Negotiating youth work : moral geographies of the Boys' Brigade in Scotland

The sites and settings of structured youth work have been a neglected sphere of study in contemporary human geography. This thesis addresses this silence through an examination of The Boys’ Brigade – a voluntary Christian uniformed youth work movement. Limited in geographic scope to Scotland, the thesis draws upon a multiple-methods research strategy comprising: a mail-based questionnaire, semi-structured interviews, and a period of participant observation, incorporating participatory approaches with boys. Resting upon Foucouldian theoretical foundations, and written with audiences both within and without academia in mind, the thesis argues that a failure to appreciate the spatialities of structured youth work settings invariably results in partial accounts of both the motives underpinning their voluntary provision by adults’ and boys’ participation in them. More specifically, it suggests that the spaces of structured youth work are realised through small-scale processes of negotiation between boys and adults that stabilise a shared spatio-temporal regime – a structure – through which youth work is conducted by both adults and boys. It contends that it is space itself, and particularly its purposive ordering, that is both enlisted and resisted to achieve this fleeting stabilisation with its attendant disciplinary and developmental ends. In so doing the thesis delivers an analytical framework through which other spaces of structured youth work can be read that, by remaining alert to the interweaving of the geographies of voluntary provision and participation, neither overplays adults’ nor downplays young people’s agency in their creation

Cancer awareness among adolescents in Britain:a cross-sectional study

Background: Little is known about adolescents’ cancer awareness and help-seeking behaviour in Britain. This study assessed adolescents’: awareness of cancer symptoms, common cancers, and the relationship between cancer and age; anticipated delay and perceived barriers to seeking medical advice; and examined variation by age, gender, ethnicity and whether individuals knew someone with cancer.Methods: A survey was conducted using a modified paper version of the Cancer Awareness Measure (CAM). The sample included 478 adolescents (male: n = 250, 52.3%) aged 11–17 years old (mean = 13.8, SD = 1.24) recruited from four British schools between August and October 2011.Results: Adolescents’ cancer awareness was low. Half of all adolescents did not know the most common childhood(51%) or teenage (49%) cancers and most (69%) believed cancer was unrelated to age. Awareness of cancer symptoms was significantly higher among older adolescents (aged 13–17 years) (p = 0.003) and those who knew someone with cancer (p < 0.001). Three-quarters (74%) of adolescents indicated they would seek help for a symptom they thought might be cancer within 3 days, and half (48%) within 24 hours. The most endorsed barriers to help-seeking were ‘worry about what the doctor might find’ (72%), being ‘too embarrassed’ (56%), ‘too scared’(54%) and ‘not feeling confident to talk about symptoms’ (53%). Endorsement of these emotional barriers was significantly higher among females (p ≤ 0.001).Conclusion: There are certain groups of adolescents with poor cancer awareness. Cancer messages need to be targeted and tailored to particular groups to prevent the emergence of health inequalities in adulthood. Interventions to raise adolescents’ cancer awareness have the potential for a life-long impact on encouraging early diagnosis and survival

Opioids depress cortical centers responsible for the volitional control of respiration

Respiratory depression limits provision of safe opioid analgesia and is the main cause of death in drug addicts. Although opioids are known to inhibit brainstem respiratory activity, their effects on cortical areas that mediate respiration are less well understood. Here, functional magnetic resonance imaging was used to examine how brainstem and cortical activity related to a short breath hold is modulated by the opioid remifentanil. We hypothesized that remifentanil would differentially depress brain areas that mediate sensory-affective components of respiration over those that mediate volitional motor control. Quantitative measures of cerebral blood flow were used to control for hypercapnia-induced changes in blood oxygen level-dependent (BOLD) signal. Awareness of respiration, reflected by an urge-to-breathe score, was profoundly reduced with remifentanil. Urge to breathe was associated with activity in the bilateral insula, frontal operculum, and secondary somatosensory cortex. Localized remifentanil-induced decreases in breath hold-related activity were observed in the left anterior insula and operculum. We also observed remifentanil-induced decreases in the BOLD response to breath holding in the left dorsolateral prefrontal cortex, anterior cingulate, the cerebellum, and periaqueductal gray, brain areas that mediate task performance. Activity in areas mediating motor control (putamen, motor cortex) and sensory-motor integration (supramarginal gyrus) were unaffected by remifentanil. Breath hold-related activity was observed in the medulla. These findings highlight the importance of higher cortical centers in providing contextual awareness of respiration that leads to appropriate modulation of respiratory control. Opioids have profound effects on the cortical centers that control breathing, which potentiates their actions in the brainstem

Numerical simulation of transom-stern waves

The flow field generated by a transom-stern hullform is a complex, broad-banded, three-dimensional phenomenon marked by a large breaking wave. This unsteady multiphase turbulent flow feature is difficult to study experimentally and simulate numerically. The results of a set of numerical simulations, which use the Numerical Flow Analysis (NFA) code, of the flow around the Model 5673 transom stern at speeds covering both wet- and dry-transom operating conditions are shown in the accompanying fluid dynamics video. The numerical predictions for wet-transom and dry-transom conditions are presented to demonstrate the current state of the art in the simulation of ship generated breaking waves. The interested reader is referred to Drazen et al. (2010) for a detailed and comprehensive comparison with experiments conducted at the Naval Surface Warfare Center Carderock Division (NSWCCD).Comment: Fluid Dynamics Video for 2010 APS Division of Fluid Dynamics Gallery of Fluid Motion include

