"Challenge Current Practice and Assumptions! Make waves!!” : What Works Scotland Collaborative Learning Event 23 & 24 February 2016 Queens Hotel, Perth

No abstract available

Unsaturated fatty acid regulation of cytochrome P450 expression via a CAR-dependent pathway.

The liver is responsible for key metabolic functions, including control of normal homoeostasis in response to diet and xenobiotic metabolism/detoxification. We have shown previously that inactivation of the hepatic cytochrome P450 system through conditional deletion of POR (P450 oxidoreductase) induces hepatic steatosis, liver growth and P450 expression. We have exploited a new conditional model of POR deletion to investigate the mechanism underlying these changes. We demonstrate that P450 induction, liver growth and hepatic triacylglycerol (triglyceride) homoeostasis are intimately linked and provide evidence that the observed phenotypes result from hepatic accumulation of unsaturated fatty acids, which mediate these phenotypes by activation of the nuclear receptor CAR (constitutive androstane receptor) and, to a lesser degree, PXR (pregnane X receptor). To our knowledge this is the first direct evidence that P450s play a major role in controlling unsaturated fatty acid homoeostasis via CAR. The regulation of P450s involved in xenobiotic metabolism by this mechanism has potentially significant implications for individual responses to drugs and environmental chemicals

An exploratory multi-case study of the health and wellbeing needs, relationships and experiences of health and social care service users and the people who support them at home in a regional area of Scotland.

The aim of this research was to explore the health and wellbeing needs, relationships, and experiences of Health and Social Care (HSC) Service Users and the people who support them at home, in a regional area of Scotland. Current United Kingdom legislation sets a precedence of person-centred HSC that meets the health and wellbeing needs of Service Users and their families through improved experiences. Despite this, current research in the field focuses on evaluation of services and models of integrated HSC, with fewer studies investigating person-centred experiences and needs of people who use HSC. This qualitative multi-case study was designed with HSC key stakeholders. Eighteen participants were recruited across three participant groups: Service User [n=6]; Informal Carer [n=5]; HSC staff [n=7]. Service Users identified an Informal carer and HSC staff member to take part with them, creating a 'case' [n=7]. Qualitative data were collected via semi-structured interviews (December 2019 – March 2020) and principles of interpretive thematic analysis were employed to synthesise data and findings. The study found that supportive relationships and interpersonal connections were instrumental in helping all participant groups to feel able to cope with their changing HSC needs and roles, promoting reassurance, information sharing and reduced anxiety. When these connections and relationships were lacking, it negatively impacted upon Service Users' experiences of HSC. Service Users and Informal Carers wanted to connect with their local communities for support. These connections appeared more cohesive and collaborative than those with statutory NHS and Local Authority services because of their personal connections with individual community members. Supportive relationships within a community were instrumental in meeting the HSC needs of their individual members. The support that statutory services provided did not always meet the needs of the people who were accessing or providing it, and they were not always aware of the support that communities provided. This study offers insight into indicators for improved HSC. Findings suggest a need to adopt Person-centred, Relationship-based HSC to encourage meaningful connections and improve experiences of accessing and providing HSC. Co-produced, community-driven services that meet the needs of the people who use them, as defined by those people themselves, should be encouraged

Ascertaining the Impact of Relativism on Moral Reasoning

This research project is part on an ongoing effort in the social sciences to expand the understanding of those factors that may influence and promote moral development. Based on Lawrence Kohlberg’s developmental theory of moral reasoning, the main focus of the current study concerns the exploration of the relationship between moral reasoning and relativistic attitudes. B-type moral reasoning is a more mature and developed form of reasoning at each of Kohlberg’s Stages 2 through 5. Hypotheses regarding the positive associations between the frequency of its use and scores on measures of relativism, equity, empathy, and open-mindedness were generated. Of the 80 possible associations predicted, all were weak, and only 2 attained an acceptable level of statistical significance. Possible explanations for these results are considered

