Followership is not following : Reframing followership in Western higher education

This article examined meanings of followership in Western higher education as reported in the literature. To retrieve sources, an electronic search was implemented. The search procedure included the terms ‘followership’ and ‘education’ on six databases and other sources. Examination of relevant works found that, in Western higher education, ‘followership’ takes a different meaning than what is currently reported in the literature. Views of self-control and agency, and strong notions of autonomy and independence surfaced, aligning with academic ideas of critical and independent thinking, and academic freedom. Indeed, many academics did not align with the idea of being a follower as well as the perspective of followership as the deference to another individual. It was revealed that what academics do in Western higher education cannot be described by the term ‘followership’. In this context, ‘followership’ is more accurately described as an endeavor related to contribution and making a difference; thus, a case for an afresh term was made. It was argued that a new term should acknowledge academics’ autonomy and independence, and that academics ‘volunteer’ but do not ‘subordinate.’ Resultantly, the term ‘endeavorship’ was offered

Systematic review: self-monitoring of blood glucose in patients with Type 2 Diabetes

The benefit of self-monitoring of blood glucose (SMBG) in the reduction of HbA1c in non-insulin-treated participants remains unclear. HbA1c may be improved in this population with SMBG. We aimed to investigate this. Meta-analyses of randomized controlled trials (RCTs) were performed comparing SMBG versus usual care and structured versus unstructured SMBG; the effect of clinician therapy adjustment based on SMBG readings was examined. Medline, Embase and Cochrane Central were electronically searched to identify articles published from 1 January 2000 to 30 June 2020. Trials investigating changes in HbA1c were selected. Screening was performed independently by two investigators. Two investigators extracted HbA1c at baseline and follow-up for each trial. Nineteen RCTs, involving 4,965 participants were included. Overall, SMBG reduced HbA1c. Preplanned subgroup analysis showed that using SMBG readings to adjust therapy contributed significantly to the reduction. No significant improvement in HbA1c was shown in SMBG without therapy adjustment). The same difference was observed in structured SMBG compared to unstructured SMBG. HbA1c is improved with therapy adjustment based on structured SMBG readings. Implications are for clinicians to prescribe structured SMBG with an aim for therapy adjustment based on the readings, and not prescribing unstructured SMBG. Participants with suboptimal glycemic control may benefit most. A SMBG regimen that improves clinical- and cost-effectiveness is presented. Future studies can investigate this regimen specifically.N/

Resilience Intervention for Families of Autistic Children:Reviewing the Literature

Given the rising diagnostic rates of autism, it is imperative to investigate the well-being of families with autistic children. Families of autistic children report more mental health difficulties than families of typically developing children. Resilience is identified as a key protective factor for mental health difficulties in many populations, and research suggests that this construct is effective for coping with mental health difficulties in families of autistic children. However, reviews on resilience interventions for families of autistic children are lacking. Accordingly, this paper aims to report (a) common mental health difficulties that families of autistic children experience, (b) how resilience may reduce mental health difficulties, (c) interventions to enhance resilience in families of autistic children, and (d) discuss implications for practice and future research. Our review identified that mental distress resulting from feelings of uncertainty and helplessness following a diagnosis, in addition to caregiving stressors, is especially common among families of autistic children. Enhancing resilience is suggested to reduce those difficulties by tapping into strengths related to various positive psychological resources such as internal locus of control, positive cognitive appraisal, acceptance and self-efficacy. Interventions such as Dance Movement Psychotherapy and spirituality-based approaches, are deemed especially helpful to families of autistic children. However, research in this area is still underdeveloped, and there is a pressing need to build a more rigorous evidence base. Findings reviewed in the current work can aid families of autistic children, healthcare practitioners, and researchers to support the mental wellbeing of families of autistic children, which in turn would support the wellbeing of autistic children

Mental health shame, self-compassion and sleep in UK nursing students: complete mediation of self-compassion in sleep and mental health

