Exploring careering:adrift on a sea of opportunity?

Career theory emphasises the central role of the individual by ascribing a high degree of personal choice and control to career experiences. In contrast, I advocate a theoretical understanding, which takes into account the significance of the context in which careers take place, including the influence of other people. My principal aim is to provide a deeper and richer understanding of the lived experience of careers, by exploring how and why change is experienced. A narrative based methodology is adopted to capture a broad range of experiences and change events within career stories. In providing a retrospective narrative of their personal stories, interviewees highlight elements of experiences of change which are meaningful and significant to their career. My findings reveal that whilst career experiences are frequently narrated by interviewees as unique, they are ‘uniquely the same’. The career stories highlight that perceived ‘uniqueness’ arises from unpredictability, and a lack of personal choice or control over, and within career experiences. This occurs due to the complex interplay of a broad range of personal, social and work-related contextual factors. Furthermore, explanations for the unanticipated and inadvertent ways in which careers evolve are frequently attributed to chance and luck. This thesis advances ‘careering’ as a theoretical and methodological construct, through which to study and comprehend the development of careers and explore how this unfolds over time, within the broader context of a person’s storied life. Careering provides a holistic perspective of careers, challenging the self-determinacy presented within existing career theory and draws attention to both the individual and contextual factors which give rise to opportunities and constraints within careers, overlooked within existing career literature. The focus on change in careering, renders visible ‘turning points’ between and within sequences of work, to reveal careering as chaotic, interrupted and seemingly out of control

Practitioner perspectives on the application of palaeoecology in nature conservation

It is widely recognised that palaeoecology holds great potential to inform and support nature conservation, but that there are difficulties in knowledge exchange between academia and practitioners that inhibit the operationalisation of research. To facilitate the integration of palaeoecology into the conservation toolkit, it is essential to understand perspectives of the practitioners themselves and the contexts in which they work. This paper reports the results of a survey of 153 UK-based conservation practitioners, concerning their perceptions of palaeoecology, the barriers to its use and potential solutions for making palaeoecological insights more accessible in conservation practice. The survey was conducted online over a period of 3 months; closed question responses were analysed for statistical trends and thematic analysis was done on open question responses. The majority of respondents were strongly positive about the role palaeoecological research could play, though they also exhibited a limited understanding of how and why one might implement it. They identified time constraints as the biggest barrier to using palaeoecology within their work, and also flagged concerns around financial resources and the accessibility of the research. Access to applied case studies and a centralised database were the most favoured solutions among respondents. Respondents with prior experience of working with palaeoecology were generally more optimistic about its incorporation. This paper makes several key recommendations to progress the integration of palaeoecology into conservation, including improving data accessibility, aligning research design with conservation and policy drivers, and increasing both respective groups’ understanding of the other

Variations in phytosanitary and other management practices in Australian grapevine nurseries

Sporadic and costly failure of newly planted vines is an ongoing problem in the Australian wine industry. Failed vines are frequently infected with wood pathogens, including the fungi associated with Young Vine Decline. Hot water treatment (HWT) and other nursery practices have also been implicated in vine failure. We undertook a survey of Australian grapevine nurseries to develop an understanding of current propagation practices and to facilitate the development of reliable propagation procedures that consistently produce high quality vines. A survey covering all aspects of grapevine propagation including sources of cuttings, HWT, sanitation and cold storage was mailed to all 60 trading Australian vine nurseries. In all, 25 nurseries responded, a response rate of 41.7%. Practices were found to vary widely both within and between nurseries. The vast majority of respondents (20) reported that they currently used, or had used, HWT, but the reliability of HWT was questioned by most nursery operators. A majority (18) felt that some Vitis vinifera varieties were more sensitive to HWT than others. Hydration also emerged as an important factor that had the potential to affect vine quality. All respondents used hydration and although the majority used treated water, cuttings were not generally seen as a source of cross contamination. Our study identified a clear need for further research into the effects of HWT on cutting physiology and the role of hydration in the epidemiology of grapevine pathogens, and the importance of incorporating the results of such research into practical and comprehensive propagation guidelines for vine nurseries

The perceptions and experiences of community nurses and patients towards shared decision-making in the home setting : An integrative review

