of cold-related mortality and highlights the importance of synoptic climatology in understanding of the phenomenon. Copyright © 2017 Elsevier B.V. All rights reserved.

Tourism in New England towns: a threat to the rural fabric

Treesearch

Robert S. Bristow

2007-01-01

A traditional tourist attraction in New England is the classic rural New England town. These small communities have a small-town feel bounded by family farms and wooded lands. These towns are heavily visited during the fall foliage season and during spring maple sugaring operations. The rural character of many New England communities is threatened by a growing...

Retention of Recent College Graduates in New England. Policy Brief 09-2

ERIC Educational Resources Information Center

Sasser, Alicia

2009-01-01

The population of recent college graduates has been growing more slowly in New England than in the rest of the United States, and New England states are concerned that an inadequate supply of skilled workers may hamper economic growth. In some sense, New England is a victim of its own success. The region's colleges and universities excel at…

The New England forest: baseline for New England forest health monitoring

Treesearch

Robert T. Brooks; Thomas S Frieswyk; Douglas M. Griffith; Ellen Cooter; Luther Smith; Luther Smith

1992-01-01

The USDA Forest Service along with various cooperators has initiated Forest Health Monitoring (FHM) in New England to assess the condition and stressors of the region's forests, to analyze changes in these data over time, and to identify any relationships between forest condition and stressors. A major component of FHM in New England is 263 permanent plots located...

A Lasting Legacy: Recommendations of the New England Governors Blue Ribbon Commission on Land Conservation

ERIC Educational Resources Information Center

Barringer, Richard

2010-01-01

In September 2008, New England's governors established a blue-ribbon Commission on Land Conservation to identify the most urgent land-conservation issues facing New England today and provide recommendations to the governors in September 2009. New England faces profound threats to its land and natural-resource base. As the nation urbanizes further,…

Patient and carer experience of obtaining regular prescribed medication for chronic disease in the English National Health Service: a qualitative study

PubMed Central

2013-01-01

Background The increasing burden of chronic disease is recognised globally. Within the English National Health Service, patients with chronic disease comprise of half of all consultations in primary care, and 70% of inpatient bed days. The cost of prescribing long-term medications for those with physical chronic diseases is rising and there is a drive to reduce medicine wastage and costs. While current policies in England are focused on the latter, there has been little previous research on patient experience of ordering and obtaining regular medication for their chronic disease. This paper presents findings from England of a qualitative study and survey of patients and their carers’ experiences of community and primary care based services for physical chronic diseases. Although not the primary focus of the study, the results highlighted particular issues around service delivery of repeat prescriptions. Methods We conducted 21 qualitative in-depth interviews with 30 patients and family carers’ in two Primary Care Trusts in England. Participants were receiving community based care for diabetes, respiratory, neurological or complex co-morbidities, and ranged in age from 39–92 years old. We used a broadly inductive approach to enable themes around patient experience to emerge from the data. Results While the study sought to gain an overview of patient experience, the findings suggested that the processes associated with ordering and obtaining regular medication – the repeat prescription, was most frequently described as a recurring hassle of managing a long-term condition. Issues for patients and carers included multiple journeys to the surgery and pharmacy, lack of synchrony and dissatisfaction with the length of prescriptions. Conclusion Much literature exists around medication waste and cost, which led to encouragement from the NHS in England to reduce dosage units to a 28-day supply. While there has been an acknowledgement that longer supplies may be suitable for people with stable chronic conditions, it appears that there is limited evidence on the impact of shorter length prescriptions on patient and carer experience, adherence and health outcomes. Recent policy documents within England also fail to address possible links between patient experience, adherence and flaws within repeat prescription service delivery. PMID:23705866

A new laboratory-based surveillance system (Respiratory DataMart System) for influenza and other respiratory viruses in England: results and experience from 2009 to 2012.

PubMed

Zhao, H; Green, H; Lackenby, A; Donati, M; Ellis, J; Thompson, C; Bermingham, A; Field, J; Sebastianpillai, P; Zambon, M; Watson, Jm; Pebody, R

2014-01-23

During the 2009 influenza A(H1N1) pandemic, a new laboratory-based virological sentinel surveillance system, the Respiratory DataMart System (RDMS), was established in a network of 14 Health Protection Agency (now Public Health England (PHE)) and National Health Service (NHS) laboratories in England. Laboratory results (both positive and negative) were systematically collected from all routinely tested clinical respiratory samples for a range of respiratory viruses including influenza, respiratory syncytial virus (RSV), rhinovirus, parainfluenza virus, adenovirus and human metapneumovirus (hMPV). The RDMS also monitored the occurrence of antiviral resistance of influenza viruses. Data from the RDMS for the 2009–2012 period showed that the 2009 pandemic influenza virus caused three waves of activity with different intensities during the pandemic and post pandemic periods. Peaks in influenza A(H1N1)pdm09 positivity (defined as number of positive samples per total number of samples tested) were seen in summer and autumn in 2009, with slightly higher peak positivity observed in the first post-pandemic season in 2010/2011. The influenza A(H1N1)pdm09 virus strain almost completely disappeared in the second postpandemic season in 2011/2012. The RDMS findings are consistent with other existing community-based virological and clinical surveillance systems. With a large sample size, this new system provides a robust supplementary mechanism, through the collection of routinely available laboratory data at minimum extra cost, to monitor influenza as well as other respiratory virus activity. A near real-time, daily reporting mechanism in the RDMS was established during the London 2012 Olympic and Paralympic Games. Furthermore, this system can be quickly adapted and used to monitor future influenza pandemics and other major outbreaks of respiratory infectious disease, including novel pathogens.

New England Wind Forum: A Wind Powering America Project, Volume 1, Issue 4 -- May 2008 (Newsletter)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grace, R. C.; Gifford, J.

2008-05-01

The New England Wind Forum electronic newsletter summarizes the latest news in wind energy development activity, markets, education, and policy in the New England region. It also features an interview with a key figure influencing New England's wind energy development. Volume 1, Issue 4 features an interview with Brian Fairbank, president and CEO of Jiminy Peak Mountain Resort.

Influence of Fire and other anthropogenic practices on grassland and shrubland birds in New England

Treesearch

Peter D. Vickery; Benjamin Zuckerburg; Andrea L. Jones; W. Gregory Shriver; Andrew P. Weik

2005-01-01

Since 1966, many species of grassland and shrubland birds have declined substantially in New England (Askins 2000). The extent of grassland and shrubland habitat in New England has changed dramatically over the past 400 years. Presently, grassland and shrubland habitat in New England are created and maintained primarily as a result of four types of habitat management:...

Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study.

PubMed

Joffres, Michel; Falaschetti, Emanuela; Gillespie, Cathleen; Robitaille, Cynthia; Loustalot, Fleetwood; Poulter, Neil; McAlister, Finlay A; Johansen, Helen; Baclic, Oliver; Campbell, Norm

2013-08-30

Comparison of recent national survey data on prevalence, awareness, treatment and control of hypertension in England, the USA and Canada, and correlation of these parameters with each country stroke and ischaemic heart disease (IHD) mortality. Non-institutionalised population surveys. England (2006 n=6873), the USA (2007-2010 n=10 003) and Canada (2007-2009 n=3485) aged 20-79 years. Stroke and IHD mortality rates were plotted against countries' specific prevalence data. Mean systolic blood pressure (SBP) was higher in England than in the USA and Canada in all age-gender groups. Mean diastolic blood pressure (DBP) was similar in the three countries before age 50 and then fell more rapidly in the USA, being the lowest in the USA. Only 34% had a BP under 140/90 mm Hg in England, compared with 50% in the USA and 66% in Canada. Prehypertension and stages 1 and 2 hypertension prevalence figures were the highest in England. Hypertension prevalence (≥140 mm Hg SBP and/or ≥90 mm Hg DBP) was lower in Canada (19·5%) than in the USA (29%) and England (30%). Hypertension awareness was higher in the USA (81%) and Canada (83%) than in England (65%). England also had lower levels of hypertension treatment (51%; USA 74%; Canada 80%) and control (<140/90 mm Hg; 27%; the USA 53%; Canada 66%). Canada had the lowest stroke and IHD mortality rates, England the highest and the rates were inversely related to the mean SBP in each country and strongly related to the blood pressure indicators, the strongest relationship being between low hypertension awareness and stroke mortality. While the current prevention efforts in England should result in future-improved figures, especially at younger ages, these data still show important gaps in the management of hypertension in these countries, with consequences on stroke and IHD mortality.

Pragmatic randomised controlled trial to evaluate the effectiveness and cost effectiveness of a multi-component intervention to reduce substance use and risk-taking behaviour in adolescents involved in the criminal justice system: A trial protocol (RISKIT-CJS).

PubMed

Coulton, Simon; Stockdale, Kelly; Marchand, Catherine; Hendrie, Nadine; Billings, Jenny; Boniface, Sadie; Butler, Steve; Deluca, Paolo; Drummond, Colin; Newbury-Birch, Dorothy; Pellatt-Higgins, Tracy; Stevens, Alex; Sutherland, Alex; Wilson, Ed

2017-03-11

Adolescence is a critical developmental stage when young people make lifestyle choices that have the potential to impact on their current and future health and social wellbeing. The relationship between substance use and criminal activity is complex but there is clear evidence that the prevalence of problematic substance use is far higher among adolescent offenders than the general adolescent population. Adolescent offenders are a marginalized and vulnerable population who are significantly more likely to experience health and social inequalities in later life than their non-offending peers. There is a paucity of evidence on effective interventions to address substance use and risk-taking behaviours in adolescent offender populations but it is clear that preventative or abstinence orientated interventions are not effective. RISKIT-CJS is an intervention developed in collaboration with young people taking account of the current best evidence. Feasibility and pilot studies have found the intervention addresses the needs of adolescents, is acceptable and has demonstrated potential in reducing substance use and risk-taking behavior. The study is a mixed method, two-armed, prospective, pragmatic randomized controlled trial with individual randomisation to either treatment as usual alone or the RISKIT-CJS intervention in addition to treatment as usual. Adolescents, aged 13 to 17 years inclusive, engaged with the criminal justice system who are identified as having problematic substance use are eligible to participate. The study will be conducted across three geographical areas; South and South East England, London and North East England between March 2017 and February 2019. The study represents an ambitious programme of work to address an area of need for a marginalized and vulnerable population. ISRCTN77037777 registered 15/09/2016.

Isotopic evidence for closed-system anatexis at midcrustal levels: An example from the Acadian Appalachians of New England

NASA Astrophysics Data System (ADS)

Lathrop, Alison S.; Blum, Joel D.; Chamberlain, C. Page

1994-05-01

We have investigated the Sr and O isotope systematics of granitoid and metasedimentary samples from the Central Main Terrane (CMT) of New England. Granitoid samples were taken from interior and contact zones within the Acadian-aged (approximately 410 m.y.), synmetamorphic and syntectonic Kinsman Quartz Monzonite (KQM), which is a member of the New Hampshire Plutonic Series. Metasedimentary samples were taken from Silurian and Devonian formations hosting the KQM. Initial Sr isotope ratios (Sr(sub i) and delta O-18 values for the KQM range from 0.70799 to 0.71246 and 7.6% to 12.9%, respectively, and Sr(sub i) and delta O-18 values of the metasedimentary rocks range from 0.70770 to 0.75008 and 6.2% to 14.1%, respectively. We observe a linear and slightly positive correlation between Sr(sub i) and delta O-18 for interior KQM samples that can be duplicated by a mixing curve calculated for metasedimentary endmembers, whereas the Sr(sub i) and delta O-18 values of contact KQM samples cluster near the Sr(sub i) and delta O-18 values of the metasedimentary rocks with which they are in contact. Mixing calculations provide no evidence for a measurable primitive mantle component in either interior or contact KQM samples, and we conclude that the Sr-O isotopic composition of the KQM is most likely a reflection of isotopic heterogeneities inherited from a complex package of midcrustal metasedimentary source rocks. We propose that the KQM is the product of midcrustal partial melting that was initiated due to excess thermal energy from the decay of anomalously high concentrations of heat-producing elements in Silurian source rocks within the CMT. Because we see no isotopic evidence for a lower-crustal or mantle component in the KQM, we suggest that midcrustal anatexis may have occurred as a closed-system process, requiring no accompanying mantle-derived magma or above normal mantle heat flow.

78 FR 79402 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

...The New England Fishery Management Council's (Council) Joint VMS/Enforcement Committee and Advisory Panel will meet to consider actions affecting New England fisheries in the exclusive economic zone (EEZ).

76 FR 63285 - New England Fishery Management Council; Public Meeting; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

...The New England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to consider actions affecting New England fisheries in the exclusive economic zone (EEZ).

What Is the Proposed Role of Research Evidence in England's "Self-Improving" School System?

