Psychosocial interventions for young people with burn injuries and their families

Burn injuries can be one of the most traumatic experiences of a young person’s life. Research has documented a wide range of effects that a burn injury can have on both the children and young people (CYP) who sustain the injury and their family, including depression, anxiety, social difficulties, and appearance-related concerns. However, while it is acknowledged that these issues may be far-reaching and long-lasting, little research has explored interventions to facilitate healthy psychosocial adjustment after a burn injury. The majority of previous research in this area has focused on camps for CYP with burn injuries but has tended to neglect other interventions, as well as support for other family members. This thesis considered a range of interventions relating to different levels of psychosocial need according to the Centre for Appearance (CAR) framework for appearance-related interventions, which suggests that as the intensity of an intervention increases, the number of people requiring that intervention decreases. This thesis employed a mixed methods approach across four studies to investigate a range of psychosocial interventions for CYP with burn injuries and their families. Study 1A utilised photoelicitation techniques to explore seven families’ (n=21 participants in total) experiences of attending a specialised family burn camp. Study 1B aimed to further research into CYP’s burn camps, by addressing a number of methodological flaws identified in previous research. Standardised outcome measures and open-ended questions were used to evaluate CYP’s (n=23) and their parents’ (n=22) expectations and experiences of camp. A feasibility study of a newlydeveloped online support programme was then undertaken with CYP (n=3), one guardian and clinical psychologists (n=10) to investigate whether it could help to improve care provision within paediatric burns. The final study was exploratory in nature, and involved qualitative interviews with clinical psychologists working within paediatric burns (n=14), to consider their current practices when providing face-to-face support to CYP with burn injuries and their families. The thesis ends with a consideration of these interventions and their place within psychosocial burn care, followed by a discussion of the clinical and research implications generated from the four studies. The current research indicated that the psychosocial needs of CYP with burn injuries and their family can be demonstrated using the CAR framework, and met using a tiered model of care. Key terms are defined throughout the thesis and in the glossary (appendix 1). Copyright permissions for all images used are located in appendix 34

VideoPoetry: Collaboration as Imaginative Method

Three Idaho professors (a poet, videographer, and historian) have been collaborating for eight years on a cross-disciplinary project called VideoPoetry, which integrates historical narration, narrative poetry, historical photographs, and videography into the video medium. To this point we\u27ve worked primarily on a specific program, Culture of Reclamation, which explores the culture of the early irrigated landscape communities in southern Idaho. In reflecting on our work-process, we’ve discovered that we’ve fundamentally changed as scholars as a result of our collaboration. This paper identifies the nature of our changes and documents instances of the ways in which we have been challenged to expand our ideas about other academic disciplines and our own. To work within the constraints of VideoPoetry, a new mode of expression, each of us has had to modify our traditional methods. For example, the poet altered a poem’s imagery to suit the sequence and duration of video images. Through the poet’s exploration of the inner lives of historical figures, the historian learned how the imagination can take us beyond what historical sources are willing to tell. Culture of Reclamation is grounded in the transformation of the arid American West, which occurred about one hundred years ago. By focusing our work on the irrigation of southern Idaho, we have come to a greater understanding of the region where we work and live. The video medium allows us to share these insights as public history—the dissemination of scholarship and research to audiences outside of the academy. VideoPoetry compels us to envision collaboratively a narrative about our regional foundations. Through video, we are able to present to a broad audience the often overlooked but transformational power of irrigation projects to turn the arid West into a land of bounty

VideoPoetry: Historical Photography in the Desert Garden

This paper presents an integration of poetry, history and photography through the video medium to convey a cultural history of the irrigated desert in southern Idaho, USA, around 1900. The VideoPoetry project is an investigation of cultural history that employs video and poetry to make it come alive. This social history is revealed through the lives of Clarence E. Bisbee and Jessie Robinson Bisbee of Twin Falls, Idaho. Their marriage focused on their photography business that involved documenting the transformation of the desert into farms, towns, and cities. This project brings out for public view a selection of historical photographs from a vast archive of images, most of which were produced by Clarence E. Bisbee over a thirty-year period. His remarkable technical competence and extraordinary breadth of subject matter reveal the texture of daily life as the settlers struggled with an inhospitable environment. In the video, a narrator provides historical contextualization, linking the photos together to create a cultural narrative. Following the narrative introduction, spoken poetry provides an imaginative, but historically based, personal perspective within this new society. Video- Poetry integrates these elements to make these photographs accessible and engaging to viewers a hundred years later, especially to young viewers who may have very few images of the early history of their state. Such dissemination of scholarship is especially important now. Budget cuts, emphasis on external funding rates, and charges of irrelevance have degraded the role of the arts and humanities on many campuses. Public scholarship and scholarship of engagement with communities—known as public history in the field of history—are essential to the preservation of humanities in higher education. VideoPoetry offers a dissemination method that engages audiences in non-traditional ways and highlights the complex, important social functions of humanities research

