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Botes, Anri, and Laetitia Fourie. "Werknemers as Lasgewende Ouers in Surrogasie-Aangeleenthede: Die Geboorte van nuwe Verlof-behoeftes in Suid-Afrika." Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad 20 (May 4, 2017): 1. http://dx.doi.org/10.17159/1727-3781/2017/v20i0a1373.
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Commissioning parents in terms of a surrogacy agreement have the same parental obligations as traditional parents towards their child. However, since the legitimising of surrogacy in terms of the Children’s Act in 2005, no provision has been made to accommodate the need for leave from work for commissioning parents in order to fulfil their obligations in this regard. The only form of recourse available to commissioning parents may be found in section 27 of the Basic Conditions of Employment Act (BCEA) which provides for family responsibility leave of three days. It is submitted that this is insufficient. In the matter of MIA v State Information Technology Agency, it was mentioned in passing that amendments to current labour legislation are necessary to address the lacunae in this respect. As was seen in this matter, the absence of legislative provisions regarding relevant leave will likely give rise to claims of discrimination based on various grounds. The Labour Laws Amendment Bill 2015 has since proposed amendments to the BCEA regarding, amongst others, leave for surrogacy matters. It currently proposes ten weeks commissioning parental leave to be available to one commissioning parent and ten days ordinary parental leave to the other, to be taken from the date of birth. Although the Bill is welcomed, various concerns pertaining to the duration and management of the various types of leave can be identified that need urgent address, particularly as far as the best interests of the child is concerned. The latest developments in the United Kingdom in relation to the above matter provides that its legal system serves as a worthy comparator to provide guidance as to how the Bill may be improved in order to protect all the relevant parties to a surrogacy agreement, as well as the child born in terms thereof.
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Ghráinne, Bríd Ní, and Aisling McMahon. "A Public International Law approach to safeguard nationality for surrogate-born children." Legal Studies 37, no. 2 (2017): 324–42. http://dx.doi.org/10.1111/lest.12146.
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International surrogacy agreements involve a child born to a surrogate mother who is of a different nationality to the commissioning parent(s) in a state other than that of which the commissioning parent(s) are nationals or reside. Many of these arrangements lead to children being born stateless, which deprives that child of many rights that are directly linked to one's nationality as well as causing significant practical problems, such as difficulty in obtaining a passport. In undertaking the first Public International Law analysis of nationality and international surrogacy agreements, we map out how various provisions can be used to guarantee protections against statelessness. Accordingly, we argue that the drafting of a proposed new convention is not the ideal solution in this respect, and should not be to the detriment of the ratification and implementation of the relevant conventions that we identify; in particular, the 1989 Convention on the Rights of the Child. We argue that these protections offer the most meaningful protection in the short term and should be used to inform any future protections under the proposed Convention. We conclude by encouraging the advancement of Public International Law arguments when petitioning in a domestic context on behalf of stateless international surrogate children.
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Gore, C., R. Griffin, T. Rothenberg, et al. "New patient-reported experience measure for children with allergic disease: development, validation and results from integrated care." Archives of Disease in Childhood 101, no. 10 (2016): 935–43. http://dx.doi.org/10.1136/archdischild-2015-309598.
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ObjectivesTo develop and validate a new allergy-specific patient-reported experience measure (PREM) for children and their parents, and to collect feedback in an integrated care setting.DesignTwo allergy-specific PREMs were produced using focus groups, cognitive testing, two prospective validation studies (collaboration: Royal College of Paediatrics and Child Health, Picker Institute Europe, Imperial College/London): ‘Your Allergy Care’, for children aged 8–16 years; ‘Your Child's Allergy Care’, for parents of children aged 0–7 years.SettingCommunity event, primary/secondary/tertiary allergy care settings.Main outcome measuresPerformance of PREMs in validation study; reported experience of allergy care.Participants687 children with allergic conditions and their parents/carers.ResultsIn total, 687 questionnaires were completed; 503/687 (253 child; 250 parent) for the final survey. In both surveys, demographic variations were not associated with differences in results. Although 71% of patients reported one or more allergic conditions (food allergy/eczema/hay fever/asthma), 62% required multiple visits before receiving final diagnosis. Overall, patient experience was good for communication with patient/parent, competence and confidence in ability, and 73% felt looked after ‘very well’ and 23% ‘quite well’. Areas for improvement included communication with nurseries/schools, more information on side effects, allergic conditions and allergen/irritant avoidance. Allergy care in primary/emergency care settings was associated with higher problem-scores (worse experience) than in specialist clinics.ConclusionsThese new PREMs will allow allergy-specific patient experience reporting for children and parents and help identification of priority areas for improvement and commissioning of care. Efforts towards better allergy care provision must be targeted at primary and emergency care settings and underpinned by improving communication between healthcare providers and the community.
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Duk, Viacheslav. "The RICH detector of the NA62 experiment." International Journal of Modern Physics: Conference Series 44 (January 2016): 1660230. http://dx.doi.org/10.1142/s2010194516602301.
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The NA62 experiment at CERN is aimed at measuring the ultra-rare decay K[Formula: see text] with 10% accuracy. One of the detectors that is crucial for the rejection of background events is the RICH detector: a gas based detector aimed at [Formula: see text]/[Formula: see text] separation in the 15–35 GeV/c momentum range with an inefficiency of less than 1%. The RICH must also provide a very precise time measurement (with the time resolution ∼100 ps) to correctly associate the [Formula: see text] with the parent K[Formula: see text] particle measured by an upstream detector. This paper contains the detailed description of the RICH detector, its readout, and the results of the commissioning run at CERN in 2014.
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Hotez, Peter. "Preventing the next pandemic and tackling antiscience: an interview with Peter Hotez." Future Microbiology 16, no. 8 (2021): 539–41. http://dx.doi.org/10.2217/fmb-2021-0088.
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This interview was conducted by Atiya Henry, Commissioning Editor of Future Microbiology. Peter J Hotez, MD, PhD is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine. He is an internationally recognized physician–scientist in neglected tropical diseases and vaccine development. As head of the Texas Children’s Center for Vaccine Development, he leads a team and product development partnership for developing new vaccines for hookworm infection, schistosomiasis, leishmaniasis, Chagas disease and SARS/MERS/SARS-2 coronavirus. Dr Hotez has authored more than 500 original papers and is the author of four single-author books. Most recently as both a vaccine scientist and autism parent, he has led national efforts to defend vaccines and to serve as an ardent champion of vaccines going up against a growing national ‘antivax’ threat.
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Jones, Glenys, and Elaine Hack. "Chapter 3. Parent/carer involvement in the commissioning of services for children and young people with autism spectrum disorder in the East Midlands." Journal of Research in Special Educational Needs 8, no. 3 (2008): 171–73. http://dx.doi.org/10.1111/j.1471-3802.2008.00112_3.x.
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Irwin, Jonathan, David Charbonneau, Philip Nutzman, and Emilio Falco. "The MEarth project: searching for transiting habitable super-Earths around nearby M dwarfs." Proceedings of the International Astronomical Union 4, S253 (2008): 37–43. http://dx.doi.org/10.1017/s1743921308026215.
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AbstractDue to their small radii, M dwarfs are very promising targets to search for transiting super-Earths, with a planet of 2 Earth radii orbiting an M5 dwarf in the habitable zone giving rise to a 0.5% photometric signal, with a period of two weeks. This can be detected from the ground using modest-aperture telescopes by targeting samples of nearby M dwarfs. Such planets would be very amenable to follow-up studies due to the brightness of the parent stars, and the favourable planet-star flux ratio. MEarth is such a transit survey of ~2000 nearby M dwarfs. Since the targets are distributed over the entire (Northern) sky, it is necessary to observe them individually, which will be done by using 8 independent 0.4m robotic telescopes, two of which have been in operation since December 2007 at the Fred Lawrence Whipple Observatory (FLWO) located on Mount Hopkins, Arizona. We discuss the survey design and hardware, and report on the current status of the survey, and preliminary results obtained from the commissioning data.
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Chorro-Mari, Veronica, and Nanna Christiansen. "SETTING UP OF A HOMECARE SYSTEM FOR HIGH COST NEBULISERS IN A PAEDIATRIC CYSTIC FIBROSIS CENTRE." Archives of Disease in Childhood 101, no. 9 (2016): e2.57-e2. http://dx.doi.org/10.1136/archdischild-2016-311535.60.
