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Activity Limitations and Life Satisfaction: A Cross-sectional Study among Amputees in an Orthopaedic Rehabilitation Centre in Ghana
Get PDFYesThe aim of this article is to examine the limitations encountered by amputees in the performance of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) and its impact on their life satisfaction.
A quantitative cross-sectional study was conducted among 200 amputees at the Nsawam Orthopaedic Training Centre (OTC). The Groningen Activity Restriction Scale (GARS) and the Life Satisfaction Questionnaire-11 (LISAT-11) were used to collect data from the respondents. All statistical analyses were made using IBM Statistical Package for the Social Sciences (SPSS) software 23.0 and summarized in tables. A multivariate analysis was used to establish the relationship between activity limitation and life satisfaction.
The respondents experienced some limitations in executing ADLs and IADLS with an overall mean activity limitation score of (36.57±10.93). There was a moderate life satisfaction of respondents with a mean score of (3.86±1.15). A multivariate analysis revealed that, there was a strong negative statistically significant relationship between activity limitations and life satisfaction [ß =--0.13, p=0.000]
The government of Ghana through the Ministry of Health and its agencies who are involved in the management and rehabilitation of amputees must explore these limitations to inform decision making during the planning and preparation of rehabilitation programs, resource allocation, and policy formulation for amputees to improve their overall satisfaction and well-being
The deployment and utilization of the Allied Health Professions support workforce: A scoping review
Get PDFYesThe demand for healthcare services internationally continues to increase, exacerbated by patient backlogs resulting from the COVID-19 pandemic and the difficulties in recruiting and retaining healthcare staff. These difficulties have led to increased interest in workforce redesign, and the upskilling of existing staff in all areas of healthcare, including within the Allied Health Professions (AHP). Clinical support staff are a key component of workforce redesign, yet little has been documented on the utilization of this workforce across the wide range of professions that collectively form the AHP workforce. Existing research is also unclear due to the variety of titles used to describe them (eg, allied health assistants, therapy assistants, etc). This study aimed to review how Support Workers and Assistant Practitioners (SWAPs) are utilized within the AHP professions. Electronic databases (MEDLINE, CINAHL complete, Scopus, and Google Scholar) were searched to find English Language primary research articles that explored the deployment of clinical support staff within Allied Health. Following the scoping review methodology, data from each study were analyzed in terms of design, key findings, and implications. A quality assessment was also completed. Thirty-nine articles met the eligibility criteria. Studies were undertaken in Australia, UK, and USA, and covered a range of AHPs and methodological approaches. Most articles employed qualitative methods, with highly variable research quality identified. Key findings were that cost-effectiveness of this workforce has not been formally evaluated in any setting or AHP discipline, and that support workers are a largely underutilized staff group potentially due to inconsistencies in their deployment and scope of practice, and the lack of a clear career pathway. Rigorous, quantitative, and mixed methods research into the deployment and impact of this staff group is needed in order to gain a clearer understanding of how they are optimally utilized across the different AHP disciplines.The study was funded by the NIHR Health Services and Delivery Research programme (I.D. NIHR133813
Uncovering the Impact of Digital Technologies on Strategising: Evidence from a Systematic Literature Review
No full textYesAdopting digital technologies in different organisations has become a trend over the last decade, yet our understanding of the impact of digital technologies on strategising is fragmented and unclear. To address this gap, this paper reviews existing research on the intersection between digital transformation and strategic management. Specifically, the aim is to explore how the digital context changes strategising. Based on a systematic review of empirical evidence from 163 journal articles, we showcased the manifestation of strategising in the digital age in terms of strategic practitioners, practices and praxis. Consolidating these findings, a typology of strategies in the digital age is developed and discussed, showing the interplay among changes in Strategy-as-Practice parameters. This framework contributes to providing clarity in strategic scenarios of digital transformation and identifies various strategic directions and actions. Overall, we argue that although digital transformation has created additional strategic options, it has yet to change the underlying assumptions of strategising in firms
A Systems Thinking approach to analyse sustainability strategies, employee motivation and impact on financial performance
Get PDFYesSocial, institutional and business interest in Sustainability has increasingly grow in the last decades. New regulations, technological progress, social awareness related to environmental impact of the industrial activities and irregular working conditions, are some of the key elements affecting the way organisations plan and measure their corporate, business unit, and operational strategies. Sustainability strategies can play a key role in driving innovation through learning, motivation, attraction and retention of skilful employees.
The aim of this paper is to analyse the interrelations between the deployment of effective sustainability strategies, employee motivation and the financial perspective of business performance.
The analysis applies a Systems Thinking approach through the development of a series of Causal Loop Diagrams to identify key factors and the nature of their interrelationships. The analysis also considers the Ability, Motivation and Opportunity (AMO) framework to explain the complexity of employee behaviour, motivation and impact on strategic performance.
