Ward housekeepers in mental health environments

Purpose – In the year 2000, the UK Government promoted the concept that hospital services be shaped around the needs of the patient to make their stay in hospital as comfortable as possible. In recognition of this, the Government advocated the introduction of a Ward Housekeeper role in at least 50 per cent of hospitals by 2004. This is a ward-based non-clinical role centred on cleaning, food service and maintenance to ensure that the basics of care are right for the patient. Much of the guidance for the ward housekeeper role has focussed on its development and implementation in an acute hospital setting. The aim of this research is to illustrate how the role has been adopted and implemented successfully in mental health environments and the subsequent impact for patient services. Design/methodology/approach – Four case studies were undertaken in a variety of mental health settings, the principle method of data collection was qualitative semi-structured interviews. Findings – Common themes were identified from the case studies relating to experiences of developing and implementing the ward housekeeper role. This paper suggests models of best practice which relate to six main areas of: role, recruitment, induction, training, integration and management. It also demonstrates that the role has been successful and is highly valued by nursing staff. Research limitations/implications – The study was largely qualitative based and therefore the results do not lend themselves to be generalisable across the NHS.</p

Running, Attention Restoration Theory and Environmental Compatibility.

The psychological responses to exercise have often taken place without a theoretical framework. Attention Restoration Theory (ART, Kaplan, 1995), previously used to explain the psychological responses to particular environments, most notably, nature, has been expanded beyond its current paradigm to incorporate activities, such as running (Norlinget al., 2008, 2010). This paper qualitatively explores the experience of running within the ART paradigm through pre- and post-intervention interviews with 18 subjects, randomly allocated to three contrasting environments (green, urban and indoor). The data was subject to a theoretical thematic analysis by applying interview data to the framework of ART. The results provide insight into how running is able to achieve the four components of ART (fascination, being-away, extent and compatibility). Of particular importance was the environments influence over involuntary distractions; thoughts that emerge sub-consciously and are unrelated to running. Involuntary distractions closely align with involuntary attention; the attention system one must switch to enable restoration. The results are discussedin relation to previous literature on the exercise-environment interaction, and syntheses of four research areas (environmental psychology, exercise psychology, cognitive neuroscience and neurobiology) is provides a theoretical explanation behind running’s ability to restore directed attention

Asymptotic properties of mathematical models of excitability

We analyse small parameters in selected models of biological excitability, including Hodgkin-Huxley (1952) model of nerve axon, Noble (1962) model of heart Purkinje fibres, and Courtemanche et al. (1998) model of human atrial cells. Some of the small parameters are responsible for differences in the characteristic timescales of dynamic variables, as in the traditional singular perturbation approaches. Others appear in a way which makes the standard approaches inapplicable. We apply this analysis to study the behaviour of fronts of excitation waves in spatially-extended cardiac models. Suppressing the excitability of the tissue leads to a decrease in the propagation speed, but only to a certain limit; further suppression blocks active propagation and leads to a passive diffusive spread of voltage. Such a dissipation may happen if a front propagates into a tissue recovering after a previous wave, e.g. re-entry. A dissipated front does not recover even when the excitability restores. This has no analogy in FitzHugh-Nagumo model and its variants, where fronts can stop and then start again. In two spatial dimensions, dissipation accounts for break-ups and self-termination of re-entrant waves in excitable media with Courtemanche et al. (1998) kinetics.Comment: 15 pages, 8 figures, to appear in Phil Trans Roy Soc London

Asymptotic analysis and analytical solutions of a model of cardiac excitation.

The original publication is available at www.springerlink.com - http://link.springer.com/article/10.1007/s11538-007-9267-0Journal ArticleCopyright © SpringerWe describe an asymptotic approach to gated ionic models of single-cell cardiac excitability. It has a form essentially different from the Tikhonov fast-slow form assumed in standard asymptotic reductions of excitable systems. This is of interest since the standard approaches have been previously found inadequate to describe phenomena such as the dissipation of cardiac wave fronts and the shape of action potential at repolarization. The proposed asymptotic description overcomes these deficiencies by allowing, among other non-Tikhonov features, that a dynamical variable may change its character from fast to slow within a single solution. The general asymptotic approach is best demonstrated on an example which should be both simple and generic. The classical model of Purkinje fibers (Noble in J. Physiol. 160:317-352, 1962) has the simplest functional form of all cardiac models but according to the current understanding it assigns a physiologically incorrect role to the Na current. This leads us to suggest an "Archetypal Model" with the simplicity of the Noble model but with a structure more typical to contemporary cardiac models. We demonstrate that the Archetypal Model admits a complete asymptotic solution in quadratures. To validate our asymptotic approach, we proceed to consider an exactly solvable "caricature" of the Archetypal Model and demonstrate that the asymptotic of its exact solution coincides with the solutions obtained by substituting the "caricature" right-hand sides into the asymptotic solution of the generic Archetypal Model. This is necessary, because, unlike in standard asymptotic descriptions, no general results exist which can guarantee the proximity of the non-Tikhonov asymptotic solutions to the solutions of the corresponding detailed ionic model

Workplace productivity and office type: an evaluation of office occupier differences based on age and gender

Purpose Open plan office environments are considered to offer workplace productivity benefits because of the opportunities that they create for interaction and knowledge exchange, but more recent research has highlighted noise, distraction and loss of privacy as significant productivity penalties with this office layout. This study aims to investigate if the purported productivity benefits of open plan outweigh the potential productivity penalties. Design/methodology/approach Previous research suggests that office environments are experienced differently according to the gender and age of the occupier across both open-plan and enclosed configurations. Empirical research undertaken with office occupiers in the Middle East (N=220) led to evaluations to establish the impact different offices had on perceived productivity. Factor analysis was used to establish five underlying components of office productivity. The five factors are subsequently used as the basis for comparison between office occupiers based on age, gender and office type. Findings This research shows that benefits and penalties to workplace productivity are experienced equally across open-plan and enclosed office environments. The greatest impact on perceived workplace productivity however was availability of a variety of physical layouts, control over interaction and the 'downtime' offered by social interaction points. Male occupiers and those from younger generations were also found to consider the office environment to have more of a negative impact on their perceived workplace productivity compared to female and older occupiers. Originality/value The originality of this paper is that it develops the concept of profiling office occupiers with the aim of better matching office provision. This paper aims to establish different occupier profiles based on age, gender and office type. Data analysis techniques such as factor analysis and t-test analysis identify the need for different spaces so that occupiers can choose the most appropriate space to best undertake a particular work task. In addition, it emphasises the value that occupiers place on ‘downtime’ leading to the need for appropriate social space

Analytically Solvable Asymptotic Model of Atrial Excitability

We report a three-variable simplified model of excitation fronts in human atrial tissue. The model is derived by novel asymptotic techniques \new{from the biophysically realistic model of Courtemanche et al (1998) in extension of our previous similar models. An iterative analytical solution of the model is presented which is in excellent quantitative agreement with the realistic model. It opens new possibilities for analytical studies as well as for efficient numerical simulation of this and other cardiac models of similar structure