Search

The author reflects on the convergence of her roles as a qualitative researcher studying social workers’ roles during Hurricane Harvey, a student of public health, and a hospital social worker in the midst of the COVID-19 pandemic. Similarities are drawn between the social work role following a natural disaster and a pandemic disaster along with observations regarding core differences. Practice and research recommendations are provided for social workers in the domains of therapeutic interactions, social justice, and public health. While therapeutic relationships have often been far more difficult to achieve during the pandemic than Hurricane Harvey, the assistance of technology and proper personal protective equipment has been helpful in filling communication gaps. Both types of disasters are universal in their reach, impacting people of all backgrounds; the social work role has been to address differences in access to resources, including health care and financial assistance. Finally, social workers play a significant role in public health during disasters through disseminating reliable information about safety, resources, and opportunities to assist others. The author recommends the expansion of social work in the public health space to provide more insight about communicating with vulnerable populations during disasters.

More than 74% of pediatric deaths occur in an intensive care unit (ICU), with 40% occurring after withdrawal of life-sustaining therapies (WOLST). No needs assessment has described provider needs or suggestions for improving the WOLST process in pediatrics.This study aims to describe interdisciplinary provider self-reported confidence, needs, and suggestions for improving the WOLST process.A convergent parallel mixed-methods design was used. An online survey was distributed to providers involved in WOLSTs in a quaternary children's hospital between January and December 2018. The survey assessed providers' self-reported confidence in their role, in providing guidance to families about the WOLST, experiences with the WOLST process, areas for improvement, and symptom management. Kruskal-Wallis testing was used for quantitative data analysis with P values0.05 considered significant. Analysis was performed with SPSS v27. Qualitative data were thematically analyzed using Atlas.ti.8 and NVivo.A total of 297 surveys were received (48% survey completion) that consisted of multiple choice, Likert-type, and yes/no questions with options for open-ended responses. Mean provider self-rated confidence was high and varied significantly between disciplines. Qualitative analysis identified four areas for refining communication: 1) between the primary team and family, 2) within the primary team, 3) between the primary team and consulting providers, and 4) logistical challenges.While participants' self-rated confidence was high, it varied between disciplines. Participants identified opportunities for improved communication and planning before a WOLST. Future work includes development and implementation of a best practice guideline to address gaps and standardize care delivery.

At the children’s hospital where I work, we palliative social workers are having something of an identity crisis during the COVID-19 pandemic.As palliative social workers, we’re usually not as invo...

Grief support changes as more is learned from current grief theory and research. The authors provide a comprehensive overview of current grief support as it relates to Pediatric Palliative Care (PPC). The following aspects of grief are addressed: (1) anticipatory grief: the nondeath losses that occur with a complex and chronic illness, as well as the time leading up to death; (2) grief around the time of death: the intense and sacred experience of companioning with a dying child; (3) grief after death: supporting bereavement and mourning through programing and other methods; (4) innovative approaches: the future of grief support. The contents of this article are meant to support and educate programs currently providing grief services and those aiming to begin the meaningful work of grief support.

This paper challenges the notion that quantitative data – as a numeric truth – exist independent of a nation’s political and racial landscape. Utilising large-scale national attainment data...

Never before in the history of the world has the movement of diverse racial, cultural, ethnic, religious, and linguistic groups within and across nation-states been as large-scale and rapid or rais...

Fear and anxiety about the ‘Muslim other’, the failure of state multiculturalism, and the perception of a disjuncture between white British values and that of Islam have become a concerning feature of the British policy landscape. The government—in response to the so-called ‘Muslim threat’—has called for a ‘muscular’ promotion of fundamental British values in the nation’s schools. As a result, ‘the rule of law’, ‘individual liberty’, ‘mutual respect’, and ‘tolerance’ have been advanced as fundamentally British principles “we should try to live by every day” (Cameron 2014). Informed by critical race theory, this paper raises important and timely questions about the dangers of conflating democratic values with British national identity, outlining how the current policy climate has served to: decivilize Muslim lifestyles and identities; construct ‘white British’ norms and mores as culturally superior; portray young Muslims as pre-disposed to extremist views and violent behaviors; and force the country’s teachers to take up roles as instruments of surveillance and defenders of the white hegemonic order.

Spinal muscular atrophy type I is a genetic disease characterized by degeneration of spinal cord motor neurons resulting in weakness, technology dependence and early demise. While the newly approved treatment nusinersen may alter the morbidity/mortality of this disease there continues to be complex treatment challenges to consider. The aim of this qualitative study was to understand from the parent’s perspective, experiences of the family and child in the emergency center, hospital, and clinical care settings to identify gaps in care. Nineteen families interviewed had 22 children with spinal muscular atrophy I (11 deceased, 11 living). Three overarching themes emerged from parent interviews describing a range of experiences surrounding diagnosis, informed medical decision making and acute care practice. Identified quality improvements include development of a diagnostic screening tool, a medical decision tool, and emergency center informational template individualized to the child and providing an overview of spinal muscular atrophy I.

Most, if not all advanced economies have suffered gravely from the 2008 global financial crisis. Growth, productivity, real income and consumption have plunged and inequality, and in some cases poverty, spiked. Some countries, like Germany and Australia, were better able to cope with the consequences but austerity has taken its toll even on the strongest economies. The UK is no exception and the more recent period of economic recovery might be halted or even reversed by the political, economic, and policy uncertainty created by the Brexit referendum. This uncertainty related risk to growth could be even greater if the UK leaves the economic and legal framework provided by the EU. This CAGE policy report offers proposals from different perspectives to answer the overarching question: What is the role of a government in a modern economy after the global financial crisis and the Brexit vote? We report on economic and social challenges in the UK and discuss potential policy responses for the government to consider. Foreword by: Lord O’Donnell of Clapham.

