The onus on us? Stage one in developing an i-Trust model for our users.

This article describes a Joint Information Systems Committee (JISC)-funded project, conducted by a cross-disciplinary team, examining trust in information resources in the web environment employing a literature review and online Delphi study with follow-up community consultation. The project aimed to try to explain how users assess or assert trust in their use of resources in the web environment; to examine how perceptions of trust influence the behavior of information users; and to consider whether ways of asserting trust in information resources could assist the development of information literacy. A trust model was developed from the analysis of the literature and discussed in the consultation. Elements comprising the i-Trust model include external factors, internal factors and user's cognitive state. This article gives a brief overview of the JISC funded project which has now produced the i-Trust model (Pickard et. al. 2010) and focuses on issues of particular relevance for information providers and practitioners

Users' trust in information resources in the Web environment: a status report

This study has three aims; to provide an overview of the ways in which trust is either assessed or asserted in relation to the use and provision of resources in the Web environment for research and learning; to assess what solutions might be worth further investigation and whether establishing ways to assert trust in academic information resources could assist the development of information literacy; to help increase understanding of how perceptions of trust influence the behaviour of information users

Why won’t workforce policy makers tackle gender inequality in healthcare?

Blog post in The BMJ Opinio

Water You Waiting For? Balancing Private Rights and Public Necessity in the South Atlantic Wetlands

A healthy and robust network of wetlands protects coastal communities from storm damage caused by hurricanes. Unfortunately, development pressures threaten wetlands along the South Atlantic coast, the region most susceptible to an increased risk of climate change induced hurricanes. If these wetlands are not protected from destruction, coastal communities will be left without a buffer against flooding, storm damage, and sea level rise. In addition to putting the public at large in physical danger, significant environmental justice concerns accompany the failure to protect coastal wetlands. In order to protect these ever-diminishing resources, federal and state law makers have enacted regulatory regimes that combat wetland degradation. However, these regimes are severely flawed, as they: (1) are difficult for private property owners to navigate; (2) lack inter-governmental coordination; and (3) give rise to litigable conflicts between private property owners and state and federal regulators. The 2013 Supreme Court decision Koontz v. St. John’s River Water Mgmt. Dist., which extends the essential nexus and rough proportionality requirements of Nollan v. California Coastal Commission and Dolan v. City of Tigard to monetary exactions, threatens to further undermine the efficacy of these regulatory regimes by inducing a regulatory chilling effect, Thus, this note argues that courts should extend the application of the public necessity defense to regulatory takings cases, thereby absolving the government of takings liability, where the state can show that the destruction of coastal wetlands will expose vulnerable communities to harm from hurricanes and sea level rise

Determining acute nurse staffing: A hermeneutic review of an evolving science

Re-use permitted under CC BY.backgroundCalculating nurse staffing in the acute hospital has become a key issue but solutions appear distant. Community, mental health and areas such as learning disability nursing have attracted less attention and remain intractable. This review aims to examine current approaches to the issue across many disciplines.DesignThe approach taken is iterative and in the form of a hermeneutic review. 769 pieces of evidence were reviewed from across disciplines such as nursing, medicine, engineering, statistics, population science, computer science and mathematics where hospital nurse staffing was the subject of the study.resultsA number of themes emerged. The first iteration showed the predominance of unit base approaches (eg, nurse numbers, ratios, activity and workload) and the second was the development of methodologies. Subsequent iterations examined issues such as demand, safety, nurse education, turnover, patient outcomes, patient or staff satisfaction, workload and activity. The majority of studies examined (n=767) demonstrated some association between staffing (units or type/skill) and various factors such as staff or patient satisfaction, working conditions, safety parameters, outcomes complexity of work achieved, work left undone or other factors. Many potential areas such as operational safety research were not utilised.ConclusionAlthough the relationship between staffing in acute care and factors such as units, safety or workload is complex, the evidence suggests an interdependent relationship which should only be dismissed with caution. The nature of these relationships should be further examined in order to determine nurse staffing. The body of knowledge appears substantial and complex yet appears to have little impact on policypublishedVersio

Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation

Background: This study aims to understand how the implementation of the advanced clinical practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The advanced clinical practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods: As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey free-text were analysed using thematic analysis in NVivo 10. Results: The questionnaire received over 500 respondents (ten times that expected) and 15 interviews were carried out. Advanced clinical practice was considered by many respondents the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ‘ACP’ was the right job title for them. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing advanced clinical practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employer’s training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework: that of advanced clinical practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions: Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.publishedVersio

A thematic analysis of the prevention of future deaths reports in healthcare from HM coroners in England and Wales 2016–2019

Background The Coroners and Justice Act allows coroners in England or Wales to issue reports after inquest, if they believe that action should be taken to prevent a future death. Coroners are under a statutory duty to issue a Prevention of Future Death (PFD) report to persons or organisations that they believe have the power to act. Cumulatively, these reports may contain useful intelligence for patient safety. The aim of this study was to examine the feasibility of extracting data from these reports and to evaluate if learning was possible from any common themes. Methods Reports were extracted from 2016 to 2019 for deaths in hospitals, care homes and the community in England and Wales. These were subjected to descriptive statistics and thematic analysis of coroner’s concerns. Application of data mining techniques was not possible due to data quality. Results 710 reports were examined, with 3469 concerns being raised (mean 4.88, range 1–33). 36 reports expressed concern about having to issue repeat PFDs to the same organisation for the same or similar concerns. Thematic analysis reliability was high ( κ 0.89 unweighted) with five emerging primary themes: deficit in skill or knowledge, missed, delayed or uncoordinated care, communication and cultural issues, systems issues and lack of resources. A codebook of 53 subthemes were identified. Conclusions PFD reports offer valuable insight. Aggregation and continued analysis of these reports could offer more informed patient safety, workforce development and organisational policy. Improved data quality would allow for possible automation of analysis and faster feedback into practice

Workforce priorities for resilience to future health shocks - and the workforce crisis

Key messagesThe NHS makes a huge investment in its workforce, and this needs to be supported by much greater funding and capacity for interdisciplinary researchThe current workforce crisis in the NHS in the UK and internationally should be seen as a further health shock, posing significant risks to the healthcare system and health outcomesThe covid-19 pandemic revealed a significant gap in the UK’s healthcare research infrastructure—that of the workforce, for which high quality evidence was too often lacking for the major decisions neededNHS staff deserve their health, wellbeing, and careers to be underpinned and informed by the best available research evidence<br/

Workforce priorities for resilience to future health shocks - and the workforce crisis

Key messagesThe NHS makes a huge investment in its workforce, and this needs to be supported by much greater funding and capacity for interdisciplinary researchThe current workforce crisis in the NHS in the UK and internationally should be seen as a further health shock, posing significant risks to the healthcare system and health outcomesThe covid-19 pandemic revealed a significant gap in the UK’s healthcare research infrastructure—that of the workforce, for which high quality evidence was too often lacking for the major decisions neededNHS staff deserve their health, wellbeing, and careers to be underpinned and informed by the best available research evidence<br/

State authenticity

State authenticity is the sense that one is currently in alignment with one’s true or real self. We discuss state authenticity as seen by independent raters, describe its phenomenology, outline its triggers, consider its well-being and behavioral implications, and sketch out a cross-disciplinary research agenda