139 research outputs found

    THE DEVELOPMENT OF A COMPUTERIZED INTERACTIVE TEACHING ASSISTANT IN PHYSICS: THE CITA ON CHIP PROJECT

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    One of the many roles of university instructors is to provide help to students throughout the semester - especially in the form of feedback on homework. Personalized feedback from the instructor might be possible in a small classroom setting, but becomes unmanageable when class sizes grow to dozens or even hundreds of students. As a result, universities are turning to computerized homework systems that guide students through problems and provide focused grades and feedback

    Preemptive local anaesthetic in gynecological laparoscopy and postoperative movement evoked pain : a randomised trial

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    STUDY OBJECTIVE: To evaluate whether preemptive local anesthetics injected into the trocar areas reduce postoperative movement-evoked pain within an enhanced recovery program (ERP) in laparoscopic gynecologic surgery. DESIGN: A randomized and double-blinded trial with parallel assignments (Canadian Task Force Classification I). SETTING: The study was conducted in the gynecologic department at the University Hospital of Stavanger, Stavanger, Norway. PATIENTS: Twenty-four women eligible for elective laparoscopic surgery for a benign indication within an ERP were included. INTERVENTIONS: The women were randomized to preemptive local injections of either 0.5% bupivacaine (intervention group) or 0.9% saline (control group) at each trocar site. MEASUREMENTS AND MAIN RESULTS: The primary outcome measure of the study was movement-evoked pain 5 hours after surgery. The secondary outcome measures were pain at rest 2 and 5 hours after surgery and the use of rescue analgesics during the postoperative period. Pain was measured on a numeric rating scale of 0 to 10. Data were treated to a per-protocol analysis, and a p < .05 was considered significant. RESULTS: Twenty-three women completed the trial. The median score for movement-evoked pain 5 hours after surgery was significantly lower in the intervention group (1 vs. 3, p = .044). There was no difference in pain at rest after 2 and 5 hours and no difference in the requirement for rescue analgesics. CONCLUSION: Preemptive local anesthetics in the trocar areas are shown to be beneficial in laparoscopic gynecologic surgery within an enhanced recovery program. Movement-evoked pain is far more intense than pain at rest

    Older people's perspectives on advance care planning : a qualitative and quantitative approach

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    EThOS - Electronic Theses Online ServiceGBUnited Kingdo

    Gaps in understanding the experiences of homecare workers providing care for people with dementia up to the end of life : a systematic review

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    This systematic review of the literature explores the perspectives and experiences of homecare workers providing care for people with dementia living at home up to the end of life. A search of major English language databases in 2016 identified 378 studies on the topic, of which 12 met the inclusion criteria. No empirical research was identified that specifically addressed the research question. However, synthesis of the findings from the broader literature revealed three overarching themes: value of job role, emotional labour and poor information and communication. The role of homecare workers supporting a person with dementia up to the end of life remains under-researched, with unmet needs for informational, technical and emotional support reported. The effective components of training and support are yet to be identified

    'A good method of quitting smoking' or 'just an alternative to smoking'? Comparative evaluations of e-cigarette and traditional cigarette usage by dual users

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    The development of e-cigarettes was initially hailed as a resource in facilitating a reduction in or cessation of cigarette smoking. Many users of e-cigarettes are ‘dual users’, smoking traditional cigarettes and e-cigarettes. The present qualitative study examines the factors that a group of 20 dual users considered to have been influential in their decisions to use e-cigarettes and their comparative evaluations of e-cigarettes and traditional cigarettes. Health concerns were not found to be sole motivators. Participants pointed to financial and contextual considerations, particularly peer influence on uptake and continued usage of e-cigarettes. E-cigarettes were evaluated as comparable to cigarettes in some ways but not in other important respects such as sensation and satisfaction. Different social evaluations of cigarette and e-cigarette usage were discerned which influenced how participants identified as smokers, ‘vapers’ or neither. Findings are discussed in relation to social representations, identity and implications for continued e-cigarette usage among dual users

    The need for flexibility when negotiating professional boundaries in the context of homecare, dementia and end of life

