The journey from neophyte to registered nurse - a Dutch experience.

Case studies of five Dutch undergraduate students form the initial focus of this longitudinal study. An ethno-methodological approach was utilised to provide insight into how student nurses made sense of their social and personal reality and dealt with situations and challenges encountered during the four-year programme leading to registration as a degreenurse. The case studies are further examined within a meta-case study -this being the auto-ethnographic context of the researcher's role as a nurse, an educator and a researcher.The study highlights the interface between sociology and education, and between power and authority, discussing the student journey in terms of Parsonian and confluent educational frameworks. The research findings also highlight student awareness in dealing with the challenges of practice and indicate that students are proactive, and use preconceived strategies to negotiate their way through their placements successfully. Specifically a student, who dropped out of the programme, is the subject of a 'deviant' case study; her experience provides an interesting backdrop to the students who completed the programme. The researcher analyses and discusses the concept of 'deviance', questioning the appropriateness of this terminology. The study provides some insights into the original research questions regarding student motivation on entering nursing; the developmentof a 'caring philosophy, the internalisation of professional values and the ability to integrate theory and practice. In addition the richness of the researcher/student interaction adds an extra dimension to the existing body of knowledge. This narrative account invites the reader to follow the researcher's thoughts and decision-making whilst it simultaneously challenges the reader to confront their personalhistory and beliefs

Vegetation and the importance of insecticide-treated target siting for control of Glossina fuscipes fuscipes

Control of tsetse flies using insecticide-treated targets is often hampered by vegetation re-growth and encroachment which obscures a target and renders it less effective. Potentially this is of particular concern for the newly developed small targets (0.25 high × 0.5 m wide) which show promise for cost-efficient control of Palpalis group tsetse flies. Consequently the performance of a small target was investigated for Glossina fuscipes fuscipes in Kenya, when the target was obscured following the placement of vegetation to simulate various degrees of natural bush encroachment. Catches decreased significantly only when the target was obscured by more than 80%. Even if a small target is underneath a very low overhanging bush (0.5 m above ground), the numbers of G. f. fuscipes decreased by only about 30% compared to a target in the open. We show that the efficiency of the small targets, even in small (1 m diameter) clearings, is largely uncompromised by vegetation re-growth because G. f. fuscipes readily enter between and under vegetation. The essential characteristic is that there should be some openings between vegetation. This implies that for this important vector of HAT, and possibly other Palpalis group flies, a smaller initial clearance zone around targets can be made and longer interval between site maintenance visits is possible both of which will result in cost savings for large scale operations. We also investigated and discuss other site features e.g. large solid objects and position in relation to the water's edge in terms of the efficacy of the small targets

The journey from neophyte to registered nurse : a Dutch experience

Case studies of five Dutch undergraduate students form the initial focus of this longitudinal study. An ethno-methodological approach was utilised to provide insight into how student nurses made sense of their social and personal reality and dealt with situations and challenges encountered during the four-year programme leading to registration as a degreenurse. The case studies are further examined within a meta-case study -this being the auto-ethnographic context of the researcher's role as a nurse, an educator and a researcher.The study highlights the interface between sociology and education, and between power and authority, discussing the student journey in terms of Parsonian and confluent educational frameworks. The research findings also highlight student awareness in dealing with the challenges of practice and indicate that students are proactive, and use preconceived strategies to negotiate their way through their placements successfully. Specifically a student, who dropped out of the programme, is the subject of a 'deviant' case study; her experience provides an interesting backdrop to the students who completed the programme. The researcher analyses and discusses the concept of 'deviance', questioning the appropriateness of this terminology. The study provides some insights into the original research questions regarding student motivation on entering nursing; the developmentof a 'caring philosophy, the internalisation of professional values and the ability to integrate theory and practice. In addition the richness of the researcher/student interaction adds an extra dimension to the existing body of knowledge. This narrative account invites the reader to follow the researcher's thoughts and decision-making whilst it simultaneously challenges the reader to confront their personalhistory and beliefs.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Shifting pedagogical priorities in facilitating mixed methods research including postgraduate student’s reflections