VideoPoetry: Integrating Video, Poetry and History in the Classroom

VideoPoetry integrates video and poetry to explore historical or geographic subjects. VideoPoetry is both a process and a product. This paper will use a short VideoPoem, Mary Hallock Foote at Stone House, to demonstrate how students of all educational levels can become engaged in creating VideoPoetry. Each VideoPoem offers students a cross-disciplinary experience that involves research, analysis of information, imaginative writing and video composition leading to a classroom presentation of the final product. As a process VideoPoetry requires the investigation of a subject, in this case, Mary Hallock Foote, artist and illustrator of the Western United States. Based on the historical research including her published reminiscences, one of the authors wrote a narrative poem imagining Foote\u27s reflections on her life at Stone House. The poem evoked mental images which we brought into the video through historical photographs, Foote\u27s woodblock drawings and present-day video footage of the landscape. Spoken by a woman narrator, the poem along with appropriate sound effects became the soundtrack and structuring element for the VideoPoem. Preceding the VideoPoem is an introduction which uses an objective voice to establish the historical context. As a product, this VideoPoem expresses an interpretation of the life and thoughts of an historical person and the place where she lived. The pictures both illustrate the poem and extend its evocative quality. As such Mary Hallock Foote at Stone House is an example of Imaginative Writing, an instructional strategy that encourages students to use their imaginations to create valid contexts in which historical figures lived and acted. For viewers, VideoPoetry conveys both historical information and a sense of what it was like to live in another era. VideoPoetry expands the possibilities of studying history by providing a multi-media and multi-sensory experience

Developing a Culture of Reclamation: Integrating History, Poetry and Video

Culture of Reclamation (Armstrong, Lutze, & Woodworth-Ney, in progress) is a sequence of videopoems about Idaho, integrating poetry, historical photographs, music and videography in a video presentation, which also includes historical narrative. Three Idaho scholars in the fields of history, literacy education, and communication—the historian (Laura), poet (Jamie), and videographer (Peter)—collaborated on this cross-disciplinary project to reclaim a portion of the history of this state in a creative and engaging medium. Culture of Reclamation expresses a response to the culture of the early irrigated settlement communities along the Snake and Boise rivers. Between 1894 and 1920, a land rush to the arid western United States occurred as private investors and the federal government built irrigation projects to reclaim the sagebrush desert for farmland. Both men and women settlers contributed to the culture of the early communities, the men with a vision of an irrigated Utopia (Smythe, 1895) and the women with literary endeavors and civic participation (Woodworth-Ney, in progress-b). In responding to the landscape and to the creative work of the early settlers, such as Clarence E. Bisbee, Annie Pike Greenwood, Mary Hallock Foote, and numerous clubwomen, we have deepened our sense of belonging to this place. Our work is both professional and personal. Through this project, each of us has developed new ideas about working within our disciplines and discovered creative ways to engage the history and geography of southwestern Idaho. Our project represents just one example of the potential for university faculty from different field to collaborate on arts-based scholarly projects. According to Diamond and Mullen, Arts-based inquiry is art pursued for inquiry’s sake, not for art’s own sake (1999, p. 25). We also intend our project to serve as a prototype for cross-disciplinary projects in secondary schools. We hope to inform and inspire students in the future to explore the past with imagination as well as historical records

An evaluation of the impact of a burn camp on children and young people’s concerns about social situations, satisfaction with appearance and behaviour

Introduction: This evaluation aimed to assess the impact of a burn camp on children and young people’s concerns about social situations, satisfaction with appearance and behaviour.Methods: Young people completed the Perceived Stigmatisation Questionnaire (PSQ), Social Comfort Questionnaire (SCQ) and Satisfaction with Appearance Scale (SWAP) one month before camp (n=23), on the last day of camp (n=21) and at a three-month follow-up (n=13). Parents completed the Strengths and Difficulties Questionnaire (SDQ) one month before camp (n = 22) and at follow-up (n=12). Parents and young people also completed open-ended questions before camp and at the follow-up.Results: Results in this evaluation were mixed. While parents’ reported scores on the SDQ were poorer after camp, young people’s reported outcomes on all three measures improved at the end of camp. PSQ and SWAP scores were maintained and improved, respectively, at the follow-up. Qualitative responses were generally consistent with these scores. Significant improvements were found between the scores before camp and at the three-month follow-up for both the SWAP and PSQ. These results indicate that the burncamp may help to improve young people’s satisfaction with their appearance and concerns about social situations. However, there was no comparison group and there was a significant loss of participants atfollow-up.Conclusion: Burn camps may therefore offer a range of psychosocial benefits to young people with burn injuries. This was the first evaluation to demonstrate a positive impact of a burn camp on satisfaction with appearance and concerns about social situations using outcome measures validated with the burns population

