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College governing boards are widely held to be the keystone of institutional strategy and the prime locus of support, challenge and accountability in respect of the actions of the senior Executive. Whilst there are many normative prescriptions about the conditions and arrangements required for effective college governance, relatively little is known about how and to what extent the practices of boards reflect or realise these prescriptions. This paper draws upon a unique research study of eight further education colleges across the four nations of the UK. Following Chia and MacKay and Hendry et al., our 'strategy as practice' approach gives primacy to emergence and immanence through board practices. Video and observational data, supplemented by some interview and documentary data are used to develop an understanding of governing practices. Our analysis suggests that current normative prescriptions lack the conceptual sophistication required to support governing as it really happens. We offer a reconceptualisation of both strategy and accountability suggesting that the latter includes lateral, inward- and outward-facing functions that make conflicting demands on governors. We argue that these distinctions are vital in enabling further positive development of governing in the college sector.

This paper presents the initial findings of a research project that aims to investigate the impact of teacher training for lecturers in post-compulsory education on engagement with continuing professional development (CPD) for learning and teaching. The majority of colleges and universities operating in the UK now ensure that all teaching staff are given access to training in skills for learning and teaching. This training can take many different forms and this paper explores the potential differences in outcome and influence on engagement with CPD and lifelong learning of graduates from these programmes. For the study, 18 lecturers from different colleges (one large multi-campus college in Scotland and another in Wales) provided narrative accounts about their professional background, training and qualifications prior to initial lecturer training and their route into teaching in further education. Respondents then engaged in semi-structured interviews about their experiences in lecturer training and ongoing engagement with CPD and further learning post-training. The findings indicate that respondents feel insufficient emphasis is placed on vocational skills training, meeting special educational needs and classroom management techniques. Lecturers agree that CPD in learning and teaching is very important but the research data show lack of meaningful engagement with the training options currently available. Recommendations are made to colleges to increase the practical and vocational focus and content of teacher training for lecturers whilst acknowledging the importance of allowing novice practitioner status. The requirement for access to high-quality, valid and targeted CPD is highlighted, with lecturers acknowledging the importance of training and expressing the desire to engage with relevant courses in learning and teaching.

This article addresses the relationships between media, media use and language retention. In pursuing this aim, we explore the utility of ethnolinguistic vitality (EV) as a fruitful conceptual tool. The extant research on the relationship between the media and language retention and development provides an encouragement to pursue in more detail the role of media in this process: in other words to address more explicitly the features of media operation, and their relationship to audiences, which interface with the dynamics of EV. Based on four case studies of bilingual communities, the article concludes that media can be an important vehicle in maintaining and supporting EV. The extent to which this can be reached depends mostly on objective factors, such as the institutional completeness of the media landscape. (Contains 4 notes, 3 tables, and 2 figures.)

Background: There is increasing interest in the role of community pharmacy in the early diagnosis and prevention of cancer. This study set out to examine how often community pharmacists (CPs) encourage patients to spot or respond to potential signs and symptoms of cancer, and how often they help people to make an informed decision about taking part in bowel cancer screening. Methods: Data from 400 UK CPs, who completed the 2018 Cancer Research UK Healthcare Professional Tracker survey, were analysed. The primary outcomes were: 'how often CPs encourage patients to spot or respond to potential signs and symptoms of cancer' and 'how often CPs encourage eligible people to make an informed decision to participate in bowel cancer screening'. Associations between behaviours and demographic and psychological variables (Capability, Opportunity and Motivation) were assessed using multivariate logistic regression. Results: Most (n = 331, 82.8%) CPs reported occasionally, frequently or always encouraging patients to spot or respond to potential signs and symptoms of cancer, while only half (n = 203, 50.8%) reported occasionally, frequently or always helping people make an informed decision to participate in bowel cancer screening. Female sex (aOR: 3.20, 95%CI: 1.51, 6.81; p < 0.01) and increased Opportunity (aOR: 1.72, 95%CIs: 1.12, 2.64; p < 0.05) and Motivation (aOR: 1.76, 95%CIs: 1.37, 2.27; p < 0.001) were associated with encouraging patients to spot or respond to potential signs and symptoms of cancer; all three psychological variables were associated with helping people to make an informed decision to participate in bowel cancer screening (Capability: aOR: 1.39, 95%CIs: 1.26, 1.52, p < 0.001; Opportunity: aOR: 1.44, 95%CIs: 1.11, 1.87; p < 0.01; Motivation: aOR: 1.45, 95%CIs: 1.05, 2.00; p < 0.05). Conclusions: Most CPs encourage patients to spot or respond to potential cancer symptoms, while only half help them make an informed decision to participate in bowel cancer screening. A multifaceted approach, targeting multiple COM-B components, is required to change these behaviours. [ABSTRACT FROM AUTHOR]