ERIC Educational Resources Information Center

Godfrey, David

2017-01-01

This article examines the English government's vision for how research is proposed to lead to improvements in the system in the context of a school-led, self-improving system and rapid and sweeping legislative reforms. The debate about the role of research in the teaching profession has been sharpened by a large consultation effort in the academic…

From the Provider-Led to an Employer-Led System: Implications of Apprenticeship Reform on the Private Training Market

ERIC Educational Resources Information Center

Chankseliani, Maia; Relly, Susan James

2015-01-01

Despite expending a great deal of public money, and after many government-led "reforms" to develop an apprenticeship system that rivals those found in other countries, the apprenticeship system in England still faces a number of challenges and failings, not least in the private training market. This paper explores the landscape of…

Why the McKinsey Reports Will Not Improve School Systems

ERIC Educational Resources Information Center

Coffield, Frank

2012-01-01

In the last four years McKinsey and Company have produced two highly influential reports on how to improve school systems. The first McKinsey report "How the world's best-performing school systems come out on top" has since its publication in 2007 been used to justify change in educational policy and practice in England and many other…

Impact of Utility-Scale Distributed Wind on Transmission-Level System Operations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brancucci Martinez-Anido, C.; Hodge, B. M.

2014-09-01

This report presents a new renewable integration study that aims to assess the potential for adding distributed wind to the current power system with minimal or no upgrades to the distribution or transmission electricity systems. It investigates the impacts of integrating large amounts of utility-scale distributed wind power on bulk system operations by performing a case study on the power system of the Independent System Operator-New England (ISO-NE).

Mycoplasma pneumoniae Epidemiology in England and Wales: A National Perspective.

PubMed

Brown, Rebecca J; Nguipdop-Djomo, Patrick; Zhao, Hongxin; Stanford, Elaine; Spiller, O Brad; Chalker, Victoria J

2016-01-01

Investigations of patients with suspected Mycoplasma pneumoniae infection have been undertaken in England since the early 1970s. M. pneumoniae is a respiratory pathogen that is a common cause of pneumonia and may cause serious sequelae such as encephalitis and has been documented in children with persistent cough. The pathogen is found in all age groups, with higher prevalence in children aged 5-14 years. In England, recurrent epidemic periods have occurred at ~4-yearly intervals. In addition, low-level sporadic infection occurs with seasonal peaks from December to February. Voluntarily reports from regional laboratories and hospitals in England from 1975 to 2015 were collated by Public Health England for epidemiological analysis. Further data pertaining cases of note and specimens submitted to Public Health England from 2005 to 2015 for confirmation, molecular typing is included.

Where Does the Drink Go?

ERIC Educational Resources Information Center

Tunnicliffe, Sue Dale

2004-01-01

In England the National Curriculum does not specifically mention the excretory system at key stages 1 and 2. Research by Reiss and Tunnicliffe (2001, 2002) has shown that children's knowledge of the organs and organ systems in their bodies increases with age but remains incomplete, even at maturity, unless they specialise in studying biology. The…

Higher Education, Further Education and the English Experiment

ERIC Educational Resources Information Center

Parry, Gareth

2009-01-01

England has a two-sector system of higher education and further education. Shaped by legislation in 1988 and 1992, the architecture of this system was intended to concentrate each type of education in separate institutions and separate sectors. In recognition of these different missions, each territory came under different funding and regulatory…

The use of LANDSAT DCS and imagery in reservoir management and operation

NASA Technical Reports Server (NTRS)

Cooper, S.; Bock, P.; Horowitz, J.; Foran, D.

1975-01-01

Experiments by the New England Division (NED), Corps of Engineers with LANDSAT-1 data collection and imaging systems are reported. Data cover the future usefulness of data products received from satellites such as LANDSAT in the day to day operation of NED water resources systems used to control floods.

A Divided Education System

ERIC Educational Resources Information Center

Chitty, Clyde

2012-01-01

In this slightly amended version of the talk with which the author opened the "Caught in the Act" Conference on 19 November 2011, he talks about fighting the most vicious right-wing government that England has known since the end of the Second World War--and one that is determined to destroy what's left of "a national system of…

Student Finance, Information and Decision Making

ERIC Educational Resources Information Center

Mangan, Jean; Hughes, Amanda; Slack, Kim

2010-01-01

Since the recent changes in the system of student finance in England, studies focusing on the impact of increased debt and the effect of the bursary system have concluded that the chances of achieving stated policy objectives in relation to widening and increasing levels of participation have been reduced. This study considers the full financial…

The Environmental Belief Systems of Organic and Conventional Farmers: Evidence from Central-Southern England

ERIC Educational Resources Information Center

Kings, David; Ilbery, Brian

2010-01-01

Little comparative work has been conducted on the environmental belief systems and behaviours of conventional and organic farmers, especially in relation to farming culture, the environment and lowland farmland avifauna. Adopting a modified behavioural approach, this paper analyses the ways in which the environmental attitudes and understandings…

The State of New Hampshire Consolidated State Application Accountability Workbook. Revised

ERIC Educational Resources Information Center

Tracy, Lyonel B.

2006-01-01

New Hampshire is in the midst of a transition--a transition between assessment systems--a transition between accountability systems. The elementary grades were assessed with the newly developed New England Common Assessment Program (NECAP) tests in October 2005. The high school (grade 10) will be assessed with New Hampshire's previous state-wide…

Studying While Doing Time: Understanding Inmates' Conceptions of Learning

ERIC Educational Resources Information Center

Rosário, Pedro; Núñez, José Carlos; Pereira, Joana; Fuentes, Sonia; Gaeta, Martha; Cunha, Jennifer; Polydoro, Soely

2016-01-01

Low levels of education and dropping out of school are associated with criminal involvement. The Portuguese prison system, similar to other prison systems (e.g. England), offers prison-based educational programmes so inmates can complete compulsory education. However, the completion rate of these educational programmes is low, and the dropout rate…

Margaret Thatcher: Iron Lady of Charter Schools

ERIC Educational Resources Information Center

Tanner, Daniel

2017-01-01

Documentary history reveals that charter schools are a vestige of the socially divided school system of 19th-century England. The current charter school movement in the United States raises the danger to American democracy of splitting up the U.S. school structure and creating a separate system of schools for other people's children.

Implementing sustainable drainage systems for urban surface water management within the regulatory framework in England and Wales.

PubMed

Ellis, J Bryan; Lundy, Lian

2016-12-01

The UK 2007 floods resulted in damages estimated to exceed over £4 billion. This triggered a national review of strategic flood risk management (Pitt, 2008) with its recommendations informing and implemented by the Flood and Water Management, Act (FWMA, 2010). Estimating that up to two-thirds of properties flooded in the 2007 event as a direct result of overloaded sewer systems, the FWMA set out an ambitious overhaul of flood risk management approaches including identifying bodies responsible for the management of local flood risk (local municipalities) and the development of over-arching Lead Local Flood Authorities (LLFAs) at a regional level. LLFAs duties include developing local flood risk management strategies and, aligned with this, many LLFAs and local municipalities produced sustainable drainage system (SUDS) guidance notes. In parallel, changes to the national planning policy framework (NPPF) in England give priority to the use of SUDS in new major developments, as does the related Town and Country Planning Order (2015). However, whilst all three pieces of legislation refer to the preferential use of SUDs, these requirements remain "economically proportionate" and thus the inclusion of SUDS within development controls remain desirable - but not mandatory - obligations. Within this dynamic policy context, reignited most recently by the December 2015 floods, this paper examines some of the challenges to the implementation of SUDS in England and Wales posed by the new regulatory frameworks. In particular, it examines how emerging organisational procedures and processes are likely to impact on future SUDS implementation, and highlights the need for further cross-sectoral working to ensure opportunities for cross-sectoral benefits- such as that accrued by reducing stormwater flows within combined sewer systems for water companies, property developers and environmental protection - are not lost. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development of risk-based trading farm scoring system to assist with the control of bovine tuberculosis in cattle in England and Wales.

PubMed

Adkin, A; Brouwer, A; Simons, R R L; Smith, R P; Arnold, M E; Broughan, J; Kosmider, R; Downs, S H

2016-01-01

Identifying and ranking cattle herds with a higher risk of being or becoming infected on known risk factors can help target farm biosecurity, surveillance schemes and reduce spread through animal trading. This paper describes a quantitative approach to develop risk scores, based on the probability of infection in a herd with bovine tuberculosis (bTB), to be used in a risk-based trading (RBT) scheme in England and Wales. To produce a practical scoring system the risk factors included need to be simple and quick to understand, sufficiently informative and derived from centralised national databases to enable verification and assess compliance. A logistic regression identified herd history of bTB, local bTB prevalence, herd size and movements of animals onto farms in batches from high risk areas as being significantly associated with the probability of bTB infection on farm. Risk factors were assigned points using the estimated odds ratios to weight them. The farm risk score was defined as the sum of these individual points yielding a range from 1 to 5 and was calculated for each cattle farm that was trading animals in England and Wales at the start of a year. Within 12 months, of those farms tested, 30.3% of score 5 farms had a breakdown (sensitivity). Of farms scoring 1-4 only 5.4% incurred a breakdown (1-specificity). The use of this risk scoring system within RBT has the potential to reduce infected cattle movements; however, there are cost implications in ensuring that the information underpinning any system is accurate and up to date. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

Biomedical Research and Technology. A Prognosis for International Economic Leadership. Commission on Academic Medical Centers and the Economy of New England [Report].

ERIC Educational Resources Information Center

New England Board of Higher Education, Boston, MA.

The focus of the work of the Commission on Academic Medical Centers and the Economy of New England is the financing competitors strength and future development of academic centers and biomedical companies in New England. Among the findings and recommendations of the Commission are the following: (1) the New England region will require several…

Character change of New England snow

USGS Publications Warehouse

Huntington, T.G.; Hodgkins, G.A.; Keim, B.D.; Dudley, R.W.

2004-01-01

The annual ratio of snow to total precipitation (S/P) for 11 out of 21 US Historical Climatology Network (USHCN) sites in New England decreased significantly from 1949 through 2000. One possible explanation for the observed decrease in S/P ratio is that their temperature increased in New England during the 20th century. The results are consistent with published reports indicating lengthening of the growing season in New England.

Travel trends in New England and the Northeast United States: updating post 9-11 trends

Treesearch

Rodney B. Warnick

2008-01-01

This paper examines the travel market trends in New England after September 11, 2001 (9- 11). Comparisons of travel to New England are also made with overall national domestic travel trends and vacation travel trends. The primary purpose is to examine the markets that travel to both the Northeast United States and New England1 regions to determine if and when the...

Relations between winter climatic variables and April streamflows in New England and implications for summer streamflows

USGS Publications Warehouse

Hodgkins, Glenn A.; Dudley, Robert W.; Schalk, Luther F.

2012-01-01

A period of much below normal streamflow in southern New England during April 2012 raised concerns that a long-term period of drought could evolve through late spring and summer, leading to potential water availability issues. To understand better the relations between winter climatic variables and April streamflows, April streamflows from 31 streamflow gages in New England that drain relatively natural watersheds were tested for year-to-year correlation with winter precipitation and air temperature from nearby meteorological sites. Higher winter (December through March) precipitation is associated with higher April streamflows at many gages in northern and central New England. This implies that snowpack accumulation is an important mechanism for winter water storage and subsequently important for spring streamflows in this area. Higher March air temperatures are associated with lower April streamflows at many gages in central and southern New England, likely because the majority of snowmelt runoff occurs before April in warm years. A warm March 2012 contributed to early snowmelt runoff in New England and to much below normal April streamflows in southern New England. However, no strong relation was found between historical April streamflows and late-spring or summer streamflows in New England. The lack of a strong relation implies that summer precipitation, rather than spring conditions, controls summer streamflows.

Primary care and health inequality: Difference-in-difference study comparing England and Ontario

PubMed Central

Cookson, Richard; Mondor, Luke; Kringos, Dionne S.; Klazinga, Niek S.

2017-01-01

Background It is not known whether equity-oriented primary care investment that seeks to scale up the delivery of effective care in disadvantaged communities can reduce health inequality within high-income settings that have pre-existing universal primary care systems. We provide some non-randomised controlled evidence by comparing health inequality trends between two similar jurisdictions–one of which implemented equity-oriented primary care investment in the mid-to-late 2000s as part of a cross-government strategy for reducing health inequality (England), and one which invested in primary care without any explicit equity objective (Ontario, Canada). Methods We analysed whole-population data on 32,482 neighbourhoods (with mean population size of approximately 1,500 people) in England, and 18,961 neighbourhoods (with mean population size of approximately 700 people) in Ontario. We examined trends in mortality amenable to healthcare by decile groups of neighbourhood deprivation within each jurisdiction. We used linear models to estimate absolute and relative gaps in amenable mortality between most and least deprived groups, considering the gradient between these extremes, and evaluated difference-in-difference comparisons between the two jurisdictions. Results Inequality trends were comparable in both jurisdictions from 2004–6 but diverged from 2007–11. Compared with Ontario, the absolute gap in amenable mortality in England fell between 2004–6 and 2007–11 by 19.8 per 100,000 population (95% CI: 4.8 to 34.9); and the relative gap in amenable mortality fell by 10 percentage points (95% CI: 1 to 19). The biggest divergence occurred in the most deprived decile group of neighbourhoods. Discussion In comparison to Ontario, England succeeded in reducing absolute socioeconomic gaps in mortality amenable to healthcare from 2007 to 2011, and preventing them from growing in relative terms. Equity-oriented primary care reform in England in the mid-to-late 2000s may have helped to reduce socioeconomic inequality in health, though other explanations for this divergence are possible and further research is needed on the specific causal mechanisms. PMID:29182652

Gove v. the Blob: The Coalition and Education

ERIC Educational Resources Information Center

Gillard, Derek

2015-01-01

The author provides a year-by-year account of events during the period of the Conservative-led coalition government from 2010 to 2015 and concludes with some observations on the damage done to England's state education system.