A systematic review of patient reported outcome measures (PROMs) used in child and adolescent burn research

Crown Copyright © 2014 Published by Elsevier Ltd and ISBI. All rights reserved. Introduction: Patient reported outcome measures (PROMs) can identify important information about patient needs and therapeutic progress. The aim of this review was to identify the PROMs that are being used in child and adolescent burn care and to determine the quality of such scales. Methods: Computerised and manual bibliographic searches of Medline, Social Sciences Index, Cinahl, Psychinfo, Psycharticles, AMED, and HAPI, were used to identify Englishlanguage articles using English-language PROMs from January 2001 to March 2013. The psychometric quality of the PROMs was assessed. Results: 23 studies met the entry criteria and identified 32 different PROMs (31 generic, 1 burns-specific). Overall, the psychometric quality of the PROMs was low; only two generic scales (the Perceived Stigmatisation Questionnaire and the Social Comfort Scale) and only one burns-specific scale (the Children Burn Outcomes Questionnaire for children aged 5-18) had psychometric evidence relevant to this population. Conclusions: The majority of PROMs did not have psychometric evidence for their use with child or adolescent burn patients. To appropriately identify the needs and treatment progress of child and adolescent burn patients, new burns-specific PROMs need to be developed and validated to reflect issues that are of importance to this population

Improving retention in radiotherapy. Delivering an intervention to enable clinical supervisors to support and nurture students to achieve their full potential

Dissatisfaction with clinical placement is rated the most frequent reason for leaving radiotherapy programmes and healthcare programmes generally. As reported in the “Mind the Gap” project different generations of students and staff have different expectations and needs. Furthermore, evidence has shown when students feel part of the team, they learn more effectively and have a positive experience. A collaboration between UWE and CUoL, supported by the Office for Students Strategic Interventions in Health Education Disciplines Challenge Fund, investigated how enhancing clinical supervisors awareness of students needs through training, could provide an innovative approach to reduce attrition

Continuous low-dose antibiotic prophylaxis to prevent urinary tract infection in adults who perform clean intermittent self-catheterisation: the AnTIC RCT

Peer reviewedPublisher PD

Associations of long chain polyunsaturated fatty acids with bone mineral density and bone turnover in postmenopausal women

PURPOSE: The immunomodulatory properties of n-3 long chain polyunsaturated fatty acids (LCPUFA) are reported to reduce bone loss through alteration of bone remodelling and n-3 LCPUFA, therefore, may benefit bone health in post-menopausal women, a vulnerable group at high risk of osteoporosis. METHODS: Measures of bone mineral density (BMD) were determined using dual energy X-ray absorptiometry (DEXA) in 300 post-menopausal women. The bone turnover markers osteocalcin (OC), C-terminal telopeptides of type 1 collagen (CTX) and total alkaline phosphatase were quantified in serum along with urinary creatinine corrected deoxypyridinoline (DPD/Cr) and CTX/Cr and the CTX:OC ratio calculated. Total serum n-6 PUFA (LA + AA) and n − 3 LCPUFA (ALA + EPA + DPA + DHA) were measured and the n − 6:n − 3 ratio was calculated. RESULTS: Mean (SD) age and body mass index (BMI) were 61 (6.4) years and 27.4 (4.8) kg/m(2), respectively with participants being 12.6 (7.6) years post-menopause. Multiple regression analysis identified no association between n-3 LCPUFA and any of the measures of T-score or BMD albeit a significant positive association between total n − 3 LCPUFA and femur BMD (β = 0.287; p = 0.043) was observed within those women with a low n − 6:n − 3 ratio. There was a significant inverse association between ALA and urinary DPD/Cr (β = − 0.141; p = 0.016). CONCLUSION: A favourable low n − 6:n − 3 ratio was associated with higher femur BMD and a higher n − 3 LCPUFA (ALA) was associated with lower bone resorption. These results support a beneficial role for n − 3 LCPUFA in reducing postmenopausal bone resorption and favourably influencing BMD. TRIAL NUMBER & DATE OF REGISTRATION: ISRCTN63118444, 2nd October 2009, “Retrospectively registered”