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Effects of 12 months of detraining on health-related quality of life in patients receiving hemodialysis therapy
No full textPurpose: Limited data exist regarding the effects of detraining on functional capacity and quality of life (QoL) in the hemodialysis population. The aim of the current study was to assess whether the discontinuation from a systematic intradialytic exercise training program will affect aspects of health-related QoL and functional capacity in hemodialysis patients. Methods Seventeen hemodialysis patients (12 Males/5 Females, age 60.8 ± 13.6 year) participated in this study. Patients were assessed for functional capacity using various functional capacity tests while QoL, daily sleepiness, sleep quality, depression and fatigue were assessed using validated questionnaires at the end of a 12-month aerobic exercise program and after 12 months of detraining.
Results:The detraining significantly reduced patients’ QoL score by 20% (P = 0.01). More affected were aspects related to the physical component summary of the QoL (P < 0.001) rather than those related to the mental one (P = 0.096). In addition, the performance in the functional capacity tests was reduced (P < 0.05), while sleep quality (P = 0.020) and daily sleepiness scores (P = 0.006) were significantly worse after the detraining period. Depressive symptoms (P = 0.214) and the level of fatigue (P = 0.163) did not change significantly.
Conclusions: Detraining has a detrimental effect in patients’ QoL, functional capacity and sleep quality. The affected physical health contributed significantly to the lower QoL score. It is crucial for the chronic disease patients, even during emergencies such as lockdowns and restrictions in activities to maintain a minimum level of activity to preserve some of the acquired benefits and maintain their health status
Visual Function and Subjective Perception of Vision following bilateral implantation of monofocal and multifocal intraocular lenses: A Randomised Controlled Trial
Get PDFPURPOSE:
Following implantation with Multifocal intraocular lenses (MIOLs) or monofocal intraocular lenses (IOLs), the study examines monocular and binocular visual function and patient reporting outcomes using a rigorous series of clinical assessments.
Setting: BMI Southend Hospital, UK
DESIGN: Prospective, randomised, double-masked clinical trial.
METHODS: 100 subjects were randomised for bilateral implantation of either Bi-Flex 677MY MIOL or Bi-Flex 677AB IOL and were assessed at 3-6 months (V1) and 12-18 months (V2). Primary outcomes included distance, intermediate and near LogMAR visual acuities (VA) and defocus curve profile assessment. Secondary outcomes included reading speed, contrast sensitivity (CS) and the subjective perception of quality-of-vision.
RESULTS: Uncorrected (MIOL 0.10±0.09LogMAR; IOL 0.09±0.11LogMAR) and best distancecorrected VA (MIOL 0.04±0.06LogMAR; IOL 0.01±0.07LogMAR) were comparable (p>0.05).
Unaided near VA (UNVA p<0.001: MIOL 0.23±0.13LogMAR; IOL 0.55±0.20LogMAR) and distancecorrected near VA (DCNVA p<0.001: MIOL 0.24±0.13LogMAR; IOL 0.54±0.17LogMAR) were
significantly improved with MIOLs. There was no significant difference in distance-corrected intermediate VA (DCIVA p=0.431: MIOL 0.38±0.13; IOL 0.39±0.13).
Defocus curves demonstrated an increased range-of-focus amongst MIOLs (MIOL 4.14±1.10D;
IOL 2.57±0.77D). Pelli-Robson CS was different at V1 (p<0.001) but similar by V2 (p=0.059).
Overall satisfaction was high (>90%) in both groups for distance tasks whereas significantly
different for near (MIOL 18.45±16.53LogUnits; MIOL 55.59±22.52LogUnits).
CONCLUSIONS: Unaided near visual acuity is demonstrably better with MIOLs and there was greater subjective satisfaction with their quality-of-near-vision. Halos reported by the MIOL group was significant compared to the IOL group, but did not show an adverse effect on overall satisfaction
A reformulated contextual model of psychotherapy for treating anxiety and depression
Get PDFThis paper describes a reformulated contextual model that uses cognitive theory (dual process theory), motivation theory (personality) and behavioral adaptation (self-correcting control systems) to show how anxiety and depression are caused, treated and prevented by an interaction between people and contexts. Depression and anxiety are the result of implicit beliefs (not cognitions) that all experience is unrewarding and threatening, these being components of the implicit belief that life is bad. Implicit beliefs are formed automatically from contextual cues and in healthy individuals are consistent with rational appraisal. They become more negative than reality through a process of adaptation when behaviors, directed by rational thinking, repeatedly create cues that signify lack of reward or threat. Such behaviors occur when social or other obligations lead people to choose behaviors that fail to satisfy their own unique goals in life and approach threatening situations, contrary to their automatic reactions. Therapeutic interventions and lifestyle change reverse these adaptive processes by positive experiences that create positive implicit beliefs, a change effected in different ways by contextual and specific mechanisms both of which correct the same fault of negative implicit beliefs. Effective therapeutic relationships and interventions are achieved by detecting and responding to a patient’s unique needs and goals and their associated implicit beliefs. Mental health requires not only that people experience life as good as defined by their own goals and beliefs but also the avoidance of contexts where social and other pressures induce people to behave in ways inconsistent with their automatically generated feelings
Examining the perceived value of extracurricular enterprise activities in relation to entrepreneurial learning processes
Get PDFPurpose
This study contributes towards increased understanding of the perceived value of extracurricular enterprise activities from an entrepreneurial learning perspective. Past decades have witnessed a global increase in the provision of enterprise and entrepreneurship education alongside a growing suite of extracurricular enterprise activities. However, there is a paucity of research examining how entrepreneurial learning might be understood in the context of these activities.
