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Transition to end-of-life care in patients with neurological diseases in an acute hospital ward
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: received 2024-04-22, registration 2024-07-16, accepted 2024-07-16, epub 2024-07-22, online 2024-07-22, collection 2024-12-01Acknowledgements: We thank the data abstractors Andrea Jona Eggertsdottir, Berglind Osk Olafsdottir, Mona Sif Hadaya and Kristin Asgeirsdottir for their invaluable contribution to this study.Publication status: PublishedFunder: The Icelandic Nurses´ Association; Grant(s): 71545Funder: The University of Iceland Research Fund of Ingibjorg R. MagnusdottirFunder: Landspitali, The National University Hospital of IcelandErna Haraldsdottir - ORCID: 0000-0003-4891-0743
https://orcid.org/0000-0003-4891-0743Background: Transitioning to end-of-life care and thereby changing the focus of treatment directives from life-sustaining treatment to comfort care is important for neurological patients in advanced stages. Late transition to end-of-life care for neurological patients has been described previously. Objective: To investigate whether previous treatment directives, primary medical diagnoses, and demographic factors predict the transition to end-of-life care and time to eventual death in patients with neurological diseases in an acute hospital setting. Method: All consecutive health records of patients diagnosed with stroke, amyotrophic lateral sclerosis (ALS), and Parkinson’s disease or other extrapyramidal diseases (PDoed), who died in an acute neurological ward between January 2011 and August 2020 were retrieved retrospectively. Descriptive statistics and multivariate Cox regression were used to examine the timing of treatment directives and death in relation to medical diagnosis, age, gender, and marital status. Results: A total of 271 records were involved in the analysis. Patients in all diagnostic categories had a treatment directive for end-of-life care, with patients with haemorrhagic stroke having the highest (92%) and patients with PDoed the lowest (73%) proportion. Cox regression identified that the likelihood of end-of-life care decision-making was related to advancing age (HR = 1.02, 95% CI: 1.007–1.039, P = 0.005), ischaemic stroke (HR = 1.64, 95% CI: 1.034–2.618, P = 0.036) and haemorrhagic stroke (HR = 2.04, 95% CI: 1.219–3.423, P = 0.007) diagnoses. End-of-life care decision occurred from four to twenty-two days after hospital admission. The time from end-of-life care decision to death was a median of two days. Treatment directives, demographic factors, and diagnostic categories did not increase the likelihood of death following an end-of-life care decision. Conclusions: Results show not only that neurological patients transit late to end-of-life care but that the timeframe of the decision differs between patients with acute neurological diseases and those with progressive neurological diseases, highlighting the particular significance of the short timeframe of patients with the progressive neurological diseases ALS and PDoed. Different trajectories of patients with neurological diseases at end-of-life should be further explored and clinical guidelines expanded to embrace the high diversity in neurological patients.pubpu
A novel approach to consumer loyalty: A case study of hospitality service organisations among Generation X and Y
No full textAccess to item restricted until 05/02/2025.Consumer loyalty is considered one of the significant factors that affect market growth and consumer behaviour. Regardless of the numerous studies on customer loyalty, the authors found no empirical study that elaborates on the importance of customer loyalty across generations. The majority of previous studies have proposed customer engagement and customer involvement as one construct in predicting customer loyalty. Thus, the current research tries to fill this gap in the literature by proposing a new model of customer loyalty blends multidimensional consumer involvement as predictors, multidimensional consumer online engagement as a mediator, and finally the moderating role of different generations (X and Y) in the hospitality services context. Present research collected (N = 390) data from Malaysia hospitality service organisations and the data were analysed using structural equation modelling. The results approve all the direct relationships as well as the moderating effect of generation generations X and Y. Moreover, the results confirm the mediating role of consumer online engagement among consumer involvement dimensions and consumer loyalty. The current study highlights significant implications to facilitate and increase consumer loyalty in the hospitality services context, especially in the airline, and hotel industries.https://doi.org/10.1504/IJEBR.2024.136497pubpu
'Going Off on One' - Nomadic-SchizoAdventures in the Playroom and Beyond
No full textAccompanying animations are available at: https://youtu.be/dVb-y-LcLX4 and https://youtu.be/jZ673ZjfMTo?feature=shared
