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Disruptive Philanthropy: Assessing the Challenges of Funding from “Big Tech” for a UK Charity
Get PDFThe immense wealth generated by the technology sector – or Big Tech – since the end of the 20th century has created a new breed of philanthropists, keen to use the business practices of Silicon Valley to ensure their money is employed to optimum social impact. This study considers how a long-established, UK-based journalism charity can understand, and engage with, the new philanthropic practices of the digital economy in to order to fund transformative change, while appreciating, and managing, the associated benefits and risks.
A characteristic of the digital economy is that it has blurred conventional boundaries between commercial and philanthropic practices. Accordingly, this study was conducted through the theoretical framework of “hybrid organizations” – defined here as non-profit entities which adopt business practices to achieve social ends but face the challenge of balancing the competing institutional logics of mission and money.
This study synthesises the literature on the new, more market-oriented philanthropic models - collectively described here as “disruptive philanthropy” – to provide a conceptual model to guide hybrid, non-profits like the journalism charity that wish to engage with the digital economy. The model is then used to inform a qualitative, inductive study of the journalism charity using semi-structured interviews with a purposive sample of eight stakeholders from the journalism charity and four “elite” interviewees from the digital economy.
This study makes a number of contributions to theory and practice in terms of understanding the digital economy’s business ethics and how non-profit organizations can assess clearly whether the funding support it is seeking from the digital economy is philanthropic or commercial.
The conceptual model serves as a guide to hybrid, non-profit organizations on the factors to assess when seeking engagement with the digital economy. A framework is offered to help non-profits ensure good governance when accepting funds from the digital economy. The study reinforces the need for non-profits to have a clear identity and mission to obtain philanthropic funding. Finally, the study provides an understanding of how organizations from the digital economy assess their funding support through the benefits to their own “ecosystems” – which can be commercial, philanthropic or hybrid in nature
Ketogenic diets for drug-resistant epilepsy
Get PDFKetogenic diets (KDs) are high in fat and low in carbohydrates and have been suggested to reduce seizure frequency in people with epilepsy. Such diets may be beneficial for children with drug-resistant epilepsy. This is an update of a review first published in 2003, and last updated in 2018.
Objectives
To assess the effects of ketogenic diets for people with drug-resistant epilepsy.
Search methods
For this update, we searched the Cochrane Register of Studies (CRS Web) and MEDLINE (Ovid, 1946 to 26 April 2019) on 29 April 2019. The Cochrane Register of Studies includes the Cochrane Epilepsy Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), and randomised controlled trials (RCTs) from Embase, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We imposed no language restrictions. We checked the reference lists of retrieved studies for additional relevant studies. Selection criteria RCTs or quasi-RCTs of KDs for people of any age with drug-resistant epilepsy. Data collection and analysis Two review authors independently applied predefined criteria to extract data and evaluated study quality. We assessed the outcomes: seizure freedom, seizure reduction (50% or greater reduction in seizure frequency), adverse effects, cognition and behaviour, quality of life, and attrition rate. We incorporated a meta-analysis. We utilised an intention-to-treat (ITT) population for all primary analyses. We presented the results as risk ratios (RRs) with 95% confidence intervals (CIs). Main results We identified 13 studies with 932 participants; 711 children (4 months to 18 years) and 221 adults (16 years and over). We assessed all 13 studies to be at high risk of performance and detection bias, due to lack of blinding. Assessments varied from low to high risk of bias for all other domains. We rated the evidence for all outcomes as low to very low certainty.
Ketogenic diets versus usual care for children
Seizure freedom (RR 3.16, 95% CI 1.20 to 8.35; P = 0.02; 4 studies, 385 participants; very low-certainty evidence) and seizure reduction(RR 5.80, 95% CI 3.48 to 9.65; P < 0.001; 4 studies, 385 participants; low-certainty evidence) favoured KDs (including: classic KD, medium-chain triglyceride (MCT) KD combined, MCT KD only, simplified modified Atkins diet (MAD) compared to usual care for children. We are not confident that these estimated effects are accurate. The most commonly reported adverse effects were vomiting, constipation and diarrhoea for both the intervention and usual care group, but the true effect could be substantially different (low-certainty evidence).
Ketogenic diet versus usual care for adults
In adults, no participants experienced seizure freedom. Seizure reduction favoured KDs (MAD only) over usual care but, again, we are not confident that the effect estimated is accurate (RR 5.03, 95% CI 0.26 to 97.68; P = 0.29; 2 studies, 141 participants; very low-certainty evidence). Adults receiving MAD most commonly reported vomiting, constipation and diarrhoea (very low-certainty evidence). One study reported a reduction in body mass index (BMI) plus increased cholesterol in the MAD group. The other reported weight loss. The true effect could be substantially different to that reported.
