20,685 research outputs found
Comparison of physical fitness between healthy and mildâtoâmoderate asthmatic children with exercise symptoms: A crossâsectional study
.Objective
Asthma is a chronic disease that may affect physical fitness, although its primary effects on exercise capacity, muscle strength, functionality and lifestyle, in children and adolescents, are still poorly understood. This study aimed to evaluate the differences in cardiorespiratory fitness, muscle strength, lifestyle, lung function, and functionality between asthmatics with exercise symptoms and healthy children. In addition, we have analyzed the association between clinical history and the presence of asthma.
Study Design
Cross-sectional study including 71 patients with a diagnosis of asthma and 71 healthy children and adolescents (7â17 years of age). Anthropometric data, clinical history, disease control, lifestyle (KIDMED and physical activity questionnaires), lung function (spirometry), exercise-induced bronchoconstriction test, aerobic fitness (cardiopulmonary exercise test), muscle strength and functionality (timed up and go; timed up and down stairs) were evaluated.
Results
Seventy-one patients with asthma (mean age 11.5â±â2.7) and 71 healthy subjects (mean age 10.7â±â2.5) were included. All asthmatic children had mild to moderate and stable asthma. EIB occurred in 56.3% of asthmatic children. Lung function was significantly (pâ<â.05) lower in the asthmatic group when compared to healthy peers, as well as the cardiorespiratory fitness, muscle strength, lifestyle and functionality. Moreover, asthmatic children were more likely to have atopic dermatitis, allergic reactions, food allergies, and a family history of asthma when compared to healthy children.
Conclusions
Children with mild-to-moderate asthma presenting exercise symptoms show a reduction in cardiorespiratory fitness, muscle strength, lung function, functionality, and lifestyle when compared to healthy peers. The study provides data for pediatricians to support exercise practice aiming to improve prognosis and quality of life in asthmatic children.S
Metaphors of London fog, smoke and mist in Victorian and Edwardian Art and Literature
Julian Wolfreys has argued that after 1850 writers employed stock images of the city without allowing them to transform their texts. This thesis argues, on the contrary, that metaphorical uses of London fog were complex and subtle during the Victorian and Edwardian periods, at least until 1914. Fog represented, in particular, formlessness and the dissolution of boundaries. Examining the idea of fog in literature, verse, newspaper accounts and journal articles, as well as in the visual arts, as part of a common discourse about London and the state of its inhabitants, this thesis charts how the metaphorical appropriation of this idea changed over time. Four of Dickens's novels are used to track his use of fog as part of a discourse of the natural and unnatural in individual and society, identifying it with London in progressively more negative terms. Visual representations of fog by Constable, Turner, Whistler, Monet, Markino, O'Connor, Roberts and Wyllie and Coburn showed an increasing readiness to engage with this discourse. Social tensions in the city in the 1880s were articulated in art as well as in fiction. Authors like Hay and Barr showed the destruction of London by its fog because of its inhabitants' supposed degeneracy. As the social threat receded, apocalyptic scenarios gave way to a more optimistic view in the work of Owen and others. Henry James used fog as a metaphorical representation of the boundaries of gendered behaviour in public, and the problems faced by women who crossed them. The dissertation also examines fog and individual transgression, in novels and short stories by Lowndes, Stevenson, Conan Doyle and Joseph Conrad. After 1914, fog was no more than a crude signifier of Victorian London in literature, film and, later, television, deployed as a cliche instead of the subtle metaphorical idea discussed in this thesis
The Professional Identity of Doctors who Provide Abortions: A Sociological Investigation
Abortion is a medicalised problem in England and Wales, where the law places doctors at the centre of legal provision and puts doctors in control of who has an abortion. However, the sex-selection abortion scandal of 2012 presented a very real threat to 'abortion doctors', when the medical profession's values and practices were questioned in the media, society and by Members of Parliament. Doctors found themselves at the centre of a series of claims that stated doctors were acting both illegally and unethically, driven by profit rather than patient needs. Yet, the perspectives of those doctors who provide abortions has been under-researched; this thesis aims to fill that gap by examining the beliefs and values of this group of doctors. Early chapters highlight the ambiguous position of the abortion provider in Britain, where doctors are seen as a collective group of professionals motivated by medical dominance and medical autonomy. They outline how this position is then questioned and contested, with doctors being presented as unethical. By studying abortion at the macro-, meso- and micro-levels, this thesis seeks to better understand the values of the 'abortion doctor', and how these levels shape the work and experiences of abortion providers in England and Wales. This thesis thus addresses the question: 'What do abortion doctors' accounts of their professional work suggest about the contemporary dynamics of the medicalisation of abortion in Britain?'. It investigates the research question using a qualitative methodological approach: face-to-face and telephone interviews were conducted with 47 doctors who provide abortions in England and Wales. The findings from this empirical study show how doctors' values are linked to how they view the 'normalisation of abortion'. At the macro-level doctors, openly resisted the medicalisation of abortion through the position ascribed to them by the legal framework, yet at the meso-level doctors construct an identity where normalising abortion is based on further medicalising services. Finally, at the micro-level, the ambiguous position of the abortion provider is further identified in terms of being both a proud provider and a stigmatised individual. This thesis shows that while the existing medicalisation literature has some utility, it has limited explanatory power when investigating the problem of abortion. The thesis thus provides some innovative insights into the relevance and value of medicalisation through a comprehensive study on doctors' values, beliefs and practices
