120 results on '"Sixsmith, J"'
Search Results
2. Laser Wire Deposition of Thick Ti-6Al-4V Buildups: Heat Transfer Model, Microstructure, and Mechanical Properties Evaluations
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Chekir, N., Tian, Y., Gauvin, R., Brodusch, N., Sixsmith, J. J., and Brochu, M.
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- 2018
- Full Text
- View/download PDF
3. Water observations from space: Mapping surface water from 25 years of Landsat imagery across Australia
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Mueller, N., Lewis, A., Roberts, D., Ring, S., Melrose, R., Sixsmith, J., Lymburner, L., McIntyre, A., Tan, P., Curnow, S., and Ip, A.
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- 2016
- Full Text
- View/download PDF
4. Advanced Tip Repair of Single Crystal HPT Blades With LW3 and LW4280 Welding Materials
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Chan, Anthony, additional, Gontcharov, Alexandre, additional, Lowden, Paul, additional, Mikolajewski, Thomas, additional, Sixsmith, J. J., additional, Tollett, Robert, additional, and Greer, Clayton, additional
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- 2022
- Full Text
- View/download PDF
5. ‘I wouldn't choose this work again’: Perspectives and experiences of care aides in long‐term residential care
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Booi, L, Sixsmith, J, Chaudhury, H, O’Connor, D, Young, M, Sixsmith, A, Booi, L, Sixsmith, J, Chaudhury, H, O’Connor, D, Young, M, and Sixsmith, A
- Abstract
Aims To provide insight into the everyday realities facing care aides working in long-term residential care (LTRC), and how they perceive their role in society. Design A qualitative ethnographic case study. Methods Data were collected over. 10 months of fieldwork at one LTRC setting [September 2015 to June 2016] in Western Canada; semi-structured interviews (70 h) with 31 care aides; and naturalistic observation (170 h). Data were analysed using reflexive thematic analysis. Results The findings in this work highlight the underpinned ageism of society, the gendered work of body care, and the tension between the need for relational connections – which requires time and economic profit. Four themes were identified, each relating to the lack of training, support, and appreciation care aides felt about their role in LTRC. Conclusion Care aides remain an unsupported workforce that is essential to the provision of high-quality care in LTRC. To support the care aide role, suggestions include: (i) regulate and improve care aide training; (ii) strengthen care aides autonomy of their care delivery; and (iii) reduce stigma by increasing awareness of the care aide role. Impact What problem did the study address? The unsupportive working conditions care aides experience in LTRC and the subsequent poor quality of care often seen delivered in LTRC settings. What were the main findings? Although care aides express strong affection for the residents they care for, they experience insurmountable systemic and institutional barriers preventing them from delivering care. Where and on whom will the research have impact? Care aides, care aide educators, care aide supervisors and managers in LTRC, retirement communities, and home care settings.
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- 2021
6. Integrating sense of place within new housing developments: a community-based participatory research approach
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Lan Fang, M., Sixsmith, J., Woolrych, R., Canham, S. L., Lupin Battersby, Hui Ren, T., and Sixsmith, A.
- Abstract
This chapter looks at a Canadian project which critically explores the potential of an action-oriented, community-based participatory research (CBPR) approach to reveal ways in which communities can be resilient to the opportunities and challenges of ageing-in-place. As part of the ‘Place-making with Seniors’ housing redevelopment project, a CBPR approach was applied in order to understand the sense of place of older adults through multiple vantage points. This resulted in a number of positive outcomes that revealed how community resilience and empowerment, articulated through participants' voices within the action research project, transformed the redevelopment in ways that were beneficial for older adults. As such, and in recognition of community requirements and aspirations, a number of changes were implemented so as to create a better living environment for older tenants.
- Published
- 2018
7. TRANSDISCIPLINARY RESEARCH IN AGING AND TECHNOLOGY: EXPERIENCES FROM A PAN-CANADIAN RESEARCH NETWORK
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Grigorovich, A, Wada, M, Sixsmith, J, Fang, M, and Kontos, P
- Subjects
Abstracts - Abstract
There has been a call for transdisciplinary research in aging and technology to enhance knowledge mobilization and commercialization of new technologies. This team-based approach is relatively new to the field of aging and technology and there is limited understanding of its practices, and how to facilitate its implementation in this field. To address this knowledge gap, this longitudinal qualitative study explored how members of a pan-Canadian Network of Centres of Excellence on aging and technology perceived and experienced transdisciplinary research. Thirty individuals from varied disciplinary backgrounds, research roles, and career stages participated in two semi-structured interviews, conducted 1 year apart. Interview data were analysed using thematic analysis. Four key themes were identified: misunderstandings of transdisciplinary principles; perceived challenges; perceived benefits; and best practices. Many participants misunderstood transdisciplinary principles and what these entailed in practice. Even when participants understood transdisciplinary principles, there were contradictions or tensions between understanding and implementation in practice. They also identified multiple individual and structural level challenges and barriers to practicing transdisciplinary research in aging and technology, including miscommunication among diverse team members, tensions between academic and other institutional reward mechanisms and practices, and the lack of structural support. However, participants also identified several benefits to transdisciplinary research in aging and technology, including enhanced opportunities for cross-disciplinary and cross-sectoral knowledge exchange and improved capacity to holistically understand and solve complex problems. Examples of promising practices where transdisciplinary principles were effectively implemented were also identified. Implications of these findings for policy and practice will be discussed.
