Back to Basics: Can Unstructured Camping Promote Wellbeing?

Purpose: The purpose of this paper is to explore the perceived wellbeing benefits of the unstructured camping experience for young adults. Design/methodology/approach: This is a cross-sectional descriptive phenomenological study. Young adults between the ages of 21 and 30 years with recent experiences of camping were invited to participate in the study. A descriptive phenomenological approach was taken, involving photograph-guided semi-structured interviews and Colaizzi’s seven-stage analysis framework. Ethical approval was granted by the university where the study was managed. Findings: Four female participants were interviewed; each interview lasted approximately 60 minutes in duration. Unstructured camping holidays were perceived to heighten general perceptions of health and wellbeing. Five themes emerged: “Getting away”, “Appreciation of the Natural Environment”, “Relationship Maintenance”, “Tranquility and Relaxation” and “Freedom and Adventure/Exploration”. The unstructured nature of the activity encouraged participant’s freewill to appreciate the natural environment and to engage in physical activity. Escape from everyday stressors to a tranquil environment provided the space and time to think and talk, relax and be active. Originality/value: Green care initiatives could use the unstructured camping experience, or what the authors have framed as the “back to basics” model of camping, as a tool to promote general health and wellbeing in clinical and non-clinical young adult populations. Further research is needed to substantiate the evidence base, especially to probe further around the benefits of the spontaneity of the “back to basics” camping experience, in contrast to the structured group camp experiences the authors advocate in the UK and overseas for children’s leisure or health purposes

An artist in a Research context

Rosie Gibson was Artist in Residence at CRFR for a year from January 2008. The project was funded by the Leverhulme and the open ended brief included interacting with CRFR staff and researchers and contributing to several research projects

Cancer and dementia: an exploratory study of the experience of cancer treatment in people with dementia

Objective Patients with comorbid cancer and dementia have poorer outcomes than those without dementia. We observe oncology teams managing patients with dementia and memory loss and explore these patients' needs and experiences of outpatient cancer services. Methods A single site investigation of case study design to examine practices in four clinics using multi‐methods of data collection: retrospective note review, observation, interviews, and recorded consultations. A framework analytic approach identifies themes within and across cases. Results Thirty‐three clinical encounters with patients with memory loss were observed. Ten consultations were audio‐recorded and 16 individuals interviewed (n = 6 patients‐carer dyads, n = 1 lone patient, and n = 5 staff). Medical records were reviewed for 338 cases. Cancer referrals did not document memory health, so clinicians rely on patient/carer disclosure to identify patients with memory problems. In practice, the problem often remains hidden. Treating teams who do become aware of memory difficulties are unsure how to support patients, but marked memory loss can limit treatment options and preclude radical intent. Carers are key facilitators of successful cancer consultations and management. Their support needs are largely unrecognized. Conclusions Training that educates cancer teams on how to identify and support individuals with memory problems before and during treatment and recognize the carer role may facilitate complex cancer care and help reduce inequalities of outcomes

Girls’ and women’s education within Unesco and the World Bank, 1945–2000

By 2000, girls’ and women’s education was a priority for international development organisations. While studies have examined the impact of recent campaigns and programmes, there has been less exploration of ideas about girls’ and women’s education within development thought in the immediate post?colonial period, and the political mechanisms through which this came to be a global concern. Through a study of policy documents, this paper investigates how the education of girls and women came to be prioritised within the two principle UN agencies involved with education since 1945, the World Bank and Unesco. A shift in priorities is evident, from ensuring formal rights and improving the status of women, to expanding the productive capacities of women, fertility control and poverty reduction. While the ascendance of human capital theory provided a space for a new perception of the role of women’s education in development, in other policy arenas women’s education was central to exploring more substantive, rights?based notions of gender equality. Ultimately, the goal of improving girls’ and women’s education fitted into diverse development agendas, paving the way for it to become a global development priority

Gait measurement in chronic mild traumatic brain injury: A model approach

INTRODUCTION: Mild traumatic brain injury (mTBI) can impact gait, with deficits linked to underlying neural disturbances in cognitive, motor and sensory systems. Gait is complex as it is comprised of multiple characteristics that are sensitive to underlying neural deficits. However, there is currently no clear framework to guide selection of gait characteristics in mTBI. This study developed a model of gait in chronic mTBI and replicated this in a separate group of controls, to provide a comprehensive and structured methodology on which to base gait assessment and analysis. METHODS: Fifty-two people with chronic mTBI and 59 controls completed a controlled laboratory gait assessment; walking for two minutes back and forth over a 13 m distance while wearing five wirelessly synchronized inertial sensors. Thirteen gait characteristics derived from the inertial sensors were selected for entry into the principle component analysis based on previous literature, robustness and novelty. Principle component analysis was then used to derive domains (components) of gait. RESULTS: Four gait domains were derived for our chronic mTBI group (variability, rhythm, pace and turning) and this was replicated in a separate control cohort. Domains totaled 80.8% and 77.4% of variance in gait for chronic mTBI and controls, respectively. Gait characteristic loading was unambiguous for all features, with the exception of gait speed in controls that loaded on pace and rhythm domains. CONCLUSION: This study contributes a four component model of gait in chronic mTBI and controls that can be used to comprehensively assess and analyze gait and underlying mechanisms involved in impairment, or examine the influence of interventions

Banner News

https://openspace.dmacc.edu/banner_news/1298/thumbnail.jp

An Insurance Value Modeling Approach That Captures the Wider Value of a Novel Antimicrobial to Health Systems, Patients, and the Population

**Background:** Traditional health economic evaluations of antimicrobials currently underestimate their value to wider society. They can be supplemented by additional value elements including insurance value, which captures the value of an antimicrobial in preventing or mitigating impacts of adverse risk events. Despite being commonplace in other sectors, constituents of the impacts and approaches for estimating insurance value have not been investigated. **Objectives:** This study assessed the insurance value of a novel gram-negative antimicrobial from operational healthcare, wider population health, productivity, and informal care perspectives. **Methods:** A novel mixed-methods approach was used to model insurance value in the United Kingdom: (1) literature review and multidisciplinary expert workshops to identify risk events for 4 relevant scenarios: ward closures, unavoidable shortage of conventional antimicrobials, viral respiratory pandemics, and catastrophic antimicrobial resistance (AMR); (2) parameterizing mitigable costs and frequencies of risk events across perspectives and scenarios; (3) estimating insurance value through a Monte Carlo simulation model for extreme events and a dynamic disease transmission model. **Results:** The mean insurance value across all scenarios and perspectives over 10 years in the UK was £718 million, should AMR remain unchanged, where only £134 million related to operational healthcare costs. It would be 50%-70% higher if AMR steadily increased or if a more risk-averse view (1-in-10 year downside) of future events is taken. **Discussion:** The overall insurance value if AMR remains at current levels (a conservative projection), is over 5 times greater than insurance value from just the operational healthcare costs perspective, traditionally the sole perspective used in health budgeting. Insurance value was generally larger for nationwide or universal (catastrophic AMR, pandemic, and conventional antimicrobial shortages) rather than localized (ward closure) scenarios, across perspectives. Components of this insurance value match previously published estimates of operational costs and mortality impacts. **Conclusions:** Insurance value of novel antimicrobials can be systematically modeled and substantially augments their traditional health economic value in normal circumstances. These approaches are generalizable to similar health interventions and form a framework for health systems and governments to capture broader value in health technology assessments, improve healthcare access, and increase resilience by planning for adverse scenarios