This research confirmed that a supportive relation can be established between the implementation of effective sustainability strategies, represented by Corporate Social Responsibility (CSR) and Human Resources (HR) initiatives, and the financial performance of a business organisations.
The study focused on publications related to private business organisations in the UK and USA, which encourages future broad studies.
This research provides relevant insights to understand better the complexity of the relationships between sustainability strategies, employee motivation and business performance
The patient’s perspectives of safe and routine proactive deprescribing in primary care for older people living with polypharmacy: a qualitative study
Get PDFYesBackground: The process of identifying and discontinuing medicines in instances in which harms outweigh benefits (deprescribing) can mitigate the negative consequences of problematic polypharmacy. This process should be conducted with a focus on the patient and involve collaborative decision-making. Evidence is needed regarding patients’ views on how deprescribing should be safely and routinely implemented in English primary care to improve its application. This study aimed to identify optimal methods of introducing and actioning deprescribing from the patient’s perspective.
Methods: Participants in England aged 65 and above who were taking five or more medicines and residing in their own homes were recruited through social media and service user groups. An interview guide was created from deprescribing literature and input from patients and the public, guided by the Normalisation Process Theory (NPT). The interviews were held online using Microsoft Teams® or via phone, recorded, and then transcribed. The data was analysed using the Framework analysis.
Results: Twenty patients (mean age of 74.5, SD = 6.93), with 75% being female, were enrolled in the study. Three main themes emerged: (1) ‘Why deprescribe now?’ emphasised the significance of explaining the reasons behind deprescribing; (2) ‘Monitoring and follow-up’ underscored the necessity of safety measures during deprescribing and patients’ willingness to self-monitor post-intervention; (3) ‘Roles and relationships’ explored patient perceptions of various healthcare professionals involved in deprescribing and the essential interpersonal skills for fostering therapeutic relationships.
Conclusion: Optimal methods of introducing deprescribing included communicating a convincing rationale for stopping medicines and preparing patients for deprescribing conversations. Patients required support from a range of healthcare professionals with whom they had an existing therapeutic relationship. Whilst patients were motivated to self-monitor unwanted/unexpected effects post-deprescribing, timely support was required. The nature of such bolstered collective action and cognitive participation within NPT enhances the normalisation potential of deprescribing. These findings highlight the significance of considering the content and process of deprescribing consultations to enhance normalisation and tackle problematic polypharmacy. This provides a deeper understanding of patients’ needs for implementing safe and routine deprescribing in primary care, which should be considered when designing medication review and deprescribing services.This research was funded by the National Institute for Health and Care Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC)
Circular economy in construction - findings from a literature review
Get PDFYesThe paper aims to enable a comprehensive definition for a Circular Economy (CE) that will support its effective introduction in the building and construction sectors. According to the European Commission (EC), the building sector in 2020 accounted for 40 % of the primary energy demand in the European Union (EU) and 37 % of its greenhouse gas emissions. Thus, the sector can play a crucial role in decarbonisation and hence in achieving a zero-emissions future in response to climate change. A CE aims to harmonise economic growth with environmental protection and is based on the concept of closing the loop with minimal practical waste as in a natural ecosystem. The adoption of CE concepts is therefore seen as a feasible response to climate change through the deployment of more sustainable construction processes that significantly reduce the need for natural resources by maximising recycling and reuse. However, and despite the recognition of the potential of a CE in relation to sustainability issues, the adoption of a CE model within building and construction sectors is challenging because of the wide range of aspects and priorities which are reflected in the diversity of definition resulting in a narrow and limited adoption. There are currently many definitions of CEs as related to building and construction in the literature, creating confusion and preventing effective implementation.
The study presented here intends, using a comprehensive literature review as its basis, to define the key domains of a CE on which to align a concise and accurate definition that will enable effective application in the building and construction sectors. The research also aims to identify current research gaps and barriers to contribute to the future of CE research in the building sector and thus drive the implementation of CE projects to mitigate the effects of climate change and support the achievement of the UN Sustainable Development Goals (SDGs) by laying the foundations for a novel and forward-looking approach to circularity based on properly established, defined and understood principles of CEs
Longitudinal Trajectories of Stress and Positive Aspects of Dementia Caregiving: Findings From the IDEAL Programme
Get PDFYesUnderstanding what influences changes over time in caregiver well-being is important for the development of effective support. This study explores differences in trajectories of caregiver stress and positive aspects of caregiving (PAC).
Methods
Caregivers of community-dwelling individuals with mild-to-moderate dementia at baseline from the IDEAL cohort were interviewed at baseline (n = 1,203), 12 months (n = 917), and 24 months (n = 699). Growth mixture models identified multiple growth trajectories of caregiver stress and PAC in the caregiver population. Associations between study measures and trajectory classes were examined using multinomial logistic regression and mixed-effects models.
