Open Research Exeter - University of Exeter
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A liminal duality of expert authority: the perpetuation of hierarchical authority in UK surgical teams contrary to a national collective leadership policy
No full textThis article examines a process which demonstrates institutional liminality. It was initiated by the implementation of a national policy. The policy was intended to reduce personnel's use of hierarchical authority and to encourage greater use of collective authority. The findings show that process, alongside other influences, contradictorily results in preserving personnel's reliance on hierarchical expert authority. This produces liminality in clinical experts' authoritative state.
This empirical study is based on conducting 73 semi-structured interviews with 60 people with experience of working in and with surgical teams in UK hospitals, across various roles. The analysis of findings is at two levels: first, individuals’ experiences in their liminal passage from reliance on hierarchical authority to greater use of collective authority. Secondly, the tension between institutional and clinical logics.
This study contributes to growing interest in the theorizing of liminality in the organizational field. Also, it provides an empirical contribution to extend understanding of phenomena that impact on the current healthcare workforce crisis and creation and retention of experts. It is theorized, firstly, that despite changes in organizational policy and expectations for a less hierarchical and more collective type of team-work hierarchical activities hierarchical activities are perpetuated by institutional liminality. Secondly, it is proposed that the institution's liminal transition has affected the liminal process of the use of expert authority by those in senior clinical roles, ‘Consultants’. Consultants' expert authority has two aspects: one aspect has reached a post-liminal phase, but the other, affected by the institution's transition, is caught between ‘old school’ authority and the institutional goal of collective authority
Development of a physiotherapy intervention using compensation strategies to improve walking in people with Parkinson’s disease
No full textAlthough we learned to walk as children and carry this skill largely automatically for the rest of our lives, this is not the case for people with Parkinson’s disease (PwP). Due to neurophysiological changes associated with the disease that affects motor control, PwP experience various walking difficulties that affect their ability to mobilise and carry out activities of daily living and negatively impact their quality of life.
Physiotherapists often employ compensation strategies to improve PwP’s walking difficulties. However, at present, there is little guidance for physiotherapists on how to optimise these strategies in their clinical practice. Therefore, the present thesis aims to develop a theoretically informed physiotherapy intervention to improve walking in PwP using compensation strategies, thus helping them prescribe and adapt these strategies in clinical practice. This thesis adopted an evidence- and theory-based approach to intervention development, and three related studies were undertaken.
Firstly, a scoping review aimed to map the available literature on one type of compensation strategy—implicit strategies—used for gait impairments in PwP and identify the gaps in the literature that could be addressed by future research. Twenty papers were identified, predominantly focused on evaluating the effectiveness of dual-task training for those in the early, mild and moderate stages of the condition for relatively short-term follow-up. The review highlighted that the rationale for training implicit strategies in PwP was poorly described. This information is fundamental to understanding what informs implicit strategies in relation to the compromised automaticity in PwP. It is especially important because it is unclear what evidence physiotherapists should rely on to guide their clinical practice. The review also highlighted the lack of primary qualitative studies exploring physiotherapists’ experiences in training compensation strategies. This evidence is important for understanding how physiotherapists prescribe and adapt compensation strategies to patient needs. Furthermore, the included studies showed little evidence of the challenges PwP could face while using compensation strategies. Therefore, two qualitative studies were undertaken to explore physiotherapists’ and PwP’s experiences using compensation strategies.
The first qualitative study explored physiotherapists’ experiences of using compensation strategies for PwP. Thirteen physiotherapists with current or recent experience working with PwP in the United Kingdom were interviewed. Although the physiotherapists strove to optimise compensation strategies, there was a lack of formal training in this area, and their knowledge was primarily acquired from peer experiences. Furthermore, a lack of specific knowledge about Parkinson’s can impact physiotherapists’ confidence in maintaining person-centred rehabilitation. However, the question remains to be answered: What accessible training could address the knowledge–practice gap to contribute to the delivery of better personalised care to improve PwP’s walking difficulties?