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AimDue to national changes to the commissioning process of high cost nebulisers (HCN) for Cystic Fibrosis (CF) patients, CF centres have to repatriate the prescribing of the HCN to the tertiary care centres.1 The following nebulisers will no longer be prescribed by primary care: Cayston® (Aztreonam); Colomycin®, Pomixin®, Clobreathe® (Colistimethate); Pulmozyme® (Dornase alfa); Tobi®, Tobi Podhaler ®, Bramitob® (Tobramycin).This abstract explains how the Royal London Hospital (RLH) Paediatric Pharmacy recruited over 100 paediatric (CF) patients smoothly within a period of 4 months and set up a homecare system to avoid patients and families having to travel large distances to obtain their medication.MethodsA number of homecare companies were evaluated initially. Parameters looked at were reports of customer satisfaction, delivery cost, turn-around time once the prescription was received and availability of same day delivery service.In order to capture existing patients we met with CF Specialist Nurses to establish the total number of patients on HCN, what nebulised treatment they were on and their respective doses. We prioritised patients that had known problems with GP prescribing and anybody newly starting on HCN.To communicate the change to parents, a letter was sent to all parents explaining the changeover to homecare delivery and tertiary prescribing. In addition a section in the parent bulletin was dedicated to the topic as well. Following this we contacted parents via phone and in clinic to request consent and explain the process.Up to 10 patients were contacted weekly (average of 7); the consent form and registration form were then faxed to the Homecare company for patient registration. In parallel to this prescriptions were requested for the patients that had been set up in the previous week, ensuring that prescribing was spread out over time to avoid having peak times for repeat prescriptions.In addition to the letter to parents GP surgeries were also informed in writing about the changes in commissioning and planned repatriation of HCN. This information was also included on discharge prescriptions for patients on any of the HCNs as part of the pharmacy screening process.A system for follow up prescriptions as repeat was set up between the team so we would not have unexpected urgent requests and we could avoid missed doses, urgent delivery charge or stress in the team. In order to manage the prescriptions and ease communication across the team a database was developed.ResultsFrom March to July 2014 (16 weeks) one hundred and four patients were successfully repatriated to tertiary care.ConclusionA planned method and agreed standard operation procedure was key to effectively capture and repatriate all patients while at the same time keeping the increase on workload for the pharmacy team to a minimum. The fact of having a strong pharmacy presence as part of the multidisciplinary team attending CF clinics and ward rounds was vital in making this work.
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Modha, Jiten. "P35 Paediatric rheumatology virtual biologic clinic (VBC)." Archives of Disease in Childhood 105, no. 9 (2020): e24.2-e25. http://dx.doi.org/10.1136/archdischild-2020-nppg.44.
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AimTo improve the overall process for the prescribing of biologics within the paediatric rheumatology service. The VBC would help achieve the following:Successful implementation within the service.Streamlined process for cost effective prescribing of biologics in line with national guidance.Ensuring all patients receive the appropriate pre–biologic checks and documentation of core set criteria (where possible) to ensure safe prescribing.Ascertaining other funding mechanisms for patients who do not meet national guidance or commissioning criteria.MethodsThe VBC was modelled on the adult service and the process comprises of the following:Patients starting or switching biologic therapy are highlighted in clinic.Patients who require continuation in therapy are highlighted by the pharmacy homecare team.For new patients, pre–biologic checks are ordered and routine bloods are requested for those continuing therapy.VBC comprises of a 2 hour multidisciplinary team (MDT) meeting between a consultant paediatric rheumatologist or senior fellow, specialist nurse and pharmacist.Patients referred to VBC are reviewed against our biologics clerking sheet. Ensuring pre–biologic checks have been completed, routine bloods have been checked, core set criteria has been recorded, patient is compliant with national guidance and that the appropriate Blueteq form has been completed.A homecare registration (if required) and prescription form are completed.A telephone consultation with the parent/patients is provided by the pharmacist explaining the homecare process and answering any clinical questions.The specialist nurse completes output documentation for GP and arranges next follow up.A real–time biologics database records core quality data for auditing purposes.VBC list is sent to the service manager for reimbursement.Patients who do not meet national guidance are referred to the weekly MDT.ResultsThe service has 120 patients being treated on biologics. Since November 2018, 112 patients of these patients have been reviewed. 1.7% have been non-compliant with national guidance and 5% did not have Blueteq numbers.The VBC has enabled the MDT to assess response to biologic therapies by ensuring core set criteria is being recorded. A snapshot audit showed that documentation had increased from 25% to 50%.Prescription turnaround time has reduced from 7 days to 3 days preventing treatment delay.DiscussionVBC has enabled the majority of patients to be reviewed, whilst showing we are compliant with national guidance. Routine and pre-biologic bloods had been requested for all patients and the recording of core set criteria had shown some improvement. Although not achieving the required level of documentation. Telephone consults have been perceived well by patients/parents. Having a pharmacist prescriber has had a positive outcome within the MDT and both the workflow and workload has improved.ConclusionThe VBC has been pivotal in improving patient care within the service. The MDT have collaboratively been able to ensure cost-effective prescribing, improve data collection, and reduce treatment delay whilst enhancing the pharmacist’s role. The process has highlighted the documentation of core set criteria is still low and requires further improvement. Ensuring compliance with NHS England commissioning criteria, Blueteq forms should be completed prior to prescriptions being written.
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Manthorpe, Jill, Jo Moriarty, and Michelle Cornes. "Parent? Carer? Mid-lifer? Older person? Similarities and diversities across different experiences of caring and their implications for practice." Working with Older People 19, no. 2 (2015): 94–103. http://dx.doi.org/10.1108/wwop-10-2014-0029.
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Purpose – The purpose of this paper is to consider the experiences of carers caring for an adult child, particularly as they affect the transition from midlife into older age. It explores aspects affecting the vast majority of carers, such as accessing information and services, but focuses on the specific concerns of those caring for a child with a life-long disability or a child who acquires a long-term health problem in adolescence or adulthood. In the context of the introduction of the Care Act (2014) in England, the paper highlights ways in which support for carers could be improved. Design/methodology/approach – This paper draws on interview data which consisted of 86 face-to-face interviews with purposefully selected participants based in four local authorities. At the end of the study in 2014 the authors held a series of five focus groups for practitioners and carers to explore how the emerging findings chimed with their experiences and to refine the study’s messages for practice. The data from interviews are set in the context of policy and practice developments in social care in England. Findings – The paper draws attention to the need for practitioners to find ways of involving carers in decision making without compromising the rights to autonomy and choice on the part of the person cared for. Both those commissioning services and practitioners need to acknowledge that parent carers need assurances about the long-term viability and quality of the plans that are developed for the person they support. Research limitations/implications – This paper is drawn on interviews with carers and practitioners in four areas of England; most of the carers interviewed were white British and female. The implications of planning research and conducting research with family carers are explored and their similarities with practice encounters identified. Practical implications – The key practice point in this paper highlights the necessity of talking about the future with parent carers, making plans for possible and highly likely events, addressing mortality, and being aware of the potential for a deeply held sense of pessimism and unspoken distress among carers. Some participants seemed to feel that practitioners conveyed a sense that they were inadequate or unwilling to discuss these matters and practitioners who suspect this may apply to them or their team could usefully consider seeking skills development to improve their practice. Originality/value – This paper is the first to consider practice perspectives in the context of the Care Act (2014) and personal budgets in England relating to parent carers.
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Pillay, Thillagavathie, Neena Modi, Oliver Rivero-Arias, et al. "Optimising neonatal service provision for preterm babies born between 27 and 31 weeks gestation in England (OPTI-PREM), using national data, qualitative research and economic analysis: a study protocol." BMJ Open 9, no. 8 (2019): e029421. http://dx.doi.org/10.1136/bmjopen-2019-029421.
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IntroductionIn England, for babies born at 23–26 weeks gestation, care in a neonatal intensive care unit (NICU) as opposed to a local neonatal unit (LNU) improves survival to discharge. This evidence is shaping neonatal health services. In contrast, there is no evidence to guide location of care for the next most vulnerable group (born at 27–31 weeks gestation) whose care is currently spread between 45 NICU and 84 LNU in England. This group represents 12% of preterm births in England and over onr-third of all neonatal unit care days. Compared with those born at 23–26 weeks gestation, they account for four times more admissions and twice as many National Health Service bed days/year.MethodsIn this mixed-methods study, our primary objective is to assess, for babies born at 27–31 weeks gestation and admitted to a neonatal unit in England, whether care in an NICU vs an LNU impacts on survival and key morbidities (up to age 1 year), at each gestational age in weeks. Routinely recorded data extracted from real-time, point-of-care patient management systems held in the National Neonatal Research Database, Hospital Episode Statistics and Office for National Statistics, for January 2014 to December 2018, will be analysed. Secondary objectives are to assess (1) whether differences in care provided, rather than a focus on LNU/NICU designation, drives gestation-specific outcomes, (2) where care is most cost-effective and (3) what parents’ and clinicians' perspectives are on place of care, and how these could guide clinical decision-making. Our findings will be used to develop recommendations, in collaboration with national bodies, to inform clinical practice, commissioning and policy-making. The project is supported by a parent advisory panel and a study steering committee.Ethics and disseminationResearch ethics approval has been obtained (IRAS 212304). Dissemination will be through publication of findings and development of recommendations for care.Trial registration numberNCT02994849 and ISRCTN74230187.
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Feder, Judy. "Operator Develops Fully Smart Onshore Field." Journal of Petroleum Technology 73, no. 05 (2021): 56–57. http://dx.doi.org/10.2118/0521-0056-jpt.