Womenâs Experiences of Accessing Breastfeeding and Perinatal Health Support in the Context of Intimate Partner Violence: An Interpretive Description Study
Background: Women experiencing intimate partner violence are at a heightened risk of negative perinatal and breastfeeding outcomes. This study explored the experiences of accessing breastfeeding support for women who endorse a history of intimate partner violence. A study of five in-depth semi-structured interviews were completed at 12-weeks postpartum with breastfeeding mothers with a history of intimate partner violence. Findings: Women expressed difficulties in accessing a healthcare provider who had specialized skill in breastfeeding support. Trust in their healthcare provider, built through displays of compassion and competence, was important to mitigate obstacles experienced during care access for this population. Trauma-and-violence-informed care principles were beneficial to the development of the therapeutic relationship in perinatal care. Women placed value on breastfeeding support received from both healthcare providers and social supports, which impacted mothersâ perceived breastfeeding support and self-efficacy. Further, mothers described increased levels of breastfeeding self-efficacy after engaging in a trauma-and-violence-informed care program aimed at supporting breastfeeding. Conclusions: Trauma-informed care may aid in the development of trust in the therapeutic relationship, which in turn impacts access to breastfeeding support and breastfeeding self-efficacy. The inclusion of trauma-and-violence informed principles in perinatal care may be effective at mitigating barriers to access for women who endorse a history of intimate partner violence. health care on how to employ trauma-informed breastfeeding care to may lead to better support for this population
Disunity in society, fractures at home: family relating in the context of divisive socio-political issues
Section A
A systematic literature review conducted to identify and explore research that has investigated adult intrafamilial relationships and divisive political issues since 2016. Ten papers are included in the review. The studies are critiqued using a mixed-methods risk of bias tool. Findings are collated using narrative synthesis. The synthesis focuses on relational responsesâto divisive political issuesâthe potential reasons for these responses, and their consequences. Review findings are discussed in relation to previous theoretical and empirical literature. Finally, clinical and research implications are presented.
Section B
A grounded theory study to develop an understanding of adult intrafamilial invalidation in the context of social and political change. Brexit and COVID-19 serve as the contextual lens through which the phenomenon was observed. Data from 11 participants and 45 screening questionnaire respondents were analysed as part of the study. A model of family âRejection of Youâ experiences is presented outlining foundational and contextual factors that frame the experience, the experience itself, and relational, behavioural, cognitive, and emotional consequences. Findings are discussed in relation to previous theory and previous empirical research. Clinical implications are considered and possible directions for future research are set out
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Know Your Bugs: A Collaborative Evaluation of a Community Health Education Module That Aims to be Accessible to Adults with Learning Disabilities
The right to health should be a fundamental right of everyone. However, despite initiatives to improve the health of adults with learning disabilities, concerns about poorer health and health inequalities remain, and have been exacerbated by the COVID-19 pandemic. Accessible health promotion can help to overcome barriers to healthy behaviour but the effectiveness of health education in infection prevention and self-care is unknown. This research aimed to understand the health education experiences of adults with learning disabilities regarding a module designed to improve knowledge about self-care, infection prevention and antibiotic use.
Beginning with a scoping review of âwhat worksâ, this research involved observation of the learning context in two locations and semi-structured interviews with 18 course participants to explore health knowledge and behaviour change in the short, medium and longer term. Data were analysed iteratively, addressing the realist concept of context/mechanism/outcome configurations.
Participants had a positive learning experience and gained knowledge about microbes, hand hygiene, self-care, and antibiotic use. Some participants reported behaviour change regarding handwashing and self-care. The contexts that influenced learning were personal, social, physical, active, and external. Mechanisms that interacted with these contexts to trigger learning included: accessible teaching methods, interactive resources, relaxed and effective participant interactions, facilitation of independent thinking and planning, appropriate involvement of supporters, and an inclusive and engaging educator style.