Why do GPs leave direct patient care and what might help to retain them? A qualitative study of GPs in South West England.

PubMed

Sansom, Anna; Terry, Rohini; Fletcher, Emily; Salisbury, Chris; Long, Linda; Richards, Suzanne H; Aylward, Alex; Welsman, Jo; Sims, Laura; Campbell, John L; Dean, Sarah G

2018-01-10

To identify factors influencing general practitioners' (GPs') decisions about whether or not to remain in direct patient care in general practice and what might help to retain them in that role. Qualitative, in-depth, individual interviews exploring factors related to GPs leaving, remaining in and returning to direct patient care. South West England, UK. 41 GPs: 7 retired; 8 intending to take early retirement; 11 who were on or intending to take a career break; 9 aged under 50 years who had left or were intending to leave direct patient care and 6 who were not intending to leave or to take a career break. Plus 19 stakeholders from a range of primary care-related professional organisations and roles. Reasons for leaving direct patient care were complex and based on a range of job-related and individual factors. Three key themes underpinned the interviewed GPs' thinking and rationale: issues relating to their personal and professional identity and the perceived value of general practice-based care within the healthcare system; concerns regarding fear and risk, for example, in respect of medical litigation and managing administrative challenges within the context of increasingly complex care pathways and environments; and issues around choice and volition in respect of personal social, financial, domestic and professional considerations. These themes provide increased understanding of the lived experiences of working in today's National Health Service for this group of GPs. Future policies and strategies aimed at retaining GPs in direct patient care should clarify the role and expectations of general practice and align with GPs' perception of their own roles and identity; demonstrate to GPs that they are valued and listened to in planning delivery of the UK healthcare; target GPs' concerns regarding fear and risk, seeking to reduce these to manageable levels and give GPs viable options to support them to remain in direct patient care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

EPA New England Opens Nomination Period for Annual Environmental Merit Awards

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency office in New England is accepting nominations for New England people, organizations, government entities or businesses whose environmental achievements during the past year deserve recognition.

Mineralogical Evidence for the Palaeohydrogeological Stability of a Deep Groundwater System in Fractured Rock, in West Cumbria, Northwest England

NASA Astrophysics Data System (ADS)

Milodowski, A. E.; Gillespie, M. R.; Chenery, S. R. N.; Naden, J.; Shaw, R. P.

2014-12-01

An important requirement of the safety assessment for a geological disposal facility (GDF) for radioactive waste is to be able to demonstrate the long-term chemical stability of the groundwater system at repository depth over the long period of time during which the waste will be a hazard, typically up to one million years. Of particular concern in the UK is the potential for oxidising groundwater to penetrate to repository depth during periods of glaciation, thereby increasing the mobility of some transuranic radionuclides.Between 1990 and 1998, United Kingdom Nirex Limited carried out geological investigations into the suitability of a potential site in the Sellafield area of NW England, for a GDF for L/ILW. As part of these investigations, detailed petrological analysis of fracture mineralisation in 23 deep boreholes identified a complex sequence of mineralisation events referred to as ME1-ME9. The distribution of the ME9 calcite mineralisation correlates closely with present-day groundwater flows. The ME9 calcite has been studied in more detail to understand the evolution of the deep groundwater system. The morphology and growth zoning characteristics of the calcites reflects the groundwater chemistry. Freshwater calcites display c-axis flattened to equant crystals, and are non-ferroan and strongly zoned with Mn-rich and Mn-free bands. Deeper saline-zone calcites display c-axis elongated crystals, with high Mn:Fe and low Mn:Fe growth zones. Calcite in the transition zone between the saline and fresh groundwater display saline-type cores overgrown by freshwater-type calcite, indicating a small depression of the position of the transition zone during the growth of the calcites. Sr isotope ratios and fluid inclusion chemistry confirm a link between ME9 calcite and the present regional groundwater system. Modelling of the oxygen isotope data indicates that some growth zones in the ME9 calcite precipitated from groundwater potentially containing a significant proportion of glacially-recharged water, and that this may have reached depths of up to 1000 m. However, the chemical (REE,Fe and Mn) compositions of the ME9 calcite show that despite the potential contribution of glacially-recharged water to the deep groundwater system, conditions at repository depth (< 500 m) have continually remained reducing.

Occurrence of Uranium and 222Radon in Glacial and Bedrock Aquifers in the Northern United States, 1993-2003

USGS Publications Warehouse

Ayotte, Joseph D.; Flanagan, Sarah M.; Morrow, William S.

2007-01-01

Water-quality data collected from 1,426 wells during 1993-2003 as part of the U.S. Geological Survey National Water-Quality Assessment (NAWQA) program were evaluated to characterize the water quality in glacial and bedrock aquifers of the northern United States. One of the goals of the NAWQA program is to synthesize data from individual studies across the United States to gain regional- and national-scale information about the behavior of contaminants. This study focused on the regional occurrence and distribution of uranium and 222radon in ground water in the glacial aquifer system of the United States as well as in the Cambrian-Ordovician and the New York and New England crystalline aquifer systems that underlie the glacial aquifer system. The occurrence of uranium and 222radon in ground water has long been a concern throughout the United States. In the glacial aquifers, as well as the Cambrian-Ordovician and the New York and New England crystalline aquifer systems of the United States, concentrations of uranium and 222radon were highly variable. High concentrations of uranium and 222radon affect ground water used for drinking water and for agriculture. A combination of information or data on (1) national-scale ground-water regions, (2) regional-scale glacial depositional models, (3) regional-scale geology, and (4) national-scale terrestrial gamma-ray emissions were used to confirm and(or) refine the regions used in the analysis of the water-chemistry data. Significant differences in the occurrence of uranium and 222radon, based primarily on geologic information were observed and used in this report. In general, uranium was highest in the Columbia Plateau glacial, West-Central glacial, and the New York and New England crystalline aquifer groups (75th percentile concentrations of 22.3, 7.7, and 2.9 micrograms per liter (ug/L), respectively). In the Columbia Plateau glacial and the West-Central glacial aquifer groups, more than 10 percent of wells sampled had concentrations of uranium that exceeded the U.S. Environmental Protection Agency (USEPA) Maximum Contaminant Level of 30 ug/L; in the New York and New England crystalline aquifer group, 4 percent exceeded 30 ug/L. Ground-water samples with high concentrations of uranium were commonly linked to geologic sources rich in uranium. In eight of nine aquifer groups defined for this study, concentrations of uranium correlated significantly with concentrations of sulfate in ground water (Spearman's rho = 0.20 to 0.56; p < 0.05). In the Columbia Plateau, glacial aquifers were derived in part from basaltic lava flows, some felsic volcanic rocks, and some paleo-lake bed materials that may be rich in uranium. In the Columbia Plateau and West-Central glacial aquifer groups, uranium correlated with total dissolved solids, bicarbonate, boron, lithium, selenium, and strontium. In the West-Central glacial aquifer group, rocks such as Cretaceous marine shales, which are abundant in uranium, probably contribute to the high concentrations in ground water; in the southern part of this group, which extends into Nebraska, the glacial or glacial-related sediment may be interbedded with uranium-rich materials that originated to the north and west and in the Rocky Mountains. In New England, crystalline bedrock that is granitic, such as two-mica granites, as well as other high-grade metamorphic rocks, has abundant uranium that is soluble in the predominantly oxic to sub-oxic geochemical conditions. This appears to contribute to high uranium concentrations in ground water. The highest 222radon concentrations were present in samples from wells completed in the New York and New England crystalline aquifer group; the median value (2,122 picocurries per liter (pCi/L)) was about 10 times the median values of all other aquifer groups. More than 25 percent of the samples from the New York and New England crystalline aquifer group wells had 222radon concentrations that exceeded the USEPA Alternative

Integration: the firm and the health care sector.

PubMed

Laugesen, Miriam J; France, George

2014-07-01

Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations.

Inference, simulation, modeling, and analysis of complex networks, with special emphasis on complex networks in systems biology

NASA Astrophysics Data System (ADS)

Christensen, Claire Petra

Across diverse fields ranging from physics to biology, sociology, and economics, the technological advances of the past decade have engendered an unprecedented explosion of data on highly complex systems with thousands, if not millions of interacting components. These systems exist at many scales of size and complexity, and it is becoming ever-more apparent that they are, in fact, universal, arising in every field of study. Moreover, they share fundamental properties---chief among these, that the individual interactions of their constituent parts may be well-understood, but the characteristic behaviour produced by the confluence of these interactions---by these complex networks---is unpredictable; in a nutshell, the whole is more than the sum of its parts. There is, perhaps, no better illustration of this concept than the discoveries being made regarding complex networks in the biological sciences. In particular, though the sequencing of the human genome in 2003 was a remarkable feat, scientists understand that the "cellular-level blueprints" for the human being are cellular-level parts lists, but they say nothing (explicitly) about cellular-level processes. The challenge of modern molecular biology is to understand these processes in terms of the networks of parts---in terms of the interactions among proteins, enzymes, genes, and metabolites---as it is these processes that ultimately differentiate animate from inanimate, giving rise to life! It is the goal of systems biology---an umbrella field encapsulating everything from molecular biology to epidemiology in social systems---to understand processes in terms of fundamental networks of core biological parts, be they proteins or people. By virtue of the fact that there are literally countless complex systems, not to mention tools and techniques used to infer, simulate, analyze, and model these systems, it is impossible to give a truly comprehensive account of the history and study of complex systems. The author's own publications have contributed network inference, simulation, modeling, and analysis methods to the much larger body of work in systems biology, and indeed, in network science. The aim of this thesis is therefore twofold: to present this original work in the historical context of network science, but also to provide sufficient review and reference regarding complex systems (with an emphasis on complex networks in systems biology) and tools and techniques for their inference, simulation, analysis, and modeling, such that the reader will be comfortable in seeking out further information on the subject. The review-like Chapters 1, 2, and 4 are intended to convey the co-evolution of network science and the slow but noticeable breakdown of boundaries between disciplines in academia as research and comparison of diverse systems has brought to light the shared properties of these systems. It is the author's hope that theses chapters impart some sense of the remarkable and rapid progress in complex systems research that has led to this unprecedented academic synergy. Chapters 3 and 5 detail the author's original work in the context of complex systems research. Chapter 3 presents the methods and results of a two-stage modeling process that generates candidate gene-regulatory networks of the bacterium B.subtilis from experimentally obtained, yet mathematically underdetermined microchip array data. These networks are then analyzed from a graph theoretical perspective, and their biological viability is critiqued by comparing the networks' graph theoretical properties to those of other biological systems. The results of topological perturbation analyses revealing commonalities in behavior at multiple levels of complexity are also presented, and are shown to be an invaluable means by which to ascertain the level of complexity to which the network inference process is robust to noise. Chapter 5 outlines a learning algorithm for the development of a realistic, evolving social network (a city) into which a disease is introduced. The results of simulations in populations spanning two orders of magnitude are compared to prevaccine era measles data for England and Wales and demonstrate that the simulations are able to capture the quantitative and qualitative features of epidemics in populations as small as 10,000 people. The work presented in Chapter 5 validates the utility of network simulation in concurrently probing contact network dynamics and disease dynamics.

Estimating farm-level private expenditure on veterinary medical inputs in England.

PubMed

Gilbert, W; Rushton, J

2014-03-15

The current re-evaluation of responsibility and cost sharing between the public and private sectors with reference to animal health and welfare (AHW) would be improved by a greater understanding of the contributions made at farm level. This knowledge would facilitate the design of a cost-sharing system which best balances technical, economic and political objectives. This paper presents a framework by which the farm-level investment in AHW can be assessed. An evaluation of data available for the framework was made and, as a benchmark, an estimate of total expenditure on veterinary medical inputs for commercial agricultural holdings in England calculated. In 2010/2011 it is calculated that farmers on commercial holdings in England spent £230 million on veterinary medicines and fees, with an additional £160 million being spent for horses kept on non-commercial holdings. By contrast, for 2012/2013, Defra budgeted £277 million on AHW. The results presented emphasise the critical importance of generating sufficient evidence to support the development of an efficient, equitable and sustainable AHW strategy.