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- 2018
8. EXPLORING TRANSNATIONAL UNDERSTANDINGS OF AGE-FRIENDLY CITIES AND COMMUNITIES
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Menezes, D, primary, Woolrych, R, additional, Makita, M, additional, Sixsmith, J, additional, Murray, M, additional, Smith, H, additional, Reddy, S, additional, and Duvvuru, J, additional
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- 2018
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9. EXPERIENCES OF SOCIAL PARTICIPATION AND PLACE AMONG OLDER ADULTS LIVING IN URBAN NEIGHBOURHOODS IN THE UK AND BRAZIL
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Woolrych, R, primary, Fisher, J, additional, Lawthom, R, additional, Sixsmith, J, additional, Makita, M, additional, Portella, A, additional, Pereira, G, additional, and Murray, M, additional
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- 2018
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10. Measuring the violence prevention climate: Development and evaluation of the VPC-14
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Hallett, N, Huber, J, Sixsmith, J, Dickens, GL, Hallett, N, Huber, J, Sixsmith, J, and Dickens, GL
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© 2018 Elsevier Ltd. Background: Violence and aggression are common in inpatient mental health hospital settings and cause problems for staff, patients and organisations. An important factor in treatment efficacy is ward atmosphere, and one element of this is the violence prevention climate. Objectives: To develop and test the psychometric properties of a new scale to measure perceptions of the violence prevention climate among staff and patients in mental health inpatient settings. Design: Scale development and cross-sectional validation study. Setting and participants: Three hospital sites within an independent sector provider of secure mental health care. Participants were patients and staff residing in/working on wards in the adult male and female mental health care pathways. Methods: The study was conducted in three stages: scale development, pilot testing and psychometric evaluation. The scale items were developed from systematic literature review, informant interviews (staff) and focus groups (patients) and expert review. The resulting scale was subject to pilot testing with staff and patients (n = 58 and n = 25). The reliability and validity of the scale was examined by administering it to 326 staff and 95 patients. Exploratory factor analysis was used to establish construct validity, and this was further assessed with Rasch modelling. Internal consistency was assessed by calculation of Cronbach's alpha coefficients. Convergent and discriminant validity were measured by comparing results with existing validated instruments. Temporal stability of the items was assessed using test-retest reliability coefficients. Results: The VPC-14 is a 14-item scale demonstrating good psychometric properties. Exploratory factor analysis revealed two subscales, staff actions and patient actions, each demonstrating good internal consistency (Cronbach's alpha.89 and.76). All items demonstrated good temporal stability. Rasch modelling confirmed the unidimensionality of the two s
- Published
- 2018
11. Age-Friendly Cities and Communities: Exploring Gaps, Challenges and Opportunities
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Woolrych, R., Fisher, J., Sixsmith, J., Murray, M., Lawthorn, R., Harry Smith, and Soledad Garcia-Ferrari
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- 2016
12. Defining and evaluating transdisciplinary research: implications for aging and technology
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Grigorovich, A., primary, Fang, M. L., additional, Sixsmith, J., additional, and Kontos, P., additional
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- 2018
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13. Exploring the potential of smart cities in the design of age-friendly urban environments
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Woolrych, R., primary, Sixsmith, J., additional, Makita, M., additional, Fisher, J., additional, and Lawthom, R., additional
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- 2018
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14. 42 The value of a night service for hospice at home; reasons for making contact at night
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Spiro, SG, primary, Ward, A, additional, Sixsmith, J, additional, and Graham, A, additional
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- 2018
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15. 39 The cost of a night nursing service at rennie grove hospice care, and the total community cost of care at home compared to an admission to hospital
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Varvel, S, primary, Spiro, SG, additional, Graham, A, additional, Sixsmith, J, additional, and Ward, A, additional
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- 2018
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16. 40 How satisfied are carers/families with a night team service as part of 24/7 hospice at home care?
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Varvel, S, primary, Ward, A, additional, Sixsmith, J, additional, Graham, A, additional, and Spiro, SG, additional
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- 2018
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17. 41 Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?
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Spiro, SG, primary, Ward, A, additional, Graham, A, additional, and Sixsmith, J, additional
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- 2018
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18. The Australian Geoscience Data Cube - foundations and lessons learned
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Lewis, Adam, Oliver, Simon, Lymburner, Leo, Evans, Benjamin, Wyborn, Lesley, Mueller, Norman, Roberts, Dale, Trenham, Claire, Sixsmith, J, Wu, Wenjun, Tan, K P, Lewis, Adam, Oliver, Simon, Lymburner, Leo, Evans, Benjamin, Wyborn, Lesley, Mueller, Norman, Roberts, Dale, Trenham, Claire, Sixsmith, J, Wu, Wenjun, and Tan, K P
- Abstract
The Australian Geoscience Data Cube (AGDC) aims to realise the full potential of Earth observation data holdings by addressing the Big Data challenges of volume, velocity, and variety that otherwise limit the usefulness of Earth observation data. There have been several iterations and AGDC version 2 is a major advance on previous work. The foundations and core components of the data cube are: (1) data preparation, including geometric and spectral radiometric corrections to Earth observation data to produce standardised surface reflectance measurements that support time-series analysis, and collection management systems which track the provenance each data cube product and formalise re-processing decisions; (2) the software environment used to manage and interact with the data, including a minimal relational model that uses ‘not-only-SQL’ to simplify the process of adding new datasets to the data cube, or to simply ‘reference’ external datasets; and (3) the supporting, integrated, high performance computing - high performance data environment (HPC-HPD) provided by the Australian National Computational Infrastructure which supports both large scale analysis within the NCI, and direct access to data using standards-based web services. A growing number of exemplars demonstrate that the data cube approach allows analysts to extract rich new information from Earth observation time series, including through new methods that draw on the full spatial and temporal coverage of the Earth observation archives. To enable easy-uptake of the AGDC, and to facilitate future cooperative development, our code is developed under an open-source, Apache License, Version 2.0. This open-source approach is enabling other organisations, including the Committee on Earth Observing Satellites (CEOS), to explore the use of similar data cubes in developing countries.
