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Enquiry
Kinds of Enquiry Selected AbstractsCAMBRIDGE THEOLOGY IN THE NINETEENTH CENTURY: ENQUIRY, CONTROVERSY AND TRUTH by David M. ThompsonNEW BLACKFRIARS, Issue 1033 2010AIDAN NICHOLS OP No abstract is available for this article. [source] A structured observation of the interaction between nurses and patients during the administration of medication in an acute mental health unitJOURNAL OF CLINICAL NURSING, Issue 17-18 2010Joy A Duxbury Aims., This aims of this study are to describe current practice in the administration of medication in an acute psychiatric unit and explore factors that influence nurses' decisions regarding the administration of medication during ,rounds'. Background., Medication ,rounds' form part of the ward routine in many inpatient mental health settings. Nurses make several clinical decisions about administrating medication; yet, concerns have been raised about the poor assessment of patients' needs and the quality of the information exchanged. Design., A structured non-participant observational design was used for this research. Method., This study involved the observation of 20 medication ,rounds' over three months. The Ward Administration of Medication Schedule was used to report on the interactions between nurses and patients and aspects of their communication during each round. Results., From the rounds observed nurses appeared adept at communicating a positive interpersonal style but less so in demonstrating skills portraying collaboration and information giving. For example whilst nurses communicated warmth in 97% of cases, using non-verbal behaviours such as good eye contact, the provision of information was only initiated in 46% of cases. Enquiries regarding the patient's general health and medication taking (35% and 17% respectively) were less commonly observed. Verbal consent was sought in only 25% of cases. Procedural matters were adhered to overall. Conclusions., Findings suggest limited collaboration between nurses and patients and the poor monitoring of health status and medication effects. Information exchange could be improved; however, this may be related to medication procedures that make it difficult to explore sensitive information with patients, rather than nursing skills and behaviour. Relevance to clinical practice., The Ward Administration of Medication Schedule can be used as a clinical or educational tool in the administration of medication. In both instances, it may be self-administered and used to reflect on personal skills or employed as an observational tool during peer review and audit. [source] The British Government and the Slave Trade: Early Parliamentary Enquiries, 1713,83PARLIAMENTARY HISTORY, Issue 2007CHRISTOPHER L. BROWN First page of article [source] Patient-assessed health outcome measures for diabetes: a structured reviewDIABETIC MEDICINE, Issue 1 2002A. M. Garratt Abstract Aims To identify available disease-specific measures of health-related quality of life (HRQL) for diabetes and to review evidence for the reliability, validity and responsiveness of instruments. Methods Systematic searches were used to identify instruments. Instruments were assessed against predefined inclusion and exclusion criteria. Letters were sent to authors requesting details of further instrument evaluation. Information relating to instrument content, patients, reliability, validity and responsiveness to change was extracted from published papers. Results The search produced 252 references. Nine instruments met the inclusion criteria: Appraisal of Diabetes Scale (ADS), Audit of Diabetes-Dependent Quality of Life (ADDQoL), Diabetes Health Profile (DHP-1, DHP-18), Diabetes Impact Measurement Scales (DIMS), Diabetes Quality of Life Measure (DQOL), Diabetes-Specific Quality of Life Scale (DSQOLS), Questionnaire on Stress in Diabetic Patients-Revised (QSD-R), Diabetes-39 (D-39) and Well-being Enquiry for Diabetics (WED). The shortest instrument (ADS) has seven items and the longest (WED) has 50 items. The ADS and ADDQoL are single-index measures. The seven multidimensional instruments have dimensions covering psychological well-being and social functioning but vary in the remainder of their content. The DHP-1 and DSQOLS are specific to Type 1 diabetes patients. The DHP-18 is specific to Type 2 diabetes patients. The DIMS and DQOL have weaker evidence for reliability and internal construct validity. Patients contributed to the content of the ADDQoL, DHP-1/18, DQOL, DSQOLS, D-39, QSD-R and WED. The authors of the ADDQoL, DHP-1/18, DQOL, DSQOLS gave explicit consideration to content validity. The construct validity of instruments was assessed through comparisons with instruments measuring related constructs and clinical and sociodemographic variables. None of the instruments has been formally assessed for responsiveness to changes in health. Conclusions Five of the diabetes-specific instruments have good evidence for reliability and internal and external construct validity: the ADDQoL, DHP-1/18, DSQOLS, D-39 and QSD-R. Instrument content should be assessed for relevance before application. The instruments should be evaluated concurrently for validity and responsiveness to important changes in health. [source] Review article: What's new in early medieval burial archaeology?EARLY MEDIEVAL EUROPE, Issue 1 2002Tania M. Dickinson Books reviewed in this article: John Hines, Karen Høilund Nielsen and Frank Siegmund (eds), The Pace of