Academic literature on the topic 'Wound care experience'
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Journal articles on the topic "Wound care experience"
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Šepl Plentaj, Anamarija, and Mirna Žulec. "Nurses’ Knowledge About Wound Care." Croatian nursing journal 5, no. 2 (January 24, 2022): 113–28. http://dx.doi.org/10.24141/2/5/2/2.
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Introduction. Nurses’ knowledge can directly lead to treatment outcomes. Aim. To investigate the knowledge and attitudes of nurses regarding chronic wounds and to compare the nurses who participated in the study according to their level of education, years of experience, and place of work. Methods. Anonymous questionnaire about wound care knowledge was completed by 193 nurses with different educational backgrounds in three counties from central Croatia. The study was conducted during lectures organized through plans for continued education. Results. Most respondents had >5 years of experience, are employed in a hospital and have secondary education in nursing. Nurses with secondary education and less than five years of experience had better knowledge regarding leg ulcers. Hospital nurses state that they have insufficient knowledge about wound healing; however, doctors are more accessible to them. Conclusion. This study examined nurses’ knowledge and attitudes regarding wound care. Mixed results indicate the need for further and more detailed research.
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Karlsson, Matilda, Pia Olofsson, Ingrid Steinvall, Folke Sjöberg, Johan Thorfinn, and Moustafa Elmasry. "Three Years' Experience of a Novel Biosynthetic Cellulose Dressing in Burns." Advances in Wound Care 8, no. 2 (February 2019): 71–76. http://dx.doi.org/10.1089/wound.2018.0790.
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Simon, Arne, Kirsten Traynor, Kai Santos, Gisela Blaser, Udo Bode, and Peter Molan. "Medical Honey for Wound Care—Still the ‘Latest Resort’?" Evidence-Based Complementary and Alternative Medicine 6, no. 2 (2009): 165–73. http://dx.doi.org/10.1093/ecam/nem175.
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While the ancient Egyptians and Greeks used honey for wound care, and a broad spectrum of wounds are treated all over the world with natural unprocessed honeys from different sources, Medihoney™ has been one of the first medically certified honeys licensed as a medical product for professional wound care in Europe and Australia. Our experience with medical honey in wound care refers only to this product. In this review, we put our clinical experience into a broader perspective to comment on the use of medical honey in wound care. More prospective randomized studies on a wider range of types of wounds are needed to confirm the safety and efficacy of medical honey in wound care. Nonetheless, the current evidence confirming the antibacterial properties and additional beneficial effects of medical honey on wound healing should encourage other wound care professionals to use CE-certified honey dressings with standardized antibacterial activity, such as Medihoney™ products, as an alternative treatment approach in wounds of different natures.
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Sylvia, Cynthia J., and Vanessa Jones. "The Lived Experience of the Wound, Ostomy, and Continence Nurse in Wound Care." Journal of Wound, Ostomy and Continence Nursing 37, no. 3 (May 2010): 265–71. http://dx.doi.org/10.1097/won.0b013e3181d8c275.
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Bakry, SSalah, Sulten Alzahrani, Dai Zafer, Nawras Alyamani, Waleed Alnemari, Suhayb Bakry, and Mohamed Elhefny. "Wound care perception and attitude. A school-related experience in Saudi Arabia." Majmaah Journal of Health Sciences 11, no. 1 (2023): 29. http://dx.doi.org/10.5455/mjhs.2023.01.004.
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Background and Aims: Wound care is a significant global health issue that’s need medical and community attention. The perception of wound care is fundamental among students and teachers in schools to enhance the awareness level and prevents undesired consequences. This study aimed to evaluate students’ and teachers’ level of experience and attitude toward basic knowledge of wound care. Methods: The current study used an electronic survey distributed via online social media platforms among Makkah regions’ schools between January and February 2022. The current study used a convenient sam¬pling method for sampling selection. Then, the recorded data were subjected to statistical analysis. Results: A total of 674 students and teachers from Makkah region were surveyed. The mean (SD) were 22.12 (SD=13.23), female respondents were predominates representing 62.9%. A high level of experience between participants toward wound care were showed in this study 67.06%. A significant association were found between participants’ level of wound care experience and occupational level (P-value, 0.001, 0.024, and 0.012, respectively). Conclusion: Excellent levels of knowledge and attitude towards wound care practice were recorded among most of the participants. However, the awareness of some wound delaying factors and the correct ways to deal with wound injuries, especially for serious cases such as diabetic wounds, is still a challenge for public health awareness.
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Ansert, Elizabeth, Anthony Tickner, Donald Cohen, Weldon Murry, and Samuel Gorelik. "Understanding the Zebras of Wound Care: An Overview of Atypical Wounds." Wounds: a compendium of clinical research and practice 34, no. 5 (2022): 124–34. http://dx.doi.org/10.25270/wnds/2022.124134.
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Atypical wounds account for approximately 5% to 20% of chronic ulcerations. Typically, clinical suspicion of an uncommon etiology is warranted for wounds that do not show signs of healing with conventional care, that are associated with pain out of proportion to the clinical presentation, or that are atypical in appearance. This review provides a general overview of various atypical wound etiologies, clinical presentations and appearance, and current treatment protocols. The clinical presentation, pathophysiologic etiology, and current literature on each etiology are presented. The etiologies discussed are pyoderma gangrenosum, calciphylaxis, lichen planus, necrobiosis lipoidica, infectious ulcers, hidradenitis suppurativa, artefactual ulcers, hydroxyurea-induced ulcers, vasculopathies, and neoplastic ulcers. Patients with atypical wounds experience a poorer prognosis and slower healing rate compared with patients with typical wound etiologies (eg, vascular and diabetic wounds). Biopsy is often vital in wound care to identify and differentiate wound etiologies. It is important to note that multiple characteristics or histologic features can overlap in a biopsy with atypical wounds. Therefore, a biopsy will still require an understanding of the presentation of these different wounds and should only be used when appropriate. The proper diagnosis for an atypical wound can greatly hasten wound closure, decrease the cost for the patient and the health care system, and improve the patient’s quality of life. Because of the limited availability of patient populations with atypical wound etiologies, literature concerning specific pathologies is limited. More research on each pathology is needed, as is a universally accepted treatment protocol for atypical wounds.
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Raducu, Laura, Cristina Nicoleta Cozma, Andra Elena Balcangiu Stroescu, Adelaida Avino, Maria Daniela Tanasescu, Daniela Gabriela Balan, and Cristian Radu Jeca. "Our Experience in Chronic Wounds Care with Polyurethane Foam." Revista de Chimie 69, no. 3 (April 15, 2018): 585–86. http://dx.doi.org/10.37358/rc.18.3.6154.
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Polyurethane foam has numerous applications, from furniture to medical field. As a wound dressing creates a moisture environment that promotes epithelialization and diminishes pain. A prospective study was realized to evaluate polyurethane foam efficacy in treating chronic wounds due to venous, arterial or diabetic causes. Our evaluation showed good results with an accelerated epithelialization.
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Morris, E. Jill, Shirley Dowlen, and Bernie Cullen. "Early Clinical Experience with Topical Collagen in Vascular Wound Care." Journal of Wound, Ostomy and Continence Nursing 21, no. 6 (November 1994): 247–50. http://dx.doi.org/10.1097/00152192-199411000-00011.
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Zargar, Haroon Rashid, Mir Mohsin, Peerzada Umar Farooq Baba, Adil Hafeez Wani, Shabir Iqbal, Mohammad Inam Zaroo, Sheikh Adil Bashir, et al. "Negative pressure wound therapy: eleven-year experience at a tertiary care hospital." International Journal of Research in Medical Sciences 5, no. 5 (April 26, 2017): 1835. http://dx.doi.org/10.18203/2320-6012.ijrms20171555.
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Background: Management of complicated wounds is a reconstructive challenge. A reconstructive surgeon has to be ready to face new challenges every day. Negative pressure wound therapy has revolutionized the management of complex wounds. We are presenting our experience with this wound care modality in the past 11 years.Methods: It was a prospective study conducted from January 2006 to December 2016 on patients having wounds of varied etiologies, who consented to participate in this study. Custom made low cost NPWT was used till definitive wound closure.Results: A total of 568 patients consented to participate in the study during these 11 years. No major complications were seen. Most of these were males (60.73%) in their 3rd and 4th decade. Trauma was the leading cause of wounds in 38.14%, followed by diabetic foot wounds in 21.5%. Ankle and foot was the most common site of wounds (30.92%) followed by leg (24.01%). A total of 322 small, 218 medium and 97 large size dressings were used. Most of the patients improved with the NPWT. No major complications were seen.Conclusions: NPWT is safe, effective and has proved to be revolutionary in managing difficult wounds. With the use of customized low cost NPWT the benefit can be extended to underprivileged population in under developed nations too.
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Eisendle, Klaus, Tobias Thuile, Jenny Deluca, and Maria Pichler. "Surgical Treatment of Pyoderma Gangrenosum with Negative Pressure Wound Therapy and Skin Grafting, Including Xenografts: Personal Experience and Comprehensive Review on 161 Cases." Advances in Wound Care 9, no. 7 (July 1, 2020): 405–25. http://dx.doi.org/10.1089/wound.2020.1160.
Full textDissertations / Theses on the topic "Wound care experience"
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Querio, Lagerberg Susanne, and Vangie Franzén. "Mer än ett sår : Att belysa sjuksköterskors erfarenheter av sårvård." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-31533.