Worship in the Nartex: identifying a contemporary site for the Eucharist

The aim of this thesis is to describe a contemporary site for eucharistic celebration. In the Introduction, we begin with the premise that a common context for understanding the liturgy, and in particular the Eucharist, as the public language of the Roman Catholic Church, has been lost. In order to restore the practice of the Eucharist, it is therefore necessary to restore a common context in relation to which the Eucharist makes sense. In Chapter One, we begin this task by exploring the history of the relationship between the Eucharist and the Church with the help of an important recent book by P.J. FitzPatrick, In Breaking ofBread: The Eucharist and Ritual. We look in particular at how the form of the Eucharist is shaped by the centralization and clericalization of power in the Church. In Chapters Two and Three, we take up FitzPatrick's suggestion that the way forward for our understanding of the Eucharist is to describe it as a ritual. What this accomplishes is to situate us within the arena of human action. In these two chapters, we explore what it means to say that the world is linguistically-structured. Language, as we discover, is not simply a tool for naming objects, rather, it embodies patterns of meaning and relationship which form us at a pre-conscious, bodily level. Likewise, the purpose of the liturgy as the Church's public language is not to pass on consciously-held beliefs or knowledge, but to give Christians a particular, pre-conscious bodily formation. Describing the Eucharist as a ritual is not sufficient, because the Church's rituals express whatever kind of life the Church is actually leading. Unless the Church is living the Gospel in practice, her rituals will not provide an adequate Christian formation. In Chapter Four, we situate this discourse in relation to the discourses of modernity and post-modemity. With the breakdown of the unified social vision of the Middle Ages, we find, in modernity, the hope that differences can be united through a common rationality. In post-modemity, we discover the extent to which our rationality is itself contingent - tied to our formation at particular locations in space and time. This awareness of the limits of what we say creates a crisis in human action. We can find no basis for common action which does not appear to eliminate differences, and we cannot act individually without being aware that what we do and say is put in question by the position of others. It is within this context that the theologian John Milbank proposes a return to Christianity as a metanarrative. Only Christianity, he argues, provides an account of difference which is not simply the occasion of violence. Milbank demonstrates how secular rationality, which presupposes the inevitability of violence, arises out of an heretical departure from Christian orthodoxy. The problem with Milbank, however, is that he creates a dichotomy between the Church and the secular which gives the impression that there is such a thing as the Christian Church uncorrupted by collusion with the secular order. Milbank creates what the philosopher Gillian Rose calls a "holy middle", a sociality outside time and space, and therefore, not a real beginning for action. Rose, by contrast, is concerned in her idea of the broken middle of modernity with the problem of how to act, aware of the limits which always already constrain us, but not paralyzed by them. We explore Rose's metaphor of modernity in Chapter Six. In the Conclusion, we return to the question of the Eucharist to show how Rose's broken middle of modernity locates for us a contemporary site for eucharistic celebration. The revolution which Christ embodies has to do with his relationship to those who fall outside the Law. Jesus teaches that love is the medium of this encounter. This love, however, demands the kind of risk which Gillian Rose describes, because it involves a movement outward from our present categories of understanding towards a greater vision which we cannot yet articulate. The poor are those who fall outside our present vision of the social whole. It is only from the perspective of the poor, therefore, that the Church can celebrate the Eucharist as the sacrament of Christ's real presence in the world

Le statut de la désinstitutionnalisation en Grande-Bretagne

Pour expliquer le statut actuel de la désinstitutionnalisation1 et du développement des soins communautaires, on examine dans quelle mesure ces soins peuvent ou pourraient assumer les fonctions de l'asile. Ces fonctions incluent celles qui sont manifestes ou explicites, et celles qui sont latentes ou non intentionnelles mais implicites (Bachrach, 1976). La pertinence toujours actuelle de ces deux types de fonctions exerce une influence importante sur le processus de fermeture des asiles et sur le développement des soins communautaires. Il s'ensuit des délais dans les fermetures d'asiles et une transinstitutionnalisation, ou transfert de certains patients depuis l'asile vers d'autres institutions, ce qui, en concentrant les dépenses dans les hôpitaux, étouffe le développement des soins communautaires.The aim of this article is to explain the current status of deinstitutionalisation and of community care development by studying the extent to which community care can or should take over the functions of the asylum. These functions include those that are manifest, or explicit, and those that are latent, or unintended but implicit (Bachrach 1976). The continuing relevance of both sets of functions is argued to be exerting a powerful influence on the processes of asylum closure and community care development. The results include delayed asylum closures and transinstitutionnalisation, the shift of some patients from asylums to other institutions, which stifle the development of community care by concentrating spending in hospitals

