11 research outputs found
Supplemental_Material – Supplemental material for The ESCAPS study: a feasibility randomized controlled trial of early electrical stimulation to the wrist extensors and flexors to prevent post-stroke complications of pain and contractures in the paretic arm
No full textSupplemental material, Supplemental_Material for The ESCAPS study: a feasibility randomized controlled trial of early electrical stimulation to the wrist extensors and flexors to prevent post-stroke complications of pain and contractures in the paretic arm by Joanna C Fletcher-Smith, Dawn-Marie Walker, Kate Allatt, Nikola Sprigg, Marilyn James, Sonia Ratib, Janet Boadu, Carla Richardson and Anand D Pandyan in Clinical Rehabilitation</p
The ESCAPS study: a feasibility randomised controlled trial of early electrical stimulation to the wrist extensors and flexors to prevent post-stroke complications of pain and contractures in the paretic arm
No full textObjective: to establish feasibility of initiating electrical stimulation treatment ofwrist extensors and flexors in patients early after stroke to prevent musclecontractures and pain.Design: feasibility randomised controlled trial with economic evaluation.Setting: a specialist stroke unit in Nottinghamshire.Subjects: forty patients recruited within 72 hours post-stroke with armhemiparesis.Interventions: participants were randomised to receive usual care or usualcare and electrical stimulation to wrist flexors and extensors for 30 minutes,twice a day, five days a week for three months. Initial treatment was deliveredby an occupational therapist or physiotherapist who trained participants to selfmanage subsequent treatments.Measures: measures of feasibility included recruitment and attrition rates,completion of treatment, successful data collection. Outcome data on wristrange of motion, pain, arm function, independence, quality of life and resourceuse were measured at 3, 6- and 12-months post-randomisation.Results: forty participants (of 215 potentially eligible) were recruited in 15months [20 men; mean age 72(SD 13.0)]. Half the participants lacked mentalcapacity and were recruited by consultee consent. Attrition at three-monthfollow-up was 12.5% [death (n=2), end-of-life care (n=2), unable to contact(n=1)]. Compliance varied [mean 65 (SD 53)] and ranged from 10 to 166treatments per patient (target dosage was 120). Data for a valid economicanalysis can be adequately collected.Conclusion: early initiation of electrical Stimulation was acceptable andfeasible. Data collection methods used were feasible and acceptable toparticipants. A large definitive study is needed to determine if electricalstimulation is efficacious and cost effective
ESCAPS study protocol: a feasibility randomised controlled trial of ‘early electrical stimulation to the wrist extensors and wrist flexors to prevent the post-stroke complications of pain and contractures in the paretic arm’
No full textIntroduction: Approximately 70% of patients with stroke experience impaired arm function, which is persistent and disabling for an estimated 40%. Loss of function reduces independence in daily activities and impacts on quality of life. Muscles in those who do not recover functional movement in the stroke affected arm are at risk of atrophy and contractures, which can be established as early as 6?weeks following stroke. Pain is also common. This study aims to evaluate the feasibility of a randomised controlled trial to test the efficacy and cost-effectiveness of delivering early intensive electrical stimulation (ES) to prevent post-stroke complications in the paretic upper limb.Methods and analysis: This is a feasibility randomised controlled trial (n=40) with embedded qualitative studies (patient/carer interviews and therapist focus groups) and feasibility economic evaluation. Patients will be recruited from the Stroke Unit at the Nottingham University Hospitals National Health Service (NHS) Trust within 72?h after stroke. Participants will be randomised to receive usual care or usual care and early ES to the wrist flexors and extensors for 30?min twice a day, 5?days a week for 3?months. The initial treatment(s) will be delivered by an occupational therapist or physiotherapist who will then train the patient and/or their nominated carer to self-manage subsequent treatments.Ethics and dissemination: This study has been granted ethical approval by the National Research Ethics Service, East Midlands Nottingham1 Research Ethics Committee (ref: 15/EM/0006). To our knowledge, this is the first study of its kind of the early application (within 72?h post-stroke) of ES to both the wrist extensors and wrist flexors of stroke survivors with upper limb impairment. The results will inform the design of a definitive randomised controlled trial. Dissemination will include 2 peer-reviewed journal publications and presentations at national conferences.Trial registration number: ISRCTN1648908; Pre-results. Clinicaltrials.gov ID: NCT02324634.<br/
Fine structure in the alpha decay of "1"9"2Po Shape coexistence in "1"8"8Pb