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Sårvård är central omvårdnadsuppgift i sjuksköterskans profession som kräverspecifika kunskaper, förberedelser och tidsplanering vilket innebär behov av en radolika resurser men även kostnader för hälso- och sjukvården. Sjuksköterskanskunskap gällande prevention och sårvårdsbehandling utgör grunden förevidensbaserad sårvård med patientens personliga behov i fokus. Syftet var att belysasjuksköterskors erfarenheter av sårvård, och genomfördes som en systematisklitteraturstudie där resultatet utgjordes av åtta kvalitativa och två kvantitativavetenskapliga artiklar. I resultatet framkom fyra teman som belyser sjuksköterskorserfarenheter av sårvård; utmaningar; helhetssyn i sårvård; behov av kunskap ochbetydelsen av stöd. Konklusionen påvisar vikten av att se på patienten som har behovav sårvård ur ett helhetsperspektiv. Det handlar inte enbart om att behandla självasåret utan bemötandet utifrån helhetssyn, att se personen i den aktuellaomvårdnadssituationen. Studien belyser även vikten av teamarbete och ett gottsamarbete mellan olika professioner i sjukvården, vilket leder till att kontinuitetuppnås. Slutligen behövs det kontinuerlig sårvårdsutbildning till sjuksköterskor inomklinisk verksamhet men även fortsatt forskning som lyfter tillämplig avevidensbaserad prevention av sår samt effektstudier av sårbehandling.Wound care is a central task of the nursing profession that requires specificknowledge, preparation and planning which means the needs of a variety of resources,but also the costs of health care. The nurse's knowledge regarding wound treatment,care, and prevention is the basis for evidence-based wound care with the patient'spersonal needs in mind. The aim was to highlight nurses' experiences of wound care,and carried out a systematic literature where the result had eight qualitative and twoquantitative scientific articles. The results revealed four themes that highlight nurses'experiences of wound care; challenges; holistic approach to wound care; need forknowledge and the importance of support. The conclusion demonstrates theimportance of ensuring the patient is in need of wound care from a holisticperspective. It is not just about treating the wound without seeing the human being inits entirety, and to respond to the patient in the current nursing situation. The studyalso highlights the importance of team work and good cooperation between differentprofessionals in health care, which leads to continuity, is achieved. Finally, we needcontinuous wound care training for nurses in clinical practice but also continuedresearch that highlights relevant evidence-based prevention of ulcers and efficacystudies of wound healing.
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Norgren, Sara, and Nils Bäcklund. "Omvårdnadspersonalens erfarenheter av sårbehandling och att vårda patienter med sår. : En litteraturstudie." Thesis, Umeå universitet, Institutionen för omvårdnad, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-131323.
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Titel: Omvårdnadspersonalens erfarenheter av sårbehandling och att vårda patienter med sår. Bakgrund: Sår är ett stort och komplext område och kunskapen har ökat sista decennierna vilket ställer nya krav på personalen. Genom att beskriva omvårdnadspersonalens erfarenheter kan utmaningar och problem synliggöras och detta kan ge möjligheter till att förbättra situationen för alla inblandade. Syfte: Att beskriva omvårdnadspersonalens erfarenheter av sårbehandling och att vårda patienter med sår. Metod: En litteraturstudie innehållandes 8 artiklar med kvalitativ ansats. Artiklarna granskades, analyserades och sammanställdes. Resultat: Helhetssyn och engagemang i patienten, inte bara såret, samt rätt kunskap och kompetens främjar hälsa hos patienter med sår. Bristande kunskaper, resurser och tid är stora utmaningar i vården av patienter med sår. Vårdteamet och stöttande kollegor spelar en viktig roll i att upprätthålla kvaliteten och stärka personalens tro på sig själva. Vårdmiljöns tillgångar och begränsningar påverkar upplevelsen av arbetet med patienterna och bidrar till utmaningar i yrkesutövningen. Konklusion: Arbetet med sår och patienter med sår är berikande men också utmanande. Mer forskning på metoder och verktyg som kan underlätta sårbehandling i hemmet behövs. Det behövs en samordnad syn på prevention och behandling av patienter med sår. Nyckelord: omvårdnad, erfarenhet, sjuksköterska, sår, sårvård
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Mattsson, Carin. "Svårt med svårläkta sår : En intervjustudie med sjuksköterskor och undersköterskor på vårdavdelningar." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-47945.
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Bakgrund: De nationella riktlinjerna i Vårdhandboken anger att sårbehandling är sjuksköterskans ansvarsområde, trots att undersköterskor oftast sköter uppgiften. Det finns inget hinder i lagstiftningen att sårbehandlingen överlåts på undersköterskan, förutsatt att vården är patientsäker. Forskning visar att sjuksköterskor ofta känner sig osäkra gällande sårbehandlingar, men forskning om undersköterskors erfarenheter saknas. Syftet: Att beskriva sjuksköterskors och undersköterskors erfarenheter av att vårda patienter med svårläkta sår på vårdavdelningar. Metod: Semistrukturerade intervjuer med sju sjuksköterskor och åtta undersköterskor analyserades med manifest kvalitativ innehållsanalys med induktiv ansats. Resultat: Deltagarna beskrev att undersköterskor vanligen utför såromläggningar och att sjuksköterskor i varierande utsträckning försöker följa behandlingen, men att tidspress utgjorde ett hinder för sjuksköterskornas önskan om att vara mer delaktiga. Det framkom att sårbehandling är en komplex uppgift, för vilken de flesta ansåg att de inte hade tillräcklig kompetens. Stöd hämtades från erfarna kollegor och teamet runt patienten som bland annat bestod av sårexperter från Sårcentrum. Slutsats: Vårdgivaren behöver inse att komplexiteten i vården av patienter med svårläkta sår utmanar målet om god och säker vård. Därför krävs personal väl förberedd för uppgiften, både genom en god teoretisk grund och omfattande klinisk erfarenhet av sårbehandlingar – som ges den tid som faktiskt behövs.Background: The National guidelines stipulate that wound care is the registered nurse's area of responsibility, but usually assistant nurses perform the task. There is no hinder in legislation to entrust the task to assistant nurses, provided the care remains safe. Research shows that nurses often feel uncertain about wound care, but research on assistant nurses' experiences is lacking. The purpose: To describe registered nurses 'and assistant nurses' experiences of caring for patients with difficult-to-heal wounds in care units. Method: Semi-structured interviews with seven registered nurses and eight assistant nurses were analyzed with manifest qualitative content analysis with inductive approach. Results: Participants described that assistant nurses usually perform the wound care and that registered nurses try to follow the treatment to varying degrees, but that the time pressure constituted an obstacle to nurses' desire to be more involved. The result showed that wound care is a complex task, for which many felt they lacked sufficient competence. Support was obtained from experienced colleagues and the team around the patient, which consisted of wound specialists from the Wound Center. Conclusion: The caregiver needs to realize that the complexity of caring for patients with hard-to-heal-wounds is a challenge to patient safety and hence requires competent staff who are well prepared for the task, both through a theoretical basis and frequent practice of wound care that is granted the time actually required.
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Carson, Paula Penelopy. "Head injury survivorship: The family experience." Diss., The University of Arizona, 1992. http://hdl.handle.net/10150/185753.
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Health professionals as well as families are being confronted with long-term care and caregiver issues that accompany the increasing incidence of individuals surviving traumatic brain injury. A sample of parents and brain-injured offspring from 20 families served as informants. The purpose of this study was to identify a qualitatively generated theory describing the parent's experience following a brain-injured child's return to the home setting. An exploratory qualitative design using grounded theory methodology was used during data collection and analysis. All the brain-injured offspring had survived a moderate-to-severe traumatic brain injury; were living with at least one parent; and were ages 17 to 34. A three-phase theory, Investing in the Comeback, was generated using grounded theory methodology. The theory's three stages, centering on fostering independence and seeking stability, describe the work of the parent living with a brain-injured offspring. The first phase, Centering On, involves the parent's focusing attention and behavior primarily on the brain-injured offspring. During Fostering Independence, the second phase, the parent initiates and maintains efforts to promote the offspring's resumption of independent functioning. The final phase, Seeking Stability, consists of the parent working to establish a regime that maintains the brain-injured offspring's optimal performance, while minimizing the strain on other family members. Theoretical sampling guided the identification of categories, properties, conditions, and consequences of each phase. Four quantitative measures supplied descriptions of sample characteristics and included demographics, cognitive deficit ratings of the child by the parent and the investigator, and the parent's perception of the family's functioning.
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Rutherford, Jodhi. "What the doctor would prescribe: Medical practitioner perspectives and experiences of the Voluntary Assisted Dying Act 2017 (Vic)." Thesis, Queensland University of Technology, 2021. https://eprints.qut.edu.au/211387/1/Jodhi_Rutherford_Thesis.pdf.
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This thesis is the first comprehensive empirical study of how doctors are perceiving and experiencing their statutory role under recently commenced voluntary assisted dying legislation in the Australian state of Victoria. The study uses doctrinal research and qualitative interviews to examine the centrality of doctors to the VAD system in Victoria, and the impact of their willingness to provide VAD on the system’s sustainability. It concludes that stronger supports for doctors who conscientiously participate in VAD is essential, in the face of significant conscientious objection and other reasons for non-participation in VAD reported by the broader medical profession.
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FitzGerald, Patricia Anne. "Needs of family members of critically ill brain-injured patients during the ICU experience." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28763.
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This descriptive exploratory study was designed to determine the perceived importance of selected needs of family members of critically ill brain-injured patients. In addition, the personal/demographic factors which may have influenced the needs of these family members were investigated, as well as the reasons family members perceived these needs as important or unimportant.
A convenience sample of one family member for each of 15 critically ill brain-injured patients was selected from two tertiary care hospitals and the community. Family members were interviewed using a pre-determined interview guide and asked to verbally rate 20 need statements on a four-point Likert-type scale. Generally, family members perceived all 20 needs to be important. However, the importance of each need was influenced by the family members' personal/demographic factors. No significant statistical relationship was found between personal/demographic factors and the family members' perceptions of the importance of selected needs. However, the findings of the study suggest that family members relate their needs to their present experience, and thus individual assessment of family members' needs is crucial.Applied Science, Faculty of
Nursing, School of
Graduate
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Patterson, Michele M. Tervo. "Adolescent Experience with Trauma and Orthopedic External Fixation: A Dissertation." eScholarship@UMMS, 2007. https://escholarship.umassmed.edu/gsn_diss/7.