Change. Studies in Early,Medieval Chronology. Catherine E. Karkov, Kelley M. Wickham,Crowley and Bailey K. Young (eds), Spaces of the Living and the Dead: An Archaeological Dialogue. Sam Lucy, The Early Anglo,Saxon Cemeteries of East Yorkshire. An Analysis and Reinterpretation. Elizabeth O'Brien, Post,Roman Britain to Anglo,Saxon England: Burial Practices Reviewed. Nick Stoodley, The Spindle and the Spear. A Critical Enquiry into the Construction and Meaning of Gender in the Early Anglo,Saxon Burial Rite. [source] Persistence of drug use during imprisonment: relationship of drug type, recency of use and severity of dependence to use of heroin, cocaine and amphetamine in prisonADDICTION, Issue 8 2006John Strang ABSTRACT Aim To investigate the persistence of use of heroin, cocaine and amphetamine drugs during imprisonment, and to identify factors associated with increased levels of persistence. Design The use of heroin, cocaine and amphetamine by current prison inmates has been examined and, in particular, the relationship between drug use within prison and the type of drug used prior to imprisonment, recency of use and severity of dependence., Setting and participants A randomly selected sample of 1009 adult male prisoners in 13 prisons in England and Wales during 1994/95; structured confidential interviews conducted by independent research staff. Enquiry about prior use of heroin, cocaine or amphetamine focused on three time-periods (ever, last year and last month pre-prison) and the use of these drugs during the first month of imprisonment. Findings A total of 557 (55%) of the 1009 prisoners had used previously one of the three drugs selected for study: 58% had used heroin, 69% cocaine and 75% amphetamine. More than half (59%; 327/557) had used these drugs in the month before the current imprisonment. Drug use in prisons was most likely to occur among those who had used in the month prior to imprisonment. The persistence of heroin use in prison occurred more frequently (70%) than use of cocaine (20%) or amphetamine (15%). Of those using heroin pre-imprisonment, 67% considered they were dependent, compared to 15% and 22%, respectively, for cocaine and amphetamine users. Conclusions Changes in the drug-taking behaviour of drug users after imprisonment vary according to the type of drug being taken. Prisoners were much more likely to continue to use heroin than either cocaine or amphetamines while in prison. Heroin was most likely to be used by those who had been using heroin during the immediate pre-imprisonment period, and particularly by the two-thirds of heroin users who considered themselves dependent. In view of the high prevalence of prior use of these drugs by individuals currently imprisoned, continuing attention is required to study of their behaviour and of the impact of interventions that may be introduced during or following their incarceration. [source] Effective management of adverse effects while on oral chemotherapy: implications for nursing practiceEUROPEAN JOURNAL OF CANCER CARE, Issue 2010K. HARROLD rn, bsc ( hons ), chemotherapy, iv access clinical nurse specialist HARROLD K. (2010) European Journal of Cancer Care19, 12,20 Effective management of adverse effects while on oral chemotherapy: implications for nursing practice The publication of guidelines by the United Kingdom National Patient Safety Agency and the National Confidential Enquiry into Patient Outcome and Death which looked into deaths within 30 days of systemic anticancer therapy and the more recent position statement from the United Kingdom Oncology Nursing Society have all highlighted the need for an improvement in the care and management of patients receiving oral chemotherapy. While it is essential that patients are aware of the rationale behind dose interruption and modification if they are to effectively deal with toxicities and complications that may arise, they also require access to a clear line of communication in order to facilitate early intervention. The value of pre treatment patient education and ongoing support for these patients has already been extensively documented and while a multidisciplinary team approach in this is vital, nurses are ideally placed to take a leading role in these two aspects of treatment management. This article aims to detail and review current best management practices for the most commonly reported toxicities associated with capecitabine, an oral chemotherapeutic agent used in the management of patients with colorectal cancer. Only if both the patient and the health care professional supporting them are aware of best management practices will the impact of toxicities be minimised and treatment outcomes optimised. [source] Law and Literature in the Romantic Era: The Law's FictionsLITERATURE COMPASS (ELECTRONIC), Issue 4 2006Sue Chaplin This essay examines the emerging ideological relation between literature and law in the Romantic era and the significance of this relation to modern Western conceptualisations of what constitutes ,law' and ,literature'. In particular, the article explores the problematics of juridical textuality in the Romantic period , the extent to which the law comes to be regarded as text, and seeks to set this within the context of developing conceptualisations of ,literature' as a juridically defined commodity. The modern understanding of ,literature' began to be shaped in the Romantic era by a juridical re-formulation of the relation between the author, the text, the