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"Cross, Susan"
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Liz Glynn : objects and actions
From her first participatory performance building Rome in 24 hours--in cardboard--to Open House, her open-air Gilded Age ballroom--cast in concrete--in Central Park, Liz Glynn examines the past to shed light on present day social and economic conditions through a diverse array of sculptures, structures, and actions. This monograph, designed to emphasize Glynn's interest in process, temporality, labor, and shifting notions of value, features a series of essays on the artist's practice as a whole, texts on each of her discrete projects as well as images from the artist's studio, and documentation of her performances. Together they give readers a comprehensive overview of an artist whose career has garnered enormous attention from audiences and critics alike.
Book
P12 Treating sleep paralysis: setting up a service to provide group cognitive behavioural therapy for sleep paralysis at the royal london hospital for integrated medicine
IntroductionThe insomnia team at the Royal London Hospital for Integrated Medicine (RLHIM), part of UCLH, is the largest NHS provider of Cognitive Behavioural Therapy for insomnia (CBTi). As part of our service development plans we are expanding the courses of treatment we offer.It is estimated that 8% of people experience Isolated Sleep Paralysis at least once in their life. Episodes can occur just after falling asleep or upon waking, and are characterised by a temporary inability to move, often accompanied by terrifying hallucinations, and the feeling of suffocation.The aims of our therapy are to reduce patient’s fear and anxiety, reduce the frequency and duration of episodes, and make each episode less distressing.MethodDuring the COVID pandemic, our CBTi service moved from face-to-face to group sessions over zoom. The Sleep Paralysis groups were introduced in 2022, running on similar lines, incorporating treatment plans suggested by Sharpless and Doghramji.1 Our Sleep Paralysis therapy course consists of 4 hour-long sessions covering education about the condition and the underlying physiology, sleep hygiene, diaphragmatic breathing, disruption techniques and strategies to manage hallucinations. Each session ends with ‘homework’ – techniques for patients to practice daily.ResultsTo date we have run 4 small groups of up to 4 patients, with a growing waiting list with 37 referrals in 2022, and 20 in the first 6 months of 2023DiscussionTherapy is well received by patients, who welcome the opportunity to talk about their condition with people who understand their experiences. Patients would like the addition of a face-to-face session to facilitate more peer support. Therapists would like face-to-face sessions to improve practical training for diaphragmatic breathing.ConclusionFurther work is needed to identify appropriate outcome measures, or to develop a new measure.Reference‘Sleep Paralysis: Historical, Psychological, and Medical Perspectives’ Brian A Sharpless and Karl Doghramji; 2015, Oxford University Press ISBN 978-0-19-931380-8
Journal Article
Positive airway pressure for sleep-disordered breathing in acute quadriplegia: a randomised controlled trial
RationaleHighly prevalent and severe sleep-disordered breathing caused by acute cervical spinal cord injury (quadriplegia) is associated with neurocognitive dysfunction and sleepiness and is likely to impair rehabilitation.ObjectiveTo determine whether 3 months of autotitrating CPAP would improve neurocognitive function, sleepiness, quality of life, anxiety and depression more than usual care in acute quadriplegia.Methods and measurementsMultinational, randomised controlled trial (11 centres) from July 2009 to October 2015. The primary outcome was neurocognitive (attention and information processing as measure with the Paced Auditory Serial Addition Task). Daytime sleepiness (Karolinska Sleepiness Scale) was a priori identified as the most important secondary outcome.Main results1810 incident cases were screened. 332 underwent full, portable polysomnography, 273 of whom had an apnoea hypopnoea index greater than 10. 160 tolerated at least 4 hours of CPAP during a 3-day run-in and were randomised. 149 participants (134 men, age 46±34 years, 81±57 days postinjury) completed the trial. CPAP use averaged 2.9±2.3 hours per night with 21% fully ‘adherent’ (at least 4 hours use on 5 days per week). Intention-to-treat analyses revealed no significant differences between groups in the Paced Auditory Serial Addition Task (mean improvement of 2.28, 95% CI −7.09 to 11.6; p=0.63). Controlling for premorbid intelligence, age and obstructive sleep apnoea severity (group effect −1.15, 95% CI −10 to 7.7) did not alter this finding. Sleepiness was significantly improved by CPAP on intention-to-treat analysis (mean difference −1.26, 95% CI −2.2 to –0.32; p=0.01).ConclusionCPAP did not improve Paced Auditory Serial Addition Task scores but significantly reduced sleepiness after acute quadriplegia.Trial registration numberACTRN12605000799651.
Journal Article
Jane Savoie's dressage 101 : the ultimate source of dressage basics in a language you can understand
Provides techniques for dressage training that range from paces and flatwork to self-carriage and extended gait, along with solutions to common training problems.
