1,324 research outputs found

    The Individual And Their World

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    “A sticking plaster over a burst artery” An explanatory theory of moral distress: Frontline workers experience of supporting rough sleepers with a mental illness through austerity, welfare reform and the COVID-19 pandemic.

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    For a decade, prior to the COVID-19 pandemic, frontline homelessness workers in England have worked within national and local policies of welfare reform and austerity, within which there was a major cut to public spending. After the COVID-19 outbreak frontline workers began working within policies relating to the pandemic and homelessness. There is little empirical research on how these policies have impacted frontline workers who support rough sleepers with a mental illness as previous research focuses on people experiencing homelessness and/or mental illness during austerity and welfare reform, rather than the experience of the frontline homelessness worker. The purpose of this empirical research was to explore the experiences of homelessness frontline workers supporting rough sleepers with a mental illness post austerity, welfare reform and during the COVID-19 pandemic in the Midlands geographical area. Using a constructivist grounded theory approach, ten frontline workers, who worked within a variety of statutory and third sector organisations, took part in sixteen semi-structured interviews. The study offers an explanation of how working within welfare reform, austerity and COVID-19 has affected frontline workers who support rough sleepers with a mental illness. An explanatory theory of moral distress was co-constructed with the research participants. The frontline workers worked within disconnected systems across, housing, health, social care and the department of work and pensions, with the COVID-19 pandemic exacerbating this. They were frequently restricted in supporting their service users as they saw fit. This caused them to experience moral distress. The findings have significance going forward as due to the cost-of-living crisis, homelessness may increase, and planned cuts to public services will put additional pressure across housing, health, and social care services, which in turn will impact on homelessness organisations and frontline workers in the sector. If this does occur without any increase to funding to homelessness and mental health services, along with changes to policy and legislation, frontline workers will be under even higher risk of experiencing moral distress

    Stroke rehabilitation. A mixed method study evaluating a novel physiotherapy intervention and patients’ experiences

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    In this thesis, the possible benefits and challenges regarding taking part in a comprehensive individualized physiotherapy intervention, called I-CoreDIST and usual care physiotherapy following an acute stroke, along with patient perceptions of participation along the rehabilitation continuum are addressed. This is a mixed method study consisting of a randomised controlled trial (RCT) and an in-depth interview study. Sixty participants with acute strokes were recruited for the RCT and randomised into receiving I-CoreDIST or usual care physiotherapy for 12 weeks in equal doses. Assessments of postural control, levels of physical activity, balance gait and health related quality of life were undertaken at baseline and at 12 weeks post inclusion. Between- and within-group effects were calculated. From the full sample, 19 participants were purposely selected for interviews. The interviews were transcribed and analysed using systematic text condensation. The findings from the quantitative and qualitative analysis were integrated through extracting the main findings and identifying common themes, divergences, and inconsistencies. In doing so we aimed to highlight aspects related to the overall aim of the study that either study could not have alone. The analysis was informed by the International Classification of Functioning, Disability and Health framework and enactive theory. There were no differences between groups in term of effect of I-CoreDIST or usual care physiotherapy except for significant gains in health-related quality of life in the usual care group. The integrated findings show improvements in postural control, balance and gait that align with experiences of becoming able, indicating that partaking in 12 weeks of intensive physiotherapy was beneficial regardless of group allocation. Variations in organisational structures and cultures shape opportunities for active patient participation in post-stroke rehabilitation. Meaning and motivation is connected to experiencing bodily changes and tailored treatment. Sustained inactivity despite functional improvements is a challenge in long-term care

    The Informal Screen Media Economy of Ukraine

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    This research explores informal film translation (voice over and subtitling) and distribution (pirate streaming and torrenting) practices in Ukraine, which together comprise what I call the informal screen media economy of Ukraine. This study addresses wider issues of debate around the distinct reasons media piracy exists in non-Western economies. There is already a considerable body of research on piracy outside of the traditional anti-piracy discourse, one that recognises that informal media are not all unequivocally destructive nor that they are necessarily marginal, particularly in non-Western countries. Yet, there remain gaps in the range of geographies and specific types of pirate practices being studied. Furthermore, academics often insufficiently address the intricate conditions of the context within which a given pirate activity is undertaken. Finally, whereas many researchers talk about pirates, considerably fewer talk to them. This project sets out to address these gaps. Specifically, I examine the distinct practicalities of the informal screen media practices in Ukraine through netnographic observations of pirate sites and in-depth interviews with the Ukrainian informal screen media practitioners. I explore their notably diverse motivations for engaging in these activities and how they negotiate their practices with the complex economic, cultural, and regulatory context of Ukraine. I find that, contrary to common perceptions, the Ukrainian pirates do not oppose the copyright law but operate largely within and around it. A more important factor in piracy in Ukraine instead is the economics of the Ukrainian language. This is reflected in the language exclusivity inherent to most Ukrainian pirate distribution platforms as well as in the motives of some informal translators, for whom their practice is a form of language activism. Overall, I argue for a more holistic approach to researching the informal space of the media economy, especially in non-Western contexts, one that recognises the heterogeneity of this space and explores accordingly intricate factors behind its existence. In addition, this project offers a methodological contribution by providing a detailed reflection on the use of ethnographic methods to study a pirate economy in a non-Western, non-anglophone country