Ketogenic diet versus ketogenic diet for children
Up to 55% of children achieved seizure freedom with a classical 4:1 KD aDer three months whilst up to 85% of children achieved seizure reduction (very low-certainty evidence). One trial reported a greater incidence of seizure reduction with gradual-onset KD, as opposed to fasting-onset KD. Up to 25% of children were seizure free with MAD and up to 60% achieved seizure reduction.Up to 25% of children became seizure free with MAD and up to 60% experienced seizure reduction. One study used a simplified MAD (sMAD)and reported that 15% of children gained seizure freedom rates and 56% achieved seizure reduction. We judged all the evidence described as very low certainty, thus we are very unsure whether the results are accurate.The most commonly reported adverse effects were vomiting, constipation and diarrhoea (5 studies, very low-certainty evidence). Two studies reported weight loss. One stated that weight loss and gastrointestinal disturbances were more frequent, with 4:1 versus 3:1 KD,whilst one reported no difference in weight loss with 20 mg/d versus 10 mg/d carbohydrates. In one study, there was a higher incidence of hypercalcuria amongst children receiving classic KD compared to MAD. All effects described are unlikely to be accurate.
Ketogenic diet versus ketogenic diet for adults
One study randomised 80 adults (aged 18 years and over) to either MAD plus KetoCal during the first month with MAD alone for the second month, or MAD alone for the first month followed by MAD plus KetoCal for the second month. No adults achieved seizure freedom. More adults achieved seizure reduction at one month with MAD alone (42.5%) compared to MAD plus KetoCal (32.5%), however, by three months only 10% of adults in both groups maintained seizure reduction. The evidence for both outcomes was of very low certainty; we are very uncertain whether the effects are accurate.Constipation was more frequently reported in the MAD plus KetoCal group (17.5%) compared to the MAD only group (5%) (1 study, very low-certainty evidence). Diarrhoea and increase/change in seizure pattern/semiology were also commonly reported (17.5% to 20% of participants). The true effects of the diets could be substantially different to that reported.
Authors' conclusions
The evidence suggests that KDs could demonstrate effectiveness in children with drug-resistant epilepsy, however, the evidence for the use of KDs in adults remains uncertain. We identified a limited number of studies which all had small sample sizes. Due to the associatedr isk of bias and imprecision caused by small study populations, the evidence for the use of KDs was of low to very low certainty.More palatable but related diets, such as the MAD, may have a similar effect on seizure control as the classical KD, but could be associated with fewer adverse effects. This assumption requires more investigation. For people who have drug-resistant epilepsy or who are unsuitable for surgical intervention, KDs remain a valid option. Further research is required, particularly for adults with drug-resistant epilepsy
The experience of young people transitioning between youth offending services to probation services
Get PDFJayne Price, The experience of young people transitioning between youth offending services to probation services,
Probation Journal (Vol. 67 Iss. 3) pp. 246-263. Copyright © 2020 (SAGE). Reprinted by permission of SAGE Publications.This article explores the experience of transitioning from youth offending services to adult probation services upon turning age 18 years whilst incarcerated. The significant differences in the level of provision has been described as a ‘cliff-edge’ (Transition to Adulthood Alliance, 2009). Drawing upon interviews with young people held in institutions, stakeholders and survey data from Her Majesty’s Inspectorate of Prisons (HMIP), it is argued that the drop in support is exacerbated by poor communication between institutions and services which has harmful implications for young people during this crucial period of developmental maturity and beyond custody
Explaining and Developing Social Capital for Knowledge Management Purposes.
No full textPurpose – The purpose of this paper is to review the growing literature bridging social capital (SC) and
knowledge management (KM). The paper seeks to identify the causal factors for this recent research
into the connection between SC and KM, and also to explicate the relationship between the most
relevant neo-capital theories and KM. Further, the paper aims to argue that Granovetter’s and Coleman’s
socially embedded understanding of market activity is the most relevant for examining the SC and KM
interface. Finally, the paper seeks to offer guiding approaches drawn from SC literature for enhancing
KM performance.
Design/methodology/approach – The paper reviews the SC literature from a KM perspective.
Findings – First, interest in SC from KM scholars is driven by a number of inter-linked causal factors.