Book
17 A systematic review of the treatment of restless leg syndrome and periodic limb movements in people with spinal cord injury
IntroductionPeople with spinal cord injury (SCI) have a high prevalence of sleep disorders, which often remain undiagnosed and untreated, resulting in reduced quality of life. Their sleep may be disturbed by pain and spasms, but these could also be symptoms of Restless Leg Syndrome (RLS) or Periodic Limb Movements (PLMs). Studies estimate that RLS affects 17-19% of people with SCI. Little is known about the management of RLS or PLMs after SCI.MethodA systematic review was conducted following PRISMA guidelines, searching 5 databases, for studies of any intervention to manage RLS and/or PLMs in people with SCI. Outcomes of interest were changes in severity of RLS or PLMs, or effects on sleep quality (see table 1).Abstract 17 Table 1Terms used in healthcare databases advanced search’ (HDAS) function in OpenAthensResults465 Manuscripts were identified. 12 studies fulfilled inclusion/exclusion criteria, totalling 108 participants. Risk of bias assessment revealed low evidence quality due to small sample sizes and lack of randomised controlled trials.Interventions investigated included• L-dopa and pramipexole were shown to reduce PLMs objectively measured by polysomnography, and subjectively reported RLS symptoms.• Exercise reduced the PLM index measured by polysomnography.• Intrathecal baclofen injection reduced PLMs.DiscussionIt is thought that in people with SCI dopaminergic medications exert their effect in the spinal cord rather than in the brain.Reviewed papers report potential confusion between PLMs and spasticity, and between neuropathic pain and RLS.The RLS diagnostic criteria are challenging to apply after SCI. It is unclear how a patient with altered sensation following SCI will experience the ‘urge’ to move.ConclusionsThere is evidence that some sleep measures improved with dopaminergic medication or exercise. Clinicians should consider investigation for RLS and PLMs in patients with neuropathic pain or spasticity unresponsive to usual treatment, with symptoms predominating in the evening or at night. These patients may respond to treatment for these sleep disorders.
Journal Article
Acting in our interests: Relational self-construal and goal motivation across cultures
Relationally-autonomous reasons (RARs) are motives for behavior that take into account one’s close relationships. A cross-cultural model tested the hypotheses that (a) people with a highly relational self-construal will pursue their goals for RARs, and (b) RARs will predict positive goal outcomes after controlling for variance explained by personally-autonomous reasons (PARs) and social support. One hundred seventy Americans and 219 Japanese completed a well-being and self questionnaire then generated and rated seven goals on several attributes. Results showed that relational self-construal was associated with RARs for goals. RARs predicted effort directly and predicted progress and purpose in life indirectly for both groups. In addition, Americans and Japanese differed in the types of goals they pursued and the degree to which social support predicted effort. Implications for self, culture, and motivation research are discussed.
Journal Article
Increasing MRI capacity at a clinical diagnostic centre and a trauma hospital using artificial intelligence-based image reconstruction (AI-IR): a quality improvement project using the Model for Improvement framework
Increasing MRI capacity is of primary importance to both NHS England and individual radiology departments. Consequently, central funding was provided to allow trusts to instal artificial intelligence-enabled image reconstruction (AI-IR) on their MRI scanners, with the stated aim of increasing capacity by two patients scanned per day within a year of installation on a given scanner. This work demonstrates how a two-phase quality improvement (QI) initiative can be followed to increase capacity using AI-IR in a community diagnostic centre (CDC) at Mile End Hospital and an acute trauma centre, the Royal London Hospital, in East London with comprehensive stakeholders’ engagement.The Model for Improvement framework was used. Our pilot study focused on 3 Plan-Do-Study-Act (PDSA) cycles for three anatomies in musculoskeletal (MSK) imaging at our CDC. A second, substantive study at our major trauma centre was followed, which was a 20-month project encompassing all MSK anatomies of interest.In our initial pilot study at the CDC, we were able to reduce booking times by 10 min for Knee, Ankle and Spine protocols. In our wide-ranging MSK programme at our trauma centre, we saved on average of 07:26 min per scan and while an increased throughput was not achieved, an increase in complex patients being scanned, from 7% to 15% was achieved, reducing healthcare inequities.Our two-centre study suggests that engaging with stakeholders in a structured QI programme can significantly reduce scanning times, improve patient experience and allow for longer precare and postcare time. Additionally, significant throughput increase at the CDC for low-risk ambulatory patients suggests efforts to increase capacity using this technology should be focused at such centres and other scanners focused on ambulatory outpatients, while for scanners focused on inpatients, paediatrics and A&E at trauma centres, the time saved can be used to increase the capacity for complex patients, reducing waiting times for these patients.
Journal Article