Aim. To explore patients' and community nurses' perceptions and experiences of shared decision-making in the home. Design. Integrative review. Data Sources. CINAHL, British Nursing Index, Psycinfo, Medline and Social Services Abstracts were searched for qualitative, quantitative and mixed methods papers published between 1 December 2001 and 31 October 2023. Review Methods. A systematic search of electronic databases was undertaken using defined inclusion criteria. The included papers were appraised for quality using the Joanna Briggs Institute critical appraisal checklist for qualitative research. Relevant data were extracted and thematically analysed. Results. Fourteen papers comprising 13 research studies were included. Patients attached great importance to their right to be involved in decision-making and noted feeling valued as a unique individual. Communication and trust between the patient and nurse were perceived as fundamental. However, shared decision-making does not always occur in practice. Nurses described tension in managing patients' involvement in decision-making. Conclusion. The findings demonstrate that although patients and community nurses appreciate participating in shared decision-making within the home, there are obstacles to achieving a collaborative process. This is especially relevant when there are fundamentally different perspectives on the decision being made. More research is needed to gain further understanding of how shared decision-making plays out in practice and to understand the tensions that patients and nurses may experience. Implications for the Profession and/or Patient Care. This paper argues that shared decision-making is more than the development of a relationship where the patient can express their views (though of course, this is important). Shared decision-making requires acknowledgement that the patient has the right to full information and should be empowered to choose between options. Nurses should not assume that shared decision-making in community nursing is easy to facilitate and should recognize the tensions that might exist when true patient choice is enabled. Impact. This paper demonstrates how the idea of shared decision-making needs to be explored in the light of everyday practice so that challenges and barriers can be overcome. In particular, the tensions that arise when patients and nurses do not share the same perspective. This paper speaks to the potential of a gap surrounding shared decision-making in theory and how it plays out in practice. Reporting Method. The reporting of this review was guided by the 2020 guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Page et al., 2021). Patient or Public Contribution. This review was carried out as part of a wider study for which service users have been consulted

Soaking grapevine cuttings in water: a potential source of cross contamination by micro-organisms

Grapevine nurseries soak cuttings in water during propagation to compensate for dehydration and promote root initiation. However, trunk disease pathogens have been isolated from soaking water, indicating cross contamination. Cuttings of Vitis vinifera cv. Sunmuscat and V. berlandieri x V. rupestris rootstock cv. 140 Ruggeri were immersed in sterilized, deionised water for 1, 2, 4, 8 and 16 h. The soaking water was cultured (25°C for 3 days) on non-specific and specific media for fungi and bacteria. The base of each cutting was debarked and trimmed and three 3 mm thick, contiguous, transverse slices of wood cultured at 25°C for 3 days. The soaking water for both cultivars became contaminated with microorganisms within the first hour. Numbers of fungi iso-lated from the wood slices soaked for one hour were significantly greater than those from non-soaked cuttings. The number of bacterial colonies growing from the wood slices increased after soaking for 2‒4 h in Sunmuscat. In a second experiment Shiraz cuttings were soaked for 1, 2, 4, 8 and 24 h. The soaking water became contaminated within the first hour but only the bacterial count increased significantly over time. Microorganisms also established on the container surfaces within the first hour although there were no significant increases over 24 h. These results confirm that soaking cuttings is a potential cause of cross contamination and demonstrate contamination of cuttings occurs after relatively short periods of soaking. Avoiding exposing cuttings to water will reduce the transmission of trunk diseases in propagation

Practitioner perspectives on the application of palaeoecology in nature conservation

It is widely recognised that palaeoecology holds great potential to inform and support nature conservation, but that there are difficulties in knowledge exchange between academia and practitioners that inhibit the operationalisation of research. To facilitate the integration of palaeoecology into the conservation toolkit, it is essential to understand perspectives of the practitioners themselves and the contexts in which they work. This paper reports the results of a survey of 153 UK-based conservation practitioners, concerning their perceptions of palaeoecology, the barriers to its use and potential solutions for making palaeoecological insights more accessible in conservation practice. The survey was conducted online over a period of 3 months; closed question responses were analysed for statistical trends and thematic analysis was done on open question responses. The majority of respondents were strongly positive about the role palaeoecological research could play, though they also exhibited a limited understanding of how and why one might implement it. They identified time constraints as the biggest barrier to using palaeoecology within their work, and also flagged concerns around financial resources and the accessibility of the research. Access to applied case studies and a centralised database were the most favoured solutions among respondents. Respondents with prior experience of working with palaeoecology were generally more optimistic about its incorporation. This paper makes several key recommendations to progress the integration of palaeoecology into conservation, including improving data accessibility, aligning research design with conservation and policy drivers, and increasing both respective groups’ understanding of the other

Frailty and use of health and community services by community-dwelling older men: the Concord Health and Ageing in Men Project