The second qualitative study explored PwP’s experiences using compensation strategies to understand the challenges of using such strategies in everyday life. The overarching perspective was that varying levels of PwP’s motivation, willingness and perceived support (i.e. access to physiotherapy services) could influence PwP’s ability to use compensation strategies and maximise their benefits. Although the participants were motivated to use such strategies and develop their own to overcome their walking difficulties, adapting these strategies to daily life situations was not always easy. A profound challenge for PwP was adapting these strategies to a different environment. This uncertainty resulting from the aforementioned challenges impacts the participants’ ability to start or continue using compensation strategies. The last phase of the present thesis involved comparing and contrasting the three studies into four key observations to provide the basic structure for the developed theory of change
Making sense of community-led place-based research
No full textThis perspective introduces a new experiment in community-led place-based research that is taking off in the United Kingdom. The article provides the background and rationale for funding nine independent Community Research Networks for up to £1 million each, for up to 5 years. This, in turn, raises questions about how human geographers might respond to this development and the implications for disciplinary thought and practice. The article explores: (1) the implications for understanding the place of place in research and knowledge production and (2) a series of questions about community-led place-based research in practice. The latter raises questions about: (i) community engagement; (ii) setting the research agenda; (iii) data sovereignty and epistemic authority; and (iv) the role of academic researchers
Threatened cetaceans in a potential deep seabed mining region, Clarion Clipperton Zone, Eastern Pacific, August 2023
No full textThe Clarion Clipperton Zone (CCZ) of the Eastern Pacific is an ~ 6 million km2 abyssal area punctuated by seamounts. The CCZ is a focus for potential mining, although this is not, as yet, a commercial reality. Records from online repositories and field guides suggest that up to 30 cetacean species are present in the CCZ, though dedicated surveys have yet to be published. We report the results of a passive acoustic survey for cetaceans conducted over 13 days during summer 2023 in two blocks of the CCZ earmarked for deep seabed mining – NORI-d and TOML-e. The areas surveyed had a mean depth of 4259 m, with no charted seamounts, with 4,328 km of survey effort (273 hours of continuous recordings). In total, there were 74 acoustic detections, with six visual encounters. We report the presence of a sperm whale (Physeter macrocephalus) (one individual), Risso’s dolphins (Grampus griseus) (two groups) and common dolphins (Delphinus delphis) (one group, confirmed by visual sighting). We also acoustically encountered 70 dolphin groups that could not be identified to species level. No baleen whales, kogiids or beaked whales were detected during this short survey. Beaked whales are challenging to detect, such that a lack of detections cannot be taken to confirm the absence of such species. We confirm one threatened species present in these blocks of the CCZ – sperm whales – and suggest that more extensive data are urgently needed to understand the risk of harm to cetaceans that may arise from human activities, including deep-sea mining
Citation practices in graduate theses and dissertations: The case of English L1 and L2 writers
No full textThis study explored forms and functions of in-text citations in 40 graduate theses (20 MA and 20 Ph.D.) by English L1 and L2 writers of applied linguistics. The analyses revolved around examining the forms and functions of citations in the introduction, literature review, method, results, discussion, and conclusion (IMRDC) subgenres of the theses. The functional analysis led to the development of a citation framework reflecting various rhetorical purposes graduate writers pursued. It was typical of graduate texts to incorporate novel ways of academic referencing, such as citations with dual roles. Also, despite considerable similarities between MA theses by L1 and L2 groups, there existed significant differences in the frequency of citation forms and functions between MA and Ph.D. theses by English L1 and L2 writers. Pair-wise comparisons indicated heavier uses of integral citations in MA than in Ph.D. theses. The results can give insights into thesis writers’ source use practices and help thesis supervisors, academic writing instructors, and materials developers effectively translate their educational policies into disciplinary actions
Investigating the therapeutic potential of bacteriophage as a novel therapy for melioidosis
No full textThe emergence of antimicrobial resistance (AMR) is a fast growing, global crisis causing untold damage to life and economy, strongly exacerbated by the global community running out of effective antibiotics. Bacteriophages - naturally occurring viruses of bacteria - are a potential solution to the AMR crisis. Bacteriophages are highly host-specific, auto-dosing, can be administered via different routes and have low production costs making them attractive alternatives to antibiotics.
