The ethics of sociocultural risk research

In socio-cultural risk research, an epistemological tension often follows if real hazards in the world are juxtaposed against the essentially socially constructed nature of all risk. In this editorial, we consider how this paradox is manifest at a practical level in a number of ethical dilemmas for the risk researcher. (1) In terms of strategies for seeking informed consent, and for addressing the power inequalities involved in interpretative and analytical work, researchers can find themselves pushing at the boundaries of standard understandings of ethical practices and ways of engaging informants in their studies. (2) Impact on participants is another key area of concern, since the subject matter on which data are collected in risk research may be a source of uncertainty, anxiety or unwanted self knowledge. (3) Risk researchers also face the possibility of institutional repercussions of raising risk issues with people who usually normalize the risks, thereby stimulating distrust in the institutions or organizations with formal responsibilities for risk management. There are no simple formulae to guide the researcher in dealing with such ethical issues and paradoxes. It is important, though, to recognize their specificity in risk studies, including the ambiguous status of questions about vulnerability since judgements about 'who is vulnerable' and 'in what ways' are themselves influenced by the situational framings and understandings of participants and researchers

Leadership and the everyday practice of consultant radiographers in the UK: transformational ideals and the generation of self-efficacy

Introduction: This paper outlines findings from a broader, two-year project investigating the role of Consultant Radiographers (CRs) in the UK, focussing specifically on the leadership aspect of that role. Methods: Using a qualitative-thematic approach, the leadership-related experiences of a purposive sample of six participating CRs are explored, alongside the systems through which they evaluated how successful they had been as leaders. Results: It is evidenced that many of the ways in which participants describe their own leadership practice, particularly in the intra-team domain, is consistent with the precepts of the Transformational Leadership Model. For example, they highlight how they have asserted positive influence and encouraged collective action and decision-making. However, the experiential focus of the analysis reveals that in specific examples of practice, the transformational approach was not always seen as the most useful route to a productive outcome given constrictions on time and other resources within real professional environments. More ‘direct’ managerial approaches were sometimes deemed necessary, and at others leadership was reduced to simply ‘solving other people's problems'. It was also found that the manner in which participants evaluated their own success as leaders was a practical concern, based in part upon having satisfied ‘hard’ institutional goals, but also on the more personal business of having affirmatively ‘surprised’ oneself, or a general sense of feeling trusted by colleagues. Conclusion: These findings may help support CRs in the business of real leadership, not least through better understanding how even apparently mundane outcomes can have significant impacts on professional self-efficacy

Reflections on the role of consultant radiographers in the UK: the perceived impact on practice and factors that support and hinder the role

Study context: This paper is the third paper arising from a two year long, in-depth case study exploring various components of the role of consultant radiographers in the UK. This paper focuses particularly upon the perceived impact of the role and factors that support and hinder the role in practice. Methods: A longitudinal case study method was used to explore the role of consultant radiographers. Interviewing was informed and guided by a phenomenological approach to promote a deeper understanding of consultants' experiences in the role. Eight consultant radiographers participated, with six involved throughout the whole study. Over an 18 month period each of those six consultants was interviewed three times. Two consultants only participated in the first interview; these interviews are also reported here. A total of 20 interviews were conducted. Findings: Interviews explored the impact of the consultant role as perceived by consultants themselves, and encouraged individual reflection on factors which had both supported and hindered success therein. Analysis demonstrated that there was substantial variation in the experiences communicated yet, and without any exception, all consultants reported that the introduction of their role had been beneficial to service delivery and quality of patient care. A number of obstacles were outlined, as well as a range of support mechanisms. Recommendations are thus made as to how the consultant role might be more effectively supported in the future

Reflections on the role of consultant radiographers in the UK: what is a consultant radiographer?

Context: This paper is the second paper from a two year in depth case study, exploring the role of consultant radiographers in the UK. Methods: A longitudinal case study approach was used to determine the role of consultant radiographers. Interviews were used to explore experiences of being a consultant, which were analysed using thematic analysis. Eight consultant radiographers participated (Note, two of the consultants withdrew after the first interview due to workload). Therefore two consultants were interviewed only once. The remaining six consultants were interviewed twice over a 12 month period. Findings: The data presented in this paper explores the nature of the role, differences between roles, the four domains of practice, and how the role fits into local organisational structures. The study shows wide variation in the types of roles undertaken, reflecting that the creation of these roles were in response to local clinical need and often related to an individual practitioner's skills. The broad scope of the role was shown across all the consultants, with evidence of roles developing into new areas of service delivery. Conclusions: The paper offers insight into the role(s) of consultant radiographers in the UK. The range and scope of their practice is extensive, with much variation. It is evident that the clinical aspect of the role dominates, with research being the least supported domain of practice. There remains a lack of clarity around the role, with concerns about remuneration and other limitations that may restrict the role developing further