No full textTwo excited J"#pi# = 0"+ states have been established in the nuclide "1"8"8Pb. The states were populated in the #alpha# decay of "1"9"2Po in an experiment performed at the University of Jyvaeskylae, Finland. A novel technique to select the decay to the states of interest by their conversion electron signal was devised and implemented in the form of a silicon detector array mounted around the existing focal plane detector of the RITU spectrometer. The #alpha#-particle energies and half-lives have been measured, together with the branching ratios, to each level so that reduced hindrance factors may be deduced. The J"#pi# = 0"+ states lie close in energy and are based upon proton pair excitations across the closed Z=82 shell. The coexisting structures are attributed to spherical, oblate and prolate minima in the potential energy surface. Mixing matrix elements, mixing amplitudes and the energies of unperturbed and unobserved levels have been estimated in terms of configuration mixing calculations. (author)Available from British Library Document Supply Centre-DSC:DXN045954 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo
Defining the middle classes: using Bourdieu's trilogy of habitus, capital and field to deconstruct the reproduction of middle-class privilege
No full textThis is a thesis about the middle classes. Using Bourdieu's trilogy of habitus, capital and field, the thesis attempts to capture the logic of practice embedded in middle-class decision-making. Drawing on longitudinal, qualitative research across two sixth-form institutions, I explore how young people's and parents' narratives disrupt dominant accounts of the middle class as homogenously privileged and strategic players in the field of education. The thesis therefore proposes a more nuanced representation of middle class practice. Furthermore, with a fee-paying sixth-form the primary research site, the thesis addresses a neglected and often demonised 'other'.The research explores the problems and gaps in the way that Bourdieu has been used so far to understand educational decision-making as a classed practice. I argue there has been a tendency to focus on the successful and straightforward educational outcomes of middle-class young people. The literature says very little about their practices, and there is a tendency to represent them as symbols of their parents' success. In many ways, middle-class young people are offered as a privileged, homogenous 'other' to working-class disadvantage. When the lens is directed to their parents, the literature emphasises how capital accumulations are strategically deployed to secure advantage for their children. The particular and practical logic generated by habitus is replaced by deliberate strategy. Although using a Bourdieuian vocabulary, when representing the middle classes, the workings of the habitus are largely absent
The ESCAPS study: a feasibility randomized controlled trial of early electrical stimulation to the wrist extensors and flexors to prevent post-stroke complications of pain and contractures in the paretic arm
No full text© The Author(s) 2019. Objective: To establish feasibility of initiating electrical stimulation treatment of wrist extensors and flexors in patients early after stroke to prevent muscle contractures and pain. Design: Feasibility randomized controlled trial with economic evaluation. Setting: A specialist stroke unit in Nottinghamshire. Subjects: A total of 40 patients recruited within 72 hours post-stroke with arm hemiparesis. Interventions: Participants were randomized to receive usual care or usual care and electrical stimulation to wrist flexors and extensors for 30 minutes, twice a day, five days a week for three months. Initial treatment was delivered by an occupational therapist or physiotherapist who trained participants to self-manage subsequent treatments. Measures: Measures of feasibility included recruitment and attrition rates, completion of treatment, and successful data collection. Outcome data on wrist range of motion, pain, arm function, independence, quality of life, and resource use were measured at 3-, 6-, and 12-months post-randomization. Results: A total of 40 participants (of 215 potentially eligible) were recruited in 15 months (20 men; mean age: 72 (SD: 13.0)). Half the participants lacked mental capacity and were recruited by consultee consent. Attrition at three-month follow-up was 12.5% (death (n = 2), end-of-life care (n = 2), and unable to contact (n = 1)). Compliance varied (mean: 65 (SD: 53)) and ranged from 10 to 166 treatments per patient (target dosage was 120). Data for a valid economic analysis can be adequately collected. Conclusion: Early initiation of electrical stimulation was acceptable and feasible. Data collection methods used were feasible and acceptable to participants. A large definitive study is needed to determine if electrical stimulation is efficacious and cost effective
Lone motherhood in England, 1945–1990 : economy, agency and identity
No full textThis thesis examines the history of lone motherhood in England between 1945 and 1990.
