When technology enters the home – a systematic and integrative review examining the influence of technology on the meaning of home

Aim: To analyse and synthesise the research that has investigated the experience of home in relation to home mechanical ventilation (HMV). Method: Systematic integrative review. Four electronic databases (CINAHL, PubMed, Scopus and ISI Web of Knowledge) were searched between January 2010 and April 2017 as well as reference lists of included studies. Quantitative and qualitative studies meeting the inclusion criteria were critically appraised. Study findings were inductively analysed and synthesised using the integrative approach. Results: Twenty-one studies were included in the review. Two main themes emerged: home and at-homeness and altered interpersonal relationships. The literature suggests that the technology alters the meaning of home through its structural and conceptual reconfiguration. Paradoxically, the space is experienced as both a home and a workplace which creates tensions and ambiguities for HMV users/families and care workers. HMV users and their families attempt to recreate a sense of home and identity while gaining control over space and decision-making. Nevertheless, the home is seen as the preferred place to live and close bonds can develop between the different actors. Conclusions: The literature suggests that the transformation of the meaning of home by the presence of technology and workers poses challenges that are often under-recognised. Healthcare professionals and personal care assistants need preparation for the complexities of working in the home setting in addition to clinical aspects of caregiving. Home adaptations need to be carefully planned and include design principles that retain ‘at-homeness’ while enabling the creation of a safe workplace

The Effects of Interlocking a Universal Hip Cementless Stem on Implant Subsidence and Mechanical Properties of Cadaveric Canine Femora.

ObjectiveTo determine if an interlocking bolt would limit subsidence of the biological fixation universal hip (BFX(®)) femoral stem under cyclic loading and enhance construct stiffness, yield, and failure properties.Study designEx vivo biomechanical study.AnimalsCadaveric canine femora (10 pairs).MethodsPaired femora implanted with a traditional stem or an interlocking stem (constructs) were cyclically loaded at walk, trot, and gallop loads while implant and bone motions were captured using kinematic markers and high-speed video. Constructs were then loaded to failure to evaluate failure mechanical properties.ResultsImplant subsidence was greater (P = .037) for the traditional implant (4.19 mm) than the interlocking implant (0.78 mm) only after gallop cyclic loading, and cumulatively after walk, trot, and gallop cyclic loads (5.20 mm vs. 1.28 mm, P = .038). Yield and failure loads were greater (P = .029 and .002, respectively) for the interlocking stem construct (1155 N and 2337 N) than the traditional stem construct (816 N and 1405 N). Version angle change after cyclic loading was greater (P = .020) for the traditional implant (3.89 degrees) than for the interlocking implant (0.16 degrees), whereas stem varus displacement at failure was greater (P = .008) for the interlocking implant (1.5 degrees) than the traditional implant (0.17 degrees).ConclusionAddition of a stabilizing bolt enhanced construct stability and limited subsidence of a BFX(®) femoral stem. Use of the interlocking implant may decrease postoperative subsidence. However, in vivo effects of the interlocking bolt on osseointegration, bone remodeling, and stress shielding are unknown

Adoption policy in Great Britain and North America

Journal ArticleThis paper has two purposes. First, to explore what existing adoption legislation may indicate about the meaning and function of adoption practices in North America and Great Britain. Second, to consider some possible policy implications revealed by clearer understanding of the social meaning of existing adoption laws. The first part of the paper summarizes briefly the history of legal adoption. The second examines what is explicitly and implicitly revealed by adoption law and policies about the social purposes of adoption and about prevailing social values concerning the family. The third part examines possible avenues of policy change in North America

Dr Who? Identity work in DBA students

This paper argues that the challenges experienced by Professional Doctorate students in completing their doctoral studies can be best understood through an identity lens. We explore how doctoral students engage in identity work as they transition through their studies, with a focus on the extent to which these senior managers accommodate the conferred identity as a student and finally, if and how their identity shifts to a doctorally qualified manager. We postulate that the identity work these students engage in will be influenced by the interactions they have with their supervisors. Additionally, we speculate trust within these interactions to be central to the student’s identity work. Thus, we will explore the role of trust in supervisory relationships, from the student’s perspective, and the implications this has for how supervisors are trained and how students’ expectations are managed throughout their doctoral studies. This study aims to contribute to identity scholarship in a novel context. By exploring the influence supervisors have on the doctoral journey, we will offer a contribution to the management of doctoral studies in higher education. Through an examination of the role trust plays in different relationships, we will offer insights into how a student’s trust in their supervisors can influence their identity work. Finally, by adopting an identity lens to analyse how senior managers accommodate the conferred identity of ‘student’, we hope to offer a typology of identity work upon which different students’ positions can be located and different approaches to supervision can be identified.N/