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This article, written by JPT Technology Editor Judy Feder, contains highlights of paper SPE 203461, “Digitalization in the Oil and Gas Industry—A Case Study of a Fully Smart Field in the United Arab Emirates,” by Muhammad Arif and Abdulla Mohammed Al Senani, ADNOC, prepared for the 2020 Abu Dhabi International Petroleum Exhibition and Conference, Abu Dhabi, held virtually from 9–12 November. The paper has not been peer reviewed. One of the first oil fields in the UAE to be fully operated remotely is in the southeast region, 250 km from Abu Dhabi. The complete paper discusses the development and commissioning of the field, which is the first smart field for ADNOC Onshore. The designed and applied technology facilitated unmanned operation of the field from downhole to export. Introduction Oilfield digitalization encompasses gathering real-time and non-real-time data from wells, flow lines, manifolds, stations, and water injection facilities; analysis of the data using algorithms, flowcharts, plots, and reports; and user access to this data on user-friendly screens. This allows engineers to focus on interpretation of data vs. searching, organizing, and formatting the data. In the bigger picture, the data collected will lead to conclusions and set bases for important decisions for similar projects in the future, enabling a lesson-learning approach to design new oil fields. The accumulated theoretical and practical research results of smart-field implementation require analysis and synthesis to maintain perspective of the entire project. Both were applied in the Mender field, which is the subject of the complete paper. Problem Statement The Mender parent field has been producing since 2013 with minimal digitalization for wellheads. Wells are not fit-ted with remote sensors, and operators have been visiting the wells to collect data using analog gauges. Collected data are stored in computers or as hard copies. Some critical data is lost, which affects decision-making. The new Mender field is 50 km from the parent field and is in a sensitive area close to international borders. The field area is a wildlife reserve for various endangered animals. The nature of operations is highly critical because of concentrations of hydrogen sulfide (H2S) that could jeopardize employees’ health and safety.
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Busk, Mary. "Commentary on “The NICE guidelines and quality standards on learning disabilities and behaviour that challenges”." Tizard Learning Disability Review 22, no. 2 (2017): 82–86. http://dx.doi.org/10.1108/tldr-01-2017-0005.
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Purpose The purpose of this paper is to provide a commentary, from a parent carer perspective, on Murphy’s overview of the NICE guidelines and quality standards on learning disabilities and behaviour that challenges. Design/methodology/approach The paper discusses the NICE approach, the content of these specific guidelines and quality standards and considers their practical relevance, with a particular focus on families of children and young people with learning disabilities and behaviour that challenges. Findings Gaps in research affect recommendations in some key areas including around transition and early intervention. Risk factors are not linked to clear recommendations for early identification and prevention. For families, additional work is needed to highlight where these guidelines fit with related national law and policies. Families also need to see how the guidelines can positively influence commissioners to improve life outcomes and avoid crises and deterioration in behaviour. Although NICE guidelines are often condition specific, many of our children and young people have co-existing conditions and so do not fit neatly into just one set of guidelines. That is why data collection is very important to understanding needs and to effective commissioning. There is a need to urgently identify and address the research gaps so that essential interventions are included in future NICE guidelines and standards. Originality/value A family carer perspective suggests ways in which implementation of the NICE guidelines can be supported and argues for the importance of the further research that will strengthen future versions of the guidelines.
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Parks, Jennifer A., and Timothy F. Murphy. "So not mothers: responsibility for surrogate orphans." Journal of Medical Ethics 44, no. 8 (2018): 551–54. http://dx.doi.org/10.1136/medethics-2017-104331.
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The law ordinarily recognises the woman who gives birth as the mother of a child, but in certain jurisdictions, it will recognise the commissioning couple as the legal parents of a child born to a commercial surrogate. Some commissioning parents have, however, effectively abandoned the children they commission, and in such cases, commercial surrogates may find themselves facing unexpected maternal responsibility for children they had fully intended to give up. Any assumption that commercial surrogates ought to assume maternal responsibility for abandoned children runs contrary to the moral suppositions that typically govern contract surrogacy, in particular, assumptions that gestational carriers are not ‘mothers’ in any morally significant sense. In general, commercial gestational surrogates are almost entirely conceptualised as ‘vessels’. In a moral sense, it is deeply inconsistent to expect commercial surrogates to assume maternal responsibility simply because commissioning parents abandon children for one reason or another. We identify several instances of child abandonment and discuss their implications with regard to the moral conceptualisation of commercial gestational surrogates. We conclude that if gestational surrogates are to remain conceptualised as mere vessels, they should not be expected to assume responsibility for children abandoned by commissioning parents, not even the limited responsibility of giving them up for adoption or surrendering them to the state.
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Lilley, Andrew. "ASSESSING THE BENEFITS THAT COMMUNITY PHARMACIES CAN HAVE ON CHILDHOOD ASTHMA OUTCOMES." Archives of Disease in Childhood 101, no. 9 (2016): e2.48-e2. http://dx.doi.org/10.1136/archdischild-2016-311535.52.
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IntroductionThe local Clinical Commissioning Group has funded an innovative one-year pilot project to assess the value of providing specialist paediatric pharmacist and physiotherapist support direct to families and health care professionals (GP's, community pharmacists, practice nurses etc.) regarding asthma in the primary care setting. Community pharmacies are the one service that asthmatic children come in contact with in order to pick up their medications it was decided to encourage staff to provide interventions at the point of collection.Methods22 large chain, small chain and independent community pharmacy branches were included in the pilot (out of 152 within CCG area) with a total of 31 pharmacists and 67 assistants trained to provide the service. The plan was to provide ‘back to basics’ leaflets on collection of prescription to help improve education on the medications being used; provide inhaler technique counselling on the collection of all prescriptions for children; encourage pharmacist's to perform medicines use reviews and the new medicines service in asthmatic children of high school age (for which they could collect the standard NHS fee). In order to assess the benefits of this, the pharmacist or assistant would first perform the standard asthma control test, marked out of 25 with the parent/patient completing an online version one month later to assess any improvement in symptom management. In order to trace the number of MURs, NMS, inhaler counselling sessions and leaflets given out a tally chart was completed each month by the branches involved.ResultsUnfortunately of the 22 branches that signed up to the pilot only 15 returned tally charts to the team. Over a six month period 23 MUR's, 3 NMS and 32 inhaler technique sessions were performed with 67 leaflets distributed. Of a possible 55 asthma control tests (MURs and inhaler technique counselling sessions) only 23 patients completed the four week post intervention online form. Of those completed the average asthma control test score increased by 7 points (30% increase). In particular feedback from the pharmacists involved was that the inhaler counselling sessions were of particular benefit to parents/patients.Feedback from the pharmacy teams in general was positive with many stating it was good to be more involved in the care of children's conditions; however many stated in order for the service to roll out to a wider audience the scheme would have to provide a financial incentive for the large chains to take part.ConclusionsIt is clear that interventions performed by the community pharmacy teams can help improve symptom control in asthmatic children. In particular ensuring patients are using their medications correctly appears to be key to symptom control. Encouraging pharmacists to provide child friendly MURs should be investigated further to prove the benefit of this service further. It should be noted that ensuring patients are using their medications correctly is already part of the essential service contract for pharmacies.
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Arvidsson, Anna, Sara Johnsdotter, Maria Emmelin, and Birgitta Essén. "Being questioned as parents: An interview study with Swedish commissioning parents using transnational surrogacy." Reproductive Biomedicine & Society Online 8 (June 2019): 23–31. http://dx.doi.org/10.1016/j.rbms.2018.08.001.
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Biyth, E. "‘Not a primrose path’: Commissioning parents' experiences of surrogacy arrangements in Britain." Journal of Reproductive and Infant Psychology 13, no. 3-4 (1995): 185–96. http://dx.doi.org/10.1080/02646839508403248.
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Xu, Hanhui. "Why only the commissioning parents should undertake parental duties in surrogacy cases?" Zeitschrift für Ethik und Moralphilosophie 2, no. 1 (2019): 5–20. http://dx.doi.org/10.1007/s42048-019-00030-x.
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Griffith, Richard. "European Union law denies commissioning parents paid leave on the birth of their child." British Journal of Midwifery 22, no. 5 (2014): 372–74. http://dx.doi.org/10.12968/bjom.2014.22.5.372.
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Arvidsson, Anna, Sara Johnsdotter, and Birgitta Essén. "Views of Swedish Commissioning Parents Relating to the Exploitation Discourse in Using Transnational Surrogacy." PLOS ONE 10, no. 5 (2015): e0126518. http://dx.doi.org/10.1371/journal.pone.0126518.
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Colver, Allan, Tim Rapley, Jeremy R. Parr, et al. "Facilitating the transition of young people with long-term conditions through health services from childhood to adulthood: the Transition research programme." Programme Grants for Applied Research 7, no. 4 (2019): 1–244. http://dx.doi.org/10.3310/pgfar07040.