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Over 13 million adolescents sustain traumatic injuries yearly, resulting in functional disability, disfigurement, psychosocial problems and fractures. These fractures are increasingly being treated with orthopedic external fixation devices (EFDs). The purpose of this study was to describe the experience of traumatically injured adolescents treated with EFDs. The 4 aims of the study focused on the circumstances leading to the traumatic event, experiences following the traumatic event, the impact of EFD treatment, and adolescents’ role in pin-care self-management, which is crucial to preventing infection.
This longitudinal, qualitative descriptive study used purposive sampling to recruit 5 male and 4 female adolescents, 13-20 years old, from a New England level-1 trauma center. Participants were injured in motor vehicle crashes (including an all-terrain vehicle), falls, by gunshot, trampoline and football trauma. Interview questions were framed by two themes from a study of adult recovery from physical injury, i.e., the event and fallout. Participants were interviewed within days of the injury, 2 weeks after returning home, and within one month of EFD removal. Data were coded from verbatim transcripts using NVIVO and organized into themes guided by the principles of qualitative analysis.
An overarching theme of “old self no more; forever changed” emerged from 26 interviews. The participants’ experience affected all tasks of adolescence: independence from parents, accepting body image, peer relations, and forming an identity. Major themes included “what risk?”, regarding circumstances leading to the traumatic event, mastering the environment, was 2 part first, processing the event, where determining fault and realizing everything has changed, they were ambivalently lucky, and not invincible. Secondly “suck it up and deal with it”, where strategies to deal with traumatic injury emerged (i.e. medication, channeling outlets, and slow caution). EFD experience revealed “Space age robot” and “they’ll do it themselves” as emergent themes. EFDs were described as painless, robotic, no big deal and necessary. One draining pin-site was noted. Findings related to use of self-administered analgesics, information technology, recall of detail, and gender differences in coping may lead to future interventions. These findings lay the groundwork for future studies that may improve care of adolescents during acute recovery from traumatic injury.
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Mpisane, Fefekazi. "Post cardiac surgery sternal wound sepsis burden, risk factors and outcomes at Red Cross War Memorial Children's Hospital, Cape Town, South Africa: a five-year experience." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33887.
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Purpose Sternal wound infection (SWI) is associated with significant morbidity and mortality in postoperative cardiac patients. We aimed to describe the burden, risk factors and outcomes of SWI in post-operative paediatric cardiac patients at a tertiary children's hospital. Methods We conducted a retrospective record review of cardiac surgeries via median sternotomy over a five-year period to identify cases of SWI. Results Between 2012-16, 1319 patients underwent median sternotomy. Thirty-four (2.6%) patients developed SWI; eighteen (1.4%) patients developed deep sternal wound infection (DSWI), and sixteen (1.2%) developed superficial sternal wound infections (SSWI). Twenty-two (1.6%) of SWIs were apparent within a week post-surgery before discharge, the remaining were re-admitted post-discharge. Seven (0.5%) patients died from complications. Conclusion Significant morbidity was associated with SWI. Furthermore, with a mortality rate of 20 % in the case of DSWI. We strongly support quality improvement procedures such as the Sternal Wound Prevention Bundle (SWPB) that was introduced in late 2014. However, the rate of SWI implies that ongoing monitoring and evaluation of the SWPB is necessary and more stringent adherence to the protocol may result in better outcomes.
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Magenuka, Nkosazana Selina. "The personal and embodied experiences of people living with a spinal cord injury in the or Tambo district municipality in the Eastern Cape." Thesis, 2006. http://hdl.handle.net/10500/2179.
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The study was undertaken to deepen understanding of living with a spinal cord injury (SCI) in the rural communities of the Eastern Cape Province, South Africa (RSA). The OR Tambo District Municipality, which was selected for its accessibility to the researcher, is virtually rural, the infrastructure is poorly developed and there is low socio-economic activity in the rural areas of the old Transkei.
In the RSA services for management and rehabilitation of SCIs varies from province to province.
A Heideggerian phenomenological approach was used to interpret the meaning of living with SCI persons in a rural community. The purpose was to describe and interpret what being-in the-world as a spinal cord injured person meant to the particpants. A key assumption in phenomenology is that understanding human beings and their actions is best achieved through examination of human experiences. Experience, including experience with living with SCI, offers itself as a record of human encounters, the interface between persons and their world, and experience can only be understood in terms of background and the social context of the experience (Pateman & Johnson 2000: 51).
Phenomenological interviews with ten people living with SCI explored their experience. The overall goal was to increase awareness of their experiences of living with SCI, and to encourage incorporation of knowledge gained into nursing practice. The central question in the study was `What is it like to live with a spinal cord injury in a rural community? Data were analysed according to Heideggerian hermeneutic phenomenology.
Two main themes were identified, namely reconceptualising being-in-the-world as a person with a disability; and being-with-each-other: experiencing being excluded, objectified and marginalized. The participants engaged in a process of reconstructing their identities following the traumatic loss of sensory and motor functioning. Data reflect the social and economic context in which living with SCI is experienced. The respondents' life experiences were influenced by socio-political, economic and historical factors, namely geographic location, poor infrastructure, poverty, low educational status, and unemployment and the community at large. It was noted that participants experienced difficulties in several areas in their daily life realm; naming, coping with health and disability problems, family interactions and relationships, and non-accessibility of amenities, including their own dwellings. In addition, being a person living with an SCI in the rural communities of the OR Tambo District Municipality carries a high physical and social risk due to lack of resources. The inability to live up to generally expected social roles led to role dissatisfaction. There is an urgent need for social support to overcome the negative societal attitudes experienced. They are forced into isolation with a limited social life and are poorly integrated into the communities in which they live. Most of what the participants raised pointed towards inadequate preparation for the outside world. Therefore, a holistic approach to rehabilitation is recommended, as holism means addressing the physical, social, emotional and cognitive needs. Accordingly, the researcher developed guidelines for facilitating community integration.
In conclusion, understanding how people experience living with SCI in a rural community is an essential prerequisite to the development of appropriate strategies to facilitate community integration.Health Studies
D. Litt et Phil (Health Studies)
Books on the topic "Wound care experience"
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The Comparative guide to American hospitals: 4,693 hospitals with key personnel and 49 quality measures relating to heart attack, heart failure, pneumonia, childhood asthma, surgical care, medical imaging and patient experience. 3rd ed. Amenia, NY: Grey House Publishing, 2011.
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Waern, Annika, and Anders Sundnes Løvlie. Hybrid Museum Experiences. Nieuwe Prinsengracht 89 1018 VR Amsterdam Nederland: Amsterdam University Press, 2022. http://dx.doi.org/10.5117/9789463726443.
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"So you're the one getting this gift? Lucky you! Someone who knows you has visited the museum. They searched out things they thought you would care about, and they took photos and left messages for you." This is the welcoming message for the Gift app, designed to create a very personal museum visit. Hybrid Museum Experiences use new technologies to augment, expand or alter the physical experience of visiting the museum. They are designed to be experienced in close relation to the physical space and exhibit. In this book we discuss three forms of hybridity in museum experiences: Incorporating the digital and the physical, creating social, yet personal and intimate experiences, and exploring ways to balance visitor participation and museum curation. This book reports on a 3-year cross-disciplinary research project in which artists, design researchers and museum professionals have collaborated to create technology-mediated experiences that merge with the museum environment.
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Hubert, Jane. Life after head injury: The experiences of twenty young people and their families. Aldershot, Hants, England: Avebury, 1995.
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Mendola, Joseph. Experience and Possibility. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780198869764.001.0001.
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This book is concerned with the ontology of the things that we experience, especially in regard to its modal features. Ontology studies the basic categories of beings, including particulars like chairs, properties like being yellow, and relations like being on. But this book focuses specifically on the ontology of the ordinary objects that our sensory experience seems to reveal, for instance blue cars and green trees. It investigates the colors, shapes, and other concrete properties these familiar objects present in experience, their spatial relations, and whatever beyond their concrete properties and relations is required to constitute them as the specific objects that they seem to be. But there is also another aspect of this topic: modality. Modality concerns what is possible and what is necessary, what could be and what must be. The central novelty of the book is an intense focus on the modal aspect of these experienced particulars and properties, and what it can tell us about modality in general. The proper understanding of such properties and relations and such forms of particularity has many implications regarding what is and is not possible. The reality of these sorts of properties, relations, and particularity would involve in surprising ways not merely what would be hence actual but what would be merely possible. And these phenomena support a novel general conception of modality, of the possible and the necessary, according to which the actual and the possible are locally entwined and involve different types of being.
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Levin, Rafael, Nomaan Ashraf, and Evan Baird MD. Evidence Based, Cost Effective, And Compassionate Surgical Care of the Spi: Comprehensive Review of the Literature and Experience-Based Fair and Balan. BookBaby, 2018.
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Barr, Jane Ellen. Stoma therapy in palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0412.
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Patients with ostomies, wounds, or incontinence in the setting of a serious or life-threatening illness experience numerous challenges, including distress related to pain and other symptoms, psychological disturbances, and family concerns. Expert management of these conditions and their many complications is an essential part of a comprehensive palliative plan of care. In many countries, nurse specialists with advanced training in the management of ostomies, wounds, or incontinence are available as consultants or as members of a specialist palliative care team. These professionals can improve health care and quality of life for selected patients across venues of care that include hospital, home, long-term care, hospice, and specialized settings. If a stoma nurse specialist is available, he or she may have a key role in directing decision-making and care management related to these problems, evaluating and controlling symptoms that cause patients and families suffering, and providing psychosocial and spiritual support.
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Pinchevski, Amit. Transmitted Wounds. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190625580.001.0001.
