Living through the death of a child: A qualitative study of bereaved parents’ experiences

Design: Cross-sectional qualitative study.

Data sources: Interviews with purposeful sample of 25 recently bereaved parents.

Methods: Semi-structured in-depth interviews.

Results: Four analytically distinct processes were identified in the responses of parents to the death of a child. These are referred to as ‘piloting’, ‘providing’, ‘protecting’ and ‘preserving’. Regardless of individual circumstances, these processes were integral to all parents’ coping, enabling an active ‘doing’ for their child and family throughout the trajectory of their child's illness and into bereavement.

Conclusions: Facilitating the capacity of parents to ‘do’ is central to coping with the stress and uncertainty of living through the death of a child. The provision of informational, instrumental and emotional support by health care professionals in the context of ‘doing’ is core to quality palliative care.

Keywords: Bereaved parents; Cancer; Dying child; End-of-life; Palliative care; Non-malignant

Capitalism, the state and health care in the age of austerity:A Marxist analysis

The capacity to provide satisfactory nursing care is being increasingly compromised by current trajectories of healthcare funding and governance. The purpose of this paper is to examine how well Marxist theories of the state and its relationship with capital can explain these trajectories in this period of ever-increasing austerity. Following a brief history of the current crisis, it examines empirically the effects of the crisis, and of the current trajectory of capitalism in general, upon the funding and organization of the UK and US healthcare systems. The deleterious effect of growing income inequalities to the health of the population are also addressed. Marx’s writings on the state and its relation to the capitalist class were fragmentary, and historically and geographically specific. From them, we can extract three theoretical variants: the instrumentalist theory of the state, where the state has no autonomy from capital; the abdication theory, whereby capital abstains from direct political power and relies on the state to serve its interests; and the class-balance theory of the state, whereby the struggle between two opposed classes allows the state to assert itself. Discussion of modern Marxist interpretations include Poulantzas’s structuralist abdication theory and Miliband’s instrumentalist theory. It is concluded that, despite the pluralism of electoral democracies, the bourgeoisie do have an overweening influence upon the state. The bourgeoisie’s ownership of the means of production provides the foundation for its influence because the state is obliged to rely on it to manage the supply of goods and services and the creation of wealth. That power is further reinforced by the infiltration of the bourgeoisie into the organs of state. The level of influence has accelerated rapidly over recent decades. One of the consequences of this has been that healthcare systems have become rich pickings for the evermore confident bourgeoisie.

I can't get a breath: experiences of living with advanced chronic obstructive pulmonary disease

This study aims to explore the potential for palliative care among people living with advanced chronic obstructive pulmonary disease (COPD). Individual semi-structured interviews (n=13) were conducted with people who had a diagnosis of advanced COPD and were on optimal tolerated drug therapy, with their breathing volume (forced expiratory volume at less than 30%) or were on long-term oxygen therapy or non-invasion ventilation. Participants raised concerns about the uncertain trajectory of the illness and reported unmet palliative care needs with poor access to palliative care services. For most people, palliative care was associated with end of life; therefore, they were unwilling to discuss the issue. There was a wide acceptance that, medically, nothing more could be done. Findings also suggest that patients had unmet palliative care needs, requiring information and support. The research suggests the need for palliative care to be extended to all (regardless of diagnosis), with packages of care developed to target specific needs.

Why the size structure of marine communities can require decades to recover from fishing

A dynamic food-web model of more than 1000 species was used to quantify the recovery trajectory of marine community size-structure under different hypothetical fishing regimes, using the Northeast Atlantic as an example. Size-structure was summarised by four indicators: the Large Fish Indicator (LFI), the Large Species Indicator (LSI), the biomass-weighted mean maximum length of fish species (EMBED Equation.3) and the biomass-weighted mean maturation length of fish species (EMBED Equation.3). Time-series of these indicators recorded recovery following release from fishing with various size-selectivities, intensities and durations. In model simulations, fishing-induced trophic cascades were observed to distort fish community size-structure, but these did not have a large influence on recovery level or duration as measured by the four indicators. However, simulations showed that local extinctions of large fish species increased in number with both fishing intensity and duration, and could strongly limit the recovery level. Recovery of fish community size-structure to near equilibrium frequently took multiple decades in simulations; these long transient periods suggest that management interventions for size-structure recovery may require much longer than previously thought. Our results demonstrate the need for community-level modelling to set realistic targets for management of community size-structure.