Most studies of lone motherhood after 1945 have focused on unmarried women, but this
study looks at all routes into lone motherhood: pre-marital pregnancy, separation,
divorce and widowhood. Existing research on post-1945 history has tended to prioritise
the role of the state in determining demographic trends in family life and behaviour. This
thesis uses oral history evidence to demonstrate how women’s agency shaped routes into
lone motherhood as well as their management of female-headed household economies
and their sense of identity within the post-war welfare state. A sample of fifty oral history
interviews, primarily selected from the Millennium Memory Bank at the National Sound
Archive forms the basis of the thesis. Interviewees are predominantly working-class and
from urban locations across all regions of England. The sample is divided into five
generational cohorts, which span the immediate post-war period, 1950s, 1960s 1970s and
1980s. Childhood, adolescent and marital experiences are analysed within each cohort in
order to understand changes and continuities in women’s entrance into lone
motherhood. In addition, contemporary sociological sources are discussed alongside the
oral histories in order to understand the relationship between the sociological
construction of lone motherhood and lone mothers’ developing social identities in the
post-war period. Three categories of analysis in relation to the experience of lone
motherhood feature: ‘Accommodation and Housing,’ ‘Maternal Economy’ and ‘Social
Membership and Identity.’ The study concludes that women’s greater entrance into lone
motherhood after 1970 was driven by their rejection of an untenable social and
economic division of labour in marriage, which remained consistent across our period.
The development of sociological classification in relation to one parent families in the
1960s is demonstrated to have been taken-up by women from the 1970s onwards to
legitimize their entitlement to state assistance and housing. This entitlement is also
argued to have rested on an inter-generational maternal identity that understood the
importance of maternity and the false demarcation between waged and domestic labour,
which working-class women, inside and outside of marriage, confronted across the
twentieth-century
Assessing outcomes : a social psychological interpretation of life course trajectories for young people leaving care
No full textThis study explores the experiences of young people who have been 'looked after' during the
transitional period in which they leave 'care', moving on to live independently. The emphasis is on
making visible the way in which young people are active in their lives; interacting with, rather than
submitting to the social environment they operate within. Drawing upon life course theory
(Elder,1997) taking an interactional biographical approach (Runyan, 1982); historical time and place
are considered, particularly in relation to the social timing of life events. Of paramount importance is
the notion of 'linked lives' where developmental pathways and life course trajectories are seen to be
located within past transitions.
Drawing upon feminist empiricist and feminist postmodernist thinking, a multi-methods approach to
data collection is used. Initially, aggregate data for the 150 young people, eligible to receive leaving
care services within the Local Authority, was made available for analysis. Structured interviews with 38
young people were completed. Fourteen young people, aged 16-18 when the research
commenced, were included in the biographical phase of the research. In this phase, in-depth
information about their unique life experiences was documented over a period of 12-18 months. It
was found, in line with previous research, that care leavers experienced a much earlier transition to
independent living, continual accommodation moves and high levels of unemployment (60-70%).
The Leaving Care Scheme's risk assessment showed the largest proportion of young people
categorised as 'high risk (44%). However, leaving care provision was not accessed by 35% of those
young people eligible to receive services.
The 'stories' told in depth reveal the way in which past experiences and past transitions can be seen to
shape and direct life course trajectories; progressing the view that outcome evaluation is limited in
utility when not viewed as part of an integrated whole. An ideological account of independence had
consequentiality in terms of 'social timing' also operating as a barrier which distanced young people
from leaving care services. There is considerable evidence in the research of young people as active
agents. Such 'agency was always located within personal and situational contexts where differing
levels of personaVinterpersonal action and compliance can be observed.
The findings suggest that outcome evaluations are of limited use, and a focus on studies which
accommodate life as a continuum, a series of 'linked states' where beginnings and endings are not so
clearly defined would offer more informative representations of young people's 'post-care' lives.
Leaving care policy makers and practitioners should reflect upon the consequentiality of the ideology
with which they engage; aiming to foster more comprehensively a favourable social environment but
one where young people are not seen exclusively as submitting to social conditions
Book Reviews: Pashukanis: Selected Writings on Marxism and the Law, Hierarchy and Society: Anthropological Perspectives on Bureaucracy, the Western Isles Today, Access to Power. Cross-National Studies of Women and Elites, Making the News, the History of Myddle, the History of Myddle, Social Darwinism and English Thought, Darwinian Impacts, White-Collar Proletariat: The Industrial Behaviour of British Civil Servants, Language, Ethnicity, and Education in Wales, White Collar Workers in America 1890–1940: A Social-Political History in International Perspective, the Sociology of Literature: Applied Studies, the Institutions of France under the Absolute Monarchy 1578–1789, Les Institutions de la France Sous La Monarchie Absolue, Die Herrschaft des Gesetzes, Class Conflict and Sectarianism. The Protestant Working Class and the Belfast Labour Movement, 1868–1920, Theories of Underdevelopment, the Transition from Capitalism to Socialism, Drinking and Alcoholism in Australia: A Power Relations Theory, the State in Western Europe, Knowledge, Ideology and the Politics of Schooling towards a Marxist Analysis of Education, Salvation and Protest
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