Centralized Wastewater System

The Village of Sanford, alongside the local chapter of Habitat for Humanity and volunteer committees of developers, are considering options to build back housing stock that was lost during the flooding. There are multiple potential lots in the Village that are being explored, with about 15-20 being potential sites to be investigated. Habitat for Humanity will facilitate the rebuilding of single family homes, but will need engineering expertise where it concerns the sanitation systems for multi-family homes, condos, townhomes, or potentially a senior center. There is no centralized wastewater system for the Village, so, engineering options would need to look towards small or decentralized systems including combined septic and leach field systems, land application systems, pond treatment systems, or batch reactors. This may include fieldwork to examine local soil conditions, environmental resources present, available land, and applicable costs. It is unlikely that the alternatives assessment would include a centralized wastewater treatment system

Patient perceptions of oral health care following stroke : a qualitative study

Background: Stroke is a serious cerebrovascular disease and is one of the world’s leading causes of disability. Maintaining good oral health is a challenge among those hospitalised after stroke. A multidisciplinary approach to oral care involving non-dental professionals can be beneficial in improving oral health outcomes for patients. The aim of this study was to understand the perceptions of stroke survivors regarding oral healthcare across acute and rehabilitation settings. Methods: A descriptive qualitative approach was used. Face-to-face semi-structured interviews were conducted. A framework analysis was employed to analyse the data. Patients who had recently experienced a stroke were purposively recruited across both acute and rehabilitation settings, at two metropolitan hospitals in Sydney, Australia. In total, 11 patients were interviewed. Results: Although participants recognised the importance of oral health, few understood the link between oral and general health. Regular oral hygiene practices varied since having stroke, with a few receiving oral care assistance from nurses. Time, cost and lack of information were some barriers to accessing dental services, while supportive measures such as coordination of oral care, financial subsidy and nurse assistance were strategies proposed to support oral care practices amongst stroke survivors. Conclusions: There is scope to improve current models of oral care in stroke. While stroke survivors understand the importance of oral care, an integrated oral health model with a multidisciplinary approach could improve health outcomes

Teacher Professional Development and Geography Teachers’ Pedagogical Practices for Climate Change Education

Education for Sustainable Development (ESD) was added to the South African Geography school curriculum when the Curriculum Assessment Policy Statement (CAPS) was implemented from 2012. Many in-service teachers who qualified prior to 2014 did not cover this concept during their initial teacher education qualification because it was not part of the curriculum at that time. To address this deficiency, a teacher professional development (TPD) module was developed by the Fundisa for Change programme and offered to a selection of in-service high school Geography teachers. Transformative learning theory helped to understand the pedagogical practices used by teachers after attending the Fundisa for Change teacher professional development programme, in particular the use of a learner-centred approach. Using a small-scale, qualitative and interpretive case study method, the influence of this short TPD course on the teaching of climate change in the Geography CAPS curriculum on teachers’ pedagogical practices was investigated. Data were collected through semi-structured interviews, document analysis and lesson observations. Data were analysed using both inductive thematic and deductive analysis. Findings from this small sample of five teachers and their practices suggest that despite attending the programme, most of the participating teachers did not sufficiently integrate climate change education in their Geography classroom practices. The majority of the research participants did not implement the learner-centred teaching methods covered in the course. It is therefore recommended that a teacher professional development programme should be incorporated into longer-term and preferably ongoing professional development programmes so as to adequately foster climate change education in classroom practices

Effective chacteristics of Iranian nursing students in their relationship with clinical nurses

Introduction: The purpose of this study was to explore the characteristics of undergraduate nursing students, which may determine the nature of their relationship with clinical nurses. Relationships between nursing students and clinical nurses are critical to maximize student learning outcomes and produce skilled graduates for the future health workforce. Methods: This qualitative content analysis study was conducted from January to August 2016. Twenty nine semi-structured in-depth interviews were conducted with 20 undergraduate nursing students in Tabriz nursing and midwifery faculty. Interviews were recorded and transcribed verbatim (in Persian), and analyzed using conventional content analysis to identify themes. Results: Four key themes emerged: educational factors (cognitive knowledge and practical skills, and learning motivation); communication skills; perceived support (perceived support from nurses and educators); and psychological state (fear of the relationship and self-confidence). Self-confidence is an emphasized concept in nursing students' willingness and ability to relate with clinical nurses. Conclusion: The results of the study showed that educational, communicative and psychological factors are important determinants of student communication with nurses. However, self-confidence is the most important factor in establishing such relationship. Self-confidence could be further assessed to identify nursing students who need greater support or would benefit from greater educational interventions to achieve relational skills