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Background As young people with long-term conditions move from childhood to adulthood, their health may deteriorate and their social participation may reduce. ‘Transition’ is the ‘process’ that addresses the medical, psychosocial and educational needs of young people during this time. ‘Transfer’ is the ‘event’ when medical care moves from children’s to adults’ services. In a typical NHS Trust serving a population of 270,000, approximately 100 young people with long-term conditions requiring secondary care reach the age of 16 years each year. As transition extends over about 7 years, the number in transition at any time is approximately 700. Objectives Purpose – to promote the health and well-being of young people with long-term conditions by generating evidence to enable NHS commissioners and providers to facilitate successful health-care transition. Objectives – (1) to work with young people to determine what is important in their transitional health care, (2) to identify the effective and efficient features of transitional health care and (3) to determine how transitional health care should be commissioned and provided. Design, settings and participants Three work packages addressed each objective. Objective 1. (i) A young people’s advisory group met monthly throughout the programme. (ii) It explored the usefulness of patient-held health information. (iii) A ‘Q-sort’ study examined how young people approached transitional health care. Objective 2. (i) We followed, for 3 years, 374 young people with type 1 diabetes mellitus (150 from five sites in England), autism spectrum disorder (118 from four sites in England) or cerebral palsy (106 from 18 sites in England and Northern Ireland). We assessed whether or not nine proposed beneficial features (PBFs) of transitional health care predicted better outcomes. (ii) We interviewed a subset of 13 young people about their transition. (iii) We undertook a discrete choice experiment and examined the efficiency of illustrative models of transition. Objective 3. (i) We interviewed staff and observed meetings in three trusts to identify the facilitators of and barriers to introducing developmentally appropriate health care (DAH). We developed a toolkit to assist the introduction of DAH. (ii) We undertook a literature review, interviews and site visits to identify the facilitators of and barriers to commissioning transitional health care. (iii) We synthesised learning on ‘what’ and ‘how’ to commission, drawing on meetings with commissioners. Main outcome measures Participation in life situations, mental well-being, satisfaction with services and condition-specific outcomes. Strengths This was a longitudinal study with a large sample; the conditions chosen were representative; non-participation and attrition appeared unlikely to introduce bias; the research on commissioning was novel; and a young person’s group was involved. Limitations There is uncertainty about whether or not the regions and trusts in the longitudinal study were representative; however, we recruited from 27 trusts widely spread over England and Northern Ireland, which varied greatly in the number and variety of the PBFs they offered. The quality of delivery of each PBF was not assessed. Owing to the nature of the data, only exploratory rather than strict economic modelling was undertaken. Results and conclusions (1) Commissioners and providers regarded transition as the responsibility of children’s services. This is inappropriate, given that transition extends to approximately the age of 24 years. Our findings indicate an important role for commissioners of adults’ services to commission transitional health care, in addition to commissioners of children’s services with whom responsibility for transitional health care currently lies. (2) DAH is a crucial aspect of transitional health care. Our findings indicate the importance of health services being commissioned to ensure that providers deliver DAH across all health-care services, and that this will be facilitated by commitment from senior provider and commissioner leaders. (3) Good practice led by enthusiasts rarely generalised to other specialties or to adults’ services. This indicates the importance of NHS Trusts adopting a trust-wide approach to implementation of transitional health care. (4) Adults’ and children’s services were often not joined up. This indicates the importance of adults’ clinicians, children’s clinicians and general practitioners planning transition procedures together. (5) Young people adopted one of four broad interaction styles during transition: ‘laid back’, ‘anxious’, ‘wanting autonomy’ or ‘socially oriented’. Identifying a young person’s style would help personalise communication with them. (6) Three PBFs of transitional health care were significantly associated with better outcomes: ‘parental involvement, suiting parent and young person’, ‘promotion of a young person’s confidence in managing their health’ and ‘meeting the adult team before transfer’. (7) Maximal service uptake would be achieved by services encouraging appropriate parental involvement with young people to make decisions about their care. A service involving ‘appropriate parental involvement’ and ‘promotion of confidence in managing one’s health’ may offer good value for money. Future work How might the programme’s findings be implemented by commissioners and health-care providers? What are the most effective ways for primary health care to assist transition and support young people after transfer? Study registration This study is registered as UKCRN 12201, UKCRN 12980, UKCRN 12731 and UKCRN 15160. Funding The National Institute for Health Research Programme Grants for Applied Research programme.
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Karim, Khalid, Victoria Tischler, Peter Gregory, and Panos Vostanis. "Homeless Children and Parents: Short-Term Mental Health Outcome." International Journal of Social Psychiatry 52, no. 5 (2006): 447–58. http://dx.doi.org/10.1177/0020764006066830.
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Background: Homeless families are an increasing but marginalised part of society. They have diverse and complex needs that have often not been addressed by the available services. There is some evidence that psychosocial factors continue to be detrimental to the mental health of these families even after rehousing. Method: Thirty-five homeless families were assessed on their mental health (Hospital Anxiety and Depression Scale, Eyberg Child Behaviour Inventory Scale, Health of the Nation Outcome Scales for Children and Adolescents), parenting problems (Parenting Daily Hassles Scale), and service satisfaction (semi-structured interview) following admission to two homeless hostels, and four months later, when most families (69%) had been rehoused in the community. Results: Children and their mothers continued to experience high rates of mental health problems whilst resident in the hostels and after rehousing. However, a proportion of parents expressed a subjective improvement, which was often associated with their housing and social circumstances. A diverse range of further needs was described. Conclusions: There is a need to address the complex problems experienced by these families, with housing only forming one aspect of this provision. Interagency strategy, commissioning and services are required to meet the needs of this vulnerable group of parents and children.
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Visalam Krishnamoorthy, Radhika. "Leader Emotional Intelligence and Staff Work Motivation." Asian Review of Social Sciences 8, no. 1 (2019): 51–60. http://dx.doi.org/10.51983/arss-2019.8.1.1534.
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Intellectually asserted, every educational institution by existence stands for the transaction of intelligence. This unchallengeable poses a need-based context for probing into the most influential yet often neglected dimension of intelligence, the emotional intelligence as an integral process of every progress plan. Schools, in their existence, are human-intensive spaces with their recipients primarily in students and parents, academic transacts in teachers, influencers in regulatory officials and most importantly the visionaries in their management. The uniqueness of such a space is in understanding that every individual comes in with their typical personalities, traits, intelligence indices as well as work-motivation patterns. The principals as leaders pivot all these commissioning dynamics around them in every context of their institution.
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Woodhouse, Leila, Patricia Bussell, Stacey Jones, Helen Lloyd, Wendy Macdowall, and Rowena Merritt. "Bostin Value." Social Marketing Quarterly 18, no. 3 (2012): 221–33. http://dx.doi.org/10.1177/1524500412460667.
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“Bostin Value” was a pilot scheme aiming to improve fruit and vegetable consumption in a deprived neighborhood in the borough of Dudley, England. Research identified the need to address both supply and demand to encourage the target audience (parents/carers of young children) to consume more fruit and vegetables along with their children. Bostin Value improved supply through commissioning a local greengrocer to sell fresh fruit and vegetables twice a week at a local primary school. Promotions were used to encourage sales, including a loyalty card system, money off vouchers, and recipe cards. To increase demand, educational sessions were run at the school to improve parent’s skills in cooking seasonal produce. Children at the school received tasting workshops to encourage them to try a variety of fruit and vegetables. Results saw the mean portions of fruit consumed weekly by parents significantly increase from 2.4 portions in April 2009 to 3.1 in July 2010. This was mirrored in children whose weekly portions increased from 2.6 to 3.7. The mean number of different fruits and vegetables tasted by children also increased significantly.
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Aston, Jeff. "9 Children/young people taking long-term medicines – a survey of the experiences of community pharmacists." Archives of Disease in Childhood 103, no. 2 (2018): e2.49-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.9.
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AimTo identify the experiences of community pharmacists in caring for children/young people, or their parents/carers, taking long-term medicines.MethodA pre-piloted 13 point semi-structured survey, participant information leaflet, consent form and pre-paid return envelope were posted to all 354 community pharmacists who had dispensed a prescription from a single specialist paediatric hospital during November and December 2015. Community pharmacy addresses were obtained from the National Health Service Business Services Authority ePACT system. Telephone follow-up of non-responders and, if necessary, a repeat mailing was made from 3 weeks after the original return by date.Participants were asked about their experiences of undertaking a medication review with either children/young people or their parents/carers, medication-related problems presenting to them, adherence, information needs of patients/carers and what issues were reported to them from this group.The data were analysed using SPSS version 22 and NVivo version 10.ResultsA response rate of 76/354 (21.5%) was achieved. Eighteen (23.7%) respondents had undertaken a Medicines Use Review (MUR),122 (28.9%) a New Medicines Service (NMS)2 review and 16 (21.1%) had undertaken another type of medication review in a child/young person. Respondents reported that patients or their carers had presented to them with adherence issues including stopping the medicine (24, 31.6%) and changing the dose (28, 36.8%) without informing the prescriber. Patients or their carers had requested information from them about the indication (59, 77.6%), dose regime (63, 82.9%), administration (64, 84.2%) and adverse effects (58, 76.6%). Respondents also reported patients/carers experiencing difficulties obtaining further supplies of a medicine from their community pharmacy (47, 61.8%) and patients’ general practitioners declining to prescribe a medicine recommended by the patient’s hospital-based specialist (27, 35.5%).ConclusionThis study has demonstrated that children, and their carers, taking long-term medicines experience a range of issues that they present to community pharmacists. Many of these issues would fall within the purview of currently funded medication review services namely the NMS and MUR.1,2 However, the proportion of pharmacists in this study undertaking formal medication review with children or their parents/carers was low. Further work is required to demonstrate the outcomes that such a review could have in this cohort of patients.ReferencesPharmaceutical Services Negotiating Committee. MURs: The basics. What is the medicines use review and prescription intervention service? [Internet] 2016. Available from: MURs: The basics http://psnc.org.uk/services-commissioning/advanced-services/murs/murs-the-basics/ [Available: 19 May 2016].Pharmaceutical Services Negotiating Committee. New Medicines Service (NMS) [Internet] 2016. http://psnc.org.uk/services-commissioning/advanced-services/nms/ [Available: 19 May 2016].