Results
Mean stress scores increased over time. A 4-class solution was identified: a “high” stable class (8.3%) with high levels of stress, a “middle” class (46.1%) with slightly increasing levels of stress, a “low” class (39.5%) with initial low levels of stress which slightly increased over time, and a small “increasing” class (6.1%) where stress level started low but increased at a steeper rate. Mean PAC scores remained stable over time. A 5-class solution was identified: 3 stable classes (“high,” 15.2%; “middle,” 67.6%; “low” 9.3%), a small “increasing” (3.4%) class, and 1 “decreasing” class (4.5%). For stable classes, positive ratings on study measures tended to be associated with lower stress or higher PAC trajectories and vice versa. Those with “increasing” stress also had worsening trajectories of several study measures including depression, relationship quality, competence, and ability to cope.
Discussion
The findings highlight the importance of identifying caregivers at risk of increased stress and declining PAC and offering them targeted support
Polymer Conformation Determination by NMR Spectroscopy: Comparative Diffusion Ordered 1H-NMR Spectroscopy of Poly(2-Ethyl-2-Oxazoline)s and Poly(Ethylene Glycol) in D2O
Get PDFYesDiffusion ordered 1H-NMR spectroscopy (DOSY) is a useful, non-destructive technique for analysing polymer hydrodynamic size and intrinsic/solution viscosity. However, to date there has been no investigation of DOSY under variable temperature conditions that allow trends in polymer conformation to be determined. Poly(2-ethyl-2-oxazoline) (P(EtOx)) is a hydrophilic polymer that has the potential to replace poly(ethylene glycol) (PEG) in biomedical applications. Applying DOSY to a series of narrow-distribution P(EtOx) revealed that the apparent hydrodynamic radii scaled with molecular weight as expected. By altering the temperature of the solution the trends in Flory-type exponents were determined, enabling the determination of the power laws related to the coil-globule conformation of linear polymers directly from NMR data. These measurements were complicated by the onset of convection currents at higher temperatures, which impose a limit to the effective measurement range of ca. 10–35 °C. It was revealed that P(EtOx) had a more expanded random coil conformation than PEG, and it trended towards θ conditions at the lower critical solution temperature. In comparison, PEG was approximately in θ-conditions at room-temperature. This shows the use, and limitations of DOSY in polymer conformation analysis, and applies it to P(EtOx), a polymer which has not been analysed in this manner before.University of Ghent (Grant Number: RM1602-1695
Power-informed practice in social work
Get PDFYesSummary: This article reviews the existing literature on power within a social work context and extends the analysis to broader sociological understandings through which to rethink the ways in which social work professionals understand and work with power within everyday practice. Findings: The review argues that prevailing dichotomies, which feature so centrally in theoretical conceptualisations of power, offering binary positions of power as ‘good or bad’, ‘positive or negative’ and ‘productive or limiting’ are limiting in themselves. It is argued that power must also be recognised as a construct which operates in a synchronous way; whereby it can impact in limiting and productive ways at the same time. Applications: To support this position, the Power-informed Practice (PiP) framework, which recognises power at the individual, professional and structural levels is offered. The utility of the framework in providing a clearer understanding of power is then presented in relation to working with children who have experienced abuse. As a tool, the framework enables social workers to structure their analysis of power within all areas of contemporary social work practice, in order to promote and support processes of empowerment
Hypoxia-responsive prodrug of ATR inhibitor, AZD6738, selectively eradicates treatment-resistant cancer cells
Get PDFYesTargeted therapy remains the future of anti-cancer drug development, owing to the lack of specificity of current treatments which lead to damage in healthy normal tissues. ATR inhibitors have in recent times demonstrated promising clinical potential, and are currently being evaluated in the clinic. However, despite the considerable optimism for clinical success of these inhibitors, reports of associated normal tissues toxicities remain a concern and can compromise their utility. Here, ICT10336 is reported, a newly developed hypoxia-responsive prodrug of ATR inhibitor, AZD6738, which is hypoxia-activated and specifically releases AZD6738 only in hypoxic conditions, in vitro. This hypoxia-selective release of AZD6738 inhibited ATR activation (T1989 and S428 phosphorylation) and subsequently abrogated HIF1a-mediated adaptation of hypoxic cancers cells, thus selectively inducing cell death in 2D and 3D cancer models. Importantly, in normal tissues, ICT10336 is demonstrated to be metabolically stable and less toxic to normal cells than its active parent agent, AZD6738. In addition, ICT10336 exhibited a superior and efficient multicellular penetration ability in 3D tumor models, and selectively eradicated cells at the hypoxic core compared to AZD6738. In summary, the preclinical data demonstrate a new strategy of tumor-targeted delivery of ATR inhibitors with significant potential of enhancing the therapeutic index.UoB STARTER Fellowship Awar