Knowledge gain and changed behaviour intentions were achieved through an engaging, interactive, and focused learning environment, underpinned by a complex and changing combination of interactions. However, further research is needed to understand effective ways of communicating health information in an education context, to understand the impact of education on behaviour change, and to identify ways in which the longer-term retention of learning can be achieved. The research proposes a draft model that can guide effective community health education provision
Epistemologies of possibility: social movements, knowledge production and political transformation
Urgent global problems - whether military conflicts, economic insecurities, immigration controls or mass incarceration-not only call for new modes of political action but also demand new forms of knowledge. For if knowledge frameworks both shape the horizons of social intelligibility and chart t he realms of political possibility, then epistemological interventions constitute a crucial part of social change. Social movements play a key role in this work by engaging in dissident knowledge practices that open up space for political transformation. But what are the processes and conditions through which social movements generate new ways of knowing?'What is politically at stake in the various knowledge strategies that activists use to generate social change? Despite a growing literature on the role of epistemological dimensions of protest, social movement studies tend to neglect specific questions of epistemological change. Often treating knowledge as a resource or object rather than a power relation and a social practice, social movement scholars tend to focus on content rather than production, frames rather than practices, taxonomies rather than processes. Missing is a more dynamic account of the conditions, means and power relations through which transformative knowledge practices come to be constituted and deployed. Seeking to better understand processes of epistemological transformation, this thesis explores the relationship between social movements, knowledge production and political change. Starting from an assumption that knowledge not only represents the world, but also works to constitute it, this thesis examines the role of social movement knowledge practices in shaping the conditions of political possibility. Drawing from the context of grassroots queer, transgender and feminist organizing around issues of prisons and border controls in North America, the project explores how activists generate new forms of knowledge and forge new spaces of political possibility. Working through a series of concepts-transformation, resistance, experience, co-optation, solidarity and analogy - this thesis explores different ways of understanding processes of epistemological change with in social movement contexts. It considers processes that facilitate or enable epistemological change and those that limit or prohibit such change. Bringing together a range of theoretical perspectives, including feminist, queer, critical race and post-structuralist analyses, and drawing on interviews with grassroots activists, the thesis explores what is politically at stake in the different ways we conceptualise, imagine and engage in processes of epistemological change
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Privacy-aware Smart Home Interface Framework
Smart home user interfaces are pervasive and shared by multiple users who occupy the space. Therefore, they pose a risk to interpersonal privacy of occupants because an individualâs sensitive information can be leaked to other co-occupants (information privacy), or they can be disturbed by intrusions into their personal space (physical privacy) when the co-occupant interacts with the smart home user interfaces. This thesis hypothesises that interpersonal privacy violations can be mitigated by adapting the user interface layer and presents insights into how to achieve usable user interface adaptation to mitigate or minimise interpersonal privacy violations in smart homes.
The thesis reports two case studies and two user studies. The first case study identifies the key characteristics needed to model the rich context of interpersonal privacy violations scenarios. Then it presents knowledge representation models that are required to represent the identified characteristics and evaluates them for adequacy in modelling the context information of interpersonal privacy violation scenarios. The second case study presents a software architecture and a set of algorithms that can detect interpersonal privacy violations and generate usable user interface adaptations. Then it evaluates the architecture and the algorithms for adequacy in generating usable privacy-aware user interface adaptations. The first user study (N=15) evaluates the usability of the adaptive user interfaces generated from the framework where storyboards were used as the stimulant. Extending the findings from the usability study and expanding the coverage of example scenarios, the second user study (N=23) evaluates the overall user experience of the adaptive user interfaces, using video prototypes as the stimulant.
The research demonstrates that the characteristics identified, and the respective knowledge representation models adequately captured the context of interpersonal privacy violation scenarios. Furthermore, the software architecture and the algorithms could detect possible interpersonal privacy violations and generate usable user interface adaptations to mitigate them. The two user studies demonstrate that the adaptive user interfaces, when used in appropriate situations, were a suitable solution for addressing interpersonal privacy violations while providing high usability and a positive user experience. The thesis concludes by providing recommendations for developing privacy-aware user interface adaptations and suggesting future work that can extend this research
Power in the health service : The effects of reorganisation on professions and bureaucracies
The National Health Service (NHS) has been analysed predominantly in terms dictated by a systems/functional model of organisational behaviour. Decision-making processes which did not comply with this model were regarded as pathological or dysfunctional. This study takes a different stance and looks at District Health Authorities (DHAs) to see if the NHS can be better understood by accepting Lukes' conception of a "third dimension of power". The study is not focussed around conflicts of interest because the third dimension of power involves situations in which "real" interests may remain unknown. Power may prevent conflicts becoming apparent and interests becoming realised. Because, however, Lukes had suggested that interests may become realised during periods of change, the study focusses on the restructuring which began with reorganisation of the NHS in 1982. The parts played by medical professionals, administrative staff, nursing staff, and lay-members on DHAs are examined and demonstrate the extent to which their activities were influenced by one another and by their external political environment, notably the Conservative government. The mechanisms of power used during the period 1982-1985 when new management structures were established and then replaced by a further reorganisation of management are examined. This shows the extent to which these new management changes became accepted as legitimate and how the legitimation process began with the 1982 reorganisation. Lukes' third dimension of power is confirmed as too restrictive a conception and that power is more subtle than even he had proposed. Nor is it always repressive or manipulative
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