Myths and Realities of Inter-professional Working

Introduction: Childhood cancers are rare and community based health care professionals have limited experience in caring for these children and often even less experience in providing their palliative care. It is well recognised that the provision of palliative care falls beyond the remit of any one profession, thus inter professional working is the standard model. This qualitative study aims to examine the experiences of the range of health care professionals involved in providing palliative care at home for children with cancer, focusing on how knowledge is exchanged; the level of communication and support both interprofessionally and at the community/specialist interface. It also aims to examine interprofessional collaboration in palliative care; identifying healthcare professional's perceptions of problems involved, interprofessional boundaries, specific areas of the organisation or provision of care that could be enhanced through changes in practice, support issues and the educational needs of health professionals. Methods The study involves three types of data collection; in-depth interviews, facilitated case discussion (FCD) and field notes from up to 20 cases (a "case" refers to the provision of palliative care to one child). Cases are selected from children who were treated at one regional childhood caner centre. For each case the community based health care professionals (for example the GP, community nurse or health visitor) involved in the care of the child at home are invited to participate in a one-to-one tape recorded in-depth interview followed by a group discussion in the form of a FCD. Field notes are completed following each interview. Data analysis follows a grounded theory approach. The term "social worlds theory" (SWT) his used to define a type of social organisation with no fixed or formal boundaries (such as membership boundaries), for example the range of health professionals that work together to provide palliative care. The boundaries of SW's are determined by the interaction and communication between recognised organisations, such as community nursing teams and general practitioners. SWT examines encounters between different professional groups and can be used to extend knowledge in both the organisation (for example general practice) and the content of what is being provisioned (for example, palliative care). The use of SWT in the analysis of the data is through examining the ethos of the different professions and the associated individual approaches to palliative care, exploring how this determines their roles in the provision of palliative care. Results 10 cases have so far been completed: 47 1:1 interviews (with a range of between 2-7 health care professionals being involved in each case): ( 9 x GP, 19 x CCN, 4 x DN, 3 x HV, 1 x HV assistant 7 x paediatric palliative care nurses, 1 x home support worker, 1 x OT, 1 x physiotherapist, 1 x community paediatrician) and 5 x FCD. The range of participants in the FCDs reflected that of the individual interview sampler. Data obtained to date gives clear insight into the personal experience of the individual health care professional in providing palliative care. Two themes emerging from the data will be focused upon: the continuity of care provision throughout treatment and palliation and the emotional burden experiences by the health care professional. Conclusions SWT can provide a useful framework in examining the social worlds of a disparate group of health care professionals working together for the first and maybe, the only time. A wide variation in the continuity of care provision has been found not only between professions, but also within professions. The emotional burden is evident across the professions.

Neiland's Choice

Catalogue for an exhibition with works selected exclusively by Brendan Neiland. Neiland, who attended the Birmingham College of Art and the Royal College of Art, London during the 1960s, has selected works from a range of artists including: Val Archer, Sarah Armstrong-Jones, Sir Peter Blake, Simon Burton, Grace Erskine Crum, Brad Faine, James Fisher, Martin Fuller, Christian Furr, Annabel Gault, Jason Gibilaro, Hugh Gilbert, Michael Harrison, David Hepher, Patrick Hughes, Andrzej Jackowski, David Mach, Danny Markey, Terry New, William Packer, Tom Phillips (RA), Donald Smith, Justine Smith, Steve Thomas, John Wilkins

'The application of Bayesian Optimization and Classifier Systems in Nurse Scheduling'

Abstract. Two ideas taken from Bayesian optimization and classifier systems are presented for personnel scheduling based on choosing a suitable scheduling rule from a set for each person's assignment. Unlike our previous work of using genetic algorithms whose learning is implicit, the learning in both approaches is explicit, i.e. we are able to identify building blocks directly. To achieve this target, the Bayesian optimization algorithm builds a Bayesian network of the joint probability distribution of the rules used to construct solutions, while the adapted classifier system assigns each rule a strength value that is constantly updated according to its usefulness in the current situation. Computational results from 52 real data instances of nurse scheduling demonstrate the success of both approaches. It is also suggested that the learning mechanism in the proposed approaches might be suitable for other scheduling problems.

