The cost of caring among healthcare professionals : the development of compassion fatigue and preventative measures and interventions for burnout

This paper is a systematic review of empirical papers investigating preventative strategies and interventions for burnout among healthcare workers. The idea was borne out of a recommendation in the independent NHS Health and Well-being Review (Department of Health, 2009a) commissioned by the Department of Health and led by Dr Stephen Boorman, that is that there should be access to effective interventions for mental health problems faced by NHS staff in all NHS Trusts.11 studies were included in the review which covered interventions ranging from brief psycho-education, peer-support, intensive residential courses involving individual counselling sessions and whole team-based interventions. Participants both within and between studies included a wide variety of healthcare professionals who worked in a variety of specialities and settings.Intensive residential courses for self-referring nurses and medics produced long-lasting reductions for those with initially high levels of burnout. Peer-support interventions were also valuable. The interventions reviewed tended to include more than one component and so future research should concentrate on determining which components of the interventions are most useful for which groups of healthcare professionals.This portfolio thesis comprises three parts: Part I is a systematic literature review of empirical papers investigating preventative strategies and interventions for burnout among healthcare workers. The idea was borne out of a recommendation in the independent NHS Health and Well-being Review (DoH, 2009a) commissioned by the Department of Health and led by Dr Stephen Boorman, that there should be access to effective interventions for mental health problems faced by NHS staff in all NHS Trusts. Part II is an empirical paper that has also arisen from a recommendation of the Boorman Review (DoH, 2009a), namely that the NHS should adopt a prevention-focused health and well-being strategy for staff. To help enable this, a clearer understanding of how healthcare professionals come to experience difficulties in the course of their work is required. To further this understanding a quantitative test was applied to the Positivity Negativity Ratio Model of the development of Compassion Satisfaction and Compassion Fatigue proposed by Radey & Figley (2007) as applied to mental health workers. Part III comprises the appendixes with additional information relevant to the systematic literature review and empirical paper, and a reflective statement of the research process

An influenza pandemic : what it could mean for Scottish tourism

There is a growing unease among World Health Organisation (WHO) officials and other global disease surveillance organisations that Avian Flu will mutate into a human influenza pandemic. Such is the concern that the Scottish Executive asked public bodies to prepare business continuity plans based upon the National Health Service Scotland‘s contingency plan and scenarios, and this briefing paper is a consequence of that request

Teachers' and children's personal epistemologies for moral education: Case studies in early years elementary education

While there is strong interest in teaching values in Australia and internationally there is little focus on young children’s moral values learning in the classroom. Research shows that personal epistemology influences teaching and learning in a range of education contexts, including moral education. This study examines relationships between personal epistemologies (children’s and teachers’), pedagogies, and school contexts for moral learning in two early years classrooms. Interviews with teachers and children and analysis of school policy revealed clear patterns of personal epistemologies and pedagogies within each school. A whole school approach to understanding personal epistemologies and practice for moral values learning is suggested

Modelling Immunological Memory

Accurate immunological models offer the possibility of performing highthroughput experiments in silico that can predict, or at least suggest, in vivo phenomena. In this chapter, we compare various models of immunological memory. We first validate an experimental immunological simulator, developed by the authors, by simulating several theories of immunological memory with known results. We then use the same system to evaluate the predicted effects of a theory of immunological memory. The resulting model has not been explored before in artificial immune systems research, and we compare the simulated in silico output with in vivo measurements. Although the theory appears valid, we suggest that there are a common set of reasons why immunological memory models are a useful support tool; not conclusive in themselves

Child sexual exploitation : definition & guide for professionals: extended text

This work was commissioned by the Department for Education (DfE) and is the extended text from which the DfE document ‘Child Sexual Exploitation: Definition and a guide for practitioners, local leaders and decision makers working to protect children from child sexual exploitation’ has been drawn. This can be viewed at www.gov.uk. The document outlines the new civil definition of child sexual exploitation, developed by the Home Office and DfE, together with an overview of our current understanding of the issue and an evidence-informed set of principles for responding. This extended version of the ‘guide’ provides professionals1 with further background information about child sexual exploitation and offers additional commentary around some of the complexities of practically responding to the issue. The document should be read in conjunction with Working together to safeguard children: A guide to inter-agency working to safeguard and promote the welfare of children (hereafter referred to as Working Together), that provides the statutory framework for responding to child sexual exploitation and all other forms of abuse. The content of this document does not in any way supersede the statutory provisions of Working Together, but rather considers some of the nuances and challenges of applying its requirements and principles to this particular form of abuse. This extended version of the ‘guide’ draws on the existing evidence base to identify issues that have proved challenging to address in practice and to draw out lessons learnt in relation to this. It does not seek to provide readers with a ‘step-by-step’ approach to addressing child sexual exploitation, but instead provides a high-level framework for building a locally informed enhanced response that concurrently addresses prevention, and responses to victimhood and perpetration, and supports the exercise of ‘professional curiosity’ within this. Although the document focuses on child sexual exploitation, many of the principles outlined herein hold relevance for responding to other forms of exploitation, abuse and vulnerability in adolescence and readers are encouraged to consider the interconnectedness of these issues and the transferability of learning between them

