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Pathways to public life for professional women in Afghanistan: Negotiating shifting patriarchal political regimes and gender regimes
No full textThis thesis examines how Afghan women from the professional social class have negotiated the patriarchy in that country and claimed their agency and public life during different political regimes. Resisting the Western representation of Afghan women as passive victims, it uses the life story method, based on interviews with a wide range of women in public life during the period of US-sponsored democracy and intervention, to analyse the complex factors involved in enabling women to access public life. From a historical sociological viewpoint it examines the shifts in the forms of patriarchy and their sustaining gender regimes from 19th century to the present, and draws on Walby’s six structures of patriarchy in order to understand how those shift affected the ability of women to access public life and employment. Those structures – culture, religion, education, employment, family – are explored through the experiences and life histories of my interviewees. The thesis also pays attention to the involvement of external, foreign actors in the affairs of Afghanistan and the impact of those interventions on the possibility for women’s agency and participation in professional and public life through different political regimes. It thus challenges a simplistic view 9/11 was a water-shed moment for women’s empowerment, and notes that the economic is-sues, an aid-dependent economy and political regimes, security and safety, poverty and psychological trauma, corruption and power struggles among different forces (local and foreign) in many ways undermined women’s prospects in public life. The finding of the research shows that the rights and position of women in Afghanistan have fluctuated over the last 100 years depending on the patriarchal cultural, political and religious ideology and practice of the political regimes, and in no small part due to the influence and interference of external actors in the country
A Hermeneutic Phenomenological Study Exploring Forced Migrant Fathers’ Experiences of the Maternity Journey in the UK, and the Prioritisation and Feasibility of Interventions to meet their Maternity Needs
No full textBackground: Migrant women experience poor maternal health outcomes in the maternity journey compared to natives. Migrant fathers accompanying these women may experience similar issues. No research has focused on the barriers they may face considering their socio-cultural construction of maternity.
Aim: The aim of this applied health research thesis is to explore the lived experiences of forced migrant fathers regarding the maternity journey in the UK, prioritise their barriers and work with stakeholders to identify feasible interventions.
Methods: Using Hermeneutic Phenomenological research design, a four-stage process was adopted involving the following: (a) A systematic review to identify the gaps in literature (b) adapted virtual semi-structured interviews with 14 forced migrant fathers to (c) virtual nominal group technique ranking exercise involving six forced migrant fathers (d) adapted virtual semi-structured interviews involving six stakeholders.
Results: Barriers related to playing second fiddle, adapting to alien NHS maternity service, and living in the asylum system. Three prevailing barriers ranked in the NGT exercise: lack of community support centres to support migrant fathers’ UK maternity journey, fear of being charged and financial burden as breadwinner and lack of access to knowledge about the maternity process in the UK. Feasibility of community support centres, interventions to address being charged and increasing maternity knowledge were intervention themes identified.
Conclusion: Forced migrant fathers’ unmet needs in the maternity journey in the UK highlight the existence of wider challenges they face. Feasible interventions that reflect their unmet needs were developed in consultation with stakeholders
Planning the Radiology Workforce for Cancer Diagnostics
Get PDFYesThe publication of the Delivery plan for tackling the COVID-10 backlog of elective care (NHSE/I, 2022:5)
contained a number of ambitions, including that, by March 2024, 75% of patients who have been
urgently referred by their GP for suspected cancer are diagnosed or have had cancer ruled out within
28 days. By March 2025, waits of longer than a year for elective care should be eliminated and 95% of
patients needing a diagnostic test should receive it within six weeks. The report acknowledged the
need to grow the workforce to achieve these ambitions and ensure a timely cancer diagnosis, while
also proposing the use of digital technology and data systems to free up capacity.
To assist West Yorkshire National Health Service (NHS) organisations to meet these ambitions, this
report presents the findings of a ‘deep dive’ that focuses on the role of radiology in meeting the
ambitions of providing timely cancer diagnosis.
