A qualitative exploration of emotional expression for healthcare professionals working within end-of-life

This thesis consists of a systematic literature review, empirical paper, and critical appraisal. The literature review is a qualitative synthesis of emotional labour experiences for healthcare professionals working within end-of-life. Although previously explored within healthcare, it has not been considered within an end-of-life context. A meta-ethnography was completed to synthesise 18 qualitative studies that met the inclusion criteria. Five concepts were identified: The continuum of emotional expression; Being vulnerable to triggers; The dual-purpose; The emotional impact; and Building resilience. Findings suggest that healthcare professionals use emotional labour to align themselves with the expectations of their role. Recommendations for increased awareness and support (both formal and informal) are provided. The important role of the organisation in promoting a normalising and accepting culture has been highlighted. The empirical paper considered the qualitative experiences of therapist crying in therapy for 10 psychological therapists working within end-of-life. Five clinical psychologists and five counsellors took part. Semi-structured interviews were completed and Interpretative Phenomenological Analysis was used to analyse these accounts. Three superordinate themes emerged: The role of the therapist; Being struck by emotion; and The balancing act. The findings indicate that crying in therapy can be therapeutic under some circumstances, as it can demonstrate therapist authenticity, the significance of an experience, and model a healthy response to emotion. Increasing therapist self-awareness may help to reduce over-empathising, that can lead to crying. Discussions about the therapist’s tears are important and may help to normalise experiences. This critical appraisal provides a reflective account of my research journey. It considers decisions made at various time-points during the research process, and the rationale for these. I considered the challenges I faced during the process, and how these were addressed. My experience of conducting research within an end-of-life context is considered throughout, and links to clinical practice are made

Home quarantined: Privacy at risk in technologically-oriented learning amidst COVID-19 pandemic

The COVID-19 triggers technologically-oriented learning and is critical in ensuring that education continues after schools close physically. The internet has a plethora of learning opportunities but may invite privacy risks to users. Using descriptive-comparative research design, the study determined the contents and artifacts exchanged in online portals, the extent of use of social media sites, teaching-learning platforms, and educational websites. The sample was 341 college students of a family-owned private higher education institution. Finally, the difference in online privacy risk management practices was determined when grouped by selected demographic variables. Using means, t-test, and ANOVA, findings from an online survey showed that personal information is shared the most in online portals. For online learning, students heavily relied on Facebook, Microsoft Teams, and Google. To protect their privacy, respondents from all classes follow online management practices. Generally, the respondents' good affordances and decorum in the online media imply that they have good behavior and value creation. Still, a comprehensive strategy to safeguard data among learners in the utilization of online productivity platforms is a must

Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse

This handbook is the culmination of a multiphase, multidisciplinary research project that used grounded theory and participatory action research to illuminate ways that healthcare providers can work sensitively (in a trauma-informed way) with adult survivors of childhood sexual abuse. The research identified nine Principles of Sensitive Practice: respect, rapport, taking time, sharing information and control, respecting boundaries, fostering mutual learning, understanding non-linear healing and demonstrating an understanding of trauma to patients. Specific guidelines were developed for a wide variety of issues pertinent to clinical practice such as, removal of clothing, touch, responding to disclosures of abuse, managing triggers among others. The methodology included interviews with women and men adult survivors of childhood sexual abuse from across Canada about how healthcare practitioners can be sensitive to their needs as survivors. It also included learnings from group meetings where survivors and healthcare practitioners discussed together ways healthcare practice could better respond to the needs of survivors. Written feedback received from physicians, nurses, dentists and dental hygienists, physical and occupational therapists, massage therapists, chiropractors, kinesiologists, professional regulators, mental health professionals and survivors from across Canada ensured that suggestions for clinical practice reflected both survivor needs and the realities of clinical practice. We concluded that because healthcare providers are not always aware that they are working with individuals who have experienced childhood trauma, clinicians should apply these principles and guidelines universally in order to work in a trauma-informed manner with all patients

Avoiding Psychological (Re)Traumatisation in Dentistry when working with Patients who are Adult Survivors of Child Sex Abuse

