The experiences of patients and carers in the daily management of care at the end of life

Background Home is the preferred location for most people with an advanced disease and at the end of life. A variety of care professionals work in community settings to provide support to this population. Patients and their spouses, who also care for them (spouse-carers), are rarely accompanied by these sources of support at all times, and have to manage independently between their contact with care professionals. Aim To explore how patients and spouse-carers manage their involvement with care professionals in the community setting. Method Interpretive phenomenology informs the design of the research, whereby 16 interviews were conducted with the patients and spouse-carers. Interviews were recorded and transcribed verbatim. Data were analysed using phenomenological techniques including template analysis. Findings Patients and spouse-carers were interdependent and both parties played a role in co-ordinating care and managing relationships with professional care providers. The patients and spouse-carers actively made choices about how to manage their situation, and develop and modify managing strategies based on their experiences. Conclusions When daily management is effective and care professionals acknowledge the dyadic nature of the patient and spouse-carer relationship, people have confidence in living with advanced disease

Gravitational waves from the early universe

These lecture notes are based on the course "Gravitational waves from the early universe" given at the 27th W.E. Heraeus "Saalburg" Summer School 2021 by Valerie Domcke. Ongoing and future collaborations will probe different frequency ranges of the gravitational wave spectrum, allowing for probing different stages of the early universe and Beyond Standard Model physics. Due to the very high energies involved, accelerators cannot probe them. Therefore, current knowledge about new physics is limited and relies on bounds from CMB observations and theoretical assumptions about these energy scales. While some models are in tension with CMB data, others are unconstrained in shorter wavelength scales. Nonetheless, each one of these models has a gravitational wave density spectrum that can be compared to data. These lecture notes review the formalism of gravitational waves in General Relativity and introduce stochastic gravitational waves, primordial sources, and detection efforts.Comment: Submission to SciPos

“It gave me something big in my life to wonder and think about which took over the space … and not MS”: Managing well-being in multiple sclerosis through art-making

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2014 Informa UK Ltd.Background and aim: Individuals living with Multiple Sclerosis (MS) often face progressive loss of function, uncertainty and disruption to self-image and valued roles. Previous studies show that creative self-expression is valued by some people living with long-term illness, yet its meaning for people living with MS is unclear. This research study explored the meanings of leisure-based visual art-making for people living with MS. Method: This qualitative study followed guidelines for Interpretative Phenomenological Analysis (IPA). Single semi-structured interviews were conducted with five adults (2 males; 3 females; 40–65 years), recruited from MS Ireland. Findings: Participants valued art-making for contributing to a more satisfying way of life; for filling occupational voids and using time well. Deep immersion offered respite from worry about illness. Creative classes offered social camaraderie and opportunities for learning and development. Art-making processes and products were highly affirmative, increasing emotional well-being and promoting self-worth. Most felt that they expressed valued aspects of self through their art. Art-making appeared to assist with identity maintenance, accommodating functional losses associated with MS whilst opening “new doors”. Conclusion: Art-making offered a multi-faceted means of supporting identity and increasing fulfilment in lives that were restricted in many ways by MS

'They're battle scars, I wear them well': A phenomenological exploration of young women's experiences of building resilience following adversity in adolescence

This is an Author's Accepted Manuscript of an article published in Journal of Youth Studies, 13(3), 273 - 290, 2010 [copyright Taylor & Francis], available online at: http://www.tandfonline.com/10.1080/13676260903520886.This phenomenological study explored young women's accounts of building resilience following chains of adverse life experiences in adolescence. Six participants were interviewed, aged 20–25 years. Most had, or were receiving, a university education. They described their recovery from adversity as starting with certain pivotal moments, followed by both short-term and longer-term strategies. Short-term strategies tended to offer respite from distress and emotional comfort, increased clarity about their experiences and social affirmation. Recovery involved gaining new perspectives on their adverse situation and recovering a positive self-image through three longer-term strategies. These involved making visible progress in their education, rebuilding relationships with family and friends, and participating in the ‘normalizing’ activities and developmental projects of adolescence. Participants believed that they were stronger and more compassionate although positive achievements co-existed with some regrets. Most perceived the adversity as catalyzing personal growth. These accounts of resilience revealed the complex psychosocial processes and resources available to some adolescents

