I want it all and I want it now. Challenging the traditional nursing academic paradigm

A recent Twitter chat facilitated by the @NurseEducToday socialmedia team provoked a particularly strong reaction among a range of contributors. The focus of the discussion – expectations of the nurse academic – resulted in a high level of engagement from several participants who clearly held strong views, which were surprisingly polarised. Here we explore aspects of this polarization; and what it might mean for nurses working in academia. Our aim is to reflect on what this dialogue might tell us about current thinking in the profession, specifically around how nurse academics see themselves, what they expect from self and others, and what they are prepared to do to meet these,often, self-generated expectations

The Influence of Transformation in Effective Training: Perspectives from Trainers in the Field

Training and development is often directly connected to human resources and less associated with adult education. However, through interviews of three trainers, it was found that through personal experiences, trainers undergo transformative learning to become trainers and such effects the way they perceive effective training

Assessment of Five Chilling Tolerance Traits and GWAS Mapping in Rice Using the USDA Mini-Core Collection

Rice (Oryza sativa L.) is often exposed to cool temperatures during spring planting in temperate climates. A better understanding of genetic pathways regulating chilling tolerance will enable breeders to develop varieties with improved tolerance during germination and young seedling stages. To dissect chilling tolerance, five assays were developed; one assay for the germination stage, one assay for the germination and seedling stage, and three for the seedling stage. Based on these assays, five chilling tolerance indices were calculated and assessed using 202 O. sativa accessions from the Rice Mini-Core (RMC) collection. Significant differences between RMC accessions made the five indices suitable for genome-wide association study (GWAS) based quantitative trait loci (QTL) mapping. For young seedling stage indices, japonica and indica subspecies clustered into chilling tolerant and chilling sensitive accessions, respectively, while both subspecies had similar low temperature germinability distributions. Indica subspecies were shown to have chilling acclimation potential. GWAS mapping uncovered 48 QTL at 39 chromosome regions distributed across all 12 rice chromosomes. Interestingly, there was no overlap between the germination and seedling stage QTL. Also, 18 QTL and 32 QTL were in regions discovered in previously reported bi-parental and GWAS based QTL mapping studies, respectively. Two novel low temperature seedling survivability (LTSS)–QTL, qLTSS3-4 and qLTSS4-1, were not in a previously reported QTL region. QTL with strong effect alleles identified in this study will be useful for marker assisted breeding efforts to improve chilling tolerance in rice cultivars and enhance gene discovery for chilling tolerance

Supporting Carers of People with Dementia:What is effective?

Carer stress is well documented, especially in those caring for individuals with dementia. A recommendation of all national dementia strategies is to provide excellent support and information to informal carers of people with dementia. NICE guidance suggests that a range of tailored interventions, including psychological input, psychoeducation and training courses, should be offered to reduce caregiver burden and stress, although good-quality outcome-based evidence is lacking. On the basis of a narrative review of the literature, we describe individual and multicomponent carer support packages and discuss their evidence base, reflecting on outcomes for carers. Multicomponent interventions have the best evidence for effectiveness.Learning Objectives• Consider the risks of both physical and psychological harm experienced by carers of people with dementia (often referred to as carer burden or caregiver burden)• Be aware of the interventions available for the support of carers of people with dementia• Consider the evidence for the effectiveness of these interventions and be aware of the limitations of the evidence</jats:sec

The relationship between frailty, functional dependence, and healthcare needs among community‐dwelling people with moderate to severe dementia

This paper examines the healthcare needs of community‐dwelling older people living in Porto, Portugal, diagnosed with moderate or severe dementia, linked to functional dependency, cognitive decline, limitations in the activities of daily life, and frailty levels. A sample of 83 participants was recruited. Data were collected between 2013 and 2017. A sociodemographic questionnaire, the Clinical Dementia Rating (CDR), the Barthel Index (BI), the Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale, and the Edmonton Frail Scale (EFS) were used. A set of 26 healthcare needs was defined to support the assessment. The Pearson chi‐square or Fisher’s exact test (as appropriate) was used to examine the association of the needs (unmet and met) with the levels of dementia and frailty. Participants were diagnosed previously with moderate or severe dementia and benefited from a structured home‐care program. There was a high number rated as “severe dementia,” “fully dependent,” “severely or fully dependent in the activities of daily living (ADL),” and “severe frailty.” There were statistically significant differences among needs identified in people with moderate or severe dementia and moderate or severe frailty. The most prevalent healthcare needs in the sample were food preparation, medication/taking pills, looking after their home, toilet use, sensory problems, communication/interaction, bladder, bowels, eating and drinking, memory, sleeping, and falls prevention. In particular, the study identifies a set of needs that are present simultaneously in both frailty and dementia stages. This study underlines that despite well‐structured home‐care programs for people with dementia, unmet health needs remain. Timely healthcare needs assessment may help professionals to avoid fragmented care and to tailor quality‐ integrated interventions, including the emotional and psychological balance of the caregiver.publishe

International Perspectives of Nurses, Midwives and Allied Health Professionals Clinical Academic Roles: Are We at Tipping Point?

