Mediating the interface between voluntariness and coercion: a qualitative study of learning disability nurses` work in medical examinations of people with intellectual disability

Aims and Objectives: To gain knowledge of prevention and use of restraints in provision of medical care to people with intellectual disability. To this end, we explore how learning disability nurses in community services support the individual through medical examinations when facing resistance. Background: Despite increased focus on limiting restraints, there is a lack of knowledge of how restraints are prevented and used in the delivery of physical health care to people with intellectual disability. Design: We used an ethnographic comparative case design (n = 6). Methods: The study was carried out in Norway. The analysis is based on data from semi-structured interviews, participant observation and document studies, in addition to health sociological perspectives on how to support individuals to make their body available for medical examination and intervention. The SRQR checklist was used. Results: Learning disability nurses strove to ensure that examinations were carried out on the individual's terms, supporting the individual in three phases: preparing for the examination, facilitating the examination and, when facing resistance, intervening to ensure safe and compassionate completion of the examination. Conclusions: Supporting the person was a precarious process where professionals had to balance considerations of voluntariness and coercion, progress and breakdown, safety and risk of injury, and dignity and violation. Through their support, learning disability nurses helped to constitute the “resistant” individual as “a cooperative patient,” whose body could be examined within the knowledge and methods of medicine, but who could also be safeguarded as a human being through the strain of undergoing examination. Relevance to clinical practice: The article sheds light on how restraints are used in the medical examination and treatment of people with intellectual disabilities and demonstrates the significance of professional support workers’ contributions, both in facilitating safe and efficient medical care and in ensuring the least restrictive and most compassionate care possible.publishedVersio

Comparison between classical potentials and ab initio for silicon under large shear

The homogeneous shear of the {111} planes along the direction of bulk silicon has been investigated using ab initio techniques, to better understand the strain properties of both shuffle and glide set planes. Similar calculations have been done with three empirical potentials, Stillinger-Weber, Tersoff and EDIP, in order to find the one giving the best results under large shear strains. The generalized stacking fault energies have also been calculated with these potentials to complement this study. It turns out that the Stillinger-Weber potential better reproduces the ab initio results, for the smoothness and the amplitude of the energy variation as well as the localization of shear in the shuffle set

Spatio-temporal dynamics and plastic flow of vortices in superconductors with periodic arrays of pinning sites

We present simulations of flux-gradient-driven superconducting rigid vortices interacting with square and triangular arrays of columnar pinning sites in an increasing external magnetic field. These simulations allow us to quantitatively relate spatio-temporal microscopic information of the vortex lattice with typically measured macroscopic quantities, such as the magnetization $M(H)$. The flux lattice does not become completely commensurate with the pinning sites throughout the sample at the magnetization matching peaks, but forms a commensurate lattice in a region close to the edge of the sample. Matching fields related to unstable vortex configurations do not produce peaks in $M(H)$. We observe a variety of evolving complex flux profiles, including flat terraces or plateaus separated by winding current-carrying strings and, near the peaks in $M(H)$, plateaus only in certain regions, which move through the sample as the field increases

Between overt and covert research: concealment and disclosure in an ethnographic study of commercial hospitality

This article examines the ways in which problems of concealment emerged in an ethnographic study of a suburban bar and considers how disclosure of the research aims, the recruitment of informants, and elicitation of information was negotiated throughout the fieldwork. The case study demonstrates how the social context and the relationships with specific informants determined overtness or covertness in the research. It is argued that the existing literature on covert research and covert methods provides an inappropriate frame of reference with which to understand concealment in fieldwork. The article illustrates why concealment is sometimes necessary, and often unavoidable, and concludes that the criticisms leveled against covert methods should not stop the fieldworker from engaging in research that involves covertness

A qualitative emancipatory inquiry into relationships between people with mental disorders and health professionals

Introduction: A therapeutic alliance with people is essential for the efficacy of treatments. However, the traditional paternalistic values of the Mediterranean society may be incompatible with patient autonomy. Aim: To explore the therapeutic relationship from the perspective of people diagnosed with mental disorders with health professionals, including nurses. Methods: This emancipatory research was performed through focus groups, with people with mental disorders who had a variety of diagnoses and experiences of acute and community‐based mental health services and other healthcare services. Data were analysed using the content analysis method. Results: Four main themes emerged: stereotypes and prejudice; quality of interactions and treatment; emotional and behavioural impacts; and demands. Discussion: According to the participants' descriptions, health professionals are not exempt from prejudice against persons with psychiatric diagnoses. They reported experiencing abuse of power, malpractice, and overmedication. Thus, in the Mediterranean culture, professional attitudes may represent a barrier for an appropriate therapeutic alliance, and people with mental disorders do not feel involved in making decisions about their health. Implications for practice: Knowing how people with mental disorders perceive their interactions with health professionals and the effects is necessary to move the care model towards more symmetric relationships that facilitate a therapeutic alliance

Social Interactions vs Revisions, What is important for Promotion in Wikipedia?

