Close enough? professional closeness and safe caring

In countries around the world, residential child care has been rocked by scandals of abuse of children and young people by the people who were supposed to be caring for them. In the UK, in particular, the reaction to these revelations has been to implement a raft of measures that seek to ensure that nothing of the same nature or scale might happen again. However, there can be tensions between the implementation of such measures and the developmental and emotional needs of children and young people in residential care. In this paper, we outline recent policy and legislative developments and address some of the issues which we see as important in attempting to strike a balance between safe caring and quality caring, between professional closeness and abusive practice

Developing a recovery ethos for psychiatric services in New Zealand

This thesis is about developing a recovery ethos for psychiatric services in New Zealand. The argument of the thesis is that currently a procedural ethos is dominant in psychiatric services in New Zealand, based on eclectic ways of facilitating recovery. Recovery from mental illness, is based on the criteria of symptom reduction and functioning and can be further refined to have a client and professional perspective. Rather than using an eclectic approach to facilitating recovery the thesis argues for a pluralistic approach, where the virtues, the relationship with professionals, client narrative and the psychiatric community become central to decision making, rather than principle based procedures. The thesis is an argued, applied philosophical thesis in terms of methodology. The scope of the thesis is psychiatric services and the focus is broadly ethical decision making. There are three main divisions to the thesis. Part 1 is concerned with clarification of the main terms used in the thesis. This involves exploring the historical background to the concept of recovery, clarifying the concept of recovery itself and providing an argument for giving greater prominence to the term mental illness over the term mental disorder. Part 2 identifies the main problem of the thesis, namely the procedural ethos, and the problems it is causing clients suffering from mental illness in facilitating their recovery. Part 3 shows what is involved in developing a recovery ethos for psychiatric services in New Zealand

Coping and its relation to gender, anxiety, depression, fatigue, cognitive difficulties and somatic symptoms

Background: The first aim of this study was to analyse the structure of coping and to develop a measuring instrument to be used in future work. A second aim was to examine associations between coping scores and negative outcomes (anxiety, depression, fatigue, cognitive difficulties and somatic symptoms). Finally, gender differences in coping with workplace events were examined, as were the relationships between gender and subjective health outcomes. Methodology: A survey of a sample of 240 adults from the South Wales area was conducted at one-time point only. The questionnaire included a factor analysed version of the Ways of Coping Checklist (WCCL) as well as scales measuring anxiety, depression, fatigue, cognitive difficulties and somatic symptoms. Results: Results showed that negative coping styles significantly predicted negative health outcomes, and positive coping styles predicted fewer negative outcomes. No significant differences were found for health outcomes between men and women, but women were significantly more likely to use self-blame and wishful thinking coping. Conclusion: This study demonstrated that coping styles are associated with wellbeing outcomes. Further research should use more independent variables, such as workplace and individual characteristics, to explain more of the variance in health outcomes than just that explained by coping styles alone

Accuracy assessment of Tri-plane B-mode ultrasound for non-invasive 3D kinematic analysis of knee joints

BACKGROUND Currently the clinical standard for measuring the motion of the bones in knee joints with sufficient precision involves implanting tantalum beads into the bones. These beads appear as high intensity features in radiographs and can be used for precise kinematic measurements. This procedure imposes a strong coupling between accuracy and invasiveness. In this paper, a tri-plane B-mode ultrasound (US) based non-invasive approach is proposed for use in kinematic analysis of knee joints in 3D space. METHODS The 3D analysis is performed using image processing procedures on the 2D US slices. The novelty of the proposed procedure and its applicability to the unconstrained 3D kinematic analysis of knee joints is outlined. An error analysis for establishing the method's feasibility is included for different artificial compositions of a knee joint phantom. Some in-vivo and in-vitro scans are presented to demonstrate that US scans reveal enough anatomical details, which further supports the experimental setup used using knee bone phantoms. RESULTS The error between the displacements measured by the registration of the US image slices and the true displacements of the respective slices measured using the precision mechanical stages on the experimental apparatus is evaluated for translation and rotation in two simulated environments. The mean and standard deviation of errors are shown in tabular form. This method provides an average measurement precision of less than 0.1 mm and 0.1 degrees, respectively. CONCLUSION In this paper, we have presented a novel non-invasive approach to measuring the motion of the bones in a knee using tri-plane B-mode ultrasound and image registration. In our study, the image registration method determines the position of bony landmarks relative to a B-mode ultrasound sensor array with sub-pixel accuracy. The advantages of our proposed system over previous techniques are that it is non-invasive, does not require the use of ionizing radiation and can be used conveniently if miniaturized.This work has been supported by School of Engineering & IT, UNSW Canberra, under Research Publication Fellowship