reader and the publisher: creative, original writing ,,literature', becomes a commodity copyrighted to an author/publisher. This development is accompanied by the State's recognition of the growing cultural and political power of new and diverse textual forms in an era of the mass production and consumption of ,literature', and the article considers alongside the contemporaneous formulation of copyright regulations the draconian censorship of textual production in this period. With reference to diverse juridical and literary sources (Clara Reeve's The Progress of Romance, Blackstone's Commentaries, Bentham's Fragment on Government, Godwin's Enquiry and Caleb Williams, amongst others), I examine the extent to which these various phenomena reveal the subjection of textuality in the Romantic era to the modern force of law. [source] Excessive volume expansion and neonatal death in preterm infants born at 27,28 weeks gestationPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2003Andrew K. Ewer Summary Volume expansion is used commonly in preterm infants to treat presumed hypovolaemia. However, the amount that should be given is uncertain. We present data that were obtained from anonymised regional case notes of Project 27/28, a national case,controlled study run by the Confidential Enquiry into Stillbirths and Deaths in Infancy. Various clinical parameters were analysed, including the volume expansion administered during the first 48 h of life. All deaths in the first year of the study in the West Midlands (cases, n = 22) and matched regional controls (survivors, n = 29) were included. The primary outcome was death within 28 days. Sixteen of the 22 deaths were considered ,not inevitable' on the basis of the neonates' condition at birth. These newborns received on average more than twice the volume expansion compared with controls in the first 48 h of life (38.2 vs. 18.2 mL/kg, P = 0.007). There were no significant differences between the groups in lowest blood pressure or base deficit within the first 12 h of life. Newborns who received , 30 mL/kg volume expansion in the first 48 h of life were more likely to die than those who received < 30 mL/kg (OR 4.5 [95% CI 1.2, 17.2]). Our data suggest that administration of , 30 mL/kg volume expansion is associated with increased mortality in neonates of 27,28 weeks' gestation. Unless there is clear evidence of hypovolaemia, clinicians should exercise caution when prescribing volume expansion. [source] Transfiguring Capitalism: An Enquiry into Religion and Global Change , By John AthertonRELIGIOUS STUDIES REVIEW, Issue 4 2009Kathryn D. Blanchard No abstract is available for this article. [source] A national survey of support and counselling after maternal death,ANAESTHESIA, Issue 11 2009S. McCready Summary The 2000,2002 Confidential Enquiry into Maternal and Child Health report highlighted several cases of maternal death where the staff who had been involved, were not offered support. The report recommended that ,Trusts must make provision for the prompt offer of support and/or counselling for all staff who have cared for a woman who has died.' We conducted a postal survey to firstly establish whether Trusts had implemented this, and also to ascertain the experience of consultant obstetric anaesthetists. Of 706 respondents (response rate 64%), 60% involved in a maternal death or other traumatic event received no offer of support, 65% were unaware of potential sources of support and only 5% received details of further help available. Furthermore, 69% were unaware of policies within their own Trusts for the provision of support services. We suggest that a formal structure should exist within all units that offers confidential support services and/or debriefing facilities to all staff involved in a maternal death or other traumatic event. [source] Previously undiagnosed aortic stenosis revealed by auscultation in the hip fracture population , echocardiographic findings, management and outcomeANAESTHESIA, Issue 8 2009M. E. McBrien Summary The 2001 Report of the National Confidential Enquiry into Perioperative Deaths recommended that an echocardiogram should be performed on patients with aortic stenosis prior to anaesthesia. In this study we present the patient details, management and outcome of the 272 hip fracture patients with a previously undiagnosed murmur and echocardiographically proven aortic stenosis admitted from 2001,2005 in our hospital. The patients with aortic stenosis were significantly older, and had significantly lower Abbreviated Mental Test Scores, than the control group of 3698 hip fracture patients without aortic stenosis. There were significant trends toward general anaesthesia over spinal anaesthesia, and use of invasive monitoring of blood pressure, as the severity of the aortic stenosis increased. There were no significant trends towards higher 30-day or 1-year mortality rates as the severity of the aortic stenosis increased. Resources for rapid pre-operative echocardiograms should be made available for hip fracture patients as the results have significant implications for their subsequent anaesthetic management. [source] Review of singleton fetal and neonatal deaths associated with cranial trauma and cephalic delivery during a national intrapartum-related confidential enquiryBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2005Fidelma O'Mahony Objective To review delivery details of intrapartum-related fetal and neonatal deaths with singleton cephalic