The challenge of patients’ unmet palliative care needs in the final stages of chronic illness.

Background: There is consensus in the literature that the end of life care for patients with chronic illness is suboptimal, but research on the specific needs of this population is limited. Aim: This study aimed to use a mixed methodology and case study approach to explore the palliative care needs of patients with a non-cancer diagnosis from the perspectives of the patient, their significant other and the clinical team responsible for their care. Patients (n 18) had a diagnosis of either end-stage heart failure, renal failure or respiratory disease. Methods: The Short Form 36 and Hospital and Anxiety and Depression Questionnaire were completed by all patients. Unstructured interviews were (n 35) were conducted separately with each patient and then their significant other. These were followed by a focus group discussion (n 18) with the multiprofessional clinical team. Quantitative data were analysed using simple descriptive statistics and simple descriptive statistics. All qualitative data were taped, transcribed and analysed using Colaizzi’s approach to qualitative analysis. Findings: Deteriorating health status was the central theme derived from this analysis. It led to decreased independence, social isolation and family burden. These problems were mitigated by the limited resources at the individual’s disposal and the availability of support from hospital and community services. Generally resources and support were perceived as lacking. All participants in this study expressed concerns regarding the patients’ future and some patients described feelings of depression or acceptance of the inevitability of imminent death. Conclusion: Patients dying from chronic illness in this study had many concerns and unmet clinical needs. Care teams were frustrated by the lack of resources available to them and admitted they were ill-equipped to provide for the individual’s holistic needs. Some clinicians described difficulty in talking openly with the patient and family regarding the palliative nature of their treatment. An earlier and more effective implementation of the palliative care approach is necessary if the needs of patients in the final stages of chronic illness are to be adequately addressed. Pa

Parent-Reported Quality of Life of Children With Cerebral Palsy in Europe

OBJECTIVE. The goal was to determine whether the type and severity of the child's impairments and the family's psychosocial, social, and economic characteristics influence parent-reported child quality of life across the spectrum of severity of cerebral palsy.<br/><br/>METHODS. Our population-based, cross-sectional survey conducted in 2004 to 2005 involved 818 children with cerebral palsy, 8 to 12 years of age, from 7 countries (9 regions) in Europe. Child quality of life was assessed through parent reports by using the Kidscreen questionnaire, and data were analyzed separately for each of its 10 domains.<br/><br/>RESULTS. The parental response rates were &gt;93% for all domains except one. Gross motor function and IQ level were found to be associated independently with quality of life in most domains. However, greater severity of impairment was not always associated with poorer quality of life; in the moods and emotions, self-perception, social acceptance, and school environment domains, less severely impaired children were more likely to have poor quality of life. Pain was associated with poor quality of life in the physical and psychological well-being and self-perception domains. Parents with higher levels of stress were more likely to report poor quality of life in all domains, which suggests that factors other than the severity of the child's impairment may influence the way in which parents report quality of life.<br/><br/>CONCLUSIONS. The parent-reported quality of life for children with cerebral palsy is associated strongly with impairment. However, depending on the areas of life, the most severely impaired children (in terms of motor functioning or intellectual ability) do not always have the poorest quality of life.

Self-perception in overweight and obese children: a cross-sectional study

Aim The aim of this study was to examine the relationship between obesity and self-esteem in children in relation to specific domains of their self-perception, and further to explore the extent to which this may vary by gender and economic circumstances. Method A total of 211 children aged 8–9 years drawn from both advantaged and disadvantaged areas of Belfast completed the Harter Self-Perception Profile for Children and measures of body mass index were obtained. Results Overweight, impoverished children had significantly reduced social acceptance and physical competence scores. Boys had significantly lower scores than girls in the behavioural conduct domain. Girls had significantly lower scores than boys for the athletic competence. Conclusion These results suggest that risk factors of increased weight and impoverished backgrounds have a combined negative effect, placing some children at increased risk of having lower self-perceptions in some, but not all domains. Health interventions for childhood obesity should consider the likelihood of specific relationships between physical and psychosocial factors.