Prehabilitation before Surgery: Delivery using mHealth technology
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Case Study: Managing delivery of a suite of programmes in a language other than English
No full textItem is restricted in this repository.According to the most recent data (HESA AOR, 2022-23), Europe remains the UK’s second largest TNE market after Asia. The number of UK TNE students in Europe is increasing and the strongest growth rate amongst the top 5 TNE host countries was in Greece. The partnership between Queen Margaret University (QMU) in Edinburgh and Metropolitan College (MC) in Greece dates back to 2000. MC is the largest private provider of post-secondary education in Greece delivering transnational programmes across eight different campuses. Starting initially with one programme the partnership has grown to include eleven undergraduate programmes accounting for over 3000 students in academic year 2023-24. MC also operates partnerships with other UK universities (University of East London, Solent University, Oxford Brookes University) as well as having relationships with educational institutions from around the world. The suite of programmes is now delivered entirely in Greek. This case study explains the rationale for this and describes the measures put in place to manage delivery in a language other than English. A brief evaluation of the impact of changing to delivery in Greek is provided.pubpu
Chapter 16: Eliciting Clients’ Perspectives: Gathering Information From Clients, Caregivers, and Other Professionals
No full textDonald Maciver - ORCID: 0000-0002-6173-429X
https://orcid.org/0000-0002-6173-429XItem is not available in this repository.https://ot.lwwhealthlibrary.com/content.aspx?sectionid=256364217&bookid=3270inpressinpres
Response to Responses: Raising Awareness isn’t Enough: The Role of the Psychology of Education in Disability. Related Justice and Inclusion in Primary Classrooms
Get PDFSian Jones - ORCID: 0000-0002-2399-1017
https://orcid.org/0000-0002-2399-1017Since writing my Open Dialogue piece, and sending it into the world, I have been bowled
over by the responses, first from the reviewers, and then from researchers who have taken
the time to carefully read the initial piece and to verbalise their own responses to it. Many
in so doing, have shared something very valuable of their own experiences of disability in
the spheres of Psychology and/or Education. For me, it has been a privilege and a pleasure
to read these responses, and I am very thankful to the editorial team of the BPS Education
section for the opportunity to do so, and for their own hard work in bringing this idea for an
Open Dialogue into being. What I offer now is a reflection on the responses, alongside what
I am tentatively framing as a ‘call to action’ among everyone working in the Psychology of
Education, to join us in enhancing disability literacy and working towards disability-related
social justice. I maintain here my focus on primary classrooms, but have on occasion
strayed beyond this, as you will see, and welcome your thinking and action on expanding
changes to our practice across the Psychology of Education, writ large.48pubpub
Understanding health system resilience in responding to COVID-19 pandemic: experiences and lessons from an evolving context of federalization in Nepal
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: received 2023-05-11, registration 2024-02-19, accepted 2024-02-19, epub 2024-04-04, online 2024-04-04, collection 2024-12Acknowledgements: The authors would like to acknowledge all stakeholders who participated in this study and shared their valuable experiences.Publication status: PublishedMaria Paolo Bertone - ORCID: 0000-0001-8890-583X
https://orcid.org/0000-0001-8890-583XSophie Witter - ORCID: 0000-0002-7656-6188
https://orcid.org/0000-0002-7656-6188This record replaces https://eresearch.qmu.ac.uk/handle/20.500.12289/13690 for the AAM, which was deposited on 2024-03-05.Introduction: The COVID-19 pandemic has tested the resilience capacities of health systems worldwide and highlighted the need to understand the concept, pathways, and elements of resilience in different country contexts. In this study, we assessed the health system response to COVID-19 in Nepal and examined the processes of policy formulation, communication, and implementation at the three tiers of government, including the dynamic interactions between tiers. Nepal was experiencing the early stages of federalization reform when COVID-19 pandemic hit the country, and clarity in roles and capacity to implement functions were the prevailing challenges, especially among the subnational governments. Methods: We adopted a cross-sectional exploratory design, using mixed methods. We conducted a desk-based review of all policy documents introduced in response to COVID-19 from January to December 2020, and collected qualitative data through 22 key informant interviews at three tiers of government, during