Second, SC is significant for KM purposes and can be understood as being complementary to and
parallel with other intangible capitalisations, such as human capital (HC) and intellectual capital (IC).
Third, there are a number of guiding notions that organisations can adapt to construct and enhance SC
for KM purposes. However, SC processes are complicated and context-dependent and therefore
resistant to micro-management and ‘‘one size fits all’’ prescriptions.
Originality/value – The paper examines the broader context of the SC and KM interdisciplinary meeting
place. It argues for an ‘‘embedded’’ theoretical understanding of SC that is most relevant for KM
performance, and also explicates the parallel nature of neo-capital theories from a KM perspective. The
paper also suggests a number of guiding approaches that organisations can adapt to analyse and
develop their SC for KM purposes
GeogEd: A New Research Group Founded on the Reciprocal Relationship between Geography Education and the Geographies of Education
Get PDFThis is the peer reviewed version of the following article: West, H., Hill, J., Finn, M., Healey, R.L., Marvell, A. & Tebbett, N. (2020). GeogEd: A new research group founded on the reciprocal relationship between geography education & the geographies of education. Area, 54(1), 24-32, which has been published in final form at [https://doi.org/10.1111/area.12661]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-ArchivingIn 2019 the Higher Education Research Group (HERG) formally became the Geography and
Education Research Group (GeogEd). What may appear as a simple change in name masks a renewed
understanding of the synergies between geography education (at all levels) and the geographies of
education. In this paper we contextualise that change through the relationships between the two interrelated fields. We suggest that these fields are integrally linked, iteratively and reciprocally, and that
research across both is vital for a truly holistic understanding of each. We reflect on the discussions and
process of forming the new Geography and Education Research Group, which we trust is sensitive to the
historic remit of HERG while being inclusive to those working in geography and education beyond HE. We
conclude by looking ahead to a renewed, inclusive and progressive Research Group, aspiring to be more
diverse and enabling fruitful discussions across the geography and education nexus
Domain wall free polar structure enhanced photodegradation activity in nanoscale ferroelectric BaxSr1-xTiO3
Get PDFThis is the peer reviewed version of the following article: Wang, Y., Zhang, M., Liu, J., Zhang, H., Li, F., Tseng, C., Yang, B., Smith, G., Zhai, J., Zhang, Z., Dunn, S. & Yan, H. (2020). Domain wall free polar structure enhanced photodegradation activity in nanoscale ferroelectric BaxSr1-xTiO3. Advanced Energy Materials, 2001802, which has been published in final form at https://doi.org/10.1002/aenm.202001802. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-ArchivingFerroelectric materials exhibit anomalous behavior due to the presence of domains and domain walls which are related to the spontaneous polarization inherent in the crystal structure. Control of ferroelectric domains and domain walls has been used to enhance device performances in ultrasound, pyroelectric detectors and photovoltaic systems with renewed interest in nanostructuring for energy applications. It is also known that the ferroelectric including domain walls can double photocatalytic rate and increase carrier lifetime from μs to ms[1] However, there remains a lack of understanding on the different contributions of the domain and domain walls to photo-catalytic activities. Herein it is found, by comparing samples of nanostructured BaxSr1 xTiO3 with and without a polar domain, that the material with polar domains has a faster reaction rate (k=0.18 min-1) than the non polar one (k = 0.11 min-1). It is further revealed that the observed enhanced photoactivity of perovskite ferroelectric materials stems from the inherent polarization of the domain instead of domain walls. Here, the new understanding of the underlying physics of materials with a spontaneous dipole opens a door to enhance the performance of light induced energy harvesting systems
Patterns of Power, Power of Patterns: Exploring Landscape Context in the Borderland of the Northern and Central Welsh Marches, AD 300-1100
Get PDFScholarship regarding the early medieval Welsh Marches is frequently disparate and disjointed. Studies have concentrated on the analysis of monuments, in part because of the paucity of early medieval archaeology upon which to create a tableau conducive to macro landscape-based research. Where syncretic works in the Welsh Marches have attempted to adopt an interdisciplinary approach, they are often dated, not embracing, or utilising new techniques or methods. This is exacerbated by approaches in archaeological remotes sensing that have focused on methods or only producing dots and lines on a map, rather than its application and integration into theoretical frameworks widening further the divide between theory and practice. Combined, these approaches also fail to integrate fully within discourses emerging in border studies, a critical field of study when analysing border regions.
