Officer Recommendations Research Articles

“Now, with a bit more knowledge, I understand why I'm asking those questions.” midwives’ perspectives on their role in the Greater Manchester health and social care partnership's programme to reduce alcohol exposed pregnancies

ObjectiveTo understand midwives’ perspectives regarding the effect of a programme of activities aimed at reducing alcohol exposed pregnancies at two NHS Trusts in Greater Manchester. The programme included new protocols for screening, a referral pathway for specialist support and alcohol training for midwives. Design and participantsSemi-structured interviews were conducted with 6 midwives working in antenatal care at the two Trusts over the telephone and via video conferencing. A review of the literature provided insight into contemporary midwifery practice. The Theory of Planned Behaviour was used to inform the interview schedule design. Data analysis used a Framework Approach and drew on a priori themes from the literature review. FindingsParticipating midwives described objective screening practice using a validated tool on multiple antenatal occasions and were confident to discuss alcohol. Participants were cognisant of local and national policies and guidelines. Discussing alcohol was viewed as important and part of the midwife's role, beliefs which supported participants’ intention to practice in line with new protocols. Maternal under-reporting and denial of alcohol consumption was a key barrier to providing effective care. Key conclusions and implications for practiceThe professional practice of participants was more in keeping with the Chief Medical Officer's recommendations than that reported in recent research from the UK and other high-income countries. However, from this small study it is not possible to attribute this directly to the local Reducing Alcohol Exposed Pregnancies programme. Training to prepare midwives to elicit more accurately details of maternal alcohol consumption may improve the efficacy of the programme.

Investigating whether the amount of physical activity in children aged 5–18 admitted for inpatient physiotherapy matches the NICE guidelines (PH17)

Purpose: The Chief Medical Officer's recommendation for children is to do a minimum of 60 min of moderate to vigorous physical activity (PA) daily. This should include weight-bearing activities to improve bone health. In addition, children should complete muscle strength and flexibility activities at least twice a week.

Problems Related to the Siting of the Laboratory Building for Civil Engineering Department at the University of Warmia and Mazury in Olsztyn, Poland

This paper deals with the conditions underlying and the problems arising from the siting of a building with specialist laboratories in a developed part of the university campus in Olsztyn, Poland. The topography of the terrain and the need to house civil engineering laboratories in the planned building had an immense impact on the shape of the building and consequently on its foundations, whose dimensions responded to the ground conditions and the specification of various loads they would have to support, including the equipment for the laboratories. The siting of a building as a step in the construction process entails several problems, which are first taken into consideration at the stage of making preliminary concept plans and are subsequently verified while working on the final construction plan. The required information included geotechnical documentation, survey of the ground conditions and the data regarding the predicted loads on the building, necessary to select the right type of foundations. All these problems grow in importance when dealing with such unique buildings like the discussed example of a laboratory building for the Civil Engineering Department, built on a site within a conservation zone on the campus of the University of Warmia and Mazury in Olsztyn, Poland. The specific character of the building and the specialist equipment with which it was to be furnished (a resistance testing machine, a 17-meter-long wave flume) necessitated a series of analyses prior to the siting of the building and selecting suitable foundations. In turn, the fact that the new building was to be erected in the conservation zone meant that collaboration with the Heritage Conservation Office had to be undertaken at the stage of making the plan and continued during the construction works. The Heritage Officer's recommendations concerning the building's shape, divisions, dimensions, materials used, etc., created a situation where the team of designers and architects had to become engaged in the process of landscape and spatial management. The above requirements concerned the functions of the building and its siting on a land parcel that was difficult to handle, also because of the protected trees growing there. Other constraints included the small size of this site, the developed surroundings, and the pre-defined programme of functions and use of the new building. On the other hand, the siting of the planned building had to be accommodated to the existing underground infrastructure (utilities). All the above circumstances made the task difficult and demanded good coordination between individual teams of engineers and architects, both at the stage of making the plan and during the construction works.