Introduction Seven percent of the adult population in the UK, including one in six women, report unwanted sexual experiences before the age of 16. The impacts of psychological trauma following child sexual abuse (CSA) creates difficulties for many survivors in accessing dental care due to fears of reminders of abuse, the power imbalance with the dentist and triggered traumatic responses. Aims To analyse and report CSA survivor perspectives of dental care and offer suggestions for practice. Method Qualitative semi-structured interviews of 17 CSA survivors generated data as part of a broader study investigating trust and trustworthiness in survivor-professional relationships. The range of dental interactions and the needs survivors described when receiving dental treatment are presented. Transcripts were analysed using NVivo software and thematic analysis methodology. Results Three main themes were identified: the dental encounter ('it really panics me'); the opportunity to disclose; and choice and control. Conclusion This is the first UK study to present qualitative data from CSA survivors about their experiences of dental care. Survivors wish to access dental care but tailored support is needed to ameliorate reminders of abuse and traumatic stress triggers. Trauma-informed care may address difficulties with treatment if dental staff adopt flexible approaches and work collaboratively with survivors to facilitate relational safety. (Please note, in this paper, 'survivors' refers to those sexually abused as children)

Eligibility of External Credit Assessment Institutions

The Basel Committee on Banking Supervision in 1999 issued a draft New Basel Capital Accord (Basel 2). Its principles are to be incorporated into the European legislation and into the Czech banking regulations. The Standardised Approach to calculating the capital requirement for credit risk is newly based on external credit assessments (ratings). Banking regulators and supervisors have to be prepared for the process of determining eligible credit assessment institutions (ECAIs) and will have to elaborate a formal recognition procedure. This paper investigates the approaches a supervisor may apply to ECAI recognition and elaborates on the criteria of recognition. First, the paper reviews the available rating agencies on the market (including their rating penetration on the Czech market), their best practices and the experience with the use of their ratings for regulatory purposes. Second, drawing on international experience and the proposed Basel 2 rules, we outline the fundamental supervisory approaches to recognition, including the legal aspects thereof, and analyse their pros and cons and the frontiers of supervisory decision making. Third, we outline the rules for recognition, including requirements or expectations (e.g. soft limits), documentation and typical interview questions with the potential candidates. We find the CNB's approach to be in compliance with CEBS Consultative Paper CP07 (issued for public consultation in June 2005).Basel capital accord, Basel II, Credit rating, default, eligibility criteria, eligibility evaluation, external credit assessment institution (ECAI), export credit agency (ECA), mapping rating grades, market acceptance of ECAIs, rating agency, recognition process

The heavenly liquidity twin : the increasing importance of liquidity risk

Liquidity and solvency have been called the"heavenly twins"of banking (Goodhart, Charles,'Liquidity Risk Management', Financial Stability Review -- Special Issue on Liquidity, Banque de France, No. 11, February, 2008). Since these"twins"interact in complex ways, it is difficult -- particularly at times of crisis--to distinguish between them, especially in the presence of information asymmetries (Information asymmetry occurs when one party has more or better information than the other, creating an imbalance of power, giving rise to adverse selection and moral hazard ). An insolvent bank can be liquid or illiquid, and a solvent bank may be at times illiquid. In the latter case, insolvency is not far away, since banking is grounded in information and confidence, and it is confidence which in the end determines liquidity. In other words, liquidity is very much endogenous, determined by the general condition of a bank, as well as the perception of it by the public and market participants. Dealing with liquidity risk is more challenging than dealing with other risks, since liquidity is the result of all the operations of a bank and it is fundamentally a relative concept which compares segments of the balance sheet on the asset and liability sides. It does not deal with absolutes, like arguably the concept of capital and it explains why there is not an internationally recognized"Liquidity Accord". This Working Paper addresses key concepts like market and funding liquidity and basic tools to address liquidity issues like cash flows, liquidity gaps and some selected financial ratios. It aims at providing an introductory guide to risk assessment and management, and provides useful and practical guidelines to undertake liquidity assessments which could prove useful in preparing Financial Assessment Programs (FSAPS) in member countries of the Bretton Woods institutions.Debt Markets,Banks&Banking Reform,Currencies and Exchange Rates,Emerging Markets,Bankruptcy and Resolution of Financial Distress

Analysis of Windows Cardspace Identity Management System

The Internet, which was originally developed for academic purposes, has expanded and been applied to commercial and business enterprises. It is possible to purchase airline tickets, check bank balances and communicate through e-mail with each other through the Internet. These services can all be performed relatively easily with the proliferation of Internet Service Providers and the lower cost of Personal Computers. The development of the Internet has also had a huge impact on businesses with the growth of e-commerce, e-banking and the tremendous growth in email traffic. There is however a negative impact to this development of the Internet with the rise in on-line criminal activity. The increasing use of the Internet has resulted in the development of on-line identities for users. There can be a great deal of sensitive and personal information associated with an on-line identity and gaining access to these privileges can provide cyber criminals with access to personal resources such as bank account details, credit card information etc. This type of activity has given rise to the term identity theft . This project will present an introduction to Microsoft Cardspace and how it relates to dealing with identity theft, the theory behind the application and present practical demonstrations of how the technology can be implemented using Microsoft© .NET framework technology