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Person centered care: advanced philosophical perspectives
Get PDFThe ideas and terminology of person-centred care have been part of health discourse for a very long time. Arguments that in healthcare one treats the whole person, not her/his component parts, date back at least to antiquity and the need to treat the patient as a person is articulated persuasively by clinical authors in the early twentieth century. Yet it is only in recent years that we have seen a growing consensus in health policy and practice literature that PCC, and associated ideas including patient expertise, co-production and shared decision-making, are not simply “fine ideals” or “ethical add-ons” to sound scientific clinical practice, but rather they represent indispensable components of any genuinely integrated, realistic and conceptually sound account of healthcare practice.
The underlying conviction of this volume - one belief that, despite their differences, unites all of its contributors - is that PCC should not become the latest “revolutionary” concept to be “operationalised” before being “conceptualised”. It is imperative that we develop an open and inclusive dialogue about what we do and do not mean by “person-centred” to inform our attempts to implement PCC
Widening participation praxis and library leadership
No full textThis chapter theorizes academic libraries and library workers as partners in social justice work in higher education, linking the core concerns of critical librarianship (or Critlib) to library leadership practices that can enable and facilitate widening participation as a political project. Widening participation, as a policy imperative and higher education practice, attempts to improve access to higher education among under-represented groups. However, rooted in the logic of marketized, neoliberal higher education, liberal approaches to widening participation are instrumentalist and contribute to a cultural discourse which reproduces inequity and unequal educational outcomes.
Drawing on Nancy Fraser's model of social justice and critical sociology of education, particularly the work of Penny Jane Burke and Diane Reay, this chapter develops a critical theory of library leadership which radically reframes widening participation practice as a project of recognition and inclusion. In connecting the rich scholarship of Critlib movement, particularly critical information literacy and library pedagogies, to shared commitments to social justice between library and other education workers, this chapter deepens our theoretical understanding of libraries’ contributions to widening participation
Use of procalcitonin, neopterin, haptoglobin, serum amyloid A and proinflammatory cytokines in diagnosis and prognosis of bovine respiratory disease in feedlot calves under field conditions
No full textBovine respiratory diseases (BRD) have long been considered a serious problem that causes major economic losses in feedlot calves (FC). This study aimed to determine the diagnostic and prognostic effect of selected biological markers including, procalcitonin (PCT), neopterin (NP), proinflammatory cytokines (IL-1β, IL-8, TNF-α, IF-γ), haptoglobin (HP) and serum amyloid A (SAA) on FC with BRD under field conditions. Sixty-nine FC that were identified to be infected with Mannheimia haemolytica and Histophilus somni and had different clinical respiratory signs (diseased group) were selected for this study. In addition, 20 healthy FC have been selected as a control group. We have detected higher serum levels of PCT, NP, HP, SAA, IL-1β, IL-8, TNF-α and IF-γ in diseased FC group compared with the control group. All tested markers revealed a high level of discrimination between BRD infected FC and healthy ones (AUC > 0.90). Moreover, the obtained data showed a high degree of prognostic accuracy for PCT, NP, IL-8, HP, IF-γ and IL-1β in predicting treatment response of FC with BRD at the selected thresholds (AUC = 0.99, 0.99, 0.97, 0.93, 0.88 and 0.82, respectively). Significant inhibition was observed for the selected biochemical markers in treated FC 7 days post-treatment. In conclusion, this study showed that BRD in FC was associated with significant alterations in serum APPs, proinflammatory cytokines, PCT and NPT levels. Furthermore, it demonstrated that these serum biomarkers are much higher in FC with BRD compared to recovered ones. Our data suggest that the measurement of PCT, NPT, APPs and cytokines together with the clinical examination may be a useful diagnostic and prognostic tool for assessment of FC naturally infected with M. haemolytica and H. somni
Convolutional neural network for classification of nerve activity based on action potential induced neurochemical signatures
Get PDFNeural activity results in chemical changes in the extracellular environment such as variation in pH or potassium/sodium ion concentration. Higher signal to noise ratio make neurochemical signals an interesting biomarker for closed-loop neuromodulation systems. For such applications, it is important to reliably classify pH signatures to control stimulation timing and possibly dosage. For example, the activity of the subdiaphragmatic vagus nerve (sVN) branch can be monitored by measuring extracellular neural pH. More importantly, gut hormone cholecystokinin (CCK)-specific activity on the sVN can be used for controllably activating sVN, in order to mimic the
gut-brain neural response to food intake. In this paper, we present a convolutional neural network (CNN) based classification system to identify CCK-specific neurochemical changes on the sVN,from non-linear background activity. Here we present a novel feature engineering approach which enables, after training, a high accuracy classification of neurochemical signals using CNN
Seventeen minutes and thirty-one seconds: An auto/biographical account of collaboratively witnessing and representing an untold life story
Get PDFAuto/biography carries with it elements of privilege as certain kinds of lives are narrated while other lives remain untold. As Arthur Frank (2004) has observed, those lives that are storied are rendered worthy of notice, while untold lives are implicitly rendered absent or insignificant. In our research we have seen how these processes can conspire to further marginalize individuals and populations whose lives are already marginal. This is the sharp edge of social exclusion. In this chapter we explore one particular instance of a creative and collaborative process we have used in an effort to avoid perpetuating exclusion and marginalization in our research. Ours is a story about how, through artistic and creative collaboration, we may begin to reanimate our own and others’ lives through including the kinds of life stories that are typically omitted in social research. Our focus is on responding the questions of how to access, witness and represent elements of an otherwise untold – and potentially untellable – life
County lines: exploitation and drug dealing among urban street gangs
No full textThis work addresses what the National Crime Agency refer to as a 'significant threat' - county lines - the transportation of large volumes of drugs, mostly crack cocaine and heroin, from metro centres to more provincial or rural areas of the UK.