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    Professional boundaries may help care staff to clarify their role, manage risk and safeguard vulnerable clients. Yet there is a scarcity of evidence on how professional boundaries are negotiated in a non-clinical environment (e.g. the home) by the home-care workforce in the context of complex care needs (e.g. dementia, end of-life care). Through analysis of semi-structured interviews, we investigated the experiences of home-care workers (N = 30) and their managers (N = 13) working for a range of home-care services in the South-East and London regions of England in 2016–17. Findings from this study indicate that home-care workers and their managers have clear perceptions of job role boundaries, yet these are modified in dementia care, particularly at end of life which routinely requires adaptability and flexibility. As a lone worker in a client’s home, there may be challenges relating to safeguarding and risk to both clients and workers. The working environment exacerbates this, particularly during end-of-life care where emotional attachments to both clients and their family may affect the maintenance of professional boundaries. There is a need to adopt context-specific, flexible and inclusive attitudes to professional boundaries, which reconceptualise these to include relational care and atypical workplace conventions. Pre-set boundaries which safeguard clients and workers through psychological contracts may help to alleviate to some extent the pressure of the emotional labour undertaken by home-care workers

    Working with colleagues and other professionals when caring for people with dementia at end of life : homecare workers' experiences

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    Caring for people with dementia often necessitates inter-professional and inter-agency working but there is limited evidence of how home care staff work as a team and with professionals from different agencies. Through analysis of semi-structured interviews, we explored the experiences of home care workers (n = 30) and managers of home care services (n = 13) in England (2016‐17). Both groups sought to collaboratively establish formal and informal practices of teamwork. Beyond the home care agency, experiences of interacting with the wider health and care workforce differed. More explicit encouragement of support for home care workers is needed by other professionals and their employers

    Behavioural responses to Covid-19 health certification: a rapid review.

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    BACKGROUND: Covid-status certification - certificates for those who test negative for the SARS-CoV-2 virus, test positive for antibodies, or who have been vaccinated against SARS-CoV-2 - has been proposed to enable safer access to a range of activities. Realising these benefits will depend in part upon the behavioural and social impacts of certification. The aim of this rapid review was to describe public attitudes towards certification, and its possible impact on uptake of testing and vaccination, protective behaviours, and crime. METHOD: A search was undertaken in peer-reviewed databases, pre-print databases, and the grey literature, from 2000 to December 2020. Studies were included if they measured attitudes towards or behavioural consequences of health certificates based on one of three indices of Covid-19 status: test-negative result for current infectiousness, test-positive for antibodies conferring natural immunity, or vaccination(s) conferring immunity. RESULTS: Thirty-three papers met the inclusion criteria, only three of which were rated as low risk of bias. Public attitudes were generally favourable towards the use of immunity certificates for international travel, but unfavourable towards their use for access to work and other activities. A significant minority was strongly opposed to the use of certificates of immunity for any purpose. The limited evidence suggested that intention to get vaccinated varied with the activity enabled by certification or vaccination (e.g., international travel). Where vaccination is seen as compulsory this could lead to unwillingness to accept a subsequent vaccination. There was some evidence that restricting access to settings and activities to those with antibody test certificates may lead to deliberate exposure to infection in a minority. Behaviours that reduce transmission may decrease upon health certificates based on any of the three indices of Covid-19 status, including physical distancing and handwashing. CONCLUSIONS: The limited evidence suggests that health certification in relation to COVID-19 - outside of the context of international travel - has the potential for harm as well as benefit. Realising the benefits while minimising the harms will require real-time evaluations allowing modifications to maximise the potential contribution of certification to enable safer access to a range of activities

    Multi-Wavelength Properties of the Type IIb SN 2008ax

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    We present the UV, optical, X-ray, and radio properties of the Type IIb SN 2008ax discovered in NGC 4490. The observations in the UV are one of the earliest of a Type IIb supernova (SN). On approximately day four after the explosion, a dramatic upturn in the u and uvw1 (lambda_c = 2600 Angstroms) light curves occurred after an initial rapid decline which is attributed to adiabatic cooling after the initial shock breakout. This rapid decline and upturn is reminiscent of the Type IIb SN 1993J on day six after the explosion. Optical/near-IR spectra taken around the peak reveal prominent H-alpha, HeI, and CaII absorption lines. A fading X-ray source is also located at the position of SN 2008ax, implying an interaction of the SN shock with the surrounding circumstellar material and a mass-loss rate of the progenitor of M_dot = (9+/-3)x10^-6 solar masses per year. The unusual time evolution (14 days) of the 6 cm peak radio luminosity provides further evidence that the mass-loss rate is low. Combining the UV, optical, X-ray, and radio data with models of helium exploding stars implies the progenitor of SN 2008ax was an unmixed star in an interacting-binary. Modeling of the SN light curve suggests a kinetic energy (E_k) of 0.5x10^51 ergs, an ejecta mass (M_ej) of 2.9 solar masses, and a nickel mass (M_Ni) of 0.06 solar masses.Comment: Accepted to ApJ Letters, 14 pages, 3 figures, 2 table
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