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Creative arts and resilient communities
Get PDFThis editorial serves to outline key themes emerging through the articles presented in this volume. As we all navigate conflicts and challenges of various proportions, the question of resilience-building is of particular interest to socially engaged creative practitioners. Working in diverse geographical and virtual locations across the fields of theatre, textile craft, curatorial practices and cultural leadership, authors here explore these themes through their work with communities: art as a practice of cultural leadership points us towards social cohesion; engagement with art strengthens attachment to place uprooted by ecological disaster; imaginative and creative practices, whether material or performative, force us to consider marginalized forms of knowledge and expertise
Microvascular Coaptation Methods: Device Manufacture and Computational Simulation
No full textThe practice of joining blood vessels has been ongoing since the late nineteenth century, although it was initially restricted to animal studies and experimental techniques. At that time, fine silk thread and curved needles had been introduced (Jassinowsky, Inaug Diss Dorpat 1–103, 1889), which was a significant advancement on previous suture materials such as leather, tendon and catgut (Mackenzie, Med Hist 17(2):158–168, 1973), although they were used for wound closure rather than vascular repair. It was not until the mid-twentieth century, circa World War II, that vascular anastomoses were performed whilst repairing or reconstructing traumatic injuries (Rickard and Hudson, Ann Plast Surg 73(4):465–472, 2014). The natural progression from repairing vascular injuries was to perform these procedures in smaller and smaller vessels. Of course, this necessitated use of an operating microscope and development and manufacture of finer suture materials, needles and more delicate instruments. This chapter aims to provide details of the common microvascular anastomotic devices and their manufacture
3D Printing of Pharmaceuticals
No full textIn the new era of medicine, 3D printing technique in pharmaceutical manufacturing has already yielded success. For example, Aprecia®, an FDA-approved pharmaceutical company, has launched its first approved product, which is unique not only because of a novel manufacturing process but is also better than conventional compressed tablets. 3D printing is an inexpensive additive manufacturing technique that builds a 3D object by successive layering on top of each other in a 2D fashion. The layering of the object in process is controlled digitally in a computer-aided design (CAD). 3D printing of pharmaceuticals suits best for personalised therapy, not only in case of doses but dosage form as well. A personalised dosage form can be designed and printed in such a way that the drugs are combined in a single pill (polypill). This can not only make the therapy and schedule convenient for patient but also increase adherence
On the frontline 8
No full textTony Douglass discusses what OAs need to consider in day-to-day interactions with younger patient
Connected Communities | Learning lessons from person-centred community-based support services’ implementation: a mixed-methods study protocol.
No full textBackground
Person-centred community-based support services (PCCBSS) are an array of non-clinical services provided by organisations such as NHS Trusts, voluntary sector organisations, or local authorities.
All PCCBSS involve an individual (variously known as a 'social prescriber’, ‘link worker’, ‘signposter’, ‘navigator’, ‘connector’ or ‘neighbourhood coach’) who talks with a service user before directing them to a range of relevant community sources of social, emotional, and practical support.
Despite much recent investment in social prescribing, and its increased prominence within the policy context across England, little is understood about how PCCBSS are implemented. Research is required across different contexts to describe PCCBSS implementation; in particular, how social care providers successfully interact to support the implementation of PCCBSS, and how services responded to circumstances imposed by the COVID-19 pandemic.
Purpose
The aim of this post-implementation mixed-methods study is to explore how PCCBSS are implemented and become part of usual working practice. Using three services in North West England as case studies, we will examine factors influencing PCCBSS implementation and establish where there is learning for the wider adult social care system.
Focus
The study comprises two work packages (WPs):
WP1: collecting data by reviewing service documents from three PCCBSS case studies;
WP2: interviewing staff and service users (≤20 participants per PCCBSS);
Key implementation data will be systematically abstracted (from WPs1&2) into a coding frame; combining contextual determinants from the Consolidated Framework for Implementation Research (CFIR) with process-related domains from Normalization Process Theory (NPT).