To explore relationships between mental health problems, mental health shame, self- compassion and average length of sleep in UK nursing students. The increasing mental health problems in nursing students may be related to a strong sense of shame they experience for having a mental health problem. Self-compassion has been identified as a protective factor for mental health and shame in other student populations. Further, studies highlight the importance of sleep relating to mental health. Design: A cross‐sectional design. A convenient sampling of 182 nursing students at a university in the East Midlands completed a paper-based questionnaire regarding these four constructs, from February to April 2019. Correlation, regression and mediation analyses were conducted. Mental health problems were positively related to shame, and negatively related to self- compassion and sleep. Mental health shame positively predicted, and self-compassion negatively predicted mental health problems: sleep was not a significant predictor of mental health problems. Lastly, self-compassion completely mediated the impacts of sleep on mental health problems (negative relationship between mental health problems and sleep was fully explained by self-compassion). The importance of self-compassion was highlighted as it can reduce mental health problems and shame. Self-compassion can protect nursing students from mental distress when they are sleep-deprived. Impact: Nurses and nursing students are required to work irregular hours (e.g., COVID-19), and mental distress can cause serious consequences in clinical practice. Our findings suggest that nurturing self-compassion can protect their mental health, and the negative impacts of sleep deprivation on mental health.N/

Dealing with isolation using online morning huddles for university lecturers during physical distancing by COVID-19 field notes

Isolation can affect our well-being negatively. To prevent the spread of the infection COVID-19, many workers, including university lecturers, are required to work from home. In order to maintain high levels of well-being and team cohesion, academics at the University of Derby Online Learning initiated a virtual huddle to briefly socialise and check on their colleagues’ well-being every morning. This piece of field notes reports the context (COVID-19 in the United Kingdom), the details of this morning socialization, the first-hand experience of attending this huddle, and possible applications. Perceived positive impacts of our huddles include better well-being, cultivating compassion in team culture, and enhanced team cohesion. These advantages can be also useful in student supervision, wider socialization with colleagues to counter the silo mentality, and other occupational sectors. Our field notes will be helpful for lecturers and other types of employees who work collaboratively yet in isolation during this uncertain and challenging time of crisis.N/

Teaching Healthcare Professional Students in Online Learning during COVID-19: Reflection of University Lecturers

Online education has been regarded as a lifeline for many education institutions during the COVID-19 pandemic, offering students a means to advance their education and career. While face-to-face teaching universities convert their education curricula to the online settings, many institutions lack effective online teaching strategies, leading to reduced student enrolment and satisfaction. Contrarily, we have been receiving an ever-increasing number of healthcare professional students in our learning department since the outbreak, while maintaining high satisfaction. These students work as registered professional key workers and study online. Among numerous measures taken to support this student group, this short paper reports four effective teaching practices we have implemented: (a) active use of adaptive learning, (b) Padlet discussions, (c) wellbeing webinars, and (d) resilience building. These teaching strategies are deemed to address weaknesses of online learning and offer emotional support to students. Our teaching practices will be useful to many universities supporting this crucial group of students in the online environment.N/

The Diversification of the LIM Superclass at the Base of the Metazoa Increased Subcellular Complexity and Promoted Multicellular Specialization

Background: Throughout evolution, the LIM domain has been deployed in many different domain configurations, which has led to the formation of a large and distinct group of proteins. LIM proteins are involved in relaying stimuli received at the cell surface to the nucleus in order to regulate cell structure, motility, and division. Despite their fundamental roles in cellular processes and human disease, little is known about the evolution of the LIM superclass. Results: We have identified and characterized all known LIM domain-containing proteins in six metazoans and three nonmetazoans. In addition, we performed a phylogenetic analysis on all LIM domains and, in the process, have identified a number of novel non-LIM domains and motifs in each of these proteins. Based on these results, we have formalized a classification system for LIM proteins, provided reasonable timing for class and family origin events; and identified lineagespecific loss events. Our analysis is the first detailed description of the full set of LIM proteins from the non-bilaterian species examined in this study. Conclusion: Six of the 14 LIM classes originated in the stem lineage of the Metazoa. The expansion of the LIM superclass at the base of the Metazoa undoubtedly contributed to the increase in subcellular complexity required for the transition from a unicellular to multicellular lifestyle and, as such, was a critically important event in the history of animal multicellularity

