Vital sign documentation in electronic records: The development of workarounds.

Workarounds are commonplace in healthcare settings. An increase in the use of electronic health records has led to an escalation of workarounds as healthcare professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in electronic health records has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient's condition. We examined workflow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas, a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of handwritten notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and ensure patients safety

Access, participation and capabilities: Theorising the contribution of university bursaries to students’ well-being, flourishing and success

For the last 10 years, universities in England have been expected to offer financial support to low-income students alongside that provided by government. These bursaries were initially conceived in terms of improving access for under-represented groups, but attention has turned to their role in supporting student retention and success. This paper reports on two qualitative studies undertaken by contrasting universities that have been brought together due to their complementary findings. Semi-structured interviews were undertaken with a total of 98 students. Students’ views on bursaries and how they impact on their lives are reported and used to develop a descriptive model of the web of choices that students have in balancing finances and time. This is contextualised within Sen’s ‘capabilities approach’, to argue that providing access to higher education is insufficient if disadvantaged students are not able to flourish by participating fully in the university experience

Misty, Spellbound and the lost Gothic of British girls’ comics.

This article is a case study of the 1970s British girls’ comics Spellbound (DC Thomson, 1976–1977) and Misty (IPC, 1978–1980). These mystery anthology comics followed the more famous American horror comics from publishers like EC Comics - but were aimed at pre-teen girls. The article situates these comics with respect to Gothic critical theory and within the wider landscape of British girls’ comics. Firstly, it closely considers and compares the structure and content of their stories with respect to theories of the terror and horror Gothic. It discovers that both comics offer similar fare, with a subversive streak that undercuts established horror archetypes. The article then looks closely at both titles’ aesthetics and their use of the page to draw comparisons. It uses comics theory and Gothic cinematic theory to demonstrate that the appearance of Misty is more strongly Gothic than the aesthetic of Spellbound. Finally, it considers a selection of stories from both comics and analyses their common themes using Gothic critical theory. It argues that both comics rework Gothic themes into new forms that are relevant to their pre-teen and teenage readers. It concludes by summarising the study’s findings and suggesting that these comics offer a “Gothic for Girls” that is part cautionary tale and part bildungsroman. This article is published as part of a collection on Gothic and horror

Crossing conceptual thresholds in doctoral communities

Pre-printThe traditional apprenticeship model of supervision in which the single scholar charts her individual research path is giving way to more collaborative learning environments. Doctoral programmes, in which communities of scholars work together, have become increasingly common. This study interrogated how being part of such a community enables the conceptual depth we expect at doctoral level. It draws on the notion of conceptual threshold crossing to make sense of the learning experiences of 28 education PhD scholars. Working in a community of doctoral scholars was found to have conceptual impact (i) when the community is supportive, (ii) encourages risk-taking and facilitates conversations across different issues and disciplines, (iii) when the scholars have to regularly articulate their position and (iv) because the programme structure enhances the likelihood of fortuitous encounters with theories and concepts

Heterogeneity within the Asian American community

BACKGROUND: Educational interventions are grounded on scientific data and assumptions about the community to be served. While the Pan Asian community is composed of multiple, ethnic subgroups, it is often treated as a single group for which one health promotion program will be applicable for all of its cultural subgroups. Compounding this stereotypical view of the Pan Asian community, there is sparse data about the cultural subgroups' similarities and dissimilarities. The Asian Grocery Store based cancer education program evaluation data provided an opportunity to compare data collected under identical circumstances from members of six Asian American cultural groups. METHODS: A convenience sample of 1,202 Asian American women evaluated the cultural alignment of a cancer education program, completing baseline and follow-up surveys that included questions about their breast cancer knowledge, attitudes, and screening behaviors. Participants took part in a brief education program that facilitated adherence to recommended screening guidelines. RESULTS: Unique recruitment methods were needed to attract participants from each ethnic group. Impressions gained from the aggregate data revealed different insights than the disaggregate data. Statistically significant variations existed among the subgroups' breast cancer knowledge, attitudes, and screening behaviors that could contribute to health disparities among the subgroups and within the aggregate Pan Asian community. CONCLUSION: Health promotion efforts of providers, educators, and policy makers can be enhanced if cultural differences are identified and taken into account when developing strategies to reduce health disparities and promote health equity

'Collaborative critique' in a supervisor development programme

Supervision of research degrees is currently undergoing significant re-evaluation, as the research environment itself responds to new and ongoing external policy and funding pressures, internationalisation, increasing cross-disciplinarity and the proliferation of sub-specialisations amongst other factors. The Exploring Supervision Program is designed to aid new supervisors of research students to find effective ways of negotiating supervision in the context of this changing academy. To this end, a workshop facilitation approach is employed that we call ‘collaborative critique’, a technique designed to extend understandings of complex situations through discussion and debate stimulated by narrative, case studies and role plays. Here, we outline the rationale of collaborative critique and then demonstrate how it is used in a workshop on working in the multicultural academy.Cally Guerin and Ian Gree

Dietary Proteins as Determinants of Metabolic and Physiologic Functions of the Gastrointestinal Tract

Dietary proteins elicit a wide range of nutritional and biological functions. Beyond their nutritional role as the source of amino acids for protein synthesis, they are instrumental in the regulation of food intake, glucose and lipid metabolism, blood pressure, bone metabolism and immune function. The interaction of dietary proteins and their products of digestion with the regulatory functions of the gastrointestinal (GI) tract plays a dominant role in determining the physiological properties of proteins. The site of interaction is widespread, from the oral cavity to the colon. The characteristics of proteins that influence their interaction with the GI tract in a source-dependent manner include their physico-chemical properties, their amino acid composition and sequence, their bioactive peptides, their digestion kinetics and also the non-protein bioactive components conjugated with them. Within the GI tract, these products affect several regulatory functions by interacting with receptors releasing hormones, affecting stomach emptying and GI transport and absorption, transmitting neural signals to the brain, and modifying the microflora. This review discusses the interaction of dietary proteins during digestion and absorption with the physiological and metabolic functions of the GI tract, and illustrates the importance of this interaction in the regulation of amino acid, glucose, lipid metabolism, and food intake