Yes / This article investigates the representation of black, Asian and minority ethnic staff in NHS disciplinary proceedings. The study involved an in-depth knowledge review and analysis of literature on the representation of black, Asian and minority ethnic staff in NHS disciplinary proceedings from 2008 to 2017, as well as semi-structured interviews with 15 key stakeholders. Participants were stakeholders from both primary and secondary care and included equality and diversity leads, human resource professionals, NHS service managers, representatives of trade unions and health professional regulatory council representatives. The knowledge review indicates that to date, black, Asian and minority ethnic staff are disproportionately represented in NHS disciplinary proceedings. Evidence gathered demonstrates the continuation of inappropriate individual disciplinary action and failure to address organisational shortcomings against black, Asian and minority ethnic members of staff. Overall, six factors were identified as underpinning the disproportionate representation of black minority ethnic staff in disciplinaries: closed culture and climate; subjective attitudes and behaviour; inconclusive disciplinary data; unfair decision making; poor disciplinary support; and disciplinary policy misapplication.

Ce travail a été entrepris dans le but de caractériser biochimiquement et biologiquement les collagènes de méduse. l’objectif de notre travail a été d’évaluer ce matériel en vue de sa valorisation pour l’élaboration de biomatériaux à usage médical. dans un premier temps, nous avons optimisé les techniques d’extractions des collagènes de quatre espèces de méduses : rhizostoma pulmo, cotylorhiza tuberculata, pelagia noctiluca et aurelia aurita. l’étude de la stabilité thermique par dichroïsme circulaire des collagènes nous a montré que la température de dénaturation des collagènes de rhizostoma pulmo était de 28,9°c. nous avons choisi de réaliser la réticulation des collagènes de méduse par la méthode des carbodiimides (edc/nhs). cette méthode nous a permis d’augmenter la température de dénaturation jusqu’à 33°c (versus 28,9°c). l’étude de l’interaction entre les cellules d’origine humaine (mg63 et fibroblastes) et les collagènes de méduses, nous a permis de démontrer qu’elles étaient capables d’adhérer aux collagènes de méduses natifs ou dénaturés. des immunomarquages de la vinculine des cellules mg63 et des fibroblastes sur collagènes de méduse natifs ou dénaturés nous ont permis de caractériser les adhésions mises en places par ces deux types cellulaires. l’analyse des milieux de culture des cellules mg63 et des fibroblastes par zymographie sur collagènes de méduse natifs ou dénaturés nous a permis de mettre en évidence que des mmps d’origine humaine, seraient capables de dégrader les collagènes de méduses. nous pouvons dans ce cas estimer que le collagène de méduse serait un bon substrat pour l’élaboration de biomatériaux résorbables / This work was undertaken to characterize biochemically and biologically jellyfish collagen. the aim of our study was to evaluate the material for the development of biomaterials for medical use. initially, we optimized the technical extraction of collagen from four species of jellyfishes: rhizostoma pulmo, cotylorhiza tuberculata, pelagia noctiluca and aurelia aurita. the study of thermal stability by circular dichroism of collagen has shown that the denaturation temperature of rhizostoma pulmo collagens was 28.9 ° c. we chose to achieve crosslinking of collagen of jellyfish by the method of carbodiimides (edc/nhs). this method allowed us to increase the denaturation temperature to 33 ° c (vs. 28.9 ° c). the study of the interaction between human cells (mg63 and fibroblasts) and jellyfish collagen, demonstrated that they were able to adhere native or denatured jellyfish collagen. the immunostains of vinculin of mg63 cells and fibroblasts seeded on native or denatured jellyfish collagen, allowed us to characterize the focal adhesions of these two cell types. analysis of culture media of mg63 cells and fibroblasts by collagen zymography on native or denatured jellyfish collagen gels, allowed us to demonstrate that mmps of human origin, are able to degrade jellyfish collagen. we estimate in this case that the jellyfish collagen is a good substrate for the development of resorbable biomaterials

This master thesis considers an investigation of protective formulations (ointment, cream) containing enzyme inhibitors. Model experiments have been made on the enzyme trypsin. It is well accepted that feces and urine are an important causing factor for skin irritation (dermatitis) while using diaper. A protective formulation is a physical barrier that separates the harmful substances from the skin. It can also be an active barrier containing active substances, which can be active both towards the skin, and the substances from feces and urine. By preventing contact from these substances the skin will not be harmed, at least for a period of time. A number of different inhibitors were tested towards trypsin and they all showed good inhibition, two of the inhibitors were selected to be immobilized with the help of NHS-­activated Sepharose. Immobilization of these two inhibitors leads to a lesser extent of the risk of developing allergy and also that the possible toxic effect can be minimized.