Researcher and Employee: Reflections on Reflective Practice in Rural Development Research

This article describes an ethnographic study that was used to critically assess the links between rural development policy and practice. It does so from the novel perspective of the researcher as an employee in the organisation where the ethnography study was conducted. The article argues that this distinctive position gives rise to specific methodological issues. Particular attention is paid in the analysis to marginalised issues in reflexive practice literature, namely, the structural context. In so doing this research places at centre stage the importance of reflexivity in the field of rural sociology, an area in which to date it has had limited acceptance.

The Impact of Disrespect on Prisoners’ Aggression: Outcomes of Experimentally Inducing Violence Supportive Cognitions

Self-report research suggests that much violence is triggered by perceived insults and disrespect. This may be particularly true in the context of a prison or another environment of acute deprivation, whereby individuals have little other recourse to means of reputation enhancement. This paper presents the findings of two studies conducted with prisoner volunteers inside a Category C (minimum security) prison in England. In the first study, the authors randomly assigned a sample of 89 prisoners to one of two conditions: the experimental group were asked to discuss times they have been disrespected by authority figures inside and outside the prison; the control group were asked more neutral questions. Both groups then completed several measures of cognitive beliefs, distortions, and hostile attribution biases. None of the measures differed across the two groups except the measure of excuse and justification acceptance. Controlling for other factors, the experimental group endorsed these rationalisations at a significantly higher rate than the control group. This finding suggests that raising the salience of disrespect - reminding prisoners of times they have been made to feel unworthy of consideration - may raise the risk that prisoners will engage in violence by providing prisoners with justifications or excuses for actions they might not otherwise endorse. These findings received some additional validation in the second study, a qualitative analysis of offender accounts of violence and aggression within the prison. Implications for reducing violence within prisons are discussed.

The Philosophy and Practice of Interpretivist Research in Entrepreneurship Quality, Validation, and Trust

Knowledge production in entrepreneurship requires inclusivity as well as diversity and pluralism in research perspectives and approaches. In this article, the authors address concerns about interpretivist research regarding validity, reliability, objectivity, generalizability, and communicability of results that militate against its more widespread acceptance. Following the nonfoundationalist argument that all observation is theory-laden, context specific, and that there are no external criteria against which to assess research design and execution and the data produced, the authors propose that quality must be internalized within the underlying research philosophy rather than something to be tested upon completion. This requires a shift from the notion of validity as an outcome to validation as a process. To elucidate this, they provide a guiding framework and present a case illustration that will assist an interpretivist entrepreneurship researcher to establish and demonstrate the quality of their work.

Steady-State and Transient Performance of Biodiesel-Fueled Compression-Ignition-Based Electrical Generation

This paper investigates the performance characteristics of rapeseed methyl ester, EN 14214 biodiesel, when used for electrical generation in compression ignition engines. The work was inspired by the need to replace fossil diesel fuel with a sustainable low carbon alternative while maintaining generator performance, power quality, and compliance with ISO 8528-5. A 50-kVA Perkins diesel engine generator was used to assess the impact of biodiesel with particular regard to gen-set fuel consumption, load acceptance, and associated standards. Tests were performed on the diesel gen-set for islanded and grid-connected modes of operation, hence both steady-state and transient performance were fully explored. Performance comparisons were made with conventional fossil diesel fuel, revealing minimal technical barriers for electrical generation from this sustainable, carbon benign fuel. Recommendations for improved transient performance are proposed and validated through tests.

Is low self-esteem an inevitable consequence of stigma? An example from women with chronic mental health problems

It is often assumed that membership in a stigmatized group has negative consequences for the self-concept. However, this relationship is neither straightforward nor inevitable, and there is evidence suggesting that negative consequences may not necessarily occur (Psychol. Rev. 96(4) (1989) 608). This paper argues that the relationship has not been sufficiently theorized, and that a more detailed analysis is called for in order to understand the relationship between stigma and the self. The paper presents a critical examination of modified labeling theory (Am. Sociol. Rev. 52 (1987) 96), with examples from a study examining perceptions of stigma and their relationship to self-evaluation in women with chronic mental health problems. Open-ended interviews and qualitative analyses were used in preference to global measures of self-esteem. It was found that although the women were aware of society's unfavorable representations of mental illness, and the effects this had on their lives, they did not accept these representations as valid and therefore rejected them as applicable to the self. The participants did not deny their mental health problems, but their acceptance of labels was critical and pragmatic. Labels were rejected when they were perceived as carrying an unrealistic and negative stereotype, or when the women felt that their symptoms did not fit with the diagnostic criteria. The research illustrates the importance of considering people's subjective understandings of stigmatized conditions and societal reactions in order to understand the relation between stigma and the self. (C) 2002 Elsevier Science Ltd. All rights reserved.