presentation and birthweight of 2500 g or more in which traumatic cranial or cervical spine injury or substantial difficulty at delivery of the head was a dominant feature. Design Review of freestyle summary reports and standard questionnaire responses submitted to the national secretariat for the Confidential Enquiry into Stillbirths and Death in Infancy (CESDI) during the 1994/1995 intrapartum-related mortality enquiry following regional multidisciplinary panel review. Setting United Kingdom. Sample Of the 873 cases of intrapartum-related deaths reported in the 1994,1995 national enquiry, 709 weighed more than 2499 g. Reports from 181 (89 from 1994 and 92 from 1995) with a chance of meeting criteria for cranial or cervical trauma as significant contributors to death were examined in detail. Thirty-seven were judged to meet the criteria stated in the objectives (23 from 1994 and 14 from 1995) and form the basis for this review. Methods Electronic and hand search of CESDI records relating to intrapartum-related deaths. Main outcome measures Intrapartum events and features of care. Results There was evidence of fetal compromise present before birth in 33 of the 37 (89%) study group cases reviewed. One delivery was performed vaginally without instrumentation, and in one there was no attempt at vaginal delivery before caesarean section (CS) in the second stage of labour. Twenty-four cases (65%) were delivered vaginally and 11 (30%) by CS after failure to deliver vaginally with instruments. A single instrument was used in six cases of vaginal delivery (four ventouse and two Kjelland's forceps). At least two separate attempts with different instruments were made in 24 cases. Overall, the ventouse was used in 27 cases and forceps in 29 cases. In six cases, three separate attempts were made with at least two different instruments, all of which included use of ventouse. The grade of operator was recorded in 27 cases. Of these, a consultant obstetrician was present at only one delivery and no consultant was recorded to have made the first attempt to deliver a baby. In six cases, shoulder dystocia was also reported. Conclusions This study suggests a lower incidence of death from difficult cephalic delivery and cranial trauma than previously reported. The CESDI studies were believed to have achieved high levels of ascertainment for all intrapartum-related deaths from which the cases reported here were selected. Strictly applied entry criteria used in this study could have restricted the number of cases considered as could limited in vivo or postmortem investigations and lack of detailed autopsy. When cranial traumatic injury was observed, it was almost always associated with physical difficulty at delivery and the use of instruments. The use of ventouse as the primary or only instrument did not prevent this outcome. Some injuries occurred apparently without evidence of unreasonable force, but poorly judged persistence with attempts at vaginal delivery in the presence of failure to progress or signs of fetal compromise were the main contributory factor regardless of which instruments were used. [source] A survey of tobacco dependence treatment guidelines in 31 countriesADDICTION, Issue 7 2009Martin Raw ABSTRACT Aims The Framework Convention on Tobacco Control (FCTC) asks countries to develop and disseminate comprehensive evidence-based guidelines and promote adequate treatment for tobacco dependence, yet to date no summary of the content of existing guidelines exists. This paper describes the national tobacco dependence treatment guidelines of 31 countries. Design, setting, participants A questionnaire on tobacco dependence treatment guidelines was sent by e-mail to a convenience sample of contacts working in tobacco control in 31 countries in 2007. Completed questionnaires were received from respondents in all 31 countries. During the course of these enquiries we also made contact with people in 14 countries that did not have treatment guidelines and sent them a short questionnaire asking about their plans to produce guidelines. Measurements The survey instrument was a 17-item questionnaire asking the following key questions: do the guidelines recommend brief interventions, intensive behavioural support, medications; which medications; do the guidelines apply to the whole health-care system and all professionals; do they refer explicitly to the Cochrane database; are they based on another country's guidelines; are they national or more local; are they endorsed formally by government; did they undergo peer review; who funded them; where were they published; do they include evidence on cost effectiveness of treatment? Findings According to respondents, all their countries' guidelines recommended brief advice, intensive behavioural support and nicotine replacement therapy (NRT); 84% recommended bupropion; 19% recommended varenicline; and 35% recommended telephone quitlines. Nearly half (48%) included cost-effectiveness evidence. Seventy-one per cent were supported formally by their government and 65% were supported financially by the government. Most (84%) used the Cochrane reviews as a source of evidence, 84% underwent a peer review process and 55% were based on the guidelines of other countries, most often the United States and England. Conclusion Overall, the guidelines reviewed followed the evidence base closely, recommending brief interventions, intensive behavioural support and NRT, and most recommended bupropion. Varenicline