The alleviation of suffering lies at the core of compassionate end-of-life care, yet
little is known about the lived experience of suffering. Motivated by a series of
reports on poor care of older people in hospital, this study addresses suffering
in older people at the end of life in an acute hospital ward in the United
Kingdom. Methods were developed from a synthesis of ethnographic fieldwork
and phenomenological interpretation.
Data were collected using participant observation on an acute care ward for
older people in a hospital in Northern England, over 186 hours between June
and August 2015. Data included field notes, documents, photographs and
informal interviewing. Staff and patient participants were identified using
theoretical sampling. Data were analysed using a hermeneutic approach
involving a continuous process of analysis, further data collection, posing of
problems and questions, and interpretation. This cyclical approach to the data
enabled the development of interpretive perspectives which could then be
further explored in the field.
Findings suggested that care for older people was shaped by competing
ideologies of care and organisational regulatory processes. Particularly when
there was ambiguity regarding prognosis, there was a tendency for care to
default to a ‘rescuing’ acute care model. Through exploring the experiences of
individual patients and placing these in the context of cultures of care, I suggest
that iatrogenic suffering was a significant concern that often went unrecognised.
Patient-centred goals must be more focused upon avoidance of iatrogenic
suffering. Recommendations include innovations in clinical education and multiprofessional working.
This thesis examines the determinants of institutional quality and the process of convergence in the ECOWAS in order to inform policy about the region’s deep integration scheme. The first part of the thesis examines the historical changes that took place in the development of common institutions in West Africa in the pre-independence era. The findings demonstrated that the region exhibited some common institutions, including common currencies, standardised trade rules and protection of trade routes which facilitated regional and international trade. A single administration system helped in the effective implementation of the common institutions. Therefore, historical changes after independence led to the loss of some facets of these common institutions in West Africa. The second part examined determinants of institutional quality and the process of convergence using econometric analysis. The findings demonstrated that the process of convergence could be accelerated if WAMZ and WAEMU work together as one monetary zone under ECOWAS. Moreover, the findings also demonstrated that the level of development, state capacity, FDI, regional trade, history and regional trade partners institutional quality contain useful information in explaining the quality of institutions today. Therefore, ECOWAS’s deep integration goal would require improving some of these factors in order to facilitate the process of developing common institutions and improve their quality. In the long term, a single administration system akin to the colonial era and the Empires of Western Sudan would be desirable. This will require political commitment to do so. ECOWAS members should have the confidence that deep integration is feasible given that it existed in the region in the past.
In 1998 the UN Guiding Principles on Internal Displacement were developed following years of crises faced by the millions of people experiencing forced displacement, especially those internally displaced. These Principles were widely considered to be precedent setting, both historically and normatively. However, the examination of the construction of the international norms that underpin the Principles indicates that there are important epistemological weaknesses in widely used constructivist frameworks that understand normative shifts in international relations. They are critiqued as being impedingly linear, temporally compressed and analytically obstructive in its agent-centric view of norm cascading. This research aims to address some of these gaps with an enhanced life-cycle model using cluster genealogies and the processes of replication and particularization. The reformulated framework is tested for robustness and feasibility using two preliminary cases – UNSC Resolution 1325 and the Chemical Weapons Convention. It is then used to conduct an in-depth original analysis of the development of the 1998 UN Guiding Principles. The findings in the case of the Guiding Principles show, for example, that though the acceptance of the IDP definition was a big leap, the replication and particularization of human rights limits the humanitarian scope of the Guiding Principles, and also brings into question existing humanitarian protection of IDPs under the Geneva Conventions. Meanwhile, rooting them in ‘sovereignty as responsibility’ has not shifted the community of states’ intersubjective take on sovereignty, but it has added to the existing normative tension – individual vs. state – that underpins the very understanding of sovereignty.
The field of cancer genomics is currently being enhanced by the power of
Epigenome-wide association studies (EWAS). Over the last couple of years
comprehensive sequence data sets have been generated, allowing analysis
of genome-wide activity in cohorts of different individuals to be increasingly
available. Finding associations between epigenetic variation and phenotype
is one of the biggest challenges in biomedical research. Laboratories lacking
dedicated resources and programming experience require bioinformatics
expertise which can be prohibitively costly and time-consuming. To address
this, we have developed a collection of freely available Galaxy tools
(Poterlowicz, 2018a), combining analytical methods into a range of convenient
analysis pipelines with graphical user-friendly interface.The tool suite
includes methods for data preprocessing, quality assessment and differentially
methylated region and position discovery. The aim of this project was to
make EWAS analysis flexible and accessible to everyone and compatible with
routine clinical and biological use. This is exemplified by my work undertaken
by integrating DNA methylation profiles of melanoma patients (at baseline and
mitogen-activated protein kinase inhibitor MAPKi treatment) to identify novel
epigenetic switches responsible for tumour resistance to therapy (Hugo et
al., 2015). Configuration files are publicly published on our GitHub repository
(Poterlowicz, 2018b) with scripts and dependency settings also available to
download and install via Galaxy test toolshed (Poterlowicz, 2018a). Results
and experiences using this framework demonstrate the potential for Galaxy to
be a bioinformatics solution for multi-omics cancer biomarker discovery tool.
