Moving to manage: A mixed methods study of later life relocation into supported housing.

This study describes relocation experiences of older people moving to supported housing in Scotland focusing on the nature of support. Using mixed methods, Phase one involved a Scottish cross-sectional survey of all people aged 65 and over moving into Coburg (Scotland) Housing Association supported accommodation during the first six months of 2008. A total of 122 respondents were included in the survey (59% response rate). People moved locally at advanced ages with moderate disability levels to achieve more manageable housing and support, suggesting ‘assistance migration’. Expectations were high, with many seeing it as a new start in life and generally positive views of moving were reported. In Phase two, five in-depth multiple-perspective longitudinal case studies were conducted to explore the experience of relocation into supported housing. In each case an older person, primary carer and the housing manager - all women – were interviewed over six months following relocation. Analysis was undertaken using a thematic framework approach (Ritchie et al., 2003). Findings suggested older women acted with agency to adapt to their new lives; recreating ‘normality’ through organising space and routines. It is argued that returning to normality formed the overarching objective of the older women as they sought to feel ‘in place’. Responsibilities for meeting assistance needs were often implicit, contested and shifting, leading to fragile, uncertain and transitory arrangements. Drawing on recent advances in developmental psychology it is argued ‘longings’ of older people, and others, to achieve an optimal life can relate and motivate towards actions such as relocation. Yet, personal ‘longings’ can be prioritised differently and may result in disputes over goal setting and ways needs are met. Further, utopian ideals must be reconciled with the reality of daily life. Policy and practitioners could adopt broader, dignity based objectives to assist older people to identify ways of aiding such reconciliation.

Increased hospital-based physical rehabilitation and information provision after intensive care unit discharge: the RECOVER randomized clinical trial.

Importance: critical illness results in disability and reduced health-related quality of life (HRQOL), but the optimum timing and components of rehabilitation are uncertain. Objective: to evaluate the effect of increasing physical and nutritional rehabilitation plus information delivered during the post–intensive care unit (ICU) acute hospital stay by dedicated rehabilitation assistants on subsequent mobility, HRQOL, and prevalent disabilities. Design, Setting, and Participants: a parallel group, randomized clinical trial with blinded outcome assessment at 2 hospitals in Edinburgh, Scotland, of 240 patients discharged from the ICU between December 1, 2010, and January 31, 2013, who required at least 48 hours of mechanical ventilation. Analysis for the primary outcome and other 3-month outcomes was performed between June and August 2013; for the 6- and 12-month outcomes and the health economic evaluation, between March and April 2014. Interventions: during the post-ICU hospital stay, both groups received physiotherapy and dietetic, occupational, and speech/language therapy, but patients in the intervention group received rehabilitation that typically increased the frequency of mobility and exercise therapies 2- to 3-fold, increased dietetic assessment and treatment, used individualized goal setting, and provided greater illness-specific information. Intervention group therapy was coordinated and delivered by a dedicated rehabilitation practitioner. Main Outcomes and Measures: the Rivermead Mobility Index (RMI) (range 0-15) at 3 months; higher scores indicate greater mobility. Secondary outcomes included HRQOL, psychological outcomes, self-reported symptoms, patient experience, and cost-effectiveness during a 12-month follow-up (completed in February 2014). Results: median RMI at randomization was 3 (interquartile range [IQR], 1-6) and at 3 months was 13 (IQR, 10-14) for the intervention and usual care groups (mean difference, −0.2 [95% CI, −1.3 to 0.9; P = .71]). The HRQOL scores were unchanged by the intervention (mean difference in the Physical Component Summary score, −0.1 [95% CI, −3.3 to 3.1; P = .96]; and in the Mental Component Summary score, 0.2 [95% CI, −3.4 to 3.8; P = .91]). No differences were found for self-reported symptoms of fatigue, pain, appetite, joint stiffness, or breathlessness. Levels of anxiety, depression, and posttraumatic stress were similar, as were hand grip strength and the timed Up & Go test. No differences were found at the 6- or 12-month follow-up for any outcome measures. However, patients in the intervention group reported greater satisfaction with physiotherapy, nutritional support, coordination of care, and information provision. Conclusions and Relevance: post-ICU hospital-based rehabilitation, including increased physical and nutritional therapy plus information provision, did not improve physical recovery or HRQOL, but improved patient satisfaction with many aspects of recovery.

Deconstructing 'Mono'-Lingualism: considerations of value for 'English' 'language' education in a global setting.

Traditionally, language speakers are categorised as mono-lingual, bilingual, or multilingual. It is traditionally assumed in English language education that the ‘lingual’ is something that can be ‘fixed’ in form, written down to be learnt, and taught. Accordingly, the ‘mono’-lingual will have a ‘fixed’ linguistic form. Such a ‘form’ differs according to a number of criteria or influences including region or ‘type’ of English (for example, World Englishes) but is nevertheless assumed to be a ‘form’. ‘Mono-lingualism’ is defined and believed, traditionally, to be ‘speaking one language’; wherever that language is; or whatever that language may be. In this chapter, grounded in an individual subjective philosophy of language, we question this traditional definition. Viewing language from the philosophical perspectives such as those of Bakhtin and Voloshinov, we argue that the prominence of ‘context’ and ‘consciousness’ in language means that to ‘fix’ the form of a language goes against the very spirit of how it is formed and used. We thus challenge the categorisation of ‘mono’-lingualism; proposing that such a categorisation is actually a category error, or a case ‘in which a property is ascribed to a thing that could not possibly have that property’ (Restivo, 2013, p. 175), in this case the property of ‘mono’. Using this proposition as a starting point, we suggest that more time be devoted to language in its context and as per its genuine use as a vehicle for consciousness. We theorise this can be done through a ‘literacy’ based approach which fronts the context of language use rather than the language itself. We outline how we envision this working for teachers, students and materials developers of English Language Education materials in a global setting. To do this we consider Scotland’s Curriculum for Excellence as an exemplar to promote conscious language use in context.

Understanding bystanders’ willingness to Intervene in traditional and cyberbullying scenarios.

Bullying incidents in traditional and online settings are a cause for concern to many parties. The goal of the current study was to explore the extent to which a bystander would intervene in a bullying incident and the degree to which this behavior is influenced by group size (the number of other witnesses), the setting (traditional or cyberbullying), and gender of the victim. Using an online survey method, participants were presented with eight bullying scenarios, each of which involved verbal bullying of a victim. Participants (N = 82) were asked to report how likely they would be to intervene in each of these scenarios. Results showed that female victims were more likely to be helped than male victims. Furthermore, female participants were more willing to intervene than the male participants in the cyberbullying scenarios. Altruism was a positive predictor of participants’ willingness to intervene. The present findings suggest that certain gender differences in helping behavior may depend on the context in which bullying is observed (traditional or cyberbullying).