Healthcare research activity improves patient outcomes. Nurses, Midwives and Allied Health Professions (NMAHPs) make an important contribution to clinical research. Within the United Kingdom (UK), there is a 25-year history of increasing healthcare research capacity and capability through clinical academic roles. Medical colleagues were the first to introduce the role in 2005. In 2007, a national policy identified inequalities in access to and success of research training fellowships between medical and nursing healthcare professionals. This was followed by a number of national initiatives, which continue to evolve to the present day. There is evidence that the UK has reached the ‘tipping point’ to increase NMAHP research capacity and capability through clinical academic roles. Despite these initiatives substantial gaps remain. Outside, the UK, the term ‘clinical academic’ is not well understood. There is evidence of the presence of senior clinical academic roles, a clinical professor within Australia and the United States, for example, but there is a lack of opportunities and of a formulised research training pathway at a junior level. There is interest and appreciation of the NMAHP research-active clinical academic within the clinical setting in the Nordic countries and China, but the pace of change is slow due to co-existing priorities involving change and innovation. There is a need to develop and agree both national and international definitions that describes the NMAHP research-focused clinical academic role activity

Understanding Teacher Morale

This study emerged from discussions within the Policy and Planning Council of the Metropolitan Educational Research Consortium (MERC), a research alliance between Virginia Commonwealth University’s School of Education and seven surrounding school divisions. The project has two goals. The first goal is to develop an understanding of the factors that impact teachers’ experience of their work in the current PK12 public school context. Although this topic could be, and has been, investigated through a number of lenses (e.g., burnout, trust, motivation), this project focuses on the idea of teacher morale, a choice that will be discussed in detail in the next section of the report. The study addresses the following three questions: 1. How do teachers experience job satisfaction and morale? 2. What are the dynamics between a teacher’s job related ideal and the professional culture of the school that support or hinder the experience of job satisfaction and morale? 3. How do differences between schools related to policy context and social context affect the dynamics of job satisfaction and morale? To answer these questions MERC assembled a research team comprised of a university researcher, graduate students, and a team of school personnel from the MERC school divisions. Over the course of two years, the team developed a conceptual framework for understanding teacher morale, designed a research study that involved observing and interviewing teachers (n=44) across three purposefully selected middle schools in the Richmond region, and then collected and analyzed the data. This report shares both the process and the findings of this collaborative research effort. The second goal of this research project is to support action by local policy makers, school division leaders, central office personnel, principals, and teachers. The study was commissioned by local school leaders not just to document and reflect on teacher morale, but more importantly to do something about it. As argued above, teachers and the conditions of teachers’ work matters for our students, our schools, and the well being of our communities and society. In this regard, this report is only one piece of this project’s action and impact plan. While the report does contain a series of recommendations based on findings and how they can be used, the release of the report is tied to additional dissemination and professional development efforts designed to effect change

Strengthening nursing, midwifery and allied health professional leadership in the UK - a realist evaluation

Purpose: This paper aims to share the findings of a realist evaluation study that set out to identify how to strengthen nursing, midwifery and allied health professions (NMAHP) leadership across all health-care contexts in the UK conducted between 2018 and 2019. The collaborative research team were from the Universities of Bangor, Ulster, the University of the West of Scotland and Canterbury Christ Church University. Design/methodology/approach: Realist evaluation and appreciative inquiry were used across three phases of the study. Phase 1 analysed the literature to generate tentative programme theories about what works, tested out in Phase 2 through a national social media Twitter chat and sense-making workshops to help refine the theories in Phase 3. Cross-cutting themes were synthesised into a leadership framework identifying the strategies that work for practitioners in a range of settings and professions based on the context, mechanism and output configuration of realist evaluation. Stakeholders contributed to the ongoing interrogation, analysis and synthesis of project outcomes. Findings: Five guiding lights of leadership, a metaphor for principles, were generated that enable and strengthen leadership across a range of contexts. – “The Light Between Us as interactions in our relationships”, “Seeing People’s Inner Light”, “Kindling the Spark of light and keeping it glowing”, “Lighting up the known and the yet to be known” and “Constellations of connected stars”. Research limitations/implications: This study has illuminated the a-theoretical nature of the relationships between contexts, mechanisms and outcomes in the existing leadership literature. There is more scope to develop the tentative programme theories developed in this study with NMAHP leaders in a variety of different contexts. The outcomes of leadership research mostly focussed on staff outcomes and intermediate outcomes that are then linked to ultimate outcomes in both staff and patients (supplemental). More consideration needs to be given to the impact of leadership on patients, carers and their families. Practical implications: The study has developed additional important resources to enable NMAHP leaders to demonstrate their leadership impact in a range of contexts through the leadership impact self-assessment framework which can be used for 360 feedback in the workplace using the appreciative assessment and reflection tool. Social implications: Whilst policymakers note the increasing importance of leadership in facilitating the culture change needed to support health and care systems to adopt sustainable change at pace, there is still a prevailing focus on traditional approaches to individual leadership development as opposed to collective leadership across teams, services and systems. If this paper fails to understand how to transform leadership policy and education, then it will be impossible to support the workforce to adapt and flex to the increasingly complex contexts they are working in. This will serve to undermine system integration for health and social care if the capacity and capability for transformation are not attended to. Whilst there are ambitious global plans (WHO, 2015) to enable integrated services to be driven by citizen needs, there is still a considerable void in understanding how to authentically engage with people to ensure the transformation is driven by their needs as opposed to what the authors think they need. There is, therefore, a need for systems leaders with the full skillset required to enable integrated services across place-based systems, particularly clinicians who are able to break down barriers and silo working across boundaries through the credibility, leadership and facilitation expertise they provide. Originality/value: The realist evaluation with additional synthesis from key stakeholders has provided new knowledge about the principles of effective NMAHP leadership in health and social care, presented in such a way that facilitates the use of the five guiding lights to inform further practice, education, research and policy development