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In Transmitted Wounds, Amit Pinchevski explores the ways media technology and logic shape the social life of trauma both clinically and culturally. Bringing media theory to bear on trauma theory, Pinchevski reveals the technical operations that inform the conception and experience of traumatic impact and memory. He offers a bold thesis about the deep association of media and trauma: media bear witness to the human failure to bear witness, making the traumatic technologically transmissible and reproducible. Taking up a number of case studies--the radio broadcasts of the Eichmann trial; the videotaping of Holocaust testimonies; recent psychiatric debates about trauma through media following the 9/11 attacks; current controversy surrounding drone operators' post-trauma; and digital platforms of algorithmic-holographic witnessing and virtual reality exposure therapy for PTSD--Pinchevski demonstrates how the technological mediation of trauma feeds into the traumatic condition itself. The result is a novel understanding of media as constituting the material conditions for trauma to appear as something that cannot be fully approached and yet somehow must be. While drawing on contemporary materialist media theory, especially the work of Friedrich Kittler and his followers, Pinchevski goes beyond the anti-humanistic tendency characterizing the materialist approach, discovering media as bearing out the human vulnerability epitomized in trauma, and finding therein a basis for moral concern in the face of violence and atrocity. Transmitted Wounds unfolds the ethical and political stakes involved in the technological transmission of mental wounds across clinical, literary, and cultural contexts.
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Shippey, Ben, and Graham Nimmo. Simulation training for critical care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0014.
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Simulation in various guises can be an extremely useful educational methodology. Its use should be planned carefully to maximize educational efficiency and minimize disruption to patient care. It requires the facilitator to enable the participants to behave as they would in the real clinical environment. Fidelity is one aspect of the simulated clinical environment that helps participants engage with the clinical material. The participants should be debriefed after the simulated experience. Video-assisted debriefing facilitates reflection on elements of behaviour that affect patient safety. Many styles of debriefing exist, but there are common elements. Debriefing should be carefully facilitated by faculty with the necessary skills. Simulation is increasingly being used as an assessment tool, but the validity of summative assessments using simulation is unclear.
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Gersel, Johan, Rasmus Thybo Jensen, Morten S. Thaning, and Søren Overgaard, eds. In the Light of Experience. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198809630.001.0001.
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A simple idea: Perception is of what is in view (before the eyes), or making noise, or the noises made, or emitting odours, or the thus emitted (etc.). What we see is, say, a pig, or its perambulations, or its rooting beneath that oak. Sight offers us a certain form of awareness of this, characterized in one way by its objects. It thus offers us occasion for another sort: we may recognize what we are aware of as, for example, a case of a pig rooting, or of an interminable drum machine. We take up the offer in exercising capacities for recognition such as they are. John McDowell has argued that this cannot be quite right (or anyway complete). For it needs to posit rational relations where there can be none. What follows argues that McDowell cannot be quite right: if he were, thought would cease to exist.
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Hassan, Hamidah, Santhna Letchmi Panduragan, Samsiah Mat, Mohd Said Nurumal, and Jalina Karim, eds. Essential Nursing Guidelines: Clinical skills and Procedures. UMS Press, 2021. http://dx.doi.org/10.51200/essentialnursingguidelinesumspress2021-978-967-2962-88-5.
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This book was an amalgamation of 120 contributors from various fields of nursing throughout Malaysia who shared their opinions and experiences in privileging this book for use in the nursing practice. The Malaysian Nursing Board collaborated during the later stage of the manuscript development to ensure complete and accurate content. The scope of skills encompasses the basics of nursing procedures and procedures specialised care. It has 17 units of basic components of care that comprise 136 procedures needed in nursing practice. The book is created based on the requirements of 14 ADL covering the following aspects; Fundamental of Nursing, Vital Signs, Personal Hygiene, Bed Making, Moving and Positioning, Maintaining Airway and Oxygenation, Oral and Enthral Nutrition, Specimen, Bowel and Elimination, Comfort Measures, Medication, Intravenous, Wound Care, Bandages, Intraoperative Procedures, Special Procedures and Care After Death. The skills and procedures were selected and consulted with experienced clinicians, nursing lecturers, nurse instructors and significant others whom we had wisely sought to ensure the book quality is sure-fire.
Book chapters on the topic "Wound care experience"
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Olsen, Sophus Béneé, Emil Rosenlund Høeg, and Cumhur Erkut. "Embodied and Sonic Interactions in Virtual Environments: Tactics and Exemplars." In Sonic Interactions in Virtual Environments, 219–35. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04021-4_7.
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AbstractAs the next generation of active video games (AVG) and virtual reality (VR) systems enter people’s lives, designers may wrongly aim for an experience decoupled from bodies. However, both AVG and VR clearly afford opportunities to bring experiences, technologies, and users’ physical and experiential bodies together, and to study and teach these open-ended relationships of enaction and meaning-making in the framework of embodied interaction. Without such a framework, an aesthetic pleasure, lasting satisfaction, and enjoyment would be impossible to achieve in designing sonic interactions in virtual environments (SIVE). In this chapter, we introduce this framework and focus on design exemplars that come from a soma design ideation workshop and balance rehabilitation. Within the field of physiotherapy, developing new conceptual interventions, with a more patient-centered approach, is still scarce but has huge potential for overcoming some of the challenges facing health care. We indicate how the tactics such as making space, subtle guidance, defamiliarization, and intimate correspondence have informed the exemplars, both in the workshop and also in our ongoing physiotherapy case. Implications for these tactics and design strategies for our design, as well as for general practitioners of SIVE are outlined.
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Baker, Robert, and Matthew K. Wynia. "The Role of Professions in a State: The Effects of the Nazi Experience on Health Care Professionalism." In The International Library of Bioethics, 35–58. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-01987-6_3.
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AbstractThis paper reviews three competing ways of organizing health care delivery—professionalism, consumerism and statism—and explores how Germany’s exclusively statist model facilitated the ascendency of an alternative Nazi medical ethics predicated on eugenic conceptions of national “race hygiene.” The primary obligation of health care personnel became using their skills and knowledge to achieve the aims of the Nazi state, which justified forcible eugenic sterilization programs, and then the killing of children and adults with mental or physical disabilities and, eventually, the medicalized mass murder of other groups seen to pose a genetic threat to the health of the state, such as homosexuals, Jews, and Roma. The evolving international response to these medical crimes would come to affect medical professional approaches to virtually every issue in contemporary Bioethics, from abortion to xenotransplantation. In the early post-war years, news of German health care professionals’ participation in these actions shocked fellow health care professionals. Many denied these accounts, some defended German researchers, others dismissed the Germans’ justifications of their actions as madness parading as medicine or medical ethics. Ultimately, however, reformers seeking to remedy or prevent actions reminiscent of Nazi medicine created the foundational documents of modern health care professional ethics and the new field of Bioethics. These are the Nuremberg Code, the Declaration of Geneva, and the Belmont Report. In firmly rejecting Nazi medical ethics, these documents emphasize the rights of autonomous individuals, with health professionals serving as their agents, thus cementing modern ideals of health care professionalism.
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Johnson, Benjamin. "The Scientification of Agriculture." In Making Ammonia, 9–27. Cham: Springer International Publishing, 2012. http://dx.doi.org/10.1007/978-3-030-85532-1_2.
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AbstractIt may seem that ammonia synthesis was a scientific triumph for chemistry that also had unexpected consequences for agriculture, much in line with Max Planck’s dictum: “Understanding must precede application.” However, in historical hindsight things often happen just the opposite: in the case of ammonia synthesis, practice and experience preceded theory. Without observations from agriculture and a general understanding of the role of fertilizer—and of nitrogen and the nitrogen cycle in particular—certain essential chemical insight would not have been considered valuable.
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Gore, Madhuri. "Experience of Wound Bed Preparation with Different Methods." In Skin Grafts for Successful Wound Closure. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.102935.
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The ultimate goal of wound care is to obtain wound closure either by natural process or by use of surgical technique and so all the steps need to be taken with a plan to reach the goal at the earliest. While performing skin grafting, closure of the existing wound is the aim, but the procedure also creates another wound (though superficial), causes pain, and may have healing issues. Optimal bed preparation is mandatory to obtain successful uptake of skin graft and to avoid loss of precious skin autograft. Every wound has its own unique needs and demands. Different agents and methods are often needed to meet these demands. It is essential to accrue experience and develop insight into the efficacy, utility, and advantages of different approaches for wound bed preparation. The availability, cost of the method, socioeconomic status of the patient, type of health care system, ease of access to facility, expertise—all these and many other factors play a role in deciding the choice of method for wound bed preparation. It is possible that different methods may be developed, evaluated, and found to be useful in different countries or different parts of the same country too. The author has evaluated methods spread over a wide spectrum including indigenously prepared topical agent, barrier foam dressing prepared using advanced technology, porcine xenografts which are not available in India, and skin allografts from the very first skin bank in India set up by the author and colleagues. The experience shared here looks at the ability of the method to control infection, inflammation, pain besides the time taken to achieve effective wound bed preparation and frequency of dressing change needed, along with ease of training.
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Grassman, Deborah. "Veterans." In Oxford Textbook of Palliative Nursing, edited by Betty Rolling Ferrell and Judith A. Paice, 539–44. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190862374.003.0044.
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In many ways, veterans face the end of life in a similar manner as civilians. In some ways, however, they experience death differently. Military experiences often change veterans in fundamental ways that shape, mold, destroy, and redeem the rest of their lives, including the ends of their lives. This chapter identifies some of these differences in the hopes that readers will understand the unique hospice and palliative care needs of veterans and their families. For example, the value of stoicism so earnestly and necessarily indoctrinated in young soldiers may interfere with a peaceful death for veterans depending on the degree to which stoicism has permeated their post-military lives. This chapter provides lessons that inform healthcare delivery for veterans and bereavement care for their families. It explains how posttraumatic stress disorder (PTSD) can become exacerbated at the end of life, complicating peaceful dying. An overlooked, unassessed wound, now identified as “soul injury” and distinguishable from moral injury, will also be addressed.
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Flynn, Maria, and Dave Mercer. "Pain." In Oxford Handbook of Adult Nursing, edited by Maria Flynn and Dave Mercer, 463–84. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198743477.003.0023.