Relational epistemic safety: what young people facing harm in their communities want and need from professionals tasked with helping them

When young people are harmed beyond their families, what kinds of professional relationships help to keep them safe? Contextual Safeguarding is an approach to creating safety in community and school contexts that asks how changes can be made in the environment to create safer contexts. However, (mis)interpretations of the approach have given rise to practice devoid of relationships with the young people affected by professional decisions, and which override their rights and ways of knowing. We draw on consultations with young people about what they need from professional relationships when they experience extra-familial harm – called the Young People's Relationship Framework (YPRF). We then use this to analyse three pilot studies of multi-agency practice aimed at creating safety in extra-familial contexts. The findings show that, for a relational orientation to be achieved, professionals need to be guided by how young people know the world. We argue that this requires professionals to undergo a process of ‘undoing’: giving up privileged ways of knowing and making decisions, leading to what we have termed relational epistemic safety. We offer this to support professionals in developing relationships with young people who experience extra-familial harm that are characterised by equality and respect

A commentary on Plautus' 'Aulularia'

This thesis provides a commentary on Plautus' Aulularia. In the introduction I examine the key themes and issues of Aulularia, in particular the two main textual problems of the names of the slaves and the lost ending, and the two main themes of communication and religion. The introduction also examines the characters of the play, some aspects relating to the Greek model, the main features of Plautine Latin, and the MSS tradition. However, there is not an attempt either to discover exactly what Plautus wrote, or to reconstruct the Greek model. The commentary focuses on the explanation of lines which are difficult or unusual linguistically, metrically, or textually, but also discusses social and historical themes as they arise, which are not examined in the introduction. Thus I have aimed to investigate technical aspects in detail, while keeping in mind a broader perspective, which enables one to discover the themes of the play. These themes have been emphasised in order to create a form useful to both undergraduate and postgraduate students, since the ultimate aim is to publish the commentary. At the end of the commentary there is a conspectus metrorum, which aims to provide a starting-point for an investigation of the metre of the play, rather than a definitive analysis. It is the aim of this commentary and introduction to aid appreciation and understanding of the material that survives to us, while not forgetting that it does not exist in isolation from its Greek model, but recognising that there is value in a study of this play for itself, whether or not Plautus remained close to or deviated much from his Greek model

The emotional response to athletic injury: Re-injury anxiety

First paragraph: Injury is often an unfortunate consequence of participation in sport. With increased participation, and subsequent increased injury rates, athletic injury is now a significant health concern (Brewer, 1998). Some studies have clearly demonstrated that athletic injury has, not only a physical, but also, an emotional impact upon the injured athlete (e.g., Daly, Brewer, Van Raalte, Petitpas, & Sklar, 1995; Gould, Udry, Bridges, & Beck, 1997; Smith, Scott, O’Fallon, & Young, 1990)

A Feminist Study of African American Art in New Orleans: Considerations of Aesthetics, Art History and Art Criticism.

How students are taught to think about what is considered art and who are artists contributes to their sense of self within the world. It can confine them to accept a system that devalues and excludes or it can inspire them to explore the political dimensions of art, to recognize social contradictions, and to contribute to cultural dialogue. The purpose of this study is to provide content for an art curriculum that develops the intellectual capabilities and broadens the critical consciousness of students. The study of aesthetics, art history, and art criticism offer possibilities for understanding the multiple social, historical, and cultural meanings of art. This dissertation adopts feminist approaches to the study of art as a means of exploring how the social reality of racial designation influences African American artistic production and meaning. Consideration is given to the cultural values that have influenced the meaning of African American art, a regional history of African American cultural production in New Orleans, Louisiana, and the experiences and artistic production of several regional African American artists. Throughout history, African American aesthetic values have been inseparable from ideological struggles for assimilation and self-determination. In 19th-century New Orleans, the work of slave and free Black artisans and free artists of color met the needs of a society that had developed a distinct Creole identity. Racial barriers limited the artistic productivity of all African Americans including the fine artists who were considered a third racial caste, had white patrons, and sometimes were trained in Paris. Following Reconstruction, legal restrictions and racial violence severely limited artistic opportunities for African Americans in New Orleans. Contemporary artists still face barriers as race relations change in the city. Interviews with five Black artists revealed the importance they attribute to transmitting African American cultural values to young people and the function of art as a means of responding to the social stereotypes that devalue African American people and culture. Conclusions of this study indicate that issues of racial identity and African American cultural values should be included in the art curriculum