The construction of the risk of falling among and by older people

Risk is frequently invoked in contemporary accounts of ill health, but its construction is often constrained by a rationalist perspective that focuses on physical causes and functional outcomes, and that presents risk as external to the self and predictable. This paper describes an empirical study of the ways in which risk was realised and managed in a day hospital for older people. An ethnographic approach, with participant observation and semi-structured interviews, and discourse analysis were used to explore these issues with the staff and fifteen users. Whilst the service providers were orientated to the management of physical risk, as through the regimes for administering medication and their attention to risk reduction in the physical environment, the service users were more concerned with the risk to their personal and social identities, and they more frequently described its manifestations in inter-personal exchanges, sometimes as infantalisation and stereotyping. The paper develops this understanding of the potential for falls among older people to elucidate a broader interpretation of risk, and reveals that it is commonly constructed as a challenge to a person's self-image and identity. Such constructions help to explain older people's responses to complex health problems and to the services and treatments that attempt to solve them

On the Search for Quasar Light Echoes

The UV radiation from a quasar leaves a characteristic pattern in the distribution of ionized hydrogen throughout the surrounding space. This pattern or light echo propagates through the intergalactic medium at the speed of light, and can be observed by its imprint on the Ly-alpha forest spectra of background sources. As the echo persists after the quasar has switched off, it offers the possibility of searching for dead quasars, and constraining their luminosities and lifetimes. We outline a technique to search for and characterize these light echoes. To test the method, we create artificial Ly-alpha forest spectra from cosmological simulations at z=3, apply light echoes and search for them. We show how the simulations can also be used to quantify the significance level of any detection. We find that light echoes from the brightest quasars could be found in observational data. With absorption line spectra of 100 redshift z~3-3.5 quasars or galaxies in a 1 square degree area, we expect that ~10 echoes from quasars with B band luminosities L_B=3x10^45 ergs/s exist that could be found at 95% confidence, assuming a quasar lifetime of ~10^7 yr. Even a null result from such a search would have interesting implications for our understanding of quasar luminosities and lifetimes.Comment: 9 pages, 7 figures, ApJ in pres

Assistant practitioners (APs) perceptions of their developing role and practice in radiography: Results from a national survey

Introduction: In 2000, the NHS Plan set out the government's plans for investment and reform across the NHS. Through the introduction of a new workforce at assistant practitioner (AP) level the Department of Health intended to implement new ways in which to deliver a more efficient service. At the time, little published information existed on the integration of these assistants into the contemporary radiography workforce. Publications were limited to experiences gained by various individual departments ranging in their perception of the role and education of APs. Further research was suggested to track the continuing implementation of the 4-tier structure, establish the precise nature and scope of the roles across Trusts and determine their impact on workload and patient care. Aim: To establish the number and employment locality of APs in radiography professions in England, and to explore their scope of applied practice. Method and materials: The study was conducted over three phases and employed a mixed methods design to address the aims and objectives. Phase I was a scoping exercise performed prior to data collection in which n = 226 radiography sites were identified for contact across England. Phase II utilized a questionnaire as data collection tool to investigate the role of APs in radiography and explore how their roles were integrated into the radiography workforce in England. Results from phase III of the study which utilized semi-structured qualitative interviews are not included in this paper. Conclusion and discussion: Key findings depict the nature and variety of roles and responsibilities undertaken by APs in radiography. This study was the first of its kind to identify the integration of APs in radiography across a sizable geographical region. There were mixed responses to the question asking APs if they were required to perform duties outside their scope of practice. Questionnaire data revealed that a high numbers of APs were working in areas under indirect supervision. Results from this study showed that APs, in some areas at least, were performing the roles of practitioners. Therefore further investigation is needed for new roles to develop criteria to determine which new roles should be the subject of statutory regulation. © 2011 The College of Radiographers

Environmental control study of space vehicles. Part III - Thermal control techniques and systems

General analysis for space vehicle thermal control systems and technique

Reflecting on the Physics of Notations applied to a visualisation case study

This paper presents a critical reflection upon the concept of 'physics of notations' proposed by Moody. This is based upon the post hoc application of the concept in the analysis of a visualisation tool developed for a common place mathematics tool. Although this is not the intended design and development approach presumed or preferred by the physics of notations, there are benefits to analysing an extant visualisation. In particular, our analysis benefits from the visualisation having been developed and refined employing graphic design professionals and extensive formative user feedback. Hence the rationale for specific visualisation features is to some extent traceable. This reflective analysis shines a light on features of both the visualisation and domain visualised, illustrating that it could have been analysed more thoroughly at design time. However the same analysis raises a variety of interesting questions about the viability of scoping practical visualisation design in the framework proposed by the physics of notations

Probing Dark Energy with Baryonic Acoustic Oscillations from Future Large Galaxy Redshift Surveys

We show that the measurement of the baryonic acoustic oscillations in large high redshift galaxy surveys offers a precision route to the measurement of dark energy. The cosmic microwave background provides the scale of the oscillations as a standard ruler that can be measured in the clustering of galaxies, thereby yielding the Hubble parameter and angular diameter distance as a function of redshift. This, in turn, enables one to probe dark energy. We use a Fisher matrix formalism to study the statistical errors for redshift surveys up to z=3 and report errors on cosmography while marginalizing over a large number of cosmological parameters including a time-dependent equation of state. With redshifts surveys combined with cosmic microwave background satellite data, we achieve errors of 0.037 on Omega_x, 0.10 on w(z=0.8), and 0.28 on dw(z)/dz for cosmological constant model. Models with less negative w(z) permit tighter constraints. We test and discuss the dependence of performance on redshift, survey conditions, and fiducial model. We find results that are competitive with the performance of future supernovae Ia surveys. We conclude that redshift surveys offer a promising independent route to the measurement of dark energy.Comment: submitted to ApJ, 24 pages, LaTe

Giving hope, ticking boxes or securing services? A qualitative study of respiratory physiotherapists' views on goal-setting with people with chronic obstructive pulmonary disease.

OBJECTIVE: To explore respiratory physiotherapists' views and experiences of using goal-setting with people with chronic obstructive pulmonary disease in rehabilitation settings. PARTICIPANTS: A total of 17 respiratory physiotherapists with ⩾12 months current or previous experience of working with patients with chronic obstructive pulmonary disease in a non-acute setting. Participants were diverse in relation to age (25-49 years), sex (13 women), experience (Agenda for Change bands 6-8) and geographic location. METHOD: Data were collected via face-to-face qualitative in-depth interviews (40-70 minutes) using a semi-structured interview guide. Interview locations were selected by participants (included participants' homes, public places and University). Interviews followed an interview guide, were audio-recorded and transcribed verbatim. DATA ANALYSIS: Data were analysed using thematic analysis; constant comparison was made within and between accounts, and negative case analysis was used. RESULTS: Three themes emerged through the process of analysis: (1) 'Explaining goal-setting'; (2) 'Working with goals'; and (3) 'Influences on collaborative goal-setting'. Goal-setting practices among respiratory physiotherapists varied considerably. Collaborative goal-setting was described as challenging and was sometimes driven by service need rather than patient values. Lack of training in collaborative goal-setting at both undergraduate and postgraduate level was also seen as an issue. CONCLUSION: Respiratory physiotherapists reflected uncertainties around the use of goal-setting in their practice, and conflict between patients' goals and organisational demands. This work highlights a need for wider discussion to clarify the purpose and implementation of goal-setting in respiratory rehabilitation