Cross-craft interactions between metal and glass working: slag additions to early Anglo-Saxon red glass

NASA Astrophysics Data System (ADS)

Peake, James R. N.; Freestone, Ian C.

Opaque red glass has been extensively studied over the years, but its compositional complexity and variability means that the way in which it was manufactured is still not fully understood. Previous studies have suggested the use of metallurgical by-products in its manufacture, but until now the evidence has been limited. SEM-EDS analysis of glass beads from the early Anglo-Saxon cemetery complex at Eriswell, southeast England, has provided further insights into the production and technology of opaque red glass, which could only have been possible through invasive sampling. The matrix of the red glasses contains angular particles of slag, the main phases of which typically correspond to either fayalite (Fe2SiO4) or kirschsteinite (CaFeSiO4), orthosilicate (olivine-type) minerals characteristic of some copper- and iron-smelting slags. This material appears to have been added in part as a reducing agent, to promote the precipitation of sub-micrometer particles of the colorant phase, copper metal. Its use represents a sophisticated, if empirical, understanding of materials and can only have resulted through deliberate experimentation with metallurgical by-products by early glass workers. Slag also seems to have been added as a source of iron to colour `black' glass. The compositions of the opaque red glasses appear to be strongly paralleled by Merovingian beads from northern Europe and Anglo-Saxon beads from elsewhere in England, suggesting that this technology is likely to have been quite widespread.

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children.

PubMed

Drinkwater, Jessica; Stanley, Nicky; Szilassy, Eszter; Larkins, Cath; Hester, Marianne; Feder, Gene

2017-06-01

Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family. To explore how and why general practice clinicians document DVA in families with children. A qualitative interview study using vignettes with GPs and practice nurses (PNs) in England. Semi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes. Most clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians. Managing DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access. © British Journal of General Practice 2017.

Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children

PubMed Central

Drinkwater, Jessica; Stanley, Nicky; Szilassy, Eszter; Larkins, Cath; Hester, Marianne; Feder, Gene

2017-01-01

Background Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family. Aim To explore how and why general practice clinicians document DVA in families with children. Design and setting A qualitative interview study using vignettes with GPs and practice nurses (PNs) in England. Method Semi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes. Results Most clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians. Conclusion Managing DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access. PMID:28137783

Spring Storm Hits New England

NASA Image and Video Library

2014-03-26

The strong coastal storm currently off the coast of New England will continue to bring strong winds and heavy snow to coastal portions of the Northeast on Wednesday. The storm will move into the Canadian Maritimes by Thursday. This image was taken by GOES East at 17:31 UTC on March 26, 2014. Credit: NOAA/NASA GOES Project NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Temporal associations between national outbreaks of meningococcal serogroup W and C disease in the Netherlands and England: an observational cohort study.

PubMed

Knol, Mirjam J; Hahné, Susan J M; Lucidarme, Jay; Campbell, Helen; de Melker, Hester E; Gray, Stephen J; Borrow, Ray; Ladhani, Shamez N; Ramsay, Mary E; van der Ende, Arie

2017-10-01

Since 2009, the incidence of meningococcal serogroup W disease has increased rapidly in the UK because of a single strain (the so-called original UK strain) belonging to the hypervirulent sequence type-11 clonal complex (cc11), with a variant outbreak strain (the so-called 2013 strain) emerging in 2013. Subsequently, the Netherlands has had an increase in the incidence of meningococcal serogroup W disease. We assessed the temporal and phylogenetic associations between the serogroup W outbreaks in the Netherlands and England, and the historical serogroup C outbreaks in both countries. For this observational cohort study, we used national surveillance data for meningococcal serogroup W and serogroup C disease in the Netherlands and England for the epidemiological years (July to June) 1992-93 to 2015-16. We also did whole genome sequencing and core genome multilocus sequence typing (1546 loci) on serogroup W disease isolates from both countries for surveillance years 2008-09 to 2015-16. We used Poisson regression to compare the annual relative increase in the incidence of serogroup W and serogroup C between both countries. In the Netherlands, the incidence of meningococcal serogroup W disease increased substantially in 2015-16 compared with 2014-15, with an incidence rate ratio of 5·2 (95% CI 2·0-13·5) and 11% case fatality. In England, the incidence increased substantially in 2012-13 compared with 2011-12, with an incidence rate ratio of 1·8 (1·2-2·8). The relative increase in the Netherlands from 2014-15 to 2015-16 was 418% (95% CI 99-1248), which was significantly higher than the annual relative increase of 79% (61-99) per year in England from 2011-12 to 2014-15 (p=0·03). Cases due to meningococcal serogroup W cc11 (MenW:cc11) emerged in 2012-13 in the Netherlands. Of 29 MenW:cc11 cases found up to 2015-16, 26 (90%) were caused by the 2013 strain. For both the current serogroup W outbreak and the historical serogroup C outbreak, the increase in incidence started several years later in the Netherlands than in England, the rate of increase was higher in the Netherlands, and age distributions were similar in both countries. Given the historical similarities of meningococcal serogroup W with meningococcal serogroup C emergence, the rapid expansion of the MenW:cc11 2013 strain in the Netherlands, its high case fatality, and the availability of a safe and effective vaccine, urgent consideration is needed for public health interventions in the Netherlands and other affected countries to prevent further serogroup W cases and deaths. National Institute for Public Health and the Environment (Netherlands), Academic Medical Center (Netherlands), and Public Health England. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

ANNUAL REPORT For Calendar Year 2007 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2008-02-02

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 2006 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2007-04-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 2009 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2010-03-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 1996 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

1997-01-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 2008 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2009-04-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 2002 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2003-11-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 2003 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2005-09-22

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 2004 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2005-12-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 2001 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2002-12-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

ANNUAL REPORT For Calendar Year 2005 : NEW ENGLAND TRANSPORTATION CONSORTIUM

DOT National Transportation Integrated Search

2006-08-01

The New England Transportation Consortium (NETC) is a cooperative effort of the transportation agencies of the six New England States. Through the Consortium, the states pool professional, academic and financial resources for transportation research ...

Teaching Public Health Networks in England: an innovative approach to building public health capacity and capability.

PubMed

Orme, J; Pilkington, P; Gray, S; Rao, M

2009-12-01

This paper examines the development and achievements of the Teaching Public Health Networks (TPHNs) in England; an initiative that aimed to catalyse collaborative working between the public health workforce and further and higher education, to enhance public health knowledge in the wider workforce with a view to enhancing capacity to tackle inequalities and meeting public health targets. This paper highlights activities under three outcomes: mobilizing resources, people, money and materials; building capacity through training and infrastructure development; and raising public and political awareness. The TPHN approach is shown to have led to innovative developments in public health education and training, including engagement with professionals that have not previously had exposure to public health. This paper aims to disseminate the learning from this complex public health initiative, now in its third year of development, and to share examples of good practice. It is hoped that other countries can use the TPHN approach as a model to address the various common and country-specific challenges in public health workforce development.

HIV is Now a Manageable Long-Term Condition, But What Makes it Unique? A Qualitative Study Exploring Views About Distinguishing Features from Multi-Professional HIV Specialists in North West England.

PubMed

Jelliman, Pauline; Porcellato, Lorna

HIV is evolving from a life-threatening infection to a long-term, manageable condition because of medical advances, radical changes in health and social care policy, and the impact of an aging population. However, HIV remains complex, presenting unique characteristics distinguishing it from other long-term conditions (LTCs). Our aim in this qualitative descriptive study was to identify and explore these features in the context of LTCs. A focus group (FG) method was used to gather the views and experiences of multi-professional HIV specialists who worked in North West England. Twenty-four staff participated in FGs (n = 3), which were audio recorded, manually transcribed, and thematically analyzed. We found four main themes: (a) stigma, (b) challenges faced by HIV specialists, (c) lack HIV-related knowledge, and (d) unique features, termed "stand alone." We concluded that these distinguishing features hindered full recognition and acceptance of HIV as an LTC. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Adaptive Flood Risk Management Under Climate Change Uncertainty Using Real Options and Optimization.

PubMed

Woodward, Michelle; Kapelan, Zoran; Gouldby, Ben

2014-01-01

It is well recognized that adaptive and flexible flood risk strategies are required to account for future uncertainties. Development of such strategies is, however, a challenge. Climate change alone is a significant complication, but, in addition, complexities exist trying to identify the most appropriate set of mitigation measures, or interventions. There are a range of economic and environmental performance measures that require consideration, and the spatial and temporal aspects of evaluating the performance of these is complex. All these elements pose severe difficulties to decisionmakers. This article describes a decision support methodology that has the capability to assess the most appropriate set of interventions to make in a flood system and the opportune time to make these interventions, given the future uncertainties. The flood risk strategies have been explicitly designed to allow for flexible adaptive measures by capturing the concepts of real options and multiobjective optimization to evaluate potential flood risk management opportunities. A state-of-the-art flood risk analysis tool is employed to evaluate the risk associated to each strategy over future points in time and a multiobjective genetic algorithm is utilized to search for the optimal adaptive strategies. The modeling system has been applied to a reach on the Thames Estuary (London, England), and initial results show the inclusion of flexibility is advantageous, while the outputs provide decisionmakers with supplementary knowledge that previously has not been considered. © 2013 HR Wallingford Ltd.

Nomination Period Extended for EPA’s New England Annual Environmental Merit Awards

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency’s New England office has extended the deadline to submit nominations for New England people, organizations, government entities or businesses whose environmental achievements during the past year deserve recognition

77 FR 27716 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

77 FR 27717 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery...

Federalism and Corporatism: On the Approaches of Policy-Making and Governance in the Dual Apprenticeship System in Germany and Their Functioning Today

ERIC Educational Resources Information Center

Kuhlee, Dina

2015-01-01

Compared with England, where new implementations and programmes in the education system are often introduced at a striking pace, the German education system seems to be rather stable in its features and less dynamic in terms of reform and change. Hence, a phenomenon called "reform bottleneck" ("Reformstau") has often been…

Backward- and forward-looking responsibility for obesity: policies from WHO, the EU and England.

PubMed

Vallgårda, Signild; Nielsen, Morten Ebbe Juul; Hartlev, Mette; Sandøe, Peter

2015-10-01

In assigning responsibility for obesity prevention a distinction may be drawn between who is responsible for the rise in obesity prevalence ('backward-looking responsibility'), and who is responsible for reducing it ('forward-looking responsibility'). We study how the two aspects of responsibility figure in the obesity policies of WHO (European Region), the EU and the Department of Health (England). Responsibility for the emergence and reduction of obesity is assigned to both individuals and other actors to different degrees in the policies, combining an individual and a systemic view. The policies assign backward-looking responsibility to individuals, the social environment, the authorities and businesses. When it comes to forward-looking responsibility, individuals are expected to play a central role in reducing and preventing obesity, but other actors are also urged to act. WHO assigns to individuals the lowest degree of backward- and forward-looking responsibility, and the Department of Health (England) assigns them the highest degree of responsibility. Differences in the assignment of backward- and above all forward-looking responsibility could be explained to some extent by the different roles of the three authorities making the plans. WHO is a UN agency with health as its goal, the EU is a liberal economic union with optimization of the internal European market as an important task, and England, as an independent sovereign country, has its own economic responsibilities. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Changes in cancer incidence in teenagers and young adults (ages 13 to 24 years) in England 1979-2003.

PubMed

Alston, Robert D; Geraci, Marco; Eden, Tim O B; Moran, Anthony; Rowan, Steve; Birch, Jillian M

2008-11-15

Cancer for teenagers and young adults represents a major source of morbidity and mortality. Trends in cancer incidence can provide pointers concerning how changes in the environment and in personal behavior affect cancer risks. Data on 39,129 neoplasms in individuals ages 13 to 24 years who were diagnosed in England from 1979 to 2003 were analyzed. Variability in incidence by time period and differences in the time trends by age group, sex, and geographic region were analyzed using generalized linear models. Incidence rates of leukemias, lymphomas, central nervous system, bone, and germ cell tumors; melanoma; and carcinomas of the thyroid, ovary, cervix, and colon/rectum increased over time (all P < .01); whereas the incidence of carcinomas of the stomach and bladder decreased (both P < .01). These changes were consistent by age, sex, and region for most neoplasms. Melanoma incidence stabilized in southern England by 1993 but continued to increase in northern England (P = .001). The increase in non-Hodgkin lymphoma was greater in individuals ages 20 to 24 year than in younger individuals, but the increase in Hodgkin lymphoma was confined to individuals ages 13 to 14 years. The changes in incidence rates may have been caused in part by environmental changes and in part by behavioral changes in young individuals. Some of these results can be used to inform public health campaigns, which can be constructed to encourage better lifestyle choices by young individuals.

75 FR 11846 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-12

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council's (Council) Joint Groundfish/Scallop Committee will meet to consider... England Fishery Management Council, 50 Water Street, Mill 2, Newburyport, MA 01950. FOR FURTHER...