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Goswami, Lopamudra, Stephen Anthony Larmar, and Jennifer Boddy. "The impacts of the Covid-19 pandemic on surrogacy in India: The role of social work." Qualitative Social Work 20, no. 1-2 (2021): 472–78. http://dx.doi.org/10.1177/1473325020981082.
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The impacts of the Covid-19 pandemic have been catastrophic internationally, with alarming rates of cases and deaths, as well as travel bans and countrywide lockdowns. While many industries are experiencing the deleterious effects of Covid-19, international surrogacy is facing enormous ethical challenges resulting from the pandemic. Drawing on the first author’s reflections on research with Indian surrogate mothers, coupled with contemporary literature, this paper highlights the impacts of Covid-19 on surrogacy in India, particularly regarding the strict lockdown laws intended to protect civil society. This paper discusses the serious issues facing key actors involved in surrogacy, including surrogate mothers and commissioning parents. Focus is given to the psychological impacts on newborn babies caught in a liminal space as a result of lockdown laws. The authors conclude with reflections on the role of social work in protecting women and children in international surrogacy, particularly during a pandemic.
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Sheiko, I. P. "New ways and methods of development of pig breeding in Belarus." Proceedings of the National Academy of Sciences of Belarus. Agrarian Series 58, no. 1 (2020): 68–78. http://dx.doi.org/10.29235/1817-7204-2020-58-1-68-78.
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The Republic of Belarus has a well-developed pig breeding industry. The main goal in pig breeding in Belarus is to obtain, in a short time, competitive breeds, types and hybrids of pigs adapted to the conditions of industrial pork production and not inferior to analogues of the world breeding. Currently, in the pig industry, effective variants of interbreeding hybridization are widely introduced, and mating of specialized maternal breeds (BLW × BM) and (Y × L) with boars of specialized paternal breeds (D, P). Piglets obtained during interbreeding hybridization have a heterosis effect in feeding and meat traits 9-11 % higher compared with purebred parents. In connection with the need to increase the efficiency of domestic pig breeding, scientists at the Research and Practical Center of the National Academy of Sciences of Belarus for Livestock Breeding have developed a new effective system for raising and breeding pigs, based on obtaining competitive parental forms of sows (F1) and paternal forms of boars for hybridization. It is shown that structural transformations in the pedigree and industrial pig breeding of the Republic of Belarus in 2020-2025 and for the period until 2030 will be aimed at further improvement and increase of performance and breeding traits of pigs based on the latest methods of genetics and selection, as well as at construction and commissioning of nuclei farms for maternal and paternal breeds with a total capacity of 3400 breeding sows, as well as 5-6 sow breeding farms with total capacity of 22100 sows. Commissioning of new high-tech capacities will allow to increase the production of high-quality pork within 5 years to 500 thousand tons, or 15.0-18.0 % higher compared to the current level.
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Ullah, Akm Ahsan, and Faraha Nawaz. "Surrogacy-led migration: reflections on the policy dilemmas." Public Administration and Policy 23, no. 2 (2020): 157–71. http://dx.doi.org/10.1108/pap-03-2020-0014.
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PurposeThere is abundant research on surrogacy; however, migration scholars have not addressed surrogacy-driven migration. Policies related to surrogacy and surrogacy-led migration are under-researched. The paper argues that surrogacy-led migration or fertility/reproductive migration constitutes a significant part of mainstream migration. The purpose of this paper is to reflect on the policy dilemmas in various countries.Design/methodology/approachA total of 9 surrogate mothers (4 from India; 2 from Thailand, 2 from Indonesia and 1 from Nepal) and 8 commissioning parents (2 from Japan; 4 from Europe; 1 from the USA; 1 from Australia) and 2 doctors (1 from India and 1 from Thailand) selected on snowball basis were interviewed between 2014 and 2016 by using a checklist.FindingsThe deficiency and inconsistency of laws regarding surrogacy facilitated the growth of the surrogacy market. Therefore, a uniform policy would help to define and improve the surrogacy and surrogacy-led migration management.Originality/valueThis paper demonstrates the interplay of surrogacy and mainstream migration. This is a fresh addition to the study of migration.
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Wray, Jo, Bruce Lindsay, Kenda Crozier, Lauren Andrews, and Janet Leeson. "Exploring perceptions of psychological services in a children's hospice in the United Kingdom." Palliative and Supportive Care 11, no. 5 (2012): 373–82. http://dx.doi.org/10.1017/s1478951512000284.
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AbstractBackground:The provision of emotional and psychological support for all family members who need it is an essential element of holistic palliative care. Within East Anglia's Children's Hospice, teams of professionally trained and experienced workers offer psychosocial support to all family members at all times during the child's and family's journey. However, the effectiveness and appropriateness of current psychosocial provision is unclear, as is the requirement for any additional psychological services.Objective:The purpose of this study was to elicit perceptions about current psychological support within the hospice from a group of stakeholders (parents, hospice staff, and external professionals).Method:Forty-five parents participated in family focus groups, telephone interviews, individual interviews in their home, or a web-based survey. Ninety-five hospice staff (including nurses, carers, play specialists, therapists, and family support practitioners) and 28 external staff (including physicians, nurses, and commissioning managers) were seen using a mixture of focus group and individual meetings. Focus groups and meetings were held at the hospice building or at an external venue. Interviews were recorded and transcribed verbatim and analyzed using thematic coding.Results:Two main themes addressing perceptions of current psychological provision emerged: “understanding psychological support” and “unmet psychological need.” Subthemes linked to support included choice, staff roles and labels, communication, and flexibility, whereas the themes within unmet need had a stronger focus on people and problems.Significance of results:Understanding different user perspectives is an important first step in enhancing current psychological provision; operationalizing the findings will be challenging.
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Thaldar, Donrich. "The in Vitro Embryo and the Law: The Ownership Issue and a Response to Robinson." Potchefstroom Electronic Law Journal 23 (January 17, 2020): 1–20. http://dx.doi.org/10.17159/1727-3781/2020/v23i0a6217.
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In 2012 the Minister of Health made the Regulations Relating to the Artificial Fertilisation of Persons, which provide that the woman who intends to be made pregnant with an in vitro embryo owns such an embryo and can control the embryo's fate in specified ways. Given that in vitro embryos are outside the woman's body, the rationale for these provisions cannot be to protect the woman's bodily integrity. These provisions are, however, problematic from a constitutional perspective, as they: exclude fathers across the board, and impede the right of all intended parents who will not gestate the pregnancy, like surrogacy commissioning parents, to make decisions regarding reproduction – which include the right not to reproduce and hence to veto the further use of an in vitro embryo for reproductive purposes. Robinson argues that the legislative intent with the 2012 Regulations was not to establish ownership of in vitro embryos, and that in vitro embryos are not legal objects (or subjects), but rather form part of the legal subjectivity of their parents. I respond that the language used in the relevant provision is plain and clear in establishing ownership of in vitro embryos, and that in vitro embryos are therefore legal objects. I further suggest that Robinson's proposition of in vitro embryos forming part of the legal subjectivity of their parents may address the gender equality concern with the 2012 Regulations, but that it in turn causes other problems. In particular, Robinson's rationale for his proposition is problematic, as it appears to conflate the embryo with the prospective child. I rely on the important recent judgment in Ex Parte KAF 2019 2 SA 510 (GJ) that held explicitly that the in vitro embryo should not be equated with the prospective child. Finally, I respond to Robinson's critique of my 2005 article, by clarifying the research questions and answers of that article. I highlight the importance of the moral status of the in vitro embryo to legal and ethical debates relating to the in vitro embryo, and invite academic debate on the topic.
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Shetty, S., N. Kennea, P. Desai, S. Giuliani, and J. Richards. "Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England." Annals of The Royal College of Surgeons of England 98, no. 1 (2016): 56–60. http://dx.doi.org/10.1308/rcsann.2016.0034.
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Introduction There is a lack of knowledge on the average length of stay (LOS) in neonatal units after surgical repair of common congenital anomalies. There are few if any publications reporting the activity performed by units undertaking neonatal surgery. Such activity is important for contracting arrangements, commissioning specialist services and counselling parents. The aim of this study was to describe postnatal LOS for infants admitted to a single tertiary referral neonatal unit with congenital malformations requiring surgery. Methods Data on nine conditions were collected prospectively for babies on the neonatal unit over a five-year period (2006–2011). For those transferred back to their local unit following surgery, the local unit was contacted to determine the total LOS. Only those babies who had surgery during their first admission to our unit and who survived to discharge were included in the study. Cost estimates were based on the tariffs agreed for neonatal care between our trust and the London specialised commissioning group in 2011–2012. Results The median LOS for the conditions studied was: gastroschisis 35 days (range: 19–154 days), oesophageal atresia 33 days (range: 9–133 days), congenital diaphragmatic hernia 28 days (range: 7–99 days), intestinal atresia 24 days (range: 6–168 days), Hirschsprung’s disease 21 days (range: 15–36 days), sacrococcygeal teratoma 17 days (range: 12–55 days), myelomeningocoele 15.5 days (range: 8–24 days), anorectal malformation 15 days (range: 6–90 days) and exomphalos 12 days (range: 3–228 days). The total neonatal bed day costs for the median LOS ranged from £8,701 (myelomeningocoele) to £23,874 (gastroschisis). The cost of surgery was not included. Conclusions There is wide variation in LOS for the same conditions in a single neonatal unit. This can be explained by different types and severity within the same congenital anomalies, different surgeons and other clinical confounders (eg sepsis, surgical complications, associated anomalies). These data will enable us to give more detailed information to families following prenatal or postnatal diagnosis. They also allow more detailed planning of resource allocation for neonatal admissions.
