The Experience of being a Qualified Female BME Clinical Psychologist in a National Health Service: An Interpretative Phenomenological and Repertory Grid Analysis

This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Constructivist Psychology on 7 April 2017, available online: http://www.tandfonline.com/doi/abs/10.1080/10720537.2017.1304301. The Accepted Manuscript is under embargo. Embargo end date: 7 April 2018.This study explores the lived experience of black and minority ethnic (BME) clinical psychologists employed in the U.K. National Health Service (NHS). A mixed method qualitative approach was employed using repertory grids and interpretative phenomenological analysis. Six female BME clinical psychologists took part. Four master themes emerged from the analysis, including standing out as different, negotiating cultural and professional values, sitting with uncertainty, and feeling proud to be a clinical psychologist. The repertory grid analysis supported these findings and enriched the study. Implications of the study are discussed—namely, the importance of the profession increasing the cultural competency and sensitivity of its members as well as becoming more diverse.Peer reviewe

Continuing bonds with the living : bereaved parents’ narratives of their emotional relationship with their children

© 2017 Cruse Bereavement Care.The death of a child can be seen as one of the most devastating experiences for parents which can result in a unique and enduring grief. Parents with surviving children face the task of navigating their own grief while continuing to parent. This narrative inquiry explores bereaved parents’ stories of their emotional relationship with their surviving children. Parents told stories of emotional connection and disconnection with surviving children, influenced by the competing and potentially incompatible tasks of ‘parenting’ and ‘grieving’. The need for a relational focus to bereavement research and practice is highlighted. The findings demonstrate the need for clinicians to provide i) parents an opportunity to explore their sometimes contradicting and troubling experiences of grief and parenting and ii) children with support to make sense of their experiences in relation to the parent-child relationship.Peer reviewe

Hemodynamic analysis based on biofluid models and MRI velocity measurements

Tesis para optar al grado de Doctor en Ciencias de la Ingeniería, Mención Fluidodinámica en cotutela con la Universidad de GroningenFor the diagnosis, treatment planning and post-surgical monitoring of cardiovascular disease (CVD), hemodynamic markers have proven to be of great utility. However, non-invasive assessment of the hemodynamics of a patient is still a challenge. Phase-contrast magnetic resonance imaging (PC-MRI) can measure the distribution of blood velocity along two-dimensional planes or in three-dimensional volumes and is limited in accuracy mainly by the image resolution and noise. The local variation in the blood pressure cannot be measured non-invasively, but is required in the clinical practice to evaluate CVD. Other hemodynamic quantities, such as the arterial wall stiffness or wall shear stress can also be relevant as diagnostic quantities and for understanding the onset of CVD, but are not observable with imaging techniques. This thesis approaches the topic of patient-specific hemodynamics on three different paths. In Chapter 2 of this thesis a method was presented to improve the accuracy of hemodynamic data recovery from partial 2D PC-MRI measurements by means of solving an inverse problem of the Navier–Stokes equations of fluid flow. Vessel geometries extracted from MRI or CT images are affected by errors due to noise, artifacts and limited image resolution. Small errors in the geometry propagate into the recovered data and lead to large errors in the solution when standard no-slip boundary conditions are used on inaccurately positioned walls. The core idea of this work was replacing no-slip boundary conditions at the arterial walls by slip/transpiration conditions with parameters which were estimated from velocity measurements. Numerical results of synthetic test cases showed an important improvement in accuracy of the estimated pressure differences and the reconstructed velocity fields. In Chapter 3 a comparison study of different direct pressure gradient estimation techniques was presented. These methods compute relative pressure fields directly from 3D PC-MRI data. The new Stokes estimation method (STE) by Švihlová et al. [Švi+16] was applied for the first time to real phantom and patient data. In comparison to the classical Poisson pressure estimation method (PPE), the STE method proved more accurate and more robust to noise and the image segmentation in most cases. Chapter 4 was dedicated to a numerical validation of the new MAPDD model [Ber+19] for a domain decomposition reduction of vascular networks. This approach considers the vessels as a network of thin pipes in which the flow has the shape of a Womersley flow, connected by arbitrary 3D junction domains where the flow is governed by the Navier–Stokes equations. In the MAPDD model, the thin pipes are replaced by coupling conditions on the junction domains. A strategy to easily implement the MAPDD model with the finite element method was presented and the theoretical results of Bertoglio et al. [Ber+19] were reproduced with numerical simulations in a simple test case. The method was shown to deliver accurate results even for moderately large Reynolds numbers, far from the regime where the theory is valid.Los indicadores hemodinámicos han demostrado gran utilidad para el diagnóstico, planificación y monitoreo post-operatorio de enfermedades cardiovasculares (CVD). Sin embargo, la evaluación hemodinámica en pacientes continúa siendo un desafío. La Resonancia Magnética de Contraste de Fase (PC-MRI) es capaz de medir la distribución de la velocidad sanguínea en planos 2D o volúmenes 3D, siendo mayormente limitada por la resolución de la imágen y el ruido. Por otro lado, las variaciónes locales en la presión sanguínea sólo pueden ser medidas invasivamente, siendo usualmente requeridas en clínica para la evaluación de las CVD. Otras cantidades hemodinámicas, tales como la rigidez arterial, pueden ser también relevantes para el diagnóstico y entendimiento del origen de las CVD, pero lamentablemente estas no son observables en las imágenes. Esta tesis aborda el tema de la hemodinámica en pacientes desde tres diferentes perspectivas. En el Capítulo 2, se presenta un método para mejorar la precisión en la reconstrucción de datos hemodinámicos, usando medidas 2D en PC-MRI. A partir de las ecuaciones de Navier-Stokes para un fluido, se plantea y resuelve un problema inverso. Además, las geometrías arteriales extraídas de imágenes MRI o CT, suelen ser afectadas por errores debidos al ruido, artefactos o propios de la limitación en la resolución espacial. Pequeños errores en la geometría son propagados en la reconstrucción, pudiendo generar mayores desviaciones en la solución, por ejemplo cuando condiciones de borde tipo no-slip son usadas en paredes mal mente posicionadas. La idea central de este trabajo es relajar las condiciones no-slip en las paredes por unas slip/transpiration, con parámetros a estimar de medidas de velocidad. Los resultados numéricos en casos sintéticos muestran mejoras en el cálculo de diferencias de presión y campo de velocidades. En el Capítulo 3 se presenta una comparación entre diferentes técnicas de estimación de presión. Estos métodos reconstruyen campos de presión directamente de medidas 3D en PC-MRI. Por primera vez el reciente estimador de Stokes (STE) Švihlová y col. [Švi+16] es aplicado en medidas a fantomas y pacientes. A diferencia del clásico estimador de Poisson (PPE), este estimador muestra, en la mayoría de los casos, menos error en la reconstrucción y ser más robusto al ruido y a la segmentación. El Capítulo 4 es dedicado a la validación numérica del nuevo modelo MAPDD Bertoglio y col. [Ber+19], para una descomposición reducida de redes vasculares. Este enfoque considera las venas como una red de delgadas tuberías, en donde el flujo tiene la forma de un flujo de Womersley, conectado por un dominio arbitrario 3D de uniones, en donde el flujo es gobernado por las ecuaciones de Navier-Stokes. En este modelo, las tuberías delgadas son reemplazadas acoplando distintas condiciones en el dominio de uniones. Aquí, se presenta una estrategia fácilmente de implementar usando elementos finitos. Se reproducen los resultados teóricos de Bertoglio y col. [Ber+19] además de simulaciones numéricas en un caso de prueba simple. El método muestra entregar buenos resultados incluso para números de Reynolds ligeramente grandes, excediendo los límites donde es válida la teória