Elucidating the Factors that Influence Parole Decision-Making and Violent Offenders’ Performance on Parole

A discretionary parole decision-making process is maintained in multiple jurisdictions internationally. There is a lack of contemporary research examining the factors that influence discretionary parole decisions, particularly in an Australian context. Moreover, there is no known research examining the relationship between these factors and the likelihood an offender will successfully complete their parole order. The current study investigated which factors were significantly associated with: (1) the parole decisions made by the Adult Parole Board of Victoria, Australia; and (2) the cancellation of an offender's parole order, in a sample of 146 violent offenders. Four variables emerged as significant predictors of the parole decision: aggressive disciplinary incidents; the Violence Risk Scale (VRS) total score; the Community Corrections Officer's (CCO) recommendations for release; and confirmed accommodation. At the multivariate level, the VRS total score and the CCO's recommendations remained significant predictors. With regard to parole cancellation, a range of factors were significant at the bivariate level; these included: a history of drug abuse; total prior convictions; aggressive disciplinary incidents; the VRS total score; previous parole cancellations; the CCO's recommendations; confirmed accommodation; and family support. However, family support emerged as the most important predictor in multivariate analysis. These findings provide valuable feedback to members of parole boards regarding the factors that influence their release decision and the factors subsequently linked to parole cancellation.

Commentary on: "Physical activity education in the undergraduate curricula of all UK medical schools. Are tomorrow's doctors equipped to follow clinical guidelines?".

Commentary on: "Physical activity education in the undergraduate curricula of all UK medical schools. Are tomorrow's doctors equipped to follow clinical guidelines?".

Uptake of the H1N1 vaccine by maternity staff at a university hospital in the UK

⁎ Corresponding author. The Maternity Centre, University Hospital of North Staffordshire, Stoke-on-Trent, Staffordshire ST4 6QG, UK. Tel.: +44 1782672377; fax: +44 1782672137. E-mail address: suzystokes@doctors.org.uk (S. Stokes). Vaccinationofmedical staff againstviruses suchasH1N1 influenza isan importantmechanism inpreventing the spreadofdisease to, andbetween, vulnerable hospitalized patients and the wider community. In October 2009, the Royal College of Obstetricians and Gynecologists supported the Chief Medical Officer's recommendation that “all frontline healthcare professionals should beprioritised to receive theH1N1vfluvaccine tohelp protect themselves and the national health infrastructure” [1]. Over a 2-week period in January 2010, an anonymous paper survey was undertaken of all staff at the Maternity Centre of the University Hospital of North Staffordshire, Stoke-on-Trent, UK. Respondents were required to confirm their age, occupation, smoking status, whether they were offered the H1N1 vaccine and, if so, by whom, whether they accepted it, and the reasons for their decision. Ninety-seven of 250 questionnaires were returned by 11 (11.3%) doctors, 45 (46.4%) midwives and nurses, 21 (21.6%) healthcare support workers, and 20 (20.6%) administrative/other staff. The mean age of the respondents was 41.7±11.2 years (range, 19–66 years); 91 (93.8%) respondents were female and 10 (10.3%) were smokers. Ninety (92.8%) respondents had been offered the vaccine: 41 (45.6%) by the Occupational Health Department; 25 (27.8%) by their manager; 4 (4.4%) by their general practitioner; 9 (10.0%) by a different source; 6 (6.7%) by multiple sources; and 5 (5.6%) by unknown sources. Of the respondents who were offered the vaccine, 48 (53.3%) accepted it (comparedwith40.3%ofhealthcareworkers across England [2]), ofwhom 31 (64.6%) had received written information about the vaccine. Common reasons for acceptance included general concerns about H1N1 influenza (29 [60.4%]); concern after receiving information from a leaflet/website/ television/newspaper (19 [39.6%]); encouragement from friends/relatives (8 [16.7%]); and advice from doctors/midwives (7 [14.6%]). Respondents could give more than 1 reason for accepting the vaccine. Forty-two (46.7%) of the respondents who were offered the vaccine declined it, ofwhom2wereunwell, 1 alreadyhadconfirmedH1N1, and3 declared allergies. Of the remaining36, 17 (47.2%)were subsequently reoffered the vaccine on another occasion. The main reasons for declining the vaccine were concerns over safety and testing, negative experiences of friends/colleagues, and a perceived lack of risk of H1N1 influenza (Fig. 1). Respondents could select more than 1 reason for declining the vaccine. Other studies have shown these, in addition to fears over adverse effects and pain, to be barriers to receiving the vaccine [3–5]. It is clear from the present study that information regarding vaccine testing and safety should be more widely available and focus on dispelling myths about the vaccine [3,5]. Ideally, information would be conveyed via multimedia campaigns tailored to specific workplace environments (e.g. where healthcare professionals interact with mothers who are at risk from the virus). By identifying and tackling common reasons for declining vaccination, the uptake of influenza vaccines in future epidemics could be improved. Thiswouldenhance the efficacyof herd immunityand reduce the healthcare burden of the disease in those most at risk [1,2].