Conceptualising In-Flight Experience: An air Traveller Perspective

The aviation industry has evolved rapidly in recent years, and so have consumer expectations with regard to air travel. This study examines how air travellers conceptualise in-flight experience. Using a mixed-methods approach, this study is divided into two phases. First, semi-structured qualitative interviews were undertaken with 32 members of the flying public and analysed using thematic analysis. Second, based upon the key themes identified in the first phase, a questionnaire (with both quantitative and qualitative questions) was developed and administered to 151 participants. The first phase identified the different ways air travellers conceptualise in-flight experience, with the most important elements being food and drinks, flight attendants, entertainment, seat comfort, and leg room. In the second phase these important elements are shown to have statistically significant effects upon in-flight experience (using a t-test and chi-squared goodness of fit test), however, the size of their effects varied. A Friedman test (with post-hoc Wilcoxon signed-rank test) demonstrates that air travellers rank the contribution of each of these elements towards in-flight experience differently. The findings allow airline managers to prioritise different aspects of in-flight experience based upon their relative importance to air travellers

The Potential of Learner-Generated Podcasts for Reading in Occupational Therapy Education

Research suggests that reading compliance among higher education students is low, warranting enhancement of educational practices to support reading, especially for students enrolled in health professional programs. Researchers used a cross-sectional study design to explore the effects of a learner-generated podcast assignment as a reading supplement in occupational therapy education using two different survey instruments assessing student perceptions and learning styles. Forty-three Occupational Therapy Doctorate (OTD) students participated in this study. Descriptive statistics indicated positive attitudes towards creating and preparing the podcasts but remained mostly neutral towards listening and watching podcasts. Tukey’s HSD test for multiple comparisons detected tactile learners on average completed less readings (40%) compared to visual and auditory learners (60%-70%), with a significant difference (0.05) between visual and auditory learners. Learner-generated podcasts present an opportunity to enhance student learning, but further research is needed to determine the best educational practices

Mental illness stigma in England: What happened after the Time to Change Programme to reduce stigma and discrimination

Background: Between 2008-2019 we reported positive change relating to mental health stigma and discrimination among the adult population of England, supporting the effectiveness of the Time to Change campaign.Aims: We investigated the extent to which positive changes in stigma were sustained by 2023, two years after the programme’s end in 2021. Methods: We used regression analyses to evaluate trends in outcomes. Measures were of stigma-related knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes to the Mentally Ill scale (CAMI)), and desire for social distance (Reported and Intended Behaviour Scale (RIBS)). We also examined willingness to interact with people based on vignettes of depression and schizophrenia, and attitudes towards workplace discrimination, using data from the British Social Attitudes Survey (BSAS) for comparison. Results: CAMI scores improved between 2008 and 2023 (SD=0.24, 95% CI=0.16 to 0.31), but decreased since 2019 (p=0.015). After improvements to 2019, 2023 MAKS and RIBS scores no longer differed from 2009 scores, indicating decreases since 2019 in stigma-related knowledge (MAKS scores declined 7.8%, p&lt;0.001) and willingness to interact (RIBS scores declined by 10.2%, p&lt;0.001). Conversely, comparison with BSAS data indicated that willingness to interact with people with depression and schizophrenia increased gradually between 2007, 2015 and 2023, and attitudes to workplace discrimination also improved. Conclusions: The lasting positive changes reflect support for non-discrimination and willingness to interact with someone after a sense of familiarity is evoked. Besides the end of Time to Change, interpretations for declines in other outcomes include the covid-19 pandemic and economic stress.<br/