Woman-centred care

Changes over the past decade have emphasised the individual service user and their relationship with the health service. Within the maternity services this has been interpreted as woman-centred care a result of key initiatives; the Winterton Report (House of Commons, 1992. Maternity Services. Second Report of the Health Committee (Winterton Report), Vol. 1. HMSO, London) and Changing Childbirth (DoH, 1993a, Changing childbirth: reports of the expert maternity group parts 1 & 2. HMSO, London). Changing Childbirth outlined key principles of the maternity services and the need for the woman (and her partner, if she wishes) to be the focus of care. The key principles are choice, continuity and control. High quality care depends on the recognition of individuals as having unique needs which continues to be reflected within contemporary policy documents (DoH, 1997, The new NHS: modern and dependable. HMSO, London). This paper presents findings related to the provision of woman-centred care from a national research and development study. The study design incorporated (i): a national survey which was undertaken with midwives, midwife supervisors and doctors; and (ii): in-depth case studies in which information was obtained through interviews with midwives, midwife supervisors, educators, managers, doctors and mothers. Midwives, at all levels, are involved in changing maternity service provision and adapting to new systems of care which aim to increase continuity of care and carer for the woman. The researchers sought to understand how woman-centred care was interpreted and experienced in practice. The findings have been used to identify the continuing educational needs of midwives, and to develop an open learning educational package to meet identified need. The curriculum was designed to enhance the move towards the provision of a more integrated woman-centred service.

Combined vertex-based - cell-centred finite volume method for flows in complex geometries

CFD modelling of 'real-life' processes often requires solutions in complex three dimensional geometries, which can often result in meshes where aspects of it are badly distorted. Cell-centred finite volume methods, typical of most commercial CFD tools, are computationally efficient, but can lead to convergence problems on meshes which feature cells with high non-orthogonal shapes. The vertex-based finite volume method handles distorted meshes with relative ease, but is computationally expensive. A combined vertex-based - cell-centred (VB-CC) technique, detailed in this paper, allows solutions on distorted meshes that defeat purely cell-centred physical models to be employed in the solution of other transported quantities. The VB-CC method is validated with benchmark solutions for thermally driven flow and turbulent flow. An early application of this hybrid technique is to three-dimensional flow over an aircraft wing, although it is planned to use it in a wide variety of processing applications in the future.

A cell-centred finite volume method for modelling viscoelastic flow

An unstructured cell-centred finite volume method for modelling viscoelastic flow is presented. The method is applied to the flow through a planar channel and the 4:1 planar contraction for creeping flow of an Oldroyd-B fluid. The results are presented for a range of Weissenberg numbers. In the case of the planar channel results are compared with analytical solutions. For the 4:1 planar contraction benchmark problem the convection terms in the constitutive equations are approximated using both first and second order differencing schemes to compare the techniques and the effect of mesh refinement on the solution is investigated. This is the first time that a fully unstructured, cell-centredfinitevolume technique has been used to model the Oldroyd-B fluid for the test cases presented in this paper.

Creative leadership & communities of practice

This Second Wave presentation focused on 'Creative Leadership and Communities of Practice', with particular reference to issues of trust affecting young people, unemployment and wider uncertainties in an economic recession when people were facing job cuts and in a social environment characterised by cynicism and a downturn in trust. Young people who join Second Wave are brought into a community of practice (CoP) (Lave and Wenger, 1991; Wenger, 1999) involving a dynamic, fluid process which is distinctive in its transformative power to change people's lives. The philosophy behind this involves Dewey's notion of the 'active self' (Dewey, 1916) and the theories of 'social constructivism' (Vygotsky, 1978). The process fosters trust, confidence and social learning (Bandura, 1977; Vygotsky, 1978) in which young people join in with a dialogue involving participation in the youth-centred creative space. The 'border zone' (Heath, 1994) in that creative space enables young people to connect with each other in the specialist field of youth arts. The youth-centred partnerships involved lead to greater confidence and development in a range of important artistic, social, cognitive and emotional skills and opportunities. Ultimately, the young person may become engaged in multi-agency working with Second Wave's external partners. Throughout all of these processes, young people are encouraged progressively to develop a more 'active self' to engage proactively with many different beneficial opportunities relating to the performing arts. In an era in which there has been a loss of trust in public life this is particularly important. If trust is defined in part as a belief in the honesty, competence and benevolence of others, it tends to act like 'social glue', cushioning difficult situations and enabling actions to take place easily that otherwise would not be permissible. The Edelman Trust Barometer for 2009 has recorded a marked diminution of trust in corporations, businesses and government, as a result of the credit crunch. While the US and parts of Europe were showing recovery from a generalised loss of trust by mid-year 2009, the UK had not. Social attitudes in Britain may be hardening - from being a nation of sceptics we may be becoming a nation of cynics: for example, only 13% of the population surveyed by Edelman trust politicians to tell the truth. In this situation, there is a need to promote positive measures to build trust. The presentation aims described key aspects of Second Wave's approach to identify and disseminate its model of good practice to make this more explicit and accessible to others. It is with awareness of the profoundly challenging circumstances facing young people, particularly but not exclusively in inner city urban areas such as Deptford, and the valuable contribution youth arts work can make to their well-being and development, that the presentation was carried out. In an era of generalised mistrust, the work done at Second Wave is crucial in empowering and supporting young people to find a positive and creative direction as part of the community.