Nurturing and Complexity – Threshold Concepts in Geriatric Medicine

Older adults make up the largest proportion of patients in UK hospitals. This will increase further over the next twenty years. To manage unwell older adults requires specific skills – yet many are looked after by non-specialists (be they doctors, nursing staff or therapists). Threshold Concepts (TCs) represent a means of examining the changes which take place in doctors in becoming ‘a geriatrician’, and thus may identify the key concepts to focus education on about the care of older patients. This article presents a qualitative study of trainers (consultants, the educational supervisors of junior doctors) and trainees (the junior doctors themselves). Twelve semi-structured interviews were analysed using a concept mapping technique in combination with a traditional qualitative analysis to identify TCs, which were then explored in more detail with a structured questionnaire delivered to trainees. The study shows that whilst there are a number of troublesome areas in geriatric medicine training, two concepts stood out as TCs. Appreciation of the ‘complexity of medical care’ of older patients and what that entails, and a new concept of ‘nurturing-care’ (focused on the wider care issues for the patient) – are proposed as TCs in geriatric medicine. Both have large degrees of tacit knowledge, and rely on a networked model of thinking. Identification of these TCs in geriatric medicine can allow a focused analysis of postgraduate medical curriculums to ensure they are covered by doctors of all grades to improve the standard of care of older patients in the UK health service

Wilkinson I (2019) ‘Social Suffering and Public Value: A Spur to New Projects of Social Inquiry and Social Care’, in A. Lindgreen, N. Koenig-Lewis, M. Kitchener, J. Brewer, M. Moore and T. Meynhardt (eds) Public Value: Deepening, Enriching, and Broadening the Theory and Practice, London: Routledge

This chapter provides a review of contemporary research and writing on ‘social suffering’. It highlights some of the contemporary intellectual and political developments that have inspired social scientists to treat manifestations of ‘the problem of suffering’ as a key concern. It also notes some of the ways in which this might construed a marking a return to ‘the social question’ of the nineteenth century. It is argued that here the conduct of social research is informed by an earlier ‘classical’ example of critical pragmatism championed by figures such as Jane Addams, W.E.B du Bois and Albion Small. This is directed by the understanding that social science should be committed to projects of ameliorative social reform. Where a focus is brought to problems of social suffering, the pedagogy of caregiving is deemed a necessary part of the processes through which we might apprehend the meaning and value of human life in social terms

Value similarity: The key to building public trust in charitable organisations

© Policy Press 2016. This article explores the relationship between value similarity and public trust in charitable organisations. Through a focus group interview and an empirical study based on a sample in the United Kingdom, findings show that value similarity between the public and charitable organisations is an important driver of trust in charities even when individuals lack in-depth knowledge of them. It is also an elemental domain of public trust in charities and makes the greatest contribution to explaining this concept. It is concluded that value similarity is the key to understanding and establishing public trust, which is essential for prosperity of the voluntary sector

Compassion: Conflicted Social Feeling and the Calling to Care

This chapter I review the cultural and social history of compassion. I highlight the involvement of compassion in the creation and maintenance of conditions of everyday life in western modernity. I aim to equip readers with some resources to think critically about the range of moral, political and social interests that are featured in favoured accounts of compassion and its consequences. In later sections, I provide some analytical reflections on contemporary forms of ‘compassion fatigue’. Throughout the chapter I emphasise that compassion courts controversy, and I further underline the potential for this to marshal critical debate towards the institutional configuration and moral character of society. I hold that compassion is a ‘social emotion’ that holds the potential to alert us to the quality of our moral attachments to others and calls on us to reflect on how we bear a moral responsibility to relate people with care. The study of compassion involves us in far more than a critical commitment to expose its potential to operate in the service of various political and social ideologies, for the issues at stake here concern the potential for individuals to enact humane forms of society. I argue that by studying compassion we are made to attend to how individuals are more or less equipped with the moral motivation to care for one another

Ultrafast dynamics in polymeric carbon nitride thin films probed by time-resolved EUV photoemission and UV-Vis transient absorption spectroscopy

