Women’s Resistance: Patient Pathographies and Medical Authority

In recent years, illness narratives have risen in popularity. Women’s medical narratives in particular have gained momentum in the literary world, and they often share commonalities including the inherent theme of medical resistance and an emphasis on the power dynamic between patients and physicians. This thesis will examine two pathographies, Susanna Kaysen’s Girl, Interrupted and Porochista Khakpour’s Sick, in the contexts of gender and disability studies, as well as theories of illness narratives. I examine how each text resists medical authority, and I also closely survey the physician-patient relationships within each text. The themes of gender and disability emerge in both Khakpour’s and Kaysen’s texts, but in other ways the texts approach illness differently. Using documents from her institutionalization in the 1960s, Kaysen humanizes her fellow patients and challenges medical authority using humor. In contrast, Khakpour uses a storytelling mode, emphasizing location and dislocation and the importance of her Iranian immigrant status and drug addiction to her experience of Lyme disease. These pathographies challenge medical authority through personal narrative

Novel electrochemical systems for asymmetric oxidation

Organic reactions, which can be carried out in water and in the absence of heavy metals, are becoming more important today due to concerns over safety and environmental impact. Thus if an oxidation reaction can be carried out, where the oxidant is generated in-situ using electrolysis, then this is advantageous over existing systems that use strong or large volumes of stoichiometric oxidant and solvent, that cannot be recycled. In this thesis a wide variety of conditions and methods for producing enantiomerically enriched epoxides and sulfoxides have been reported using both electrochemically generated percarbonate and hypochlorite. It has been possible to carry out a range of oxidation reactions both as a one-pot reaction and with the oxidant generated in a batch process. Carrying out sulfoxidation reactions as a batch process with a carbonate solution it is possible to obtain ees of 20%. Using our in-situ generation of oxidant, as a one-pot electrochemical reaction, has provided a wide range of sulfoxides in good to excellent yield, with the application of this system to the oxidation of alkenes using a chiral iminium salt resulting in 100% conversion, with up to 44% ee

Exposure to patient aggression and health outcomes for forensic mental health nurses:A cross-sectional survey

Aims: The aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences. Design: Cross-sectional survey conducted January to April 2020. Methods: All 205 nurses working in an Australian high-security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF-36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored. Results: Sixty-eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self-harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non-acute units. Higher level of aggression was associated with number of days sick leave taken and days off due to aggression or violence. Higher level of aggression was associated with poorer mental health, and patient self-harming behaviour was associated with poorer physical health. Conclusions: Nurses in acute units experience higher levels of inpatient aggression and are therefore at increased risk of being impacted by the exposure. Findings indicate a psychological impact of exposure to frequent aggression and potential for an accumulative effect of exposure to traumatic events on nurse well-being. Nurses who are victim of, or witness, physical violence are most likely to take time off work. Impact: This study provides further evidence that forensic mental health nurses are frequently exposed to various forms of patient aggression. For some nurses, this exposure to patient aggression negatively impacted their mental and physical health. Employing organizations should therefore prioritize provision of formal support for nurses. No patient or public contribution.</p

Evidence that implementation intentions reduce drivers' use of mobile phones while driving

Implementation intentions are IF-THEN plans that have the potential to reduce mobile phone use while driving and thus contribute towards the prevention of road traffic crashes. We tested whether an intervention, designed to promote the formation of implementation intentions, could reduce drivers’ use of mobile phones. A randomized controlled design was used. The participants (N = 136) were randomised to an implementation or a control condition. Self-report questionnaires were administered to all participants at both pre- and one-month post-intervention to measure the use of mobile phones while driving, goal intentions and the theoretically derived motivational pre-cursors of goal intentions (attitudes, subjective norm and perceived behavioural control). Immediately following the pre-intervention questionnaire, the participants in the implementation intention condition (n = 67) were given a volitional help sheet, which asked them to form implementation intentions by specifying target driving situations that tempted them the most to use a mobile phone and linking them with goal-directed responses that could be used to resist the temptation. The participants in the control condition (n = 69) were asked to specify target situations that tempted them the most to use a mobile phone while driving and to generally try to avoid using a mobile phone in those situations. One-month post-intervention, the participants in the implementation intention condition reported using a mobile phone less often while driving in their specified target driving situations than did the participants in the control condition. As expected, no differences were found between the conditions in the reported frequency of mobile phone use in unspecified driving situations, goal intentions or any motivational pre-cursor of goal intentions. The implementation intention intervention that was tested in this study is a potentially effective tool for reducing mobile phone use while driving in target driving situations where behaviour-change is most needed