- Published
- 2017
19. ENHANCING KNOWLEDGE MOBILIZATION AND COMMERCIAL OUTCOMES IN AGING AND TECHNOLOGY
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Fang, M., primary, Battersby, L., additional, Grigorovich, A., additional, Sixsmith, J., additional, Kontos, P., additional, Moreno, L., additional, Mihailidis, A., additional, and Sixsmith, A., additional
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- 2017
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20. INVOLVING OLDER ADULTS IN TECHNOLOGY RESEARCH AND DEVELOPMENT (OA-INVOLVE): AGE-WELL
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Ishigami-Doyle, Y., primary, Panek, I., additional, Battersby, L., additional, O’Doherty, K., additional, Kontos, P., additional, Sixsmith, J., additional, and Kirkland, S., additional
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- 2017
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21. TRANSLATING RESEARCH BACK TO THE COMMUNITY: FINDINGS FROM A REALIST REVIEW
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Canham, S.L., primary, Wilson, R., additional, Battersby, L., additional, Fang, M., additional, Sixsmith, J., additional, and Sixsmith, A., additional
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- 2017
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22. PERSPECTIVE WORKSHOPS: CO-CREATING SERVICE SOLUTIONS FOR SENIORS IN AFFORDABLE HOUSING
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Fang, M., primary, Canham, S.L., additional, Battersby, L., additional, Woolrych, R., additional, Sixsmith, J., additional, and Sixsmith, A., additional
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- 2017
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23. LEVELS OF OLDER ADULTS’ ENGAGEMENT IN TECHNOLOGY RESEARCH, DESIGN AND DEVELOPMENT: A SCOPING REVIEW
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Panek, I., primary, Crumley, E.T., additional, Ishigami-Doyle, Y., additional, Sixsmith, J., additional, Kontos, P., additional, O’Doherty, K., additional, and Kirkland, S., additional
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- 2017
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24. THE TREAT SCALE: A REFLEXIVE TOOL FOR TRANSDISCIPLINARY WORKING IN AGING AND TECHNOLOGY RESEARCH
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Grigorovich, A., primary, Fang, M., additional, Sixsmith, J., additional, and Kontos, P., additional
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- 2017
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25. Experiencing 'pathologized presence and normalized absence'; Understanding health related experiences and access to health care among Iraqi and Somali asylum seekers, refugees and persons without legal status Health behavior, health promotion and society
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Fang, ML, Sixsmith, J, Lawthom, R, Mountian, I, and Shahrin, A
- Abstract
© 2015 Fang et al.Background: Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of 'othering'. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting 'minoritization' processes and the 'pathologization' of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities. Methods: For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status. Results: The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation. Discussions: Macro- and micro-level intersections of accustomed societal beliefs, practices and norms, broad-levellegislation and policy decisions, and health care and social services delivery methods have affected the health and health care experiences of forced migrants that reside in the UK. Research highlights how 'minoritization processes,' influencing the intersections between social identities, can hinder access to and delivery of health and social services to vulnerable groups. Similar findings were reported here; and the most influential mechanism directly impacting health and access to health and social services was legal status. Conclusions: Equitable health care provision requires systemic change that incorporate understandings of marginalization, 'othering' processes and the intersections between the past histories and everyday realities of asylum seekers, refugees and persons without legal status.
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- 2015
26. Defining and evaluating transdisciplinary research: implications for aging and technology.
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Grigorovich, A., Fang, M. L., Sixsmith, J., and Kontos, P.
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DECISION making ,DIFFUSION of innovations ,HEALTH ,INTELLECT ,INTERDISCIPLINARY research ,INTERPERSONAL relations ,MEDICAL technology ,MEDLINE ,QUALITY of life ,RESEARCH funding ,HEALTH self-care ,SYSTEMATIC reviews ,LITERATURE reviews ,ACTIVE aging ,EVALUATION - Abstract
Purpose: Transdisciplinary research has the potential to enhance the real-world impact of the field of aging and technology. This is a context-driven and problem-focused approach to knowledge production that involves collaboration across scientific disciplines and academic and nonacademic sectors. To sustain broader implementation of this approach, a scoping review was conducted on the impact of this approach on research processes, outcomes and uptake. Materials and Methods: A systematic search was conducted of aging, health/medicine, and technology literatures indexed in three electronic data bases (Medline/OVID, EBSCO, ProQuest) from 1 January 2005 to 31 December 2015. Search terms included three themes: (1) transdisciplinarity; (2) research outcomes and (3) social change. Results: Twenty articles met the inclusion criteria. We found that a transdisciplinary approach to research enhances integration of diverse knowledge, scientific and extra-scientific outcomes, capacity to engage in translational research and the uptake of research knowledge. We also identified a number of facilitators and barriers to successful implementation of this approach. No articles evaluating transdisciplinary research specifically in the context of aging and technology were found. Conclusions: Adoption of transdisciplinary research in aging and technology may foster greater uptake of technological innovation in the real-world by supporting integration of diverse knowledge and enhancing engagement of experiential and nonacademic stakeholders in the research and development process. However, supporting successful implementation of this approach requires investment of personal and structural resources. More research is needed to better understand the evidence base on the adoption of this approach in aging and technology projects. Transdisciplinary research is context-driven and problem-focused and involves collaboration between academic and non-academic sectors. A transdisciplinary approach can enhance knowledge integration, scientific productivity and capacity and public involvement in research. Future research is needed to determine the effectiveness of transdisciplinarity for optimizing the development and uptake of assistive technologies. [ABSTRACT FROM AUTHOR]
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- 2019
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27. Age-Friendly Cities and Communities: Exploring Gaps, Challenges and Opportunities
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Fisher, JC, Lawthom, R, Woolrych, R, Sixsmith, J, Murray, M, Smith, H, Garcia-Ferrari, S, Fisher, JC, Lawthom, R, Woolrych, R, Sixsmith, J, Murray, M, Smith, H, and Garcia-Ferrari, S
- Published
- 2016
28. Water observations from space: Mapping surface water from 25 years of Landsat imagery across Australia
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Mueller, Norman, Lewis, Adam, Roberts, Dale, Ring, Steven, Melrose, R, Sixsmith, J, Lymburner, Leo, McIntyre, A, Tan, K P, Curnow, S, Ip, Alex, Mueller, Norman, Lewis, Adam, Roberts, Dale, Ring, Steven, Melrose, R, Sixsmith, J, Lymburner, Leo, McIntyre, A, Tan, K P, Curnow, S, and Ip, Alex
- Abstract
Following extreme flooding in eastern Australia in 2011, the Australian Government established a programme to improve access to flood information across Australia. As part of this, a project was undertaken to map the extent of surface water across Australia using the multi-decadal archive of Landsat satellite imagery. A water detection algorithm was used based on a decision tree classifier, and a comparison methodology using a logistic regression. This approach provided an understanding of the confidence in the water observations. The results were used to map the presence of surface water across the entire continent from every observation of 27 years of satellite imagery. The Water Observation from Space (WOfS) product provides insight into the behaviour of surface water across Australia through time, demonstrating where water is persistent, such as in reservoirs, and where it is ephemeral, such as on floodplains during a flood. In addition the WOfS product is useful for studies of wetland extent, aquatic species behaviour, hydrological models, land surface process modelling and groundwater recharge. This paper describes the WOfS methodology and shows how similar time-series analyses of nationally significant environmental variables might be conducted at the continental scale.