Background: frailty is a concept used to describe older people at high risk of adverse outcomes, including falls, functional decline, hospital or nursing home admission and death. The associations between frailty and use of specific health and community services have not been investigated. Methods: the cross-sectional relationship between frailty and use of several health and community services in the last 12 months was investigated in 1,674 community-dwelling men aged 70 or older in the Concord Health and Ageing in Men study, a population-based study conducted in Sydney, Australia. Frailty was assessed using a modified version of the Cardiovascular Health Study criteria. Results: overall, 158 (9.4%) subjects were frail, 679 (40.6%) were intermediate (pre-frail) and 837 (50.0%) were robust. Frailty was associated with use of health and community services in the last 12 months, including consulting a doctor, visiting or being visited by a nurse or a physiotherapist, using help with meals or household duties and spending at least one night in a hospital or nursing home. Frail men without disability in activities of daily living were twice more likely to have seen a doctor in the previous 2 weeks than robust men (adjusted odds ratio 2.04, 95% confidence interval 1.21-3.44), independent of age, comorbidity and socio-economic status. Conclusion: frailty is strongly associated with use of health and community services in community-dwelling older men. The high level of use of medical services suggests that doctors and nurses could play a key role in implementation of preventive intervention

Automated VR therapy for improving positive self-beliefs and psychological well-being in young patients with psychosis: a proof of concept evaluation of Phoenix VR self-confidence therapy

Background: Low self-confidence in patients with psychosis is common. This can lead to higher symptom severity, withdrawal from activities, and low psychological well-being. There are effective psychological techniques to improve positive self-beliefs but these are seldom provided in psychosis services. With young people with lived experience of psychosis we developed a scalable automated VR therapy to enhance positive-self beliefs. Aims: The aim was to conduct a proof of concept clinical test of whether the new VR self-confidence therapy (Phoenix) may increase positive self-beliefs and psychological well-being. Method: Twelve young patients with non-affective psychosis and with low levels of positive self-beliefs participated. Over 6 weeks, patients were provided with a stand-alone VR headset so that they could use Phoenix at home and were offered weekly psychologist meetings. The outcome measures were the Oxford Positive Self Scale (OxPos), Brief Core Schema Scale, and Warwick-Edinburgh Well-being Scale (WEMWBS). Satisfaction, adverse events and side-effects were assessed. Results: Eleven patients provided outcome data. There were very large end-of-treatment improvements in positive self-beliefs (OxPos mean difference = 32.3; 95% CI: 17.3, 47.3; Cohen’s d=3.0) and psychological well-being (WEMWBS mean difference = 11.2; 95% CI: 8.0, 14.3; Cohen’s d=1.5). Patients rated the quality of the VR therapy as: excellent (n=9), good (n=2), fair (n=0), poor (n=0). An average of 5.3 (SD=1.4) appointments were attended. Conclusions: Uptake of the VR intervention was high, satisfaction was high, and side-effects extremely few. There were promising indications of large improvements in positive self-beliefs and psychological well-being. A randomized controlled clinical evaluation is warranted

Randomised controlled trial of automated VR therapy to improve positive self-beliefs and psychological well-being in young people diagnosed with psychosis: a study protocol for the Phoenix VR self-confidence therapy trial

Introduction The confidence of young people diagnosed with psychosis is often low. Positive self-beliefs may be few and negative self-beliefs many. A sense of defeat and failure is common. Young people often withdraw from many aspects of everyday life. Psychological well-being is lowered. Psychological techniques can improve self-confidence, but a shortage of therapists means that very few patients ever receive such help. Virtual reality (VR) offers a potential route out of this impasse. By including a virtual coach, treatment can be automated. As such, delivery of effective therapy is no longer reliant on the availability of therapists. With young people with lived experience, we have developed a staff-assisted automated VR therapy to improve positive self-beliefs (Phoenix). The treatment is based on established cognitive behavioural therapy and positive psychology techniques. A case series indicates that this approach may lead to large improvements in positive self-beliefs and psychological well-being. We now aim to conduct the first randomised controlled evaluation of Phoenix VR. Methods and analysis 80 patients with psychosis, aged between 16 and 30 years old and with low levels of positive self-beliefs, will be recruited from National Health Service (NHS) secondary care services. They will be randomised (1:1) to the Phoenix VR self-confidence therapy added to treatment as usual or treatment as usual. Assessments will be conducted at 0, 6 (post-treatment) and 12 weeks by a researcher blind to allocation. The primary outcome is positive self-beliefs at 6 weeks rated with the Oxford Positive Self Scale. The secondary outcomes are psychiatric symptoms, activity levels and quality of life. All main analyses will be intention to treat. Ethics and dissemination The trial has received ethical approval from the NHS Health Research Authority (22/LO/0273). A key output will be a high-quality VR treatment for patients to improve self-confidence and psychological well-being. Trial registration number ISRCTN10250113