Restorative Care Unit: A Focused Ethnography of Leadership in a 20- Bed Hospital

The creation of a restorative care unit (RCU) within an acute care environment caused a change in the nursing team relationships that impacted leadership and culture of the RCU. A focused ethnographic approach provided insight into the nursing team members’ (registered nurses [RNs], registered practical nurses [RPNs] and personal support workers [PSWs]) shared experiences, and the contextual factors that impacted the culture of the RCU. Critical Social Theory and intersectionality (Hankivsky & Christoffersen, 2008) provided the theoretical basis for the study design, data collection and data analysis for understanding the experiences on the RCU. This study found four themes: (1) uncertainty within a new intersection; (2) working together emerges from within; (3) leading within the hierarchy; and (4) everyone contributing within a team. The implications for practice, policy and research include PSWs being an integral part of the nursing team, need for more RCUs, and examining best place for RCUs

A preliminary investigation into the use of the emotional contagion effect in the exercise environment

Based upon the theory of Emotional Contagion, the purpose of this investigation was to examine whether the use of positively-charged imagery could create a more positive exercise experience. Participants were randomly allocated into one of three test conditions (‘neutral’, ‘happy’ and control) whereupon they performed two step-aerobic sessions; baseline/familiarisation and experimental. Upon completion of the trials various exercise related, psychological measures were taken (Session RPE, FS, Enjoyment and Subjective Exercise Experience). A 3 × 2 Factorial MANOVA was used to assess for main effects and between condition interactions. There was no evidence of any effect for any of the DVs. ES data appeared to support this conclusion. Numerous recommendations are made to direct future research into this area

The 'managed' co-operative : a case study into the social and economic benefits of participating in rural co-operatives in KwaZulu-Natal.

Thesis (M.Soc.Sc.)-University of Natal, Durban, 1999.The primary goal of development is to alleviate poverty, and thus improve people's lives. Co-operatives around the world are becoming used more regularly as a vehicle for such development. However, as a result of economic pressures, co-operatives have changed over the years, reflecting a more business-like approach in order to compete in a competitive market. As a result certain types of co-operatives come under the banner of 'new wave' co-operatives. This dissertation examines two such co-operatives and analyses what social and economic benefits accrue to individuals as a result of participating in rural co-operatives. It also reflects upon the 'managed' status of the co-operative and its implication for members

The 'managed' co-operative : a case study into the social and economic benefits of participating in rural co-operatives in KwaZulu-Natal.

Thesis (M.Soc.Sc.)-University of Natal, Durban, 1999.The primary goal of development is to alleviate poverty, and thus improve people's lives. Co-operatives around the world are becoming used more regularly as a vehicle for such development. However, as a result of economic pressures, co-operatives have changed over the years, reflecting a more business-like approach in order to compete in a competitive market. As a result certain types of co-operatives come under the banner of 'new wave' co-operatives. This dissertation examines two such co-operatives and analyses what social and economic benefits accrue to individuals as a result of participating in rural co-operatives. It also reflects upon the 'managed' status of the co-operative and its implication for members

Bio-Hacking Better Health—Leveraging Metabolic Biochemistry to Maximise Healthspan

In the pursuit of longevity and healthspan, we are challenged with first overcoming chronic diseases of ageing: cardiovascular disease, hypertension, cancer, dementias, type 2 diabetes mellitus. These are hyperinsulinaemia diseases presented in different tissue types. Hyperinsulinaemia reduces endogenous antioxidants, via increased consumption and reduced synthesis. Hyperinsulinaemia enforces glucose fuelling, consuming 4 NAD+ to produce 2 acetyl moieties; beta-oxidation, ketolysis and acetoacetate consume 2, 1 and 0, respectively. This decreases sirtuin, PARPs and oxidative management capacity, leaving reactive oxygen species to diffuse to the cytosol, upregulating aerobic glycolysis, NF-kB and cell division signalling. Also, oxidising cardiolipin, reducing oxidative phosphorylation (OXPHOS) and apoptosis ability; driving a tumourigenic phenotype. Over time, increasing senescent/pathological cell populations occurs, increasing morbidity and mortality. Beta-hydroxybutyrate, an antioxidant, metabolite and signalling molecule, increases synthesis of antioxidants via preserving NAD+ availability and enhancing OXPHOS capacity. Fasting and ketogenic diets increase ketogenesis concurrently decreasing insulin secretion and demand; hyperinsulinaemia inhibits ketogenesis. Lifestyles that maintain lower insulin levels decrease antioxidant catabolism, additionally increasing their synthesis, improving oxidative stress management and mitochondrial function and, subsequently, producing healthier cells. This supports tissue and organ health, leading to a better healthspan, the first challenge that must be overcome in the pursuit of youthful longevity

Medicine and Metaphor: The Poetics of Disability and Environment & The Poetry Collection ‘Gut Feeling’

The creative portion of this thesis is an experimental collection of poetry titled Gut Feeling. In this collection, I explore my own disability, its complexities, and its intra-activity with environment as a form of creative writing as research. Thematically, I discuss my own lived experiences with disability, medical consent and autonomy, contagion, the impact of covid-19 on extremely clinically vulnerable people, and the boundaries of the body. I do this through experimental forms and found materials. In the critical portion, I expand on the work of disability and pain theorists, Scarry and Sontag, and explore ways that figurative language can enable discussion of disability and intra-activity in environment—complex topics which often evade symbolic and medical language. Within disability studies, disability is regarded as being influenced by biological, social, and environmental factors. Yet, environmental factors are often overlooked and overshadowed, leading to a distorted understanding of the condition in question. I compare two texts: the contemporary experimental poetry collection, Love Minus Love by Wayne Holloway-Smith, and the popular medical textbook, the Diagnostic and Statistical Manual of Mental Disorders, 5th ed, text revision (DSM-5-TR). I analyse what is implied to the reader regarding the environmental factors which are attributed to causing and exacerbating obsessive-compulsive disorder, and the uncomfortable relationships that are often created with the nonhuman (i.e., fear of bacteria). I will be analysing the two texts in the same way, considering their language choices and modes, their formatting, and performing an ecocritical reading, whilst acknowledging their different contexts and purposes. In an innovative and interdisciplinary literary reading of the DSM-5-TR, I consider how different modes of language enable or hinder discussion on the environmental factors of OCD

Mid-term functional outcome after the internal fixation of distal radius fractures

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to report the functional outcome of a large number of patients at a significant follow up time after fixation of their distal radius with a volar locking plate. Methods 180 patients with 183 fractures and a mean age of 62.4 years were followed up retrospectively at a mean of 30 months (Standard deviation = 10.4). Functional assessment was performed using the Disabilities of the Arm, Shoulder and Hand (DASH) and modified MAYO wrist scores. Statistical analysis was performed to identify possible variables affecting outcome and radiographs were assessed to determine time to fracture union. Results The median DASH score was 2.3 and median MAYO score was 90 for the whole group. Overall, 133 patients (74%) had a good or excellent DASH and MAYO score. Statistical analysis showed that no specific variable including gender, age, fracture type, post-operative immobilisation or surgeon grade significantly affected outcome. Complications occurred in 27 patients (15%) and in 11 patients were major (6%). Conclusion This single centre large population series demonstrates good to excellent results in the majority of patients after volar locking plate fixation of the distal radius, with complication rates comparable to other non-operative and operative treatment modalities. On this basis we recommend this mode of fixation for distal radius fractures requiting operative intervention.Peer Reviewe