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Narrative Collisions, Sociological Pressures and Dementia: The relational basis of personhood reconsidered.
Get PDFPersonal relationships are recognised as a key contextual influence upon the experience of dementia. An exclusive focus on dementia as a state of disease and the substantial strain it places upon people’s lives can result in challenges of the condition being exacerbated and, at worst, lead to cruelty due to lack of care. As a consequence, person-centred approaches (in contrast to illness-centred) offer counterbalance by emphasising that people live their lives within interdependent relationships, which can enable people with dementia to sustain a positive personal identity
“You Obviously Just Have to Put on a Brave Face”: A Qualitative Study of the Experiences and Coping Styles of Men With Rheumatoid Arthritis
Get PDFObjective
To explore the experiences, coping styles, and support preferences of male rheumatoid arthritis (RA) patients.
Methods
Six focus groups comprised 22 men with RA. Transcripts were analyzed using inductive thematic analysis.
Results
Three overarching themes describe the experiences, coping styles, and support preferences of men with RA. In “challenges to masculinity,” the men described a “reduction in strength and abilities,” which can lead to loss of independence, “challenges to masculine identity and role,” and “loss of power and control.” Coping by “getting through life with RA” meant dealing with RA by “just getting on with it,” “information seeking,” engaging in “destructive behaviors,” and “withdrawing socially.” Preferred “sources of support” tended not to include friends, as they were perceived to lack understanding or support. For acceptable support the men reported a preference for information‐giving sessions rather than a discussion group, but there was no agreement on whether these should be mixed‐sex or men only, or who should run the sessions.
Conclusion
Male patients reported a range of coping styles and support preferences to address their experiences of living with RA, many of which may not be shared with women. Further research is needed to investigate whether these findings exist in a larger sample and whether the support preferences of men with RA are broadly different from those of women with RA to decide whether there is a clinical need to design a service for the potentially different needs of men
Professional Practice in Paramedic, Emergency and Urgent Care, First Edition
No full textHealth policy changes from 1997 set out to modernise the NHS through the
delivery and continuous improvements of high-quality healthcare services
that was designed around the patients. As a result, demand-driven, highprofil
services such as emergency and urgent care, saw the implementation
of national standards to reduce waiting times and improve access to
emergency and urgency care services. This led to dramatic changes in new
ways of working, role redesign and changes in skill mix to redesign service
delivery. Like the NHS, ambulance services in England are also playing an
increasingly wide role in the NHS in response to national policy changes.
Traditionally, ambulance services have been designed around delivering
resuscitation, trauma care and cardiac care to patients who are critically
ill. Eighty percent of training to front-line ambulance clinicians has
been focused on this. Today, 90% of patients do not fi into this category.
Ambulance services have changed their traditional approach and are now
more embedded in urgent care as a whole to provide a mobile healthcare
service for the NHS. Added to this is an increase in public expectations,
advanced medical and information technology, an ageing population and
chronic conditions has put even greater pressure and demand on emergency
and urgent care services. This has been a positive move towards roles
of nurses and paramedics, perhaps politically driven but also out of the
desire to enhance patient care, improve access, reduce unnecessary attendance
to emergency departments, provide care closer to home and unlock
and utilise nursing and paramedical potential.
The current provision of emergency and urgent care services, roles and
responsibilities of nurses and paramedics are continuously evolving and
increasing in the UK. Patients are now accessing and seeking care at the
point of delivery. As a result, the front-line practitioners have to consider
options for referral and the use of alternative care pathways. Paramedics
and nurses working in this sector need to be educated and trained to deal
with the mixed case they see both at the pre-registration education and
continuing professional development. They must have the underpinning
knowledge and skills which will enable the correct clinical decisions to be
made, which are demonstrably in the patients’ best interest. This can only
be achieved in a clinically safe, professional and lawful manner (Nursing
and Midwifery Council 2008; Health & Care Professions Council 2012).
This book is intended to provide the underpinning theoretical knowledge
of the issues that you encounter on a daily basis when working
in the pre-hospital, emergency and urgent care environment. This will
hopefully enable you to develop a comprehensive theoretical understanding
of the issues underpinning professional practice which is fundamental
to everyday clinical practice. The chapters will provide clinical exemplars,
discussion points and critical thinking points throughout. This is intended
for you to reflec on your own experiences in order for you to link and apply
the theory to your own area of practice. Illustrations given will also
demonstrate how the theory is applied in practice to increase your understanding
of the concepts explored in this book.
The firs three chapters are focused on patient assessment which includes
history taking, consultation and communication skills and clinical decision
making. These three chapters are inextricably linked and cannot be viewed
as separate subjects. Therefore, all three chapters should be read in conjunction
with each other in order for you to gain a comprehensive theoretical
understanding that will enable to justify your decision making when assessing
and managing patient care.