This paper examines the role of the Frontier and Cobb-Douglas production functions in the measurement of company level productivity. The productivity of a typical British batch production company is measured using the production function concept. This approach utilizes the engineering concept of efficiency and this represents a major departure from the conventional measurement of company level productivity. [ABSTRACT FROM AUTHOR]

This paper presents the results of a case study analysis of total productivity trends within a typical British batch production company. Two models of corporate productivity are tested using historical data for 1975-79 and the results are interpreted and discussed. The paper also demonstrates how the results could be extended to produce simple predictive models of company productivity and total unit cost. The authors conclude that measures of total company productivity offer a valuable aid to decision-making for production engineers and mangers. [ABSTRACT FROM AUTHOR]

Since 2008, health policy in England has been focusing increasingly on improving quality in healthcare services. To ensure quality improvements in community nursing, providers are required to meet several quality targets, including an incentive scheme known as Commissioning for Quality and Innovation (CQUIN). This paper reports on a study of how financial incentives are used in district nursing, an area of care which is particularly difficult to measure and monitor. [ABSTRACT FROM AUTHOR]

This article explores the nature of provision of higher education (HE) within the further education (FE) context and discusses the prevalent cultures of delivery. Attention is drawn to the skills and pedagogic methods prevalent within FE that could offer significant benefits to the delivery of advanced-level apprenticeships and applied vocationally based higher education. Discussion turns to the recontextualisation of the HE provision in FE and the possible economic and social benefits of widening access to skills focussed higher-level training courses. [ABSTRACT FROM PUBLISHER]

Collaborative education and training is the only way forward for the cancer care work force. The Calman-Hine report has become the benchmark on which to build practice since its launch in 1995. A forward looking group - the Cancer Care Alliance of Teesside, South Durham and North Yorkshire Education Group and the University of Teesside - adopted its principles from the Calman-Hine Report and developed some strategic projects to address and achieve them. A needs assessment of cancer education influenced the agenda within the Cancer Care Alliance. The education portfolio that was developed had a multiprofessional focus, incorporating both academic and non-academic study. [ABSTRACT FROM AUTHOR]

Discolouration is an international phenomenon in drinking water distribution systems due to erosion of particulate material layers. In the UK water companies are implementing hydraulic layer conditioning for maintenance and resilience with significant cost benefits, despite limited understanding of the material accumulation processes. In this paper 18 months turbidity data from a 4 km trunk main is simulated using four extended period Epanet MSX model formulations. The measured data demonstrates recurrent regeneration of discolouration risk and hydraulic conditioning as pro-active mitigation. Modelling facilitates investigation of layer regeneration processes, helping inform future discolouration models and operational strategies to safeguard water quality. [ABSTRACT FROM AUTHOR]

Prescribing is a characteristic role of a medical practitioner. On graduating from medical school, students are presumed to have acquired the necessary pharmacology knowledge underpinning the therapeutics and developed their personal skills and behaviors in order to write a safe and effective prescription (The Four Ps). However, there are reports of errors in medical prescribing and dissatisfied feedback from recent graduates, which evidence potential flaws in the current training in the practice of prescribing. We examine the Four Ps from a systems approach and offer scope for educators and curriculum designers to review and reflect on their current undergraduate teaching, learning, and assessment strategies in a similar manner. We also adopt a national framework of common competencies required of all prescribers to remain effective and safe in their area of practice as a more objective layer to the broader learning outcomes of the General Medical Council Tomorrow's Doctors 2009. This exercise demonstrates where standard, recognized competencies for safe prescribing can be accommodated pedagogically within existing medical curricula. [ABSTRACT FROM AUTHOR]