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It is widely recognized that the experience of pain is unique to the individual, which makes caring for people in pain a challenge. The general hospital nurse is most likely to see people in pain due to an acute injury, an episode of ill health, following surgery, or at a wound dressing change. People living with chronic pain conditions will most often be in the care of community nurses or specialist pain management teams. In both acute and chronic pain conditions, it is important that general nurses can accurately assess, monitor, and treat pain. This chapter identifies the key features of acute and chronic pain and describes pain assessment tools which are in widespread use. It outlines common pharmacological and non-pharmacological approaches to pain management, along with a summary table of frequently prescribed pain medications. Key considerations in nursing practice and decision-making are outlined.
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McClelland, Tom. "Four Impediments to the Case for Mineness." In Self-Experience, 50–76. Oxford University PressOxford, 2023. http://dx.doi.org/10.1093/oso/9780198805397.003.0003.
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Abstract This chapter argues that a compelling case for the existence of a sense of mineness is yet to be made. It proposes that any such case must overcome four impediments. The first is epistemological and concerns how we could identify this putative feature of experience. The second concerns the representational content of such experiences. The third concerns the function that these experiences would perform; and the fourth concerns the possibility of malfunction. The chapter argues that although none of these impediments constitute a knock-down objection to the sense of mineness, they each present a serious challenge that advocates of the sense of mineness must address.
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Dewachi, Omar. "Revealed in the Wound: Medical Care and the Ecologies of War in Post-Occupation Iraq." In Vulnerability and the Politics of Care, 126–40. British Academy, 2021. http://dx.doi.org/10.5871/bacad/9780197266830.003.0008.
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Decades of war and western interventions in Iraq have produced toxic legacies of wounding and affliction that have redefined geographies and everyday experiences of vulnerability and care. Building on what I call anthropology of wounding, I explore a number of methodological insights related to conducting ethnographic research on war injury across conflict landscapes in the Middle East. Taking the “wound” as a method, I explore what is “revealed” in such wounds as they map the incongruent trajectories, terrains and relations of vulnerability and care in everyday life. Anchoring my analysis in a deeper understanding of the changing ecologies of war, I show how an anthropology of wounding further unravels the biosocial relations of distress and care, and provides a deeper understanding of the lived experiences of war and the body, as well as the inscription of a history of war in the molecular and genetic makeup of the environment.
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Cordingley, Timothy, Daniel Chepurin, Ghada Younis, Islam Nassar, and David Mitchell. "Fast Track Arthroplasty Using Local Infiltration Analgesia." In Topics in Regional Anesthesia [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.99433.
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Fast track arthroplasty is a holistic approach to patients who undergo total hip and knee arthroplasty, a journey or care that begins with setting patient’s expectation, optimising medical status, using intraoperative local anaesthetic infiltra-tion, decreasing narcotics usage either in spinal or post-operative medication, discouraging usage of patient controlled analgesia or urinary catheters, encouraging day of operation mobilisation and optimising post-operative physiotherapy protocols. The use of local infiltration analgesia (LIA) is a good alternative compared to other traditional pain management techniques. The purpose of adoption of LIA technique is to provide comfort from the trauma associated with hip and knee arthroplasty particularly for the first 36 h post-operatively, during the time of high post-operative pain, to facilitate increased post-operative mobilisation and function. LIA is safe and effective to achieve good outcomes, early mobilisation and decreasing length of stay without jeopardising clinical outcomes. This chapter discusses LIA and its multimodal approach to analgesia, regional anaesthesia and early mobilisation that improves overall patient experience and satisfaction. The chapter discusses LIA techniques, wound catheter placement, and postoperative protocol to achieve fast track hip and knee arthroplasty.
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Reuber, Markus, Gregg H. Rawlings, and Steven C. Schachter. "Neurologist, 1 year’s experience, USA." In Non-Epileptic Seizures in Our Experience, edited by Markus Reuber, Gregg H. Rawlings, and Steven C. Schachter, 278–81. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190927752.003.0092.
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This chapter discusses how a neurologist started a Psychogenic Non-Epileptic Seizures (PNES) clinic. As an Epileptologist, the Neurologist would be best equipped to care for children and young adults who present with non-epileptic seizures. Patients with PNES often fall through the cracks because their condition lies between the land of Psychiatry and Neurology. The Neurologist hoped to serve patients with PNES who were lost in the gap between traditional Neurology and behavioral healthcare. Six months after its inception, a patient came to the newly established PNES clinic. The Neurologist learned from the chart review that the patient had been in inpatient Psychiatry care on more than one occasion several years prior. She had been treated for Depression and Post-Traumatic Stress Disorder (PTSD) from repeated sexual and verbal abuse from a family member. Her somatic symptom–related disorder developed shortly after discharge from her first psychiatric inpatient care several years ago, which manifested as chest pain, dizziness, fainting, chronic nausea, chronic abdominal pain, eating disorder, severe malnutrition, headache, weakness, and PNES. The chapter then argues that each patient in the PNES clinic brings unique challenges that require a creative and individualized solution.
Conference papers on the topic "Wound care experience"
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Wonham, Louise, and Lynn Cornish. "P-157 Improving the patient experience of wound/pressure ulcer care in a hospice setting." In Leading, Learning and Innovating, Hospice UK 2017 National Conference, 22–24 November 2017, Liverpool. British Medical Journal Publishing Group, 2017. http://dx.doi.org/10.1136/bmjspcare-2017-hospice.182.
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Chin, Jessica, Abe Zeid, and Sagar Kamarthi. "Investigating a Framework for Modeling and Analysis for Wound Progression." In ASME 2012 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/imece2012-86856.
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Wounds are as unique as a fingerprint. A wound can be a tear, scrape or cut — simply anything that damages the protective layer of skin. Wounds occur anywhere on the body from a small paper cut to a large gash. Because the topology of a wound varies so significantly, current tracing and modeling methods fail to adapt to the changing environment. Similarly, traumatic wounds are a greater challenge to heal without infection due to their nature, size, depth and moisture. Presently, tracing and modeling methods are inaccurate and unreliable for wounds that exceed a certain depth. With any wound, non-invasive, full field methods are necessary to effectively measure and assess the severity of the wound. Due to lack of diagnosis options, wounds are expensive to treat and heal. There are few methodologies that exist to help affect the decision for clinicians regarding wound care, how wounds are evaluated, and how wounds are created. In the U.S., there are an estimated 2.5 million pressure ulcers treated each year in acute care facilities. The epidemiology of pressure wounds result in particular physiological principles that we can use to quantify and determine a baseline wound condition. At the moment, the physician and his experience rather than a standard diagnostic system determines the wound condition. This paper presents methods of quantifying wound progression and their impact thus far on patient care. It also provides open-ended research issues that support the need for a structured, systematic methodology for the modeling and analysis of wound progression. The purpose of this paper is also to disseminate a preliminary epistemology on wound progression and modeling in a quantifiable manner.
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Kristinawati, Beti, Datik Wahyuningsih, and Siti Rahmawati. "The Lived Experiences of Family Members Treating Gangrene Wound Patients with the Concept of Care." In Proceedings of the 1st International Conference on Education, Humanities, Health and Agriculture, ICEHHA 2021, 3-4 June 2021, Ruteng, Flores, Indonesia. EAI, 2021. http://dx.doi.org/10.4108/eai.3-6-2021.2310743.
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Davey, Bill, and David Kelly. "System Analysis Education Using Simulated Case Studies." In InSITE 2005: Informing Science + IT Education Conference. Informing Science Institute, 2005. http://dx.doi.org/10.28945/2885.
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Transfer of learning can be demonstrated by assessment tasks mirroring real life situations. This can be attempted in real organisations, or by simulating the real, life experience in a structured case study. In this paper we discuss experiences with work situated learning and difficulties that commonly arise. The alternative of encapsulating real life experience in hypermedia based materials is then presented using a number of case studies. Finally a model is presented for producing these “real life” encapsulations which overcomes the problems of lack of structure in individual experience without losing the advantages of common lifelike experiences. Some testing of the model is presented. The model involves the steps of: • Determine real life skills commonly required • Imagine a context rich enough (and having the case study design team with enough knowledge of the context that they can draw from their experience to fill in the holes) • Structure (partition) the case so that team work is possible without too much overlap between tasks. Identify the overlapping points that will force the level of teamwork between students that is intended • Identify parts of the solution development where students can be synchronised using a published solution to part of the problem • Create answers for each skill point starting from the top • Tag each part of the answer with the essential component of information required for an answer • Determine the most likely format that the tagged information would be found in real life • Create the set of tagged information using unskilled labour to provide detailed data • Write the project brief so that an appropriate level of guidance is given for navigating the information sources
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Bu¨chert, Jakob. "Modeling of Ethylene in Pipeline Leak Detection System." In 2004 International Pipeline Conference. ASMEDC, 2004. http://dx.doi.org/10.1115/ipc2004-0382.
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This paper describes experiences with an improved equation of state (EOS) for ethylene for an existing real time pipeline model. The main scope of the model is leak detection, batch, contaminant and pig tracking. Altogether the pipeline model includes transportation of batched liquid ethylene, ethane, propane, butane and natural gas liquids (NGL). The pipeline is approximately 1900 miles miles long and includes laterals, 33 pump stations, 9 injection/delivery stations and 5 propane terminals. Originally the model used a BWRS EOS for all the above products. At that time a number of false leak alarms were experienced related to pipeline sections containing ethylene. A case study was carried out, specifically for ethylene, to investigate the effect of replacing the BWRS EOS with a modified Helmholtz EOS. The study showed that replacing the EOS on average would improve determination of the ethylene densities by 1.6%–5.6% with an expected reduction in the alarm rate for ethylene cases by approximately 50%. As a result the modified Helmholtz EOS was implemented in the real time model. Results are presented to show the practical experience with the new EOS gained over the last years.
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Dharmarajan, Adarsh, and M. Geetha. "Audit on early stage carcinoma cervix primarily treated with radical surgery: A tertiary cancer care centre experience." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685262.