Methodology
The study draws on an empirical study of student and educator participants across 24 United Kingdom (UK) universities using semi-structured surveys and in-depth interviews. Three main learning theories drawn from the entrepreneurial learning literature; experiential, social and self-directed learning provided a conceptual framework to frame the research phenomenon.
Findings posit that extracurricular enterprise activities provide perceived value in the experiential and social learning opportunities afforded for students. However, these activities are restricted in enabling the experiential learning cycle to be completed due to limited reflection opportunities. Positioning these extracurricular activities outside the main curriculum also empowers participants to self-direct aspects of their learning and develop their autonomous learning capabilities.
Originality/value
The existing literature focuses upon the entrepreneurial learning processes of established entrepreneurs rather than latent and nascent entrepreneurs within a Higher Education (HE)setting. The limited literature examining HE entrepreneurial learning does so by concentrating upon entrepreneurial learning resulting from in-curricular activities. This study offers novel insights into students entrepreneurial learning processes, highlighting the importance of experiential, social and self-directed learning opportunities to the entrepreneurial learning process and the perceived value of extracurricular activities as a platform for these types of learning
Innovation as a neoliberal ‘silver bullet’: critical reflections on the EU’s Erasmus + Key Action 2
Get PDFThis paper critically evaluates the concept of innovation, in the context of the funding of youth work within Erasmus+ Key Acton 2, but the findings are applicable to other settings which emphasise innovation. The paper argues that, first, innovation is problematic because it lacks a definition. Second, innovation is founded on a neoliberal business model, where solutions are identified and mainstreamed, and the consumer is the ultimate arbiter. Third, the importance of innovation as both context dependent and contested is not appreciated. One result of these problems is that established professional knowledge is undermined, and an emphasis on innovation also has the potential to run counter to the existing established educational practices of youth work. It is argued that innovation is becoming a euphemism for quality, and therefore innovation is taking on the guise of a ‘silver bullet’ for wider EU policy problems
Educational Isolation in England: Understanding Place-Based Challenges for Teacher Recruitment and Retention in Coastal and Rural Schools
No full textThe international context of an appropriate and sustained supply of high-quality teachers is one of great concern (Ovenden-Hope and Passy, 2020). In England the recruitment and retention of teachers is a challenge for the majority of schools, regardless of location (DfE 20222). The increase in the number of trainee teachers, and resulting teachers, as a response to the economic challenges presented by the COVID-19 pandemic has not been sustained in England (Worth and Faulkner-Ellis, 2021). A demographic bulge of pupils entering secondary education (age 11) is predicted for 2025, with 15% more children than in 2018 (DfE, 2019a). Teacher retention is below levels of 2018 when one-fifth of teachers left the profession after 2 years and one-third by their fifth year of teaching (DfE, 2019b, DfE, 2022, Education Support and Public First, 2023). Trainee teacher applications are more than half below the number needed to teach all the children that will be in school in 2025 (Guardian, 2023). England has a teacher recruitment and retention, and typically harder to staff rural and coastal schools are experiencing the greatest staffing challenge of all. In this chapter we present the concept of “Educational Isolation” as a way of understanding the complexity of place as a limiting factor for a school’s access to resources, focusing on recruiting and retaining a high-quality workforce. In England, Educational Isolated schools are predominantly in rural and coastal areas that are geographically remote, socioeconomically deprived and culturally isolated (Ovenden-Hope and Passy, 2019). We discuss the ways in which these schools experience issues of teacher recruitment and retention in relation to place
Review of: The Self-Reflective Art of Don DeLillo by Graley Herren
Get PDFThe status and significance of Don DeLillo as a meditative and critical commentator on the literary and political landscape of modern US society cannot be underestimated. The novelist has spent fifty years exploring and shaping the creative vanguard of US culture. From the Kennedy assassination in Libra (1988) to the rise and fall of dotcoms in Cosmopolis (2003) via the bitingly satirical White Noise (1985), DeLillo’s is an essential critical voice whose commentaries and observations both reflect and shape the zeitgeist. DeLillo’s oeuvre has a particular focus on the creative process; many of his characters are both artistic creators themselves and/or are spectators of others’ creative output, and it is to this particular facet of DeLillo’s fictional body of work that Graley Herren applies his own critical lens
Visibly constraining an agent modulates observers’ automatic false-belief tracking
No full textOur motor system can generate representations which carry information about the goals of another agent’s actions. However, it is not known whether motor representations play a deeper role in social understanding, and, in particular, whether they enable tracking others’ beliefs. Here we show that, for adult observers, reliably manifesting an ability to track another’s false belief critically depends on representing the agent’s potential actions motorically. One signature of motor representations is that they can be disrupted by constraints on an observed agent’s action capacities. We therefore used a ‘mummification’ technique to manipulate whether the agent in a visual ball-detection task was free to act or whether he was visibly constrained from acting.