Key outputs
The findings from WP1 and WP2 will be presented in the form of an illustrated ‘pen portrait’, developed collaboratively with Applied Research Collaboration North West Coast ARC NWC public advisers, to illustrate how implementation evolved for each of the PCCBSS across key time-points in the process (initiation; operation; maintenance). The findings will also inform an online implementation toolkit providing recommendations for setting up future PCCBSS
In Vitro and In Vivo Evaluation of Dark Chocolate as Age-appropriate Oral Matrix
Get PDFSwallowing difficulties encountered by geriatric patients who undergo polypharmacy represent a significant challenge that hampers patient compliance and therapeutic management. As an appealing and sensory-pleasing, chocolate-based formulations have emerged as a potential alternative oral dosage form suitable for both the elderly and paediatric populations. However, the extent to which the incorporation of drugs into a chocolate matrix affects their oral availability remains unclear. Therefore, the objective of this investigation was to explore the in vitro and in vivo performance of an ibuprofen-based chocolate dosage form. A matrix based on dark chocolate and the model drug was prepared at two distinct temperatures: 50 and 80 °C. In vitro release studies revealed that ibuprofen formulated through co-melting at 80 °C exhibited a statistically significant slower drug release (p < 0.05) compared to formulations prepared at 50 °C in both FaSSGF (fasted-state simulated gastric fluid) and lipolysis media. The enzymatic degradation of chocolate in the presence of lipase accelerated in vitro ibuprofen release from chocolate matrices. To delve deeper into the bioavailability of ibuprofen within the chocolate formulations, we conducted an in vivo assessment, comparing the pharmacokinetic profiles of ibuprofen in its conventional suspension form with our chocolate-based dosage forms. A notable drop (p < 0.05) in the maximum serum concentration of ibuprofen when incorporated into co-melted or solid-suspension chocolate matrices. However, no significant differences in plasma exposure were observed between the two formulations. These findings shed a light on the potential of chocolate to extend of ibuprofen when integrated into various chocolate matrices, showcasing the potential held by these innovative formulations. [Abstract copyright: Copyright © 2023. Published by Elsevier B.V.
Advancing the scholarship of integration for impactful, sustainable and holistic student success
Get PDF‘Paradise Regained’? Dreaming of Community Wealth Building as a ‘Somewhere’ Utopia
Get PDFThis chapter is an investigation of the value of dream-thinking as a process for imagining the impossible. The ‘impossible’ is one aspect of Utopia, or ‘no-place’. A connection is made between dream-thinking and the potential for ‘ecological thinking’ as a process that is expansive, relational and associational instead of linear and causal. Taking a psychosocial approach and the wide inter-disciplinary perspective that such an approach offers, the chapter suggests that the complex inter-relationality that is part of dream and ecological thinking is an opportunity for imagining futures that go beyond standard linear thought processes. In this context, dream-thinking can be linked to the innovative and creative potential for a different kind of social economy. Such a utopian, dream society is compared to contemporary developments in Community Wealth Building (CWB) and its principal exponent, the Preston Model. A further component of the dream utopia behind CWB is the adherence of CWB projects to cooperative values and principles, where cooperation can be viewed as a benign alternative to competition and individualism. In the spirit of innovation and utopian thinking, the chapter concludes by encouraging the reader to live with the uncertainty of progress, an uncertainty without endings and targets, where process is one of continuous renovation as innovation
The RETurn to work After stroKE (RETAKE) trial: Findings from a mixed-methods process evaluation of the Early Stroke Specialist Vocational Rehabilitation (ESSVR) intervention
Get PDFIntroduction: A key goal for working age stroke survivors is to return to work, yet only around 50% achieve this at 12 months. Currently, there is limited evidence of effectiveness of early stroke-specialist vocational rehabilitation (ESSVR) interventions from randomised controlled trials. This study examined fidelity to ESSVR and explored social and structural factors which may have influenced implementation in the RETurn to work After stroKE (RETAKE) randomised controlled trial. Methods: Mixed-methods process evaluation assessing intervention fidelity and incorporating longitudinal case-studies exploring stroke survivors’ experiences of support to return to work. Normalisation Process Theory, and the Conceptual Model for Implementation Fidelity, informed data collection and analysis. Results: Sixteen sites across England and Wales participated in RETAKE. Forty-eight occupational therapists (OTs), supported by 6 mentors experienced in vocational rehabilitation (VR), delivered the intervention (duration 12 months) between February 2018 and April 2022. Twenty-six participants (15 ESSVR, 11 usual care (UC)) were included in longitudinal case-studies. An additional 18 participants (8 ESSVR and 10 UC) were interviewed once. Nineteen OTs, 6 mentors and 19 service managers were interviewed. Fidelity was measured for 39 ESSVR participants; mean fidelity score was 78.8% (SD:19.2%, range 31–100%). Comparison of the experiences of ESSVR and UC participants indicated duration and type of support to return to work were perceived to be better for ESSVR participants. They received early, co-ordinated support including employer liaison and workplace adjustments where appropriate. In contrast, UC participants reported limited or no VR or return to work support from health professionals. Typically, UC support lasted 2–8 weeks, with poor communication and co-ordination between rehabilitation providers. Mentor support for OTs appeared to increase fidelity. Service managers indicated ESSVR would enhance post-stroke services. Conclusions: ESSVR was valued by participants and was delivered with fidelity; implementation appeared to be facilitated by mentor support for OTs