The effect of teachers trained in a fundamental movement skills programme on children’s self-perceptions and motor competence

Perceived and actual motor competence are hypothesized to have potential links to children and young people’s physical activity (PA) levels with a potential consequential link to long-term health. In this cross-sectional study, Harter’s (1985, Manual for the Self-perception Profile for Children. Denver, CO: University of Denver) Competency Motivation-based framework was used to explore whether a group of children taught, during curriculum time, by teachers trained in the Fundamental Movement Skills (FMS) programme, scored higher on self-perception and on core motor competencies when compared to children whose teachers had not been so trained. One hundred and seventy seven children aged 7–8 years participated in the study. One hundred and seven were taught by FMS-trained teachers (FMS) and the remaining 70 were taught by teachers not trained in the programme (non-FMS). The Harter Self-Perception Profile for Children assessed athletic competence, scholastic competence, global self-worth and social acceptance. Three core components of motor competence (body management, object control and locomotor skills) were assessed via child observation. The FMS group scored higher on all the self-perception domains (p &lt; 0.05). Statistically significant differences were found between the schools on all of the motor tasks (p &lt; 0.05). The relationships between motor performance and self-perception were generally weak and non-significant. Future research in schools and with teachers should explore the FMS programme’s effect on children’s motor competence via a longitudinal approach.

Climate change, Hans Jonas and indirect investors

This article considers how corporate behaviour in relation to climate change might be reconfigured and the role that indirect investors might play in this reconfiguring. The article suggests that the consequences of climate change are serious enough that indirect investors might be prevailed upon, using a model of behaviour suggested by the work of Hans Jonas, to pressure institutional investors into demanding changes in corporate policy towards climate change. Jonas' work represents a plea for the recognition and acceptance of responsibility in the face of nature's vulnerability and humanity's power over technology. The article suggests that this ethic can be operationalised in relation to corporate governance by building on the changes in the pattern of investment holdings that have taken place in large public companies in the preceding two decades or so. The idea is to appeal to individuals who may perceive themselves as currently being outsiders – or at least only distant stakeholders in relation to the corporation – to realise the responsibility vested in them as beneficiaries through their interest in pension funds, life assurance policies, annuities and other arm's-length financial arrangements with corporations. The hope is that these individuals may, through the influence of a model of responsibility, become active investors and beneficiaries interested in corporate practices that impact on climate change and, encourage others to do likewise.

Long Term Use of HU210 Adversely Affects Spermatogenesis in Rats by modulating the Endocannabinoid System

Recent societal acceptance of cannabinoids as recreational and therapeutic drugs has posed a potential hazard to male reproductive health. Mammals have a highly sophisticated endogenous cannabinoid (ECS) system that regulates male (and female) reproduction and exo-cannabinoids may influence it adversely. Therefore it is imperative to determine their effects on male reproduction so that men can make informed choices as to their use. Here, an animal model was used to administer HU210, a synthetic analogue of ?9-tetrahydrocannabinol (THC) and potent cannabinoid receptor (CB) agonist to determine its effects on reproductive organ weights, spermatogenesis, testicular histology and sperm motility. Its effects on the physiological endocannabinoid system were also investigated. Spermatogenesis was markedly impaired with reductions in total sperm count after 2 weeks of exposure. Spermatogenic efficiency was depleted, and Sertoli cell number decreased as exposure time increased with seminiferous tubules showing germ cell depletion developing into atrophy in some cases. Sperm motility was also adversely affected with marked reductions from 2 weeks on. HU210 also acted on the sperm’s endocannabinoid system. Long term use of exo-cannabinoids has adverse effects on both spermatogenesis and sperm function. These findings highlight the urgent need for studies evaluating the fertility potential of male recreational drug users.