was not on the market in most of the countries in this survey when their guidelines were written, illustrating the need for guidelines to be updated periodically. None recommended interventions not proven to be effective, and some recommended explicitly against specific interventions (for lack of evidence). Most were peer-reviewed, many through lengthy and rigorous procedures, and most were endorsed or supported formally by their governments. Some countries that did not have guidelines expressed a need for technical support, emphasizing the need for countries to share experience, something the FCTC process is well placed to support. [source] Instruments of the warning service for plant protection in Bayern (Germany),EPPO BULLETIN, Issue 1 2000H. Tischner The warning service for plant protection in Bayern (Germany) obtains its information mainly from its own observations. The appearance of pests (including diseases and weeds) is investigated in cultivated areas and field trials. Weather data complementary to the pest enquiries can be made available from a measuring network of 116 field weather stations and is used to estimate the development of pests in relation to weather requirements. For several fungi and animal pests, computer-based decision support systems (DSSs) and forecasting models are being used. The results are processed and passed on to farmers via circulars, branch reviews, public notices, telephonic announcement services, telefax services and the Internet. [source] Monogenic diabetes: information seeking and genetic testing access via e-mailEUROPEAN DIABETES NURSING, Issue 2 2010M Shepherd RGN, PhD Honorary Clinical Senior Lecturer Abstract Background: Confirmation of monogenic diabetes by molecular genetic testing has allowed many patients, often previously assumed to have type 1 diabetes, to transfer from insulin injections to sulphonylurea tablets, with improvements in glycaemic control and quality of life: www.diabetesgenes.org provides information about monogenic diabetes and genetic testing. Aim: To investigate key issues raised by individuals who e-mailed the monogenic diabetes team about genetic testing and monogenic diabetes management. Methods: Sixty e-mail enquiries, received over a six-month period from patients and professionals worldwide, were analysed using a qualitative thematic content approach. Results: Five themes emerged: 1. Accessing genetic technology: patients and professionals both enquired about access to testing; 2. Presentation of evidence: medical facts presented by patients and professionals included characteristics specifically relevant to diagnosing monogenic diabetes; 3. Experiences of healthcare: patients often researched their condition online and some felt dissatisfied with routine consultations; 4. Seeking specialist advice regarding treatment: specific information was sought relating to management of neonatal diabetes or monogenic diabetes and pregnancy; 5. Searching for a cure through genetic technology: patients questioned whether genetic advances would lead to a cure for diabetes. Conclusion: This project offers the first insights into use of e-mail as a means of gaining access to a specialist monogenic team and information about genetic testing. Although providing advice via e-mail can prove complicated, particularly when received from patients under the care of other clinicians, it is an efficient means of communicating specialist knowledge. Study findings will aid development of a ,frequently asked questions' section of www.diabetesgenes.org. Copyright © 2010 FEND [source] Institutional Performance And Social Capital: An Application To The Local Government LevelJOURNAL OF URBAN AFFAIRS, Issue 5 2005Hilde Coffé This literature reveals that societies characterized by higher levels of social capital tend to achieve superior performance. Still, enquiries to date predominantly concentrate on country-level data or large sub-national units. The primary purpose of this article is to extend the empirical work to the local government level, while retaining the use of objective data to gauge institutional performance. This use of local data has the advantage of increasing the data set available and provides a more stringent test of the effect of social capital because social capital is likely to vary less at lower levels of government. The results,based on an empirical analysis of 305 Flemish municipalities in 2000,support the view that social capital leads to government (out)performance also at the local level of government. [source] Drug information for patients,an update of long-term results: type of enquiries and patient characteristics,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 2 2009Martin Huber MPharm Abstract Purpose To analyse the type of enquiries to a drug information service in Germany, available exclusively for patients. Methods Sociodemographic characteristics of the patients who used the service, number and kind of drugs taken, existing diseases, reasons for enquiry as well as type of answers provided were recorded. For the present evaluation we analysed all enquiries to the service from August 2001 to January 2007. Results A total of 5587 enquiries were received. 5013 enquiries from 4091 patients were available for further analysis in detail. The patient group using the service most frequently were women between 61 and 70 years (23.3%). 