For the remaining chapters, it is inevitable that the subject areas
discussed and explored in this book are integrated with each other and
therefore there will be some overlap in each individual chapter. Wherever
possible, these have been cross-referenced to chapters where it is discussed
more in detail.
As the book title suggests, it is intended for paramedics and nurses
working in pre-hospital, emergency and urgent care. Chapters 3, 6 and 7
predominately focus on paramedic practice; however, the principles of professional
practice are transferable and therefore can be applied to all areas
of healthcare practice.
Paramedics and paramedic practice is an emerging profession and therefore
the literature predominately relates to the clinical aspects of practice
with very little relating to the professional aspect of practice. Therefore,
the literature used throughout this book has been drawn from other disciplines,
predominately nursing. It is important to understand that regardless
of this, the theoretical knowledge and skills are transferable and will
apply to all healthcare practitioners.
It is hoped that this book will enable you to develop a broader and deeper
knowledge base of the theoretical issues that underpin professional practice
and how this is applied to everyday clinical practice. I hope you enjoy
reading this book as much as I have enjoyed writing and editing this book.
Val Nixo
PRE-CRASH EXTRACTION OF THE CONSTELLATION OF A FRONTAL COLLISION BETWEEN TWO MOTOR VEHICLES
Get PDFOne of the strategic objectives of the European Commission is to halve the number of road traffic fatalities by 2020. In addition, in 2010, the United Nations General Assembly initiated the "Decade of Action for Road Safety 2011-2020" to reduce the number of fatalities and decrease the number of road traffic injuries. To address the scourge of road traffic accidents, this thesis presents a research study which has devised and evaluated a novel algorithm for extracting the constellation of an unavoidable frontal vehicle-to-vehicle accident. The primary research questions addressed in this work are:
• What are the most significant collision parameters which influence the injury
severity for a frontal collision between two motor vehicles?
• How to extract the constellation of a crash before the accident occurs?
In addition, the secondary research questions given below were addressed:
• How to integrate physical constraints, imposed on the rate of acceleration of a
real vehicle, together with data from vehicle-to-vehicle (V2V) communication,
into the crash constellation extraction algorithm?
• How to integrate uncertainties, associated with the data captured by sensors
of a real vehicle, into a simulation model devised for assessing the performance
of crash constellation extraction algorithms?
Statistical analysis, conducted to determine significant collision parameters, has
identified three significant crash constellation parameters: the point of collision on the vehicle body and the relative velocity between the vehicles; and the vehicle alignment offset (or vehicle overlap). The research reported in this thesis has also produced a novel algorithm for analysing the data captured by vehicle sensors, to extract the constellation of an unavoidable vehicle-to-vehicle frontal accident. The algorithm includes a model of physical constraints on the acceleration of a vehicle,
cast as a gradual rise and eventual saturation of vehicle acceleration, together with the acceleration lag relative to the timing of information received from V2V communication.
In addition, the research has delivered a simulation model to support the evaluation of the performance of crash constellation extraction algorithms, including a technique for integrating (into the simulation model, so that the simulation can approach real-world behaviour) the uncertainties associated with the data captured by the sensors of a real vehicle.
The results of the assessment of the soundness of the simulation model show that the model produces the expected level of estimation errors, when simulation data is considered on its own or when it is compared to data from tests performed with a real vehicle.
Simulation experiments, for the performance evaluation of the crash constellation extraction algorithm, show that the uncertainty associated with the estimated time-to-collision decreases as vehicle velocity increases or as the actual time-to-collision decreases. The results also show that a decreasing time-to-collision leads to a decreasing uncertainty associated with the estimated position of the tracked vehicle,
the estimated collision point on the ego vehicle, and the estimated relative velocity between the two vehicles about to collide. The results of the performance assessment of the crash constellation extraction algorithm also show that V2V information has a beneficial influence on the precision of the constellation extraction, with regards to the predicted time-to-collision, the predicted position and velocity of the oncoming vehicle against which a collision is possible; the predicted relative velocity between the two vehicles about to collide, and the predicted point of collision on the body of the ego vehicle.
It is envisaged that the techniques, developed in the research reported in this thesis, will be used in future integrated safety systems for motor vehicles. They could then strongly impact passenger safety by enabling optimal activation of safety measures to protect the vehicle occupants, as determined from the estimated constellation of the impending crash
Does psychological functioning mediate the relationship between bullying involvement and weight loss preoccupation in adolescents? A two-stage cross-sectional study
Get PDFBackground
Adolescent bullying is associated with a range of adversities for those who are bullied (i.e., victims and bully-victims), including reduced psychological functioning and eating disorder symptoms. Bullies are generally well-adjusted psychologically, but previous research suggests that bullies may also engage in problematic diet behaviours. This study investigates a) whether adolescents involved in bullying (bullies, victims, bully-victims) are at increased risk of weight loss preoccupation and whether psychological functioning mediates this relationship and b) whether sex is a key moderator.
