The impact of a simulated intervention on attitudes of undergraduate nursing and medical students towards end of life care provision

Background: The concerns of undergraduate nursing and medical students’ regarding end of life care are well documented. Many report feelings of emotional distress, anxiety and a lack of preparation to provide care to patients at end of life and their families. Evidence suggests that increased exposure to patients who are dying and their families can improve attitudes toward end of life care. In the absence of such clinical exposure, simulation provides experiential learning with outcomes comparable to that of clinical practice. The aim of this study was therefore to assess the impact of a simulated intervention on the attitudes of undergraduate nursing and medical students towards end of life care.
Methods: A pilot quasi-experimental, pretest-posttest design. Attitudes towards end of life care were measured using the Frommelt Attitudes Towards Care of the Dying Part B Scale which was administered pre and post a simulated clinical scenario. 19 undergraduate nursing and medical students were recruited from one large Higher Education Institution in the United Kingdom.
Results: The results of this pilot study confirm that a simulated end of life care intervention has a positive impact on the attitudes of undergraduate nursing and medical students towards end of life care (p < 0.001).
Conclusions: Active, experiential learning in the form of simulation teaching helps improve attitudes of undergraduate nursing and medical students towards end of life. In the absence of clinical exposure, simulation is a viable alternative to help prepare students for their professional role regarding end of life care.

Loyalism, Women and Standpoint Theory

Most recent studies of Loyalism in Northern Ireland have focused on the nature and development of Loyalist paramilitaries and their methods, ideology and attitudes to the peace process. This article argues that the nature of Loyalist paramilitarism is primarily masculinist and that there is a perspective that has gone generally unheard from women in Loyalist communities. Using standpoint theory, evidence from interviews with women in Loyalist communities associated with Belfast is analysed and a picture is formed that suggests that there are gendered attitudes towards women who become involved in the conflict through paramilitary organisations and that paramilitaries are not representative of their communities. It is concluded that researchers need to bear in mind the gender dimensions of their work and be aware of who is present and who is absent when research is being carried out.

‘Poor prison flowers’: convict mothers and their children in Ireland, 1853-1900

Pregnant women and mothers were among the thousands of individuals who were sentenced to at least three years’ penal servitude and admitted to the nineteenth-century Irish female convict prison. While some babies were born behind bars, others were permitted to accompany their convicted mothers into the prison after the penal practice of transportation had ceased. Other dependent children were separated from their convicted mothers for years, cared for by family members or friends, or accommodated in Ireland’s growing web of institutions. Using individual case studies, this article focuses on convict mothers and their young offspring. It draws attention to the increasing restrictions on the admission of infants that were imposed as the nineteenth century progressed, the problems that children of various ages in the penal system seemed to pose for officials, and the difficulties faced by incarcerated mothers who wished to maintain communication with their offspring. This article argues that while there were benefits to parenting within the confines of the prison, sentences of penal servitude had a significant impact on the lives of dependent offspring by dislocating families, separating siblings, or initiating institutional or other care that broke familial bonds permanently. In so doing, the article reveals attitudes towards motherhood as well as female criminality and institutionalization generally during this period and sheds light on an aspect of convict life unique to the women’s prison.

Is there really "nothing you can do"? Pathways to enhanced flood-risk preparedness

Whilst policy makers have tended to adopt an ‘information-deficit model’ to bolster levels of flood-risk preparedness primarily though communication strategies promoting awareness, the assumed causal relation between awareness and preparedness is empirically weak. As such, there is a growing interest amongst scholars and policy makers alike to better understand why at-risk individuals are underprepared. In this vein, empirical studies, typically employing quantitative methods, have tended to focus on exploring the extent to which flood-risk preparedness levels vary depending not only on socio-demographic variables, but also (and increasingly so) the perceptual factors that influence flood risk preparedness. This study builds upon and extends this body of research by offering a more solution-focused approach that seeks to identify how pathways to flood-risk preparedness can be opened up. Specifically, through application of a qualitative methodology, we seek to explore how the factors that negatively influence flood-risk preparedness can be addressed to foster a shift towards greater levels of mitigation behaviour. In doing so, we focus our analysis on an urban community in Ireland that is identified as ‘at risk’ of flash flooding and is currently undergoing significant flood relief works. In this regard, the case study offers an interesting laboratory to explore how attitudes towards flood-risk preparedness at the individual level are being influenced within the context of a flood relief scheme that is only partially constructed. In order to redress the dearth of theoretically informed qualitative studies in this field, we draw on Protection Motivation Theory (PMT) to help guide our analysis and make sense of our results. Our findings demonstrate that flood-risk preparedness can be undermined by low levels of efficacy amongst individuals in terms of the preparedness measures available to them and their own personal capacity to implement them. We also elucidate that the ‘levee effect’ can occur before engineered flood defences are fully constructed as the flood relief works within our case study are beginning to affect people’s perception of flood risk in the case study area. We conclude by arguing that 1) individuals’ coping appraisals need to be enhanced through communication strategies and other interventions which highlight that future floods may not replicate past events; and 2) the concept of residual risk needs to be communicated at all stages of a flood relief scheme, not just upon completion.

Making British Indian Fictions, 1772-1823

This book examines fictional representations of India in novels, plays and poetry produced between the years 1772 to 1823 as historical source material. It uses literary texts as case studies to investigate how Britons residing both in the metropole and in India justified, confronted and imagined the colonial encounter during this period. The study will situate the texts in relation to the shifting colonial context and to the changing attitudes towards India within Britain in general and on the part of Britons who had experience of living in India, such as East India Company men or their wives and daughters, in particular. Moreover, it will analyse how this literature responded to the increasing influence of the subcontinent on metropolitan culture. This book, then, approaches fictional texts as case studies that illuminate trends taking place within Britain such as the growing consumption of Indian-style imported goods and the commoditisation of an Indian aesthetic within British visual culture. Whilst the book will utilise fictional portrayals to comment upon shifts in the relationship between coloniser and colonised and to discuss the cross-cultural influences between the metropole and the colonial periphery, it also outlines how literary production and print capitalism played a part in shaping depictions of the subcontinent and stereotypes of the colonial 'other'. The study will also examine how representations of the subcontinent in British art and scholarship were influenced by metropolitan literary and popular culture. At the same time it will look at how representations by metropolitan authors influenced early-nineteenth century depictions by British authors who resided in India.