1457 enquiries (29.1%) were made by patients who had contacted the information service once or several times before. The group of drugs most often asked about were cardiovascular drugs (33.4%), followed by drugs for the nervous system (16.2%) and for the alimentary tract and metabolism (12.4%). On average, each patient had questions about 2.6 (median 1; 1,22) drugs simultaneously. Common reasons for contacting the service were adverse drug reactions (22.1%), the need for general information about the drug (19.9%), information about therapy (12.4%) and drug interactions (10.2%). Conclusions A lot of patients need additional information about their medication, especially concerning drug groups that are frequently prescribed. The presented drug information service can be one helpful tool to counteract these information deficits and to increase patients' knowledge about their drugs. Copyright © 2008 John Wiley & Sons, Ltd. [source] Employment, flexible working and the familyTHE BRITISH JOURNAL OF SOCIOLOGY, Issue 4 2002Rosemary Crompton ABSTRACT This paper assesses some of the implications of one of the major social changes to have taken place in the West during the second half of the twentieth century , that is, the increased employment of women, together with normative changes in gender relations and in women's expectations. These changes have been linked to an increase in individualism, which itself is associated with the transcendence of ,first modernity'. Thus it is suggested that new approaches to social analysis are required (Beck). Here it is argued that, rather than develop completely new approaches in order to grasp the changes that are under way, the ,economic' and the ,social' (that is, employment and the family) should be seen as intertwined, rather than approached as separate phenomena. Past debates in feminism, changes in the family, and flexible employment are critically examined. The growing tensions between employment and family life are discussed. It is argued that these changes are associated with the intensification of capitalist development, rather than reflecting a fundamental transformation of society. Existing approaches to the analysis of social change, including Polanyi's analysis of the development of ,counter-movements' against the ,self-regulating' market, will, therefore, still be relevant to our enquiries. In the concluding section, a programme of research that would examine these changes is outlined. [source] Between Pinochet and Kropotkin: state terror, human rights and the geographersTHE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 3 2001John Wiley Lecture The lecture develops a civil perspective on states engaged in systematic but arbitrary armed violence against their home populations: what the Nürnberg Tribunal called ,government by terror. Civilians, or most of them, appear uniquely vulnerable to such violence and the gross violations of human rights accompanying it. Moreover, this, rather than wars as usually understood, involved the largest uses of armed force in the twentieth century. It was the main cause of violent death of civilians. Two geographical concerns are addressed: the ,geographic' nature of such violence, and its implications for the thought and practice of geographers. They are explored especially through the work of two geographers whose lives bracket the past ,century of violence, Peter Kropotkin and Augusto Pinochet. Pinochet's dictatorship in Chile fully illustrates the scope of state terror. Geographies of coercion are seen in the system of political prisons and torture, the making of a society and landscapes of fear, and the unmaking of civil life. The atrocities also violated Chile's former commitment to human rights initiatives. Pinochet's geographical work, especially the geopolitics, is in accord with, or offers no counter to, the repressive, authoritarian regime he headed, Kropotkin's descriptions of imperial Russia show many parallels to the Chilean case, and the kind of repressive state power that he rejected to dedicate his life to its vulnerable and innocent victims. Almost alone among geographers he developed a coherent, influential vision of violence, social justice and interpersonal ethics, based on geographical investigations as well as an anarchist perspective. These two may also seem to represent conceptual and lived extremes - respectively, an extreme deployment of state violence, and a total rejection of the state because of the facts and potential of violent repression. Unfortunately, enquiries into violence and the state, let alone terrorist states, are virtually absent from contemporary geographical scholarship. Its emergence as an essentially ,civil field' has reinforced this - when it should have had the opposite effect. In part this involves a failure to temper our long, and less-than-critical, service to the state in all areas, and a continuing governmental mind-set. It is suggested that the absence of critical reflection on the contested relations of civil society and the state, especially as they involve state violence, undermines the intellectual value and ethical standards of our work. [source] Maternal mortality and serious maternal morbidity in Jehovah's witnesses in the NetherlandsBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2009ME Van Wolfswinkel Objective, To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in the Netherlands. Design, A retrospective study of case notes. Setting, All tertiary care centres, general teaching hospitals and other general hospitals in the Netherlands. Sample, All cases of maternal