Aims
1. To understand current and projected demand for radiology expertise in cancer diagnosis in
West Yorkshire.
2. To understand the current and projected radiology workforce in West Yorkshire
and determine the gap between the projected radiology workforce and the required radiology
workforce.
3. To identify possible solutions to assist in providing the radiology workforce required for West
Yorkshire and explore their acceptability and potential impact.
Methods
A range of sources of data and methods were utilised. We examined publicly available quantitative
data concerning cancer waiting times and diagnostic waiting times and activity and used this to
forecast future cancer waiting times and diagnostic waiting times and activity. We examined data from
Health Education England (HEE) regarding radiologists’ and radiographers’ workforce profile data for
West Yorkshire, the number of radiologists completing training, and the number of radiographers
graduating, and data submitted by West Yorkshire Trusts to HEE regarding their plans for growing their
radiology and radiographer workforce. Interviews (N=15) conducted with radiology service managers,
university academics and key strategic and operational stakeholders delivering radiology services
were used to understand the current and future issues around strategic workforce planning,
workforce changes and transformation, workforce roles and skills, training and education and service
changes. A rapid review of the literature examining the impacts of artificial intelligence (AI) on the
workload of radiology services was also undertaken. To put this work in context, we also reviewed
relevant policy documents and reports. Alongside this, we consulted with the Yorkshire Imaging
Collaborative (YIC) and the West Yorkshire Cancer Alliance (WYCA) and attended a series of workshops
run by the Yorkshire Imaging Collaborative.
Results
Overall, the findings show that demand for radiology services is increasing and that both cancer
waiting times and the waiting times for diagnostic tests increased, with a concurrent downward trend
in activity that, if all else stays the same, is forecast to continue up to 2025. The cancer waiting times
data indicate that patients were waiting longer and that their needs were not being met. Moreover,
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the proportion of people treated within accepted cancer waiting times decreased both nationally and
within the West Yorkshire region from 2013. This was exacerbated by COVID-19 which caused a
further decrease nationally and for the West Yorkshire region.
National data for waiting times for all diagnostic tests show a significant decline between 2006 and
2008, with a decrease in median waiting times from just under 6.0 weeks to approximately 2.0 weeks.
Overall, waiting times remained stable until late 2020 when they started to rise with the longest
median waiting times at just over 8.0 weeks in mid-2020. The total number of people waiting for
radiology tests nationally is decreasing and is predicted to continue to do so, while in West Yorkshire
the number of people waiting for radiology tests decreased until 2020 but has since been on an
upward trend which is predicted to continue. Nationally, the total number of radiology tests is on an
upward trend that is predicted to continue, while in West Yorkshire activity has been decreasing since
well before COVID-19 and is predicted to continue to do so.
Data examining the current and future workforce showed that the national figures for the total
radiology and radiography workforce are small relative to other health professional groups. In West
Yorkshire, 265 radiologists and 926 radiographers were employed, and staff turnover was generally
low. Trusts’ forecasts for the number of radiologists and radiographers they believe they need suggest
a 16% increase in the number of radiologists in post between March 2022 and March 2027 and a 25%
increase in the number of radiographers in post. The numbers of radiographers and radiologists being
trained in West Yorkshire suggest that this is feasible.
Interview data identified a number of main themes and associated issues: delivering diagnostic cancer
targets, strategic workforce planning, workforce roles and skills, service transformation, recruitment
and retention, universities, artificial intelligence, collaboration, and international recruitment. Across
all themes, some reoccurring issues were identified: a lack of staff, increased demands, a lack of
capacity in terms of space and staff, a lack of strategic workforce planning with a focus on operational
or financial plans. Respondents proposed potential solutions to some of the issues raised that
included: new ways of working, upskilling, developing current and emerging roles, Community
Diagnostic Centres (CDCs), greater collaboration between NHS Trusts, universities, CDCs, imaging
academies and networks and the private sector, and the international recruitment of radiologists and
radiographers to address workforce gaps.