In epistemic community, people are said to be selected on their knowledge contribution to the project (articles, codes, etc.) However, the socialization process is an important factor for inclusion, sustainability as a contributor, and promotion. Finally, what does matter to be promoted? being a good contributor? being a good animator? knowing the boss? We explore this question looking at the process of election for administrator in the English Wikipedia community. We modeled the candidates according to their revisions and/or social attributes. These attributes are used to construct a predictive model of promotion success, based on the candidates's past behavior, computed thanks to a random forest algorithm. Our model combining knowledge contribution variables and social networking variables successfully explain 78% of the results which is better than the former models. It also helps to refine the criterion for election. If the number of knowledge contributions is the most important element, social interactions come close second to explain the election. But being connected with the future peers (the admins) can make the difference between success and failure, making this epistemic community a very social community too

The effect of pre-shot routines on golf wedge shot performance

The objective of this study was to examine the effect of pre-performance routines among golfers of low skill and non-golfers on wedge golf shot performance. The intervention strategies involved a physical skill and cognitive-behavioral routine program, as well as a physical skills-only program. Performance was measured on a pre-intervention test, postintervention test, and following a period of time without treatment, and involved wedge shots being played from distances of 40, 50, and 60 m from a target. Participants in this study (N = 68) were assigned to either a golfer or non-golfer group. Participants in the treatment groups attended 2 practice sessions per week during the acquisition phase. A variable practice design was incorporated during the intervention phase. Non-golfers in both intervention groups improved performance following the acquisition phase and maintained these levels of performance in the retention test. Greater improvements in performance were found in the non-golfer physical skills and cognitive-behavioral routine group. The non-golfer physical skills and cognitive-behavioral routine group was the only group to realize significant improvements in performance when comparing initial test performance measures to post-intervention and retention test performance measures across all test distances. Although the golfer treatment groups had consistent improvement in performance measures following the intervention phase, these improvements did not reach statistical significance in the majority of cases

Determinants of online shopping among tertiary students in Ghana: An extended technology acceptance model

The increasing penetration rate of the internet and technology in the world is quickly promoting online shopping. This has been fueled by growing innovations in the telecommunication and financial sector in an attempt to depeen financial inclusion. Innovations such as mobile money payments systems by mobile telephony companies have contributed to the continuous growth in online shopping amidst and the new generation of consumers who desire richer experiences. This study sought to identify the determinants of online shopping behaviour among tertiary students through the lens of the Technology Acceptance Model (TAM). The study proposed a revised TAM that integrated perceived cost and perceived risk to investigate what determined students online shopping intention and actual use. The survey involved a sample of 580 undergraduate students. The statistical technique used was Structural Equation Modelling-Partial Least Squares (SEM-PLS). The results showed that effect of ease of use on usefulness was very significant as same has been predicted by the Technology Acceptance Model. Among the independent variables, perceived cost (PC) was found to be the most significant factor affecting actual use (AU) of online shopping among students, nonetheless, perceived cost (PC) had no significant effect on purchase intention (PI). Perceived risk (PR) had no significant effect on actual use (AU) however, had a significant effect on purchase intention (PI). The study recommends online sellers to make online shopping efficient and less costive with assured safety and security of transactions as well as the product itself. A set of shopping platform could even be created specifically to give discounts and other offers to students. It also recommends future studies to employ additional determining factors such as the type of product/service, convenience and personal/demographic and geographic factors as influential to students’ online purchasing behaviour. © 2019, © 2019 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license

Hepatitis B virus infected physicians and disclosure of transmission risks to patients: A critical analysis

BACKGROUND: The potential for transmission of blood-borne pathogens such as hepatitis B virus from infected healthcare workers to patients is an important and difficult issue facing healthcare policymakers internationally. Law and policy on the subject is still in its infancy, and subject to a great degree of uncertainty and controversy. Policymakers have made few recommendations regarding the specifics of practice restriction for health care workers who are hepatitis B seropositive. Generally, they have deferred this work to vaguely defined "expert panels" which will have the power to dictate the conditions under which infected health care workers may continue to practice. DISCUSSION: In this paper we use recent Canadian policy statements as a critical departure point to propose more specific recommendations regarding disclosure of transmission risks in a way that minimizes practice restriction of hepatitis B seropositive health care workers without compromising patient safety. The range of arguments proposed in the literature are critically examined from the perspective of ethical analysis. SUMMARY: A process for considering the ethical implications of the disclosure of the sero-status of health care workers is advanced that considers the varied perspectives of different stakeholders