This phenomenon has impacted local drug markets, increasing criminal activity.
Harding explores how county lines evolve, and reveals an extensive network of criminal exploitation and control in the daily 'grind' to sell drugs.
Harding uses a background in research, criminology and marketing to describe in details how county lines operate as a business , shifting product from a to B with a view to increasing professionalisation and market orientation. He accessess street dealers and county line managers alongside drug users, police and local stakeholders, to provide a indepth analysis of how county lines work
Advance care planning and syringe drivers in palliative and end-of-life care
Get PDFThis article discusses the practicalities of syringe drivers (subcutaneous continuous infusion pumps) for symptom control in patients requiring palliative or end-of-life care, which may form part of an advance care plan. It includes a discussion of palliative and end-of-life care, advance care planning, and when a syringe driver might be beneficial for the patient. It also provides step-by-step clinical guidance on setting up a syringe driver
Joint computation and communication design for UAV-assisted mobile edge computing in IoT
Get PDFUnmanned aerial vehicle (UAV)-assisted mobile edge computing (MEC) system is a prominent concept, where a UAV equipped with a MEC server is deployed to serve a number of terminal devices (TDs) of Internet of Things (IoT) in a finite period. In this paper, each TD has a certain latency-critical computation task in each time slot to complete. Three computation strategies can be available to each TD. First, each TD can operate local computing by itself. Second, each TD can partially offload task bits to the UAV for computing. Third, each TD can choose to offload task bits to access point (AP) via UAV relaying. We propose an optimization problem formulation that aims to minimize the total energy consumption including communication-related energy, computation-related energy and UAV flight energy by optimizing the bits allocation, time slot scheduling and power allocation as well as UAV trajectory design. As the formulated problem is nonconvex and difficult to find the optimal solution, we propose to solve the problem by two parts, and obtain the near optimal solution by the Lagrangian duality method and successive convex approximation (SCA) technique, respectively. By analysis, the proposed algorithm can be guaranteed to converge within a dozen of iterations. Finally, numerical results are given to validate the proposed algorithm, which is verified to be efficient and superior to the other benchmark cases
Harnessing the "unique voice" of the child for programme evaluation and development in education research in the United Kingdom: methodological and ethical challenges
Get PDFChildren with high levels of wellbeing are more engaged in learning and achieve greater academic success. Conversely, psychological distress has a detrimental impact on children’s learning experiences and ability to achieve their potential. Schools and communities can offer optimal settings to intervene in social contexts, and to support children’s mental health and learning outcomes. Effectiveness studies show that interventions can help students identified with socio-emotional difficulties to improve in these dual domains, yet few programme evaluations investigate the process issues underlying behaviour change in recipients (Mackenzie & Williams, 2018). While it is increasingly recognised that children themselves need to be engaged in evaluating and developing the interventions and services that affect them (McLaughlin, 2015), research environments are typically adult spaces in which children have less control.
In this chapter, the author challenges research encounters shaped by adult perceptions of children and of children’s marginalised position in society. Using her research with children (aged 11-14 years old) who attended a targeted, socio-emotional programme, she discusses how behaviour change interventions can be understood fully only through the ‘unique voice’ of the child, not through inferences and assumptions on the part of researchers. The author’s case study illustrates how a child-focused, reflexive approach was used to guide the research process. Behaviour change drivers underpinning improvements in children’s wellbeing and facilitating their increased engagement in learning were understood through the unique, personal expertise of programme recipients. Children’s ‘voice’ is shown as being integral to a meaningful understanding of intervention effectiveness and to developing services to meet users’ needs most effectively
Securitisation: the Irish insolvency framework
Get PDFSecuritisation is a financing technique that, if applied under the appropriate circumstances, enables capital utilisation, improves market efficiency and allows a better allocation of risk. This financial tool has evolved over the past few decades and represented a substantial part of Irish and global debt capital
markets.
The key to securitisation is the concept of bankruptcy-remoteness with respect to the securitisation special purpose vehicle (“SPV”). This because SPV will normally be a company which has only minimum outside creditors, and whose sole functions are to acquire and hold the assets and to issue the securities.
Thus, the value of securities issued by the SPV will be determined by the performance of the pool of segregated assets, and not by the continuing creditworthiness of the originator the assets. The separation of the credit risk
of the originator of the assets (“Originator”) and the credit risk of the SPV in this way often enables the originator to obtain lower-cost financing through the
SPV than it would otherwise be able to obtain. As a result, the objective of Irish securitisation structures is to isolate the SPV from insolvency risks. This article
will explore the potential risks that investors in an Irish securitisation transaction may have to face should the underlying assets fail to perform as initially expected