    Out of sight, out of mind: accessibility for people with hidden disabilities in museums and heritage sites

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    As of 2020, an estimated 14.1 million residents of the United Kingdom reported a disability (DWP 2020). Within this population, approximately 6.1 million people have a hidden disability (Buhalis and Michopoulou 2011). These hidden disabilities range widely, from neurodiverse conditions like autism and dyslexia to long term chronic conditions such as fibromyalgia and arthritis. Due to the wide range of disabilities and their impact on a disabled person’s life, they have generally been underrepresented in accessibility studies. This thesis uncovers the accessibility needs of people with hidden disabilities, specifically in museums and heritage sites where they have heretofore mostly been overlooked. I utilise semi-structured interviews and correspondence with people with hidden disabilities, as well as participant-led experiences through three case study sites in Northern England, to understand the barriers they face. Their experiences help me expose the importance of passive accessibility – accessibility measures built directly into an exhibition design, such as adequate lighting and personal interpretation boards. Additionally, this thesis aims to understand the cultural forces that prevent or support accessibility-related improvements to such sites from taking place. By studying the cultural make-up of each case study organisation through ethnographic observations of the staff at these sites, institutional roadblocks to enacting accessibility-related adjustments are revealed. Specifically, the lack of communication at these sites presents a significant barrier to enacting accessibility suggestions from disabled visitors. Tying together the themes of active/passive accessibility and lack of communication is the theme of gaps in disability awareness, by which I mean that heritage organisations do not wilfully create these barriers to inclusion, and yet they create them still because they simply do not realise these things. Filling these gaps opens up countless possibilities for improving accessibility not only for people with hidden disabilities but for all visitors and staff at museums and heritage sites

    Loss of a sense of aliveness, bodily unhomeliness and radical estrangement: A phenomenological inquiry into service users’ experiences of psychiatric medication use in the treatment of early psychosis

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    Quantitative research drawing on the disease-centred model of psychiatric drug action dominates research on psychiatric medication, while little is known about service users’ subjective, embodied experiences of taking psychiatric medication. This research explored service users’ felt, embodied and relational experiences of psychiatric medication use in the treatment of early psychosis using a multimodal, longitudinal research design. A more in-depth understanding of what it is like and what it means to take psychiatric medication from service users’ idiographic perspectives is needed to improve the clinical care and support service users receive and better understand the treatment choices they make. Ten participants between the age of 18 and 30 years were recruited from London-based NHS Early Intervention in Psychosis services and participated in in-depth idiographic interviews. Eight participants took part in a follow-up interview between six and nine months later. Visual methods were used to explore the verbal as well as the pre-reflective, embodied aspects of participants’ medication experiences. The data was analysed using a combination of interpretative phenomenological analysis and framework analysis. While taking psychiatric medication, participants reported the loss of a sense of aliveness, feelings of radical estrangement from themselves, the world and other people and a sense of being suspended in a liminal, time-locked dimension in which they felt unable to transition from past experiences of psychosis to future recovery. The findings of this study highlight the highly distressing and adverse iatrogenic effects of psychiatric medication use, including medication-induced coporealisation, disembodiment, estrangement and a loss of belonging. More holistic, human rights-based, recovery-oriented and body-centred ways of treating psychosis are needed

    Examining the Relationships Between Distance Education Students’ Self-Efficacy and Their Achievement

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    This study aimed to examine the relationships between students’ self-efficacy (SSE) and students’ achievement (SA) in distance education. The instruments were administered to 100 undergraduate students in a distance university who work as migrant workers in Taiwan to gather data, while their SA scores were obtained from the university. The semi-structured interviews for 8 participants consisted of questions that showed the specific conditions of SSE and SA. The findings of this study were reported as follows: There was a significantly positive correlation between targeted SSE (overall scales and general self-efficacy) and SA. Targeted students' self-efficacy effectively predicted their achievement; besides, general self- efficacy had the most significant influence. In the qualitative findings, four themes were extracted for those students with lower self-efficacy but higher achievement—physical and emotional condition, teaching and learning strategy, positive social interaction, and intrinsic motivation. Moreover, three themes were extracted for those students with moderate or higher self-efficacy but lower achievement—more time for leisure (not hard-working), less social interaction, and external excuses. Providing effective learning environments, social interactions, and teaching and learning strategies are suggested in distance education
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