Ecohydrological separation in wet, low energy northern environments? A preliminary assessment using different soil water extraction techniques

Funded by European Research Council ERC. Grant Number: project GA 335910 VEWA ACKNOWLEDGEMENTS The constructive comments and suggestions from two anonymous reviewers greatly improved an earlier version of this manuscript. Jon Dick, Jason Lesselsand Jane Bang Poulsen are thanked for assistance with data collection; Audrey Innes for sample preparation and assistance with the cryogenic extraction of water samples; Paula Craib for glassware design; Colleagues in Prof. J. Anderson’s lab for day-to-day assistance incryogenic extraction; Todd Dawson and Nathalie Schultz for providing information on extraction techniques and the analysis of vegetation water; Hedda Weitz for help with the centrifugation of soil samples;and Iain Malcolm and colleagues at the Marine Scotland Freshwater Lab for providing meteorological data. We thank Jason Newton and the Scottish Universities Environmental Research Centre (SUERC) Mass Spectrometry Facility Laboratory in East Kilbride for theisotopic analyses of the xylem water samples. The European Research Council ERC (project GA 335910VEWA) is thanked for funding.Peer reviewedPostprin

Towards equity: a qualitative exploration of the implementation and impact of a digital educational intervention for pharmacy professionals in England.

Background: Patients belonging to marginalised (medically under-served) groups experience problems with medicines (i.e. non-adherence, side effects) and poorer health outcomes largely due to inequitable access to healthcare (arising from poor governance, cultural exclusion etc.). In order to promote service equity and outcomes for patients, the focus of this paper is to explore the implementation and impact of a new co-produced digital educational intervention on one National Health Service (NHS) funded community pharmacy medicines management service. Methods: Semi-structured interviews with a total of 32 participants. This included a purposive sample of 22 community pharmacy professionals, (16 pharmacists and 6 pharmacy support staff) all who offered the medicine management service. In order to obtain a fuller picture of the barriers to learning, five professionals who were unable to complete the learning were also included. Ten patients (from a marginalised group) who had received the service (as a result of the digital educational intervention) were also interviewed. Drawing on an interpretative analysis, Normalisation Process Theory (NPT) was used as a theoretical framework. Results: Three themes are explored. The first is how the digital learning intervention was implemented and applied. Despite being well received, pharmacists found it challenging completing and cascading the learning due to organisational constraints (e.g. lack of time, workload). Using the four NPT constructs (coherence, cognitive participation, collective action and reflexive monitoring) the second theme exposes the impact of the learning and the organisational process of ‘normalisation’. Professional reflective accounts revealed instances where inequitable access to health services were evident. Those completing the intervention felt more aware, capable and better equipped to engage with the needs of patients who were from a marginalised group. Operationally there was minimal structural change in service delivery constraining translation of learning to practice. The impact on patients, explored in our final theme, revealed that they experience significant disadvantage and problems with their medicines. The medication review was welcomed and the discussion with the pharmacist was helpful in addressing their medicine-related concerns. Conclusions: The co-produced digital educational intervention increases pharmacy professionals’ awareness and motivation to engage with marginalised groups. However structural barriers often hindered translation into practice. Patients reported significant health and medicine challenges that were going unnoticed. They welcomed the additional support the medication review offered. Policy makers and employers should better enable and facilitate ways for pharmacy professionals to better engage with marginalised groups. The impact of the educational intervention on patients’ health and medicines management could be substantial if supported and promoted effectively

Supporting underserved patients with their medicines: a study protocol for a patient/professional coproduced education intervention for community pharmacy staff to improve the provision and delivery of Medicine Use Reviews (MURs)

Introduction Community pharmacy increasingly features in global strategies to modernise the delivery of primary healthcare. Medicine Use Reviews (MURs) form part of the English Government's medicines management strategy to improve adherence and reduce medicine waste. MURs provide space for patient–pharmacist dialogue to discuss the well-known problems patients experience with medicine taking. However, ‘underserved’ communities (eg, black and minority ethnic communities, people with mental illness), who may benefit the most, may not receive this support. This study aims to develop, implement and evaluate an e-learning education intervention which is coproduced between patients from underserved communities and pharmacy teams to improve MUR provision. Methods and analysis This mixed-methods evaluative study will involve a 2-stage design. Stage 1 involves coproduction of an e-learning resource through mixed patient–professional development (n=2) and review (n=2) workshops, alongside informative semistructured interviews with patients (n=10) and pharmacy staff (n=10). Stage 2 involves the implementation and evaluation of the intervention with community pharmacy staff within all community pharmacies within the Nottinghamshire geographical area (n=237). Online questionnaires will be completed at baseline and postintervention (3 months) to assess changes in engagement with underserved communities and changes in self-reported attitudes and behaviour. To triangulate findings, 10 pharmacies will record at baseline and postintervention, details of actual numbers of MURs performed and the proportion that are from underserved communities. Descriptive and inferential statistics will be used to analyse the data. The evaluation will also include a thematic analysis of one-to-one interviews with pharmacy teams to explore the impact on clinical practice (n=20). Interviews with patients belonging to underserved communities, and who received an MUR, will also be conducted (n=20). Ethics and dissemination The study has received ethical approval from the NHS Research Ethics Committee (East Midlands–Derby) and governance clearance through the NHS Health Research Authority. Following the evaluation, the educational intervention will be freely accessible online

Supporting the provision of pharmacy medication reviews to marginalised (medically underserved) groups: a before/ after questionnaire study investigating the impact of a patient-professional co-produced digital educational intervention.