To tackle these challenges, this thesis examines the borderland landscape of the North and Central Marches using traditional geographical and archaeological techniques, combined with GIS and remote sensed methodologies such as lidar to offer new insight into processes of power and how that is reflected in the landscape. This research targets not only landscape morphology but embraces border theory on the expression and apparatus of power emphasising the ‘borderland’ as an active agent in territoriality and social processes.
This study has analysed remote sensed data and data sets that have previously been underutilised and combined theoretical concepts into a holistic body of work. New or misinterpreted archaeological sites have been identified, adding to the archaeological knowledge of the region and facilitated an enhanced picture of the early medieval landscape.
In addition, the interrelationship of boundaries and sites hitherto unrecognised in the Welsh Marches have collectively opened new avenues and concepts to underpin and augment further research on dyke systems and border formation processes
Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study
Get PDFNon-alcoholic steatohepatitis (NASH) leads to cirrhosis and is associated with a substantial socioeconomic burden, which, coupled with rising prevalence, is a growing public health challenge. However, there are few real-world data available describing the impact of NASH. The Global Assessment of the Impact of NASH (GAIN) study is a prevalence-based burden of illness study across Europe (France, Germany, Italy, Spain, and the UK) and the USA. Physicians provided demographic, clinical, and economic patient information via an online survey. In total, 3,754 patients found to have NASH on liver biopsy were stratified by fibrosis score and by biomarkers as either early or advanced fibrosis. Per-patient costs were estimated using national unit price data and extrapolated to the population level to calculate the economic burden. Of the patients, 767 (20%) provided information on indirect costs and health-related quality of life using the EuroQOL 5-D (EQ-5D; n = 749) and Chronic Liver Disease Questionnaire - Non-Alcoholic Fatty Liver Disease (CLDQ-NAFLD) (n = 723). Mean EQ-5D and CLDQ-NAFLD index scores were 0.75 and 4.9, respectively. For 2018, the mean total annual per patient cost of NASH was €2,763, €4,917, and €5,509 for direct medical, direct non-medical, and indirect costs, respectively. National per-patient cost was highest in the USA and lowest in France. Costs increased with fibrosis and decompensation, driven by hospitalisation and comorbidities. Indirect costs were driven by work loss. The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in Europe and the USA, showing a substantial burden on health services and individuals. There has been little research into the socioeconomic burden associated with non-alcoholic steatohepatitis (NASH). The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in five European countries (UK, France, Germany, Spain, and Italy) and the USA. Mean total annual per patient cost of NASH was estimated at €2,763, €4,917, and €5,509 for the direct medical, direct non-medical, and indirect cost categories, respectively. [Abstract copyright: © 2020 The Author(s).
Comparing physician associates and foundation year two doctors-in-training undertaking emergency medicine consultations in England: a mixed-methods study of processes and outcomes
Get PDFObjectives: To compare the contribution of physician associates to the processes and outcomes of emergency medicine consultations with that of foundation year two doctors-in-training. Design: Mixed-methods study: retrospective chart review using 4 months’ anonymised clinical record data of all patients seen by physician associates or foundation year two doctors-in-training in 2016; review of a subsample of 40 records for clinical adequacy; semi-structured interviews with staff and patients; observations of physician associates. Setting: Three emergency departments in England. Participants: The records of 8816 patients attended by 6 physician associates and 40 foundation year two doctors-in-training; of these n=3197 had the primary outcome recorded (n=1129 physician associates, n=2068 doctor); 14 clinicians and managers and 6 patients or relatives for interview; 5 physician associates for observation. Primary and secondary outcome measures: The primary outcome was unplanned re-attendance at the same emergency department within 7 days. Secondary outcomes: consultation processes, clinical adequacy of care, and staff and patient experience. Results: Re-attendances within 7 days (n=194 (6.1%)) showed no difference between physician associates and foundation year two doctors-in-training (OR 0.87, 95% CI 0.61 to 1.24, p=0.437). If seen by a physician associate, patients were more likely receive an X-ray investigation (OR 2.10, 95% CI 1.72 to 4.24), p<0.001), after adjustment for patient characteristics, triage severity of condition and statistically significant clinician intraclass correlation. Clinical reviewers found almost all patients’ charts clinically adequate. Physician associates were evaluated as assessing patients in a similar way to foundation year two doctors-in-training and providing continuity in the team. Patients were positive about the care they had received from a physician associate, but had poor understanding of the role. Conclusions: Physician associates in emergency departments in England treated patients with a range of conditions safely, and at a similar level to foundation year two doctors-in-training, providing clinical operational efficiencies
Integrating visual arts into post-diagnostic dementia support groups in Memory Services.
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