Promoting sunscreen use and skin self-examination to improve early detection and prevent skin cancer:quasi-experimental trial of an adolescent psycho-educational intervention

Background: Skin cancer rates are increasing. Interventions to increase adolescent sunscreen use and skin self-examination (SSE) are required. Methods: Quasi-experimental design; 1 control and 4 intervention group schools in Scotland, UK. Participants were 15-16 year old students on the school register. The intervention was a theoretically-informed (Common-Sense Model and Health Action Process Approach) 50-min presentation, delivered by a skin cancer specialist nurse and young adult skin cancer survivor, to students in a classroom, supplemented by a home-based assignment. Outcome variables were sunscreen use intention, SSE intention/behaviour, planning, illness perceptions and skin cancer communication behaviour, measured 2 weeks pre- and 4 weeks post- intervention using self-completed pen and paper survey. School attendance records were used to record intervention up-take; students self-reported completion of the home-based assignment. Pearson's chi-square test, analysis of variance, and non-parametric Wilcoxon Signed Ranks Test were used to measure outcomes and associations between variables. Focus groups elicited students' (n = 29) views on the intervention. Qualitative data were analysed thematically. Results: Five of 37 invited schools participated. 639 (81%) students in intervention schools received the intervention; 33.8% completed the home-based assignment. 627 (69.6%) of students on the school register in intervention and control schools completed a questionnaire at baseline; data for 455 (72.6%) students were available at baseline and follow-up. Focus groups identified four themes - personal experiences of skin cancer, distaste for sunscreen, relevance of SSE in adolescence, and skin cancer conversations. Statistically significant (p &lt; 0.05) changes were observed for sunscreen use, SSE, planning, and talk about skin cancer in intervention schools but not the control. Significant associations were found between sunscreen use, planning and 2 illness perceptions (identity and consequence) and between SSE, planning and 3 illness perceptions (timeline, causes, control). Conclusions: It is feasible to promote sunscreen use and SSE in the context of an adolescent school-based psychoeducation intention. Further research is required to improve study uptake, intervention adherence and effectiveness.</p

Supportive care needs of women with breast cancer in rural Scotland

Purpose: The aim of this study was to identify the supportive care needs and unmet needs of women with breast cancer (BC) in rural Scotland. Methods: In 2013, a survey of supportive care needs of rural women with BC was conducted using the short-form Supportive Care Needs Survey (SCNS-SF34). Semi-structured interviews were subsequently conducted with a purpose sample of questionnaire respondents. Results: Forty-four women with BC completed the survey and ten were interviewed. Over half of participants reported at least one moderate to high unmet need (56.8 %, n = 25), a tenth reported low needs (11.4 %, n = 5), and around a third reported no unmet needs for all 34 items (31.8 %, n = 14). The most prevalent moderate to high needs were ‘being informed about cancer in remission’ (31.8 %, n = 14), ‘fears about the cancer spreading’ (27.3 %, n = 12), ‘being adequately informed about the benefits and side-effects of treatment’ and ‘concerns about the worries of those close to you’ (both 25.0 %, n = 11). Interviews highlighted the following unmet needs: information about treatment and side effects, overview of care, fear of recurrence, impact on family and distance from support. Conclusions: Rural women with BC report similar unmet needs to their urban counterparts. Fear of recurrence is a key unmet need that should be addressed for all women with BC. However, they also report unique unmet needs because of rural location. Thus, it is critical that cancer services address the additional unmet needs of rural women with BC and, in particular, needs relating to distance from services. © 2014, The Author(s)

Biogeography as critical nursing pedagogy: Breathing life into nurse education

Insights from the social sciences, including geography, sociology, and anthropology, have long been incorporated into pre-registration nursing programmes. However, scholars have suggested that their inclusion has been sporadic and lacks clear theoretical rationale. In this paper we argue anew that the social sciences – and particularly, human geography – could be central to nurse education. Specifically, we recast the concept of ‘biogeography’ drawn from human geography that emphasises the interplay between life (bio) and place (geo) to propose pedagogy that theoretically justifies and practically enables the inclusion of the social sciences in nurse education. Biogeography can breathe new life into nursing curricula by animating our students through the cultivation of three ‘spirits of nursing’. First, a ‘spirit of empathy’ that can shatter patient-professional dualisms by facilitating person-centred and place-sensitive care. Second, a ‘spirit of engagement’ that situates practice in social structures awakening a desire to effect change by fomenting an acute sense of social justice. Third, a ‘spirit of enquiry’ that holds in critical tension the theory-practice gap by fostering continual questioning and pursuit of evidence. In so doing, biogeographical pedagogy releases the latent potential of the social sciences to revitalise nurse education, reinvigorate our students, and renew ourselves as nurse educator