Objectives People who are marginalised (medically underserved) experience significant health disparities and their voices are often ‘seldom heard’. Interventions to improve professional awareness and engagement with these groups are urgently needed. This study uses a co-production approach to develop an online digital educational intervention in order to improve pharmacy staffs’ intention to offer a community pharmacy medication review service to medically underserved groups. Design Before/after (3 months) self-completion online questionnaire. Setting Community pharmacies in the Nottinghamshire (England) geographical area. Participants Community pharmacy staff. Intervention Online digital educational intervention. Primary and secondary outcome measures The primary outcome measure was ‘behaviour change intention’ using a validated 12-item survey measure. The secondary outcome measure was pharmacist self-reported recruitment of underserved groups to the medication review service. Results All pharmacies in the Nottinghamshire area (n=237) were approached in June 2017 and responses were received from 149 staff (from 122 pharmacies). At 3 months (after completing the baseline questionnaire), 96 participants (from 80 pharmacies) completed a follow-up questionnaire, of which two-thirds (n=62) reported completing the e-learning. A before/after comparison analysis found an improving trend in all the five constructs of behaviour change intention (intention, social influence, beliefs about capabilities, moral norms and beliefs about consequences), with a significant increase in mean score of participants’ ‘beliefs about capabilities’ (0.44; 95% CI 0.11 to 0.76, p=0.009). In the short-term, no significant change was detected in the number of patients being offered and the patient completing a medication review. Conclusions Although increases in the numbers of patients being offered a medication review was not detected, the intervention has the potential to significantly improve pharmacy professionals’ 'beliefs about capabilities' in the short-term. Wider organisational and policy barriers to engagement with marginasied groups may need to be addressed. Future research should focus on the interplay between digital learning and practice to better identify and understand effective practice change pathways

Parenting through place-of-care disruptions: a qualitative study of parents' experiences of neonatal care

© 2024 The Authors. Published by Wiley. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1111/hex.13933Introduction: Neonatal care is complex, involving multiple people and technologies within a community of care. When preterm babies are cared for far from home and/or transferred between units, the whole community of care (and particularly parent participation) is disrupted. Although previous studies have captured subjective experiences of parents, there has been little research exploring the material practices undertaken by parents as a consequence of place-of-care decisions, or the social organisation of those practices. Methods: As part of a wider study exploring optimal place-of-care, semistructured interviews were conducted between July 2018 and October 2019 with 48 parents (36 families) with one or more preterm babies (born at 27–31 weeks gestation) cared for in a neonatal unit in the last 12 months. Findings: We highlight parents' labour-intensive and stressful work to: (1) parent in the neonatal care community (an oversight role that goes beyond contemporary notions of ‘involvement’); (2) create continuity amid place-of-care disruptions; and (3) adapt to the managerial logics of neonatal care settings. Our analysis focuses on the work generated by managerial systems that organise place-of-care decision-making and other efficiency-focused practices. Parents are absorbed into negotiating institutional systems and diverted from routine parenting activities. Conclusion: Those involved in the organisation and management of neonatal care should take account of how managerial systems impact parents' workload, ability to participate in their baby's community of care and, ultimately, on the wellbeing and development of babies and their families. Patient or Public Contribution: The OPTI-PREM study embedded parents' experiences of neonatal care into the research, through a discrete workstream that employed qualitative methodology to capture parents' experiences—as reported in this paper. The OPTI-PREM project was also supported by a Bliss volunteer parent panel, which was involved in designing and overseeing the research. Bliss ‘champion[s] the right for every baby born premature or sick to receive the best care by supporting families, campaigning for change and supporting professionals and enabling life-changing research’ (https://www.bliss.org.uk/about-us/about-bliss). A representative of Bliss is a co-author of this manuscript, and a parent representative (named in the Acknowledgements) provided feedback during its preparation.Natalie Armstrong is supported by a Health Foundation Improvement Science Fellowship and also by the National Institute for Health & Care Research (NIHR) Applied Research Collaboration East Midlands (ARC EM).Published versio

Ilha Interdisciplinar de Racionalidade: Uma Proposta na Educação Infantil a partir do Tema Moradia

