Service delivery for people with hereditary spastic paraparesis living in the South West of England.

PURPOSE: Hereditary Spastic Paraplegia (HSP) is an inherited nervous system disorder characterized by development of leg weakness, spasms and stiffness. While generally acknowledged that health and social care services can minimise symptoms and improve quality of life, there is a lack of research exploring this from the perspective of people affected by HSP. This qualitative study explored the users and providers experience of using rural services. METHOD: Focus groups and interviews were undertaken of people with HSP (n = 14), carers (n = 6) and professionals (n = 12), to describe their experience of service provision and to suggest improvements for care. These were taped, transcribed and analysed. RESULTS: Four themes emerged: (1) Diagnosis, symptoms and finding support; (2) Therapy, treatment and the delivery of care; (3) Managing the disease together; and (4) The way forward. CONCLUSIONS: Rehabilitation and support for self-management is valued by those affected with HSP throughout the disease trajectory from diagnosis onwards. Key to this is the development of a partnership approach which includes carers. Single point, well-informed, gatekeepers may enhance the coordination and delivery of care in rural areas. These findings underline current guidance promoting a holistic approach for people with neurological conditions

Using meta-ethnography to understand the emotional impact of caring for people with increasing cognitive impairment.

The definitive version is available at www.blackwell-synergy.comThe majority of people with degenerative neurological conditions are cared for within their own families. Cognitive impairment can be a significant and increasing symptom of these conditions. In this article we report how a team of experienced researchers carried out a meta-ethnography of qualitative research articles focusing on the impact of caring for a loved one with cognitive impairment. We followed the seven-step process outlined by Noblit and Hare. Synthesized findings from 31 papers suggest emotional impact is complex and uncertain and varies from day to day. The benefit of using meta-ethnography is that the results represent a larger sample size and a reinterpretation of multiple studies can hold greater application for practice. The results of this study offer an opportunity for nurses to be aware of both the positive and negative sides of caring and being cared for. This knowledge can be used to discuss with patients and carers how best to prepare for decreasing cognition and still maintain a worthwhile quality of life

Combustion detector

A device has been developed for generating a rapid response signal upon the radiation-emitting combustion reaction of certain gases in order to provide a means for the detection and identification of such reaction and concurrently discriminate against spurious signals. This combustion might be the first stage of a coal mine explosion process, and thereby this device could provide a warning of the impending explosion in time to initiate quenching action. This device has the capability of distinguishing between the light emitted from a combustion reaction and the light emitted by miners' lamps, electric lamps, welding sparks or other spurious events so that the quenching mechanism is triggered only when an explosion-initiating combustion occurs

The Use of Descriptive Words and Metaphor in Patient and Carer Experience of Palliative Day Care: Secondary Analysis of a Qualitative Study

BACKGROUND: An independent evaluation of changes to the delivery of Palliative Day Services was carried out during 2006-2007 using interviews with service users. The analysis found that the words and metaphors employed by users of services emphasized their emotional response to the changes, and helped to explain their depth of feeling about their experiences, warranting further investigation. AIM: To conduct a secondary analysis on interview data collected for the Day Services Evaluation Study in order to understand how patients and their carers use descriptive words and metaphor when talking about their experiences of palliative day services. METHODS: Interview transcripts from 40 patients and 8 carers were subjected to secondary thematic analysis. These were read individually and coded where metaphor or descriptive words had been used to emphasize the effect of the illness and the experiences of the Day Services. FINDINGS: Examples of the metaphorical expressions and words used described the service as a 'secure rock in a changing world'; transition was felt as 'sadness', a 'betrayal', with feelings that the changes were 'bitter and twisted;' and left 'a black hole'. Post transition the mood had changed to acceptance 'When life throws lemons at you, you make lemonade'. CONCLUSIONS: The metaphors and descriptive words used act as what we describe as 'emotional intensifiers' which provide a measure of the impact of the effect of illness, the effect of the day services on users and carers and the intensity of feeling during the time of transition

Mathematical modelling and simulation of irrigation sprinklers

A set of equations suitable for describing the dynamics of a liquid droplet - gas mixture (spray) have been developed. The equations are arrived at by considering the spray as a multiphase continuum within which the gas and droplets of different sizes constitute individual phases. By ignoring droplet-droplet interactions and considering the gas phase as an inviscid fluid a simplified form of the equations of motion has been arrived at. The equations are considered in one dimension and used to describe the dynamics of the interior of spray produced by a large or medium scale irrigation sprinkler. When combined with data representing the distribution of droplet diameters within the spray this model can be used to predict the water application produced by a sprinkler operating in windy conditions. Such simulations have been undertaken to predict the water application from static sprinklers and the results validated by comparison with data obtained experimentally. A simulation methodology is used to determine the uniformity of water application produced by a travelling sprinkler. By considering the results of large number of simulations produced using meteorological data spanning several years the manner in which the simulation can be used for determining optimum irrigation practice is demonstrated. A simple model has been developed for predicting the water application from a travelling sprinkler operating in still air. The model can be used for obtaining first approximations to optimum operating conditions and provides a means for easily quantifying the performance of a given sprinkler. Further use of the model may be made for aiding in the design and control of irrigation sprinklers

A qualitative investigation of lay perspectives of diagnosis and self-management strategies employed by people with progressive multiple sclerosis

This is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this record.This article explores how people with progressive multiple sclerosis give meaning to their experiences. It builds upon the self-management literature, which has captured the tension between the desire for retaining normalcy and the increasing burden of self-management associated with chronic disease progression. This repeat interview study is empirically grounded in 28 interviews with 14 people with progressive multiple sclerosis. We identified gender differences in diagnosis-seeking which impacted subsequent sense-making. Male respondents found a diagnosis of multiple sclerosis difficult to come to terms with, and an enduring sense of loss or anger could inhibit further sense-making. A diagnosis of multiple sclerosis was more difficult to obtain for women respondents, and any sense of certainty that diagnosis provided framed their subsequent sense-making strategies. The complex sequelae of multiple sclerosis require that self-management strategies are both contextual and timely, although even the most accomplished self-managers can lose their sense of self with neurodegeneration. Disease progression can be associated with suicidal ideation, suggesting the need for greater dialogue to ensure that people with multiple sclerosis are adequately supported to fulfil their quality of life at all stages of neurodegeneration. These lay perspectives emphasise the articulation of affect rather than the rendering of a medical diagnosis, although diagnosis may provide a degree of certainty in the short term. The ethos of self-management ensures people attempt to retain their sense of ‘normality’ and existent social roles for as long as possible, but this ethos can negate both one’s ability to self-manage and the management of self.The author(s) disclosed receipt of the following financial support for the research, authorship, and/ or publication of this article: This research was funded by the MS Society (Grant No. 908)