Trajectories of Adolescent Aggression and Family Cohesion: The Potential to Perpetuate or Ameliorate Political Conflict

Correlations between intergroup violence and youth aggression are often reported. Yet longitudinal research is needed to understand the developmental factors underlying this relation, including between-person differences in within-person change in aggression through the adolescent years. Multilevel modeling was used to explore developmental and contextual influences related to risk for youth aggression using 4 waves of a prospective, longitudinal study of adolescent/mother dyad reports (N = 820; 51% female; 10–20 years old) in Belfast, Northern Ireland, a setting of protracted political conflict. Experience with sectarian (i.e., intergroup) antisocial behavior predicted greater youth aggression; however, that effect declined with age, and youth were buffered by a cohesive family environment. The trajectory of aggression (i.e., intercepts and linear slopes) related to more youth engagement in sectarian antisocial behavior; however, being female and having a more cohesive family were associated with lower levels of youth participation in sectarian acts. The findings are discussed in terms of protective and risk factors for adolescent aggression, and more specifically, participation in sectarian antisocial behavior. The article concludes with clinical and intervention implications, which may decrease youth aggression and the perpetuation of intergroup violence in contexts of ongoing conflict.

Virtual Thrower Versus Real Goalkeeper: The Influence of Different Visual Conditions on Performance

In order to use virtual reality as a sport analysis tool, we need to be sure that an immersed athlete reacts realistically in a virtual environment. This has been validated for a real handball goalkeeper facing a virtual thrower. However, we currently ignore which visual variables induce a realistic motor behavior of the immersed handball goalkeeper. In this study, we used virtual reality to dissociate the visual information related to the movements of the player from the visual information related to the trajectory of the ball. Thus, the aim is to evaluate the relative influence of these different visual information sources on the goalkeeper's motor behavior. We tested 10 handball goalkeepers who had to predict the final position of the virtual ball in the goal when facing the following: only the throwing action of the attacking player (TA condition), only the resulting ball trajectory (BA condition), and both the throwing action of the attacking player and the resulting ball trajectory (TB condition). Here we show that performance was better in the BA and TB conditions, but contrary to expectations, performance was substantially worse in the TA condition. A significant effect of ball landing zone does, however, suggest that the relative importance between visual information from the player and the ball depends on the targeted zone in the goal. In some cases, body-based cues embedded in the throwing actions may have a minor influence on the ball trajectory and vice versa. Kinematics analysis was then combined with these results to determine why such differences occur depending on the ball landing zone and consequently how it can clarify the role of different sources of visual information on the motor behavior of an athlete immersed in a virtual environment.

Refining the Chronology of the Neolithic Settlement at Pool, Sanday, Orkney: Implications for the Emergence and Development of Grooved Ware

New radiocarbon dates for the Neolithic settlement at Pool on Sanday, Orkney, are interpreted in a formal chronological framework. Phases 2.2 and 2.3, during which flat-based Grooved Ware pottery with incised decoration developed, have been modelled as probably dating to between the 31st and 28th centuries cal bc. There followed a hiatus of a century or so, before the resumption of occupation in Phase 3, which has a different Grooved Ware style featuring the use of applied decoration. This has been modelled as probably dating from the 26th to the 24th centuries cal bc. The implications of these results are discussed for the emergence and development of Grooved Ware, and for the trajectory of settlement and monumentality on Sanday.

