Counselling Psychology of Infertility

The central theme of this thesis is infertility. It links different areas of my work as a chartered counselling psychologist working with clients experiencing difficulties conceiving. I currently work in private practice specialising in this area. Previously I worked as an NF counsellor at the Assisted Conception Unit of the Lister Hospital in London. Although the term `infertility' is commonly used, being `infertile' means a total absence of reproductive function and this condition is rare (HFEA, 1999). The majority of people presenting with difficulties in conceiving actually have `sub-fertility', where one or more parts of the reproductive system are impaired. Throughout this thesis the term `infertility' is used to refer to both infertility and sub-fertility. I initially became interested in the psychological impact of infertility when a number of close friends started having difficulties conceiving. I observed that whilst there was a wealth of medical support available, psychological and emotional support was somewhat lacking. This led me to reflect on the counselling psychology of infertility. After conducting a review of the infertility literature it became apparent that research contributions from counselling psychologists were somewhat scant. The main body of literature is comprised of contributions from nurses, medical practitioners, clinical psychologists and counsellors working in the field. Part of my motivation in undertaking this degree was to establish the role that counselling psychology can play in the field of infertility. Linked to this, was the motivation to make a difference and raise the profile of infertility within the field of counselling psychology. The thesis focuses on three different areas of infertility that are all linked to the practice of counselling psychology with this client group. Firstly there is an exploratory piece of research. It focuses on the psychological and emotional impact of the infertility experience and the role of counselling. Secondly there is a case study. This is reflexive exploration which focuses on some of the challenging issues that I encountered in my clinical work with an infertile female client. Finally there is critical review of the literature that explores infertility and counselling from a historical perspective. The review places infertility in a historical context so that the complex psychological aspects of the infertility experience today can be more fully understood and appreciated. An overview of each section is now provided

A discourse analysis of trainee teacher identity in online discussion forums

Teacher education involves an identity transformation for trainees from being a student to being a teacher. This discourse analysis examined the online discussion board communications of a cohort of trainee teachers to better understand the situated identities of the trainees and how they were presented online. Their discussion board posts were the primary method of communication during placement periods and, as such, provided insight into how the trainees situated their identities in terms of being a student or being a teacher. During the analysis, the community boundaries, language and culture were explored along with the tutor's power and role in the identity transformation process. This involved looking at the lexis used by the students, the use of pronouns to refer to themselves and others such as teachers and pupils, the types of messages allowed in the community and the effect of the tutor's messages on their communication. The research found that the trainees felt comfortable with teaching but did not feel like teachers during the course. Tutors and school teachers need to develop an awareness of the dual nature of trainees' identities and help promote the transition from student to teacher. In the beginning of the course, trainees should be familiarised with teacher vocabulary and practical concepts in addition to pedagogical theory. Towards the end of the course, trainee identity as teachers could be promoted through the use of authentic assessments that mirror real teacher tasks and requirements

Integrating process design and control: An application of optimal control to chemical processes

In this paper, the optimal design of process systems generically used in chemical industries is studied. The closely coupled nature of optimal design specification of the equipment, the determination of the optimal process parameters in steady-state, moreover, some issues of the application of optimal control is shown. The solution of the overall optimization problem including (i) optimal design of the equipment and (ii) specification of its optimal control strategy can be found relying on two different design concepts, namely, on the conventionally used sequential or, on the newly emerged simultaneous design approaches. This paper gives the theoretical background of the ideas and presents a comparative summary of the approaches. The two approaches are contrasted to each other in which the effects of the interaction of optimal process design and optimal control is highlighted. A new simultaneous optimization procedure providing economic and operability benefits over the traditional stand-alone approach is proposed. The applicability of the idea is demonstrated by means of a design study carried out for optimal design of a coaxial heat exchanger and a reactive distillation column for the synthesis of ethyl tert butyl ether (ETBE), relying on the benefits of the utilization of optimal control

Using chemical, microbial and fluorescence techniques to understand contaminant sources and pathways to wetlands in a conservation site

Nutrients and faecal contaminants can enter wetland systems in a number of ways, with both biological and potentially human-health implications. In this study we used a combination of inorganic chemistry, dissolved organic matter (DOM) fluorescence and Escherichia coli and total coliform (TC) count techniques to study the sources and multiple pathways of contamination affecting a designated sand dune site of international conservation importance, surrounded by agricultural land. Analysis of stream samples, groundwater and dune slack wetlands revealed multiple input pathways. These included riverbank seepage, runoff events and percolation of nutrients from adjacent pasture into the groundwater, as well as some on-site sources. The combined techniques showed that off-site nutrient inputs into the sand dune system were primarily from fertilisers, revealed by high nitrate concentrations, and relatively low tryptophan-like fulvic-like ratios < 0.4 Raman units (R.U.). The E. coli and TC counts recorded across the site confirm a relatively minor source of bacterial and nutrient inputs from on-site grazers. Attenuation of the nutrient concentrations in streams, in groundwater and in run-off inputs occurs within the site, restoring healthier groundwater nutrient concentrations showing that contaminant filtration by the sand dunes provides a valuable ecosystem service. However, previous studies show that this input of nutrients has a clear adverse ecological impact