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- 2016
29. Experiencing 'pathologized presence and normalized absence'; Understanding health related experiences and access to health care among Iraqi and Somali asylum seekers, refugees and persons without legal status
- Author
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Fang, ML, Sixsmith, J, Lawthom, R, Mountian, I, Shahrin, A, Fang, ML, Sixsmith, J, Lawthom, R, Mountian, I, and Shahrin, A
- Abstract
© 2015 Fang et al.Background: Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of 'othering'. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting 'minoritization' processes and the 'pathologization' of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities. Methods: For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status. Results: The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation. Discussions
- Published
- 2015
30. ‘A plague of our times’: Addressing health-related lifestyle choices in England
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Callender, M, primary and Sixsmith, J, additional
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- 2015
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31. Understanding Dementia within National Dementia Policy in England: A Critical Discourse Analysis
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Sixsmith, J, primary and Callender, M, additional
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- 2015
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32. “No Home, No Place”: Addressing the Complexity of Homelessness in Old Age Through Community Dialogue
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Woolrych, R., primary, Gibson, N., additional, Sixsmith, J., additional, and Sixsmith, A., additional
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- 2015
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33. Facilitating error recognition and patient safety awareness in pre-registration physiotherapy students using video reflexive ethnography and simulation-based education
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Gough, S., primary, Yohannes, A., additional, Roberts, P., additional, Murrray, J., additional, and Sixsmith, J., additional
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- 2015
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34. Paid work, life-work and leisure: a study of wellbeing in the context of academic lives in higher education.
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Siddiquee, A., Sixsmith, J., Lawthom, R., and Haworth, J.
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HIGHER education , *LEISURE industry , *LEISURE class , *DATA analysis , *WELL-being - Abstract
Living, working, leisure, and well-being are of increasing concern to educators, policy-makers, governments and people generally. The aim of this research note is to investigate the relationships between paid work, life work and leisure in terms of well-being associated with activity. The research used a modified experience sampling method for a one-week period with a staff group based in an educational institution. The data collection period included a bank holiday (three days holiday and four days work). A mobile phone was used to collect data eight times a day, over seven days, on activity, enjoyment, interest, visual interest, challenge, skill and happiness. Data analysis showed a significant correlation between enjoyment and happiness; enjoyment and interest; and visual interest, which also correlated with happiness. Enjoyment and happiness were experienced more in leisure than in paid work and life work. Level of enjoyment was greatest when skills were greater than moderate challenge in activity, though high enjoyment was more frequent when moderate and high challenge were met with equal skills (satisfying conditions of ‘flow’). High enjoyment came as much from paid work as from leisure. The findings replicate and extend earlier research, and the research note emphasises the importance of measures of enjoyment in the investigation of national wellbeing. [ABSTRACT FROM PUBLISHER]
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- 2016
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35. Laser Wire Deposition of a Large Ti-6Al-4V Space Component.
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CHEKIR, N., SIXSMITH, J. J., TOLLETT, R., and BROCHU, M.
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LASER deposition ,HEAT treatment of metals ,MANUFACTURING processes ,LEAD time (Supply chain management) ,THREE-dimensional printing ,REQUIREMENTS engineering ,METALLURGY - Published
- 2019
36. An intersectional place perspective for AgeTech Research, policy and practice.
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Fang, M. L., Sixsmith, J. S., and Woolrych, R.
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- 2020
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37. A theoretical grounding for AgeTech research: The inclusion of older people as experiential stakeholders.
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Sixsmith, J. A. and Fang, M. L.
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- 2020
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38. 41 Does a 24/7 hospice at home service prevent or postpone acute hospital admissions?
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Spiro, SG, Ward, A, Graham, A, and Sixsmith, J
- Abstract
BackgroundMost people wish to die at home but in England almost 50% die in hospital, suggesting that more can be done to keep people at home. Some studies have shown this may be possible, especially with adequate support and good pain control.MethodsRennie Grove Hospice Care carried out an independent study to identify the value of their night team in providing 24/7 care over a period of 145 nights. The study considered whether the provision of overnight care affected decisions to make hospital admissions. Data from a night nurse template recording all overnight visits, a review of 42 patient/carer records of those who had called the night team, a carer questionnaire (n=87), carer interviews (n=18) and staff interviews (n=9), were analysed.ResultsThe night nurse template recorded 5 overnight admissions made during the study period, all for acute reasons and considered unavoidable. Review of 42 patient records showed 23 hospital/hospice admissions occurred, most during the daytime (18 to hospital, 5 to a hospice) of which only 3 were considered avoidable. The carer questionnaires showed 13 (16%) of their cared for persons had been admitted to hospital in the last few weeks of life, with most reporting the admission was necessary. Staff interviews identified a pride in supporting patients to stay at home, while information from carers gave a clear indication that Rennie Grove nurses enabled their cared for individual to remain at home; that contact with the night team helped prevent or postpone an admission; and without Rennie Grove their alternative would have been 111/999, district nurse or out-of-hours GP.ConclusionsThere are occasions when hospital admission is appropriate. However, there was clear evidence showing support from the night team could prevent or postpone hospital admissions.