Method
A two-stage design was used. In stage 1, adolescents (n=2782) from five UK secondary schools were screened for bullying involvement using self and peer reports. In stage 2, a sample of bullies, victims, bully-victims and uninvolved adolescents (n=767) completed a battery of assessments. The measures included the eating behaviours component of the Child and Adolescent Psychiatric Assessment, which was reduced to one factor (weight loss preoccupation) and used as the outcome variable. Measures of self-esteem, body-esteem and emotional problems were reduced to a latent (mediator) variable of psychological functioning.
Results
Bullies, victims and bully-victims were at increased risk of weight loss preoccupation compared to adolescents uninvolved in bullying. The mechanism by which bullying involvement related to increased weight loss preoccupation varied by bullying role: in bullies the effect was direct, in victims the effect was indirect (via reduced psychological functioning) and in bully-victims the effect was both direct and indirect. Sex significantly moderated the relationship in bullies: weight loss preoccupation was only statistically significant in bullies who were boys.
Conclusion
Bullying involvement during adolescence is associated with weight loss preoccupation. Bullies are likely driven by a desire to increase attractiveness and social status; whereas weight loss preoccupation in bullied adolescents may have maladaptive influences on diet and exercise behaviours due to its association with reduced psychological functioning. Peer victimisation should be considered as a potential modifiable risk factor for weight loss preoccupation and associated maladaptive diet and exercise behaviours
SceneMaker: Creative Technology for Digital StoryTelling
No full textWe brought together the subject of computing with creative technologies, cinematic arts (film), drama, dance, music and design in terms of research and education and propose here the development of a flagship computer software platform, SceneMaker, acting as a digital laboratory workbench for integrating and experimenting with the computer processing of new theories and methods in these multidisciplinary fields. We discuss the architecture of SceneMaker and relevant technologies for processing within its component modules. SceneMaker will enable the automated production of multimodal animated scenes from film and drama scripts or screenplays. SceneMaker will highlight affective or emotional content in digital storytelling with particular focus on character body posture, facial expressions, speech, non-speech audio, scene composition, timing, lighting, music and cinematography. Applications of SceneMaker include automated simulation of productions and education and training of actors, screenwriters and directors
Archival research and historical consultant for the BBC Four & The Open University documentary series on Five Decades of LGBT+ life in Britain for 7 Wonder, Birmingham. Tx. date, 2017.
No full textDetection and Forensic Evidential Value of Tattoos Identified Using Alternative Light Sources
No full textTattoos have been used for over 5,000 years as a means of
differentiating one person from another. However, different types of
tattoos have increased in popularity over the last decade and are
continuing to gain attention. A tattoo can be either temporary or
permanent and can be on any area of a person's anatomy. Previously,
tattoos have been ignored as a valuable biometric feature in human
identification as they are not specific to one individual compared to
favoured evidence such as DNA. Additionally, developments in
technology are resulting in new ways to cover-up and remove traces of
tattoos, causing intelligence gaps in the identification procedure. There
has been limited research conducted on the use of tattoos in human
identification processes.
This study investigated the influence of burning and decomposition
upon temporary and permanent tattoos as a means of visualisation in
a forensic identification context
Subject Specific Optimisation of the Stiffness of Footwear Material for Maximum Plantar Pressure Reduction
No full textCurrent selection of cushioning materials for therapeutic footwear and orthoses is based on empirical and anecdotal evidence. The aim of this investigation is to assess the biomechanical properties of carefully selected cushioning materials and to establish the basis for patient-specific material optimisation. For this purpose, bespoke cushioning materials with qualitatively similar mechanical behaviour but different stiffness were produced. Healthy volunteers were asked to stand and walk on materials with varying stiffness and their capacity for pressure reduction was assessed. Mechanical testing using a surrogate heel model was employed to investigate the effect of loading on optimum stiffness. Results indicated that optimising the stiffness of cushioning materials improved pressure reduction during standing and walking by at least 16 and 19% respectively. Moreover, the optimum stiffness was strongly correlated to body mass (BM) and body mass index (BMI), with stiffer materials needed in the case of people with higher BM or BMI. Mechanical testing confirmed that optimum stiffness increases with the magnitude of compressive loading. For the first time, this study provides quantitative data to support the importance of stiffness optimisation in cushioning materials and sets the basis for methods to inform optimum material selection in the clinic
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