A grounded theory study on work related stress in professionals who provide health & social care for people who exhibit behaviours that challenge

Providing direct health and social care services for people who exhibit behaviours that challenge can be a highly stressful occupation. Existing literature has suggested that there is a need to develop further theoretical understanding of how work related stress can be reduced in professions that consist of providing care for people who exhibit behaviours that challenge. The aim for this study was to use a Classic Grounded Theory approach to develop a theoretical framework to illustrate a common issue that could influence work related stress levels experienced when managing behaviours that challenge in health and social care settings. A series of focus groups and 1:1 semi-structured interviews were conducted to explore the articulated experiences of 47 health/social care professionals who provide care for people who exhibit behaviours that challenge. This led to the development of Therapeutic Engagement Stress Theory (TEST), which illustrates that the perceived capacity to therapeutically engage with people who exhibit behaviours that challenge is an issue that can influence the levels of stress experienced by health/social care professionals. TEST provides a framework that could be applied to identify specific factors that inhibit staff to successfully deliver caring interventions for people who exhibit behaviours that challenge, and also inform bespoke support mechanisms to reduce stress in health/social care professionals

The assessment of benchmarks executed on bare-metal and using para-virtualization

A full assessment of para-­virtualization is important, because without knowledge about the various overheads, users can not understand whether using virtualization is a good idea or not. In this paper we are very interested in assessing the overheads of running various benchmarks on bare-­‐metal, as well as on para-­‐virtualization. The idea is to see what the overheads of para-­‐ virtualization are, as well as looking at the overheads of turning on monitoring and logging. The knowledge from assessing various benchmarks on these different systems will help a range of users understand the use of virtualization systems. In this paper we assess the overheads of using Xen, VMware, KVM and Citrix, see Table 1. These different virtualization systems are used extensively by cloud-­‐users. We are using various Netlib1 benchmarks, which have been developed by the University of Tennessee at Knoxville (UTK), and Oak Ridge National Laboratory (ORNL). In order to assess these virtualization systems, we run the benchmarks on bare-­‐metal, then on the para-­‐virtualization, and finally we turn on monitoring and logging. The later is important as users are interested in Service Level Agreements (SLAs) used by the Cloud providers, and the use of logging is a means of assessing the services bought and used from commercial providers. In this paper we assess the virtualization systems on three different systems. We use the Thamesblue supercomputer, the Hactar cluster and IBM JS20 blade server (see Table 2), which are all servers available at the University of Reading. A functional virtualization system is multi-­‐layered and is driven by the privileged components. Virtualization systems can host multiple guest operating systems, which run on its own domain, and the system schedules virtual CPUs and memory within each Virtual Machines (VM) to make the best use of the available resources. The guest-­‐operating system schedules each application accordingly. You can deploy virtualization as full virtualization or para-­‐virtualization. Full virtualization provides a total abstraction of the underlying physical system and creates a new virtual system, where the guest operating systems can run. No modifications are needed in the guest OS or application, e.g. the guest OS or application is not aware of the virtualized environment and runs normally. Para-­‐virualization requires user modification of the guest operating systems, which runs on the virtual machines, e.g. these guest operating systems are aware that they are running on a virtual machine, and provide near-­‐native performance. You can deploy both para-­‐virtualization and full virtualization across various virtualized systems. Para-­‐virtualization is an OS-­‐assisted virtualization; where some modifications are made in the guest operating system to enable better performance. In this kind of virtualization, the guest operating system is aware of the fact that it is running on the virtualized hardware and not on the bare hardware. In para-­‐virtualization, the device drivers in the guest operating system coordinate the device drivers of host operating system and reduce the performance overheads. The use of para-­‐virtualization [0] is intended to avoid the bottleneck associated with slow hardware interrupts that exist when full virtualization is employed. It has revealed [0] that para-­‐ virtualization does not impose significant performance overhead in high performance computing, and this in turn this has implications for the use of cloud computing for hosting HPC applications. The “apparent” improvement in virtualization has led us to formulate the hypothesis that certain classes of HPC applications should be able to execute in a cloud environment, with minimal performance degradation. In order to support this hypothesis, first it is necessary to define exactly what is meant by a “class” of application, and secondly it will be necessary to observe application performance, both within a virtual machine and when executing on bare hardware. A further potential complication is associated with the need for Cloud service providers to support Service Level Agreements (SLA), so that system utilisation can be audited