mortality in the Netherlands between 1983 and 2006 and all cases of serious maternal morbidity in the Netherlands between 2004 and 2006. Methods, Study of case notes using two different nationwide enquiries over two different time periods. Main outcome measures, Maternal mortality ratio (MMR) and risk of serious maternal mortality. Results, The MMR for Jehovah's witnesses was 68 per 100 000 live births. We found a risk of 14 per 1000 for Jehovah's witnesses to experience serious maternal morbidity because of obstetric haemorrhage while the risk for the total pregnant population was 4.5 per 1000. Conclusions, Women who are Jehovah's witnesses are at a six times increased risk for maternal death, at a 130 times increased risk for maternal death because of major obstetric haemorrhage and at a 3.1 times increased risk for serious maternal morbidity because of obstetric haemorrhage, compared to the general Dutch population. [source] Teaching approaches which support inclusive education: a connective pedagogyBRITISH JOURNAL OF SPECIAL EDUCATION, Issue 2 2001Jenny Corbett In this article, Jenny Corbett, a Reader in Education at the Institute of Education, University of London, considers the factors which can help to support effective inclusive learning. She uses her reading of the growing body of literature on inclusion in order to reflect upon her own enquiries into practice at an inclusive primary school in London. Drawing upon the three key elements in the Index for Inclusion, she presents findings about school culture, school policy and school practice. Her conclusions will help policy-makers and practitioners to reflect upon the relationships between effectiveness and inclusivity. [source] Towards an understanding of the high death rate among young people with diabetes in UkraineDIABETIC MEDICINE, Issue 1 2001M. Telishevka SUMMARY Aims Published rates of deaths attributed to diabetes mellitus among those aged under 50 have risen substantially in several former Soviet republics since the late 1980s. The reasons for this increase, and the situation facing patients with diabetes in these countries are poorly understood. The aim of this study was to describe the circumstances leading up to the death of individuals dying under the age of 50 years with mention of diabetes on their death certificate. Methods Interviews with surviving relatives or neighbours, combining elements of verbal autopsy and confidential enquiry. For those who had lived in the city of Lviv a random sample was taken. For those in rural areas a purposive sample was used to ensure coverage of more and less remote areas. Results Key informants were identified and agreed to be interviewed for 64 individuals out of a possible 79 with insulin-treated diabetes identified from their death certificates. The main immediate causes of death were renal failure (69%), ischaemic heart disease (9%), ketoacidosis (6%) and hypoglycaemia (3%). Over a third of men, but no women, were reported to have been heavy drinkers. Informants described many difficulties in obtaining regular supplies of insulin and related supplies since 1990. Although insulin is officially available free of charge, most had retained supplies for use in an emergency. More than half had, at some time, purchased supplies. The large number of deaths from renal failure reflects the effective absence of renal replacement therapy for patients with diabetes. Conclusions Individuals with diabetes in Ukraine face profound challenges involving access to necessary care. Their needs require significantly more attention from policy makers. [source] Rendering the World Unsafe: ,Vulnerability' as Western DiscourseDISASTERS, Issue 1 2001Gregory Bankoff Disasters seem destined to be major issues of academic enquiry in the new century if for no other reason than that they are inseparably linked to questions of environmental conservation, resource depletion and migration patterns in an increasingly globalised world. Unfortunately, inadequate attention has been directed at considering the historical roots of the discursive framework within which hazard is generally presented, and how that might reflect particular cultural values to do with the way in which certain regions or zones of the world are usually imagined. This paper argues that tropicality, development and vulnerability form part of one and the same essentialising and generalising cultural discourse that denigrates large regions of world as disease-ridden, poverty-stricken and disaster-prone. [source] Interview with Peter BaumeDRUG AND ALCOHOL REVIEW, Issue 1 2002Article first published online: 29 MAY 200 Professor Peter Baume is the Chancellor of the Australian National University. He has been a minister in the Federal Government and in 1977 chaired the Senate Standing Committee on Social Welfare, which conducted a pathfinding enquiry about alcohol and drugs. Prior to his current post he was Professor of Community Medicine at the University of New South Wales. [source] What kind of evidence do we need for evaluating therapeutic interventions?DYSLEXIA, Issue 4 2007Mary N. Haslum Abstract The belief that randomized controlled trials provide a ,gold standard' for evaluating therapeutic interventions is challenged. The need for research designs that produce valid and reliable information about interventions, which is clinically/educationally relevant and personally important, is discussed together with possibilities for broadening the methods of enquiry and