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Lehane, David, Philip Oliver, Caroline Mitchell, and Christopher Burton. "Interpreter costs across clinical commissioning groups in England 2017–2018: a cross sectional survey using ‘freedom of information’ requests." British Journal of General Practice 70, suppl 1 (2020): bjgp20X711377. http://dx.doi.org/10.3399/bjgp20x711377.
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BackgroundProfessional interpreters are considered to be the gold standard when meeting the needs of patients with limited English proficiency (LEP) in primary care. The models by which CCGs supply interpreting services (IS) vary. Many CCGs use external commercial IS, while other CCGs commission ‘not for profit’ services such as the Advocacy and Interpreting Service in Tower Hamlets, the Sussex Interpreting Service, and the decommissioned Sheffield Community Access and Interpreting Service. Research on comparative costs and needs of the LEP population is lacking.AimTo compare the costs of interpreting services between CCG’s in England.MethodA cross-sectional study involving CCGs in England. A standardised request was sent to 195 CCGs inviting comment on how much the CCG spent (2017–2018) on IS. The data were plotted against a number of demographic variables (https://fingertips.phe.org.uk) and analysed using regression analysis.ResultsSurvey response rate: 86% of CCGs (n = 169). Of those CCGs who responded, 39% (n = 66) did not hold IS cost data. NHS England spent £2 951 348.16 for IS services for the year 2017–2018. A positive correlation was noted with increased cost of interpreting services when plotted against increasing percentage BME or percentage birth to non-UK parents. However, there were wide variations around correlation of best fit indicating variation in spending between CCGs for similar populations.ConclusionInter CCG variation in correlations between demographic variables and expenditure suggests further research is needed to determine how to optimise and resource safe and equitable IS across the UK population.
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Fenton-Glynn, Claire. "THE DIFFICULTY OF ENFORCING SURROGACY REGULATIONS." Cambridge Law Journal 74, no. 1 (2015): 34–37. http://dx.doi.org/10.1017/s0008197315000203.
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OVER the past 15 years, international surrogacy has grown from a niche practice catering only to a few adventurous couples, to a convenient response to infertility for those who would otherwise be hindered by restrictive national regimes. While the Hague Conference Permanent Bureau continues to debate the desirability, and indeed viability, of an international convention in this area, governments and courts around the world have been confronted by the difficult question of whether to recognise an agreement that takes place legally in another jurisdiction, but which is contrary to their own laws. In this, England is no exception. With approximately 25%. of all surrogacy arrangements now taking place outside its borders, English courts are regularly being asked to confer parenthood on commissioning parents in circumstances in which the statutory requirements have not only not been met, but in some cases flagrantly breached. The latest development in this regard is Re X (A Child) (Surrogacy: Time Limit) [2014] EWHC 3135 (Fam), where the tension between public policy as evinced in the legislation, and the welfare of the child who will bear the burden of any refusal to recognise parenthood, once again came to a head.
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Kitzinger, Jenny, and Celia Kitzinger. "Why futile and unwanted life-prolonging treatment continues for some patients in permanent vegetative states (and what to do about it): Case study, context and policy recommendations." International Journal of Mental Health and Capacity Law 2017, no. 24 (2018): 129. http://dx.doi.org/10.19164/ijmhcl.v2017i24.687.
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In August 2017 a judge sanctioned withdrawal of clinically assisted nutrition and hydration from a patient who had been sustained in a vegetative state for twenty-three years, finding it “overwhelmingly in his best interests” for treatment to stop, allowing him to die. Injured in 1994, this patient had continued to receive life-sustaining treatment long after clinicians, and his family, had abandoned any hope for recovery and with no evidence that he would have wanted to be kept alive this way. Based on interviews with his parents, and the court hearing, we explore how it came about that he received this treatment for so long. We contextualize this in relation to our wider research about the treatment of severely brain injured patients and ask why, despite guidelines, policies and statute concerning best interests decision-making, thousands of patients in permanent vegetative states are similarly maintained in England and Wales without any formal review of whether continuing clinically assisted nutrition and hydration is in their best interests. We consider the implications for ethics, policy and practice in relation to patients with prolonged disorders of consciousness more broadly, highlighting in particular the actions that need to be taken by clinicians, inspection bodies, Clinical Commissioning Groups and Health Boards across England and Wales.
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Simopoulou, M., K. Sfakianoudis, P. Tsioulou, et al. "Risks in Surrogacy Considering the Embryo: From the Preimplantation to the Gestational and Neonatal Period." BioMed Research International 2018 (July 17, 2018): 1–9. http://dx.doi.org/10.1155/2018/6287507.
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Surrogacy is an assisted reproduction-based approach in which the intended parents assign the gestation and birth to another woman called the surrogate mother. The drivers of surrogacy refer largely to infertility, medical conditions, same-sex couples’ parenting, and cases of diversity regarding sexual identity and orientation. Surrogacy consists of a valid option for a variety of conditions or circumstances ranging from medical to social reasons. However, surrogacy may be associated with risks during the preimplantation, prenatal, and neonatal period. It became obvious during the exhaustive literature research that data on surrogacy and its association with factors specific to the IVF practice and the options available were not fully represented. Could it be that surrogacy management adds another level of complexity to the process from the ovarian stimulation, the subsequent IVF cycle, and the techniques employed within the IVF and the Genetic Laboratory to the fetal, perinatal, and neonatal period? This work emphasizes the risks associated with surrogacy with respect to the preimplantation embryo, the fetus, and the infant. Moreover, it further calls for larger studies reporting on surrogacy and comparing the surrogate management to that of the routine IVF patient in order to avoid suboptimal management of a surrogate cycle. This is of particular importance in light of the fact that the surrogate cycle may include not only the surrogate but also the egg donor, sperm donor, and the commissioning couple or single person.
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Joseph, James, and Dr Sr Celine E. "Redefining Motherhood: Problems of Surrogacy in Kishwar Desai’s Origins of Love." SMART MOVES JOURNAL IJELLH 8, no. 2 (2020): 5. http://dx.doi.org/10.24113/ijellh.v8i2.10404.
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There is a great deal concerning the body of woman. The flesh trade is now a legalized business. Organ transplantation fetches lot of money to the middleman. Kishwar Desai presents the story of multi-million business of surrogacy and artificial pregnancy going on in the modern world in her novel Origins of Love. Surrogacy is the recent trend found among the economically backward women in India. Fertility clinics are mushrooming in India. The desire of the couples for a child is exploited to its maximum by the doctors. The need for money to solve some crucial problems in life drives some young women to lend their womb for upbringing the child of some other couple. The money minded doctors and the agents, who supply the surrogate mother and the commissioning parents, make the money-deal to their maximum advantage. There are many issues related to the so called womb trade. Is it not violence against motherhood and womb? Is it not a denial of a child’s maternal care? Who will be the mother to the child? How will a woman simply forget the fruit of her womb? The psychological emptiness the mother feels is so severe that it may create mental imbalance. When the healthy embryo is selected what will be the fate of the rejected embryos? Is it not an abortion outside the womb? This paper presents the problems related to surrogacy in the light of the novel Origins of Love.
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Whitaker, Emilie Morwenna. "Personalisation in children’s social work: from family support to “the child’s budget”." Journal of Integrated Care 23, no. 5 (2015): 277–86. http://dx.doi.org/10.1108/jica-07-2015-0031.
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Purpose – The purpose of this paper is to explore the changing meaning of personalisation from the New Labour era of bespoke, integrated family support to the more recent implementation of personal budgets for disabled children to deliver “choice and control”. The paper explores the discursive change from early help to “intervention”, the shifting conceptualisation of parents and the turn away from family support towards a focus upon individualised commissioning to meet needs. Design/methodology/approach – In addition to a literature review of policy shifts, findings presented are taken from an ethnographic case study of one team of children’s disability social workers. Observations were undertaken of the team in the office space and at meetings, in addition interviews were conducted with all team members and with seven families. An interpretivist and qualitative approach was adopted throughout. Findings – Findings reveal the frontline and familial challenges of delivering choice and control in a climate of austerity and child-centricism. Salient points for integration around families and between organisations as personalisation narrows in scope are also considered. Research limitations/implications – Findings are taken from one case study site; further research in different sites is required to consider the array of understandings and experiences across the social care landscape and to provide a strong empirical baseline. Originality/value – The paper reports on one of the first ethnographic studies of personalisation in children’s services. The paper is of value to practitioners and managers in social care and the NHS. It is also of value to academics exploring the conceptual and practical issues of individualised care.
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Baase, Mathabo. "The Ratification of Inadequate Surrogate Motherhood Agreements and the Best Interest of the Child." Potchefstroom Electronic Law Journal 22 (May 21, 2019): 1–26. http://dx.doi.org/10.17159/1727-3781/2019/v22i0a6083.
