Making a difference? Understanding the working lives of learning disability nurses; 30 years of learning disability nursing in England

The study aimed to explore the lived experience of the careers of learning disability nurses in England. The methodology was informed by Hermeneutic Phenomenology, and the study design utilised narrative interviewing techniques based on an adapted model of the Biographic Narrative Interpretive Method (Wengraf 2001) in order to explore the career choices, experiences and beliefs, and values about learning disability nursing. Twenty in-depth qualitative interviews with learning disability nurses, who had been in practice in the 30-year period between 1979 and 2009, were undertaken in 2010 across nine counties in England. The data was interpreted using a narrative analysis approach. Key findings indicated that nurses, working in a diverse range of settings with varying degrees of experience, are motivated by working with people with learning disabilities and narrate their experiences of building relationships with people articulating the meaning of this for them as nurses. The initial reasons for choosing learning disability nursing as a career formed a key theme within the findings, with complex influences on their career choice. Additionally, all participants in this study created a narrative of change, focusing on the ways in which change in policy, practice and in societal views have impacted upon their working lives and their identity. The individual narratives have also been interpreted to form a collective narrative of learning disability nursing to specifically explore the identity of learning disability nurses and nursing in a changing context of health and social care provision

Radio as a Screen Medium in BBC Arts Broadcasting

Today more than half of all radio listening in the UK is occurring through digital platforms. Within this context the BBC’s current arts proposition provides a valuable insight into how public service broadcasters are adapting and responding to this burgeoning digital audience. In particular, attention is drawn to the ways in which digital platforms are used to supplement and enhance the auditory listening experience. In doing so, the present article argues that radio continues to occupy a significant position in furthering public engagement with the arts due to, rather than despite of, advances in digital technology

An invisible army: The role of freelance labour in Bristol’s film and television industries

The purpose of this report is to complement current statistical data on freelance labour by providing a detailed, qualitative portrait of how freelancers negotiate precarious careers within specific regional contexts. It is based on a one-year research project (January 2018–19) funded by the Arts and Humanities Research Council (AHRC) through the National Productivity Investment Fund. The research was conducted by a research fellow employed by the University of the West of England Bristol and undertaken in partnership with the Royal Television Society Bristol, Creative England, Creative Skillset, and Bristol Media

Diagnostic Imaging Strategies for Patients with Suspected Coronary Artery Disease

In this thesis, our aim was to determine and optimize the diagnostic work-up for patients who are suspected of having coronary artery disease (CAD). We showed that the diagnostic performance of stress perfusion magnetic resonance imaging (MRI) compares favorably to the diagnostic performance of single-photon emission computed tomography (SPECT). If both tests can be performed in a patient, then stress perfusion MRI should be the preferred test, even more so because it does not involve exposure to radiation. We demonstrated that the coronary CT calcium score has predictive value beyond existing cardiovascular risk factors for diagnosing obstructive CAD in patients with chest pain. The CT coronary calcium score could be considered as an initial triage test in patients with a low pre-test probability of CAD, preventing (unnecessary) further work-up if the score is zero, and justifying further testing when coronary calcium is present. The optimal diagnostic strategy depends on the pre-test probability of CAD, which is traditionally estimated based on the Diamond & Forrester method or the Duke Clinical Score. We demonstrated that these prediction rules systematically overestimate the probability of CAD and we updated the models based on contemporary data. An online probability calculator was developed that provides systematically lower (but more accurate) estimates of the pre-test probability. Although we did not study the clinical impact of implementing our new prediction model, a more accurate estimate of the pre-test probability is likely to lead to better decisions regarding further testing and it could potentially reduce costs since less high probabilities are predicted which in turn may prevent unnecessary diagnostic work-up. Lastly, we evaluated the long term effectiveness and costs of coronary CT angiography in various different settings and for various countries. In the Dutch setting, coronary CT angiography was found to be cost-effective as triage test prior to catheter-based coronary angiography (CAG) if the pre-test probability was below 44% in men and below 37% in women. CT coronary calcium scoring with or without subsequent coronary CT angiography as initial strategy for patients presenting with stable chest pain was less expensive and equally effective compared to standard-of-care. Finally, we showed that a strategy using coronary CT angiography, if positive followed by cardiac magnetic resonance imaging (CMR) was cost-effective compared to strategies with coronary CT angiography and CMR alone, for the United States, the United Kingdom, as well as the Netherlands. All-in-all, our updated prediction models combined with the results from our decision models and cost-effectiveness analyses provide a practical framework for efficient implementation of diagnostic imaging tests, in particular for the CT coronary calcium score and coronary CT angiography