The rapid review findings helped to identify a number of potential benefits of use of AI in radiology,
including contributing to improved workflow efficacy and efficiency of radiology services. However,
this is dependent on the nature of the work and the AI function. As a result of faster AI reading,
radiologists may be able to focus more on high-risk, complex reading tasks. AI can support automation
of image segmentation and classification and aid the diagnostic confidence of less experienced
radiologists. Respondents’ views on AI were mixed. There was acknowledgement that AI was already
used to support radiology service delivery and both the benefits and problems associated were
identified. The implications of AI for radiologists’ and radiographers’ roles were discussed in terms of
changing work, AI being used to support or in some cases substitute radiologists and radiographers,
and the need for the radiology workforce to adapt to the technological change whilst maintaining a
caring servic
'Some of my patients only come to renew their prescriptions. They are not interested in any additional advice or support'. Physicians' perceptions on their roles in cardiovascular diseases risk reduction and management in Fiji
Get PDFYesPrimary health care (PHC) physicians' perceptions are vital to understand as they are the first-line health care providers in cardiovascular diseases (CVD) risk assessment and management. This study aims to explore PHC physicians' perceptions on their roles and their perceptions on management and risk reduction approaches on CVD risk reduction and management in Fiji.
This is a qualitative study conducted in the Suva Medical area among 7 health centers from 1 August to 31 September, 2021. Purposive sampling was used to recruit physicians who worked in the Suva medical area as PHC physicians with at least 6 months' experience in the Special Outpatients Department clinics. In-depth interview were conducted using a semi-structured questionnaire over the telephone and recorded on a tablet device application. The interview content was then transcribed, and thematic analysis was done.
This study included 25 PHC physicians. From the thematic analysis, 2 major themes emerged with 6 subthemes. Theme 1 was CVD management skills with 3 subthemes including education, experience and trainings, beliefs and attitudes of physicians, self-confidence and effectiveness in CVD risk reduction and management. Theme 2 was roles and expectations with 3 subthemes including perceptions of effective treatment, perceptions of physicians' roles and perceptions of patients' expectations. Physicians generally see their role as central and imperative. They perceive to be important and leading toward combating CVDs.
Physicians' perceptions on their commitment to prevention and management of CVDs through their skills and knowledge, beliefs and motivation should be acknowledged. It is recommended that the physicians are updated on the current evidence-based medicine. Limitations include results that may not be the reflection of the entire physician and multidisciplinary community and the difficulties in face-to-face interviews due to the coronavirus diseases of 2019 pandemic
Demographic efficiency drivers in the Chinese energy production chain: A hybrid neural multi-activity network data envelopment analysis
Get PDFYesFor meeting the external requirements of the Paris Agreement and reducing energy consumption per gross domestic product, China needs to improve its energy efficiency. Although the existing studies have attempted to investigate energy efficiency from different perspectives, little effort has yet been made to consider the collaboration among different stages in the production chain to produce energy outputs. In addition, various studies have also examined the determinants of energy efficiency, however, they mainly focused on technology and economic factors, no study has yet proposed and considered the influence of geographical factors on energy efficiency. In this article, we fill in the gap and make theoretical and empirical contributions to the literature. In this study, a two-stage analysis method is used to analyse energy efficiency and the influencing factors in China between 2009 and 2021. More specifically, from the theoretical/methodological perspective, a multi-activity network data envelopment analysis model is used to measure energy efficiency of different processes in the energy production chain. From the empirical perspective, we attempt to investigate the influence of geographical factors on energy efficiency through a neural network analysis. Meanwhile, the comparisons among different provinces are made. The result shows that the overall energy efficiency is low in China, and China relies more on the traditional energy industry than the clean energy industry. The efficiency level experiences a level of volatility over the examined period. Finally, we find that raw fuel pre-process and industry have a significant and positive impact on energy efficiency in China