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South Africa has developed domestic legislation governing all surrogacy matters within the country. These provisions are contained in Chapter 19 of the Children's Act 38 of 2005.
 In Ex parte MS; In re: Confirmation of Surrogate Motherhood Agreement 2014 2 All SA 312 (GNP), the commissioning parents did not adhere to the requirement provided by Chapter 19. The parties to the (initially informal) surrogacy agreement authorised the artificial fertilisation of the surrogate mother prior to the confirmation of the surrogate motherhood agreement by the court. In considering the best interest of the resultant child, the High Court decided to ratify the inadequate surrogate motherhood agreement.
 This discussion aims to establish whether the court's judgement in Ex parte MS; In re: Confirmation of Surrogate Motherhood Agreement 2014 2 All SA 312 (GNP) was in accordance with the provisions of current legislation and case law. It furthermore aims to answer two primary questions: firstly, whether adjudicators should make use of the best interest of the child when ratifying inadequate surrogate motherhood agreements; and secondly, in what manner the court should go about implementing the best interest of the child when validating inadequate surrogate motherhood agreements.
 It is submitted that courts should refrain from applying the best interest of the child as a constitutional right in inadequate surrogacy matters where the child is yet to be born alive, in accordance with the Digesta Texts. Parties to the invalid agreement should rather be instructed to make use of a section 22 parental responsibilities and rights agreement, a section 28 termination agreement, or adoption as provided for by chapter 15 of the Children's Act.
 
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Shah, Sarit. "P042 Evaluation of ‘let’s talk medicines’ helpline." Archives of Disease in Childhood 104, no. 7 (2019): e2.48-e2. http://dx.doi.org/10.1136/archdischild-2019-nppc.52.
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IntroductionStudies and research have shown that providing patient education through knowledge and counselling of the disease process and subsequent treatment empower patients and carers to improve patient’s health. Through understanding rationale for treatment, implications of non- compliance, non-adherence, disease progression and adverse effects of therapy, pharmacy staff are perfectly placed to empower patients and carers with evidence based knowledge and information to make their own educated decisions regarding therapy. The ‘Let’s Talk Medicines’ telephone service was set up in 2015 for exactly this purpose. It is a dedicated medicines information (MI) service aimed at patients, parents and carers, giving the opportunity to ask questions and obtain advice from specialist paediatric pharmacists about their child’s medicines once leaving the hospital. The services have vastly expanded over the last 2 and half years with the addition of an email address as an alternative means for contact. The helpline number and email address are heavily publicised to parents and carers through posters throughout the hospital, details published on all paediatric discharge summaries and printed information cards given to all outpatients during counselling.AimTo evaluate the service progression by analysing the sheer volume and types of queries over the last 3 years to identify how beneficial the novel service has proven to be.MethodsTo retrospectively analyse data from 3 monthly reports over the last 2.5 years of the service to identify number of calls, emails, types of queries received and users of the service.ResultsThe current service relies on all members of the pharmacy team answering calls on a dedicated patient line on an ad-hoc basis with several specialist pharmacists reviewing queries on a daily basis. Average call durations were between 5 to 8 minutes with more complex queries requiring in depth data search taking up to 30 minutes. All queries are logged on paper and then reviewed on a monthly basis as they are entered onto a database. Since the introduction of the service, the volume of calls received has increased by more than 50% with average of 35 per month in 2015 and 54 in 2017. Originally, the service was designed primarily for patients, parents and carers. Due to the increased recognition, the service has now been expanded to a variety of internal and external healthcare professionals, community practitioners and pharmacies, drug companies, commissioning staff, researchers and students. The types of queries range from supply issues, procurement of unlicensed medicines, to adverse effects, administration advice and complex pharmaceutical queries.ConclusionThe service has grown and developed with focus based around improving patient care, medication adherence and minimising medicines related risks. Through providing accurate, up-to-date and evidence based information its appeal has reached a wider audience including healthcare professionals. Combined with an increase in the number of calls and technological advances, a new email service has been rolled out in 2017, as an alternate means to contact the service. Direct comments from users of the service has shown positive feedback and trust.
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Schneider, Nadja-Christina. "Crossmedia Flows of Documentary Images and the Transnational Communicative Figuration Surrounding Gestational Surrogacy in India." BioScope: South Asian Screen Studies 9, no. 2 (2018): 184–207. http://dx.doi.org/10.1177/0974927618813477.
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The article is based on the assumption that documentary films are an important ‘ channel of mediation’ (Strathern, 2002, Journal of Molecular Biology, 319(4), 985–993) that helps make visible the changing configurations of family, kinship and social reproduction. It further assumes that documentary images of egg donors, medical procedures, fertility clinics, delivery or labouring bodies of surrogates, and handing over of a ‘commodified’ newborn baby to the commissioning parents effectively convey the repercussions that gestational surrogacy has for all the medicalised bodies which are involved in the transnational processes of reproduction. Widely circulated and received documentaries such as Google Baby (2009), House of Surrogates (2013), Ma Na Sapna: A Mother’s Dream (2013) or Can We See the Baby Bump Please? (2013) often function as a starting point and major reference for the debate about this complex issue. But while academic or journalistic articles mostly refer to individual films and on the theme in focus, the different context(s) of the medium itself are less reflected upon. Documentary filmmaking is of course always situated in a specific sociopolitical context, and this in turn shapes the way in which the visual medium make us, as non-experts, see and learn. It also forms the basis of our quest for more knowledge and better understanding, that is, in this case of the transnational entanglements in the field of assisted reproductive technologies. In addition to that, like any other medium or media-related practice today, documentary filmmaking is also embedded in profoundly transformed media environments, networks and communicative practices. In order to understand how information and knowledge about split parenthood and gestational surrogacy is mediated to transnational audiences and framed in public discussions, it is thus necessary to shed light on the interconnectedness of different media forms and framings through which the communication around this complex topic has formed. Instead of a close reading of selected documentaries, the article therefore attempts to trace and contextualise the crossmedial and translocal itineraries of three key images and central tropes that have influenced the framing of transnational reproduction and gestational surrogacy in India significantly: (a) the medical authority-cum-media actor (i.e., internationally well-known fertility expert and doctor in charge, Dr Nayana Patel), (b) the surrogacy hostels and dormitories (i.e., the central symbol of constant surveillance and control of surrogates) and (c) the metaphor of ‘rented/hired wombs’ (i.e., the notion of a passive provision of body parts and understanding of gestational surrogacy as active labour).
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Lilley, Andrew, and Leanne Turner. "ASSESSING THE BENEFITS OF HAVING A SPECIALIST PAEDIATRIC PHARMACIST AND PHYSIOTHERAPIST IN THE COMMUNITY TO IMPROVE CHILDHOOD ASTHMA OUTCOMES." Archives of Disease in Childhood 101, no. 9 (2016): e2.56-e2. http://dx.doi.org/10.1136/archdischild-2016-311535.6.
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IntroductionThe local Clinical Commissioning Group has funded an innovative one-year pilot project to assess the value of providing specialist paediatric pharmacist and physiotherapist support direct to families and health care professionals (GP's, community pharmacists, practice nurses etc.) regarding asthma in the primary care setting. Currently no such support is provided within community setting by physiotherapy or pharmacy.MethodsJoint holistic reviews by the clinical specialist physiotherapist and specialist paediatric pharmacist were performed in the patient's home environment or school. The review involved a thorough respiratory review and in-depth medication optimisation review ensuring patients were on appropriate regimes and using devices appropriately. Specifically, if an inhaler was indicated a device that the patient was comfortable using was chosen. Furthermore, parents, patients, teachers and school support workers were counselled on how to self manage asthma exacerbations. In order to review benefits patients answered the five question asthma control test (score out of 25), a standardised quality of life questionnaire (score out of 92) and hospital admissions were monitored.ResultsAt the six-month stage of the project a total of 42 patients had been reviewed and followed up by the project. During the review period there was a total of 1 hospital admission and 1 attendance to the accident and emergency, this is in comparison to the 8 hospital admissions and 47 accident and emergency attendances with this group of patients in the same period the previous year. All patients had an improvement in outcome measures. The average improvement in asthma control test after intervention was 7 points (30%) and a 30% increase in QoL score. We found that symptomatic children had poor FEF25-75 values (<80%) indicating poor lower airways function possibly due to poor drug deposition. After interventions these scores returned to normal limits (>80%). Compliance to medications regimes was noted to be improved after optimisation.ConclusionsIt can be clearly seen that joint multidisciplinary reviews by physiotherapy and pharmacy can help improve the outcomes of asthma patients. The joint review of inhaler technique in particular was key. Pharmacy services will tend to concentrate on the use of the device itself whereas physiotherapy monitor the strength and depth of breathes taken. It is well known that good drug deposition is key to the success of inhaled medications. By combining pharmacy and physiotherapy both the use of the device and breathing patterns were optimised both contributing to better drug deposition and improved FEF 25–75% reading. Optimisation of medication was also vital. By ensuring the patient was happy with the device they were using and that it had little negative impact on their daily routine compliance with medications was increased. At the six month stage of the pilot this aspect has proven vital to outcomes in asthmatic patients.
