Hero stories: A coping strategy for a child who has autism

This paper explores Hero Stories, a different narrative approach developed to support a child with autism to gain self-control and allow him to navigate his world as a competent and capable learner. It examines the development and use of 'Hero Stories books' as a strategy for assisting a child with autism to cope with stressful situations within the home and school, and explores how these stories can contribute to enhancing a child's sense of themselves as thinkers and powerful learners, in charge of their lives

Is the bladder filling protocol for prostate cancer patients undergoing radiotherapy fit for purpose? (Abstract only)

Introduction: Conventional radiotherapy has been planned with a full bladder based on the rationale that it will move the small bowel out of the treatment field and result in greater sparing of the bladder itself[1]. Our department has moved from a ‘comfortably full’ bladder to a strict drinking protocol of emptying the bladder, drinking three cups of water and waiting 30 minutes prior to treatment for our prostate cancer patients. A service evaluation was carried out to determine if this change in practice results in a more consistent bladder volume from CT panning to treatment. Method and Materials: Based on 233 prostate patients treated per year a sample size of 146 was determined to result in a 95% confidence level with a 5% margin of error[2]. The last 73 patients on the comfortably full protocol and the first 73 patients on the new bladder protocol were compared. Their bladder volume from CT and on their CBCT fraction one was outlined by one observer to ascertain the difference in bladder volume and assess consistency. Results: The bladder filling protocol does not result in a statistically significant difference in bladder volume from CT to CBCT fraction one compared to comfortably full; the results prove that there is statistically no benefit from moving from comfortably full to the strict drinking protocol in terms of consistency of bladder volume achieved. Conclusion and Discussion: In the UK there are currently no official guidelines on what is the optimal volume of bladder for prostate cancer patients[3]. To attend a busy regional cancer centre patients may have had to travel a long distance. This coupled with any unintended delays can result in patients having to empty or be taken of the treatment couch, therefore a strict drinking protocol may not be feasible .The results of this well powered study that there is no statistically significant difference in consistency gained from employing a strict drinking protocol compared to maintaining a comfortably full bladder

Leda or living doll? Women as dolls in Angela Carter's The Magic Toyshop

This article will use the figure of the doll to consider female identity and performativity in Angela Carter’s The Magic Toyshop (1967). It will build upon recent Gothic criticism from Andrew Hock Soon Ng’s Women and Domestic Space in Contemporary Gothic Narratives: The House as Subject (2015), which defines the domestic space in this novel as a theatre box that reduces its occupants to actors that must execute the correct gender performativity at all times. Specifically, it will use a doll motif to explore the effect of this demand on the Gothic heroine who is demoted to the status of a silent and submissive doll-like entity. Firstly, it will discuss the complex formation of female identity and the various elements that influence the process. Secondly, it will analyze the female subject’s struggle for control of her identity and autonomy against a villainous patriarch, which is a common theme in many classic and contemporary Gothic narratives. Finally, it will evaluate how the doll and heroine analogy epitomizes the many components of female identity and performativity as well as the repression of the Gothic heroine by outside forces through its discussion of the relentless conflict between Melanie and Uncle Philip

The post-discharge medication compliance of elderly medical patients: Incidence and influencing factors

This study was designed to estimate the extent to which elderly patients complied with their medication regimens post-discharge from three general medical wards of an acute hospital in Perth. Relationships between medication compliance and age, education, cognitive function, medication supervision, number of drugs taken, number of doses per drug per day, regimen recall and drug knowledge were observed. The sample of the study was the general medical patients of three medical wards who were 60 years or older, fluent in the English language, returning to a home in the metropolitan area with no full-time nursing care needs and discharged during the 14-day data collection period. Participants were visited in hospital prior to discharge and at home seven days after being discharged. During the home visit each medication had it\u27s residual pills counted. This provided a measure of medication compliance. The Mini-Mental State Examination developed by Folstein, Folstein and HcHugh (1975) was used to measure cognitive function. The mean compliance rate for each of the 26 medications observed was 86.4% (SD 19.39, range 21.4-100\). The 11 participants took an average (mean) of 89.1% (SD 9.63, range 67.8-100%) of all their medications. Medication compliance among recently discharge elderly patients was directly related to cognitive function (r = .570, p \u3c .05), inversely related to the number of drugs taken (r = -.599, p \u3c .025) and significantly dependent on the patient\u27s ability to recall the drug regimen (x1 = 4.49, 2, p \u3c .05) and drug knowledge (x1 = 4.21, p \u3c .05). The findings demonstrate that the medication compliance of recently discharged elderly patients is less than optimal, outline means of identifying potential non-compliers and provide objective evidence to support the implementation of education strategies. The study tested a research design that can be replicated

Ecological and erosion protection functions of Chesapeake Bay living shorelines : Comprehensive Monitoring of Ecological and Erosion Protection Functions of Chesapeake Bay Living Shorelines (CMLS), Phase I

Armoring shorelines to prevent erosion, improve access, and accommodate individual landscaping interests can result in fragmentation or loss of habitats, reduction in capacity to moderate pollutant loads delivered to coastal waters, reduction in nekton and macrobenthic integrity (Bilkovic et al. 2005, King et al. 2005, Seitz et al. 2006, Bilkovic et al. 2006, Bilkovic & Roggero 2008), increases in invasive species, such as Phragmites australis (Chambers et al. 1999, King et al. 2007), and disturbance of sediment budgets sustaining adjacent properties. As an alternative to traditional armoring of shorelines, shoreline protection techniques incorporating natural elements from the system are increasingly promoted as not only less harmful to the system, but also beneficial due to their ability to provide or enhance coastal ecosystem services. However, there remains significant uncertainty regarding the benefits and impacts associated with many natural shoreline protection designs because there has been limited scientific investigation of adverse ecological affects associated with many of the current management options (e.g. Carroll 2002, Burke et al. 2005, Davis et al. 2006, Bilkovic & Roggero 2008)

Biofiltration potential of ribbed mussel populations

Our primary study objective was to characterize the ribbed mussel population and estimate their water processing potential along the York River, Virginia

Embracing dynamic design for climate-resilient living shorelines

As natural marshes are lost to erosion, sea level rise, and human activity, small created marshes, (sometimes with ancillary stabilization structures, and frequently called living shorelines) have gained interest as a replacement habitat; providing both shoreline stabilization and restoration of important ecological functions. These living shorelines enhance ecological function while reducing erosion through the use of marsh plants (Table 1). In all but the lowest energy settings, oyster reefs, low rock structures, or other stabilizing material are frequently used to enhance marsh establishment. Due to their ability to stabilize the shoreline with minimal impact to the ecology, living shorelines are considered a method to increase coastal community resilience to sea level rise (e.g., Sutton- Grier, Wowk, & Bamford, 2015; Van Slobbe et al., 2013) but little consideration is being given to living shoreline resilience under changing climate. Although it has been stated that living shorelines have the capacity to adapt to rising sea levels (e.g., Moosavi, 2017; Sutton- Grier etal., 2015; Toft, Bilkovic, Mitchell, & La Peyre, 2017), their ability to fulfill this potential relies on being designed to incorporate all the processes occurring in natural systems. The extent to which living shorelines can mimic the resiliency of natural marshes and oyster reefs will depend on their setting, design and the type of human maintenance provided. Truly resilient projects will require engineers and ecologists to work together to describe the dynamics of shore line processes under sea level rise and translate this understanding into living shoreline desig