Disruptive Business Models and Market Performance: The Roles of Technological Turbulence and Adaptive Marketing Capability
Get PDFYesThis study examines the antecedents and market performance outcomes of disruptive business models on one hand and the boundary conditions of the disruptive business model–market performance relationship on the other hand
From Civic Space to the Internet: Legislating rights to peaceful assembly during pandemic
No full textYesWith the social distancing measures implemented during Pandemic Covid 19, many peaceful assemblies have attempted to restructure, equip, and empower themselves creatively for online gathering. This incident emphasises the importance of digital tools, such as the Internet and ICTs, in exercising online rights to peaceful assembly and association. Given the above, this article attempts to deliberate on transforming rights to the peaceful assembly from offline to online and the legal challenges attached. The authors argue that the right to peaceful assembly and association is vital to ensuring enhanced transparency and accountability in implementing human rights policies within countries.This research is financially supported under the fundamental national research grant No. FRGS/1/2020/SSI0/MSU/03/1bythe Ministry of Higher Education (MOHE) andManagement and Science University, Selangor, Malaysia
Addressing inequitable maternity service provision in England for asylum seeking and refugee women who present with symptoms of perinatal depression. A post-colonial feminist inquiry into the experiences of asylum seeking and refugee women and the midwives who care for them
Get PDFBackground: Perinatal depression disproportionately affects asylum seeking and refugee (AS&R) women, but they are less likely to receive support than other women. There is no published research which considers the assessment and support for symptoms of perinatal depression provided by midwives for AS&R women navigating England’s maternity services.
Aim: To investigate how midwifery practice can be developed to support asylum seeking and refugee women with symptoms of perinatal depression.
Methods: A post-colonial feminist inquiry consisting of a scoping survey (study one) and a qualitative research study (study two) using remote interviews with AS&R women and midwives. Qualitative data was analysed using reflexive thematic analysis.
Findings: Study one demonstrated that midwives who care for AS&R women work within diverse roles and service structures across England. Study two identified that midwives lack the resources and support structures required to effectively recognise and support symptoms of perinatal depression in AS&R women. These factors were sometimes invisible to AS&R women, but still negatively affected their ability to effectively discuss perinatal depression with a midwife and access help for any symptoms. The lack of appropriate resources was harmful to both AS&R women and midwives.
Conclusion: AS&R women and midwives who care for them navigate an inequitable maternity system in England. Midwives do not have the appropriate resources to provide a level of care which is equitable to women in the general maternity population. This leaves AS&R women’s perinatal mental health needs unrecognised and unmet, acting as a barrier to receiving effective support.Mary Seacole research development scholarshi
Gesturing Beyond Bones: Proposing a Decolonised Zooarchaeology
Get PDFYesThis is paper represents a long process of self-reflection and critique of prior work I have presented on decolonising zooarchaeology. Engaging with current discourse on the misuse and appropriation of decolonial theory, I instead propose a framework which promotes movement towards decolonisation without co-opting the terminology. Through this, I also propose some alterations and considerations to my original proposal from 2019
Automated Gland Detection in Colorectal Histopathological Images
No full textNoClinical morphological analysis of histopathological specimens is a successful manner for diagnosing benign and malignant diseases. Analysis of glandular architecture is a major challenge for colon histopathologists as a result of the difficulty of identifying morphological structures in glandular malignant tumours due to the distortion of glands boundaries, furthermore the variation in the appearance of staining specimens. For reliable analysis of colon specimens, several deep learning methods have exhibited encouraging performance in the glands automatic segmentation despite the challenges. In the histopathology field, the vast number of annotation images for training the deep learning algorithms is the major challenge. In this work, we propose a trainable Convolutional Neural Network (CNN) from end to end for detecting the glands automatically. More specifically, the Modified Res-U-Net is employed for segmenting the colorectal glands in Haematoxylin and Eosin (H&E) stained images for challenging Gland Segmentation (GlaS) dataset. The proposed Res-U-Net outperformed the prior methods that utilise U-Net architecture on the images of the GlaS dataset