1456 A Survey of Paediatricians Practices and Knowledge About Pneumococcal Vaccines in High Risk Children Before the Era of Universal Immunisation

Aims and Background: We aimed to assess the knowledge and practice of paediatricians in the Trent region of England about the Chief Medical Officer's (CMO) recommendations for the pneumococcal vaccines (PV) to high-risk children before the introduction of the vaccine into the routine universal immunisation programme in Sept 2006. Methods and Design: A total of 68 self-administered questionnaires were returned from a total of 100 posted out to paediatricians in the Trent region. Results: 89% of the paediatricians were aware of the CMO's recommendations of pneumococcal and influenza vaccines to high risk children. The most correctly identified high risk groups for PV were children with asplenia / splenic dysfunction (71%), chronic lung disease (69%), previous invasive pneumococcal disease (65%), congenital heart disease (63%), neuromuscular diseases (59%), nephrotic syndrome (57%), cystic fibrosis (54%) and chronic heart failure (54%). Table 1 The least correctly identified high-risk groups were children previously admitted for asthma or a lower respiratory tract disease (9% each), cirrhosis (28%), patients with CSF shunts (31%), following renal transplant (37%), on chemotherapy or steroids (38%) and chronic liver diseases (38%). Conclusion: Most paediatricians were aware of the CMO's recommendations on pneumococcal vaccines for high-risk children. This knowledge however was poorly translated into correct advice given to patients. The introduction of PV into the universal immunisation schedule would enable all the high-risk children to be optimally protected and not subjected to the unreliable knowledge of their busy paediatricians and ”postcode lottery” effect.

‘Doctor, how much physical activity should I be doing?’: how knowledgeable are general practitioners about the UK Chief Medical Officer's (2004) recommendations for active living to achieve health benefits?

In 2004, the UK Chief Medical Officer (CMO) published new recommendations regarding active living to achieve health benefits. For general health, adults should achieve at least 30min of at least moderate intensity physical activity per day on at least five days of the week, while the minimum requirement for children and young people is at least 60min. In addition, it was stated that, for many people, 45–60min of moderate intensity physical activity per day would be necessary to prevent the development of obesity. Given that physical inactivity and obesity have become serious public health concerns, coupled with the recent National Institute for Clinical Excellence public health guidance on physical activity which recommended that primary care practitioners should take every opportunity to

Human Embryonic Stem Cell Research

It is generally acknowledged that research on stem cells derived from human embryos has the potential to dramatically increase our understanding and treatment of many common diseases. All clinical and research work involving human embryos in the UK is under the tight control of the Human Fertilisation and Embryological Authority (HFEA). Strict adherence to the HFEA Code of Practice ensures that the interests of patients, and their potential children, always remain priorities. All clinical and laboratory procedures involving human embryos are only permitted if the couple have given prior informed, written consent. Research on embryos that are not suitable for infertility treatment and would otherwise be discarded, is considered to be highly desirable. Already many couples have given consent for research using their embryos. It is the expressed wish of these couples that their embryos are used to progress research. The British Fertility Society represents over 800 doctors, scientists, nurses, counsellors and patients who are principally involved in the provision of fertility treatment in the UK. The expertise of these practitioners is an integral part of future stem cell research since it is spare embryos, created within fertility units, generously donated by infertility couples, which would be used as a source of stem cells. The Society has therefore examined all the implications of this research, both as they affect our patients directly and as they affect the wider community. On the basis of these considerations, we strongly support the Chief Medical Officer's recommendation in the UK to allow research in this area, which we anticipate will lead to new treatments for many devastating clinical problems. The public can be reassured that infertile couples will not be disadvantaged by such research.

