Whistleblowing as a means to raise concerns, or a means to an end!

This is a reflection on a whistleblowing policy in practice.  This will be linked to a specific issue from practice.  Consideration will be given to the impact of culture within an organisation of a staff member decision to use the whistleblowing policy.While whistleblowing is an option where a staff member has serious concerns about quality of care, it is one that is only taken when all other avenues are exhausted.  It will explore some of the challenges that staff and students can encounter when making a decision to whistleblow.  It will explain how a whistleblowing policy can support professionals in practice.It argues how those on the receiving end of care may have limited choice on the quality of that care, but as health professionals we do have choices and it is about what choices we make

Assessment of pain in older people : where are we now and what needs to be done?

The purpose of this paper is to present the findings of a review of the literature into pain and older people. The funded study was part of the development of an annotated bibliography published in August 2005. The review included all major databases and involved the collection of 214 papers between the dates of 1995 and 2005. The papers were divided into several major themes, which include experiences, management (pharmacological and non-pharmacological), assessment, and attitudes. Within this paper, the results of the review into pain assessment will be discussed, which includes 42 of the collected papers. The other sections will be published later. The paper will discuss issues pertaining to the development of specific tools for older people, a discussion of tools already available, comparisons of staff versus older people’s perceptions of pain scales, and articles with cognitive impairment as a focus. Recommendations for further study are made.University of Sheffiel

Assessment of Pain in adults with cognitive impairment : a review of the tools

The aim of this paper is to discuss the results of a review into the literature related to chronic pain and the older adult. Several themes within the review have been identified and reported elsewhere and the final report has been published by the University of Sheffield in the form of an annotated bibliography. This report focuses upon the findings of the in relation to the assessment of pain in the adult with cognitive impairment. Issues surrounding assessment in the non-cognitively impaired older adult have also been reported elsewhere. For this paper nine studies will be discussed which report the development and testing of pain assessment scales the focus of which is upon behavioural indicators of pain. Some scales have been omitted from the review and the rationale for this decision will be discussed. Each of the selected scales will be discussed and the authors will make recommendations for both clinical practice and for future research based upon the validity, reliability and user friendliness of the scales. From the paper it can be concluded that the Abbey, DOLOPLUS-2 and PACSLAC appear to be the most reliable and valid and in terms of the “user friendliness” would be appropriate to explore further. Recommendations are made for further multi-centre evaluation of these scales.University of Sheffiel

Aftermath of an Officer Involved Shooting: Formal Education, Continuing Education, and Responsibility

This is a policy review presentation that shows there are areas for improvement and recommendations to implement in the professional and academic sides of law enforcement using the lens of a current officer involved shooting that generated a lot of publicity. The recommendations would require a partnership between formal education providers, continuing education providers and practitioners

Women’s and peer supporters’ experiences of an assets-based peer support intervention for increasing breastfeeding initiation and continuation: a qualitative study

Background and context. Breastfeeding peer support is valued by women, but UK trials have not demonstrated efficacy. The ABA feasibility trial offered pro-active peer support underpinned by behaviour change theory and an assets-based approach to women having their first baby, regardless of feeding intention. This paper explores women and infant feeding helpers’ (IFHs) views of the different components of the ABA intervention. Setting and participants. Trained IFHs offered 50 women an antenatal meeting to discuss infant feeding and identify community assets in two English sites - one with a paid peer support service and the other volunteer-led. Postnatally, daily contact was offered for the first 2 weeks, followed by less frequent contact until 5 months. Methods. Interviews with 21 women and focus groups/interviews with 13 IFHs were analysed using thematic and framework methods. Results. Five themes are reported highlighting that women talked positively about the antenatal meeting, mapping their network of support, receiving proactive contact from their IFH, keeping in touch using text messaging and access to local groups. The face-to-face antenatal visit facilitated regular text-based communication both in pregnancy and in the early weeks after birth. Volunteer IFHs were supportive of and enthusiastic about the intervention, whereas some of the paid IFHs disliked some intervention components and struggled with the distances to travel to participants. Conclusions. This proactive community assets-based approach with a woman-centred focus was acceptable to women and IFH’s and is a promising intervention warranting further research as to its effect on infant feeding outcomes

Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding

Abstract Background A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s and infant feeding helpers’ experiences and use of an infant feeding genogram delivered to the intervention group of the Assets-based infant feeding help Before and After birth (ABA) randomised feasibility trial. Methods 103 primiparous mothers aged 16+ years were recruited to the trial in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers co-constructed a genogram at the first antenatal meeting for the intervention group, and then provided proactive, woman-centered support from ~32 weeks gestation to up to 5 months postnatal. Infant feeding helpers and women’s experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically. Results Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4-21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs’ application of the tool. The genogram was either used as intended to raise women’s awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted.Discussion/Conclusion The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended

Older people’s views and expectations about the competences of health and social care professionals: a European qualitative study

Adapting and providing quality services for people as they age is a common challenge across Europe. The perspective of older people is fundamental in a person-centred care approach. Expanding research at the European level that explicitly includes their views can ofer a relevant contribution to the development of evidence-based guidelines that can be shared in education and training across health and social care professions. This study aimed to identify common meaningful dimensions of pro fessional competence in health and social care emphasised by older people from six countries in diferent regions of Europe according to their experiences. A qualitative approach was chosen with a total of 95 semi-structured interviews conducted in Austria, Finland, Lithuania, Portugal, Turkey and UK, following a common topic guide. Participants in this study were aged 60 and above, and recruitment considered age, gender, level of education and living arrangements. Results identifed a set of universal skills and practices that according to older people, health and social care professionals should meet. Competences at the interpersonal level were central in older people’s discourses, and its core dimensions are anchored in relational, com munication and socio-emotional skills of professionals. These fndings reinforce the aspiration of establishing best practices in care that relies on the harmonisation of a competence framework that can be shared in the training and education of health and social care professionals across Europe and that voices older people’s preferences, expectations and needs.info:eu-repo/semantics/publishedVersio

Determination of protein thiol reduction potential by isotope labeling and intact mass measurement

Oxidation/reduction of thiol residues in proteins is an important type of post-translational modification that is implicated in regulating a range of biological processes. The nature of the modification makes it possible to define a quantifiable electrochemical potential, E⊕, for oxidation/reduction that allows cysteine-containing proteins to be ranked based on their propensity to be oxidized. Measuring oxidation of cysteine residues in proteins is difficult using standard electrochemical methods but recently top-down mass-spectrometry has been shown to enable the quantification of E⊕ for thiol oxidations. In this paper we demonstrate that mass spectrometry of intact proteins can be used in combination with an isotopic labeling strategy and an automated data analysis algorithm to measure E⊕ for the thiols in both E Coli Thioredoxin 1 and Human Thioredoxin 1. Our methodology relies on accurate mass measurement of proteins using LC-MS analyses and does not necessarily require top-down fragmentation. As well as analyzing homogeneous protein samples, we also demonstrate that our methodology can be used to determine thiol E⊕ measurements in samples which contain mixtures of proteins. Thus the combination of experiential methodology and data analysis regime have the potential to make such measurements in a high-throughput manner and in a manner more accessible to a broad community of protein scientists

Systematically searching for and assessing the literature for self-management of chronic pain: a lay users’ perspective

Background: The Engaging with older adults in the development of strategies for the self management of chronic pain (EOPIC) study aims to design and develop self management strategies to enable older adults to manage their own pain. Involving older adults in research into chronic pain management will better enable the identification and development of strategies that are more appropriate for their use, but how can perspectives really be utilised to the best possible outcomes? Method: Seven older adults were recruited through a local advertising campaign to take part. We also invited participants from the local pain services, individuals who had been involved in earlier phase of the EOPIC study and a previous ESRC funded project. The group undertook library training and research skills training to facilitate searching of the literature and identified sources of material. A grading tool was developed using perceived essential criteria identified by the older adults and material was graded according to the criteria within this scale. Results: Fifty-seven resources from over twenty-eight sources were identified. These materials were identified as being easily accessible, readable and relevant. Many of the web based materials were not always easy to find or readily available so they were excluded by the participants. All but one were UK based. Forty-four items were identified as meeting the key criteria for inclusion in the study. This included five key categories as follows; books, internet, magazines, leaflets, CD’s/Tapes. Conclusion: This project was able to identify a number of exemplars of self management material along with some general rules regarding the categories identified. We must point out that the materials identified were not age specific, were often locally developed and would need to be adapted to older adults with chronic pain. For copyright issues we have not included them in this paper. The key message is really related to the format rather than the content. However, the group acknowledge that these may vary according to the requirements of each individual older adult and therefore recommend the development of a leaflet to help others in their search for resources. This leaflet has been developed as part of Phase IV of the EOPIC study