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Introduction: Clinical staging is universally accepted for ca cervix. In early stage of carcinoma cervix both radiation and radical hysterectomy given equivalent local control rates as well as survival. Poor prognostic factors following surgery would necessitate-post-operative adjuvant radiation. Selecting the patients who is unlikely to require adjuvant treatment after surgery spares them the toxicity of multiple treatment modalities, which is worse than alone. Aim: To find out clinico-pathological correlation in early stage carcinoma cervix treated with the surgery. Materials and Methods: It is a retrospective audit of study. All carcinoma cervix cases primarily treated with surgery. Results: A total of 25 cases were treated in this study. The median age of patients observed with 48 years. The common symptoms and stage were vaginal discharge (i.e., 42.30%) and 1B1 (61.53%). Most of patients were treated with type III radical hysterectomy and their clinical staging was correlated with the final histo-pathological staging. A total of 11 (i.e., 42.30%) required adjuvant treatment among them 7 (63.633%), 1 (9.09%) and 3 (27.27%) patients were in 1B1 1B2 and 2A respectively. The chi-square test has been performed to compute the correlation between clinical and histo-pathological finding. It shows that significant amount of relation present between clinical and histo-pathological findings.
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Catlow, Fred. "Experience in Choices for Decommissioning the Dounreay Site." In ASME 2009 12th International Conference on Environmental Remediation and Radioactive Waste Management. ASMEDC, 2009. http://dx.doi.org/10.1115/icem2009-16183.
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The paper describes the public participation from the viewpoint of a stakeholder and member of the public. The dialogue between various members of the Dounreay Stakeholders Committee vary widely and do not always seem to represent the views of the wider public. Whilst great care has been taken to select various options for the ultimate condition of the Dounreay site and these have been discussed at great length and the preferred option selected by consensus, there still appears to be some conflict within the local community. It is probable that if the local population had to vote on the options for the future of the Dounreay nuclear site the outcome would be vastly different from that of the Stakeholders Committee. Whilst the politicians have been elected by the people, they represent a distinctly anti-nuclear view (even to the extent of decommissioning) whereas many local people (especially the workers on the Dounreay site) would prefer to see a continuation of nuclear activity at Dounreay. The problem is not only with local politicians but at national level in Scotland itself where the Scottish National Party has formed a coalition with the Green Party on condition all nuclear activities are phased out.
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Haroldsen, Brent, Jerome Stofleth, Mien Yip, and Allan Caplan. "Experience With Using Code Case 2564 to Design and Certify an Impulsively Loaded Vessel." In ASME 2013 Pressure Vessels and Piping Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/pvp2013-97987.
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Code Case 2564 for the design of impulsively loaded vessels was approved in January 2008. In 2010 the US Army Non-Stockpile Chemical Materiel Program, with support from Sandia National Laboratories, procured a vessel per this Code Case for use on the Explosive Destruction System (EDS). The vessel was delivered to the Army in August of 2010 and approved for use by the DoD Explosives Safety Board in 2012. Although others have used the methodology and design limits of the Code Case to analyze vessels, to our knowledge, this was the first vessel to receive an ASME explosive rating with a U3 stamp. This paper discusses lessons learned in the process. Of particular interest were issues related to defining the design basis in the User Design Specification and explosive qualification testing required for regulatory approval. Specifying and testing an impulsively loaded vessel is more complicated than a static pressure vessel because the loads depend on the size, shape, and location of the explosive charges in the vessel and on the kind of explosives used and the point of detonation. Historically the US Department of Defense and Department of Energy have required an explosive test. Currently the Code Case does not address testing requirements, but it would be beneficial if it did since having vetted, third party standards for explosive qualification testing would simplify the process for regulatory approval.
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Silva, Matheus Henrique de Freitas, Karina Santos Wandeck, Sílvia Santiago Cordeiro, Ruth Lira Oliveira, and Síura Aparecida Borges Silva. "Experience of hypothermia as a therapeutic alternative for severe hypoxic-ischemic encephalopathy in a neonatal intensive care unit in Belo Horizonte." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.354.
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Introduction: Therapeutic hypothermia (TH) is an effective treatment alternative in newborns (NB) with moderate to severe hypoxic-ischemic encephalopathy (HIE). It is suggested that hypothermia, initiated in the first 6 hours after the hypoxic insult, by reducing brain metabolism, decreases cytotoxic edema, free radical production, neuronal excitability, the synthesis and release of neurotransmitters, nitric oxide and cytokines and apoptosis, mechanisms responsible for the late neurological lesions of EHI. Thus, TH improves survival and neurological prognosis in these newborns. Materials: Review of medical records of newborns submitted to TH in the period from 01/01/15 to 12/31/2015. Discussion: The TH protocol was implemented in the Unit from 01/01/2015, for all newborns older than 35 weeks, with evidence of moderate to severe HIE. TH starts in the first 6 hours of life and is performed for a period of 72 hours, after which rewarming begins, in the next 24 hours. In 2015, five newborns were submitted to the protocol. One of them died, on the fifth day of life, due to refractory shock and multiple organ failure. The other four newborns would be followed up on an outpatient basis. There was no need to stop hypothermia before 72 hours due to adverse events. The main events observed were bradycardia and shock, responsive to amines. Conclusion: The experience with TH showed good results in the medium term in newborns with moderate to severe HIE. The adverse events observed during the procedure were manageable, which suggests that TH can be an effective and safe alternative.
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Sfakianakis, Eleftherios, Foivos Irakleidis, and Peng Tan. "“NO DRAIN” AND DAY-CASE MASTECTOMY AND AXILLARY SURGERY: OUR EXPERIENCE." In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2062.
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Background: Seroma formation is the most common complication following breast cancer and axillary surgery, with incidence ranging from 15% to 85%. Delayed wound healing, discomfort, infection, and delay in starting adjuvant therapies are the main complications following seroma formation. Several factors have been considered responsible for seroma; however, its pathogenesis is not yet fully understood. Despite the fact that there is no clear evidence that the use of drain reduces the incidence of seroma formation, closed suction drainage following mastectomy and axillary lymph node clearance remains the standard of practice for most of the breast surgeons in the UK. Patients’ discomfort, wound infection, and prolonged hospital stay are the major drawbacks of drain surgery. Objective: The aim of this study is to present and evaluate our experience in no drain mastectomy combined with axillary surgery. Methodology: Patients who underwent a simple mastectomy and axillary surgery from January 2017 to January 2021 for breast cancer were divided by a single oncoplastic breast surgeon in a tertiary Breast Unit in London, UK, into mastectomy and sentinel lymph node biopsy and axillary clearance subgroups. Parameters such as patients’ demographics, performance status, tumor characteristics, hospital stay, drain status, and complications were evaluated. Mastectomy flaps were dissected using electrocautery, with thoroughly sealing of the lymphatics, and were fixed onto the chest wall with polyglactin 910 sutures, and an axillary cavity was closed by suturing clavipectoral fascia to prevent seroma formation. No drain was used in either subgroup of patients apart from a single case with bleeding disorders. Results: A total of 52 patients (51 females and 1 male) underwent mastectomy and axillary surgery. Of these, 32 patients had axillary clearance (axillary lymph node clearance [ALND]) and 19 had sentinel lymph node biopsy (SLNB). Of the 52 patients, 9 were 60 years old. Performance status (ASA score) was as follows: ASA I: 20 patients, ASA II: 20, ASA III: 10, and ASA IV: 2 patients. A total of 42 patients had day surgery (24 in the ALND and 18 in the SLNB subgroup). The medial number of lymph node retrieval was 2.6 and 13.6 in the SLNB and ALND, respectively. In terms of complications, three patients developed seroma in the early post-op period (two in the ALND and one in the SLNB subgroup), two patients had wound infection treated with antibiotics, and three had hematoma treated conservatively. Conclusion: Despite the lack of clear evidence that drain reduces the incidence of seroma, the use of drain is widely accepted among surgeons when mastectomy is performed with either SLNB or axillary clearance. The data demonstrate that no drain and day-case approach in mastectomy combined with axillary surgery can be safely performed even in patients with axillary clearance, with minimum complication rates. Sealing of the lymphatics with electrocautery combined with the fixation of mastectomy skin flaps on the chest wall with plication sutures and closure of axillary dead space seems to be efficient in seroma prevention.
Reports on the topic "Wound care experience"
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Jauny, Ray, and John Parsons. Delirium Assessment and Management: A qualitative study on aged-care nurses’ experiences. Unitec ePress, November 2017. http://dx.doi.org/10.34074/ocds.72017.
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Aged residential care (ARC) residents with morbid health conditions frequently experience delirium. This condition is associated with diminished quality of life, preventable morbidity and untimely death. It is challenging and costly to manage delirium because of the complex interplay of physical and psychiatric symptoms associated with this condition in both primary and secondary services. With awareness of risk factors and knowledge about delirium, ARC nurses can play a vital role in early identification, assessment and treatment, but most importantly in preventing delirium in aged-care residents as well as improving health outcomes. Focus groups were carried out with ARC nurses to ascertain their opinions on how they assess and manage delirium in ARC facilities in South Auckland, New Zealand. Findings identified that there were strengths and weaknesses, as well as gaps in assessment and management of delirium. Nurses would benefit from delirium education, appropriate tools and adequate resources to help them manage delirium. Issues with diagnosing delirium, anxiety about challenging behaviours, family dynamics, lack of training and absence of IV treatment were noticeable features in this study.
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Chopra, Deepta, Kas Sempere, and Meenakshi Krishnan. Assessing Unpaid Care Work: A Participatory Toolkit. Institute of Development Studies, March 2021. http://dx.doi.org/10.19088/ids.2021.016.