Predicting the subsurface

Britain is blessed with a magnificent variety of landscapes, much of it the result of the diverse range of rock types that form our small island, and the different ways in which they respond to weathering and erosion. Nowhere is this clearer than when enjoying a walk along many of the paths that snake around our coastline; dramatic colour changes in the cliffs, steep climbs and descents between headlands and bays all reflect changes in the underlying geology. Sometimes the connection is obvious, such as the contrast between the low, sandy and muddy cliffs that tumble into the sea along the coast of Essex, and the rugged white cliffs on the south coast of England. These natural features, which we take for granted, have a significant impact on how we live and move about our island

Advancing imaging technologies for patients with spinal pain : with a focus on whiplash injury

Background: Radiological observations of soft-tissue changes that may relate to clinical symptoms in patients with traumatic and non-traumatic spinal disorders are highly controversial. Studies are often of poor quality and findings are inconsistent. A plethora of evidence suggests some pathoanatomical findings from traditional imaging applications are common in asymptomatic participants across the life span, which further questions the diagnostic, prognostic, and theranostic value of traditional imaging. Although we do not dispute the limited evidence for the clinical importance of most imaging findings, we contend that the disparate findings across studies may in part be due to limitations in the approaches used in assessment and analysis of imaging findings. Purpose: This clinical commentary aimed to (1) briefly detail available imaging guidelines, (2) detail research-based evidence around the clinical use of findings from advanced, but available, imaging applications (eg, fat and water magnetic resonance imaging and magnetization transfer imaging), and (3) introduce how evolving imaging technologies may improve our mechanistic understanding of pain and disability, leading to improved treatments and outcomes. Study Design/Setting: A non-systematic review of the literature is carried out. Methods: A narrative summary (including studies from the authors' own work in whiplash injuries) of the available literature is provided. Results: An emerging body of evidence suggests that the combination of existing imaging sequences or the use of developing imaging technologies in tandem with a good clinical assessment of modifiable risk factors may provide important diagnostic information toward the exploration and development of more informed and effective treatment options for some patients with traumatic neck pain. Conclusions: Advancing imaging technologies may help to explain the seemingly disconnected spectrum of biopsychosocial signs and symptoms of traumatic neck pain

Influence of Ionizing Radiation on the Mechanical Properties of a Wood-Plastic Composite

AbstractThe focus of this study was to examine the potential benefits of irradiating polyethylene (PE)-based wood-plastic composites (WPCs) in order to enhance the mechanical properties of the WPC. The PE-based WPCs were irradiated, post extrusion, at dose levels of 0, 50, 100, 150, 200, and 250 kGy with an electron beam (EB). The irradiated WPCs were then evaluated using a third point bending test (ASTM D4761) along with scanning electron microscopy (SEM). It was found that ultimate strength and modulus of elasticity (MOE) increased with increasing dose level. Examination of the fracture surfaces of polyethylene revealed a distinct difference in failure between irradiated and non-irradiated surfaces