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Exploring the experiences of physiotherapy in North Wales for people with Multiple Sclerosis: informing service development and practice
Get PDFBackground: Multiple Sclerosis (MS) is one of the most prevalent neurological conditions affecting adults and physiotherapy is recommended for people with MS (PwMS) (National Institute of Clinical Excellence (NICE), 2018). The high prevalence and complex needs of this group of people often require significant physiotherapy, yet there is a paucity of research exploring experiences of physiotherapy for PwMS.
Aim: To explore the experiences of physiotherapy for PwMS in North Wales to inform physiotherapy service development and practice. This will make an original contribution to research by exploring this under-researched area, providing insight and understanding for physiotherapists and other people involved in the care of PwMS which can lead to better informed, more empathetic practice (Cassidy et al., 2011) and service development.
Design: Six PwMS were interviewed. Interview transcripts were analysed and interpreted using interpretive phenomenological analysis (IPA) methodology. Themes were developed, explored and considered alongside relevant research to situate and contextualise this research.
Findings: Three main themes emerged. There was an over-arching theme of sense of self in relation to experience of physiotherapy; sense of self was affected by most aspects of physiotherapy, from practical aspects of service delivery, to more nuanced aspects such as the context in which exercise was situated. Embodied experience of physiotherapy explored the lived experience of physiotherapy, including what physiotherapy meant to these PwMS regarding self-management, person centred care and communication as examples. Embodied experience of living with MS was intrinsic to each participant’s experience of physiotherapy and included aspects such as the emotional and physical effects of living with MS.
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Recommendations: Increased awareness regarding highlighted aspects of the lived experience of physiotherapy and the significant impact physiotherapy can have on sense of self for PwMS, would help improve, enrich and individualise experience of physiotherapy in its’ broadest sense. This research increases insight and awareness regarding the lived experience, thoughts, feelings and perceptions of PwMS regarding physiotherapy which can lead to more sensitive, informed, empathetic and contextualised physiotherapy for this population. This research has found the experiences of physiotherapy for PwMS are inextricably linked and inter-dependent with sense of self, a concept further explored within this research
Breast care nursing in North Wales: an evaluation of breast care nursing from the perspective of practice nurses and district nurses
No full textBackground to the study: Breast care services for Wales have developed in response to government requirements that breast cancer care should be delivered only by specialist multi-disciplinary teams in cancer units treating at least 100 new breast cancer patients per year. Study aims: This paper presents the findings of the second stage of a three-stage study, which evaluated the North Wales Breast Care Nursing Service. The aim of this stage was to evaluate the breast care nursing service from the perspective of District Nurses and Practice Nurses. Methodological issues: A postal questionnaire was distributed to the total population of District Nursing Sisters (n=97) and Practice Nurses (n=243) within North Wales. The questionnaire comprised both open and closed items as well as a 15-item Likert Scale. Findings/conclusion: The study demonstrated the value of the BCNS, as perceived by two other community nursing disciplines within North Wales. The service was considered to be responsive, accessible and to offer support and advice for patients. Community nurses who were familiar with the BCNS service, or had used the service, considered BCNSs to have excellent clinical skills, on which they could draw as a resource. Nurses who were less familiar with the service considered that it should be promoted more effectively to community nurses. It is concluded that District Nurses could have a vital role in the care of women with breast cancer, but need support, advice and training from the BCNS service to enable them to provide a complementary role. This could ultimately enable BCNS time could be used more effectively
Interpretation of Absolute Laser Reflectance During Optical Monitoring of Polycrystalline GaAs Deposition on Quartz Using Metalorganic Chemical Vapor Deposition
Get PDFGallium arsenide was deposited by metal organic chemical vapor deposition in a horizontal quartz reactor tube using trimethylgallium and arsine at 400oC - 500oC. Nucleation time and deposition rate were monitored using in situ laser reflectometry. This allowed differentiation between film and parasitic growth, which was not possible with other optical techniques. An absolute reflectance model was developed using measurements prior to GaAs deposition, and then employed to calculate values for GaAs on quartz. Detected reflectance intensities during experimental GaAs deposition were low compared to the model due to 3-dimensional island growth, causing scattering of the incident laser radiation
Trimethylplatinum(IV) complexes of anionic N/O and O/O donor ligands: synthesis, NMR and fluxional behaviour