Problems of minimal aerodynamic resistance

Nesta tese estamos preocupados com o problema da resistência mínima primeiro dirigida por I. Newton em seu Principia (1687): encontrar o corpo de resistência mínima que se desloca através de um médio. As partículas do médio não interagem entre si, bem como a interação das partículas com o corpo é perfeitamente elástica. Diferentes abordagens desse modelo foram feitas por vários matemáticos nos últimos 20 anos. Aqui damos uma visão geral sobre estes resultados que representa interesse independente, uma vez que os autores diferentes usam notações diferentes. Apresentamos uma solução do problema de minimização na classe de corpos de revolução geralmente não convexos e simplesmente conexos. Acontece que nessa classe existem corpos com resistência menor do que o mínimo da resistência na classe de corpos convexos de revolução. Encontramos o infimum da resistência nesta classe e construimos uma sequência regular de corpos que aproxima este infimum. Também apresentamos um corpo de resistência nula. Até agora ninguém sabia se tais corpos existem ou não, evidentemente o nosso corpo não pertence a nenhuma classe anteriormente analisado. Este corpo é não convexo e não simplesmente conexo; a forma topológica dele é um toro, parece um UFO extraterrestre. Apresentamos aqui várias famílias de tais corpos e estudamos as suas propriedades. Também apresentamos um corpo que é natural de chamar um corpo "invisíveis em uma direção", uma vez que a trajectória de cada partícula com a certa direcção coincide com a linha recta fora do invólucro convexo do corpo. ABSTRACT: In this thesis we are concerned with the problem of minimal resistance first addressed by I. Newton in his Principia (1687): find the body of minimal resistance moving through a medium. The medium particles do not mutually interact, and the interaction of particles with the body is perfectly elastic. Different approaches to that model have been tried by several mathematicians during the last 20 years. Here we give an overview of these results that represents interest in itself since all authors use different notations. We present a solution of the minimization problem in the class of generally non convex, simply connected bodies of revolution. It happens that in this class there are bodies with smaller resistance than the minimum in the class of convex bodies of revolution. We find the infimum of the resistance in this class, and construct a sequence of bodies which approximates this infimum. Also we present a body of zero resistance. Since earlier it was unknown if such bodies exists or not, evidently our body does not belong to any class previously examined. The zero resistance body found by us is non-convex and non-simply connected; topologically it is a torus, and it looks like an extraterrestrial UFO. We present here several families of such bodies and study their properties. We also present a body which is natural to call a body "invisible in one direction", since the trajectory of each particle with the given direction, outside the convex hull of the body, coincides with a straight line.

The Structure of Design Processes: ideal and reality in Bruce Archer’s 1968 doctoral thesis

The paper centres on a single document, the 1968 doctoral thesis of L Bruce Archer. It traces the author’s earlier publications and the sources that informed and inspired his thinking, as a way of understanding the trajectory of his ideas and the motivations for his work at the Royal College of Art from 1962. Analysis of the thesis suggests that Archer’s ambition for a rigorous ‘science of design’ inspired by algorithmic approaches was increasingly threatened with disruption by his experience of large, complex design projects. His attempts to deal with this problem are shown to involve a particular interpretation of cybernetics. The paper ends with Archer’s own retrospective view and a brief account of his dramatically changed opinions. Archer is located as both a theorist and someone intensely interested in the commercial world of industrial design.

Product innovation and the costs of energy-using product policies

Energy-using Products (EuPs) contribute significantly to the United Kingdom’s CO2 emissions, both in the domestic and non-domestic sectors. Policies that encourage the use of more energy efficient products (such as minimum performance standards, energy labelling, enhanced capital allowances, etc.) can therefore generate significant reductions in overall energy consumption and hence, CO2 emissions. While these policies can impose costs on the producers and consumers of these products in the short run, the process of product innovation may reduce the magnitude of these costs over time. If this is the case, then it is important that the impacts of innovation are taken into account in policy impact assessments. Previous studies have found considerable evidence of experience curve effects for EuP categories (e.g. refrigerators, televisions, etc.), with learning rates of around 20% for both average unit costs and average prices; similar to those found for energy supply technologies. Moreover, the decline in production costs has been accompanied by a significant improvement in the energy efficiency of EuPs. Building on these findings and the results of an empirical analysis of UK sales data for a range of product categories, this paper sets out an analytic framework for assessing the impact of EuP policy interventions on consumers and producers which takes explicit account of the product innovation process. The impact of the product innovation process can be seen in the continuous evolution of the energy class profiles of EuP categories over time; with higher energy classes (e.g. A, A+, etc.) entering the market and increasing their market share, while lower classes (e.g. E, F, etc.) lose share and then leave the market. Furthermore, the average prices of individual energy classes have declined over their respective lives, while new classes have typically entered the market at successively lower “launch prices”. Based on two underlying assumptions regarding the shapes of the “lifecycle profiles” for the relative sales and the relative average mark-ups of individual energy classes, a simple simulation model is developed that can replicate the observed market dynamics in terms of the evolution of market shares and average prices. The model is used to assess the effect of two alternative EuP policy interventions – a minimum energy performance standard and an energy-labelling scheme – on the average unit cost trajectory and the average price trajectory of a typical EuP category, and hence the financial impacts on producers and consumers.