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- 2018
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39. 42 The value of a night service for hospice at home; reasons for making contact at night
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Spiro, SG, Ward, A, Sixsmith, J, and Graham, A
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BackgroundPeople approaching the end of their lives have physical and psychological needs that should be met in a timely way, at any point during the night or day, and met in a way which addresses their needs and preferences. Crises at any time requires prompt, safe and effective urgent care (NICE 2011).MethodsRennie Grove (RG) provides 24/7 care, with a night service available from 9.15 pm to 7.15 am. RG conducted an independent study to identify the value of the service, including reasons people make contact at night and how many calls could be settled without a visit. Over the study period (145 nights) each call was charted with demographic details, reason for call and outcome.Results550 calls were received, resulting in 335 visits. On 7 nights there were no visits, the highest number in a night was 9, with an average 3.79 visits per night. Only those consenting to participate were analysed, reducing eligibility to 351 calls and 208 visits. Of these, reasons for a night visit included symptom control (64%), carer support (19%), death (13%), death verified by night team (9%), message (7.5%), planned visit (7%) and ‘other’ (4%). Major symptoms included pain (42%), anxiety (32%), nausea (17%) and a small number with chest problems, bowel issues, pyrexia, syringe pumps. In 143 cases a visit was not necessary due to telephone reassurance (55%), another service being more suitable (12%), the team were too busy (8%), and 12% were handed to the next shift.ConclusionsThe night team plays a vital role in 24/7 care, with 40% of calls being managed without a visit. Visits were, in the main, for symptoms or problems concerning support. Death, for a Hospice at Home service also becomes a significant issue requiring a prompt and caring response.
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- 2018
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40. 39 The cost of a night nursing service at rennie grove hospice care, and the total community cost of care at home compared to an admission to hospital
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Varvel, S, Spiro, SG, Graham, A, Sixsmith, J, and Ward, A
- Abstract
BackgroundRennie Grove (RG) runs a 24/7 Hospice at Home service. An independent study calculated the cost of a visit and the total community cost of home care, including all health care professional (HCP), carer, and family member visits.MethodsOver a period of 145 days, 550 calls and 335 visits made to/by the night team were recorded, averaging 3.79 per night. The salary cost per hour for each nurse, plus organisational add on costs, were calculated. To derive a total community cost, 35 families, able to consent, kept a diary for up to two-weeks, recording all HCP, carer and family support visits and duration of each visit. 17 diaries were returned. Descriptive analysis was used with the Statistical Package for the Social Sciences (SPSS v22). Costs were taken for HCPs and social care services from the PSSRU data 2015/2016.ResultsAverage length of the diaries was 10.4 days. For 3.79 visits per night the cost per visit was £195 (RG nurses travel in pairs). 17 patient diaries covered 177 days and showed a range of visits and complexity of care. RG staff provided 19% of the care at a cost of £3,295; district nurses 13%, cost £2,005; formal carers 55% at a cost of £1344. 23 GPs visits comprised 4% of visits but 15% of total costs. MacMillan/Marie Curie nurses accounted for just 2% of visits but 19% of cost as they stayed overnight. The cost of 177 days of care for 17 patients was £11,814; i.e. £66.7 per day as care was not needed every day of each diary period.ConclusionsThe cost of home care seems acceptable, compared to the national average cost of a day in an inpatient specialist palliative care bed at £397-£400 (Data.Gov.UK, 2015).
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- 2018
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41. 40 How satisfied are carers/families with a night team service as part of 24/7 hospice at home care?
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Varvel, S, Ward, A, Sixsmith, J, Graham, A, and Spiro, SG
- Abstract
BackgroundRennie Grove (RG) runs a 24/7 service with a dedicated responsive night team. Through an independent study, carers’ levels of service satisfaction with the night team were investigated.MethodsA questionnaire was sent to carers (n=268) who had a relative die under the care of RG within the last 6 weeks to one year, 84 completed questionnaires were returned. Follow-up face-to-face semi-structured interviews were carried out with carers (n=18). Quantitative data was analysed using SPSS v 22, while qualitative data was thematically analysed.ResultsThe carer questionnaire reported that 71% thought the speed of the response by the night team was fast. Overall satisfaction with telephone call response was high with 82% very satisfied. Carers also agreed strongly that the telephone calls provided good quality of care (90%), good follow-up care (88%), that they were given sufficient time (88%), and received useful advice (83%). For a visit, 93% of carers were highly satisfied and 7% satisfied. Carers strongly agreed that they were given sufficient time (90%), and were confident in the care provided (90%), care was useful (87%) and follow-up was good (84%), worries were reduced (81%) and they had a say in decisions made (81%). During the interviews, carers described the night service as: supportive, amazing, caring, reassuring, professional, kind and compassionate, excellent, loving, calm. Carers perceived the service to be holistic and rated the service highly for supporting them to ensure family members could be cared for at home, as preferred. For comparison, of those dying in hospital, only 46% were highly satisfied. Carer wellbeing scores were lower than the national average, but reported similar levels of anxiety.ConclusionsA night team service can provide excellent, reassuring and holistic care that meets the care needs and wishes of the patient and family.
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- 2018
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42. How and why does social connectedness change in families living with the effects of behavioural variant frontotemporal dementia?
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Hayo, Hilda, Sixsmith, J., and Dobson, M.