Hospital service use in the last year of life by Indigenous Australians who died of heart failure or cardiomyopathy : a linked data study

Background: Aboriginal and Torres Strait Islander peoples experience disproportionate rates of heart failure. However, information regarding their use of hospital services in the last year of life is poorly delineated to inform culturally appropriate end-of-life health services. Objectives: To quantify hospital service use in the last year of life of Aboriginal and Torres Strait Islander peoples who died of heart failure or cardiomyopathy in Queensland, Australia. Methods: A subgroup analysis of a larger retrospective linkage study using administrative health data in Queensland, Australia. Individuals that identified as an Aboriginal and Torres Strait Islander person from their first hospital admission in the last year of life, who died of heart failure or cardiomyopathy from 2008 to 2018, were included. Results: There were 99 individuals, with emergency department presentation/s recorded for 85 individuals. Over 50% of individuals presenting to the Emergency Department were from regional areas (n = 43, 51%). The 99 individuals had a total of 472 hospital admissions, excluding same day admissions for haemodialysis, and 70% (n = 70) died in hospital. Most admissions were coded as acute care (n = 442, 94%), and fewer were coded as palliative care (n = 19, 4%). Median comorbidities or factors that led to hospital contact = 5 (interquartile range 3–9). Conclusion: Acute care hospital admissions in the last year of life by this population are common for those who died of heart failure or cardiomyopathy. Multimorbidity is prevalent in the last year of life, underscoring the importance of primary health care, provided by nurses and Indigenous health workers

Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): a qualitative study of the views of specialist respiratory clinicians

INTRODUCTION: The battery-operated hand-held fan ('fan') is an inexpensive and portable non-pharmacological intervention for chronic breathlessness. Evidence from randomised controlled trials suggests the fan reduces breathlessness intensity and improves physical activity in patients with a range of advanced chronic conditions. Qualitative data from these trials suggests the fan may also reduce anxiety and improve daily functioning for many patients. This study aimed to explore barriers and facilitators to the fan's implementation in specialist respiratory care as a non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD). METHODS: A qualitative approach was taken, using focus groups. Participants were clinicians from any discipline working in specialist respiratory care at two hospitals. Questions asked about current fan-related practice and perceptions regarding benefits, harms and mechanisms, and factors influencing its implementation. Analysis used a mixed inductive/deductive approach. RESULTS: Forty-nine participants from nursing (n = 30), medical (n = 13) and allied health (n = 6) disciplines participated across 9 focus groups. The most influential facilitator was a belief that the fan's benefits outweighed disadvantages. Clinicians' beliefs about the fan's mechanisms determined which patient sub-groups they targeted, for example anxious or palliative/end-stage patients. Barriers to implementation included a lack of clarity about whose role it was to implement the fan, what advice to provide patients, and limited access to fans in hospitals. Few clinicians implemented the fan for acute-on-chronic breathlessness or in combination with other interventions. CONCLUSION: Implementation of the fan in specialist respiratory care may require service- and clinician-level interventions to ensure it is routinely recommended as a first-line intervention for chronic breathlessness in patients for whom this symptom is of concern, regardless of COPD stage

Which strategies support the effective use of clinical practice guidelines and clinical quality registry data to inform health service delivery? A systematic review