NHS maternity services in England must increase productivity if the NHS is to make efficiency savings by 2014. At the same time, it is expected to maintain or improve patient outcomes such as safety and quality. Given staff costs are 60% of the budget; it is likely that either the number or composition of the workforce will need to be changed to meet these targets. In this article, the authors argue that very little is known about the impact of altering the skill mix on either productivity or patient outcomes. Furthermore, it is unclear whether output and outcomes are themselves trade-offs between increased workload, increased number of deliveries and the increased complexity of demand.

Yes / There have been concerns about the quality and safety of NHS hospital services since the turn of the millennium. This study investigated the progress that acute NHS hospital trusts have made in developing and using technology infrastructures to enable them to monitor quality and safety following the publication in 2013 of the second Francis report on the scandal at Mid Staffordshire NHS Foundation Trust (The Mid Staffordshire NHS Foundation Trust Public Inquiry. Chaired by Sir Robert Francis QC. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. HC 898. London: The Stationery Office; 2013). Methods: A telephone survey of 15 acute NHS trusts in the Yorkshire and the Humber region, and a review of board papers of all acute NHS trusts in England for January 2015, were undertaken. The telephone survey was used to identify trusts for a larger field study, which was undertaken in four acute NHS trusts between April 2015 and September 2016. The methods included the direct observation of the use of whiteboards and other technologies on two wards in each trust, an observation of board quality committees, semistructured interviews and an analysis of the quality and safety data in board papers. Published sources about national and local agencies were reviewed to identify the trust quality and safety data that these agencies accessed and used. An interview programme was also undertaken with those organisations. The Biography of Artefacts approach was used to analyse the data. Findings: The data and technology infrastructures within trusts had developed over many years. The overall design had been substantially determined by national agencies, and was geared to data processing: capturing and validating data for submission to national agencies. Trust boards had taken advantage of these data and used them to provide assurance about quality and safety. Less positively, the infrastructures were fragmented, with different technologies used to handle different quality and safety data. Real-time management systems on wards, including electronic whiteboards and mobile devices, were used and valued by nurses and other staff. The systems support the proactive management of clinical risks. These developments have occurred within a broad context, with trusts focusing on improving the quality and safety of services and publishing far more data on their performance than they did just 3 years earlier. Trust-level data suggest that quality and safety improved at all four trusts between 2013 and 2016. Our findings indicate that the technology infrastructures contributed to these improvements. There remains considerable scope to rationalise those infrastructures. / National Institute for Health Research Health Services and Delivery Research programme.

This thesis seeks to understand the role of audit in managing the performance of the NHS in Scotland and the impact which the relationship between performance and audit has upon key actors, including NHS organisations and national audit bodies. It is informed by Michael Power’s Audit Society (1999) and associated works, which present audit as a collection of ideas which shape how society defines control, accountability and transparency. The premise of this doctoral research is that the age of performance assessment in the NHS is evidence of Power’s Audit Society in action. A longitudinal analysis of annual Overview Reports produced by Audit Scotland, which symbolise the national audit body’s identity relative to the NHS, explores the impact which the performance assessment regime had upon the evolution of the national audit body and demonstrates the capacity of a national audit body to forge its own role in performance assessment and in doing so shift its identity from traditional external auditor to authoritative commentator on performance. A recent performance crisis in a Scottish NHS board is the subject of a case study which explores the role of audit when significant gaming is uncovered in a previously high-trust system. This case demonstrates how the ritual appeal of audit can be mobilised by the government to restore public confidence in reported improvements in performance across the whole NHS. The organisational impact of audit on performance management is explored through an observation-based case study set in a Scottish NHS board, which traces interactions between the main actors in audit and performance networks. These analyses show how audit can permeate the performance assessment of NHS bodies, at both the national and organisational level, even where it is not given a formal role in the assessment framework.

This research study investigates the concept of workplace information literacy (IL) theoretically and empirically, focusing on the connections between information literacy and knowledge management (KM). This dissertation examines the relevance and applicability of current IL frameworks in a workplace environment by means of a review of the literature, a review of NHS Scotland documentation on its KM initiatives, and a phenomenographic study undertaken with frontline staff at NHS24, a nurse-led, 24/7 service of NHS Scotland that provides over-the-phone consultation and health information. For that study, a working definition of IL as ‘effective information use’ was employed. The concept of information literacy has been developed mainly within librarianship, researched mainly within educational contexts and focused on individual competence in information use. While its application to workplace environments has been assumed, comparatively little research has been done into workplace situations. On the other hand, the concept of knowledge management is directed at a wider organizational level. However, while there is a clear focus in the KM literature on the value of information and its importance for organizations, little attention has been paid to the theoretical and empirical developments of Library and Information Science (LIS) relative to information behaviour and effective information use. The findings of this research identified limitations in the current IL frameworks, notably the lack of consideration for people’s exchanges of knowledge and information and of the social sense making that influences information interpretation and application. The findings endorse views of learning and information use grounded in socio-constructive perspectives and a consideration of context as situated practice. The conclusions suggest the need for more collaboration between studies of IL and information behaviour, and for LIS research to focus more on workplace studies and knowledge management.

