Evaluating best value through clustered benchmarking in UK local government: building control services
In: International journal of public sector management: IJPSM, Band 15, Heft 6and7
ISSN: 0951-3558
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In: International journal of public sector management: IJPSM, Band 15, Heft 6and7
ISSN: 0951-3558
In: Journal of human development and capabilities: a multi-disciplinary journal for people-centered development, Band 22, Heft 2, S. 360-378
ISSN: 1945-2837
Loneliness has emerged as a problem for individuals and society. A group whose loneliness has recently grown in severity and visibility is students in higher education. Complementing media reports and surveys of students' lockdown loneliness, this paper presents qualitative research findings on students loneliness during the COVID-19 pandemic. It explores the how, why and where of student loneliness through research co-produced with undergraduate and postgraduate students. Student-researchers investigated loneliness as a function of relationships and interactions through self-interviews and peer interviews (n = 46) and through objects, chosen by participants to represent their experiences of lockdown. This research led to three conclusions, each with a geographical focus. First, as the spaces in which students live and study were fragmented, interactions and relationships were disrupted. Second, students struggled to put down roots in their places of study. Without a sense of belonging—to the city and institution where they studied, and the neighbourhood and accommodation where they lived—they were more likely to experience loneliness. Third, many students were unable to progress through life transitions associated with late adolescence including leaving home, learning social skills, forming sexual relationships and emerging into adulthood. Those facing bigger changes such as bereavement struggled to process these events and spoke of feeling 'neither here nor there'—in limbo. But students displayed resilience, finding ways to cope with and mitigate their loneliness. Their coping strategies speak to the efforts of policymakers and practitioners—including those in universities, government, health and wellbeing services, and accommodation services—who are seeking ways to tackle students' (and other peoples') loneliness.
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After 2 decades of cooperative governmental reforms on water, Australia established a world-leading hybrid governance system involving top-down regulation, water markets and water planning with stakeholder cooperation. Yet, with the abolition of the National Water Commission (NWC) in 2015,1 there is a growing belief that Australia may have "dropped the ball on water". At this critical juncture, it is both significant and timely to examine the challenges and future direction of Australia's water reforms. In light of these concerns, in December 2015, the Faculty of Law and the Connected Waters Initiative Research Centre at UNSW Australia hosted a group of water law specialists to consider the key successes and limits of Australia's hybrid water governance system, as well as to explore how best to steer water governance towards a more sustainable future path. At the conclusion of the workshop, it was apparent that although Australia has come a long way in water management under the NWI, the design and implementation of this national reform does not appear sufficient to meet future water challenges. Further reforms and changes will be required and this article sets out 10 priorities that should be considered and addressed by governments, civil society and industries if we are to achieve a sustainable water future for Australia.
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Background Sepsis and severe focal infections represent a substantial disease burden in children admitted to hospital. We aimed to understand the burden of disease and outcomes in children with life-threatening bacterial infections in Europe. Methods The European Union Childhood Life-threatening Infectious Disease Study (EUCLIDS) was a prospective, multicentre, cohort study done in six countries in Europe. Patients aged 1 month to 18 years with sepsis (or suspected sepsis) or severe focal infections, admitted to 98 participating hospitals in the UK, Austria, Germany, Lithuania, Spain, and the Netherlands were prospectively recruited between July 1, 2012, and Dec 31, 2015. To assess disease burden and outcomes, we collected demographic and clinical data using a secured web-based platform and obtained microbiological data using locally available clinical diagnostic procedures. Findings 2844 patients were recruited and included in the analysis. 1512 (53·2%) of 2841 patients were male and median age was 39·1 months (IQR 12·4–93·9). 1229 (43·2%) patients had sepsis and 1615 (56·8%) had severe focal infections. Patients diagnosed with sepsis had a median age of 27·6 months (IQR 9·0–80·2), whereas those diagnosed with severe focal infections had a median age of 46·5 months (15·8–100·4; p<0·0001). Of 2844 patients in the entire cohort, the main clinical syndromes were pneumonia (511 [18·0%] patients), CNS infection (469 [16·5%]), and skin and soft tissue infection (247 [8·7%]). The causal microorganism was identified in 1359 (47·8%) children, with the most prevalent ones being Neisseria meningitidis (in 259 [9·1%] patients), followed by Staphylococcus aureus (in 222 [7·8%]), Streptococcus pneumoniae (in 219 [7·7%]), and group A streptococcus (in 162 [5·7%]). 1070 (37·6%) patients required admission to a paediatric intensive care unit. Of 2469 patients with outcome data, 57 (2·2%) deaths occurred: seven were in patients with severe focal infections and 50 in those with sepsis. Interpretation Mortality in children admitted to hospital for sepsis or severe focal infections is low in Europe. The disease burden is mainly in children younger than 5 years and is largely due to vaccine-preventable meningococcal and pneumococcal infections. Despite the availability and application of clinical procedures for microbiological diagnosis, the causative organism remained unidentified in approximately 50% of patients.
BASE
Background: Sepsis and severe focal infections represent a substantial disease burden in children admitted to hospital. We aimed to understand the burden of disease and outcomes in children with life-threatening bacterial infections in Europe. Methods: The European Union Childhood Life-threatening Infectious Disease Study (EUCLIDS) was a prospective, multicentre, cohort study done in six countries in Europe. Patients aged 1 month to 18 years with sepsis (or suspected sepsis) or severe focal infections, admitted to 98 participating hospitals in the UK, Austria, Germany, Lithuania, Spain, and the Netherlands were prospectively recruited between July 1, 2012, and Dec 31, 2015. To assess disease burden and outcomes, we collected demographic and clinical data using a secured web-based platform and obtained microbiological data using locally available clinical diagnostic procedures. Findings: 2844 patients were recruited and included in the analysis. 1512 (53·2%) of 2841 patients were male and median age was 39·1 months (IQR 12·4–93·9). 1229 (43·2%) patients had sepsis and 1615 (56·8%) had severe focal infections. Patients diagnosed with sepsis had a median age of 27·6 months (IQR 9·0–80·2), whereas those diagnosed with severe focal infections had a median age of 46·5 months (15·8–100·4; p<0·0001). Of 2844 patients in the entire cohort, the main clinical syndromes were pneumonia (511 [18·0%] patients), CNS infection (469 [16·5%]), and skin and soft tissue infection (247 [8·7%]). The causal microorganism was identified in 1359 (47·8%) children, with the most prevalent ones being Neisseria meningitidis (in 259 [9·1%] patients), followed by Staphylococcus aureus (in 222 [7·8%]), Streptococcus pneumoniae (in 219 [7·7%]), and group A streptococcus (in 162 [5·7%]). 1070 (37·6%) patients required admission to a paediatric intensive care unit. Of 2469 patients with outcome data, 57 (2·2%) deaths occurred: seven were in patients with severe focal infections and 50 in those with sepsis. Interpretation: Mortality in children admitted to hospital for sepsis or severe focal infections is low in Europe. The disease burden is mainly in children younger than 5 years and is largely due to vaccine-preventable meningococcal and pneumococcal infections. Despite the availability and application of clinical procedures for microbiological diagnosis, the causative organism remained unidentified in approximately 50% of patients.
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