Prescription of adrenaline auto-injectors for potential anaphylaxis—a population survey

Objective. To assess the quality of training provided to parents of children prescribed adrenaline auto-injector devices, adherence to the Chief Medical Officer's recommendation regarding specialist referral, and effect of allergies on quality of life. Setting. Middlesbrough, Redcar and Cleveland districts in North-east England. Design. Postal questionnaire to parents of all children prescribed an auto-injector in the area ( n=154). Results. One hundred and seven parents replied. General practitioners were the source of initial prescription for 30 children. Fifty-one children were not referred to a specialist allergy clinic. Four parents said that they had received no training in the use of the device. Dummy auto-injectors were not used to train 51 parents. Forty-six families were not given the opportunity to retrain. Eleven parents had low or very low confidence in the use of the device, and 13 parents were unsure when to use it. Quality of life was significantly affected. Sixteen children were bullied as a result of their allergy. Thirty parents felt that their child could not do something they really enjoyed as a result of the allergy, and 39 parents felt that their own lifestyle was affected. Conclusion. The impact of the prescription of auto-injector devices should not be underestimated. National guidelines regarding specialist referral were often not followed, and this needs to be addressed by primary care organizations. Quality of training issues needed to be addressed and this has led to re-organization of services in our district.

The Probation Officer's Recommendation in His “Investigation Report”

Abstract Our purpose in this study was to review empirically the Israeli probation officer's recommendation in his “investigation report” concerning offenders of the 18-21 year age group. We studied the factors influencing the probation officer's recommending probation vs. refraining from a probation recommendation. The research variables were based on the following four models: the “diagnostic-rehabilitation” model, the “prognostic-public defense” model, the “organizational” model, and the “conflict” model. Our findings did not verify the diagnostic-rehabilitation hypothesis, though special legal and structural arrangements have been made in Israel for this age group in order to facilitate the rehabilitation of those belonging to it. The conflict model hypothesis was verified to only a limited degree. Our findings indicated the predominance of the prognostic-public defense model hypothesis and also of the organizational model hypothesis.

The probation officer's recommendation in his “investigation report”

The probation officer's recommendation in his “investigation report”

Race and Plea Bargained Outcomes: A Research Note

Peterson and Hagan (1984) argue that the influence of race on criminal sentencing must be considered within specific contexts and in varying social settings. The adjudication of male burglary defendants is analyzed within the context of plea negotiations and between southern and nonsouthern judicial jurisdictions. In the southern jurisdictions, the odds of imprisonment markedly increase among defendants who are: (1) racial minorities or (2) have been previously convicted of a felony. Support is given to Peterson and Hagan's contention that the effect of race on criminal sentencing is context specific. Considerable controversy surrounds the understanding of the effect of race on criminal sentencing. Analyses of the race-sentencing link find that harsher sentences are typically imposed on minority defendants (Petersilia 1985; Unnever 1982; Welch, Spohn & Gruhl 1985). However, the impact of the defendant's race on sentencing outcomes is shown to be diminished by: (a) the nondiscriminatory attitude of the judge (Gibson 1978); (b) the victim's race (LaFree 1980; Paternoster 1984; Radelet 1981); (c) the probation officer's recommendation (Myers 1979; Unnever, Frazier & Henretta 1980); (d) urban-rural court setting (Hagan 1977); (e) region of the United States (Kleck 1981); and (f) pretrial release status (Clarke & Kurtz 1983). *This is a revision of a paper read at the 1985 meetings of the American Sociological Association. The data were made available by the Inter-University Consortium for Political and Social Reseach. The data for the study Plea Bargaining in the United States, 1978 were originally collected by Herbert S. Miller, William McDonald, and James A. Cramer. Neither the collector of the original data nor the Consortium bear any responsibility for the analyses or interpretations presented here. We thank Colin Loftin and the anonymous referees for their insightful critiques of an earlier version of this paper. Address correspondence to John A. Humphrey, Department of Sociology, University of North Carolina, Greensboro, NC 27412. ? 1987 The University of North Carolina Press

Presentence reports: The utility of information to the sentencing decision.

