Beyond you and I: role play and reflection-in-action in communication training

This article will explore the development of communication training within nurse training. Beginning by outlining current thinking around this practice, it then discusses Schön’s notion of reflective practice and its frequently cited relevance to nursing before pointing out some of its limitations. In particular, it looks at the limitations of the individual being able to critically reflect on their self within a broader social context. Drawing on the theories of Habermas and Bourdieu, it suggests that encouraging a greater awareness of one’s own social context, and hence of one’s own subject position, would develop a deeper awareness of other potential perspectives and a better ability to listen to patients. Finally, it argues for the use of role play in assisting nurses to gain such awareness, particularly in difficult clinical situations such as end-of-life care

Assessing demand for faecal sludge management (FSM) services in Freetown

‘Achieving sustained environmental health improvements in Freetown through faecal sludge management enterprises’ was a partnership project between Freetown City Council (FCC), International Water Association (IWA), and GOAL. This project aimed to improve faecal sludge management (FSM) through public – private partnerships and improved financial flows to ensure viability of businesses. A market assessment was conducted in Freetown which considered demand and supply for FSM services. This paper discusses findings from the household survey which was a key component of the market assessment. While the households felt that they were getting value for money for existing services, they were not satisfied with existing services and hence were willing to pay higher prices for improved services. This highlights the importance of quality service provision in relation to revenue generation. Improved pit emptying services was noted to be of high priority to households. In order to improve pit emptying services the FSM strategy proposed intermediate transfer stations and formation of a Sanitation Unit and Contact Centre within FCC

fNIRS neuroimaging in olfactory research: A systematic literature review

There are a number of key features which make olfaction difficult to study; subjective processes of odor detection, discrimination and identification, and individualistic odor hedonic perception and associated odor memories. In this systematic review we explore the role functional near-infrared spectroscopy (fNIRS) has played in understanding olfactory perception in humans. fNIRS is an optical neuroimaging technique able to measure changes in brain hemodynamics and oxygenation related to neural electrical activity. Adhering to PRISMA guidelines, results of this search found that generally the majority of studies involving healthy adult subjects observed increased activity in response to odors. Other population types were also observed, such as infants, individuals with autism, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), mild cognitive impairment (MCI) and dysosmia. fNIRS coverage heavily favored the prefrontal cortex, temporal and parietal regions. This review finds that odor induced cortical activation is dependent on multiple factors, such as odorant type, gender and population type. This review also finds that there is room for improvement in areas such as participant diversity, use of wearable fNIRS systems, physiological monitoring and multi-distance channels

Results of cross-faculty 'capstone' assessments involving nursing and performing arts students

This article describes how ‘capstone’ assessments were created to provide two different student groups, nursing and performing arts students, with a lived experience of learning together about their own fields of practice. Capstone assessments combine ‘live’ human simulation with self‑reflection and peer review. A capstone assessment is the integration of a body of relatively fragmented knowledge and learning to form a unified whole and can be used as a transitional assessment and a bridging experience to connect knowledge between modules or courses. The capstone assessments involved two faculties and four modules, three nursing and one performing arts. Case studies were designed to represent real-life situations that students were likely to encounter during their careers, either playing a patient as an actor or performing a caring role as a nurse. Assessments for the capstone simulation were formative, and involved the students engaging in self-reflection and peer review. Videos were available to enhance the self-reflection and peer-review process. Evaluation was undertaken through verbal feedback during debrief, written feedback, video footage and nursing student and acting student peer review. The experience of capstone assessments for two diverse student groups provided valuable learning from their own and from a different group outside their subject area

Supporting employees with chronic conditions to stay at work:perspectives of occupational health professionals and organizational representatives

Contains fulltext : 231735.pdf (publisher's version ) (Open Access)Background: Supporting employees with chronic conditions can prevent work-related problems and facilitate sustainable employment. Various stakeholders are involved in providing support to these employees. Understanding their current practices and experienced barriers is useful for the development of an organizational-level intervention to improve this support. The aim of this study was to explore the current practices of occupational physicians and organizational representatives, identifying both barriers to providing support and opportunities for improvement. Methods: Two focus groups with sixteen occupational physicians and seven semi-structured interviews with organizational representatives were held between January and June 2018. Data was analyzed using thematic content analysis. Results: Several barriers to offer support were identified, including barriers at the organizational level (negative organizational attitudes towards employees with chronic conditions), the employee level (employees' reluctance to collaborate with employers in dealing with work-related problems), and in the collaboration between occupational physicians and organizational representatives. In addition, barriers in occupational health care were described, e.g. occupational physicians' lack of visibility and a lack of utilization of occupational physicians' support. Opportunities to optimize support included a shared responsibility of all stakeholders involved, actively anchoring prevention of work-related problems in policy and practice and a more pronounced role of the health care sector in preventing work-related problems. Conclusions: Preventing work-related problems for employees with chronic conditions can be achieved by addressing the identified barriers to provide support. In addition, both occupational physicians and organizational representatives should initiate and secure preventive support at the organizational level and in occupational health care. These insights are helpful in developing an intervention aimed at supporting employees with chronic conditions to stay at work.13 p

Multi-parameter phenotyping of platelets and characterisation of the effects of agonists using machine learning

Platelet function is driven by the expression of specialised surface markers. The concept of distinct circulating sub-populations of platelets has emerged in recent years, but their exact nature remains debatable. Objective To design a spectral flow cytometry-based phenotyping workflow to provide a more comprehensive characterisation, at a global and individual level, of surface markers in resting and activated healthy platelets. Secondly, to apply this workflow to investigate how responses differ according to platelet age. Methods A 14-marker flow cytometry panel was developed and applied to vehicle- or agonist-stimulated platelet-rich plasma and whole blood samples obtained from healthy volunteers, or to platelets sorted according to SYTO-13 staining intensity as an indicator of platelet age. Data were analysed using both user-led and independent approaches incorporating novel machine learning-based algorithms. Results The assay detected differences in marker expression in healthy platelets, at rest and on agonist activation, in both platelet rich plasma and whole blood samples, that are consistent with the literature. Machine learning identified stimulated populations of platelets with high accuracy (>80%). Similarly, machine learning differentiation between young and old platelet populations achieved 76% accuracy, primarily weighted by FSC-A, CD41, SSC-A, GPVI, CD61, and CD42b expression patterns. Conclusions Our approach provides a powerful phenotypic assay coupled with robust bioinformatic and machine learning workflows for deep analysis of platelet sub-populations. Cleave-able receptors, GPVI and CD42b, contribute to defining shared and unique sub-populations. This adoptable, low-volume approach will be valuable in deep characterisation of platelets in disease