189 research outputs found
Studying clinical reasoning, part 2: Applying social judgement theory
Part 1 of this paper (Harries and Harries 2001) examined the reasoning studies of the 1980s and 1990s and critiqued the ethnographic and informationprocessing approaches, based on stated information use. The need for an approach that acknowledged the intuitive nature of experienced thinkersā reasoning was identified. Part 2 describes such an approach Ā± social judgement theory Ā± and presents a pilot application in occupational therapy research. The method used is judgement analysis. The issue under study is that of prioritisation policies in community mental health work. The results present the prioritisation policies of four occupational therapists in relation to managing community mental health referrals
Special Issue: Driving and community mobility (II) - interventions to enable driving
The first part of our Special Issue on āDriving and community mobilityā (British Journal of Occupational Therapy 78(2)) focused on the assessment of drivers with health or age-related declines, and revealed over 25 years of research evidence that occupational therapists can use to help determine an individualās fitness-to-drive. The focus of this second part of our Special Issue is on occupational therapy interventions that support access to the community
Detection and prevention of financial abuse against elders
This article is made available through the Brunel Open Access Publishing Fund. Copyright @ The Authors. This article is published under the Creative Commons Attribution (CC BY 3.0) licence. Anyone
may reproduce, distribute, translate and create derivative works of this article (for both
commercial and non-commercial purposes), subject to full attribution to the original publication
and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/
by/3.0/legalcode.Purpose ā This paper reports on banking and finance professionals' decision making in the context of elder financial abuse. The aim was to identify the case features that influence when abuse is identified and when action is taken.
Design/methodology/approach ā Banking and finance professionals (n=70) were shown 35 financial abuse case scenarios and were asked to judge how certain they were that the older person was being abused and the likelihood of taking action.
Findings ā Three case features significantly influenced certainty of financial abuse: the nature of the financial problem presented, the older person's level of mental capacity and who was in charge of the client's money. In cases where the older person was more confused and forgetful, there was increased suspicion that financial abuse was taking place. Finance professionals were less certain that financial abuse was occurring if the older person was in charge of his or her own finances.
Originality/value ā The research findings have been used to develop freely available online training resources to promote professionals' decision making capacity (www.elderfinancialabuse.co.uk). The resources have been advocated for use by Building Societies Association as well as CIFAS, the UK's Fraud Prevention Service.The research reported here was funded by the UK cross council New Dynamicsof Ageing Programme, ESRC Reference No. RES-352-25-0026, with Mary L.M. Gilhooly asPrincipal Investigator. Web-based training tools, developed from the research findings, weresubsequently funded by the ESRC follow-on fund ES/J001155/1 with Priscilla A. Harries asPrincipal Investigator
Circumstellar environment of RX Puppis
The symbiotic Mira, RX Pup, shows long-term variations in its mean light
level due to variable obscuration by circumstellar dust. The last increase in
extinction towards the Mira, between 1995 and 2000, has been accompanied by
large changes in the degree of polarization in the optical and red spectral
range. The lack of any obvious associated changes in the position angle may
indicate the polarization variations are driven by changes in the properties of
the dust grains (e.g. variable quantity of dust and variable particle size
distribution, due to dust grain formation and growth) rather than changes in
the viewing geometry of the scattering region(s), e.g. due to the binary
rotation.Comment: Paper presented at Torun 2000 conference on Post-AGB objects as a
phase of stellar evolution; 8 pages, 3 figure
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A systematic review of evidence for fitness-to-drive among people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder.
Background: Limited evidence exists regarding fitness-to-drive for people with the
mental health conditions of schizophrenia, stress/anxiety disorder, depression,
personality disorder and obsessive compulsive disorder (herein simply referred to as
'mental health conditions'). The aim of this paper was to systematically search and
classify all published studies regarding driving for this population, and then critically
appraise papers addressing assessment of fitness-to-drive where the focus was not on
the impact of medication on driving.
Methods: A systematic search of three databases (CINAHL, PSYCHINFO, EMBASE)
was completed from inception to May 2016 to identify all articles on driving and mental
health conditions. Papers meeting the eligibility criteria of including data relating to
assessment of fitness-to-drive were critically appraised using the American Academy
of Neurology and Centre for Evidence-Based Medicine protocols.
Results: A total of 58 articles met the inclusion criteria of driving among people with
mental health conditions studied, and of these, 16 contained data and an explicit focus
on assessment of fitness-to-drive. Assessment of fitness-to-drive was reported in three
ways: 1) factors impacting on the ability to drive safely among people with mental
health conditions, 2) capability and perception of health professionals assessing
fitness-to-drive of people with mental health conditions, and 3) crash rates. The level of
evidence of the published studies was low due to the absence of controls, and the
inability to pool data from different diagnostic groups. Evidence supporting fitness-todrive
is conflicting.