Background Empirical evidence suggests data and insights from the clinical practice guidelines and clinical quality registries are not being fully utilised, leaving health service managers, clinicians and providers without clear guidance on how best to improve healthcare delivery. This lack of uptake of existing research knowledge represents low value to the healthcare system and needs to change. Methods Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane Central and Cochrane Database of Systematic Reviews) were systematically searched. Included studies were published between 2000 and 2020 reporting on the attributes, evidence usage and impact of clinical practice guidelines and clinical quality registries on health service delivery. Results Twenty-six articles including one randomised controlled trial, eight before-and-after studies, eight case studies/reviews, five surveys and four interview studies, covering a wide range of medical conditions and conducted in the USA, Australia and Europe, were identified. Five complementary strategies were derived to maximise the likelihood of best practice health service delivery: (1) feedback and transparency, (2) intervention sustainability, (3) clinical practice guideline adherence, (4) productive partnerships and (5) whole-of-team approach. Conclusion These five strategies, used in context-relevant combinations, are most likely to support the application of existing high-quality data, adding value to health service delivery. The review highlighted the limitations of study design in opportunistic registry studies that do not produce clear, usable evidence to guide changes to health service implementation practices. Recommendations include exploration of innovative methodologies, improved coordination of national registries and the use of incentives to encourage guideline adherence and wider dissemination of strategies used by successful registries

SMARTER Teamwork: System for Management, Assessment, Research, Training, Education, and Remediation for Teamwork

SMARTER Teamwork: System for Management, Assessment, Research, Training, Education, and Remediation for TeamworkThe rapid adoption of Team-Maker and the Comprehensive Assessment of Team MemberEffectiveness (CATME) tools for team formation and peer evaluation make it possible to extendtheir success to have a significant impact on the development of team skills in higher education.The web-based systems have been used by more than 110,000 students of more than 2400faculty at more than 500 institutions internationally—the figure below shows the growth of theuser base. 2400 The system has had 113,373 unique student users. 2200 Fitted curves are third order. 2000 1800 Faculty and staff 1600 1400 1200 Number of 1000 users 800 Institutions 600 400 Aug Oct. 2005 2012 200 0 0 1 2 3 4 5 6 7 Years since software was releasedThis paper and its accompanying poster will describe strategies for broadening the scope of thosetools into a complete system for the management of teamwork in undergraduate education. TheSystem for the Management, Assessment, Research, Training, Education, and Remediation ofTeamwork (SMARTER Teamwork) has three specific goals: 1) to equip students to work inteams by providing them with training and feedback, 2) to equip faculty to manage student teamsby providing them with information and tools to facilitate best practices, and 3) to equipresearchers to understand teams by broadening the system’s capabilities to collect additionaltypes of data so that a wider range of research questions can be studied through a secureresearcher interface. The three goals of the project support each other in hierarchical fashion:research informs faculty practice, faculty determine the students’ experience, which, if wellmanaged based on research findings, equips students to work in teams. Our strategies forachieving these goals are based on a well-accepted training model that has five elements:information, demonstration, practice, feedback, and remediation.The paper that will be submitted and the poster presented at the conference will focus on newfeatures of the system, the development of training materials, and the deployment of a partnerwebsite that shares information about the SMARTER tools for teamwork and provides basicinformation about teamwork and team management

Rating and Ranking the Role of Bibliometrics and Webometrics in Nursing and Midwifery

Background. Bibliometrics are an essential aspect of measuring academic and organizational performance. Aim. This review seeks to describe methods for measuring bibliometrics, identify the strengths and limitations of methodologies, outline strategies for interpretation, summarise evaluation of nursing and midwifery performance, identify implications for metric of evaluation, and specify the implications for nursing and midwifery and implications of social networking for bibliometrics and measures of individual performance. Method. A review of electronic databases CINAHL, Medline, and Scopus was undertaken using search terms such as bibliometrics, nursing, and midwifery. The reference lists of retrieved articles and Internet sources and social media platforms were also examined. Results. A number of well-established, formal ways of assessment have been identified, including h- and c-indices. Changes in publication practices and the use of the Internet have challenged traditional metrics of influence. Moreover, measuring impact beyond citation metrics is an increasing focus, with social media representing newer ways of establishing performance and impact. Conclusions. Even though a number of measures exist, no single bibliometric measure is perfect. Therefore, multiple approaches to evaluation are recommended. However, bibliometric approaches should not be the only measures upon which academic and scholarly performance are evaluated