Long sentenced women prisoners: Rights, risks and rehabilitation

This paper re-examines critically the role of rehabilitative interventions for a seriously neglected group of prisoners: women serving long sentences. Drawing on empirical research conducted in a democratic therapeutic community in a women’s prison in the south of England, it considers how far established criticisms identify insuperable difficulties that exacerbate existing harms and inequalities. It argues that evidence can be adduced to support rehabilitative interventions that are not predominantly concerned with the reduction of criminal risk but which provide tangible benefits to the personal wellbeing of women in prison and may increase their prospects of integration post release. It explores how such rehabilitative policies and practices could be supported and protected from attrition by penal power, by embedding them within a doctrine of human rights. By challenging and replacing prevalent assumptions and justifications that uphold existing power relations in prisons, we argue that a specific duty of care, owed by the prison service to women serving long sentences, can protect, support and re-imagine their right to rehabilitative opportunities

Precarious work and creative placemaking: Freelance labour in Bristol

As an occupational group characterized by their responsiveness, resilience and innovation, freelancers make a vital contribution to the UK’s creative economy. However, although there has been a general acknowledgement of their importance, a number of existing studies abstract freelancers from the localities in which they work. Based on twenty in-depth interviews with freelancers working in Bristol’s film and television industries, this article contends that freelance work is strongly situated in place and locality and, as such, defining the nature of freelance work also requires understanding the local cultural, political and economic contexts in which it is situated. In making this argument, this article situates precarity as not only an occupational issue, but also a place-based, policy issue. It concludes by arguing that, rather than instrumentalist approaches, policy interventions designed to promote growth in local production centres should be informed by the place-based nature of how freelancers negotiate precarious careers

Building and sustaining freelance careers in a small nation: The case of Cardiff’s film and television industries

Often characterised as an occupational group of highly skilled, responsive, resilient and creative individuals, freelancers make a vital contribution to the strength and sustainability of film and television production. Freelancers are both intrinsically situated in the places they work through the interrelations of local authorities, cultural institutions and the labour market, and are themselves placemakers, contributing to the local milieu through building place-based communities to mitigate the inherently precarious nature of their careers. Based on in-depth interviews with freelancers and screen agencies in Cardiff, this paper explores the complex relationships between creative workers and their locality. It exams how freelancers negotiate precarious careers in a small nation through the support of local development agencies and government intervention. In doing so, this work builds on previous research concerning freelancer labour in Bristol, furthering the contention that place-based interventions and policy occupies an important role in nurturing diverse and resilient regional production sectors

‘We shouldn't let great art disappear into BBC Four's cultural ghetto’: The impact of BBC Four on mainstream arts provision

Although BBC Four has been lauded for its dedication to more esoteric content and artforms, since the channel was introduced there has concern for the range and depth of arts content on the BBC’s terrestrial services – BBC One and BBC Two. As journalist Stuart Jeffries warned at the launch of the new channel: ‘We shouldn’t let great art disappear into BBC Four’s cultural ghetto and let the mainstream be dominated by Carol Smillie’s mirthless smile’ (2002). This paper examines the impact BBC Four has had on the BBC’s mainstream arts provision as part of a broader shift in the BBC’s provision from a Reithian mixed schedule of programming to specialist digital services for niche audiences