Conclusions: There is a relatively small literature in the area of driving with mental
health conditions, and the overall quality of studies examining fitness-to-drive is low.
Large-scale longitudinal studies with age-matched controls are urgently needed in
order to determine the effects of different conditions on fitness-to-drive
Medical causes of admissions to hospital among adults in Africa: a systematic review.
BACKGROUND: Despite the publication of several studies on the subject, there is significant uncertainty regarding the burden of disease among adults in sub-Saharan Africa (sSA). OBJECTIVES: To describe the breadth of available data regarding causes of admission to hospital, to systematically analyze the methodological quality of these studies, and to provide recommendations for future research. DESIGN: We performed a systematic online and hand-based search for articles describing patterns of medical illnesses in patients admitted to hospitals in sSA between 1950 and 2010. Diseases were grouped into bodily systems using International Classification of Disease (ICD) guidelines. We compared the proportions of admissions and deaths by diagnostic category using Ļ2. RESULTS: Thirty articles, describing 86,307 admissions and 9,695 deaths, met the inclusion criteria. The leading causes of admission were infectious and parasitic diseases (19.8%, 95% confidence interval [CI] 19.6-20.1), respiratory (16.2%, 95% CI 16.0-16.5) and circulatory (11.3%, 95% CI 11.1-11.5) illnesses. The leading causes of death were infectious and parasitic (17.1%, 95% CI 16.4-17.9), circulatory (16%, 95% CI 15.3-16.8) and digestive (16.2%, 95% CI 15.4-16.9). Circulatory diseases increased from 3.9% of all admissions in 1950-59 to 19.9% in 2000-2010 (RR 5.1, 95% CI 4.5-5.8, test for trend p<0.00005). The most prevalent methodological deficiencies, present in two-thirds of studies, were failures to use standardized case definitions and ICD guidelines for classifying illnesses. CONCLUSIONS: Cardiovascular and infectious diseases are currently the leading causes of admissions and in-hospital deaths in sSA. Methodological deficiencies have limited the usefulness of previous studies in defining national patterns of disease in adults. As African countries pass through demographic and health transition, they need to significantly invest in clinical research capacity to provide an accurate description of the disease burden among adults for public health policy
Stellar winds from Massive Stars
We review the various techniques through which wind properties of massive
stars - O stars, AB supergiants, Luminous Blue Variables (LBVs), Wolf-Rayet
(WR) stars and cool supergiants - are derived. The wind momentum-luminosity
relation (e.g. Kudritzki et al. 1999) provides a method of predicting mass-loss
rates of O stars and blue supergiants which is superior to previous
parameterizations. Assuming the theoretical sqrt(Z) metallicity dependence,
Magellanic Cloud O star mass-loss rates are typically matched to within a
factor of two for various calibrations. Stellar winds from LBVs are typically
denser and slower than equivalent B supergiants, with exceptional mass-loss
rates during giant eruptions Mdot=10^-3 .. 10^-1 Mo/yr (Drissen et al. 2001).
Recent mass-loss rates for Galactic WR stars indicate a downward revision of
2-4 relative to previous calibrations due to clumping (e.g. Schmutz 1997),
although evidence for a metallicity dependence remains inconclusive (Crowther
2000). Mass-loss properties of luminous (> 10^5 Lo) yellow and red supergiants
from alternative techniques remain highly contradictory. Recent Galactic and
LMC results for RSG reveal a large scatter such that typical mass-loss rates
lie in the range 10^-6 .. 10^-4 Mo/yr, with a few cases exhibiting 10^-3 Mo/yr.Comment: 16 pages, 2 figures, Review paper to appear in Proc `The influence of
binaries on stellar population studies', Brussels, Aug 2000 (D. Vanbeveren
ed.), Kluwe
Eta Carinae and the Luminous Blue Variables
We evaluate the place of Eta Carinae amongst the class of luminous blue
variables (LBVs) and show that the LBV phenomenon is not restricted to
extremely luminous objects like Eta Car, but extends luminosities as low as
log(L/Lsun) = 5.4 - corresponding to initial masses ~25 Msun, and final masses
as low as ~10-15 Msun. We present a census of S Doradus variability, and
discuss basic LBV properties, their mass-loss behaviour, and whether at maximum
light they form pseudo-photospheres. We argue that those objects that exhibit
giant Eta Car-type eruptions are most likely related to the more common type of
S Doradus variability. Alternative atmospheric models as well as
sub-photospheric models for the instability are presented, but the true nature
of the LBV phenomenon remains as yet elusive. We end with a discussion on the
evolutionary status of LBVs - highlighting recent indications that some LBVs
may be in a direct pre-supernova state, in contradiction to the standard
paradigm for massive star evolution.Comment: 27 pages, 6 figures, Review Chapter in "Eta Carinae and the supernova
imposters" (eds R. Humphreys and K. Davidson) new version submitted to
Springe
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