January-March 2021. Two municipalities were purposively selected for data collection in Lumbini province. Our analysis is based on a resilience framework that has been developed by our research project, ReBUILD for Resilience, which helps to understand pathways to health system resilience through absorption, adaptation and transformation. Results: In the newly established federal structure, the existing emergency response structure and plans were utilized, which were yet to be tested in the decentralized system. The federal government effectively led the policy formulation process, but with minimal engagement of sub-national governments. Local governments could not demonstrate resilience capacities due to the novelty of the federal system and their consequent lack of experience, confusion on roles, insufficient management capacity and governance structures at local level, which was further aggravated by the limited availability of human, technical and financial resources. Conclusions: The study findings emphasize the importance of strong and flexible governance structures and strengthened capacity of subnational governments to effectively manage pandemics. The study elaborates on the key areas and pathways that contribute to the resilience capacities of health systems from the experience of Nepal. We draw out lessons that can be applied to other fragile and shock-prone settings.pubpu
Exploring the feasibility of a cluster pilot randomised control trial to improve children’s 24-hour movement behaviours and dietary intake: Happy homework
Get PDFRosie Arthur - ORCID: 0000-0003-0651-4056
https://orcid.org/0000-0003-0651-4056We aimed to explore the feasibility, acceptability, and potential efficacy of Happy Homework (HH); an 8-week home-focussed intervention, with the purpose of encouraging children’s positive dietary behaviours and engagement in positive physical activity (PA) and sleep behaviours. We randomised four Scottish schools (n = 71 participants; 5 classrooms) to either the HH intervention (n = 2) or usual curriculum control group (n = 2). HH consisted of movement and dietary-focused parent and child tasks. Primary outcome measures were intervention feasibility, acceptability, and potential efficacy. Secondary outcomes were objectively measured PA via ActiGraph GT3X+, sedentary behaviours (SBs) and sleep duration via activPAL4™ accelerometers and dietary behaviours, fruit and vegetable consumption and screen-time via questionnaires. After controlling for pre-test levels, post intervention stepping time and sleep duration were significantly greater for the HH group in comparison to the control group. The HH group reported eating more fruit and vegetables at post-test than the control group. Participants also reported the intervention to be enjoyable and motivating. These findings provide promising evidence that given a greater sample size, better retention and the prioritisation of health and wellbeing homework, HH could enhance children’s health and wellbeing.https://doi.org/10.1080/02640414.2023.230056241pubpub1
The Compartmental Tongue
Get PDFAlan Wrench - ORCID: 0000-0003-2547-9671
https://orcid.org/0000-0003-2547-9671Purpose: Tongue anatomy and function is widely described as consisting of four extrinsic muscles to control position and four intrinsic muscles to control shape. This myoarchitecture cannot, however, explain independent tongue body and blade movement nor accurately model the subtlety of observed lingual shapes. This study presents the case for a finer neuromuscular structure and functional description.
Method: Using the theoretical framework of the partitioning hypothesis, evidence for neuromuscular compartments of each of the lingual muscles was discerned by reviewing studies of lingual anatomy, hypoglossal nerve staining, hypoglossal motoneuron axon tracing, muscle fiber type distribution, and electromyography. Muscle fibers of the visible human female were manually traced to produce a three-dimensional atlas of muscular compartments. A kinematic study was undertaken to determine the degree of independent movement between different parts of the tongue. A simple biomechanical model was used to demonstrate how synergistic groups of compartments can control sectors of the tongue.
Results: Results indicated as many as 10 compartments of genioglossus, two each of superior and inferior longitudinal, eight of styloglossus, three of hyoglossus, and six each of transversus and verticalis, while palatoglossus may not have a significant role in tongue function. Kinematic analysis indicated independent control of five sectors of the tongue body, and biomechanical modeling demonstrated how this control may be achieved.
Conclusion: Evidence is presented for a lingual structure based on neuromuscular compartments, which work together to position and shape sectors of the tongue and independently control tongue body and blade.https://doi.org/10.1044/2024_JSLHR-23-0012567pubpub10
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