Alam and Husband explore the ways in which two policies of central government, in both conception and expression, have operated in such a way as to promote the growth of Islamophobia in Britain. Policies of community cohesion developed in response to the riots in northern British cities in 2001, while the counter-terrorist polices that emerged following the bombings on mainland Britain in 2005 were targeted at Britain's Muslim populations. The rhetoric employed in the public sphere to legitimate these policies had the effect of making Islamic identity salient, and aberrant, in the context of twenty-first-century Britain. The scapegoating of Muslims, as essentially an alien wedge in British society with a deep resistance to entering into ‘the British way of life’, was attached to an interpretation of their demographic location in British cities so as to present them as both ‘self-segregating’ and ‘living parallel lives’. The emergence of ‘home-grown bombers’ resulted in the state maintaining a sense of risk to terrorist assault that fed off and into the existing securitization of urban life, consolidating a policy environment defined by the sense of an essentially permanent state of crisis. These exceptional circumstances permitted a suspension of previously sacrosanct principles of human rights and freedoms. The empirical evidence underpinning this paper reinforces the notion that these policies were mutually contradictory in practice, and that the penetration of social cohesion initiatives by the logics of surveillance resulted in a breakdown of trust between large sections of the British Muslim population and the agents of the state. [ABSTRACT FROM PUBLISHER]

Objectives To compare risk of fatal injury in elderly road users (drivers, passengers, pedestrians) with that of younger age groups and to assess the contribution of elderly road users to the number of reported fatalities in the population. Design Fatality age was categorized as 21 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, or 70 and older, and road user was categorized as driver, passenger, or pedestrian. Estimated number of trips made by each age group was used to adjust for exposure and to measure individual risk. Setting Fatalities recorded in Britain between 1989 and 2009. Participants Population-wide fatal injury counts in Britain. Measurements Age of fatally injured drivers, passengers, and pedestrians. Estimated number of trips made per year by drivers, passengers, and pedestrians. Results Risk of fatal injury, but not fatality numbers in the population, were higher for older adult (≥70) drivers than for younger age groups. Risk of fatal injury was also high for older adult passengers and pedestrians, who represented the majority of older adult fatalities. Conclusion Previous emphasis on driver impairment in older age has unduly focussed attention on elderly drivers, who represent a minority of all driver fatalities. Older adults represent a much larger proportion of passenger and pedestrian fatalities. Additional policy schemes and initiatives should be targeted at safeguarding older adult passengers and making the road environment safer for elderly pedestrians. [ABSTRACT FROM AUTHOR]

Background:Tympanostomy tube (grommet) insertion is a common procedure, with little guidance in the current literature regarding post-operative surveillance. Our institution implemented a protocol to follow up post-surgical grommet patients via audiology at six weeks.Methods:A retrospective audit of all patients less than 16 years old who had undergone grommet insertion during a three-month period.Results:A total of 149 patients had grommets inserted. Exclusion criteria left a cohort of 123 individuals; 82 (67 per cent) were followed up by audiology. Of these, 13 (11 per cent) did not attend follow up, and were discharged; 53 (43 per cent) were discharged from audiology with normal thresholds; and 16 (13 per cent) were referred back to a consultant. Therefore, the overall reduction in patients followed up by an otolaryngologist was 54 per cent.Conclusion:We recommend a six-week follow up with audiology following grommet insertion, allowing for referral back to ENT services in the event of related complications. [ABSTRACT FROM PUBLISHER]

Discoloration in water distribution systems has been studied in partnership with a number of U.K. water companies by measuring the turbidity response to changes in hydraulic conditions induced by systematic flushing. The resulting data was used to verify a predictive empirical model and hence the underlying assumptions made in its development. Model simulations, made using previously established parameters defined solely by pipe diameter and pipe material, are presented alongside measured data to demonstrate this verification. The primary cause of discoloration observed is the mobilization of material from cohesive layers bonded to pipe walls. These layers demonstrate a profile of increasing shear strength with increasing degree of discoloration. Differences are demonstrated in the layer and ultimate shear strength characteristics of the discoloration layers formed in iron and plastic pipes, with a modeled shear stress of 1.2 N/m2 shown to exhaust material layers in plastic pipes. Based on the observed data it is theorized that accumulation of material to the pipe walls is primarily dependent on two mechanisms; ubiquitous background concentrations in the bulk water, and if present corrosion by-products from iron pipes and fittings. A consequence of this is that all pipes within a water distribution system are susceptible to the development of material layers. In the formulation of operation and maintenance strategies it is suggested that iron and plastic pipes should be treated differently to obtain optimum operational effectiveness and minimize discoloration risk. [ABSTRACT FROM AUTHOR]