Alternative media for public pedagogy: "Chief" concerns and human agency

To demonstrate how the growing influence of alternative media in civil society correlates with the rise of social movements and their influence on contemporary manifestations of resistance, this research uses critical ethnographic methodologies to document the narratives of alternative media producers in the pro-Indigenous and anti-“Chief” campaigns at the University of Illinois at Urbana-Champaign during the 2006-2007 school year. These narratives demonstrate not only the ways alternative media help transmit dissent by distributing information to diverse populations, but also the manner they facilitate contexts that influence identity formations and strengthen counter-cultural communal practices. Particular lineages of critical social theory are used to situate knowledge construction and social relationships within specific socio-historic contexts to approach issues of subjectivity, human agency, and resistance. These include the Frankfurt School for Social Research, the Birmingham Centre for Contemporary Cultural Studies, and the Brazilian education philosopher Paulo Freire, who emphasize criticality based on the engagement of ideological analysis, as well as developing capacities to critique and resist oppressive social and political relationships. Thus, this study argues for expanding traditional notions of literacy to include the ability to decode and produce media as a critical element of meaningful democratic participation.

'The application of Bayesian Optimization and Classifier Systems in Nurse Scheduling'

Abstract. Two ideas taken from Bayesian optimization and classifier systems are presented for personnel scheduling based on choosing a suitable scheduling rule from a set for each person's assignment. Unlike our previous work of using genetic algorithms whose learning is implicit, the learning in both approaches is explicit, i.e. we are able to identify building blocks directly. To achieve this target, the Bayesian optimization algorithm builds a Bayesian network of the joint probability distribution of the rules used to construct solutions, while the adapted classifier system assigns each rule a strength value that is constantly updated according to its usefulness in the current situation. Computational results from 52 real data instances of nurse scheduling demonstrate the success of both approaches. It is also suggested that the learning mechanism in the proposed approaches might be suitable for other scheduling problems.

American Perceptions of British Regional Dialects

Sociolinguists have discussed problematic language ideologies, such as Standard Language Ideology (Lippi-Green 1997) extensively and social perceptions of Standard English in the U.S and U.K are well documented. However, most work in this area has focused on perceptions of dialects within national contexts. This study makes a novel contribution to the study of language attitudes, investigating perceptions of British regional dialects within the U.S. A survey was created to gauge perceptions of five British regional dialects (Liverpool, Leeds, Birmingham, Newcastle, London). 49 survey participants listened to audio clips of British regional dialect speakers and then completed a mapping activity, answered perception questions, and ranked each speaker on specific qualities. Results showed that speaker region had a significant effect on perception of almost all variables at a statistically significant rate, despite unfamiliarity with all but the London dialect. Results suggest that although participants are largely unfamiliar with varieties of English in England outside of London, they assessed them by recruiting pre-existing stereotypes about vernacular dialects.

Management and outcome of cholesterol embolus identified in a diabetic retinopathy screening program

Purpose. We examined the incidence, management, and outcomes of patients known to be at high cardiovascular risk, and to assess whether specialist referral to an ophthalmic medical clinic is worthwhile. Methods. Patients in the East Birmingham area with cholesterolembolus who were identified on digital diabetic retinopathy screening over a 3-year period were referred to a specialist ophthalmic medicine clinic within Heart of England NHS Trust for management and investigation. Results. A total of 33 patients were referred for clinical management.(male:female = 22:11, mean age 72 years). A total of 28 patients were known to be receiving medication: 14 anti hypertensive therapy(42%), 19 aspirin (59%), and 21 statin (64%). A total of 18 patients had known cardiovascular disease, 10 of whom had received carotid stenting or coronary artery bypass surgery. Ten patients diagnosed with embolus required and consented to carotid Doppler studies. Six patients were confirmed with significant carotid stenosis and 2 (6%)of these patients required carotid endarterectomy surgery. Overall, 4patients died, a mortality rate of 12% over 3 years. Conclusions. Annual diabetic retinopathy screening provide sopportunistic identification of asymptomatic cholesterol emboli and provides an opportunity for review of medical management in the high-risk patient group with appropriate identification and referral for carotid stenosis surgery. A total of 11 patients were identified with sub optimal cardiovascular risk management: e.g., statin use.