This study investigated the use made by judges of background information provided in presentence reports in reaching their sentencing decisions. The presentence reports were furnished in a number of modified forms during an experimental manipulation in a real-life setting. By obtaining judges' provisional decisions during their reading of the report, along with their indications of what they found useful, the influence of different sections of information in the report was determined. All sections were used by judges to some extent. The recommendation section was analyzed in some detail; while there was high agreement between the probation officer's recommendation and the judge's final disposal, judges tended to rate the recommendation low in terms of usefulness. However, analysis of changes to intended disposals, which occurred during reading of the reports, indicated that these recommendations were in fact quite influential, and even when there was not perfect agreement the recommendation produced a high frequency of shifts in the final disposal, bringing it closer to the recommendation than a preliminary decision had been. Reasons for these inconsistencies are considered in terms of the different methods used.

The Parolee's Dilemma: Effect of Interpersonal Attraction on Recommendations for Parole

In a study of the contaminating effects of interpersonal attraction on decision-making 104 undergraduate males made parole recommendations for fictitious convicts. Two levels of four factors (severity of crime committed, rehabilitation officer's recommendation for parole, interpersonal attraction, and subject's authoritarianism) were employed in a factorial design. Results of multivariate analysis of variance indicated that severity of crime committed, officer's recommendation, and subject's authoritarianism directly affected the parole recommendations made by the subjects. Also significant was a three-way interaction (severity × recommendation × authoritarianism). Contrary to previous findings, interpersonal attraction induced through differing levels of proportion of similar attitudes did not have a significant effect on recommendations for parole.

Decision Process in Children's Court and the Social Background Report

Experts agree that there is a need to know more about the process of judicial decision-making and that this area has been comparatively ne glected by research workers. This study was concerned with the decision- making process of sentencing of male juvenile offenders by Children's Courts. Bayes's Theorem was used as the mathematical analog of the pro cess. It was found that, in sentencing, most weight is attached to Child Welfare Officer's recommendation. When no recommendation is made, the greatest weight is carried by the number of the offender's previous court appearances. Next in importance are the number of current charges, type of offense, the offender's plea, his age, and number of pre vious charges, in that order. Of least importance are the location of the court, circumstances of offender's current residence, and types of pre vious sentence. Apart from C.W.O.'s recommendation, in specific sen tencing decisions the number of previous court appearances is most weighty in committal to an institution and in admonishment, offender's plea and circumstances of residence carry most weight in admonishment, his age in fines, and types of previous sentence in decisions involving committal to an institution. The findings were discussed critically.

The Case of the Singing Canary

Do harassed law enforcement officers sometimes imply that an offender will receive "special consideration" for probation in return for "singing" about others? If the offender "cooperates" and later comes to the probation officer with the belief that he "has probation coming," how does this affect their subsequent relationship? If the defendant's "singing" has resulted in convic tion of additional offenders, to what extent does this fact affect the probation officer's recommendation? If the defendant's in formation advanced the cause of law enforcement, but certain elements in his background militate strongly against granting probation, how significant is the "reward" factor to total case evaluation? Should the defendant's cooperation with law en forcement officers be set forth in the probation officer's report and thus become a matter of public record? If it cannot be made a part of the report but nevertheless tends to influence the probation officer's evaluation, on what grounds can the officer justify his recommendation to the judge?

Some Hidden Factors behind a Probation Officer's Recommendations

The article reports on an informal "bull session" held by pro bation officers whose primary function is to make a presentence investigation of adult candidates for probation in the criminal courts. The group met for the express purpose of looking into some of the less obvious factors which may, consciously or uncon sciously, influence a probation officer's recommendation to the court in a particular case. Discussion centered in some rather searching questions which called for and elicited interesting and frank responses.

Criteria for the Probation Officer's Recommendations to the Juvenile Court Judge

This study, conducted at the Bronx Children's Court in New York City, analyzes the underlying criteria used by probation officers in recommending probation, institutionalization, psychi atric examination, or discharge. Such features as sex, age, religion, race, home situation, employment, church attendance, and per sonality difficulties of the children in each of the four recom mendation groups are described and evaluated.