In this project I investigate the therapeutic potential of bacteriophages in combatting Burkholderia thailandensis and Burkholderia pseudomallei, the intrinsically antibiotic-resistant causative agent of melioidosis - a life-threatening and difficult to treat disease that predominantly affects the Aboriginal and Torres Strait Islander peoples in Australia, as well as rural populations in South-East Asia.
I utilize single- cell microfluidics-based time-laps microscopy alongside comparative transcriptomics, as well as classic microbiological methods, to investigate phage-host interactions, and combinations of phage and antibiotics, on both the individual-, and bulk cell level in Burkholderia thailandensis and Burkholderia pseudomallei. I discover that ampunavirus ΦBp-AMP1 is additive in suppressing the growth of B. thailandensis in combination with antibiotics from major antibiotic classes in liquid bulk, including quinolones, β-lactams and tetracyclines at sub-minimum inhibitory concentrations (MIC), yet is antagonistic in combination with folate reductase inhibitors. I further show that ΦBp-AMP1 synergizes with ciprofloxacin at supra-MIC and improves full population clearance. In the structured environment of the microfluidic ‘mother machine’, I show that the combination of ΦBp-AMP1 and sub-MIC ciprofloxacin is additive by increasing the proportion of non-growing cells, rather than increasing the frequency of lysis and without incurring cell filamentation. Finally, I use comparative transcriptomics of B. thailandensis transcriptomes under phage-, and phage-ciprofloxacin therapies and discover that the bacterial response to phage stress results in a depletion of efflux-, and energy generation associated genes, reducing both active efflux and the proton motive force. I therefore hypothesize that the additivism observed is underpinned by a reduction of antibiotic efflux, resulting in an increased intracellular accumulation of antibiotics and therefore increased growth suppression in cotreatment that is seemingly independent on the antibiotics mode of action.
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Next, I investigate the efficacy of novel phage-, and phage- antibiotic combinations in treating the more clinically relevant Burkholderia pseudomallei. I show that these phages interact with their hosts in a complex way and have differing infectious ranges on clinical isolates of B. pseudomallei. Nonetheless, I discover that infecting bacteriophages remain additive with ciprofloxacin and display antagonism or no effect in combination with trimethoprim in liquid bulk - and are antagonistic with trimethoprim on-plate - independent on their putative phage-receptors and degree of homology with ΦBp-AMP1.
The potential of bacteriophages in therapy is recognised throughout the scientific and medical communities. However, the interactions between bacteriophages and their hosts on an individual cell level are severely underreported in the current literature, as is the potential of therapeutic phage as a treatment for melioidosis. To date, the treatment for melioidosis spans between several weeks - up to two months - of intensive antibiosis (depending on the severity of disease) and no working vaccine currently exists. The phage-induced depletion of antibiotic efflux I discovered in this work therefore bears great potential to improve future melioidosis therapies although more research will be required
Informal Digital Learning of English (IDLE) as form‐focused and meaning‐focused activities: Refining its measurement and examining its predictive role in L2 achievement and confidence
No full textAcknowledging the limitations of existing measurement instruments in adequately capturing the distinct cognitive processes (e.g., form-focused vs. meaning-focused) involved in informal digital learning of English (IDLE), this paper asserts a pressing need to develop and validate robust instruments that measure form-focused and meaning-focused IDLE (FM-IDLE). It comprises two interrelated studies investigating the measurement and impact of informal digital English learning practices among Chinese university students. Study 1 aimed to develop and validate a psychometrically sound instrument to assess learners’ participation in form-focused IDLE Activities (FIA) and meaning-focused IDLE activities (MIA). Study 2 examined the predictive relationship between FIA, MIA, and two critical language learning outcomes: L2 achievement as indicated by students’ standardized English test scores and L2 confidence. The research engaged 1,202 Chinese undergraduate EFL learners, with the sample randomly divided into two datasets (Sample 1: N = 601; Sample 2: N = 601) for scale validation, while the complete sample (N = 1202) was utilized to examine the scale's predictive validity. Study 1 yielded a refined 14-item FM-IDLE Scale comprising two distinct factors, FIA and MIA, demonstrating robust psychometric properties. Study 2, employing structural equation modeling, revealed differential effects: FIA demonstrated significant and negative associations with L2 achievement and L2 confidence, whereas MIA could positively predict these outcomes. These findings yield important pedagogical implications by highlighting the importance of promoting meaning-focused IDLE activities through technological affordances while fostering language learning confidence against the backdrop of the global spread of English
