1,621 research outputs found

    Developing sexual competence? Exploring strategies for the provision of effective sexualities and relationships education

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    School-based sexualities and relationships education (SRE) offers one of the most promising means of improving young people's sexual health through developing 'sexual competence'. In the absence of evidence on whether the term holds the same meanings for young people and adults (e.g. teachers, researchers, policy-makers), the paper explores 'adult' notions of sexual competence as construed in research data and alluded to in UK Government guidance on SRE, then draws on empirical research with young people on factors that affect the contexts, motivations and outcomes of sexual encounters, and therefore have implications for sexual competence. These data from young people also challenge more traditional approaches to sexualities education in highlighting disjunctions between the content of school-based input and their reported sexual experience. The paper concludes by considering the implications of these insights for developing a shared notion of what SRE is trying to achieve and suggestions for recognition in the content and approaches to SRE.</p

    A fundamental conflict of care: nurses' accounts of balancing sleep with taking vital signs observations at night.

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    AIMS AND OBJECTIVES: To explore why adherence to vital signs observations scheduled by an Early Warning Score protocol reduces at night. BACKGROUND: Regular vital signs observations can reduce avoidable deterioration in hospital. Early Warning Score protocols set the frequency of these observations by the severity of a patient's condition. Vital signs observations are taken less frequently at night, even with an Early Warning Score in place, but no literature has explored why. DESIGN: A qualitative interpretative design informed this study. METHODS: Seventeen semi-structured interviews with nursing staff working on wards with varying levels of adherence to scheduled vital signs observations. A thematic analysis approach was used. RESULTS: At night, nursing teams found it difficult to balance the competing care goals of supporting sleep with taking vital signs observations. The night-time frequency of these observations was determined by clinical judgement, ward-level expectations of observation timing and the risk of disturbing other patients. Patients with COPD or dementia could be under-monitored while patients nearing the end of life could be over-monitored. CONCLUSION: In this study we found an Early Warning Score algorithm focused on deterioration prevention did not account for long-term management or palliative care trajectories. Nurses were therefore less inclined to wake such patients to take vital signs observations at night. However the perception of widespread exceptions and lack of evidence regarding optimum frequency risks delegitimising the Early Warning Score approach. This may pose a risk to patient safety, particularly patients with dementia or chronic conditions. RELEVANCE TO CLINICAL PRACTICE: Nurses should document exceptions and discuss these with the wider team. Hospitals should monitor why vital signs observations are missed at night, identify which groups are under-monitored and provide guidance on prioritising competing expectations. Early Warning Score protocols should take account of different care trajectories. This article is protected by copyright. All rights reserved

    Rotationally resolved photoelectron spectra in resonance enhanced multiphoton ionization of Rydberg states of NH

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    Results of combined theoretical and experimental studies of photoelectron spectra resulting from (2+1) resonance enhanced multiphoton ionization (REMPI) via the f ^1Ī (3pĻƒ), g ^1Ī”(3pĻ€), and hā€‰^1Ī£^+(3pĻ€) Rydberg states of NH are reported. The overall agreement between these calculated and measured spectra is encouraging. Strong Ī”N=N+āˆ’Nā€™=even peaks, particularly for Ī”N=0, are observed in these spectra. Lowā€energy Cooper minima are predicted to occur in the l=2 wave of the kĻ€(^1Ī£^+), kĻ€(^1Ī£^āˆ’), and kĻ€(^1Ī”) photoelectron channels for the f state, the kĻ€(^1Ī”), kĪ“(^1Ī ), and kĪ“(^1Ī¦) channels for the g state, and the kĻ€(^1Ī£^+) and kĪ“(^1Ī ) channels for the h state of NH. Depletion of the d wave (l=2) contributions to the photoelectron matrix element in the vicinity of these Cooper minima subsequently enhances the relative importance of the odd lā€‰ waves. The observed Ī”N transitions are also affected by strong lā€‰ mixing in the electronic continuum induced by the nonspherical molecular potential. Interference of continuum waves between degenerate ionization channels also determines the spectral pattern observed for photoionization of the fā€‰^1Ī  state of NH. Photoelectron angular distributions and the angular momentum compositions of photoelectron matrix elements provide further insight into the origin of these Cooper minima

    Older LGBT+ health inequalities in the UK: setting a research agenda

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    Lesbian, gay, bisexual and trans+ (LGBT+) people report poorer health than the general population and worse experiences of healthcare particularly cancer, palliative/end-of-life, dementia and mental health provision. This is attributable to: (a) social inequalities, including ā€˜minority stressā€™; (b) associated health-risk behaviours (eg, smoking, excessive drug/alcohol use, obesity); (c) loneliness and isolation, affecting physical/mental health and mortality; (d) anticipated/experienced discrimination and (e) inadequate understandings of needs among healthcare providers. Older LGBT+ people are particularly affected, due to the effects of both cumulative disadvantage and ageing. There is a need for greater and more robust research data to support growing international and national government initiatives aimed at addressing these health inequalities. We identify seven key research strategies: (1) Production of large data sets; (2) Comparative data collection; (3) Addressing diversity and intersectionality among LGBT+ older people; (4) Investigation of healthcare servicesā€™ capacity to deliver LGBT+ affirmative healthcare and associated education and training needs; (5) Identification of effective health promotion and/or treatment interventions for older LGBT+ people, and subgroups within this umbrella category; (6) Development of an (older) LGBT+ health equity model; (7) Utilisation of social justice concepts to ensure meaningful, change-orientated data production which will inform and support government policy, health promotion and healthcare interventions

    On the poverty of a priorism: technology, surveillance in the workplace and employee responses

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    Many debates about surveillance at work are framed by a set of a priori assumptions about the nature of the employment relationship that inhibits efforts to understand the complexity of employee responses to the spread of new technology at work. In particular, the debate about the prevalence of resistance is hamstrung from the outset by the assumption that all apparently non-compliant acts, whether intentional or not, are to be counted as acts of resistance. Against this background this paper seeks to redress the balance by reviewing results from an ethnographic study of surveillance-capable technologies in a number of British workplaces. It argues for greater attention to be paid to the empirical character of the social relations at work in and through which technologies are deployed and in the context of which employee responses are played out
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