75 FR 80798 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council's (Council) Groundfish Committee will meet to consider actions... England Fishery Management Council, 50 Water Street, Mill 2, Newburyport, MA 01950. FOR FURTHER...

78 FR 41283 - Airworthiness Directives; Dowty Propellers Propellers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-10

... service information at the FAA, Engine & Propeller Directorate, 12 New England Executive Park, Burlington... Engineer, Boston Aircraft Certification Office, FAA, Engine and Propeller Directorate, 12 New England... Engineer, Boston Aircraft Certification Office, FAA, Engine and Propeller Directorate, 12 New England...

77 FR 70737 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

... Atmospheric Administration RIN 0648-XC366 New England Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council's (Council...

The climatic context of major plague outbreaks in late medieval England

NASA Astrophysics Data System (ADS)

Pribyl, Kathleen

2017-04-01

The climatological triggers of major plague outbreaks in late medieval and early modern Europe remain unclear; recent studies have been inconclusive. Plague is primarily a rodent disease and due to the involvement of rodent hosts and insect vectors, the epidemiology of plague is complicated, but research on outbreaks in the Third Pandemic, which began in the late nineteenth century, has shown that in central and eastern Asia plague is linked to specific meteorological conditions. The disease adapts to a varied spectrum of ecological and climatological settings, which influence the development of plague waves, and due to Europe's geographical diversity, this paper focuses on one region, England, in its search for meteorological parameters contributing to plague outbreaks. The study period of this paper is defined by the arrival of Yersinia pestis in the British Isles in 1348 and the end of the fifteenth century. During this time, England's population dynamics were mortality-driven due to recurrent epidemic disease; and public health measures, such as quarantining, had not yet been introduced, hence the influence of social factors on the formation of major plague waves was very limited. The geographical and temporal focus of this study allows for the combination of the series of English major plague outbreaks, verified in the original texts, with the high-quality climate reconstructions based on both documentary sources and proxy data available for this region. The detailed analysis of the mechanisms contributing to English plague waves presented in this paper, reveals a complex interplay of time-lag responses and concurrent conditions involving temperature and precipitation parameters.

Ethnic variations in overweight and obesity among children over time: findings from analyses of the Health Surveys for England 1998-2009.

PubMed

Karlsen, S; Morris, S; Kinra, S; Vallejo-Torres, L; Viner, R M

2014-06-01

The increase in the prevalence of obesity among children and adolescents in England since the mid-1990s has been dramatic. Cross-sectional evidence suggests ethnic variations in childhood obesity prevalence. The objective of the study was to examine whether and how ethnic variations in childhood overweight/obesity have changed over time, and are affected by socioeconomic factors. This study uses logistic regression to analyse ethnic differences in the relative likelihood of being at or above the age- and gender-specific thresholds for overweight and obesity developed by the International Obesity Task Force among children aged between 2 and 15 from 11 ethnic groups included in the Health Surveys for England between 1998 and 2009, adjusting for age, gender, year of data collection and equivalized household income. We separately analyse the likelihood of being at or above the thresholds for overweight (but below those for obesity) and obesity. Trends in overweight/obesity over time among ethnic minority groups do not follow those of white English children. Black African children had higher rates of overweight and obesity, which appear to have peaked, and black Caribbean children had higher rates of obesity than other groups examined, which appear to continue rising. These differences were not explained by socioeconomic variations between groups. Policies are required that encourage healthy lifestyles among ethnic minority young people, while engaging with the complexities associated with these choices during childhood and adolescence. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Meeting needs of Muslim girls in school sport: case studies exploring cultural and religious diversity.

PubMed

Benn, Tansin; Pfister, Gertrud

2013-01-01

This paper contains a sociocultural analysis of school sport experiences of Muslim girls in two countries with different gender policies in physical education (PE) classes: England and Denmark. In Denmark, PE lessons take place in co-educative classes, in England schools are more diverse, with predominantly co-educational but also single-sex and faith schools offering different learning contexts. Two case studies from Denmark and England are used to explore the experiences of migrant Muslim girls in these different settings. A social constructionist approach to gender underpins the interpretation of stakeholders' voices on the inclusion of Muslim girls and the analysis of PE discourses in these countries. Findings illustrate similarities and differences at the interface of cultural diversity, political rhetoric of inclusion and realities of sport experiences for Muslim girls in both countries. Complex influences on PE experiences include gender stereotypes, cultural and religious orientations and practices, as well as actions and expectations of parents, communities and coaches/teachers. The studies provide insights into the ways participants managed their identities as Muslim girls in different sport environments to enable participation and retention of their cultural identities. Highlighted throughout the paper are the ways in which school sport policy and practice, providers and gatekeepers, can include or exclude groups, in this case Muslim girls. Too often coaches and teachers are unaware of crucial facts about their learners, not only in terms of their physical development and capabilities but also in terms of their cultural needs. Mistakes in creating conducive learning environments leave young people to negotiate a way to participate or refrain from participation.

Non-Methane Hydrocarbon Measurements Aboard the NOAA Research Vessel Ronald H. Brown during the 2002 New England Air Quality Study (NEAQS 2002)

NASA Astrophysics Data System (ADS)

Goldan, P. D.; Kuster, W. C.; Williams, E.; Fehsenfeld, F. C.

2003-12-01

During the NEAQS 2002 study, in-situ NMHC measurements were made aboard the NOAA research vessel Ronald H. Brown by a two channel automated gas chromatograph using both flame ionization and mass-spectrometric detection techniques. Five minute average samples were cryogenically trapped each 1/2 hour and analyzed immediately for C2 through C10 alkanes, C2 through C5 alkenes, C6 through C9 aromatics, C2 through C8 aldehydes and ketones, C1 through C5 alcohols and a variety of compounds of biogenic origin including 6 monoterpenes, isoprene and its primary oxidation products methacrolein and methylvinyl ketone. The relative contributions of these classes of compounds to OH photochemistry has been determined for air masses ranging from those showing significant anthropogenic influence to clean marine air. For the most anthropogenically influenced air masses, alkenes were observed to play a dominant role whereas oxy-hydrocarbons, principally acetaldehyde, were observed to dominate under clean marine conditions. Both the NMHC measurements and back trajectory analyses indicated periods of significant influx into the New England coastal region of urban air masses showing elevated ozone levels from the Boston/Providence urban corridor. About as frequently, less photochemically mature air masses, depleted in ozone but laden with light reactive alkenes, were observed coming from the Portsmouth NH/Kittery ME coastal urban complex. Even in the presence of these anthropogenic plumes, biogenic hydrocarbons appear to dominate OH photochemistry in the New England region much of the time. Data demonstrating all of these conclusions will be shown.

Comparison of Students' Understanding of Functions in Classes Following English and Israeli National Curricula

ERIC Educational Resources Information Center

Watson, Anne; Ayalon, Michal; Lerman, Stephen

2018-01-01

This paper arises from a study of how concepts related to understanding functions develop for students across the years of secondary/high school, using small samples from two different curricula systems: England and Israel. We used a survey consisting of function tasks developed in collaboration with teachers from both curriculum systems. We…

Monitoring the Effective and Efficient Use of Land: The English Approach

NASA Astrophysics Data System (ADS)

Ganser, Robin

In England quantified targets for the reuse of brownfields and of existing buildings place particular requirements on the planning system as part of the overall strategy to make effective use of natural resources. Achieving these targets is not free of obstacles and potential conflicts. Therefore monitoring of policy implementation is a necessity in the planning system.

An Examination of Electronic Links between the Book Trade and Library Acquisitions Systems.

ERIC Educational Resources Information Center

Bonk, Sharon C.

Based on interviews and correspondence conducted during 1981, this report describes British library and book trade plans for expansion of their internal order processing systems to include the eventual exchange of data through the use of telecommunications. Comparisons are made between the situation in England and the United States. The report…

Moving Knowledge Around: Strategies for Fostering Equity within Educational Systems

ERIC Educational Resources Information Center

Ainscow, Mel

2012-01-01

This paper describes and analyses the work of a large scale improvement project in England in order to find more effective ways of fostering equity within education systems. The project involved an approach based on an analysis of local context, and used processes of networking and collaboration in order to make better use of available expertise.…

Neoliberalism and the (Internal) Marketisation of Primary School Assessment in England

ERIC Educational Resources Information Center

Pratt, Nick

2016-01-01

This paper considers the effect of recent education policy on assessment practices in English primary schools and how these affect relationships between teachers and pupils in an increasingly market-driven school system. Previous research has focused largely on the effect of markets at a systemic level, but less attention has been paid to how…

Rethinking General Education in the English Upper Secondary System

ERIC Educational Resources Information Center

Hodgson, Ann; Spours, Ken

2011-01-01

The Secretary of State for Education's recent announcement of an English Baccalaureate at 16+ has opened up a debate about the nature of general education in the English upper secondary system. Drawing on evidence from national and local studies, we argue that it is important to see general education in England, not only in terms of the…

An International Perspective on Regulated Family Day Care Systems

ERIC Educational Resources Information Center

Davis, Elise; Freeman, Ramona; Doherty, Gillian; Karlsson, Malene; Everiss, Liz; Couch, Jane; Foote, Lyn; Murray, Patricia; Modigliani, Kathy; Owen, Sue; Griffin, Sue; Friendly, Martha; McDonald, Grace; Bohanna, India; Corr, Lara; Smyth, Lisa; Morkeseth, Elisabeth Ianke; Morreaunet, Sissel; Ogi, Mari; Fukukawa, Sumi; Hinke-Rahnau, Jutta

2012-01-01

Despite emerging evidence of the contributors to high-quality family day care, a comprehensive comparison of international family day care systems has not been undertaken. The aim of this paper is to compare regulated family day care (FDC) in Australia, Canada, England and Wales, Germany, Ireland, Japan, Norway, New Zealand, Sweden, and the USA,…

The Impact of Doctoral Study on Educational Leaders' Work for Students' Participation in Education Systems and Society

ERIC Educational Resources Information Center

Taysum, Alison

2013-01-01

This paper examines ways educational leaders engaging with doctoral research have worked for students' participation in education systems. Twenty-four interviews were conducted with educational leaders of schools, colleges, and districts in England and the US doing doctoral research. The findings reveal that the leaders identify US and English…

Monitoring Student Progress and Publicising the Results. Information Bank Number 1270.

ERIC Educational Resources Information Center

Jones, D. T. L.

Arguing that assessments of student progress describe the consequences of the interaction of the multitude of elements that make up the educational system, this paper examines the three-tiered assessment system used at Redhill Technical College (RTC), in Surrey, England, to fulfill diagnostic and motivational functions for the college as a whole.…

Obesity Treatment in the UK Health System.

PubMed

Capehorn, Matthew S; Haslam, David W; Welbourn, Richard

2016-09-01

In the UK, as in most other countries in the world, levels of obesity are increasing. According to the Kinsey report, obesity has the second largest public health impact after smoking, and it is inextricably linked to physical inactivity. Since the UK Health and Social Care Act reforms of 2012, there has been a significant restructuring of the National Health Service (NHS). As a consequence, NHS England and the Department of Health have issued new policy guidelines regarding the commissioning of obesity treatment. A 4-tier model of care is now widely accepted and ranges from primary activity, through community weight management and specialist weight management for severe and complex obesity, to bariatric surgery. However, although there are clear care pathways and clinical guidelines for evidence-based practice, there remains no single stakeholder willing to take overall responsibility for obesity care. There is a lack of provision of adequate services characterised by a noticeable 'postcode lottery', and little political will to change the obesogenic environment.

Uncoupled O and Hf isotopic systems in zircon from the contrasting granite suites of the New England Orogen, eastern Australia: Implications for studies of Phanerozoic magma genesis

NASA Astrophysics Data System (ADS)

Jeon, Heejin; Williams, Ian S.; Bennett, Vickie C.

2014-12-01

The Permo-Triassic granites of the New England Orogen, eastern Australia, were emplaced into a volcanic arc complex accreted to the eastern Gondwana margin in the Late Devonian or Early Carboniferous. Zircon U-Pb dating shows that the S-type Hillgrove (∼297 Ma) and Bundarra (∼287 Ma) Supersuites predated intrusion of the I-type Moonbi Supersuite (∼250 Ma) by up to 50 Ma. The high δ18Ozrn of the S-type granites (10.0-11.5‰), and range of U-Pb ages (∼370-300 Ma) and δ18Ozrn (∼5-10‰) of their inherited zircon cores, show that their source rocks were predominantly weathered Carboniferous volcaniclastics, the youngest deposited < 25 Ma before the granites were emplaced. In contrast, the lower δ18Ozrn (6.9-7.8‰) and lack of inheritance in the I-type granites is consistent with a zircon poor, more juvenile source, probably a mafic igneous underplate mixed with a small amount of volcanogenic and/or oceanic sediment. Despite the differences in source materials, the εHf(t) values of all granites, both S- and I-type, are similar (+5.0 ± 0.5 cf. +5.9 ± 0.5), consistent with both the mafic and sedimentary components in the granite sources being relatively young and similar in Hf isotopic composition at the time of granite genesis. In young, isotopically juvenile orogens, the O isotopic composition of well-dated igneous and inherited zircon can be a much more sensitive indicator of petrogenetic processes than the zircon Hf isotopic compositions alone.