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362.1968 ,RC521 Dementia - Abstract
There is a paucity of research studies exploring the changes to social connectedness of people diagnosed with bvFTD and their families, from the premorbid to late stages of the condition. The purpose of this exploratory study was to establish how and why social connectedness changed for the study families over the progression of bvFTD. Social citizenship was selected as the conceptual framework and case study research as the methodology. Five families living with the effects of bvFTD volunteered for the research, and each person with the diagnosis was in the middle/late stages of the condition. Data was collected from the case study families and contacts, using a range of data collection tools (semi structured interviews; document review; diaries and participant observations). Thematic analysis was selected to examine the data collected from each family (within case analysis) and then the findings were compared and contrasted with the other families studied (cross case analysis). Six themes were identified from the collected data: i).“Why are they behaving like this?:Finding a reason; ii).“What is happening to our family? Changing family relationships.; iii).“Other people are noticing”; iv).“Getting a diagnosis”; v).“Now we know what it is.” and vi). “Grief and loss”. Findings indicated that relationships and social connectedness deteriorated in the pre diagnosis stage, and families stated it was largely due to the behavior, personality and social functioning changes of their family member, and the belief that these changes were intentional. By the time a diagnosis was given, the relationships and social connectedness had broken down to such a degree that they could not be rebuilt. The families described how they were no longer invited to social events in the same way as before and their social network reduced significantly. The families also stated that they tended to withdraw from social networks and events due to the embarrassment caused by their family member’s changed behavior. In conclusion, if bvFTD was recognized, diagnosed and specialist advice and support, given earlier by practitioners it could enable families to understand the effects of bvFTD on their family member’s behaviour. This could enable the family to retain relationships and connectedness, develop coping strategies, build resilience and prevent crises. Recommendations for clinical practice: i) increased training for medical practitioners, health and social care staff regarding early recognition and diagnosis of bvFTD; ii) specialist post diagnostic support offered immediately after diagnosis, and iii) awareness raising through campaigns which could include workplace awareness training.
- Published
- 2016
43. Lived experiences of becoming and being a young maternal grandmother : an interpretative phenomenological analysis
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Spencer, Melinda, Sixsmith, J., and Dobson, M.
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306.874 ,HQ The family. Marriage. Women - Abstract
In the last 40 years there has been a surge of academic research into grandparenthood as a result of increased longevity and changing family structures. However, limited research has been identified that explores the experiences of young grandparenthood in England, despite academic researchers’ assertions of deviant young grandparenthood made in the 1980s. Maternal grandmothers have been reported to be the most involved grandparent in the lives of their grandchildren. Further, there is likelihood that the transition to young maternal grandmotherhood is a consequence of young motherhood (of mother and/or daughter). Young motherhood literatures report that mothers of young mothers (maternal grandmothers) can be a primary source of support for their daughters, yet this body of research rarely focuses on the maternal grandmother. With the current cultural norm of grandparenting childcare in the UK and the UK Government’s objectives of increasing women in work, improving maternal health, child health and economic self-sufficiency for young mothers, it is important to understand how young maternal grandmothers are, or are not, contributing to Government targets whilst balancing their own working and family lives. This study makes initial steps in addressing these neglected areas of research by exploring the lived experiences of 10 young maternal grandmothers (aged 35 to 42 years at first transition) living in England. Data was collected using face-to-face semi-structured interviews, prompt objects and photo elicitation in order to answer the research question, ‘what are the lived experiences of young maternal grandmotherhood?’ Guided by British sociologists’ conceptualisations of family life and relationships and the use of Interpretative phenomenological analysis (IPA), data were analysed at an idiographic level before moving on to explore convergences and divergences across person cases, resulting in the emergence of shared patterns of meaning and experience. Analysis of the transitional stage to grandmotherhood identified two essential experiences: Experiencing acceptance (or lack of acceptance) of her daughter’s pregnancy and experiencing acceptance (or lack of acceptance) of her grandmotherhood. Analysis of being a young maternal grandmother identified three essential experiences: Experiencing grandmothering through time, distance, places, spaces and inanimate objects; experiencing grandmotherhood in the social world (the influence of others and on others); owning and romancing the grandchild, experiences of connectedness and disconnectedness. The study concludes with a discussion of the current findings in relation to existing literatures and new understandings. Consideration is applied to the research design and the perceived strengths and limitations. The wider implications of this research are presented with specific focus on the potential to develop a conceptual framework for use in intervention measures for mothers (young maternal grandmothers) and/or daughters (young mothers) and recommendations for possible future directions in this research area.
- Published
- 2016
44. Antibody-Fab and -Fc features promote Mycobacterium tuberculosis restriction.
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Grace PS, Peters JM, Sixsmith J, Lu R, Luedeman C, Fenderson BA, Vickers A, Slein MD, Irvine EB, McKitrick T, Wei MH, Cummings RD, Wallace A, Cavacini LA, Choudhary A, Proulx MK, Sundling C, Källenius G, Reljic R, Ernst JD, Casadevall A, Locht C, Pinter A, Sasseti CM, Bryson BD, Fortune SM, and Alter G
- Abstract
Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis (TB), is a leading cause of death by an infectious disease globally, with no efficacious vaccine. Antibodies are implicated in Mtb control, but the mechanisms of antibody action remain poorly understood. We assembled a library of TB monoclonal antibodies (mAb) and screened for the ability to restrict Mtb in mice, identifying protective antibodies targeting known and novel antigens. To dissect the mechanism of mAb-mediated Mtb restriction, we optimized a protective lipoarabinomannan-specific mAb through Fc-swapping. In vivo analysis of these Fc-variants revealed a critical role for Fc-effector function in Mtb restriction. Restrictive Fc-variants altered distribution of Mtb across innate immune cells. Single-cell transcriptomics highlighted distinctly activated molecular circuitry within innate immune cell subpopulations, highlighting early activation of neutrophils as a key signature of mAb-mediated Mtb restriction. Therefore, improved antibody-mediated restriction of Mtb is associated with reorganization of the tissue-level immune response to infection and depends on the collaboration of antibody Fab and Fc.
