School of Historical and Philosophical Studies - Research Publications
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ItemNo Preview AvailableRespect: Engendering participatory relationships in conservation education(Canadian Association for Conservation, 2009)In 2004, the Centre for Cultural Materials Conservation (The University of Melbourne) established a new subject, Respect, as part of a new Masters by Coursework in Cultural Materials Conservation. In this subject, guest lecturers who have extraordinary or senior cultural expertise and knowledge introduce students to the political and societal aspects of cultural materials conservation. They lead students through the complexity of issues relating to context, disruption, authenticity, legal standing, development, reinvention, identity, and minority status. In Respect, students are asked to think about conservation as a practice that could benefit from incorporating intellectual positions and emotional skills that have been developed by other cultures, or marginalized communities within our own culture, to support the preservation of their cultural material or cultural identity. In order to do this, Respect seeks to indicate to students the political nature of cultural material conservation decision-making. The subject also asks students to consider who the partners in cultural materials conservation are, and whether conservators and those with the responsibility and interest in cultural preservation have the skills to enter into successful participatory partnerships with a diverse range of stakeholders.
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ItemSilence and the History of Menstruation(Oral History Association of Australia, 2007)Oral history is often concerned not only with what is said but also with silences and what they might mean—what is omitted from interview responses or the historical record, and in this case, omission from both social discourse and research in general about women’s experience of what is virtually a universal experience for them. From interviews with twelve women, the author sought to ‘penetrate the veil of silence’ and transcend the dearth of documentary evidence about the meaning of menstruation in women’s lives. Interviews ‘yielded fascinating and complex responses that opened up questions rather than providing definitive answers. Perhaps the most profound insight gained through the project was an appreciation of the power of silence, which can communicate more loudly than words.’
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ItemNo Preview AvailableCluster randomisation or randomised consent as an appropriate methodology for trials in palliative care: a feasibility study [ISRCTN60243484].(Springer Science and Business Media LLC, 2004-04-27)BACKGROUND: Although guidelines for the care of the dying patient exist the evidence base to support the guidelines is poor. Some of the factors contributing to this include failure to recruit to trials, protective healthcare professionals and subsequent attrition from trials due to the death of the patients. Recent studies report favourably on the use of cluster randomisation as an appropriate methodology for use in this patient group. METHODS/DESIGN: A feasibility study, exploring two types of randomisation as appropriate methodology for trials involving dying patients. Cluster randomisation and randomised consent will be utilised following a crossover design at two sites, one oncology ward and one Macmillan unit within the Northwest Wales NHS Trust. All patients commencing on the Integrated Care Pathway (ICP) for the Last Days of Life will be eligible for inclusion in the study. Using the hypothesis that it is not necessary to prescribe an anti-emetic medication when setting up a syringe driver for the dying patient, the study will evaluate different models of research methodology. DISCUSSION: The identification of the most appropriate methodology for use in studies concerning this patient group will inform the development of future clinical studies. Furthermore, the outcomes of this feasibility study will inform the development, of a proposal seeking funding for Wales-wide trials in palliative care. The identification of an appropriate methodology will provide a starting point for the establishment of a robust evidence base for the care of the dying patient.
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ItemNo Preview AvailableAccuracy of prognosis estimates by four palliative care teams: a prospective cohort study.(Springer Science and Business Media LLC, 2002)BACKGROUND: Prognosis estimates are used to access services, but are often inaccurate. This study aimed to determine the accuracy of giving a prognosis range. METHODS AND MEASUREMENTS: A prospective cohort study in four multi-professional palliative care teams in England collected data on 275 consecutive cancer referrals who died. Prognosis estimates (minimum - maximum) at referral, patient characteristics, were recorded by staff, and later compared with actual survival. RESULTS: Minimum survival estimates ranged <1 to 364 days, maximum 7 - 686 days. Mean patient survival was 71 days (range 1 - 734). In 42% the estimate was accurate, in 36% it was over optimistic and in 22% over pessimistic. When the minimum estimate was less than 14 days accuracy increased to 70%. Accuracy was related, in multivariate analysis, to palliative care team and (of borderline significance) patient age. CONCLUSIONS: Offering a prognosis range has higher levels of accuracy (about double) than traditional estimates, but is still very often inaccurate, except very close to death. Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.