Physical functioning, mental health, and quality of life in different congenital heart defects : comparative analysis in 3538 patients from 15 countries

Background: We compared physical functioning, mental health, and quality of life (QoL) of patients with different subtypes of congenital heart disease (CHD) in a large international sample and investigated the role of functional class in explaining the variance in outcomes across heart defects. Methods: In the cross-sectional Assessment of Patterns of Patient-Reported Outcome in Adults with Congenital Heart Disease-International Study (APPROACH-IS), we enrolled 4028 adult patients with CHD from 15 countries. Diagnostic groups with at least 50 patients were included in these analyses, yielding a sample of 3538 patients (median age: 32 years; 52% women). Physical functioning, mental health, and QoL were measured with the SF-12 health status survey, Hospital Anxiety and Depression Scale (HADS), linear analog scale (LAS) and Satisfaction with Life Scale, respectively. Functional class was assessed using the patient-reported New York Heart Association (NYHA) class. Multivariable general linear mixed models were applied to assess the relationship between the type of CHD and patient-reported outcomes, adjusted for patient characteristics, and with country as random effect. Results: Patients with coarctation of the aorta and those with isolated aortic valve disease reported the best physical functioning, mental health, and QoL. Patients with cyanotic heart disease or Eisenmenger syndrome had worst outcomes. The differences were statistically significant, above and beyond other patient characteristics. However, the explained variances were small (0.6% to 4.1%) and decreased further when functional status was added to the models (0.4% to 0.9%). Conclusions: Some types of CHD predict worse patient-reported outcomes. However, it appears that it is the functional status associated with the heart defect rather than the heart defect itself that shapes the outcomes.peer-reviewe

Patient-reported outcomes in the aging population of adults with congenital heart disease : results from APPROACH-IS

The congenital heart disease (CHD) population now comprises an increasing number of older persons in their 6th decade of life and beyond. We cross-sectionally evaluated patient-reported outcomes (PROs) in persons with CHD aged 60 years or older, and contrasted these with PROs of younger patients aged 40–59 years and 18–39 years. Adjusted for demographic and medical characteristics, patients ≥60 years had a lower Physical Component Summary, higher Mental Component Summary, and lower anxiety (Hospital Anxiety and Depression Scale-Anxiety) scores than patients in the two younger categories. For satisfaction with life, older persons had a higher score than patients aged 40–59 years.peer-reviewe

Heart failure and patient-reported outcomes in adults with congenital heart disease from 15 countries

Background: Heart failure (HF) is the leading cause of mortality and associated with significant morbidity in adults with congenital heart disease. We sought to assess the association between HF and patient‐report outcomes in adults with congenital heart disease. Methods and Results: As part of the APPROACH‐IS (Assessment of Patterns of Patient‐Reported Outcomes in Adults with Congenital Heart disease—International Study), we collected data on HF status and patient‐reported outcomes in 3959 patients from 15 countries across 5 continents. Patient‐report outcomes were: perceived health status (12‐item Short Form Health Survey), quality of life (Linear Analogue Scale and Satisfaction with Life Scale), sense of coherence‐13, psychological distress (Hospital Anxiety and Depression Scale), and illness perception (Brief Illness Perception Questionnaire). In this sample, 137 (3.5%) had HF at the time of investigation, 298 (7.5%) had a history of HF, and 3524 (89.0%) had no current or past episode of HF. Patients with current or past HF were older and had a higher prevalence of complex congenital heart disease, arrhythmias, implantable cardioverter‐defibrillators, other clinical comorbidities, and mood disorders than those who never had HF. Patients with HF had worse physical functioning, mental functioning, quality of life, satisfaction with life, sense of coherence, depressive symptoms, and illness perception scores. Magnitudes of differences were large for physical functioning and illness perception and moderate for mental functioning, quality of life, and depressive symptoms. Conclusions: HF in adults with congenital heart disease is associated with poorer patient‐reported outcomes, with large effect sizes for physical functioning and illness perception.peer-reviewe