Get PDFReaction of pentane-2,4-dione, pyridine-2-carboxylic acid or pyridine-2,6-dicarboxylic acid with trimethylplatinum(IV) gives dimeric complexes of general formulae fac-[PtMe₃L]₂, in which the ionised ligand acts in a chelating and a bridging fashion. High-resolution solid-state ¹⁹ ;Pt NMR data shows that the two platinum atoms are equivalent ; the chemical shielding anisotropy and the principal components of the shielding tensor are reported. The complexes are soluble in co-ordinating solvents, yielding monomeric species of general formulae fac-[PtMe₃L(solvent)], which are fluxional. The pyridine adducts, fac-[PtMe₃L(py)] (L = pentane-2,4-dionato or pyridine-2-carboxylato), are also stereochemically non-rigid. The energetics of the dynamic processes have been studied by standard ¹H NMR band shape analysis techniques ; ΔG ‡ (298 K) is in the range 69–86 kJ mol⁻¹. Solid-state ¹³C, and solution-state ¹³C and ¹⁹;Pt NMR data are also reported
Evaluating the implementation of the WHO Healthy Cities Programme across Germany (1999-2002)
Get PDFThe WHO Healthy Cities Project (1988) is a well-known example of the setting-based approach to health promotion. Developed as a framework for translating the key principles of the Ottawa Charter for Health Promotion (1986) into practice, it is best characterized as a process for successfully encouraging healthy public policy. In 2001, the German Healthy Cities Network (HCN) commissioned a survey of the 52 local Healthy Cities programme Coordinators (HCC) to monitor progress and identify strengths and weaknesses associated with its implementation. Most (90%; 47/52) HCC participated in the survey. Several positive aspects of the Health Cities Programmes (HCP) in Germany were identified: during the first 5 years, it expanded rapidly; project coordinators felt highly engaged, despite limited resources; a combination of traditional and innovative approaches was adopted and applauded; and almost 75% of HCC felt that their efforts had been beneficial. Nonetheless, the following shortcomings were identified: increased resources required; greater clarification of concepts and strategies at the local level; stronger commitment to the Nine-Point Programme of Action; greater integration within the national HCN and the local political administrative system (PAS); better programme documentation and evaluation. In conclusion, the HCN in Germany has expanded and developed since its inception 20 years ago. German HCP will only improve if professionalism and quality of local work are improved, particularly in terms of strengthening their influence on the local PAS and on public policies
Community involvement at what cost? – Local appraisal of a pan-European nutrition promotion programme in low-income neighbourhoods
No full textIn the UK, government has committed itself to improving health and reducing inequalities in health. For the first time, issues such as food poverty will be addressed by tackling the causes of poverty and wider determinants of ill health. The time has never been better, therefore, for health and local authorities to work collaboratively to promote and improve health. Community involvement is also paramount to sustainable programmes. However, such a dramatic shift in policy and greater emphasis on public health requires health professionals themselves to adopt a different approach.
The World Health Organisation recommends a health promotion approach as a framework for action. But despite the existence of this framework there is little evidence that a wider understanding of health promotion and the necessary practical experience has been achieved. This has weakened the potential impact of health promotion and has possibly encouraged inappropriate use of health promotion principles in practice.
This refers to a programme of work titled the European Food and Shopping Research Project (SUPER-project) during the period 1989-1997. SUPER was established under the WHO European network of Healthy Cities, to help local projects implement the principles of health promotion (WHO, 1986). This paper describes the SUPER -project and its implementation in Liverpool (1989-1997), where levels of unemployment, deprivation and ill health are amongst the highest in the UK. Participation in SUPER is appraised to identify the various benefits and obstacles involved and to identify links with progress at the local level. This appraisal is discussed and the use, and potential misuse, of participatory appraisal techniques to elicit information and mobilise communities is examined
Principles of Cost Minimisation in Wireless Networks
Get PDFThis paper considers variations of the minimum connected vertex cover problem to be found in the study of wireless network design. A simple, theoretic formulation is followed by a discussion of practical constraints. Two algorithms are given and results compared
Investigations of polarization purity and specific absorption rate for two dual-band antennas for satellite-mobile handsets
Get PDFA study of the effects of human proximity on the polarization purity of two types of circularly-polarized handset antennas for personal satellite communications was investigated using the hybrid method of moments (MoM)/finite-difference time-domain technique. Associated with this, assessments of specific absorption rate in the head were made. The method gave stable results, in accordance with physical expectations; good agreement with the pureMethod of Moments was shown in simplified cases omitting the head. The quadrifilar spiral antenna (QSA) was shown to be a propitious design for personal satellite communications
Some Notes and Results on Bandwidth-based Routing and Implicit Load Balancing
Get PDFThe Maximum Bandwidth Path Algorithm (MBPA) is introduced as an alternative to Dijkstra’s Shortest Path Algorithm (DSPA) for Internet routing. The two are compared and differences noted. Of particular interest is the extent to which each algorithm achieves Implicit Load Balancing (ILB) – the principle of effective link usage for traffic across the network as a whole for non-equal paths and without the use of explicit routing variance. Although MBPA may prove to be more efficient than DSPA generally (further work is required), it is shown, through extensive simulation, that it produces better levels of ILB for real, as opposed to artificial, network scenarios