An analysis of bimanual actions in natural feeding of semi-wild chimpanzees

Objective The objective of the current study was to investigate the lateral dominance for a bimanually coordinated natural feeding behavior in semi-wild chimpanzees. Materials and Methods We investigated strychnos spp. fruit consumption behaviors in semi-wild chimpanzees as an ecologically comparable feeding behavior to those found in cerebral lateralization studies of non-primate species. Video recordings of thirty-three chimpanzees were assessed while they consumed hard-shelled strychnos fruits. We explored statistical and descriptive measures of hand dominance to highlight lateralized patterns. Results Statistical evaluation of feeding bouts revealed a group-level right-handed bias for bimanual coordinated feeding actions, however few individuals were statistically lateralized. Descriptive analyses revealed that the majority of individuals were lateralized and possessed a right-handed bias for strychnos feeding behavior. Discussion The results provide empirical evidence in supports of an early evolutionary delineation of function for the right and left hemispheres. The present findings suggest that great apes express an intermediate stage along the phylogenetic trajectory of human manual lateralization.

Adaptive tackling of the swinging problem for a 2 DOF crane – payload system

The control of a crane carrying its payload by an elastic string corresponds to a task in which precise, indirect control of a subsystem dynamically coupled to a directly controllable subsystem is needed. This task is interesting since the coupled degree of freedom has little damping and it is apt to keep swinging accordingly. The traditional approaches apply the input shaping technology to assist the human operator responsible for the manipulation task. In the present paper a novel adaptive approach applying fixed point transformations based iterations having local basin of attraction is proposed to simultaneously tackle the problems originating from the imprecise dynamic model available for the system to be controlled and the swinging problem, too. The most important phenomenological properties of this approach are also discussed. The control considers the 4th time-derivative of the trajectory of the payload. The operation of the proposed control is illustrated via simulation results.

Writing and living on the stage of history

This article studies the intercultural trajectory of a Portuguese female aristocrat of the eighteenth to nineteenth centuries. Her trajectory of intercultural transition from a Portuguese provincial lady into an independent owner of a sugar mill in tropical Bahia is documented through family letters, which provide a polyphonic representation of a movement of personal, family, and social transculturation over almost two decades. Maria Bárbara began her journey between cultures as a simple spectator-reader, progressively becoming a commentator-actor-protagonist-author in society, in politics, and in history. These letters function as a translation that is sometimes consecutive, other times simultaneous, of the events lived and witnessed. This concept of intercultural translation is based on the theories of Boaventura de Sousa Santos (2006, 2008), who argues that cultural differences imply that any comparison has to be made using procedures of proportion and correspondence which, taken as a whole, constitute the work of translation itself. These procedures construct approximations of the known to the unknown, of the strange to the familiar, of the ‘other’ to the ‘self’, categories which are always unstable. Likewise, this essay explores the unstable contexts of its object of study, with the purpose of understanding different rationalities and worldviews.