Quantitative data are frequently assumed to be more trustworthy and robust than qualitative evidence - but numbers are no more obvious, neutral and factual than any other form of data. At every stage in the production of statistics there is opportunity for the racialized assumptions of the researcher to come into play. By explicitly drawing on the core insights of Critical Race Theory (CRT), this chapter offers a quantitative CRT (‘QuantCrit’) framework to take forward critical-race informed quantitative research. Using real-World examples we seek to explore principles that can guide researchers to fully engage with the potential of numbers to work in the service of equity and dismantle their frequent deployment in defence of White Supremacy and oppression.

Ataxia telangiectasia mutated kinase (ATM) is activated in response to DNA damage. We have previously shown that ATM plays a critical role in myocyte apoptosis and cardiac remodeling after myocardial infarction (MI). Here, we tested the hypothesis that ATM deficiency results in autophagic impairment in the heart early during MI. MI was induced in wild-type (WT) and ATM heterozygous knockout (hKO) mice by ligation of the left anterior descending artery. Structural and biochemical parameters of the heart were measured 4 h after left anterior descending artery ligation. M-mode echocardiography revealed that MI worsens heart function, as evidenced by reduced percent ejection fraction and fractional shortening in both groups. However, MI-induced increase in left ventricular end-diastolic and end-systolic diameters and volumes were significantly lower in hKO hearts. ATM deficiency resulted in autophagic impairment during MI, as evidenced by decreased microtubule-associated protein light chain 3-II increased p62, decreased cathepsin D protein levels, and increased aggresome accumulation. ERK1/2 activation was only observed in WT-MI hearts. Activation of Akt and AMP-activated protein kinase (AMPK) was lower, whereas activation of glycogen synthase kinase (GSK)-3β and mammalian target of rapamycin (mTOR) was higher in hKO-MI hearts. Inhibition of ATM using KU-55933 resulted in autophagic impairment in cardiac fibroblasts, as evidenced by decreased light chain 3-II protein levels and formation of acidic vesicular organelles. This impairment was associated with decreased activation of Akt and AMPK but enhanced activation of GSK-3β and mTOR in KU-55933-treated fibroblasts. Thus, ATM deficiency results in autophagic impairment in the heart during MI and cardiac fibroblasts. This autophagic impairment may occur via the activation of GSK-3β and mTOR and inactivation of Akt and AMPK. NEW & NOTEWORTHY Ataxia telangiectasia mutated kinase (ATM) plays a critical role in myocyte apoptosis and cardiac remodeling after myocardial infarction (MI). Here, we provide evidence that ATM deficiency results in autophagic impairment during MI. Further investigation of the role of ATM in autophagy post-MI may provide novel therapeutic targets for patients with ataxia telangiectasia suffering from heart disease.

Study Purpose The purpose of this qualitative study was to understand, from the parent perspective, the experience of the family whose child has Type 1 spinal muscular atrophy (Type 1 SMA), in the emergency center, hospital, and clinical care settings to identify opportunities for improved family-centered care (FCC). Design and Methods This study used a qualitative descriptive design with individual or small group interviews guided by a semi-structured questionnaire. Reviewers used framework analysis to identify gaps in the provision of FCC and opportunities for improvement with respect to services health professionals may provide families of children with Type 1 SMA. Results Nineteen families with 22 children with Type 1 SMA participated. Results are organized according to eight basic tenets of FCC. Family-to-family interactions strongly impacted participants' decision-making and perceived level of support. Participants valued strong family/provider partnerships, feeling heard and respected by their providers, and receiving complete education regarding disease trajectory. Conclusions Our analyses revealed both successful application of FCC and gaps in care where FCC could have been used to benefit families who have children with Type 1 SMA. As a pediatric chronic illness affects the whole family, FCC is important in maintaining the providers' focus on the family during the child's care. Practice Implications There are opportunities for nursing, social work, care managers and others to engage as care coordinators to explain the family's goals and values to the medical team. Care coordinators help ensure understanding between families and providers, empowering the family to articulate their hopes and concerns.

There is a large gender gap in the likelihood of taking maths and physics at A-level, even among high-achieving pupils. Among pupils who achieved grade A or A* (equivalent to grades 7-9) in GCSE maths in 2010, 36.5% of girls compared to 51.1% of boys took maths A-level. Among those who achieved grade A or A* in GCSE physics, just 13.2% of girls compared to 39.3% of boys took physics A-level. By contrast, there is almost no gender gap in the likelihood of taking chemistry A-level amongst those who score highly in the subject at GCSE, and girls are actually more likely to take biology A-level than boys. In partnership with the STEM Skills Fund, we conducted a study to understand the barriers that stop girls from taking maths and physics at A-level. This took the form of a small-scale randomised control trial in which girls in Year 11 who were predicted to achieve at least grade 7 (equivalent to at least grade A) in maths, physics or combined science GCSE were offered financial support in return for applying to study physics or maths A-level. As part of this trial, we surveyed 266 girls, as well as a senior staff member across 40 schools, about girls' A-level subject choices and what drives them. We also conducted four focus groups with 6-8 girls in schools in Bolton, Hull, Birmingham and Portsmouth to discuss these reasons in more detail.