Weather effects on academic performance: an analysis using administrative data
No full textThis paper contributes to the growing body of research examining the impact of temperature on educational outcomes. Utilising national-level administrative data on nearly one million Australian students, it investigates whether temperature fluctuations, and prolonged heatwaves influence test performance. The analysis reveals that both heat and cold affect student test scores, with some evidence of the effects intensifying during heatwaves. Australia’s vast geographical diversity and climate variability provide a unique opportunity to explore spatial heterogeneity in these effects. Findings suggest that in regions with hot weather conditions, the most thermally comfortable temperature is likely to be higher, whereas students in the coldest parts of the country appear to be less sensitive to cold weather conditions, consistent with the adaptation hypothesis. In contrast, in regions with moderate and temperate weather conditions, student scores are affected by both hot and cold weather
The role of gender in shaping the effect of volunteering on first-time voter turnout
No full textFalling youth turnout in Europe has increased interest in measures that can encourage electoral participation among young voters, including the promotion of volunteering. Recent studies show that volunteering can increase turnout among young people; the effects are moderated, however, by family background. This highlights the potential importance of other institutions that structure political socialisation on the volunteer/voting relationship, of which gender is a powerful example. This article examines that potential, and shows that while volunteering increases first-time voter turnout among young men there is no evidence of such benefit for young women. Data limitations prevent hypotheses explaining this relationship from being tested, but the article argues that this reflects the impact of gendered political socialisation on the types of volunteering young men and women engage in, with that of men being more productive of resources that encourage turnout
Public Policy and the Enforcement of Arbitral Awards: A Nigerian Case Study
No full textThis dissertation examines the interpretation and application of the public policy exception to arbitral awards in Nigeria, focusing on how socio-legal factors integral to Nigeria's diversity and identity should influence this exception. Due to the flexibility of the public policy exception under enforcing conventions, it remains a contentious ground for the annulment or refusal of enforcement of arbitral awards. This study employs a mixed methodology approach to reach its conclusions. Initially, an analysis of relevant case law and statutory provisions is conducted to provide insight into the legal framework of Nigeria's interpretation and its jurisdictional goals.
Furthermore, this thesis undertakes a comparative analysis of other jurisdictions that have successfully integrated their socio-legal contexts into the arbitration process. By examining the practices and frameworks of these countries, the study identifies best practices and potential reforms that could enhance the clarity, consistency, and predictability of the public policy exception in Nigeria. Additionally, a qualitative research methodology is utilised, incorporating questionnaires with legal practitioners, arbitrators, and judiciary members to understand the on-ground influences of these socio-legal factors and their impact on Nigeria's public policy exception.
Through these approaches, the research uncovers the underlying socio-legal factors, such as cultural and religious backgrounds, that shape Nigeria’s application and understanding of public policy. The findings indicate that these socio-legal elements significantly influence judicial attitudes and decisions, necessitating recognition and regulation to reduce inconsistencies and unpredictability in the enforcement of arbitral awards.
The research concludes with recommendations for policymakers and legal practitioners, advocating for clearer guidelines and a more nuanced, context-sensitive approach to the interpretation and application of public policy in arbitration. Ultimately, this dissertation aims to contribute to the advancement of a more robust and coherent arbitration regime in Nigeria, fostering greater confidence in the international arbitration process within the jurisdiction