evaluation of interventions. It is also suggested that there is an opportunity to further support the development of rigour in reporting intervention studies irrespective of the epistemology employed. Copyright © 2007 John Wiley & Sons, Ltd. [source] The readiness is all The degree level qualifications and preparedness of initial teacher trainees in EnglishENGLISH IN EDUCATION, Issue 2 2010Julie Blake Abstract This article is the first of two reporting research concerned with the profile of degree level qualifications of initial teacher trainees who start Postgraduate Certificate of Education (PGCE) Secondary English courses. In a context where there is no existing database of such information, the researchers sought to establish the patterns in this profile and collate a summary of Initial Teacher Education (ITE) tutors' perceptions about the level of subject knowledge preparedness of students with different degree level qualifications. Following from this, the enquiry was also interested in the ways that PGCE institutions support students with different subject knowledge development needs. The article that follows below treats the issue of degree qualifications and the PGCE selection process in the context of recent changes to subject English. The evidence suggests patterned but divergent practices with an overall trend of preference for prior qualifications in English Literature despite significant alterations in the study of English since 1980. PGCE courses surveyed attract many more applicants than there were places and tutors exercise considerable discretion in admissions practices which are not always made transparent by published policies and rationales, including those made available to prospective applicants. The review of the literature showed little published discourse on this topic to date. [source] PURGING THE GENOME WITH SEXUAL SELECTION: REDUCING MUTATION LOAD THROUGH SELECTION ON MALESEVOLUTION, Issue 3 2009Michael C. Whitlock Healthy males are likely to have higher mating success than unhealthy males because of differential expression of condition-dependent traits such as mate searching intensity, fighting ability, display vigor, and some types of exaggerated morphological characters. We therefore expect that most new mutations that are deleterious for overall fitness may also be deleterious for male mating success. From this perspective, sexual selection is not limited to influencing those genes directly involved in exaggerated morphological traits but rather affects most, if not all, genes in the genome. If true, sexual selection can be an important force acting to reduce the frequency of deleterious mutations and, as a result, mutation load. We review the literature and find various forms of indirect evidence that sexual selection helps to eliminate deleterious mutations. However, direct evidence is scant, and there are almost no data available to address a key issue: is selection in males stronger than selection in females? In addition, the total effect of sexual selection on mutation load is complicated by possible increases in mutation rate that may be attributable to sexual selection. Finally, sexual selection affects population fitness not only through mutation load but also through sexual conflict, making it difficult to empirically measure how sexual selection affects load. Several lines of enquiry are suggested to better fill large gaps in our understanding of sexual selection and its effect on genetic load. [source] The British House of Lords' enquiry into complementary and alternative medicineFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 1 2000Edzard Ernst [source] Geography's Emerging Cross-Disciplinary Links: Process, Causes, Outcomes and ChallengesGEOGRAPHICAL RESEARCH, Issue 1 2002J.H. Holmes In Australian universities the discipline of Geography has been the pace-setter in forging cross-disciplinary links to create multidisciplinary departments and schools, well ahead of other disciplines in humanities, social sciences and sciences, and also to a greater extent than in comparable overseas university systems. Details on all cross-disciplinary links and on immediate outcomes have been obtained by surveys of all heads of departments/schools with undergraduate Geography programs. These programs have traced their own distinctive trajectories, with ramifying links to cognate fields of enquiry, achieved through mergers, transfers, internal initiatives and, more recently, faculty-wide restructuring to create supradisciplinary schools. Geography's ,exceptionalism' has proved short-lived. Disciplinary flux is now extending more widely within Australian universities, driven by a variety of internal and external forces, including: intellectual questioning and new ways of constituting knowledge; technological change and the information revolution; the growth of instrumentalism and credentialism, and managerialism and entre-preneurial imperatives; reinforced by a powerful budgetary squeeze. Geographers are proving highly adaptive in pursuit of cross-disciplinary connections, offering analytical tools and selected disciplinary insights useful to non-geographers. However, this may be at cost to undergraduate programs focussing on Geography's intellectual core. Whereas formerly Geography had high reproductive capacity but low instrumental value it may now be in a phase of enhanced utility but perilously low reproductive capacity. [source] | ||||||||||||||||||||||||||||||||||||||||||||||