The ground- and excited-state electronic structures of four polymeric carbon nitride (PCN) materials have been investigated using a combination of photoemission and optical absorption spectroscopy. To establish the driving forces for photocatalytic water-splitting reactions, the ground-state data was used to produce a band diagram of the PCN materials and the triethanolamine electron scavenger, commonly implemented in water-splitting devices. The ultrafast charge-carrier dynamics of the same PCN materials were also investigated using two femtosecond-time-resolved pump–probe techniques: extreme-ultraviolet (EUV) photoemission and ultraviolet-visible (UV-Vis) transient absorption spectroscopy. The complementary combination of these surface- and bulk-sensitive methods facilitated photoinduced kinetic measurements spanning the sub-picosecond to few nanosecond time range. The results show that 400 nm (3.1 eV) excitation sequentially populates a pair of short-lived transient species, which subsequently produce two different long-lived excited states on a sub-picosecond time scale. Based on the spectro-temporal characteristics of the long-lived signals, they are assigned to singlet-exciton and charge-transfer states. The associated charge-separation efficiency was inferred to be between 65% and 78% for the different studied materials. A comparison of results from differently synthesized PCNs revealed that the early-time processes do not differ qualitatively between sample batches, but that materials of more voluminous character tend to have higher charge separation efficiencies, compared to exfoliated colloidal materials. This finding was corroborated via a series of experiments that revealed an absence of any pump-fluence dependence of the initial excited-state decay kinetics and characteristic carrier-concentration effects that emerge beyond few-picosecond timescales. The initial dynamics of the photoinduced charge carriers in the PCNs are correspondingly determined to be spatially localised in the immediate vicinity of the lattice-constituting motif, while the long-time behaviour is dominated by charge-transport and recombination processes. Suppressing the latter by confining excited species within nanoscale volumes should therefore affect the usability of PCN materials in photocatalytic devices

The electronic structure of the aqueous permanganate ion: aqueous-phase energetics and molecular bonding studied using liquid jet photoelectron spectroscopy

Permanganate aqueous solutions, MnO4(aq.)-, were studied using liquid-micro-jet-based soft X-ray non-resonant and resonant photoelectron spectroscopy to determine valence and core-level binding energies. To identify possible differences in the energetics between the aqueous bulk and the solution-gas interface, non-resonant spectra were recorded at two different probing depths. Similar experiments were performed with different counter ions, Na(+)and K+, with the two solutions yielding indistinguishable anion electron binding energies. Our resonant photoelectron spectroscopy measurements, performed near the Mn L-II,L-III- and O K-edges, selectively probed valence charge distributions between the Mn metal center, O ligands, and first solvation shell in the aqueous bulk. Associated resonantly-enhanced solute ionisation signals revealed hybridisation of the solute constituents' atomic orbitals, including the inner valence Mn 3p and O 2s. We identified intermolecular coulombic decay relaxation processes following resonant X-ray excitation of the solute that highlight valence MnO4(aq.)--H(2)O((l))electronic couplings. Furthermore, our results allowed us to infer oxidative reorganisation energies of MnO(4)((aq.))and adiabatic valence ionisation energies of MnO4(aq.)-, revealing the Gibbs free energy of oxidation and permitting estimation of the vertical electron affinity of MnO4(aq.). Finally, the Gibbs free energy of hydration of isolated MnO(4)(-)was determined. Our results and analysis allowed a near-complete binding-energy-scaled MnO(4)((aq.))(-)molecular orbital and a valence energy level diagram to be produced for the MnO4(aq.)-/MnO(4)((aq.))system. Cumulatively, our mapping of the aqueous-phase electronic structure of MnO(4)(-)is expected to contribute to a deeper understanding of the exceptional redox properties of this widely applied aqueous transition-metal complex ion

Micromanipulation of InP lasers with optoelectronic tweezers for integration on a photonic platform

The integration of light sources on a photonic platform is a key aspect of the fabrication of self-contained photonic circuits with a small footprint that does not have a definitive solution yet. Several approaches are being actively researched for this purpose. In this work we propose optoelectronic tweezers for the manipulation and integration of light sources on a photonic platform and report the positional and angular accuracy of the micromanipulation of standard Fabry-Pérot InP semiconductor laser die. These lasers are over three orders of magnitude bigger in volume than any previously assembled with optofluidic techniques and the fact that they are industry standard lasers makes them significantly more useful than previously assembled microdisk lasers. We measure the accuracy to be 2.5 ± 1.4 µm and 1.4 ± 0.4° and conclude that optoelectronic tweezers are a promising technique for the micromanipulation and integration of optoelectronic components in general and semiconductor lasers in particular