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- 2024
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45. Fc-engineered antibodies promote neutrophil-dependent control of Mycobacterium tuberculosis.
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Irvine EB, Nikolov A, Khan MZ, Peters JM, Lu R, Sixsmith J, Wallace A, van Woudenbergh E, Shin S, Karpinski W, Hsiao JC, Casadevall A, Bryson BD, Cavacini L, Grace PS, Alter G, and Fortune SM
- Subjects
- Humans, Protein Engineering, Animals, Receptors, Fc immunology, Receptors, Fc metabolism, Receptors, Fc genetics, Mice, Mycobacterium tuberculosis immunology, Mycobacterium tuberculosis genetics, Neutrophils immunology, Immunoglobulin Fc Fragments immunology, Immunoglobulin Fc Fragments genetics, Tuberculosis immunology, Tuberculosis microbiology, Antibodies, Bacterial immunology
- Abstract
Mounting evidence indicates that antibodies can contribute towards control of tuberculosis (TB). However, the underlying mechanisms of humoral immune protection and whether antibodies can be exploited in therapeutic strategies to combat TB are relatively understudied. Here we engineered the receptor-binding Fc (fragment crystallizable) region of an antibody recognizing the Mycobacterium tuberculosis (Mtb) capsule, to define antibody Fc-mediated mechanism(s) of Mtb restriction. We generated 52 Fc variants that either promote or inhibit specific antibody effector functions, rationally building antibodies with enhanced capacity to promote Mtb restriction in a human whole-blood model of infection. While there is likely no singular Fc profile that universally drives control of Mtb, here we found that several Fc-engineered antibodies drove Mtb restriction in a neutrophil-dependent manner. Single-cell RNA sequencing analysis showed that a restrictive Fc-engineered antibody promoted neutrophil survival and expression of cell-intrinsic antimicrobial programs. These data show the potential of Fc-engineered antibodies as therapeutics able to harness the protective functions of neutrophils to promote control of TB., (© 2024. The Author(s).)
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- 2024
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46. Palliative care in the treatment of women with breast cancer: A scoping review.
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Velasco Yanez RJ, Carvalho Fernandes AF, de Freitas Corpes E, Moura Barbosa Castro RC, Sixsmith J, and Lopes-Júnior LC
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- Humans, Female, Quality of Life psychology, Palliative Care methods, Breast Neoplasms psychology, Breast Neoplasms therapy, Breast Neoplasms complications
- Abstract
Objectives: Recent studies on the quality of life in women with breast cancer show a high prevalence of signs and symptoms that should be the focus of palliative care (PC), leading us to question the current role they play in addressing breast cancer. Therefore, the objective of this review is to map the scope of available literature on the role of PC in the treatment of women with breast cancer., Methods: This is a methodologically guided scoping review by the Joanna Briggs Institute and adapted to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist for report writing. Systematic searches were conducted in 8 databases, an electronic repository, and gray literature. The searches were conducted with the support of a librarian. The study selection was managed through the RAYYAN software in a blind and independent manner by 2 reviewers. The extracted data were analyzed using the qualitative thematic analysis technique and discussed through textual categories., Results: A total of 9,812 studies were identified, of which only 136 articles and 3 sources of gray literature are included in this review. In terms of general characteristics, the majority were published in the USA (35.7%), had a cross-sectional design (44.8%), and were abstracts presented at scientific events (19.6%). The majority of interventions focused on palliative radiotherapy (13.6%). Thematic analysis identified 14 themes and 12 subthemes., Significance of Results: Our findings offer a comprehensive view of the evidence on PC in the treatment of breast cancer. Although a methodological quality assessment was not conducted, these results could guide professionals interested in the topic to position themselves in the current context. Additionally, a quick synthesis of recommendations on different palliative therapies is provided, which should be critically observed. Finally, multiple knowledge gaps are highlighted, which could be used for the development of future studies in this field.
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- 2024
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47. Implementing advance care planning in palliative and end of life care: a scoping review of community nursing perspectives.
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Wilkin K, Fang ML, and Sixsmith J
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- Humans, Palliative Care, Interpersonal Relations, Terminal Care, Advance Care Planning
- Abstract
Background: Advance care planninganning (ACP) is a priority within palliative care service provision. Nurses working in the community occupy an opportune role to engage with families and patients in ACP. Carers and family members of palliative patients often find ACP discussions difficult to initiate. However, community nurses caring for palliative patients can encourage these discussions, utilising the rapport and relationships they have already built with patients and families. Despite this potential, implementation barriers and facilitators continue to exist. To date, no research synthesis has captured the challenges community nurses face when implementing ACP, nor the facilitators of community nurse-led ACP. Considering this, the review question of: 'What factors contribute to or hinder ACP discussion for nurses when providing care to palliative patients?' was explored., Method: To capture challenges and facilitators, a global qualitative scoping review was undertaken in June 2023. The Arksey and O'Malley framework for scoping reviews guided the review methodology. Six databases were searched identifying 333 records: CINAHL (16), MEDLINE (45), PUBMED (195), EMBASE (30), BJOCN (15), IJOPN (32). After de-duplication and title and abstract screening, 108 records remained. These were downloaded, hand searched (adding 5 articles) and subject to a full read. 98 were rejected, leaving a selected dataset of 15 articles. Data extracted into a data extraction chart were thematically analysed., Results: Three key themes were generated: 'Barriers to ACP', 'Facilitators of ACP' and 'Understanding of professional role and duty'. Key barriers were - lack of confidence, competence, role ambiguity and prognostic uncertainty. Key facilitators concerned the pertinence of the patient-practitioner relationship enabling ACP amongst nurses who had both competence and experience in ACP and/or palliative care (e.g., palliative care training). Lastly, nurses understood ACP to be part of their role, however, met challenges understanding the law surrounding this and its application processes., Conclusions: This review suggests that community nurses' experience and competence are associated with the effective implementation of ACP with palliative patients. Future research is needed to develop interventions to promote ACP uptake in community settings, enable confidence building for community nurses and support higher standards of palliative care via the implementation of ACP., (© 2024. The Author(s).)