Comparative epidemiology of Clostridium difficile infection: England and the USA.

PubMed

King, Alice; Mullish, Benjamin H; Williams, Horace R T; Aylin, Paul

2017-10-01

To examine whether there is an epidemiological difference between Clostridium difficile infection (CDI) inpatient populations in England and the United States. A cross-sectional study. National administrative inpatient discharge data from England (Hospital Episode Statistics) and the USA (National Inpatient Sample) in 2012. De-identifiable non-obstetric inpatient discharges from the national datasets were used to estimate national CDI incidence in the United States and England using ICD9-CM(008.45) and ICD10(A04.7) respectively. The rate of CDI was calculated per 100 000 population using national population estimates. Rate per 100 000 inpatient discharges was also calculated separated by primary and secondary diagnosis of CDI. Age, sex and Elixhauser comorbidities profiles were examined. The USA had a higher rate of CDI compared to England: 115.1/100 000 vs. 19.3/100 000 population (P < 0.001). CDI age profiles differed between the countries (P < 0.001): in England, patients ≥75 years constitute a larger proportion of CDI cases, whilst those aged 25-70 constitute more cases in the US (P < 0.001). Overall adjusted odds of CDI in females compared to males was elevated in both England (odds ratios (OR) 1.26 95% CI [1.21,1.31] P < 0.001) and the USA (OR 1.20 95% CI [1.18,1.22] P < 0.001). The proportion of CDI patients with comorbidities was greater in the USA compared to England apart from dementia, which was greater in England (9.63% vs. 1.25%, P < 0.0001). The 2012 inpatient CDI rate within the USA was much higher than in England. Age and comorbidity profiles also differed between CDI patients in both countries. The reasons for this are likely multi-factorial but may reflect national infection control policy. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The development and application of landscape evolution models to coupled coast-estuarine environments

NASA Astrophysics Data System (ADS)

Morris, Chloe; Coulthard, Tom; Parsons, Daniel R.; Manson, Susan; Barkwith, Andrew

2017-04-01

Landscape Evolution Models (LEMs) are proven to be useful tools in understanding the morphodynamics of coast and estuarine systems. However, perhaps owing to the lack of research in this area, current models are not capable of simulating the dynamic interactions between these systems and their co-evolution at the meso-scale. Through a novel coupling of numerical models, this research is designed to explore coupled coastal-estuarine interactions, controls on system behaviour and the influence that environmental change could have. This will contribute to the understanding of the morphodynamics of these systems and how they may behave and evolve over the next century in response to climate changes, with the aim of informing management practices. This goal is being achieved through the modification and coupling of the one-line Coastline Evolution Model (CEM) with the hydrodynamic LEM CAESAR-Lisflood (C-L). The major issues faced with coupling these programs are their differing complexities and the limited graphical visualisations produced by the CEM that hinder the dissemination of results. The work towards overcoming these issues and reported here, include a new version of the CEM that incorporates a range of more complex geomorphological processes and boasts a graphical user interface that guides users through model set-up and projects a live output during model runs. The improved version is a stand-alone tool that can be used for further research projects and for teaching purposes. A sensitivity analysis using the Morris method has been completed to identify which key variables, including wave climate, erosion and weathering values, dominate the control of model behaviour. The model is being applied and tested using the evolution of the Holderness Coast, Humber Estuary and Spurn Point on the east coast of England (UK), which possess diverse geomorphologies and complex, co-evolving sediment pathways. Simulations using the modified CEM are currently being completed to ascertain the processes influential to the morphodynamics and evolution of these systems; presently this includes increasing sea levels and changing wave climate patterns. Outputs and findings from these runs will be presented and discussed, with the aid of the improved graphical visualisations and animations that illustrate the evolution of simulated environments.

'Trying to do a jigsaw without the picture on the box': understanding the challenges of care integration in the context of single assessment for older people in England.

PubMed

Wilson, Rob; Baines, Susan; Cornford, James; Martin, Mike

2007-06-25

Demographic ageing is one of the major challenges for governments in developed countries because older people are the main users of health and social care services. More joined-up, partnership approaches supported by information and communications technologies (ICTs) have become key to managing these demands. This article discusses recent developments towards integrated care in the context of one of the arenas in which integration is being attempted, the Single Assessment Process (SAP) to support the care for older people in England. It draws upon accounts of local SAP implementations in order to assess and reflect upon some of the successes and limitations of service integration enabled by ICTs. At the Department of Health in England, policy and strategy are directed at the integration of services through a 'whole systems' approach, with services that are interdependent upon one another and organised around the person that uses them. The Single Assessment Processes (SAP) is an instance of inter-organisational and cross-sectoral sharing of information intended to improve communication and coordination amongst professions and agencies and so support more integrated care. The aim of SAP is to ensure that older people receive appropriate, effective and timely responses to their health and social care needs and that professionals do not duplicate each others efforts. This article examines examples from two programmes of work within the context of SAP in England: one with the direction coming from local government social services, the other where the momentum is coming from the National Health Service (NHS). Both examples show that the policy and practice of ICT-supported integration continues to represent a significant challenge. Although the notion of integrated care underpinned by ICT-enabled information sharing is persuasive, it has limitations in practice. The notion of an 'open systems' approach is proposed as an alternative way of improving communication and coordination across the domains of health and social care.

Evaluation of the measles, mumps and rubella vaccination catch-up campaign in England in 2013.

PubMed

Simone, Benedetto; Balasegaram, Sooria; Gobin, Maya; Anderson, Charlotte; Charlett, André; Coole, Louise; Maguire, Helen; Nichols, Tom; Rawlings, Chas; Ramsay, Mary; Oliver, Isabel

2014-08-06

In January-March 2013 in England, confirmed measles cases increased in children aged 10-16 years. In April-September 2013, the National Health System and Public Health England launched a national measles-mumps-rubella (MMR) campaign based on data from Child Health Information Systems (CHIS) estimating that approximately 8% in this age group were unvaccinated. We estimated coverage at baseline, and, of those unvaccinated (target), the proportion vaccinated up to 20/08/2013 (mid-point) to inform further public health action. We selected a sample of 6644 children aged 10-16 years using multistage sampling from those reported unvaccinated in CHIS at baseline and validated their records against GP records. We adjusted the CHIS MMR vaccine coverage estimates correcting by the proportion of vaccinated children obtained through sample validation. We validated 5179/6644 (78%) of the sample records. Coverage at baseline was estimated as 94.7% (95% confidence intervals, CI: 93.5-96.0%), lower in London (86.9%, 95%CI: 83.0-90.9%) than outside (96.1%, 95%CI 95.5-96.8%). The campaign reached 10.8% (95%CI: 7.0-14.6%) of the target population, lower in London (7.1%, 95%CI: 4.9-9.3) than in the rest of England (11.4%, 95%CI: 7.0-15.9%). Coverage increased by 0.5% up to 95.3% (95% CI: 94.1-96.4%) but an estimated 210,000 10-16 year old children remained unvaccinated nationally. Baseline MMR coverage was higher than previously reported and was estimated to have reached the 95% campaign objective at midpoint. Eleven per cent of the target population were vaccinated during the campaign, and may be underestimated, especially in London. No further national campaigns are needed but targeted local vaccination activities should be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

Aortic dissection in pregnancy in England: an incidence study using linked national databases

PubMed Central

Banerjee, Amitava; Begaj, Irena; Thorne, Sara

2015-01-01

Objectives To conduct the first population-level incidence study of aortic dissection in pregnancy using linked hospital-based data in England. Setting Hospital-based data (Hospital Episode Statistics (HES) linked with mortality data from the Office of National Statistics), national enquiries (Confidential Enquiries into Maternal Mortality) and surveys (UK Obstetric Surveillance System; UKOSS) of aortic dissection in pregnancy from 2003 to 2011 in England. Participants Between 2003 and 2011, all female patients admitted with diagnoses of aortic dissection (not necessarily as the primary cause of admission) and of pregnancy, childbirth and puerperium, were included. Outcome measures Diagnosis of aortic dissection during pregnancy, operated or not operated, with outcome of death or live patient from 2003 to 2011 in England. Results There were significant differences in characteristics of databases with respect to study population, time of study, recorded event and follow-up of outcomes. On the basis of HES, annual incidence of aortic dissection was 1.23 (95% CI 1.22 to 1.24) per 100 000 maternities. Incidence of aortic dissection with death within 1 year was 0.30 (0.29 to 0.31) per 100 000 maternities. Incidence of aortic dissection increased from 0.74 (0.73 to 0.75) per 100 000 maternities in 2003–2005 to 1.52 (1.51 to 1.53) per 100 000 maternities in 2009–2011. In the Confidential Enquiries into Maternal Deaths, incidence of deaths was highest for 2003–2005 (0.43/100 000 maternities) and lowest for 1997–1999 (0.21/100 000 maternities). In the UK Obstetric Surveillance System, national incidence of aortic dissection was 0.80 (0.50 to 1.50) per 100 000 maternities between 2009 and 2011. Conclusions The case of aortic dissection in pregnancy illustrates data limitations regarding complications in pregnancy from different sources in the UK, even for a diagnosis with seemingly few alternative coding and diagnostic possibilities. These limitations should be acknowledged when estimating incidence and outcome. PMID:26297370

Comparison of elderly suicide rates among migrants in England and Wales with their country of origin.

PubMed

Shah, Ajit; Lindesay, James; Dennis, Mick

2009-03-01

The black and minority ethnic (BME) elderly population size in England and Wales has progressively increased over the last three decades. Only two studies, both well over a decade old, have compared suicide rates in BME groups in England and Wales with those in their country of origin. A study comparing suicide rates among elderly migrants in England and Wales and in their country of origin using the latest available mortality data from the Office of National Statistics and the World Health Organization was conducted. There were wide variations in standardised mortality ratios for elderly suicides among migrants from different countries compared with those born in England and Wales and in their country of origin. There was convergence towards elderly suicide rates for England and Wales in some migrant groups in males in the age-bands 65-74 years and 75 + years, and in females in the age-band 75 + years. However, males aged 75 + years from most migrant groups had higher rates than those born in England and Wales. A more detailed analysis of suicide of older people from migrant groups is required to determine vulnerability and protective influences.

78 FR 54240 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-03

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a public meeting of its Scallop Committee to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from...

77 FR 57076 - New England Fishery Management Council; Public Meeting

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2012-09-17

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a public meeting of its Groundfish Advisory Panel to consider actions affecting New England fisheries in the exclusive economic zone (EEZ...

76 FR 29726 - New England Fishery Management Council; Public Meeting

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2011-05-23

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council's (Council) Groundfish Committee, Plan Development Team and Advisory...: (978) 777-2500; fax: (978) 750-7991. Council address: New England Fishery Management Council, 50 Water...

76 FR 7823 - New England Fishery Management Council; Public Meeting

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2011-02-11

... Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in February 2011, to consider actions affecting New England fisheries in the...

76 FR 31304 - New England Fishery Management Council; Public Meeting

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2011-05-31

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council's (Council) VMS/ Enforcement Committee and Advisory Panel will meet to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting...

75 FR 62507 - New England Fishery Management Council; Public Meeting

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2010-10-12

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council's (Council) Groundfish Committee will meet to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting will be held on...

Biology Notes

ERIC Educational Resources Information Center

School Science Review, 1972

1972-01-01

Short articles on a demonstration of enzyme action, models of mammalian circulatory systems, measuring the height of trees, the ecology of the African amphibian Xenopus under natural conditions in England, experiments with liverwort gemmae, investigations using stick insects, and a culture medium for Paramecium bursaria. (AL)

Teaching Geomorphology at University

ERIC Educational Resources Information Center

Sugden, David; Hamilton, Patrick

1978-01-01

Geomorphology courses in British universities emphasize the main landform/process systems rather than more abstract concepts. Recommends a more theoretical focus on fundamental geomorphic processes and methodological problems. Available from: Faculty of Modern Studies, Oxford Polytechnic, Headington, Oxford OX3 OBP, England. (Author/AV)

Comparative analysis of the outcomes of elective abdominal aortic aneurysm repair in England and Sweden

PubMed Central

Karthikesalingam, A.; Holt, P. J.; Vidal‐Diez, A.; Thompson, M. M.; Wanhainen, A.; Bjorck, M.; Mani, K.