Background: Epigenetic silencing of O(6)-methylguanine-DNA-methyltransferase (MGMT) by promoter methylation is associated with improved survival in glioblastomas treated with alkylating agents. In this study, we investigated MGMT promoter methylation in glioblastomas treated with temozolomide and radiotherapy in a single UK treatment centre.Methods: Quantitative methylation data at individual CpG sites were obtained by pyrosequencing for 109 glioblastomas.Results: Median overall survival (OS) was 12.4 months with 2-year survival of 17.9%. Pyrosequencing data were reproducible with archival samples yielding data for all glioblastomas. Variation in methylation patterns of discrete CpG sites and intratumoral methylation heterogeneity were observed. A total of 58 out of 109 glioblastomas showed average methylation >non-neoplastic brain in at least one clinical sample; 86% had homogeneous methylation status in multiple samples. Methylation was an independent prognostic factor associated with prolonged progression-free survival (PFS) and OS. Cases with methylation more than 35% had the longest survival (median PFS 19.2; OS 26.2 months, 2-year survival of 59.7%). Significant differences in PFS were seen between those with intermediate or high methylation and unmethylated cases, whereas cases with low, intermediate or high methylation all showed significantly different OS.Conclusions: These data indicate that MGMT methylation is prognostically significant in glioblastomas given chemoradiotherapy in the routine clinic; furthermore, the extent of methylation may be used to provide additional prognostic stratification. [ABSTRACT FROM AUTHOR]

In the UK the clinical nurse specialist role (CNS) has evolved in an uncoordinated manner resulting in a broad job remit, with clinical, managerial, research and educational elements. CNSs working in specialist palliative care are expected to contribute to the delivery of education but many have received no formal training to support them in this aspect of their role. There has been limited research exploring the role the community palliative care CNS in providing education, making this study timely. Aim: The aim of this study was to explore the role of the community palliative care CNS as educator. Method: Hermeneutic phenomenology, using semi-structured interviews with a convenience sample of eight community palliative care CNSs was the approach used. Formal ethical approval was obtained and all participants provided written informed consent. Colaizzi's framework for analysis provided a structured and transparent approach to data analysis. A summary of the findings were verified by the participants to enhance the credibility of interpretation presented here. Results: Data analysis identified three main themes; conflict of expectations, credibility as a teacher and making the education role work. This study highlighted a team approach may address the conflict of expectations between the role specifications and practice reality. Conclusion: The CNS has a role in education. However for some CNSs, providing informal education rather than formal education may be appropriate. If the community palliative care CNS provides formal education, they require the knowledge and skills to deliver it effectively. The role of the CNS in palliative care education in the community should respond to personal, professional and local needs. [ABSTRACT FROM AUTHOR]

Since the 1970s, advanced countries have gone through a distinct process of economic restructuring. In a number of countries manufacturing industries such as clothing and textiles have suffered a gradual decline. In the UK the problems of the industry have been exacerbated by price rises in raw materials, the ability of retail groups to shift their manufacturing base to cheaper offshore locations and increased importation from developing countries. Despite these setbacks, Asians originating in the Indian subcontinent and East Africa continue to establish small clothing enterprises. Large numbers of these operate on the fringes of the formal economy, maintained against a background of low profit margins and competition. This study centres on the ways in which aid and information agencies are tackling the problems of this often hidden sector in Birmingham, Manchester and Leicester. Qualitative interviews were undertaken with 24 individuals representing a variety of formal and voluntary agencies connected to business development. In addition case-study research was undertaken with five firms. The results highlight the slow progress being made in the area of networking between the various institutions and the clear gulf between government-backed support agencies and the majority of Asian-owned clothing and textile enterprises. [ABSTRACT FROM AUTHOR]

Examines the role of computed tomography (CT) in the management of cancer in Great Britain. Advantages and limitations of CT cancer diagnosis; Lack of information on the influence of CT on patient management in oncology; Influence of CT results on the clinical decisions of patients.

