Clinical application of penicillin

Mostly reprintsIncludes bibliographical references.10 pts. in 1 v.Title page and introduction only. The complete thesis in print form is available from the University Library.Thesis (M.D.)--University of Adelaide, Dept. of Medicin

A Home-Start peer support scheme for women with low mood following childbirth

Perinatal mental health problems vary in impact and severity, and can have long-lasting effects on maternal health and child psychological health and development. The evidence to support the effectiveness of postnatal peer and volunteer support schemes to improve the long-term health of women is mixed, with some studies highlighting positive effects in terms of reducing symptoms of depression. Using data from a peer support scheme designed to support women with low mood following childbirth, this paper provides insight into the initial support needs of women, alongside the challenges of using volunteer and peer support services. This paper provides health visitors and others working in community settings with an understanding of how volunteer befriending services may, or may not work in community settings. The data suggests that Home-Start does have a positive impact on the lives of some women, however more work is required in order to understand which aspects of the Home-Start intervention women find effective and why

A qualitative evaluation of home based contraceptive and sexual health care for teenage mothers

This paper reports on the findings from a qualitative study exploring the experiences of teenage mothers using a nurse-led, home-based contraceptive service designed to prevent repeat unplanned pregnancies. The aim was to understand if, and how the service was effective in equipping teenage mothers to make informed choices about contraception, thus preventing a second pregnancy. Unplanned teenage pregnancy remains a significant focus of health and social policy in the United Kingdom (UK). Despite the long-term pattern of declining conception rates, the UK continues to report higher rates than comparable countries elsewhere in Europe. Current estimates suggest that approximately one fifth of births amongst under 18’s are repeat pregnancies (Teenage Pregnancy Independent Advisory Group, 2009). Services that are designed to reduce second unplanned pregnancies are an important element in promoting teenage sexual health. However, there has been no UK research that explores this kind of service and the experiences of service users. We conducted a qualitative interview study. From 2013–2014 we interviewed 40 teenage mothers who had engaged with the nurse-led, home-based contraceptive service. The data demonstrates that the service was effective in preventing repeat pregnancies in a number of cases. Among the aspects of the service which were found to contribute to its effectiveness were privacy, convenience, flexibility, appropriately timed access, the non-judgemental attitude of staff and ongoing support

The information worlds of a disadvantaged community

Information seeking in context is a developing area of research, which explores the subject in settings ranging from high schools to legal practices to health organisations. Relatively little research, however, has been devoted to information behaviour in disadvantaged communities from a non-library perspective, particularly within a UK context. This study contributes to this field of research by exploring the information worlds — the everyday lives and information behaviour — of people living on a disadvantaged estate in Northeast England. The project was firmly rooted within the qualitative paradigm and employed a combination of ethnographic data collection methods to explore information behaviour including episodic narrative and extended participant observation. Interviews were carried out with 21 estate residents and with 13 key workers. The study discovered that everyday life on the estate was difficult and complex, a fact mirrored in the participants' information needs and in their information seeking behaviour. Cognitive information needs stemmed from everyday life issues such as debts, employment and health problems and were often met only with affective support from informal networks of family, friends and trusted on-estate regeneration workers. Trust was a major factor in information seeking owing to the insular nature of the estate and the participants' need for confidentiality and privacy. Participants often used the term information to indicate what was happening on the estate in terms of gossip and local news, but they also found the term a worrying one, associating it with intrusive questioning and with formal institutions. Formal, off-estate information providers were used for health reasons or in crisis situations, and the public library was not considered as an information source. In order to overcome the many barriers to information seeking, information providers need to focus on working in ongoing partnership with other agencies and on developing trusting relationships with people within their communities

Identifying longitudinal sustainable hierarchies in activities of daily living

© 2017 Elsevier B.V. Activities of daily living serve as an indicator of progression in disability and rehabilitation. It is know that some of the measurement scales used show hierarchical properties indicating that activities of daily living are lost and gained in a consistent pattern. Few studies have investigated the extent to which these patterns are sustained across time and across a range of disability. The study aimed to investigate the hierarchical properties of the activity of daily living items in the ValGraf functional ability scale, to establish if there is a hierarchy of items in the scale and to study the sustainability of the hierarchy over time. Secondary analysis of a retrospective database from 13,113 people over 65 years in 105 nursing homes in northern Italy, between 2008 and 2013 was conducted. Data were gathered 6-monthly and analysed using Mokken scaling to identify a hierarchy of items in the scale and if this was sustainable over time. A sustainable hierarchy of items was observed running in difficulty from urinary incontinence to feeding. The hierarchical structure of the activities of daily living observed in the present study is stable over time meaning that changes in total score for these items can be compared meaningfully across time

Institutional thickening and innovation: reflections on the remapping of the Great Bear Rainforest