Referencias sociológicas y culturales en la obra de John Osborne

La presente tesis doctoral tiene por objeto el estudio crítico-literario de la obra del escritor y dramaturgo británico John Osborne (1929-1994) en su contexto histórico-social y político. Una aproximación analítica de carácter cultural – materialista a la obra de Osborne, siguiendo para ello los estudios critico-literarios reflejados por el crítico literario Alan Sinfield en su libro Literature, Politics and Culture in Postwar Britain (2004), acerca al lector al contexto histórico-sociales y político en el que la obra de Osborne fue recibida por lectores y público en general (incluida la crítica especializada). El termino cultural-materialista fue utilizado por R. Williams en su libro Marxism and Literature, texto clave, así como la obra de Stuart Hall y del Círculo de Estudios Culturales de Birmingham que dirigió, llegando a una mejor comprensión de cómo han influido las autoridades políticas en la producción y recepción de obras literarias. El objetivo general de esta tesis es proporcionar al lector un conocimiento global de las circunstancias socio-políticas y culturales en las que se circunscriben las obras de John Osborne ofreciendo una perspectiva nueva, original e incluso sorprendente del propio autor así como sus implicaciones, para llegar a una mejor comprensión del teatro británico en la primera década del nuevo milenio. Los manuales de Historia de la Literatura Británica contemplan el año 1956 como la fecha que marca el comienzo de una nueva etapa del teatro británico del periodo de posguerra. Y la razón de esto es la puesta en escena de la obra Mirando Hacia Atrás con Ira en mayo de ese mismo año. El año 1956 es clave por la coincidencia de su estreno con el comienzo de la Crisis de Suez unas semanas más tarde. La obra de Osborne fue importante por lo que supuso para el joven y novato Royal Court Theatre, situándolo en el panorama contemporáneo del teatro subvencionado de posguerra. En torno a esta fecha Bertolt Bretch visita Gran Bretaña por primera vez, estimulando el interés y la controversia en torno al género dramático en los círculos literarios de la época...

Trastornos musculoesqueléticos en trabajadores de la industria automotriz: revisión de la literatura 2000 a 2016.

Los trastornos musculoesqueléticos (TME) tienen alta relación con la industria automotriz afectando a los trabajadores en quienes se puede encontrar varias patologías como Síndrome Del Túnel Del Carpo, Epicondilitis, Síndrome del Manguito Rotador, discopatía lumbar y lumbalgias, entre otros. Entre los factores de riesgo asociados a estos trastornos están los movimientos repetitivos, posturas inadecuadas, vibración, uso manual de herramientas, tareas físicas demandantes y el mal levantamiento de pesos. Todas estas patologías son causa de ausentismo laboral en todo el mundo, lo que conlleva a un aumento en el costo económico por incapacidades, ayudas diagnósticas y tratamientos. Se realizó una revisión de la literatura científica de artículos publicados del año 2000 a 2016 con relación a los trastornos musculoesqueléticos en la industria automotriz en las bases de datos de Pubmed, Ebsco Host, ScienceDirect y Embase. La evidencia encontrada sugiere que la patología lumbar es la que presenta mayor prevalencia en la industria, con 65% en la población Europea, 42% en Asia, Norteamérica en un 20% y en América Latina en un 46%. A pesar que en la industria automotriz predominan como fuerza laboral los hombres, se reportó que las mujeres eran las que tenían mayores factores de riesgo para desarrollar un TME y dentro de estos las posturas inadecuadas, movimientos repetitivos, sobrecarga laboral y levantamiento de pesos, sumado al tiempo de exposición que fue un común denominador en cada uno de los estudios analizados. Las conclusiones fueron que la prevalencia de TME en esta industria es elevada y esto amerita la implementación de programas de prevención más enfocados en este tema. Además no se encontró en la literatura la existencia de un método eficiente para análisis postural y de sobrecarga física, lo que habla de una necesidad urgente de realizar más investigaciones enfocadas en este tipo de población.

Matlab simulink modeling of photovoltaic cells for understanding shadow effect

Irradiation is the main component for producing the electricity from solar energy. When obstacles come in between the sun and the PV cell then it doesn’t get sufficient irradiance to produce enough electricity. Shadowing has a great impact on photovoltaic cell. The main fuel of PV cell is solar radiation. Using solar radiation, a photovoltaic cell produces electricity. The shadow on a PV cell decreases the output of the photovoltaic cell. It has been already shown in different papers that shadow effect decreases the output of the PV cell. There are different kinds of shadow effects which are observed, some minimize the PV cell output and some reduce the output to zero. There are different types of shadow based on their effects on the photovoltaic cell. The shadow has also effects depending on whether the PV cells are connected in series connection or in parallel connection. In series when one cell is out of order then the whole series of the PV cells will not work but in parallel connection if one cell is damaged, the others will work because they work independently. According to the output requirement the arrangement of the PV cells are made in series or parallel. Simulink modeling is made for series and parallel connection between two PV cells and the shadow effect is analyzed on one of the PV cells. Using SIMULINK, the shadowing is simulated on the two PV cells, where in one system they are in series and in another system they are in parallel. Slowly the irradiance is decreased to simulate the shadow effect. Simulation of the shadow effect gives an idea about the output of the PV cell system when system has shadow on the PV cells. Here the shadow effect on the two PV cells using series and parallel combinations are simulated and analyzed for understanding the effects on output.