A comparative study of three techniques for determining photocatalytic activity

Quantitative measurement of the activity of photoactive films is an area of importance. The establishment of tests for standardisation of performance is important for efficient research but also a major milestone in achieving technology acceptance. In this paper, we compare three different techniques across a range of film samples from various sources. Furthermore, we demonstrate the potential of the dye-based approach as a quick and simple test. A series of photoactive film samples are compared for measured activity against each test. The test is shown to be capable of reproducible and quantitative activity results. The test has potential for use

Detection of 3-amino-2-oxazolidinone (AOZ), a tissue-bound metabolite of the nitrofuran furazolidone, in prawn tissue by enzyme immunoassay

Furazolidone, a nitrofuran antibiotic, is banned from use in food animal production within the European Union. Increasingly, compliance with this ban is monitored by use of analytical methods to detect a stable tissue-bound metabolite, 3-amino-2-oxazolidinone (AOZ). Widespread use of furazolidone in poultry and prawns imported into Europe highlighted the urgent need for development of nitrofuran immunoassay screening tests. The first enzyme-linked immunoabsorbant assay for detection of AOZ residues in prawns (shrimps) is now described. Prawn samples were derivatized with o-nitrobenzaldehyde, extracted into ethyl acetate, washed with hexane and applied to a competitive enzyme immunoassay based on a rabbit polyclonal antiserum. Assay limit of detection (LOD) (mean+3 s) calculated from the analysis of 20 known negative cold and warm water prawn samples was 0.1 mug kg(-1). Intra- and interassay relative standard deviations were determined as 18.8 and 38.2%, respectively, using a negative prawn fortified at 0.7 mug kg(-1). The detection capability (CCbeta), defined as the concentration of AOZ at which 20 different fortified samples yielded results above the LOD, was achieved at fortification between 0.4 and 0.7 mug kg(-1). Incurred prawn samples (n=8) confirmed by liquid chromatography coupled with tandem mass spectrometry detection to contain AOZ concentrations between 0.4 and 12.7 mug kg(-1) were all screened positive by this enzyme-linked immunoabsorbant assay. Further data are presented and discussed with regard to calculating assay LOD based on accepting a 5% false-positive rate with representative negative prawn samples. Such an acceptance improves the sensitivity of an ELISA and in this case permitted an LOD of 0.05 mug kg(-1) and a CCbeta of below 0.4 mug kg(-1).

Towards Charity Accountability: Narrowing the gap between provision and needs?

Although charities currently play a rich and varied role in modern society, their continued success is dependent upon the public's trust. With respect to charity accountability, two key questions emerge: to whom is a charity accountable; and what form should that account take? Despite the widespread acceptance that charities should discharge accountability, there is limited knowledge of the relative importance of different stakeholder groups and whether the information currently being disclosed meets their needs. Using extensive document analysis and a survey of stakeholders, this research explores these issues in the context of the top 100 UK fundraising charities. Furthermore, it compares the results with much earlier research to identify changes over time.

Measurement of absolute charge-exchange cross sections for He2+ collisions with He and H-2

Reported are total, absolute charge-exchange cross sections for collisions of 3He(2+) ions with He and H-2. Measurements are reported at fixed energies between 0.33 and 4.67 keV/amu. Both the present results and earlier results of others are analyzed in terms of available experimental small-angle differential cross sections as a function of collision energy, and hence the geometry of the exit aperture of the gas-collision cells used by the various experimental groups. In addition, the effective length of gas-collision cells is studied using fluid dynamic and molecular flow simulations to address the density patterns near the cell entrance and exit apertures. When small acceptance-angle corrections were applied, the results of present and previous measurements for the single electron capture in these systems were brought into good accord in the relevant energy ranges. Taken in their entirety, the present data for 3He(2+) with He and H-2 lend themselves to new theoretical calculations of the multichannel charge-exchange cross sections.