New York City: "gilt cage" or "promised land" ? : representations of urban space in Edith Wharton and Anzia Yezierska

This thesis explores the importance of literary New York City in the urban narratives of Edith Wharton and Anzia Yezierska. It specifically looks at the Empire City of the Progressive Period when the concept of the city was not only a new theme but also very much a typical American one which was as central to the American experience as had been the Western frontier. It could be argued, in fact, that the American city had become the new frontier where modern experiences like urbanization, industrialization, immigration, and also women's emancipation and suffrage, caused all kinds of sensations on the human scale from smoothly lived assimilation and acculturation to deeply felt alienation because of the constantly shifting urban landscape. The developing urban space made possible the emergence of new female literary protagonists like the working girl, the reformer, the prostitute, and the upper class lady dedicating her life to 'conspicuous consumption'. Industrialization opened up city space to female exploration: on the one hand, upper and middle class ladies ventured out of the home because of the many novel urban possibilities, and on the other, lower class and immigrant girls also left their domestic sphere to look for paid jobs outside the home. New York City at the time was not only considered the epicenter of the world at large, it was also a city of great extremes. Everything was constantly in flux: small brownstones made way for ever taller skyscrapers and huge waves of immigrants from Europe pushed native New Yorkers further uptown on the island, adding to the crowdedness and intensity of the urban experience. The city became a polarized urban space with Fifth Avenue representing one end of the spectrum and the Lower East Side the other. Questions of space and the urban home greatly mattered. It has been pointed out that the city setting functions as an ideal means for the display of human nature as well as social processes. Narrative representations of urban space, therefore, provide a similar canvas for a protagonist's journey and development. From widely diverging vantage points both Edith Wharton and Anzia Yezierska thus create a polarized city where domesticity is a primal concern. Looking at all of their New York narratives by close readings of exterior and interior city representations, this thesis shows how urban space greatly affects questions of identity, assimilation, and alienation in literary protagonists who cannot escape the influence of their respective urban settings. Edith Wharton's upper class "millionaire" heroines are framed and contained by the city interiors of "old" New York, making it impossible for them to truly participate in the urban landscape in order to develop outside of their 'Gilt Cages'. On the other side are Anzia Yezierska's struggling "immigrant" protagonists who, against all odds, never give up in their urban context of streets, rooftops, and stoops. Their New York City, while always challenging and perpetually changing, at least allows them perspectives of hope for a 'Promised Land' in the making. Central for both urban narrative approaches is the quest for a home as an architectural structure, a spiritual resting place, and a locus for identity forming. But just as the actual city embraces change, urban protagonists must embrace change also if they desire to find fulfillment and success. That this turns out to be much easier for Anzia Yezierska's driven immigrants rather than for Edith Wharton's well established native New Yorkers is a surprising conclusion to this urban theme.

Locating home : the diverse experiences of recent newcomer youth and first generation youth within Ontario's education system

This study has found that youth who or whose parents had left their home country for fear-based reasons were less involved within their school and wider community than youth who left or whose parents left for reasons concerning their social mobility. Many existing studies focus on the challenges newcomer youth experience within the education system (see Anisef, Brown, Phythian, & Sweet, 2010), however through the use of qualitative methodologies this study expanded on the current literature by further examining why it is some youth are successful in overcoming such challenges, while others are not. This study supported what has been demonstrated in the literature regarding challenges faced by newcomer youth and resources to address such challenges. Despite challenges experienced within the education system, youth planned to complete secondary school and attend a postsecondary institution. However, not all youth anticipated remaining in Canada upon completion of their education, with youth or youth whose parents left their home country for fear-based reasons frequently discussing the possibility of returning to their or their parents' home country. Thus, perhaps these youth were less involved within their school, as their goal was not necessarily to establish or maintain connections within their community as they may have viewed residing in Canada as temporary. This finding has important implications, as there are benefits to involvement in extracurricular activities, which may assist youth in overcoming challenges encountered within the education system. Therefore, it would seem that youth who had or whose parents had left their home country for reasons concerning their social mobility may have be at an advantage within the education system with respect to their involvement in school. Perhaps then this differential involvement may at least partially explain why it is some newcomer youth are able to overcome challenges they experience in the education system, while others are not. Both policy and theoretical implications are discussed.