Uncertainty prior to pulmonary rehabilitation in primary care

Pulmonary rehabilitation (PR) is recommended for patients functionally restricted by chronic obstructive pulmonary disease (COPD). However, attendance and adherence to PR remains suboptimal. No previous research has explored COPD patient experiences during the key period from referral to initiation of PR in the United Kingdom. This research aimed to explore the lived experience of COPD patients referred to PR programmes prior to participation. COPD participants were recruited from referrals to two community PR programmes. Semi-structured interviews withCOPDparticipants occurred followingPRreferral, but prior to programme initiation. Data were analyzed using applied interpretive phenomenology. Twenty-five COPD participants aged 42–90 were interviewed. ‘Uncertainty’ affected participants throughout their lived experience of COPD that negatively impacted illness perceptions, PR perceptions and increased participant’s panic and anger. Participants who perceivedCOPDless as a chronic condition andmore as a cyclical process experienced fewer feelings of panic or anger. The experience of uncertainty was disabling for these COPD participants. Recognition of the role that uncertainty plays in patients withCOPDis the first step towards developing interventions focused on reducing this uncertainty, thereby reducing the burden of the disease for the individual patient and facilitating PR attendance.NHS Education South Centra

‘Being’ in the coaching world: new insights on youth performance coaching from an interpretative phenomenological approach

Since Heidegger's influential text; Being and time (1927/2005), the phenomenological question of what it means to ‘be’ has generated a vast body of work. This paper reports data from a phenomenological study that investigated what it means to ‘be’ a youth performance coach. An overview of the interpretive phenomenological methods used is followed by presentation of coaches and data. Data analysis resulted in the identification of three constituent ‘essences’ of youth performance coaching: (i) care; (ii) a commitment to educate athletes authentically for corporeal challenges to come; and (iii) working with others to achieve a specialised corporeal excellence. The three identified essences manifest themselves in a broad lifeworld that includes settings on and off the field of play (FOP). Given the very different insights into the practice of coaching that emerge from this study, we argue it would be useful for future studies of coaching practice and coach education to extend their focus to take into account coaches' wider lives both on and off the FOP. We also argue for further exploration of coaching by drawing on phenomenological concepts such as care and relationality

Fostering 21st Century Skill Development by Engaging Students in Authentic Game Design Projects in a High School Computer Programming Class

This study used technology-rich ethnography (TRE) to examine the use of game development in a high school computer programming class for the development of 21st century skills. High school students created games for elementary school students while obtaining formative feedback from their younger clients. Our experience suggests that in the teaching of computer science in high schools, the development of games that include common game features such as dynamic feedback systems, backstory, levels, cheats, and compelling graphics challenges students and engages them in learning. Incorporating real client feedback is also useful for improving their work and connecting it to the “real” world. This article reports findings from the second year of a research project with a high school computer programming class. The authors argue that such approaches that leverage video games, design, programming, authenticity, and cooperation mobilize multiple 21st century skills that must be nurtured among contemporary young people so that they may grow to be part of a productive citizenry.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Magma Design Automation: Component placement on chips; the "holey cheese" problem.

The costs of the fabrication of a chip is partly determined by the wire length needed by the transistors to respect the wiring scheme. The transistors have to be placed without overlap into a prescribed configuration of blockades, i.e. parts of the chipthat are beforehand excluded from positioning by for example some other functional component, and holes, i.e. the remaining free area on the chip. A method to minimize the wire length when the free area is a simply connected domain has already been implemented by Magma, but the placement problem becomes much more complex when the free area is not a simply connected domain anymore, forming a ``holey cheese''. One of the approaches of the problem in this case is to first cluster the transistors into so-called macro's in such a way that closely interconnected transistors stay together, and that the macro's can be fit into the holes. One way to carry out the clustering is to use a graph clustering algorithm, the so-called Markov Cluster algorithm. Another way is to combine the placement method of Magma on a rectangular area of the same size as the total size of the holes, and a min cut-max flow algorithm to divide that rectangle into more or less rectangular macro's in such a way that as little wires as possible are cut. It is now possible to formulate the Quadratic Assignment Problem that remains after clustering the original problem to one with 100 up to 1000 macros. There exists a lot of literature on finding the global minimum of the costs, but nowadays computational possibilities are still too restrictive to find an optimal solution within a reasonable amount of time and computational memory. however, we believe it is possible to find a solution that leads to a acceptable local minimum of the costs