Teaching mixed methods research for quality improvement and translating evidence base practice to address meaningful change has become increasingly popular. In times of evidence-based and data-driven calls for improvement, it is important to provide students with knowledge and skills about mixed methods research that will help with the translation of research into practice. The literature identifies diverse pedagogical challenges that students face within mixed methods classrooms. Students are not usually equipped in both qualitative and quantitative approaches. The knowledge gap can result in deep pedagogical challenges compromising student’s ability to fully understand the mixed methods paradigm. Although we are shifting from a teacher centered (pedagogical) to a learner centered, self-directed approach (anagogical) student reluctance to engage with blackboard activities and critical appraisal of mixed methods design and papers persist. The present study explores the student perception about learning mixed methods research by collecting written reflections at the end of a mixed methods post graduate study day and across a post graduate module on mixed methods research. A reflective teaching-learning methodology was employed aligned to the self-inquiry model. Using a systematic framework for content data analysis, two distinct categories were revealed. These relate to ‘barriers’ and ‘enablers’ that influenced the quality of the learning event. The data analysis yielded four themes including ‘grappling with mixed methods research’, ‘classroom challenges’ moving to ‘creative engagement with mixed methods’ and ‘pedagogic teacher –student interactions’. To tackle the myriad of challengesencountered, innovative teaching strategies and thesustainability of student centered approaches will beconsidered to lever up and empower the learning climatein mixed methods classrooms and build a pedagogicalculture

Investigating hair zinc concentrations in children with and without atopic dermatitis

Background. Atopic dermatitis (AD) is a common chronic inflammatory skin condition that disproportionately affects children and is associated with reduced quality of life. Zinc deficiency may contribute to the pathogenesis of AD because zinc plays a role in epidermal barrier integrity and the immune system. Systematic review evidence suggests that low zinc is associated with AD, but limitations of included studies support further investigation.Objectives. To investigate hair zinc concentrations in children with AD v. healthy controls in a low- to middle-income country setting.Methods. One hundred and five children aged 1 - 12 yea­rs participated in a frequency-matched for age case-control study. The outcome variable, AD, was confirmed by a clinician and corroborated using the UK Working Party criteria. The primary predictor, long-term average zinc concentration, was determined by measuring hair zinc using inductively coupled mass spectrometry. Baseline demographic characteristics, anthropometry and measures of socioeconomic status were included in our logistic regression analysis. Subgroup analysis was performed where interaction terms suggested effect modification.Results. Using data from the overall sample, population median hair zinc was not significantly different between children with AD and healthy controls. However, subgroup analysis suggested a clinically and statistically significant difference in median zinc between children with AD (175.35 µg/g) and healthy controls (206.4 µg/g) in the older age group (5 - 12 years) (p=0.01). In this age group, multivariable logistic regression analysis also found significantly decreased hair zinc concentrations in AD (odds ratio 0.83; 95% confidence interval 0.66 - 0.96; p=0.046).Conclusions. The inverse association between zinc status and AD in children aged 5 - 12 years in our setting is consistent with the international literature. The clinical importance of decreased zinc levels in AD is not yet known. Further investigation into relevant underlying mechanisms seems warranted given the global reach of AD, its effect on quality of life, and the low cost of potential zinc-based interventions.

Professional boundaries: crossing a line or entering the shadows?