Este artigo tem o objetivo de apresentar os resultados de um estudo realizado com alunos de uma turma de educação infantil na construção de uma Ilha Interdisciplinar de Racionalidade sobre o tema moradia. A abordagem metodológica da pesquisa foi a qualitativa, de natureza interpretativa, com observação participante. O trabalho foi realizado com 18 alunos da Educação Infantil, de um colégio particular da cidade de Ponta Grossa, estado do Paraná, Brasil. Para a coleta dos dados utilizou-se, anotações em diário de campo das ações/interações e produções dos alunos (desenhos e colagens). Os principais resultados evidenciam a percepção de que as formas de construir moradias variam de lugar para lugar, conforme as características inerentes ao contexto. Por meio de atividades lúdicas que foram desenvolvidas e observações notou-se essa variedade de moradias, proporcionando o desenvolvimento de diversos conceitos, dentre eles o uso de materiais, a arquitetura, as prioridades locais e as necessidades dos habitantes, inclusive a dos animais que também precisam ter seu lugar. Podendo ainda em algumas situações o proprietário ser o construtor de sua própria casa. Desta feita colaborações dos mais diversos aspectos e materiais são de suma importância para minimizar desigualdades. Estes resultados apontam para a possibilidade de um ensino interdisciplinar com cooperação entre as disciplinas e as especialidades, possibilitando assim, desde a educação infantil um processo de ensino e aprendizagem com ação e participação do aluno na tomada de decisão e uma visão não fragmentada

Ilha Interdisciplinar de Racionalidade: Uma Proposta na Educação Infantil a partir do Tema Moradia

Este artigo tem o objetivo de apresentar os resultados de um estudo realizado com alunos de uma turma de educação infantil na construção de uma Ilha Interdisciplinar de Racionalidade sobre o tema moradia. A abordagem metodológica da pesquisa foi a qualitativa, de natureza interpretativa, com observação participante. O trabalho foi realizado com 18 alunos da Educação Infantil, de um colégio particular da cidade de Ponta Grossa, estado do Paraná, Brasil. Para a coleta dos dados utilizou-se, anotações em diário de campo das ações/interações e produções dos alunos (desenhos e colagens). Os principais resultados evidenciam a percepção de que as formas de construir moradias variam de lugar para lugar, conforme as características inerentes ao contexto. Por meio de atividades lúdicas que foram desenvolvidas e observações notou-se essa variedade de moradias, proporcionando o desenvolvimento de diversos conceitos, dentre eles o uso de materiais, a arquitetura, as prioridades locais e as necessidades dos habitantes, inclusive a dos animais que também precisam ter seu lugar. Podendo ainda em algumas situações o proprietário ser o construtor de sua própria casa. Desta feita colaborações dos mais diversos aspectos e materiais são de suma importância para minimizar desigualdades. Estes resultados apontam para a possibilidade de um ensino interdisciplinar com cooperação entre as disciplinas e as especialidades, possibilitando assim, desde a educação infantil um processo de ensino e aprendizagem com ação e participação do aluno na tomada de decisão e uma visão não fragmentada

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Parenting through place‐of‐care disruptions: A qualitative study of parents' experiences of neonatal care

Introduction: Neonatal care is complex, involving multiple people and technologies within a community of care. When preterm babies are cared for far from home and/or transferred between units, the whole community of care (and particularly parent participation) is disrupted. Although previous studies have captured subjective experiences of parents, there has been little research exploring the material practices undertaken by parents as a consequence of place‐of‐care decisions, or the social organisation of those practices. Methods: As part of a wider study exploring optimal place‐of‐care, semistructured interviews were conducted between July 2018 and October 2019 with 48 parents (36 families) with one or more preterm babies (born at 27–31 weeks gestation) cared for in a neonatal unit in the last 12 months. Findings: We highlight parents' labour‐intensive and stressful work to: (1) parent in the neonatal care community (an oversight role that goes beyond contemporary notions of ‘involvement’); (2) create continuity amid place‐of‐care disruptions; and (3) adapt to the managerial logics of neonatal care settings. Our analysis focuses on the work generated by managerial systems that organise place‐of‐care decision‐making and other efficiency‐focused practices. Parents are absorbed into negotiating institutional systems and diverted from routine parenting activities. Conclusion: Those involved in the organisation and management of neonatal care should take account of how managerial systems impact parents' workload, ability to participate in their baby's community of care and, ultimately, on the wellbeing and development of babies and their families. Patient or Public Contribution: The OPTI‐PREM study embedded parents' experiences of neonatal care into the research, through a discrete workstream that employed qualitative methodology to capture parents' experiences—as reported in this paper. The OPTI‐PREM project was also supported by a Bliss volunteer parent panel, which was involved in designing and overseeing the research. Bliss ‘champion[s] the right for every baby born premature or sick to receive the best care by supporting families, campaigning for change and supporting professionals and enabling life‐changing research’ (https://www.bliss.org.uk/about-us/about-bliss). A representative of Bliss is a co‐author of this manuscript, and a parent representative (named in the Acknowledgements) provided feedback during its preparation