Facing loss and finding hope in narrating together: Accounts of parenthood following the death of a child to muscular dystrophy

© The Author(s) 2021. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/).Muscular dystrophy is a terminal muscle-wasting condition, whereby families face continuous challenges as their child’s health deteriorates. This research explored accounts of parenthood following bereavement of their child to muscular dystrophy. Narrative inquiry was used to analyse interviews with four couples. Findings suggest an importance in narrating adversities (waking up to different futures) and positive influence (creating legacies). The research highlighted how humour is often used to support others to witness painful accounts (humour through the struggle). Parents appeared to co-regulate the painfulness of narrating loss (storytelling together). Further research is needed on conjoint narrative interviews and how these may enable participants to address shared loss experiences. Practitioners who support bereaved parents could consider the potential value highlighted in this study of meeting with parents conjointly, which include that, through co-regulatory, collaborative processes, families seemed to be supported to reach narrative cohesion, sensitively and safely, when facing loss and bereavement.Peer reviewedFinal Published versio

Shape based assignment tests suggest transgressive phenotypes in natural sculpin hybrids (Teleostei, Scorpaeniformes, Cottidae)

BACKGROUND: Hybridization receives attention because of the potential role that it may play in generating evolutionary novelty. An explanation for the emergence of novel phenotypes is given by transgressive segregation, which, if frequent, would imply an important evolutionary role for hybridization. This process is still rarely studied in natural populations as samples of recent hybrids and their parental populations are needed. Further, the detection of transgressive segregation requires phenotypes that can be easily quantified and analysed. We analyse variability in body shape of divergent populations of European sculpins (Cottus gobio complex) as well as natural hybrids among them. RESULTS: A distance-based method is developed to assign unknown specimens to known groups based on morphometric data. Apparently, body shape represents a highly informative set of characters that parallels the discriminatory power of microsatellite markers in our study system. Populations of sculpins are distinct and "unknown" specimens can be correctly assigned to their source population based on body shape. Recent hybrids are intermediate along the axes separating their parental groups but display additional differentiation that is unique and coupled with the hybrid genetic background. CONCLUSION: There is a specific hybrid shape component in natural sculpin hybrids that can be best explained by transgressive segregation. This inference of how hybrids differ from their ancestors provides basic information for future evolutionary studies. Furthermore, our approach may serve to assign candidate specimens to their source populations based on morphometric data and help in the interpretation of population differentiation