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- 2024
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48. Development of an Engineered Mycobacterium tuberculosis Strain for a Safe and Effective Tuberculosis Human Challenge Model.
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Wang X, Su H, Wallach JB, Wagner JC, Braunecker B, Gardner M, Guinn KM, Klevorn T, Lin K, Liu YJ, Liu Y, Mugahid D, Rodgers M, Sixsmith J, Wakabayashi S, Zhu J, Zimmerman M, Dartois V, Flynn JL, Lin PL, Ehrt S, Fortune SM, Rubin EJ, and Schnappinger D
- Abstract
Human challenge experiments could greatly accelerate the development of a tuberculosis (TB) vaccine. Human challenge for tuberculosis requires a strain that can both replicate in the host and be reliably cleared. To accomplish this, we designed Mycobacterium tuberculosis (Mtb) strains featuring up to three orthogonal kill switches, tightly regulated by exogenous tetracyclines and trimethoprim. The resultant strains displayed immunogenicity and antibiotic susceptibility similar to wild-type Mtb under permissive conditions. In the absence of supplementary exogenous compounds, the strains were rapidly killed in axenic culture, mice and nonhuman primates. Notably, the strain that contained three kill switches had an escape rate of less than 10
-10 per genome per generation and displayed no relapse in a SCID mouse model. Collectively, these findings suggest that this engineered Mtb strain could be a safe and effective candidate for a human challenge model.- Published
- 2023
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49. "I didn't know it was going to be like this.": unprepared for end-of-Life care, the experiences of care aides care in long-term care.
- Author
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Booi L, Sixsmith J, Chaudhury H, O'connor D, Surr C, Young M, and Sixsmith A
- Subjects
- Humans, Quality of Life, Emotions, Canada, Long-Term Care, Terminal Care
- Abstract
Background: Care aides provide up to 70-90% of the direct care for residents in long-term care (LTC) and thus hold great potential in improving residents' quality of life and end-of-life (EoL) care experiences. Although the scope and necessity of the care aide role is predicted to increase in the future, there is a lack of understanding around their perceptions and experiences of delivering EoL care in LTC settings. The aim of this study was to gain an understanding of the perspectives, experiences, and working conditions of care aides delivering end-of-life care in LTC in a rural setting, within a high-income country., Methods: Data were collected over ten months of fieldwork at one long-term care home in western Canada; semi-structured interviews (70 h) with 31 care aides; and observation (170 h). Data were analysed using Reflexive Thematic Analysis., Results: Two themes were identified: (i) the emotional toll that delivering this care takes on the care aids and; (ii) the need for healing and support among this workforce. Findings show that the vast majority of care aides reported feeling unprepared for the delivery of the complex care work required for good EoL care. Findings indicate that there are no adequate resources available for care aides' to support the mental and emotional aspects of their role in the delivery of EoL care in LTC. Participants shared unique stories of their own self-care traditions to support their grief, processing and emotional healing., Conclusions: To facilitate the health and well-being of this essential workforce internationally, care aides need to have appropriate training and preparation for the complex care work required for good EoL care. It is essential that mechanisms in LTC become mandatory to support care aides' mental health and emotional well-being in this role. Implications for practice highlight the need for greater care and attention played on the part of the educational settings during their selection and acceptance process to train care aides to ensure they have previous experience and societal awareness of what care in LTC settings entails, especially regarding EoL experiences., (© 2023. BioMed Central Ltd., part of Springer Nature.)
- Published
- 2023
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50. Health literacy education at the time of COVID-19: development and piloting of an educational programme for university health professional students in 4 European countries.
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Papa R, Sixsmith J, Giammarchi C, Lippke S, McKenna V, Di Furia L, Ceravolo MG, and De Winter A
- Subjects
- Humans, Pandemics, Universities, Europe, Students, Health Literacy, COVID-19 epidemiology
- Abstract
Background: Health literacy has a strong influence on individual health outcomes and the sustainability of healthcare systems. Healthcare professionals often overestimate patients' health literacy levels and lack adequate competencies to address limited health literacy effectively. Therefore, promoting understanding through effective health communication between professionals and citizens is becoming increasingly important. Although health literacy has recently gained more attention, health literacy educational programmes targeting future healthcare professionals are still scarce, especially in Europe. This study describes the piloting process of a pan-European health literacy educational programme and shows how the educational material is being used during time of crisis such as the COVID-19 pandemic., Methods: The educational programme was developed through the definition of an educational philosophy and iterative co-creation processes consisting of stakeholders' consultations, material development and pilots with students. The evaluation was carried out in Italy through four pilot tests involving 107 students of health-related degrees. An evaluation questionnaire and a pre-post test were developed and used to collect students' and educators' feedback (quantitative and qualitative) and assess changes in health literacy awareness, respectively. Three additional pilots were organized in Italy and Germany mostly during the COVID-19 pandemic to evaluate the feasibility of the educational programme through online and hybrid learning, respectively., Results: The pilots received positive feedback from both students and educators. Students were highly satisfied with the courses, reported their relevance for their future profession and appreciated the interactive teaching methods. The pre-post test showed a significant improvement in health literacy awareness after the training. Educators reported the adequacy and flexibility of the training material, the ease of transferability of the content of the lessons into practice, and the validity of the tested options to integrate the educational programme into the curricula., Conclusions: Our comprehensive, evidence-based educational programme contributes to addressing the existing challenges in Europe, and its flexibility allows for easy integration in the curricula, through different options, hence supporting a widespread uptake in the European Union and maybe beyond. Health literacy education is a useful tool to improve citizens' access to healthcare information and services, achieve better health outcomes and support healthcare systems' sustainability., (© 2023. BioMed Central Ltd., part of Springer Nature.)
- Published
- 2023
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