2018-01-01

Background There is substantial international variation in mortality after abdominal aortic aneurysm (AAA) repair; many non‐operative factors influence risk‐adjusted outcomes. This study compared 90‐day and 5‐year mortality for patients undergoing elective AAA repair in England and Sweden. Methods Patients were identified from English Hospital Episode Statistics and the Swedish Vascular Registry between 2003 and 2012. Ninety‐day mortality and 5‐year survival were compared after adjustment for age and sex. Separate within‐country analyses were performed to examine the impact of co‐morbidity, hospital teaching status and hospital annual caseload. Results The study included 36 249 patients who had AAA treatment in England, with a median age of 74 (i.q.r. 69–79) years, of whom 87·2 per cent were men. There were 7806 patients treated for AAA in Sweden, with a median of age 73 (68–78) years, of whom 82·9 per cent were men. Ninety‐day mortality rates were poorer in England than in Sweden (5·0 versus 3·9 per cent respectively; P < 0·001), but were not significantly different after 2007. Five‐year survival was poorer in England (70·5 versus 72·8 per cent; P < 0·001). Use of EVAR was initially lower in England, but surpassed that in Sweden after 2010. In both countries, poor outcome was associated with increased age. In England, institutions with higher operative annual volume had lower mortality rates. Conclusion Mortality for elective AAA repair was initially poorer in England than Sweden, but improved over time alongside greater uptake of EVAR, and now there is no difference. Centres performing a greater proportion of EVAR procedures achieved better results in England. PMID:29468657

The implications of e-health system delivery strategies for integrated healthcare: lessons from England.

PubMed

Eason, Ken; Waterson, Patrick

2013-05-01

This paper explores the implications that different technical strategies for sharing patient information have for healthcare workers and, as a consequence, for the extent to which these systems provide support for integrated care. Four technical strategies were identified and the forms of coupling they made with healthcare agencies were classified. A study was conducted in England to examine the human and organizational implications of systems implemented by these four strategies. Results were used from evaluation reports of two systems delivered as part of the NPfIT (National Programme for Information Technology) and from user responses to systems delivered in two local health communities in England. In the latter study 40 clinical respondents reported the use of systems to support integrated care in six healthcare pathways. The implementation of a detailed care record system (DCRS) in the NPfIT was problematic because it could not meet the diverse needs of all healthcare agencies and it required considerable local customization. The programme evolved to allow different systems to be delivered for each local health community. A national Summary Care Record (SCR) was implemented but many concerns were raised about wide access to confidential patient information. The two technical strategies that required looser forms of coupling and were under local control led to wide user adoption. The systems that enabled data to be transferred between local systems were successfully used to support integrated care in specific healthcare pathways. The portal approach gave many users an opportunity to view patient data held on a number of databases and this system evolved over a number of years as a result of requests from the user community. The UK national strategy to deliver single shared database systems requires tight coupling between many users and has led to poor adoption because of the diverse needs of healthcare agencies. Sharing patient information has been more successful when local systems have been developed to serve particular healthcare pathways or when separate databases are viewable through a portal. On the basis of this evidence technical strategies that permit the local design of tight coupling are necessary if information systems are to support integrated care in healthcare pathways. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Choosing a Global Positioning System Device for Use in U.S. Army Corps of Engineers Regulatory Districts

DTIC Science & Technology

2017-12-01

Information Systems Center of Expertise (RS/GIS CX) (CEERD-RZR), U.S. Army Engineer Research and Development Center, Cold Regions Research and...GIS Geographic Information Systems GPS Global Positioning System HH Handheld IWR U.S. Army Engineer Institute for Water Resources n/a Not...Applicable NAE U.S. Army New England Regulatory District RS/GIS Remote Sensing/Geographic Information Systems SD Secure Digital SDHC Secure Digital High

A national framework for flood forecasting model assessment for use in operations and investment planning over England and Wales

NASA Astrophysics Data System (ADS)

Moore, Robert J.; Wells, Steven C.; Cole, Steven J.

2016-04-01

It has been common for flood forecasting systems to be commissioned at a catchment or regional level in response to local priorities and hydrological conditions, leading to variety in system design and model choice. As systems mature and efficiencies of national management are sought, there can be a drive towards system rationalisation, gaining an overview of model performance and consideration of simplification through model-type convergence. Flood forecasting model assessments, whilst overseen at a national level, may be commissioned and managed at a catchment and regional level, take a variety of forms and be large in number. This presents a challenge when an integrated national assessment is required to guide operational use of flood forecasts and plan future investment in flood forecasting models and supporting hydrometric monitoring. This contribution reports on how a nationally consistent framework for flood forecasting model performance has been developed to embrace many past, ongoing and future assessments for local river systems by engineering consultants across England & Wales. The outcome is a Performance Summary for every site model assessed which, on a single page, contains relevant catchment information for context, a selection of overlain forecast and observed hydrographs and a set of performance statistics with associated displays of novel condensed form. One display provides performance comparison with other models that may exist for the site. The performance statistics include skill scores for forecasting events (flow/level threshold crossings) of differing severity/rarity, indicating their probability and likely timing, which have real value in an operational setting. The local models assessed can be of any type and span rainfall-runoff (conceptual and transfer function) and flow routing (hydrological and hydrodynamic) forms. Also accommodated by the framework is the national G2G (Grid-to-Grid) distributed hydrological model, providing area-wide coverage across the fluvial rivers of England and Wales, which can be assessed at gauged sites. Thus the performance of the national G2G model forecasts can be directly compared with that from the local models. The Performance Summary for each site model is complemented by a national spatial analysis of model performance stratified by model-type, geographical region and forecast lead-time. The map displays provide an extensive evidence-base that can be interrogated, through a Flood Forecasting Model Performance web portal, to reveal fresh insights into comparative performance across locations, lead-times and models. This work was commissioned by the Environment Agency in partnership with Natural Resources Wales and the Flood Forecasting Centre for England and Wales.

75 FR 78976 - New England Fishery Management Council; Public Meeting

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2010-12-17

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a public meeting of its Habitat/MPA/Ecosystem Committee, in January, 2011, to consider actions affecting New England fisheries in the exclusive economic...

78 FR 62587 - New England Fishery Management Council; Public Meeting

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2013-10-22

... prepare a work plan regarding how the New England Fishery Management Council (Council) may proceed in... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XC923 New England... Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New...

76 FR 22080 - New England Fishery Management Council; Public Meeting

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2011-04-20

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a public meeting of its Scallop Advisory Panel...: (508) 747- 8937. Council address: New England Fishery Management Council, 50 Water Street, Mill 2...

76 FR 7548 - New England Fishery Management Council; Public Meeting

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2011-02-10

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a public meeting of its Scallop Committee in...; fax: (401) 734-9700. Council address: New England Fishery Management Council, 50 Water Street, Mill 2...

76 FR 70420 - New England Fishery Management Council (NEFMC); Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-14

...), National Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in November, 2011, to consider actions affecting New England fisheries in...

75 FR 66072 - New England Fishery Management Council; Public Meeting

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2010-10-27

... Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in November, 2010, to consider actions affecting New England fisheries in...

76 FR 17381 - New England Fishery Management Council; Public Meeting

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2011-03-29

... Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice; public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in April, 2011, to consider actions affecting New England fisheries in the exclusive...

76 FR 10561 - New England Fishery Management Council; Public Meeting

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2011-02-25

... Oceanic and Atmospheric Administration (NOAA), Commerce. ACTION: Notice of a public meeting. SUMMARY: The New England Fishery Management Council (Council) is scheduling a public meeting of its Research Steering Committee (Committee), in March, 2011, to consider actions affecting New England fisheries in the...

76 FR 31304 - New England Fishery Management Council; Public Meeting

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2011-05-31

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... England Fishery Management Council (Council) is scheduling a joint public meeting of its Skate Committee and Advisory Panel, in June, 2011, to consider actions affecting New England fisheries in the...

75 FR 68757 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-09

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... New England Fishery Management Council's (Council) Herring Committee will meet to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). DATES: The meeting will be held on...

The nursing role in ICU outreach: an international exploratory study.

PubMed

Endacott, Ruth; Chaboyer, Wendy

2006-01-01

It is widely acknowledged that many critically ill patients are managed outside of designated critical care units. One strategy adopted in Australia and England to assess and manage risk in these patients is the intensive care unit (ICU) outreach or liaison nurse service. This article examines how ICU outreach/liaison roles in Australia and England operate in the context of Manley's theoretical framework for advanced nursing practice. Descriptive case study design using semi-structured interviews and job descriptions as sources of evidence. Findings of interviews with six Australian ICU Liaison nurses are already published; this study replicated the Australian study with four ICU Consultant Nurses in England and mapped interview and job description data from both countries onto Manley's conceptual framework for advanced practice/consultant nurse. Four themes emerged from the English data: patient interventions, support for ward staff, liaison between ward and ICU staff and hospital-wide impact. The first three of these comprised the core service common to the roles in both countries. Manley's four subroles (expert practitioner, consultant, educator and researcher) were present across both countries. However, the interview and job description data demonstrated that there were lower expectations in Australia that the roles would lead to staff development and build capacity across the hospital system. Similarly, formal education for ward staff such as ALERT and CRiSP courses were more developed in UK. Our data demonstrate that the role undertaken in England and Australia is sufficiently comparable to use as a research intervention in international studies across the two countries. However, the macro service level differs. Job descriptions across both countries emphasized the need to influence hospital policy; however, the ICU consultant nurses in England might be considered better placed to achieve this through role title and access to the hospital executive. In both countries, the roles would benefit from systematic evaluation of the impact on outcomes. This is particularly important for longer-term integration of the role in the health services in both countries.

New England SPARROW Water-Quality Modeling to Assist with the Development of Total Maximum Daily Loads in the Connecticut River Basin

NASA Astrophysics Data System (ADS)

Moore, R. B.; Robinson, K. W.; Simcox, A. C.; Johnston, C. M.

2002-05-01

The U.S. Geological Survey (USGS), in cooperation with the U.S. Environmental Protection Agency (USEPA) and the New England Interstate Water Pollution Control Commission (NEWIPCC), is currently preparing a water-quality model, called SPARROW, to assist in the regional total maximum daily load (TMDL) studies in New England. A model is required to provide estimates of nutrient loads and confidence intervals at unmonitored stream reaches. SPARROW (Spatially Referenced Regressions on Watershed Attributes) is a spatially detailed, statistical model that uses regression equations to relate total phosphorus and nitrogen (nutrient) stream loads to pollution sources and watershed characteristics. These statistical relations are then used to predict nutrient loads in unmonitored streams. The New England SPARROW model is based on a hydrologic network of 42,000 stream reaches and associated watersheds. Point source data are derived from USEPA's Permit Compliance System (PCS). Information about nonpoint sources is derived from data such as fertilizer use, livestock wastes, and atmospheric deposition. Watershed characteristics include land use, streamflow, time-of-travel, stream density, percent wetlands, slope of the land surface, and soil permeability. Preliminary SPARROW results are expected in Spring 2002. The New England SPARROW model is proposed for use in the TMDL determination for nutrients in the Connecticut River Basin, upstream of Connecticut. The model will be used to estimate nitrogen loads from each of the upstream states to Long Island Sound. It will provide estimates and confidence intervals of phosphorus and nitrogen loads, area-weighted yields of nutrients by watershed, sources of nutrients, and the downstream movement of nutrients. This information will be used to (1) understand ranges in nutrient levels in surface waters, (2) identify the environmental factors that affect nutrient levels in streams, (3) evaluate monitoring efforts for better determination of nutrient loads, and (4) evaluate management options for reducing nutrient loads to achieve water-quality goals.

Stress Testing Water Resource Systems at Regional and National Scales with Synthetic Drought Event Sets

NASA Astrophysics Data System (ADS)

Hall, J. W.; Mortazavi-Naeini, M.; Coxon, G.; Guillod, B. P.; Allen, M. R.

2017-12-01

Water resources systems can fail to deliver the services required by water users (and deprive the environment of flow requirements) in many different ways. In an attempt to make systems more resilient, they have also been made more complex, for example through a growing number of large-scale transfers, optimized storages and reuse plants. These systems may be vulnerable to complex variants of hydrological variability in space and time, and behavioural adaptations by water users. In previous research we have used non-parametric stochastic streamflow generators to test the vulnerability of water resource systems. Here we use a very large ensemble of regional climate model outputs from the weather@home crowd-sourced citizen science project, which has generated more than 30,000 years of synthetic weather for present and future climates in the UK and western Europe, using the HadAM3P regional climate model. These simulations have been constructed in order to preserve prolonged drought characteristics, through treatment of long-memory processes in ocean circulations and soil moisture. The weather simulations have been propagated through the newly developed DynaTOP national hydrological for Britain, in order to provide low flow simulations at points of water withdrawal for public water supply, energy and agricultural abstractors. We have used the WATHNET water resource simulation model, set up for the Thames Basin and for all of the large water resource zones in England, to simulate the frequency, severity and duration of water shortages in all of these synthetic weather conditions. In particular, we have sought to explore systemic vulnerabilities associated with inter-basin transfers and the trade-offs between different water users. This analytical capability is providing the basis for (i) implementation of the Duty of Resilience, which has been placed upon the water industry in the 2014 Water Act and (ii) testing reformed abstraction arrangements which the UK government is committed to implementing.