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This is a participatory toolkit for understanding unpaid care work and its distribution within local communities and families. Together, these tools provide a way of ascertaining and capturing research participants’ understanding of women’s unpaid care work – giving special attention to the lived experiences of carrying out unpaid care work and receiving care. Please note that these tools were developed and used in a pre-Covid-19 era and that they are designed to be implemented through face-to-face interactions rather than online means. We developed the first iteration of these tools in our ‘Balancing Care Work and Paid Work’ project as part of the Growth of Economic Opportunities for Women (GrOW) programme. The mixed-methods project sought to collect data across four countries – India, Nepal, Tanzania, and Rwanda – with data collected in four sites in each country (16 sites in total). The participatory tools were developed with two main intentions: (1) as a data collection tool to gain a broader understanding of the social norms and perspectives of the wider community in each of the 16 sites; and (2) to be implemented with our local partners as a sensitisation tool for the community regarding women’s unpaid care work burdens. While it is not essential to apply these tools in the order that they are presented, or even all of them, we would suggest that this toolkit be used in its entirety, to gather in-depth knowledge of social norms around the distribution of unpaid care, and the impacts that these have on care providers’ lives and livelihoods.
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Bano, Masooda. In Need of Fresh Thinking: What Pratham’s Experience of Mobilising Communities Says about Current Development Thinking about Community Participation in Education. Research on Improving Systems of Education (RISE), July 2022. http://dx.doi.org/10.35489/bsg-rise-wp_2022/100.
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For more than two decades, the international development community has advocated that establishing school-based management committees to involve communities to monitor and hold teachers, principals, and district government officials accountable would improve state schooling in developing countries; yet the evidence to sustain this claim to date remains questionable. Considering the case of Pratham, the largest education NGO in India, which is widely recognised as having developed a successful model to improve learning outcomes among children in state schools and is known for doing it through active community engagement, this paper questions whether the current development thinking on best modes of engaging communities to improve learning outcomes in state schools needs fresh thinking. The paper questions the validity of the two central assumptions underpinning the school-based management model: that better-informed communities will become involved in education activities with some mobilisation and training; and that engaged communities will be able to hold to account front-line state officials, starting with teachers and principals and moving on to the district government officials. Pratham’s experience shows that dissemination of information about benefits of education does not automatically result in community engagement; instead, people are motivated to become involved on the basis of individual-based incentives. Equally, it shows that for a community to influence the actions of front-line staff, it is important to develop a co-operative and supportive relationship, instead of focusing on accountability. Pratham’s experience thus shows that there is much scope for fresh thinking within the international development community on how to engage communities in developing countries in improving learning outcomes in state schools.
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Zheng, Wanzheng, and Jason Merret. Aerodynamic Survey of Novel eVTOL Configuration Using SU2. Illinois Center for Transportation, August 2022. http://dx.doi.org/10.36501/0197-9191/22-014.
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This report summarizes computational fluid dynamics (CFD) results of electric vertical takeoff and landing (eVTOL) geometries using the SU2 Reynolds-averaged Navier-Stokes (RANS) solver. Geometries were generated based on the Smart Transportation Infrastructure Initiative (STII) Rappor 15th iteration with various rotor-installment solutions. It was found that although open rotors installed on an underwing pylon were superior to shrouded rotors installed in a canoe, the canoe configuration would provide more potential for improvement, and using a canoe door to cover the first rotor opening would reduce the drag experienced by the canoe case below that upon the rod case. Rotor doors were found to be most efficient in reducing drag of the canoe case: Average drag reduction with covering the first rotor and all rotors was 66 and 165 counts, respectively. Changing rotor distributions along the chordwise direction had minimal impact on drag reduction, and placing rotors along the spanwise direction was not advised due to the increase of the projected frontal area. Increasing canoe chord length did not have significant impact on drag reduction; and if rotor doors were implemented, increasing canoe size had negative impact on drag. Rounding rotor edges did not change the aerodynamic performance of the canoe case but promotes vertical air intake when running lifting fans. Drag received by the canoe parabolically correlated to rotor diameter, with 126 counts of drag if the rotor diameter was 0 and 377 counts if the rotor diameter was 2.95 ft. Fuselage and tail added an average 179 counts of drag, and thus the aforementioned differences were still significant in the scale of aerodynamic properties of the full configuration.
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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, July 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.
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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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Uhrig, Bettina, and Barbara Spanó. Working on impact and contributing to R&I policies – looking back and ahead. Fteval - Austrian Platform for Research and Technology Policy Evaluation, April 2022. http://dx.doi.org/10.22163/fteval.2022.557.
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This article presents impact case studies at research project and organisational levels by exploiting the Horizon Europe concept of pathways to impact and the proposed indicators. In Horizon Europe, which is the European Commission’s funding programme for research and innovation, time-sensitive Key Impact Pathways and related indicators are used as a tool for assessing the different types of impact: scientific, societal, and economic. Based on many years of experience with stakeholder engagement and impact, the authors focus on the indicators for assessing societal impact. In this way, the authors would like to contribute to the discussion on creating societal impact through research projects and institutional strategies. Leading questions are 1) Can Research & Innovation (R&I) policies be improved by using Horizon Europe Key Impact Pathways and related indicators? And 2) Can an institutional impact project and even a research project benefit from using Horizon Europe indicators and at the same time feed into R&I policies?
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Paez, Kathryn, Rachel Shapiro, Lee Thompson, Erica Shelton, Lucy Savitz, Sarah Mossburg, Susan Baseman, and Amy Lin. Health System Panel To Inform and Encourage Use of Evidence Reports: Findings From the Implementation and Evaluation of Two Evidence-Based Tools. Agency for Healthcare Research and Quality (AHRQ), August 2022. http://dx.doi.org/10.23970/ahrqepchealthsystempanel.
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Objectives. The Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) Program wants learning health systems (LHSs) to use the evidence from its reports to improve patient care. In 2018, to improve uptake of EPC Program findings, the EPC Program developed a project to enhance LHSs’ adoption of evidence to improve the quality and effectiveness of patient care. AHRQ contracted with the American Institutes for Research (AIR) and its partners to convene a panel of senior leaders from 11 LHSs to guide the development of tools to help health systems use findings from EPC evidence reports. The panel’s contributions led to developing, implementing, and evaluating two electronic tools to make the EPC report findings more accessible. AIR evaluated the LHSs’ use of the tools to understand (1) LHSs’ experiences with and impressions of the tools, (2) how well the tools helped them access evidence, and (3) how well the tools addressed barriers to LHS use of the EPC reports and barriers to applying the evidence from the reports. Data sources. (1) Implementation meetings with 6 LHSs; (2) interviews with 27 health system leaders and clinical staff who used the tools; and (3) website utilization metrics. Results. The tools were efficient and useful sources of summarized evidence to (1) inform systems change, (2) educate trainees and clinicians, (3) inform research, and (4) support shared decision making with patients and families. Clinical leaders appreciated the thoroughness and quality of the evidence reviews and view AHRQ as a trusted source of information. Participants found both tools to be valuable and complementary. Participants suggested optimizing the content for mobile device use to facilitate health system uptake of the tools. In addition, they felt it would be helpful to have training resources about tool navigation and interpreting the statistical content in the tools. Conclusions. The evaluation shows that LHSs find the tools to be useful resources for making the EPC Program reports more accessible to health system leaders. The tools have the potential to meet some, but not all, LHS evidence needs, while exposing health system leaders to AHRQ as a resource to help meet their information needs. The ability of the EPC reports to support LHSs in improving the quality of care is limited by the strength and robustness of the evidence, as well as the relevance of the report topics to patient care challenges faced by LHSs.
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Mpofu, David, Michael Ndiweni, Kwanele Moyo, Samuel Wadzai, and Marjoke Oosterom. Youth Active Citizenship for Decent Jobs: A Handbook for Policy & Practice. Institute of Development Studies (IDS), March 2022. http://dx.doi.org/10.19088/ids.2022.017.
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This Handbook has been created for development partners and civil society actors that design and implement youth employment interventions, particularly in contexts marked by fragility and political-economic crises. Youth employment programmes usually strengthen young people’s business and entrepreneurship skills. They fail to consider the civic and political competencies needed by young people in order to negotiate fair, safe, and decent working conditions and influence the wider policy environment for decent work. The Handbook offers suggestions for integrating youth active citizenship strategies into youth employment interventions, thus building young people’s civic and political skills. Adopting these strategies will strengthen the capacities of young people to engage both private sector and government actors, foster inclusion, and strengthen coalitions that can influence a enabling environment for decent jobs for youth. Recognising that many young people start their trade and businesses in theinformal economy, the Handbook takes their experiences as the point of departure. It is widely recognised that political economy matters for development and development interventions. This also applies to youth employment programming. Ideas in this Handbook recognise that politics influence youth employment opportunities. This is particularly the case in contexts commonly referred to as fragile, conflict-affected and violent settings (FCVS). Approaches to youth employment interventions need to respond to these dynamics to avoid that powerful actors capture them to serve their interests and avoid increasing risks to conflict. Moreover, the Covid-19 pandemic has proved that fragility is multidimensional and manifests in many countries across the globe. Early on in the pandemic, it quickly became clear that the informal economy would be hard hit. In addition, the challenging politics of FCVS influence opportunities for both formal and informal employment.
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McKenna, Patrick, and Mark Evans. Emergency Relief and complex service delivery: Towards better outcomes. Queensland University of Technology, June 2021. http://dx.doi.org/10.5204/rep.eprints.211133.
