Paramedic experiences of providing care in Wales (UK) during the 2020 COVID-19 pandemic (PECC-19): a qualitative study using evolved grounded theory

Objective: To explore paramedic experiences of providing care during the 2020 COVID-19 pandemic and develop theory in order to inform future policy and practice. Design: Qualitative study using constructivist evolved grounded theory (EGT) methodology. One-to-one semistructured interviews were conducted using a general interview guide. Voice over Internet Protocol was used through Skype. Setting: Conducted between March 2020 and November 2020 in the Welsh Ambulance Services National Health Services Trust UK which serves a population of three million. Participants: Paramedics were recruited through a poster circulated by email and social media. Following purposive sampling, 20 Paramedics were enrolled and interviewed. Results: Emergent categories included: Protect me to protect you, Rapid disruption and adaptation, Trust in communication and information and United in hardship. The Basic Social Process was recognised to involve Tragic Choices, conceptualised through an EGT including Tragic personal and professional choices including concerns over personnel protective equipment (PPE), protecting themselves and their families, impact on mental health and difficult clinical decisions, Tragic organisational choices including decision making support, communication, mental health and well-being and Tragic societal choices involving public shows of support, utilisation and resourcing of health services. Conclusions: Rich insights were revealed into paramedic care during the COVID-19 pandemic consistent with other research. This care was provided in the context of competing and conflicting decisions and resources, where Tragic Choices have to be made which may challenge life’s pricelessness. Well-being support, clinical decision making, appropriate PPE and healthcare resourcing are all influenced by choices made before and during the pandemic, and will continue as we recover and plan for future pandemics. The impact of COVID-19 may persist, especially if we fail to learn, if not we risk losing more lives in this and future pandemics and threatening the overwhelming collective effort which united society in hardship when responding to the COVID-19 Pandemic. Trial registration number: IRAS ID: 282 623.Peer reviewedFinal Published versio

Co-Governance in Digital Transformation Initiatives: The Roles of Digital Culture and Employee Experience

Digital transformation (DT) is increasingly fundamental for organizations to not only implement but thoroughly understand and dictate. Recent studies suggest that DT is not limited to the process of implementing digital technology to enhance business performance; it is the process of harmonizing organizational goals, values, and culture with employees by the mean of digital technologies. Therefore, it is critical to understand DT and determine its success from the perspective of the employee. To further understand the role of employees in DT, this paper theorizes and validates the relationships between digital culture, employee experience with DT, and DT co-governance. The findings guide theoretical and practical development in the field

The Effects of Classroom and Informal-Interactional Diversity on Learning and Democracy Outcomes

Exposure to increased diversity has been found to produce beneficial results in both learning and democracy outcomes across races; however, this relationship is more consistent for White students than students of color (Gurin, Dey, Hurtado, & Gurin, 2002). Using the data from a campus-wide diversity survey, the relationship between two types of diversity (informal-interactional and classroom) with learning and democracy outcomes was examined in a mid-sized university. Additional analyses were conducted to identify trends in diversity attitude and perception of campus climate toward diversity. Increased classroom diversity and informal-interactional diversity were both found to be related to increased learning and democracy outcomes for White students. For students of color, only classroom diversity was related to increased learning and democracy outcomes. Students of color and females were found to possess more positive attitudes toward diversity. Students of color perceived the more negative campus diversity climate than did White students

Culture conditions govern mouse embryonic stem cell behaviour: dependence on heparan sulfate and optimisation of synthetic polymer substrates

Human embryonic stem cell (hESC)-based therapies will only become viable once we eliminate the use of animal-derived material during ESC scale-up. Some groups have demonstrated the expansion of hESCs in xeno-free systems but the effect on downstream self-renewal and differentiation is poorly understood. Heparan sulfate (HS) is a master regulator of cellular behavior but the role of HS during ESC expansion is unclear, as is the exogenous source of HS in cultures. It has been shown that mESCs synthesise low levels of low-sulfated HS, but it is unclear if culture condition has any impact. In the studies here, three discrete culture conditions were employed for E14 mESC expansion along with immunostaining and RT-qPCR to study marker expression for differentiation to the three lineages and corresponding BM synthesis. SAX-HPLC was used to characterise soluble HS from cells/medium/serum. A varierty of polymers were tested as synthetic alternatives for ESC expansion. It was found that HS-deficient embryoid bodies (EBs) (derived from EXT1-/- mESCs in normal culture conditions) remained in a pluripotent state and lacked a typical differentiation pattern. Furthermore, HS-deficient mESCs could not be maintained in the absence of serum, highlighting a link between serum and HS. EBs derived from E14 mESCs cultured in the absence of serum displayed unusual differentiation patterns, which were rescued by exogenous porcine mucosal heparin (PMH). Feeder cells displayed cell-surface HS but feeder-cell conditioned medium (CM) was predominantly an unsulfated structure. An array of low and highly sulfated HS structures were identified in serum-alone. 10-fold more HS was purified from serum-free feeder-free (-F –FBS) CM compared to the other mESC CM (with/without feeders but in the presence of serum; +/-F +FBS). Furthermore, unlike +/-F +FBS conditions, highly sulfated HS disaccharide UA2S–GlcNS6S was the major constituent in –F-FBS and Sulf2 levels were significantly reduced. Poly-Ɛ-lysine macroporous substrates supported mESC and kidney-derived stem cells (KSCs-GFP) adherence and proliferation, further enhanced by adsorbing RGD or per-sulfated HS structures to the surface of the poly-Ɛ-lysine. The key conclusions from these studies were that serum is a source of HS, without which, mESCs behave uncharacteristically; that synthetic HS-mimetic structures could represent an alternative to serum; and poly-Ɛ-lysine shows great promise to replace current animal-derived coating materials for ESC expansion

South African Pine Cut-to-Length Harvesting: an Analysis of Fibre Loss and Productivity

A study was conducted in Pinus elliottii and Pinus patula clear-felling stands in the Southern Cape and Mpumulanga forestry regions of South Africa. A hybrid harvester was observed over four compartments in a cut-to-length system in order to assess its productivity as well as its precision with regards to potential fibre loss while processing Pinus elliottii and Pinus patula for sawlog production. Potential fibre loss results show that the harvester contributes minimally through inaccurate cross-cutting, accounting for 1.5% of the total wood volume processed. Converted to a cost, this indicated losses up to € 0.18 m–3 for P. elliottii and € 1.61 m–3 for P. patula. Additionally, the machines were found to be more productive when working with P. elliottii (32.12 m3 SMH–1) than P. patula (17.55 m3 SMH–1). Based on these findings, the loss was estimated at up to € 22 650 and € 101 530 y–1 for P. elliottii and P. Patula, respectively. Species showed to have a significant impact on the processing accuracy, with cross-cutting of P. patula stems being less precise than P. elliottii. This was attributed to the species’ tendency to grow thicker branches, although differences in harvesting conditions could have contributed. Results suggest that harvesting P. patula stands in a CTL system requires more caution since these can be associated with higher economic losses, and lower productivities. Considering the recent growth of mechanised CTL harvesting, this study hopefully aids in exploring the efficacy of a system, which has gone largely untested to date in South African conditions