Prevalence and risk factors of sarcopenia among adults living in nursing homes

Objectives: Sarcopenia is a progressive loss of skeletal muscle and muscle function, with significant healthand disability consequences for older adults. We aimed to evaluate the prevalence and risk factors ofsarcopenia among older residential aged care adults using the European Working Group on Sarcopeniain Older People (EWGSOP) criteria.Study design: A cross-sectional study design that assessed older people (n = 102, mean age 84.5 ± 8.2 years)residing in 11 long-term nursing homes in Australia.Main outcome measurements: Sarcopenia was diagnosed from assessments of skeletal mass index bybioelectrical impedance analysis, muscle strength by handheld dynamometer, and physical performanceby the 2.4 m habitual walking speed test. Secondary variables where collected to inform a risk factoranalysis.Results: Forty one (40.2%) participants were diagnosed as sarcopenic, 38 (95%) of whom were categorizedas having severe sarcopenia. Univariate logistic regression found that body mass index (BMI) (Oddsratio (OR) = 0.86; 95% confidence interval (CI) 0.78–0.94), low physical performance (OR = 0.83; 95% CI0.69–1.00), nutritional status (OR = 0.19; 95% CI 0.05–0.68) and sitting time (OR = 1.18; 95% CI 1.00–1.39)were predictive of sarcopenia. With multivariate logistic regression, only low BMI (OR = 0.80; 95% CI0.65–0.97) remained predictive.Conclusions: The prevalence of sarcopenia among older residential aged care adults is very high. Inaddition, low BMI is a predictive of sarcopenia

Policy Recommendations for Meeting the Grand Challenge to End Homelessness

This brief was created forSocial Innovation for America’s Renewal, a policy conference organized by the Center for Social Development in collaboration with the American Academy of Social Work & Social Welfare, which is leading theGrand Challenges for Social Work initiative to champion social progress. The conference site includes links to speeches, presentations, and a full list of the policy briefs

The incidence of deep vein thrombosis detected by routine surveillance ultrasound in neurosurgery patients receiving dual modality prophylaxis.

The optimal method of thromboprophylaxis and the value of screening ultrasonography for detection of deep venous thrombosis (DVT) in neurosurgery patients remains unclear. The goal of this study was to determine the incidence of DVT in neurosurgical patients who, by hospital protocol, receive surveillance ultrasonography of the lower extremities twice weekly, in addition to prophylaxis with unfractionated heparin and external pneumatic compression sleeves. A retrospective review of 7,298 ultrasound studies carried out on 2,593 patients over 4 years at a university neurosurgical hospital was conducted. There was a 7.4% incidence of proximal lower extremity DVT and a 9.7% total incidence including distal DVT. A greater number of distal DVTs were detected with the implementation of whole-leg ultrasonography in the last 2 years of observation. Chart review of 237 patients diagnosed with DVT demonstrated an admitting diagnosis of subarachnoid hemorrhage in nearly half of the patients. The median hospital length of stay for DVT patients was 18 days. Institutional control data demonstrated non-ruptured aneurysm and cerebrovascular anomalies to be the leading reason for admission, followed closely by subarachnoid hemorrhage. The hospital protocol of biweekly screening ultrasound and dual modality prophylaxis for neurosurgery patients resulted in a proximal DVT incidence consistent with that demonstrated by previous studies of standardized dual modality prophylaxis, and higher than that demonstrated in previous studies that employed ultrasound screening protocols

Solubilised bright blue-emitting iridium complexes for solution processed OLEDs

EZ-C acknowledges the University of St Andrews for financial support. IDWS and AKB acknowledge support from EPSRC (EP/J01771X). The authors would like to thank the Engineering and Physical Sciences Research Council for financial support for Adam Henwood: EPSRC DTG Grants: EP/J500549/1; EP/K503162/1; EP/L505097/1.Combining a sterically bulky, electron-deficient 2-(2,4-difluorophenyl)-4-(2,4,6- trimethylphenyl)pyridine (dFMesppy) cyclometalating C^N ligand with an electron rich, highly rigidified 1,1’-(α,α’-o-xylylene)-2,2’-biimidazole (o-xylbiim) N^N ligand gives an iridium complex, [Ir(dFMesppy)2(o-Xylbiim)](PF6), that achieves extraordinarily bright blue emission (ΦPL = 90%; λmax = 459 nm in MeCN) for a cationic iridium complex. This complex is compared with two reference complexes bearing 4,4’-di-tert-butyl-2,2’- bipyridine, and solution-processed organic light emitting diodes (OLEDs) have been fabricated from these materials.Publisher PDFPeer reviewe

The logics of invited and uninvited material participation: bringing blood pressure self-monitoring into the clinic

This paper addresses debates concerning the ‘participatory turn’ in healthcare. It focuses on the case of blood pressure self-monitoring, understanding this as a form of patient participation at the level of individual care. Drawing and expanding on the work of Marres and Wynne and their notions of material participation and of uninvited engagement, we examine how patients’ home blood pressure self-monitoring is incorporated into clinical care, how the materials of blood pressure self-monitoring mediate participation and how we might characterise the practices of participation found within everyday clinical care. Our analysis makes new conceptual links, suggesting that, in this context, invited participation appears to align with participation made easy, while uninvited participation involves more invested, more engaged participation. We offer two further developments of these concepts. First, we trouble characterisations of invited and uninvited participation as distinct and separate, observing movement between these. Second, through applying the logics of material participation in a new context, everyday clinical practice, we suggest that the logic of participation made easy might be extended beyond lay people, to apply to professionals as well. Our analysis illustrates how materials are mobilised to facilitate invited and uninvited participation within the context of the on-going asymmetries in doctor patient relationships