This article explores the professional boundaries guidance for social workers. It presents research findings from the formal literature, from agency codes of practice, from telephone interviews with regulatory and professional bodies and from an exercise using ‘snowballing techniques’ in which informants responded to brief scenarios illustrating boundary dilemmas. The findings suggest that formal research plays little part in the guidance that individuals use to help them determine professional boundaries. Similarly, only 10–15 per cent of informants made regular reference to regulatory and professional codes of practice, with an even smaller percentage quoting specific sections from these codes. A slightly larger group (15–20 per cent) made fairly regular reference to their agency's policy documents. However, a clear majority relied on their own sense of what is appropriate or inappropriate, and made their judgements with no reference to any formal guidance. Agency guidance tended to ignore the ambiguous areas of practice and seemed to act as an insurance policy, brought out and dusted off when something goes awry. The authors caution against ever-increasing bullet points of advice and prescription, and advance a notion of ethical engagement in which professionals exercise their ethical senses through regular discussion of professional boundary dilemmas

Micromanipulation at an infertility centre

Aim. Human in vitro fertilisation (IVF) and gamete intrafallopian transfer have been used in the management of various forms of infertility. In cases of severe male-factor infertility, fertilisation can be a factor. In this study micromanipulation was used to increase fertilisation in such cases.Methods. Two micromanipulation techniques, subzonal sperm injection (SUZI) and partial zona dissection (PZD), were used to assist fertilisation in patients with abnorTl)al semen parameters. Ten couples with severe oligo-, teratoand asthenozoospermia participated in the SUZI programme. Seventy-three oocytes were obtained from these 10 patients. PZD was used on day 1 oocytes in cases of male infertility as well as a rescue attempt on day 2 oocytes when fertilisation had failed after routine insemination.Results. The SUZI technique had a fertilisation rate of 37,7%. In this group, a biochemical pregnancy was achieved. Differences between the fertilisation rate of conventionallVF (33,3%) and PZD (56,3%) in cases of male infertility, were not statistically significant although a clinical difference could be detected. PZD was statistically effective in facilitating fertilisation (37,5% v. 8,3%) in couples where this procedure was introduced to reinseminate 24-hour-old unfertilised oocytes. Four patients received PZD reinseminated embryos. An average of 1,45 PZD embryos were replaced and 1 implantation pregnancy was confirmed.Conclusion. The micromanipulation results are encouraging arid seemed to increase the efficiency of IVF in humans. Furthermore, our data support the conclusion that micromanipulation procedures can bring about pregnancies

Costs Of Using “Tiny Targets” to Control Glossina fuscipes fuscipes, a Vector of Gambiense Sleeping Sickness in Arua District of Uganda

Introduction To evaluate the relative effectiveness of tsetse control methods, their costs need to be analysed alongside their impact on tsetse populations. Very little has been published on the costs of methods specifically targeting human African trypanosomiasis. Methodology/Principal Findings In northern Uganda, a 250 km2 field trial was undertaken using small (0.5 X 0.25 m) insecticide-treated targets (“tiny targets”). Detailed cost recording accompanied every phase of the work. Costs were calculated for this operation as if managed by the Ugandan vector control services: removing purely research components of the work and applying local salaries. This calculation assumed that all resources are fully used, with no spare capacity. The full cost of the operation was assessed at USD 85.4 per km2, of which USD 55.7 or 65.2% were field costs, made up of three component activities (target deployment: 34.5%, trap monitoring: 10.6% and target maintenance: 20.1%). The remaining USD 29.7 or 34.8% of the costs were for preliminary studies and administration (tsetse surveys: 6.0%, sensitisation of local populations: 18.6% and office support: 10.2%). Targets accounted for only 12.9% of the total cost, other important cost components were labour (24.1%) and transport (34.6%). Discussion Comparison with the updated cost of historical HAT vector control projects and recent estimates indicates that this work represents a major reduction in cost levels. This is attributed not just to the low unit cost of tiny targets but also to the organisation of delivery, using local labour with bicycles or motorcycles. Sensitivity analyses were undertaken, investigating key prices and assumptions. It is believed that these costs are generalizable to other HAT foci, although in more remote areas, with denser vegetation and fewer people, costs would increase, as would be the case for other tsetse control techniques