Hopping Conduction in Disordered Carbon Nanotubes

We report electrical transport measurements on individual disordered carbon nanotubes, grown catalytically in a nanoporous anodic aluminum oxide template. In both as-grown and annealed types of nanotubes, the low-field conductance shows as exp[-(T_{0}/T)^{1/2}] dependence on temperature T, suggesting that hopping conduction is the dominant transport mechanism, albeit with different disorder-related coefficients T_{0}. The field dependence of low-temperature conductance behaves an exp[-(xi_{0}/xi)^{1/2}] with high electric field xi at sufficiently low T. Finally, both annealed and unannealed nanotubes exhibit weak positive magnetoresistance at low T = 1.7 K. Comparison with theory indicates that our data are best explained by Coulomb-gap variable range hopping conduction and permits the extraction of disorder-dependent localization length and dielectric constant.Comment: 10 pages, 5 figure

Advance telephone calls ahead of reminder questionnaires increase response rate in non-responders compared to questionnaire reminders only : The RECORD phone trial

Peer reviewedPublisher PD

Pion-Muon Asymmetry Revisited

Long ago an unexpected and unexplainable phenomena was observed. The distribution of muons from positive pion decay at rest was anisotropic with an excess in the backward direction relative to the direction of the proton beam from which the pions were created. Although this effect was observed by several different groups with pions produced by different means, the result was not accepted by the physics community, because it is in direct conflict with a large set of other experiments indicating that the pion is a pseudoscalar particle. It is possible to satisfy both sets of experiments if helicity-zero vector particles exist and the pion is such a particle. Helicity-zero vector particles have direction but no net spin. For the neutral pion to be a vector particle requires an additional modification to conventional theory as discussed herein. An experiment is proposed which can prove that the asymmetry in the distribution of muons from pion decay is a genuine physical effect because the asymmetry can be modified in a controllable manner. A positive result will also prove that the pion is NOT a pseudoscalar particle.Comment: 9 pages, 3 figure

Patient, health service factors and variation in mortality following resuscitated out-of-hospital cardiac arrest in acute coronary syndrome : analysis of the Myocardial Ischaemia National Audit Project

Aims To determine patient and health service factors associated with variation in hospital mortality among resuscitated cases of out-of-hospital cardiac arrest (OHCA) with acute coronary syndrome (ACS). Methods In this cohort study, we used the Myocardial Ischaemia National Audit Project database to study outcomes in patients hospitalised with resuscitated OHCA due to ACS between 2003 and 2015 in the United Kingdom. We analysed variation in inter-hospital mortality and used hierarchical multivariable regression models to examine the association between patient and health service factors with hospital mortality. Results We included 17604 patients across 239 hospitals. Overall hospital mortality was 28.7%. In 94 hospitals that contributed at least 60 cases, mortality by hospital ranged from 10.7% to 66.3% (median 28.6%, IQR 23.2% to 39.1%)). Patient and health service factors explained 36.1% of this variation. After adjustment for covariates, factors associated with higher hospital mortality included increasing serum glucose, ST-Elevation myocardial infarction (STEMI) diagnosis, and initial admission to a primary percutaneous coronary intervention (pPCI) capable hospital. Hospital OHCA volume was not associated with mortality. The key modifiable factor associated with lower mortality was early reperfusion therapy in STEMI patients. Conclusion There was wide variation in inter-hospital mortality following resuscitated OHCA due to ACS that was only partially explained by patient and health service factors. Hospital OHCA volume and pPCI capability were not associated with lower mortality. Early reperfusion therapy was associated with lower mortality in STEMI patients

Surface and Image-Potential States on the MgB_2(0001) Surfaces

We present a self-consistent pseudopotential calculation of surface and image-potential states on $MgB_2(0001)$ for both $B$-terminated ($B-t$) and $Mg$-terminated ($Mg-t$) surfaces. We find a variety of very clear surface and subsurface states as well as resonance image-potential states n=1,2 on both surfaces. The surface layer DOS at $E_F$ is increased by 55% at $B-t$ and by 90% at the $Mg-t$ surface compared to DOS in the corresponding bulk layers.Comment: 3 pages, 6 figure