Interpersonal communication during preoperative handover. Status of current practices and the effect of a desktop virtual reality intervention for learning handover skills in nursing education

Background: When a patient undergoes surgery, a substantial exchange of information occurs among healthcare providers. Structured communication emerges as a crucial skill for healthcare professionals during patient transfers. To enhance such communication, a general, transferrable nontechnical approach, such as the identification-situation-background-assessment-recommendation (ISBAR) approach, can be applied. This necessitates knowledge about effective learning methods and the development of new learning activities in nursing education. One such emerging learning activity is desktop virtual reality (VR). However, successful integration of VR into nursing education requires knowledge of current practices and an exploration of the usability and effectiveness of new learning activities. Aim: The overall aim of this thesis was to gain knowledge about pre- and postoperative learning activities for nursing students, develop an application in desktop VR to learn interpersonal communication for a preoperative patient handover, and assess the usability and learning outcomes of the developed VR application. The thesis had the following three sub-objectives: 1) to systematically map and summarize the body of knowledge about pre- and postoperative nursing care learning activities for undergraduate nursing students (Paper I), 2) to investigate how second-year undergraduate nursing students evaluated the usability of the Preoperative ISBAR Desktop VR Application (Paper II), and 3) to investigate whether second-year nursing students self-practicing the ISBAR approach during handovers in a preoperative setting in a desktop VR application experienced a noninferior learning outcome compared with self-practicing the traditional paper-based method to sort patient information (Paper III). Research design, methodology, and samples: This study comprised three separate papers: a scoping review (Paper I), a qualitative study involving observation and interviews (Paper II), and a noninferior parallel group randomized controlled trial (RCT) (Paper III). The scoping review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Extension for Scoping Reviews (PRISMA-ScR) and the modified PRISMA 2020, along with Johanna Briggs Institute guidelines. A desktop VR simulation application was developed, and usability was evaluated by nine undergraduate second-year nursing students using the think-aloud method and focus group interviews, along with the system usability scale (SUS) questionnaire (Paper II). A revised version of the application was used as part of the simulation training sessions iv for second-year undergraduate nursing students for clinical placements. Students were randomly assigned to self-practice the ISBAR approach for 45 minutes in groups of three using either the desktop VR application (N = 87) or a conventional traditional paper-based (TP) simulation practice (N = 88). The primary outcome was the proportion of nursing students who sorted all patient information in the correct ISBAR order within a time limit of five minutes. The predefined one-sided noninferiority limit was 13 percentage points in favor of TP.publishedVersio

Unintentional retrieval of stereotype congruent memories

The present study investigated the prediction that the stereotype physical attractiveness produces automatic memory, this means automatic encoding and retrieval of stereotype congruent information. Furthermore, subjects' relationship between automatic memory and explicit prejudice was explored. Forty-seven subjects participated in a novel implicit memory test. After conceptual priming, they judged the valence of "face-trait word" pairs, in old and new stimuli. Reaction times and self-reported prejudice levels were recorded. Results confirmed automatic memory. However, participants failed to exhibit better automatic memory for stereotype congruent stimuli than for stereotype incongruent stimuli. Significant interactions showed that participants unintentionally retrieved positive and negative traits together with attractive faces faster. A positive trend was found between subjects' automatic memory for stereotype prejudice information and their explicit prejudice attitude. The findings support automaticity of memory

Community energy initiatives to alleviate fuel poverty : the material politics of Energy Cafés

Community action has an increasingly prominent role in the debates surrounding transitions to sustainability. Initiatives such as community energy projects, community gardens, local food networks and car sharing clubs provide new spaces for sustainable consumption, and combinations of technological and social innovations. These initiatives, which are often driven by social good rather than by pure monetary motives, have been conceptualised as grassroots innovations. Previous research in grassroots innovations has largely focused on conceptualising such initiatives and analysing their potential for replication and diffusion; there has been less research in the politics involved in these initiatives. We examine grassroots innovations as forms of political engagement that is different from the 1970s' alternative technology movements. Through an analysis of community-run Energy Cafes in the United Kingdom, we argue that while present-day grassroots innovations appear less explicitly political than their predecessors, they can still represent a form of political participation. Through the analytical lens of material politics, we investigate how Energy Cafes engage in diverse - explicit and implicit, more or less conscious forms of political engagement. In particular, their work to "demystify" clients' energy bills can unravel into various forms of advocacy and engagement with energy technologies and practices in the home. Some Energy Cafe practices also make space for a needs-driven approach that acknowledges the embeddedness of energy in the household and wider society.Peer reviewe

An example of integration between en economic and an hydrologic model in the framework of water resource management problems