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Emergency Relief (ER) is a Department of Social Services (DSS) funded program, delivered by 197 community organisations (ER Providers) across Australia, to assist people facing a financial crisis with financial/material aid and referrals to other support programs. ER has been playing this important role in Australian communities since 1979. Without ER, more people living in Australia who experience a financial crisis might face further harm such as crippling debt or homelessness. The Emergency Relief National Coordination Group (NCG) was established in April 2020 at the start of the COVID-19 pandemic to advise the Minister for Families and Social Services on the implementation of ER. To inform its advice to the Minister, the NCG partnered with the Institute for Governance at the University of Canberra to conduct research to understand the issues and challenges faced by ER Providers and Service Users in local contexts across Australia. The research involved a desktop review of the existing literature on ER service provision, a large survey which all Commonwealth ER Providers were invited to participate in (and 122 responses were received), interviews with a purposive sample of 18 ER Providers, and the development of a program logic and theory of change for the Commonwealth ER program to assess progress. The surveys and interviews focussed on ER Provider perceptions of the strengths, weaknesses, future challenges, and areas of improvement for current ER provision. The trend of increasing case complexity, the effectiveness of ER service delivery models in achieving outcomes for Service Users, and the significance of volunteering in the sector were investigated. Separately, an evaluation of the performance of the NCG was conducted and a summary of the evaluation is provided as an appendix to this report. Several themes emerged from the review of the existing literature such as service delivery shortcomings in dealing with case complexity, the effectiveness of case management, and repeat requests for service. Interviews with ER workers and Service Users found that an uplift in workforce capability was required to deal with increasing case complexity, leading to recommendations for more training and service standards. Several service evaluations found that ER delivered with case management led to high Service User satisfaction, played an integral role in transforming the lives of people with complex needs, and lowered repeat requests for service. A large longitudinal quantitative study revealed that more time spent with participants substantially decreased the number of repeat requests for service; and, given that repeat requests for service can be an indicator of entrenched poverty, not accessing further services is likely to suggest improvement. The interviews identified the main strengths of ER to be the rapid response and flexible use of funds to stabilise crisis situations and connect people to other supports through strong local networks. Service Users trusted the system because of these strengths, and ER was often an access point to holistic support. There were three main weaknesses identified. First, funding contracts were too short and did not cover the full costs of the program—in particular, case management for complex cases. Second, many Service Users were dependent on ER which was inconsistent with the definition and intent of the program. Third, there was inconsistency in the level of service received by Service Users in different geographic locations. These weaknesses can be improved upon with a joined-up approach featuring co-design and collaborative governance, leading to the successful commissioning of social services. The survey confirmed that volunteers were significant for ER, making up 92% of all workers and 51% of all hours worked in respondent ER programs. Of the 122 respondents, volunteers amounted to 554 full-time equivalents, a contribution valued at $39.4 million. In total there were 8,316 volunteers working in the 122 respondent ER programs. The sector can support and upskill these volunteers (and employees in addition) by developing scalable training solutions such as online training modules, updating ER service standards, and engaging in collaborative learning arrangements where large and small ER Providers share resources. More engagement with peak bodies such as Volunteering Australia might also assist the sector to improve the focus on volunteer engagement. Integrated services achieve better outcomes for complex ER cases—97% of survey respondents either agreed or strongly agreed this was the case. The research identified the dimensions of service integration most relevant to ER Providers to be case management, referrals, the breadth of services offered internally, co-location with interrelated service providers, an established network of support, workforce capability, and Service User engagement. Providers can individually focus on increasing the level of service integration for their ER program to improve their ability to deal with complex cases, which are clearly on the rise. At the system level, a more joined-up approach can also improve service integration across Australia. The key dimensions of this finding are discussed next in more detail. Case management is key for achieving Service User outcomes for complex cases—89% of survey respondents either agreed or strongly agreed this was the case. Interviewees most frequently said they would provide more case management if they could change their service model. Case management allows for more time spent with the Service User, follow up with referral partners, and a higher level of expertise in service delivery to support complex cases. Of course, it is a costly model and not currently funded for all Service Users through ER. Where case management is not available as part of ER, it might be available through a related service that is part of a network of support. Where possible, ER Providers should facilitate access to case management for Service Users who would benefit. At a system level, ER models with a greater component of case management could be implemented as test cases. Referral systems are also key for achieving Service User outcomes, which is reflected in the ER Program Logic presented on page 31. The survey and interview data show that referrals within an integrated service (internal) or in a service hub (co-located) are most effective. Where this is not possible, warm referrals within a trusted network of support are more effective than cold referrals leading to higher take-up and beneficial Service User outcomes. However, cold referrals are most common, pointing to a weakness in ER referral systems. This is because ER Providers do not operate or co-locate with interrelated services in many cases, nor do they have the case management capacity to provide warm referrals in many other cases. For mental illness support, which interviewees identified as one of the most difficult issues to deal with, ER Providers offer an integrated service only 23% of the time, warm referrals 34% of the time, and cold referrals 43% of the time. A focus on referral systems at the individual ER Provider level, and system level through a joined-up approach, might lead to better outcomes for Service Users. The program logic and theory of change for ER have been documented with input from the research findings and included in Section 4.3 on page 31. These show that ER helps people facing a financial crisis to meet their immediate needs, avoid further harm, and access a path to recovery. The research demonstrates that ER is fundamental to supporting vulnerable people in Australia and should therefore continue to be funded by government.
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Rarasati, Niken, and Rezanti Putri Pramana. Giving Schools and Teachers Autonomy in Teacher Professional Development Under a Medium-Capability Education System. Research on Improving Systems of Education (RISE), January 2023. http://dx.doi.org/10.35489/bsg-rise-ri_2023/050.
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A mature teacher who continuously seeks improvement should be recognised as a professional who has autonomy in conducting their job and has the autonomy to engage in a professional community of practice (Hyslop-Margison and Sears, 2010). In other words, teachers’ engagement in professional development activities should be driven by their own determination rather than extrinsic sources of motivation. In this context, teachers’ self-determination can be defined as a feeling of connectedness with their own aspirations or personal values, confidence in their ability to master new skills, and a sense of autonomy in planning their own professional development path (Stupnisky et al., 2018; Eyal and Roth, 2011; Ryan and Deci, 2000). Previous studies have shown the advantages of providing teachers with autonomy to determine personal and professional improvement. Bergmark (2020) found that giving teachers the opportunity to identify areas of improvement based on teaching experience expanded the ways they think and understand themselves as teachers and how they can improve their teaching. Teachers who plan their own improvement showed a higher level of curiosity in learning and trying out new things. Bergmark (2020) also shows that a continuous cycle of reflection and teaching improvement allows teachers to recognise that the perfect lesson does not exist. Hence, continuous reflection and improvement are needed to shape the lesson to meet various classroom contexts. Moreover, Cheon et al. (2018) found that increased teacher autonomy led to greater teaching efficacy and a greater tendency to adopt intrinsic (relative to extrinsic) instructional goals. In developed countries, teacher autonomy is present and has become part of teachers’ professional life and schools’ development plans. In Finland, for example, the government is responsible for providing resources and services that schools request, while school development and teachers’ professional learning are integrated into a day-to-day “experiment” performed collaboratively by teachers and principals (Niemi, 2015). This kind of experience gives teachers a sense of mastery and boosts their determination to continuously learn (Ryan and Deci, 2000). In low-performing countries, distributing autonomy of education quality improvement to schools and teachers negatively correlates with the countries’ education outcomes (Hanushek et al., 2011). This study also suggests that education outcome accountability and teacher capacity are necessary to ensure the provision of autonomy to improve education quality. However, to have teachers who can meet dynamic educational challenges through continuous learning, de Klerk & Barnett (2020) suggest that developing countries include programmes that could nurture teachers’ agency to learn in addition to the regular content and pedagogical-focused teacher training materials. Giving autonomy to teachers can be challenging in an environment where accountability or performance is measured by narrow considerations (teacher exam score, administrative completion, etc.). As is the case in Jakarta, the capital city of Indonesia, teachers tend to attend training to meet performance evaluation administrative criteria rather than to address specific professional development needs (Dymoke and Harrison, 2006). Generally, the focus of the training relies on what the government believes will benefit their teaching workforce. Teacher professional development (TPD) is merely an assignment for Jakarta teachers. Most teachers attend the training only to obtain attendance certificates that can be credited towards their additional performance allowance. Consequently, those teachers will only reproduce teaching practices that they have experienced or observed from their seniors. As in other similar professional development systems, improvement in teaching quality at schools is less likely to happen (Hargreaves, 2000). Most of the trainings were led by external experts or academics who did not interact with teachers on a day-to-day basis. This approach to professional development represents a top-down mechanism where teacher training was designed independently from teaching context and therefore appears to be overly abstract, unpractical, and not useful for teachers (Timperley, 2011). Moreover, the lack of relevancy between teacher training and teaching practice leads to teachers’ low ownership of the professional development process (Bergmark, 2020). More broadly, in the Jakarta education system, especially the public school system, autonomy was never given to schools and teachers prior to establishing the new TPD system in 2021. The system employed a top-down relationship between the local education agency, teacher training centres, principals, and teachers. Professional development plans were usually motivated by a low teacher competency score or budgeted teacher professional development programme. Guided by the scores, the training centres organised training that could address knowledge areas that most of Jakarta's teachers lack. In many cases, to fulfil the quota as planned in the budget, the local education agency and the training centres would instruct principals to assign two teachers to certain training without knowing their needs. Realizing that the system was not functioning, Jakarta’s local education agency decided to create a reform that gives more autonomy toward schools and teachers in determining teacher professional development plan. The new system has been piloted since November 2021. To maintain the balance between administrative evaluation and addressing professional development needs, the new initiative highlights the key role played by head teachers or principals. This is based on assumption that principals who have the opportunity to observe teaching practice closely could help teachers reflect and develop their professionalism. (Dymoke and Harrison, 2006). As explained by the professional development case in Finland, leadership and collegial collaboration are also critical to shaping a school culture that could support the development of professional autonomy. The collective energies among teachers and the principal will also direct the teacher toward improving teaching, learning, and caring for students and parents (Hyslop-Margison and Sears, 2010; Hargreaves, 2000). Thus, the new TPD system in Jakarta adopts the feature of collegial collaboration. This is considered as imperative in Jakarta where teachers used to be controlled and join a professional development activity due to external forces. Learning autonomy did not exist within themselves. Hence, teachers need a leader who can turn the "professional development regulation" into a culture at schools. The process will shape teachers to do professional development quite autonomously (Deci et al., 2001). In this case, a controlling leadership style will hinder teachers’ autonomous motivation. Instead, principals should articulate a clear vision, consider teachers' individual needs and aspirations, inspire, and support professional development activities (Eyal and Roth, 2011). This can also be called creating a professional culture at schools (Fullan, 1996). In this Note, we aim to understand how the schools and teachers respond to the new teacher professional development system. We compare experience and motivation of different characteristics of teachers.