The major themes of this thesis are the impact of Intellectual Property (IP) systems on foreign direct investment spillovers and bilateral FDI flows.
This thesis consists of three empirical studies. The first study integrates in the existing theoretical frameworks the distinct effect of the public IP enforcement element of IP systems on FDI horizontal spillovers. By employing a meta-analysis approach and the ordered probit model estimation technique, it finds that the strength of public IP enforcement in a host country has a positive effect on FDI horizontal spillovers but it dampens the positive effect of IP law protection on FDI horizontal spillovers when it becomes too strong.
The second empirical study examines the impact of IP systems on FDI vertical spillovers. This study employs a similar conceptual and empirical approach and finds that the strength of public IP enforcement has a positive effect on FDI vertical spilloversbut a negative moderating effect on the relationship between the strength of IP law protection and FDI vertical spillovers. In the third empirical study, a gravity model is applied to test the effect of IP systems on bilateral FDI flows in OECD countries. Using the Poisson pseudo-maximum-likelihood, it finds both the strength of IP law protection and the strength of public IP enforcement to have a positive effect on bilateral FDI flows.
The broad implication of these findings is that countries should strengthen both their IP law protection and enforcement but apply appropriate measures to mitigate the negative effect resulted from excessive IP protection.
Contemporary studies of Peace Journalism have yet to examine how
photographs, as visual content captured by print media, fit within the model
of Peace Journalism. In this research, a content analysis of press images
was conducted using predefined methodology on newspaper coverage of the
annual July 12th Drumcree Parades (Marching) in Portadown, Northern
Ireland, during the pre-, intra-, and post-peace process that occurred
between 1996 and 2000. In most newspapers, the proportions of both
violent/aggressive and nonviolent/non-peaceful content were higher in the
relatively peaceful period of 2000, as compared to their proportions in at least
one of the other ‘violent’ years of 1996 and 1998. No overall trend in content
was observed in relation to the level of violence across 1996 to 2000. During
this period, media practice in Portadown, Northern Ireland did not support the
publication of newspaper commensurate with actual level of violence in the
Northern Ireland or the depictions of peace building and the peaceful
resolution of conflict. The implications of these findings for the development
of ‘Peace Photojournalism’ are explored.
This thesis explores the role and impact of leadership as a socially
constructed and aesthetic phenomenon in tribal-dominated Bedouin Arabia.
The concept of leadership is investigated in terms of its discursive and
aesthetic dimensions across different geographical, historical, and
intellectual settings by adopting and applying a Foucauldian perspective of
interconnected concepts of power/knowledge, discourse, subjectivity, body
symbolism and the power of gaze. The thesis draws on three related types of
data: First, images to understand the leaders’ perspective. Second,
interviews with artists to gain insights into the visual message and the
creative process. Third, through semi-structured interviews with the audience
to garner an understanding of how it perceives the message leaders send.
This thesis contributes theoretically to ongoing research into the visual
representation of leadership and to critical debates concerning Foucauldian
perspectives on discourse, power, discipline and the body. This thesis
concludes by recommending practical implications for rethinking leadership
as something both aesthetic and mythical to consider the role of followership
in the consumption of leadership-themed visual artworks and
communication, and the growing global role and influence of social media in
shaping leader-follower relations.
Embodied cognition is the study of how actions and interactions with objects and individuals affect cognitive processing. Neuroaesthetics deals with the neural, biological and evolutionary aspects of aesthetic experience which occur through the senses and consist of the emotional value placed onto objects, for example the appreciation of art work, dance, or music. These
are individual and differ depending on level of expertise and experience within the art. The main aim of the thesis was to investigate the link between embodiment and aesthetics through examining people’s level of creativity, colour perception and sensory processing sensitivity (SPS) in relation to levels of empathy and theory of mind (ToM). Research into this is sparse as
the role of the body in relation to aesthetic experiences is a relatively new concept. Preference for portraits versus landscapes was also investigated to look at any role of social stimuli in aesthetic preference. Results demonstrate that participants with (i) higher levels of creativity (for some types of creativity) and (ii) more acute colour perception had higher levels of empathy/ToM. Individuals who had higher SPS demonstrated higher empathy/ToM. It was also found that colour perception and empathy levels decrease with age, and aesthetic preference for portraits increase with age. These results have implications for education/schools, the prison service, for specific clinical conditions such as autism, Parkinson’s disease, schizophrenia, and attention deficit/hyperactivity disorder, particularly given the role of dopamine in these disorders and in colour perception. Future research should investigate these findings using brain imaging and physiological measures.
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