Investigates the computed tomography of the body in Great Britain. Accessibility of computed tomography; Impact of tomography on management of patients with cancer; Importance of scanning facilities in district general hospitals and specialized centers.

Investigates earnings in five British manufacturing firms over the three year period 1973-1975 inclusive. Dominance of the problem of restricting pay increases; Comparison of earnings and rates between the five firms; Degree of management's autonomy over the structure of earnings.

Examines the cyclical chemotherapy of children with acute lymphoblastic leukemia in Great Britain. Administration of three combination of four drugs; Cranial irradiation and intrathecal injection of methotrexate; Increase in the length of remission and survival; Decrease in the incidence of overt central nervous system.

Provides information on VOX, a partnership project between the Oxfordshire Learning Disability National Health Service Trust and Millenium Volunteers. Significance of the project to unleash the potential of people with learning disabilities; Objectives of VOX; Examination of the principles of volunteering; Efforts made by VOX members to ensure that the correct type of support is given to volunteers.

Reports the practicality of the plans for medical library services in Great Britain. Source of help and support in practical planning; Health and safety and disability issues in planning; Guidelines in developing library and information technology facilities.

• Post-phosphate flushing events revealed increased water discolouration risk. • Microbiological differences arise post-phosphate treatment, irrespective of pipe material. • Higher phosphate influence on bacteria attached to a range of materials used in DWDS. • Phosphate dosing reduced bacterial and fungal richness. Phosphate is routinely dosed to ensure regulatory compliance for lead in drinking water distribution systems. Little is known about the impact of the phosphate dose on the microbial ecology in these systems and in particular the endemic biofilms. Disturbance of the biofilms and embedded material in distribution can cause regulatory failures for turbidity and metals. To investigate the impact of phosphate on developing biofilms, pipe wall material from four independent pipe sections was mobilised and collected using two twin-flushing operations a year apart in a chlorinated UK network pre- and post-phosphate dosing. Intensive monitoring was undertaken, including turbidity and water physico-chemistry, traditional microbial culture-based indicators, and microbial community structure via sequencing the 16S rRNA gene for bacteria and the ITS2 gene for fungi. Whole metagenome sequencing was used to study shifts in functional characteristics following the addition of phosphate. As an operational consequence, turbidity responses from the phosphate-enriched water were increased, particularly from cast iron pipes. Differences in the taxonomic composition of both bacteria and fungi were also observed, emphasising a community shift towards microorganisms able to use or metabolise phosphate. Phosphate increased the relative abundance of bacteria such as Pseudomonas, Paenibacillus, Massilia, Acinetobacter and the fungi Cadophora, Rhizophagus and Eupenicillium. Whole metagenome sequencing showed with phosphate a favouring of sequences related to Gram-negative bacterium type cell wall function, virions and thylakoids, but a reduction in the number of sequences associated to vitamin binding, methanogenesis and toxin biosynthesis. With current faecal indicator tests only providing risk detection in bulk water samples, this work improves understanding of how network changes effect microbial ecology and highlights the potential for new approaches to inform future monitoring or control strategies to protect drinking water quality. Image, graphical abstract [ABSTRACT FROM AUTHOR]

Extensive carcinoma of the hypopharynx requires aggressive surgery, which can lead to loss of function and a high morbidity and mortality. This paper reports 50 patients with carcinoma of the hypopharynx treated with total pharyngolaryngo-oesophagectomy and gastric transposition. Thirty-two patients had primary surgery and 18 had salvage surgery for recurrence following radiotherapy. Two technical modifications to the standard procedure that have evolved during this period are the use of a diverticuloscope for dissection of the middle third of the oesophagus and the routine insertion of chest drains peroperatively. Complications were relatively unusual in the primary surgery group, but were a problem in those patients undergoing salvage surgery. Stenosis did not tend to occur with gastric transposition repair, but three patients had delayed gastric emptying with prolonged hospital stays. The tumour-specific actuarial survival at 4 years was 39% and the observed survival was 25%. Pharyngolaryngo-oesophagectomy and gastric transposition is becoming safer owing to increased multidisciplinary experience in this form of surgery. Survival is improved with the use of postoperative radiotherapy in patients undergoing primary surgery. [ABSTRACT FROM AUTHOR]