In Nightingale's footsteps: A qualitative analysis of the impact of leadership development within the clinical learning environment

Aim To identify and describe the impact areas of a newly developed leadership development programme focussed on positioning leaders to improve the student experience of the clinical learning environment. Background There is a need to consider extending traditional ways of developing leaders within the clinical learning in order to accommodate an increased number of students and ensure their learning experience is fulfilling and developmental. The Florence Nightingale Foundation implemented a bespoke leadership development programme within the clinical learning environment. Identifying the areas of impact will help to inform organisational decision making regarding the benefits of encouraging and supporting emerging leaders to undertake this type of programme. Method For this qualitative descriptive study, eight health care professionals who took part in a bespoke leadership development programme were interviewed individually and then collectively. The Florence Nightingale Foundation fellowship/scholarship programme is examined to determine impact. Results Two key themes were described in relation to impact of the programme. These were ‘Personal Development’ and ‘Professional Impact’. The two key themes comprised several subthemes. The notion of time and space to think was subsumed within each theme. Conclusion Data highlights that the Florence Nightingale Foundation programme had a distinct impact on participants by transforming thinking and increasing self-confidence to enable changes to make improvements both within their organisations and at national level. Implications for Nursing Management Health care managers must continue to invest in building leadership capacity and capability through programmes that can help position individuals to realize their potential to positively influence health outcomes and wider society

The response to patient deterioration in the UK National Health Service - A survey of acute hospital policies.

BACKGROUND: The assessment of acute-illness severity in adult non-pregnant patients in the United Kingdom is based on early warning score (EWS) values that determine the urgency and nature of the response to patient deterioration. This study aimed to describe, and identify variations in, the expected clinical response outlined in 'deteriorating patient' policies/guidelines in acute NHS hospitals. METHODS: A copy of the local 'deteriorating patient' policy/guideline was requested from 152 hospitals. Each was analysed against pre-determined areas of interest, e.g., minimum expected vital sign observations frequency, expected response and expected staff response times. RESULTS: In the 55 responding hospitals (36.2%), the documented structure and process of the response to deterioration varied considerably. All hospitals used a 12-hourly minimum vital signs measurement frequency. Thereafter, for a low-risk patient, the minimum frequency varied from '6-12 hourly' to 'hourly'. Frequencies were higher for higher risk categories. Expected escalation responses were highly individualised between hospitals. Other than repeat observations, only nine (16.4%) documents described specific clinical actions for ward staff to consider/perform whilst awaiting responding personnel. Maximum permitted response times for medium-risk and high-risk patients varied widely, even when based on the same EWS. Only 33/55 documents (60%) gave clear instructions regarding who to contact 'out of hours'. CONCLUSIONS: The 'deteriorating patient' policies of the hospitals studied varied in their contents and often omitted precise instructions for staff. We recommend that individual hospitals review these documents, and that research and/or consensus are used to develop a national algorithm regarding the response to patient deterioration

Ocean acidification of a coastal Antarctic marine microbial community reveals a critical threshold for CO2 tolerance in phytoplankton productivity

© 2017 Author. High-latitude oceans are anticipated to be some of the first regions affected by ocean acidification. Despite this, the effect of ocean acidification on natural communities of Antarctic marine microbes is still not well understood. In this study we exposed an early spring, coastal marine microbial community in Prydz Bay to CO2 levels ranging from ambient (343μatm) to 1641μatm in six 650 L minicosms. Productivity assays were performed to identify whether a CO2 threshold existed that led to a change in primary productivity, bacterial productivity, and the accumulation of chlorophyll a (Chl a) and particulate organic matter (POM) in the minicosms. In addition, photophysiological measurements were performed to identify possible mechanisms driving changes in the phytoplankton community. A critical threshold for tolerance to ocean acidification was identified in the phytoplankton community between 953 and 1140μatm. CO2 levels ≥1140μatm negatively affected photosynthetic performance and Chl a-normalised primary productivity (csGPP14C), causing significant reductions in gross primary production (GPP14C), Chl a accumulation, nutrient uptake, and POM production. However, there was no effect of CO2 on C VN ratios. Over time, the phytoplankton community acclimated to high CO2 conditions, showing a down-regulation of carbon concentrating mechanisms (CCMs) and likely adjusting other intracellular processes. Bacterial abundance initially increased in CO2 treatments ≥953μatm (days 3-5), yet gross bacterial production (GBP14C) remained unchanged and cell-specific bacterial productivity (csBP14C) was reduced. Towards the end of the experiment, GBP14C and csBP14C markedly increased across all treatments regardless of CO2 availability. This coincided with increased organic matter availability (POC and PON) combined with improved efficiency of carbon uptake. Changes in phytoplankton community production could have negative effects on the Antarctic food web and the biological pump, resulting in negative feedbacks on anthropogenic CO2 uptake. Increases in bacterial abundance under high CO2 conditions may also increase the efficiency of the microbial loop, resulting in increased organic matter remineralisation and further declines in carbon sequestration

Explosivity : an unusual challenge in drug development

There remains an urgent global need for new drugs to combat diseases such as malaria, tuberculosis and cancer, as well as overcoming increasing antibiotic resistance. Chemists are moving into ‘new chemical space’ for drug design (1,2) and with this comes the possibility of traditional (and stable) ‘carbon-carbon’ bond structures being replaced by more ‘exotic’ bonding arrangements. While the implication of this on pharmaceutical stability can often be mitigated by suitable formulation and storage strategies, we came across an unusual case of chemical stability: the possibility that the drug was an explosive! By pushing drug designing into uncharted chemical space it could be argued that the possibility of finding explosive molecules of pharmaceutical interest will increase

ACADEMIC DISCIPLINE «ALTERNATIVE ENERGY»: A TUTORIAL ASPECT

The necessity to update academic discipline contents taking into account international experience is shown. At the School of Ecology in the framework of British Council project «Alternative Energy: Education and Science» (implemented together with Keele University, UK) the course «Alternative Energy» was updated: new topics were included, new methods of teaching were introduced. The content of the course is presented in details. Due to up-dating students receive new competencies which allow them to solve complex problems and to be more competitive on the labour market

Drinking in pregnancy: poor guidelines or lack of evidence?

Each year Bournemouth University (BU) holds a Festival of Learning (FoL), a week-long series of events aimed at encouraging members of the public, academics and healthcare professionals to engage with BU’s current science and research projects. This year BU’s Centre for Midwifery, Maternal and Perinatal Health (CMMPH) resumed the tradition of holding a debate during the festival on a topic relevant to maternal health and childbirth. In 2016 the FoL debate took place at the end of June and focused on the motion: " Advising pregnant women to avoid drinking alcohol during pregnancy is a symptom of the Nanny State and another step towards the medicalisation of childbirth.