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Webb, Edward J. D., Elizabeth Stamp, Michelle Collinson, et al. "Measuring commissioners’ willingness-to-pay for community based childhood obesity prevention programmes using a discrete choice experiment." BMC Public Health 20, no. 1 (2020). http://dx.doi.org/10.1186/s12889-020-09576-7.
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Abstract Background In the UK, rates of childhood obesity remain high. Community based programmes for child obesity prevention are available to be commissioned by local authorities. However, there is a lack of evidence regarding how programmes are commissioned and which attributes of programmes are valued most by commissioners. The aim of this study was to determine the factors that decision-makers prioritise when commissioning programmes that target childhood obesity prevention. Methods An online discrete choice experiment (DCE) was used to survey commissioners and decision makers in the UK to assess their willingness-to-pay for childhood obesity programmes. Results A total of 64 commissioners and other decision makers completed the DCE. The impact of programmes on behavioural outcomes was prioritised, with participants willing to pay an extra £16,600/year if average daily fruit and vegetable intake increased for each child by one additional portion. Participants also prioritised programmes that had greater number of parents fully completing them, and were willing to pay an extra £4810/year for every additional parent completing a programme. The number of parents enrolling in a programme (holding the number completing fixed) and hours of staff time required did not significantly influence choices. Conclusions Emphasis on high programme completion rates and success increasing children’s fruit and vegetable intake has potential to increase commissioning of community based obesity prevention programmes.
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Bryant, Maria, Michelle Collinson, Wendy Burton, et al. "Cluster randomised controlled feasibility study of HENRY: a community-based intervention aimed at reducing obesity rates in preschool children." Pilot and Feasibility Studies 7, no. 1 (2021). http://dx.doi.org/10.1186/s40814-021-00798-z.
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Abstract Background Community-based obesity prevention interventions are often commissioned despite the limited evidence base. HENRY (Health, Exercise, Nutrition for the Really Young) is a programme delivered to parents of preschool children across the UK. Early evidence suggests that it may be effective, but a robust evaluation has not been conducted. We initiated a systematic evaluation of HENRY by studying the feasibility of conducting a multi-centre definitive trial to evaluate its effectiveness and cost-effectiveness to prevent obesity. Objectives were to assess the feasibility of recruiting local authorities, centres and parents; test processes and time required to train and certify intervention staff; explore HENRY commissioning processes; identify potential sources (and associated impact) of contamination; and consider the feasibility of trial procedures. Methods We conducted a multi-centre, open labelled, two group, prospective, cluster randomised, controlled, feasibility study, with embedded process evaluation and pre-defined criteria for progression to definitive trial. We sought to recruit 120 parents from 12 children’s centres, across two UK local authority (government) areas. Within each local authority, we planned to randomise three centres to HENRY and three to ‘standard care’ control. Our plan was to collect data in family homes at baseline and 12 months, including parent and child height and weight, and parent-reported questionnaires on self-efficacy, feeding, eating habits, quality of life and resource use. Contamination, implementation and study acceptability were explored using parent interviews. Results We recruited two local authorities and 12 children’s centres within eight months. One hundred and seventeen parents were recruited (average 3.9 parents per programme) and follow-up data were collected from 85% of participants. Process data from 20 parents and 24 members of staff indicate that both would benefit from more detail about their involvement as participants, but that methods were acceptable. Contamination was likely, though the impact of this on behaviour was unclear. Conclusion Our findings indicate that a cluster RCT of HENRY to assess its effect on childhood obesity prevention is feasible. This study has allowed us to design a pragmatic definitive trial with minimal bias, taking account of lessons learnt from conducting evaluation research in public health settings. Trial registration ClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017.
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Dyer, Clare. "UK should change law on surrogacy to help commissioning parents, report says." BMJ, November 23, 2015, h6302. http://dx.doi.org/10.1136/bmj.h6302.
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Warner, Nell. "Improvements in Parental Emotional Well-Being During Home Visiting Support: What Works for Whom?" British Journal of Social Work, October 23, 2020. http://dx.doi.org/10.1093/bjsw/bcaa117.
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Abstract Home visitors can support parents who have low levels of emotional well-being. While support may be effective for some families, the circumstances in which it is effective are less well understood. Longitudinal administrative data from Home-Start UK were analysed to identify how the nature of support was related to changes in parental emotional well-being, and whether these effects were the same for families with different risk factors. Sub-groups were identified of people experiencing problems with various aspects of emotional well-being: mental ill health (n = 1,289), social isolation (n = 1,413) and low self-esteem (n = 1,400). Multiple linear regression models were used to explore the relationships between the nature of support and the rate of improvement. These effects were considered in subgroups of families with domestic violence problems, disabled parents, a disabled child, large family sizes or multiple risks. More frequent visits and support being provided by paid workers, as opposed to volunteers were related to faster improvements. Paid worker support was particularly related to faster improvements in families with domestic abuse, disabled parents and multiple risks. However, volunteer support seemed just as effective for large families and those with disabled children. These findings have implications for those providing and commissioning home visiting services.
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"THE CONSTITUTIONAL AND LEGAL BASES OF COUNTERACTING BULLYING IN UKRAINE." Journal of V. N. Karazin Kharkiv National University, Series "Law", no. 29 (2020). http://dx.doi.org/10.26565/2075-1834-2020-29-10.
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The article describes bullying as a constitutionally legal tort that violates fundamental human rights. It has been identified that bullying is a conflict that occurs among adolescents in the process of fighting for authority and leadership. Given that the established administrative responsibility for the commissioning of bullying does not give an effective result in counteracting this phenomenon, it is proposed to bring the counteraction of bullying to the constitutional and legal level. To this end, it is proposed to amend the National Human Rights Policy Framework and the National Strategy on Human Rights accordingly. It is emphasized that the legal policy of the state should be aimed at eliminating the causes and conditions of the emergence of bullying, so that not only domestic violence should be combated, but also the growing generation should be educated in the spirit of respect for human rights. The study proposes to supplement Article 173-4 of the Code of Administrative Offenses of the "Bullying (harassment) of a participant in the educational process" as a qualifying characteristic of a person with disability, since in 50% children become victims of bullying because of their appearance, including through physical disabilities. It is noted that in Ukraine both public authorities and public organizations are engaged in counteraction to bullying. A special role is assigned to the Ministry of Justice of Ukraine, which conducts preventive work, which includes lectures, trainings, development of campaign materials, videos, organization of the All-Ukrainian Week of Countering Bullying. It is proposed to introduce the practice of "logging" cases of bullying at school to describe the situation; attention should be paid to educational programs for teachers regarding the overall study of the issue of bullying; conduct informative discussions with parents about bullying; deliver lectures / trainings with the involvement of a school psychologist to counter bullying. Organizing leisure activities for teenagers is also a sufficiently effective way of preventing bullying, creating free sports sections contributes to channeling adolescents' energy into a peaceful channel. The state's legal policy should be directed not at punishing the aggressor, but at preventing bullying.
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Rautenbach, Christa. "Editorial." Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad 18, no. 2 (2016). http://dx.doi.org/10.17159/1727-3781/2015/v18i2a495.
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This issue of PER consists of 11 articles and one case note dealing with a wide range of topics in the global legal landscape. Monray Botha analyses the responsibility of South African companies towards their employees for achieving social justice in the corporate world. Fawzia Cassim examines how identity thieves use the personal information of individuals to commit identity fraud and theft, and looks at legislative solutions introduced in South Africa, the United States of America, the United Kingdom and India to combat identity theft crimes. Howard Chitimira discusses the regulation of market manipulation in Australia with the purpose of assessing if lessons can be learnt from it for South Africa. Leentjie de Jong deals with parenting coordination, a new alternative dispute resolution process to alleviate the negative effects of high-conflict co-parenting cases on the South African court system and the children of divorce. Yvonne Donders investigates the cultural dimensions of the right to health endorsed by several treaty provisions and treaty monitoring bodies and comes to the conclusion that states can implement the right to the enjoyment of the highest attainable standard of health in a culturally sensitive and responsible way by consulting cultural communities and individuals. Joel Modiri reflects on the development of a radical democratic political theory that shifts analytical and conceptual registers in which the relationship between law and poverty is conventionally addressed and argues for the creation of a radical alternative that defatalizes the present. Stephen Peté's unconventional historical examination of the Barberton Prison Complex during the 1980s is published in two parts. The first part deals with the deaths of three prisoners and the injury of many others during a day of violence at the Barberton prison farm on 29 December 1982 and the second part examines a string of violent incidents which occurred within the Barberton Prison Complex during the course of 1983, leading to nine inmate deaths. Robbie Robinson raises the question of whether or not the constitutionally entrenched right to make decisions concerning reproduction may be limited, as the continued existence of the State may ultimately be jeopardised if the size of the population is not limited to the available levels of subsistence. Olufemi Soyejudiscusses the incapacity of low-income countries to realise the Millennium Development Goals and seeks to make a case for the adoption of a development-driven approach to law as a linchpin for the post-2015 development agenda. Carmel van Niekerk considers the constitutionality of section 294 of the Children's Act 38 of 2005, which permits commissioning parents to engage in surrogacy arrangements only in instances where they are able to provide a genetic link to their future offspring. In the only case note, Salona Lutchman evaluates the implications ofSS v Litako 2014 SACR 431 (SCA): A Clarification on Extra Curial Statements and Hearsay.