The information, practices and views in this article are those of the author(s) and do not necessarily reflect the opinion of the Royal Geographical Society (with IBG). © 2016 Royal Geographical Society (with the Institute of British Geographers) As a response to forest conflict, contemporary remapping refers to re-evaluations of resource values, new and diverse forms of governance among stakeholders, and compromises within patterns of land use that give greater emphasis to environmental and cultural priorities. This paper elaborates the processes of remapping by examining the role of institutional innovation in conflict resolution, with particular reference to the iconic Great Bear Rainforest of British Columbia. After years of conflict and protest, peace in the Great Bear Rainforest was heralded by an interim agreement in 2006, with final ratification likely in 2016. Conceptually, a four-legged stakeholder model identifies the main institutional interests and their interactions through learning and bargaining. New forms of governance were created to bring the stakeholders together in constructive dialogue and then to reach and implement acceptable bargains. Analytically, the paper examines how this agreement has worked in practice by reflecting on the emergence of novel institutions that integrate the interests of key stakeholders. The discussion identifies six bilateral negotiations between: industrial and environmental interests; federal and provincial governments and aboriginal peoples; government and environmental interests; government and industry; industry and aboriginal peoples; and environmental groups and local communities. The remapping process has produced a thickening architecture of institutions that remain experimental even as they seek to promote sustainability, resilience and legitimacy

An integrative review on women living with obstetric fistula and after treatment experiences

Aims and objectives. To review literature on the experiences of women with obstetric fistula, their lived experiences after treatment; and to provide evidence for future research. Background. Obstetric fistula is an injury most commonly resulting from a pro-longed labour. Long eradicated in developed countries, obstetric fistula remains a public health issue in sub-Saharan Africa and Asia. This is a highly stigmatised health condition, and an understanding of the women’s experience is required to inform holistic approaches for care and prevention. Design. An integrative review. Data sources. EBSCO host (Academic Search Premier, MEDLINE, PsychINFO, CINAHL), Web of Science; Grey literature and websites of international organisa-tions such as Women’s Dignity Project and EngenderHealth. Keywords, inclusion and exclusion criteria were defined and 25 articles published from 2004–January 2015 were identified. Review method. The review was guided by Whittemore and Knafl’s revised ana-lytical framework. All articles were assessed for methodological quality and criti-cally analysed to elicit emergent themes and subthemes. Results. Three broad themes were identified: challenges of living with fistula; treatment and care experiences; and reintegration experiences of women after fis-tula repair. Conclusions. Living with a fistula presents multidimensional consequences affect-ing women, families and communities. Accessing treatment is difficult, and there are no standardised treatment packages. Surgical repairs were variable in their success rate. Some authors claim women resume normal lives irrespective of their continence status, whilst others claim they face discrimination despite being conti-nent, thereby hindering reintegration. Quality of life is diminished for those remaining incontinent. Postrepair psychosocial support services are beneficial for reintegration, but research on programme benefits is limited. Therefore, further research is required to support its benefits and for policy development to meet care provision for women with fistula

Functional decline in residents living in nursing homes : a systematic review of the literature

Objectives To describe the functional dependence progression over time in older people living in nursing homes (NHs). Design A systematic review of the literature was performed. Studies involving individuals 65 years and older living in NHs, describing their functional decline, improvement or stability in activities of daily living (ADLs), were eligible. The search strategy was applied in MedLine, Cochrane, CINAHL, and SCOPUS databases; aimed at identifying an unbiased and complete list of studies, searching by hand was also performed. The methodological quality of the 27 studies included was assessed. Results Functional trajectories were documented mainly through multicenter study design including sample size ranging from 2 to 9336 NHs, from 1983 to 2011 throughout a single or multiple follow-ups (>20). The average rate of decline was expressed in different metrics and periods of time: from 3 months with a decline of −0.13 points of 28, to 6 months (−1.78 points of 2829) to 1.85 years (−0.5 points of 6). Eating and toileting were the most documented ADLs and the decline is approximately 0.4 points and 0.2 to 0.4 points of 5 a year, respectively. Among the covariates, individual factors, such as cognitive status, were mainly considered, whereas only 13 studies considered facility-level factors. Conclusions Findings report the slow functional decline mainly in women living in US NHs, in years when residents were admitted with a low or medium degree of functional dependence. Considering that in recent years residents have been admitted to NHs with higher-level functional dependence, studies measuring each single ADL, using standardized instruments capable of capturing the signs of decline, stability, or improvement are strongly recommended. Among the covariates, evaluation of both individual and facility-level factors, which may affect functional decline, is also suggested

Perverse pleasures: Spectatorship- The blair witch project

Student Number : 9803476V - MA research report - School of Arts - Faculty of HumanitiesBy drawing on contemporary scholarship that addresses spectatorship in the cinema generally, and in the horror genre specifically, I analyze the perverse pleasure afforded by The Blair Witch Project. To do this I argue that pleasure in horror is afforded through the masochistic positioning of the viewer, especially in relation to psychoanalytic theories surrounding gender in spectator positioning. I also look at the way the film re-deploys conventions, both documentary conceptions of the ‘real’, as well as generic expectations of horror, to activate the perverse pleasure of horror