Growing scarcity, increasing demand and bad management of water resources are causing weighty competition for water and consequently managers are facing more and more pressure in an attempt to satisfy users? requirement. In many regions agriculture is one of the most important users at river basin scale since it concentrates high volumes of water consumption during relatively short periods (irrigation season), with a significant economic, social and environmental impact. The interdisciplinary characteristics of related water resources problems require, as established in the Water Framework Directive 2000/60/EC, an integrated and participative approach to water management and assigns an essential role to economic analysis as a decision support tool. For this reason, a methodology is developed to analyse the economic and environmental implications of water resource management under different scenarios, with a focus on the agricultural sector. This research integrates both economic and hydrologic components in modelling, defining scenarios of water resource management with the goal of preventing critical situations, such as droughts. The model follows the Positive Mathematical Programming (PMP) approach, an innovative methodology successfully used for agricultural policy analysis in the last decade and also applied in several analyses regarding water use in agriculture. This approach has, among others, the very important capability of perfectly calibrating the baseline scenario using a very limited database. However one important disadvantage is its limited capacity to simulate activities non-observed during the reference period but which could be adopted if the scenario changed. To overcome this problem the classical methodology is extended in order to simulate a more realistic farmers? response to new agricultural policies or modified water availability. In this way an economic model has been developed to reproduce the farmers? behaviour within two irrigation districts in the Tiber High Valley. This economic model is then integrated with SIMBAT, an hydrologic model developed for the Tiber basin which allows to simulate the balance between the water volumes available at the Montedoglio dam and the water volumes required by the various irrigation users

Cyanobacterial psbA gene family: optimization of oxygenic photosynthesis

The D1 protein of Photosystem II (PSII), encoded by the psbA genes, is an indispensable component of oxygenic photosynthesis. Due to strongly oxidative chemistry of PSII water splitting, the D1 protein is prone to constant photodamage requiring its replacement, whereas most of the other PSII subunits remain ordinarily undamaged. In cyanobacteria, the D1 protein is encoded by a psbA gene family, whose members are differentially expressed according to environmental cues. Here, the regulation of the psbA gene expression is first discussed with emphasis on the model organisms Synechococcus sp. and Synechocystis sp. Then, a general classification of cyanobacterial D1 isoforms in various cyanobacterial species into D1m, D1:1, D1:2, and D1′ forms depending on their expression pattern under acclimated growth conditions and upon stress is discussed, taking into consideration the phototolerance of different D1 forms and the expression conditions of respective members of the psbA gene family

Learning activities in bachelor nursing education to learn pre- and postoperative nursing care—A scoping review

The aim of this scoping review was to systematically map and summarise the existing literature on learning activities in pre- and postoperative nursing care for undergraduate nursing students. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses–Extension for Scoping Reviews (PRISMA-ScR) and the Johanna Briggs Institute guidelines were applied. Eleven articles were included in the scoping review. The learning activities involved simulation-based learning (including human patient simulation and virtual simulation), web-based learning and case studies. A range of pre- and postoperative content was applied in the learning activities. Students’ knowledge, skills, clinical decision making, clinical reasoning, experiences and stress and anxiety were measured. The review highlights findings for nursing educators planning teaching methods for pre- and postoperative nursing care.publishedVersio

Photosystem II repair in plant chloroplasts — Regulation, assisting proteins and shared components with photosystem II biogenesis

AbstractPhotosystem (PS) II is a multisubunit thylakoid membrane pigment–protein complex responsible for light-driven oxidation of water and reduction of plastoquinone. Currently more than 40 proteins are known to associate with PSII, either stably or transiently. The inherent feature of the PSII complex is its vulnerability in light, with the damage mainly targeted to one of its core proteins, the D1 protein. The repair of the damaged D1 protein, i.e. the repair cycle of PSII, initiates in the grana stacks where the damage generally takes place, but subsequently continues in non-appressed thylakoid domains, where many steps are common for both the repair and de novo assembly of PSII. The sequence of the (re)assembly steps of genuine PSII subunits is relatively well-characterized in higher plants. A number of novel findings have shed light into the regulation mechanisms of lateral migration of PSII subcomplexes and the repair as well as the (re)assembly of the complex. Besides the utmost importance of the PSII repair cycle for the maintenance of PSII functionality, recent research has pointed out that the maintenance of PSI is closely dependent on regulation of the PSII repair cycle. This review focuses on the current knowledge of regulation of the repair cycle of PSII in higher plant chloroplasts. Particular emphasis is paid on sequential assembly steps of PSII and the function of the number of PSII auxiliary proteins involved both in the biogenesis and repair of PSII. This article is part of a Special Issue entitled: Chloroplast Biogenesis