No description available.

This research project aimed to further knowledge regarding the relationship between community capacity building (CCB), community development and health within the context of the Health Issues in the Community (HIIC) programme. CCB refers to the development of capabilities to identify and address community issues and was conceptualised using four dimensions: participation, resource mobilisation, links with others and role of outside agents. HIIC is a learning resource supported by NHS Health Scotland, the national health promotion agency. The main objective of HIIC is to help students explore the processes involved in tackling health-related concerns in the community. The main concepts in this study were explored by referring to a range of academic literatures and five research questions were formulated. ‘How did HIIC tutors and students understand the concept of community and was this understanding influenced by completing HIIC?’, ‘How did stakeholders and tutors understand the notion of CCB?’, ‘Was CCB evident in the experiences of the students after their involvement with the course?’, ‘Did participating in the HIIC course contribute towards furthering students’ understanding about health?’ and ‘Did participating in HIIC have any other impact on participants?’ Face-to-face, semi-structured interviews were conducted across Scotland with three participant groups: stakeholders, tutors and students. This involved a total of thirtyfive interviews with students and tutors from eleven different courses. Interviews were transcribed and analysed using thematic analysis. Four key themes emerged: community, CCB, health, and impact of learning. Tutors and students suggested that people could be members of multiple communities. Community was understood as a geographical location, a common interest and as a sense of belonging. Tutors also considered the community as a site of professional practice. Some participants had an expectation that community members should act collectively to help one another. Completing HIIC appeared to influence students’ understanding about their own circumstances, issues within their community and how it functions, rather than informing how they defined the concept of community. CCB was seen by tutors as a process that develops competencies to address community issues. Stakeholders and tutors differed in their views about whether CCB was an individual level or a collective process. Participants likened CCB to community development, but stakeholders questioned if it shared the same value base or if it was an outcome of community development. Tutors expressed a range of opinions about their understanding of CCB. It was viewed as a potentially helpful idea in terms of understanding the work of community / health-based practitioners. However, others were unable to give a definition of CCB and some tutors considered CCB a concept with little meaning or an indicator to fulfil in the context of a funding application. The manifestation of individual aspects of CCB were identified in the accounts of some participants, but the data did not support the contention that HIIC promoted CCB, within the timescale of this study, although, it could be argued that latent CCB was developed. The data did indicate that participants’ understanding about the concept of health was reaffirmed, broadened or changed and that participating in HIIC could increase an individual’s awareness of social and health issues, develop interpersonal skills and widen social networks. This study indicated that by exploring the concepts of CCB, community and health, a contribution was made towards understanding the processes by which participating in a HIIC course influenced students to address health-related concerns.

A study to optimise an IgG based immunosensor is presented, that has been carried out by absorbing monolayers to a gold transducer surface at varying immersion times and temperatures. The theory and kinetics of monolayer adsorption are analysed and discussed. Existing mathematical models are reviewed and experimentally researched, to highlight gaps in knowledge that would facilitate high quality, cost effective immunosensor production. The creation of two mathematical models to predict monolayer adsorption kinetics and optimal immersion times are discussed. Details are provided of how the new mathematical models may be advanced, and how the production of immunosensors may be further improved. The first novel mathematical model (PTCS) has been created to model the presence of two sequentially forming structures on the surface of a substrate. It gives an insight into the percentages of each structure on the surface, along with the actual adsorption process. This model provides a good fit to all applicable experimental data and has allowed the deduction of optimum immersion times. The second novel model (PIF) provides a greater insight than existing models into the individual contributions to surface coverage by both random and island growth. This allows an insight into how the monolayer surface is covered, which is critical to determine the optimum conditions for adsorption. This model also provides a good fit to the isotherm data it has been applied to. To provide a thorough understanding of the bulk properties of monolayer formation over the gold transducer, and how these properties vary with immersion time and temperature, various measurement techniques have been employed. Electrochemical Impedance Spectroscopy (EIS) has been the principle measurement technique used to measure the bulk properties, but confirmation studies have also been carried out including, Contact angle measurements, FTIR microscopy with BSA molecular labels, Fluorescence microscopy for small adsorbed molecules and AFM for layers assembled from macromolecules. The data generated from the different techniques show consistency with the arguments discussed in each instance. Two different IgG adsorption processes have been compared. These include direct IgG addition and a multilayered streptavidin-based process. The results indicate that IgG molecules adsorbed via the streptavidin based multilayer process are more vertically orientated and have a higher packing density of IgG molecules. Keywords: Self Assembled Monolayer, impedance-based immunoassay, Streptavidin, biotinylated IgG, mathematical adsorption modelling.