The role of bio-physical cohesive substrates on sediment winnowing and bedform development

NASA Astrophysics Data System (ADS)

Ye, Leiping; Parsons, Daniel; Manning, Andrew

2017-04-01

Existing sediment transport and bedform size predictions for natural open-channel flows in many environments are seriously impeded by a lack of process-based knowledge concerning the dynamics of complex bed sediment mixtures comprising cohesionless sand and biologically-active cohesive muds. A series of flume experiments (14 experimental runs) with different substrate mixtures of sand-clay-EPS (Extracellular Polymeric Substance) are combined with a detailed estuarine field survey (Dee estuary, NW England) to investigate the development of bedform morphologies and characteristics of suspended sediment over bio-physical cohesive substrates. The experimental results indicate that winnowing and sediment sorting can occur pervasively in bio-physical cohesive sediment - flow systems. Importantly however, the evolution of the bed and bedform dynamics, and hence turbulence production, is significantly reduced as bed substrate cohesivity increases. The estuarine subtidal zone survey also revealed that the bio-physical cohesion provided by both the clay and microorganism fractions in the bed plays a significant role in controlling the interactions between bed substrate and sediment suspension, deposition and bedform generation. The work will be presented here concludes by outlining the need to extend and revisit the effects of cohesivity in morphodynamic systems and the sets of parameters presently used in numerical modelling, particularly in the context of the impact of climate change on estuarine and coastal systems.

78 FR 65617 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National... New England Fishery Management Council (Council) will hold a one-day meeting on November 20, 2013 to... special accommodations should be addressed to the New England Fishery Management Council, 50 Water Street...

Integrating Economics into the Curriculum: Teaching Ideas from England.

ERIC Educational Resources Information Center

Waite, Patrick; And Others

1991-01-01

Reviews economics teaching methods in England in light of curriculum reform there. Explains economics' cross-curricular status in England's national curriculum. Stresses students' experiential learning in simulations, interview projects, and a minienterprise approach in which students produce and market goods. Describes one elementary school's…

The New England Transportation Consortium (NETC) : a summary of the multistate cooperative research program between 1994 and 2011.

DOT National Transportation Integrated Search

2014-10-01

The six New England state transportation agencies are cooperating with the six New England state land-grant : universities and the Federal Highway Administration in a program of transportation research. This joint venture is : called the New Engla...

Climate Change Science Activities of the U.S. Geological Survey in New England

USGS Publications Warehouse

Lent, Robert M.

2016-03-23

This fact sheet presents recent climate change investigations of the USGS in New England using selected recent publications. These publications highlight the broad spectrum of expertise and commitment to understanding the relations of climate change and water resources in New England.

PERFORMANCE AND DIAGNOSTIC EVALUATION OF OZONE PREDICTIONS BY THE ETA-COMMUNITY MULTISCALE AIR QUALITY FORECAST SYSTEM DURING THE 2002 NEW ENGLAND AIR QUALITY STUDY

EPA Science Inventory

A real-time air quality forecasting system (Eta-CMAQ model suite) has been developed by linking the NCEP Eta model to the U.S. EPA CMAQ model. This work presents results from the application of the Eta-CMAQ modeling system for forecasting O₃ over the northeastern U.S d...

Estimating vaccine effectiveness against severe influenza in England and Scotland 2011/2012: applying the screening method to data from intensive care surveillance systems.

PubMed

Thomas, H L; Andrews, N; Green, H K; Boddington, N L; Zhao, H; Reynolds, A; McMenamin, J; Pebody, R G

2014-01-01

Methods for estimating vaccine effectiveness (VE) against severe influenza are not well established. We used the screening method to estimate VE against influenza resulting in intensive care unit (ICU) admission in England and Scotland in 2011/2012. We extracted data on confirmed influenza ICU cases from severe influenza surveillance systems, and obtained their 2011/2012 trivalent influenza vaccine (TIV) status from primary care. We compared case vaccine uptake with population vaccine uptake obtained from routine monitoring systems, adjusting for age group, specific risk group, region and week. Of 60 influenza ICU cases reported, vaccination status was available for 56 (93%). Adjusted VE against ICU admission for those aged ≥ 65 years was -10% [95% confidence interval (CI) -207 to 60], consistent with evidence of poor protection from the 2011/2012 TIV in 2011/2012. Adjusted VE for those aged <65 years in risk groups was -296% (95% CI -930 to -52), suggesting significant residual confounding using the screening method in those subject to selective vaccination.

"The reflection of England's light": the instructive District Nursing Association of Boston, 1884-1914.

PubMed

Howse, Carrie

2009-01-01

This article examines the extent to which the Instructive District Nursing Association (IDNA) of Boston was influenced by the English system of district nursing. The schemes had the same aims and motivation, but the differences in their organizational structures, in particular the lack of specialist training and professional supervision of the Boston nurses, affected the IDNA's work with its poor, mainly immigrant patients. It is clear that much was achieved, but it is also apparent that problems increased as the work expanded. Attempts to solve these difficulties can be traced through the introduction of a nurse supervisor, establishment of a training school, and eventual radical reorganization. The IDNA also had a leading role in the expansion of the visiting nurse movement throughout the United States. I discuss attempts to establish national standards, particularly through the formation of the National Organization for Public Health Nursing (NOPHN). With the disparate arrangements in the U.S. health care system, the NOPHN was unable to reach a workable consensus and failed to produce a comprehensive and cohesive national system similar to that which had been established in England.

Understanding the occupational and organizational boundaries to safe hospital discharge.

PubMed

Waring, Justin; Marshall, Fiona; Bishop, Simon

2015-01-01

Safe hospital discharge relies upon communication and coordination across multiple occupational and organizational boundaries. Our aim was to understand how these boundaries can exacerbate health system complexity and represent latent sociocultural threats to safe discharge. An ethnographic study was conducted in two local health and social care systems (health economies) in England, focusing on two clinical areas: stroke and hip fracture patients. Data collection involved 345 hours of observations and 220 semi-structured interviews with health and social care professionals, patients and their lay carers. Hospital discharge involves a dynamic network of interactions between heterogeneous health and social care actors, each characterized by divergent ways of organizing discharge activities; cultures of collaboration and interaction and understanding of what discharge involves and how it contributes to patient recovery. These interrelated dimensions elaborate the occupational and organisational boundaries that can influence communication and coordination in hospital discharge. Hospital discharge relies upon the coordination of multiple actors working across occupational and organizational boundaries. Attention to the sociocultural boundaries that influence communication and coordination can help inform interventions that might support enhanced discharge safety. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Introduction of shared electronic records: multi-site case study using diffusion of innovation theory.

PubMed

Greenhalgh, Trisha; Stramer, Katja; Bratan, Tanja; Byrne, Emma; Mohammad, Yara; Russell, Jill

2008-10-23

To explore the introduction of a centrally stored, shared electronic patient record (the summary care record (SCR)) in England and draw wider lessons about the implementation of large scale information technology projects in health care. Multi-site, mixed method case study applying utilisation focused evaluation. Four early adopter sites for the SCR in England-three in urban areas of relative socioeconomic deprivation and the fourth in a relatively affluent rural area. Data sources and analysis Data included 250 staff interviews, 1500 hours of ethnographic observation, interviews and focus groups with 170 patients and carers, 2500 pages of correspondence and documentary evidence, and incorporation of relevant surveys and statistics produced by others. These were analysed by using a thematic approach drawing on (and extending) a theoretical model of complex change developed in a previous systematic review. Main findings The mixed fortunes of the SCR programme in its first year were largely explained by eight interacting influences. The first was the SCR's material properties (especially technical immaturity and lack of interoperability) and attributes (especially the extent to which potential adopters believed the benefits outweighed the risks). The second was adopters' concerns (especially about workload and the ethicality of sharing "confidential" information on an implied consent model). The third influence was interpersonal influence (for example, opinion leaders, champions, facilitators), and the fourth was organisational antecedents for innovation (for example past experience with information technology projects, leadership and management capacity, effective data capture systems, slack resources). The fifth was organisational readiness for the SCR (for example, innovation-system fit, tension for change, power balances between supporters and opponents, baseline data quality). The sixth was the implementation process (including the nature of the change model and the extent to which new routines associated with the SCR aligned with existing organisational routines). The seventh influence was the nature and quality of links between different parts of the system, and the final one was the wider environment (especially the political context of the programme). Shared electronic records are not plug-in technologies. They are complex innovations that must be accepted by individual patients and staff and also embedded in organisational and inter-organisational routines. This process is heavily influenced at the micro-level by the material properties of the technology, individuals' attitudes and concerns, and interpersonal influence; at the meso-level by organisational antecedents, readiness, and operational aspects of implementation; and at the macro-level by institutional and socio-political forces. A case study approach and multi-level theoretical analysis can illuminate how contextual factors shape, enable, and constrain new, technology supported models of patient care.

Workshops and Training | Eliminating Sanitary Sewer ...

EPA Pesticide Factsheets

2017-04-10

EPA New England is working with partners to develop outreach, workshops and tools to assist those working to prevent sewage overflows and improve the management of water/wastewater systems. We have ongoing efforts on CMOM (Capacity, Management, Operation and Maintenance), Asset Management and energy management.

Comparing Measures of Estuarine Ecosystem Production in a Temperate New England Estuary

EPA Science Inventory

Anthropogenic nutrient enrichments and concerted efforts at nutrient reductions, compounded with the influences of climate change, are likely changing the net ecosystem production (NEP) of our coastal systems. To quantify these changes, scientists monitor a range of physical, che...

Implementation, driver behavior, and simulation : issues related to roundabouts in northern New England.

DOT National Transportation Integrated Search

2014-06-01

Roundabouts are an emerging type of intersection design and a relatively new addition to the : transportation system in the United States. This imposes two traffic engineering and research : related issues. First, data and research on traffic operati...

England Policy in Gifted Education: Current Problems and Promising Directions

ERIC Educational Resources Information Center

Koshy, Valsa; Smith, Carole Portman; Casey, Ronald

2018-01-01

This article presents and analyzes policies in identification and provisions in England with respect to gifted education. England has developed a national policy to provide services to identified students. Surveys and interviews with teachers illustrate how implementation of both identification and provision policy elements were handled. Although…

Trendsetting: A New Way to Keep up with Trends & Indicators in New England's Education and Economy

ERIC Educational Resources Information Center

Harney, John O.

2013-01-01

For more than half a century, the "New England Journal of Higher Education" ("NEJHE") has been publishing tables and charts exploring "Trends & Indicators" (T&I) in New England's demography, high school performance and graduation, college enrollment, college graduation rates and degree production, higher…

Schooling Reforms in England: From Quasi-Markets to Co-Opetition?

ERIC Educational Resources Information Center

Adnett, Nick; Davies, Peter

2003-01-01

Economic analysis of the impact of recent schooling reforms in England designed to promote competition or cooperation between schools. Outlines the theoretical relationships between school competition and cooperation and school effectiveness. Briefly describes the development of policy in England and analyzes the interaction between the incentives…

75 FR 27056 - Record of Decision for Environmental Impact Statement: New Bedford Regional Airport, New Bedford, MA

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-13

... Impact Statement: New Bedford Regional Airport, New Bedford, MA AGENCY: Federal Aviation Administration... England Executive Park, Burlington, MA. Telephone (781) 238-7613. SUPPLEMENTARY INFORMATION: The FAA is... locations: FAA New England Region, Airports Division, 16 New England Executive Park, Burlington, MA...

A Comparative Analysis of Primary Teacher Professionalism in England and Finland

ERIC Educational Resources Information Center

Webb, Rosemary; Vulliamy, Graham; Hamalainen, Seppo; Sarja, Anneli; Kimonen, Eija; Nevalainen, Raimo

2004-01-01

Policy-makers' conceptions of teacher professionalism currently differ markedly in England and Finland. In England they are shaped by agendas associated with the drive to raise standards and "commercialized professionalism" whilst in Finland they are influenced by notions of "teacher empowerment". This article analyses findings…

78 FR 79672 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

...The New England Fishery Management Council (Council) is scheduling a public meeting of its Herring Advisory Panel to consider actions affecting New England fisheries in the exclusive economic zone (EEZ). Recommendations from this group will be brought to the full Council for formal consideration and action, if appropriate.

New England's travel & tourism markets: trends in the geographic target markets in the 90's

Treesearch

Rodney B. Warnick

2001-01-01

The purpose of this paper was to examine the travel and lifestyle activity market trends to New England in the 90s. The central theme was to fully examine in detail the primary, secondary and tertiary geographic markets targeted by New England destinations.

75 FR 61746 - New England Wire Technologies Corp; Supplemental Notice That Initial Market-Based Rate Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER10-2754-000] New England Wire Technologies Corp; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for...-referenced proceeding of New England Wire Technologies Corp's application for market-based rate authority...