Adults’ reaction times reliably reflected the agent’s beliefs only when the agent was free to act on the ball and not when the agent was visibly constrained from acting. Furthermore, it was the agent’s constrained action capabilities, rather than any perceptual novelty, that determined whether adult observers’ reaction times reliably reflected the agent’s beliefs. These findings signal that our motor system may underpin more of social cognition than previously imagined, and, in particular, that motor representations may underpin automatic false-belief tracking
Local Government and Sustainable Development in the UK: Engaging the Local to Achieve the Global
No full textSustainable development is one of the 21st century’s most important concepts (Borne 2010; Borne 2018). The adoption of the United Nations Sustainable Development Goals in 2015 has further embedded the concept on the international, national and local stage. Whilst the emphasis is on the achievement of targets in relation to the 17 goals the success or otherwise will rest on the ability to effectively communicate the central components of sustainable development to organisations and individuals around the world. The salience of the risks that are inherently represented within the discourse of sustainable development remains starkly under researched and under represented in policy frameworks.
This book will explore the ability of sustainable devleopment and the global risks associated with it to effect real change at the global and local scales of analysis. Drawing on and advancing theoretical frameworks that emphasis risk and reflexive modernity (Borne 2010; 2017, 2018) this book will present data, discussion and recommendations from the largest and most detailed empirical research in the UK to explore sustainable devleopment and associated risks at the local, community and individual level.
The focus of the research and analysis presented in this book is the local government tier of parish councils. There are over 10000 town in parish councils in England and Wales that sit at the heart of many local communities. Parish councils are the closest level of government to their communities and play a pivotal role in shaping these communities. They are constituent of and should be representative of these communities and are therefore best placed to understand local needs. With this in mind there is a significant lack of research that relates to parish councils and their ability to understand and respond to sustainable development related policies (Brownhill and Bradley 2017; Wills 2016).
This book will argue that there needs to be a reconceptualization of parish councils that sit within not only local governance structures but are impacted by and impact upon global governance discourses. This book therefore identifies parish councils as a nexus point of multiple local and global networks that highlight the relationship between global and local dynamics. The book will argue that the research points to a poorly understood and so significantly underutilised tier of government that can directly address some of the most pressing problems that face society in the 21st Century. The book will bridge the divide between global and local scales of analysis provides an internationally relevant This book argues that there needs to be a discursive, structural and behavioural realignment if the SDGs are to have a realistic impact on local communitie
RETAIN: A research-informed model of continuing professional development for early career teacher retention
No full textIn this chapter, we explore whether RETAIN, a continuing professional development programme (CPD) designed to retain early career teachers (ECTs), offers a potential
solution for early career teacher retention. We provide a rationale for the development of RETAIN, identifying shortages in teacher supply and the need to address this. The Education Endowment Foundation, a grant-funder focused on closing the attainment gap for disadvantaged pupil through research-informed interventions, funded the development of RETAIN, a pilot programme situated in coastal-rural primary schools with high levels of persistent disadvantage in Cornwall, England.
The chapter continues with a discussion of the research findings used to inform the key components of the RETAIN model and the methodological approach used to evaluate the findings from the pilot programme. The conclusion is that the RETAIN model does demonstrate, through indicators of impact and longer-term outcomes, promise as a solution for early career teacher retention. The key components of classroom, collaboration, coaching and child – the 4 ‘Cs’ of RETAIN – create a model for CPD that improves teacher self-efficacy through enhancing skills, knowledge and understanding of pedagogy and practice, and that keeps teachers in teaching. We therefore answer the question of the importance of how CPD is delivered: a model of effective CPD