Blended Learning and Satisfaction Among University Students Experiencing Concussion Symptoms

Professional sport organizations have successfully raised societal awareness of the serious nature of concussions and the effect on returning to sports activities or “return-to-play.” Existing literature places significant emphasis on return-to-play protocols for concussed athletes, while minimal information is available about when and/or how a concussed person can best return to a formal educational environment. In particular, there is a gap in the literature regarding a holistic view of educational approaches, learning implications, and accommodation needs for Canadian university students recovering from a concussion. Based on this gap, in this study a comparative quantitative-dominant mixed methods research design was used to investigate the suitability of in-person and blended learning environments for university students who have experienced one or more concussions. The study also explored learning implications and accommodations required following a concussion. Fifty current or former university students who have suffered a concussion at some time in their life were placed into two groups: (1) those who had studied in an in-person learning environment; and (2) those who had studied in a blended learning environment. An online questionnaire was used to explore how the students’ concussion symptoms affected their learning, the accommodations they were provided, and self-reported satisfaction with each learning environment. The following controlled variables were considered when analyzing self-reported satisfaction: concussion symptoms, site of injury, accommodations, accident versus sport-related injury, length of time since original injury, isolated versus multiple injuries, gender, medication use, approaches to learning, age, number of courses previously taken in their respective learning environments, and grade achievement. The findings revealed that students who had studied in a blended learning environment reported a higher level of satisfaction. Recommendations focused on the reported changes in learning that follow a concussion, the use of accommodations in different learning environments, and the role of faculty as students reintegrate into a formal learning environment.202

Les Barrières à la Pratique des Sages-Femmes au Canada

Barriers to the current practice of midwives in Canada relate to the perception of clients and care providers, the lack of financial and physical resources, the reluctance on the part of other medical specialists and a lack of recognition of midwives professional activity and their skills. Although deliveries without serious complications are the vast majority of births, lowrisk pregnancies are often supported by physicians, rather than by midwives. In Quebec, long waiting lists prevent women from resorting to a midwife because, often, this service is simply not present, despite the satisfaction with care extended by the mothers. Training programs for midwives have limited contingency. At the global level, access to the practice of midwives is restricted due to lack of funding, although the practice of midwives generates less cost than other practitioners’. In addition, obstetricians are not open to the idea of losing less complicated cases, handled by midwives. However, in light of the current budgetary constraints, Governments would benefit from investing in the profession of midwives which clearly demonstrates its effectiveness in the delivery of quality care.Les barrières à la pratique actuelle des sages-femmes au Canada sont reliées à la perception des pourvoyeurs de soins et des clientes, au manque de ressources matérielles et humaines, aux réticences de la part du personnel médical et à un manque de reconnaissance de l’activité des sages-femmes et de leurs compétences. Malgré que la plupart des accouchements se déroulent sans complications graves, les grossesses à faibles risques sont souvent prises en charge par des médecins, plutôt que par des sages-femmes. Au Québec, de longues listes d’attente empêchent les femmes d’avoir recours à une sagefemme car ce service est peu développé, même inexistant par endroit, et ce, malgré la satisfaction des soins reportée par les parturientes. Les programmes de formation de sages-femmes sont contingentés. Au niveau mondial, l’accès à la pratique des sages-femmes est restreint en raison d’un manque de financement, bien que la pratique des sages-femmes génère moins de coût que la pratique des autres praticiens. De plus, les obstétriciens ne sont pas ouverts à l’idée de perdre les cas les moins compliqués, pouvant être confiés aux sages-femmes. En tout et compte tenu des difficultés budgétaires actuelles, les gouvernements auraient avantage à investir dans cette profession qui, de toute évidence, démontre clairement son efficacité et offre des soins de qualité

Nurse Practitioner Education in a Blended Learning Environment

A total of 76% of a targeted population of adult learners who were experienced nurses completed a questionnaire that evaluated satisfaction levels on several dimensions of engagement for two graduate level clinical nursing courses delivered in a blended learning environment. Elluminate© (synchronous) and forum interactions (asynchronous) were the online components, and standard onsite laboratories were the three approaches to course delivery. There were significant increases in level of comfort with the Elluminate© and forum interactions but not onsite approaches during the course. However the onsite component was ranked as facilitating more personal satisfaction and development. Residential distance from the university was associated with greater initial comfort for the Elluminate© component while higher levels of education were associated with more positive responses for the forum modes. The mean rankings of the preferences were primarily positive for all three components of instruction and suggest that such blended programs may satisfy a greater diversity of student needs

Clozapine vs. Haloperidol in Aggression Prevention

Nurses and physicians working in forensic psychiatric facilities are frequently exposed to violent incidents at the hands of forensic psychiatric patients and inmates. Aside from seclusion, segregation and restraint, prevention serves as an efficient strategy in dealing with violence and aggression, including a proper medication regimen. This paper aims to address a specific clinical research question in terms of prevention of violence and aggression among forensic psychiatric patients, from a pharmaceutical perspective. Clinical Question: In forensic psychiatric patients with a history of aggression, is regular use of Clozapine more effective in reducing the incidence of violence and/or aggression than regular use of Haloperidol? Five primary research studies were found to be specific to the clinical question and its context. Review results: Resulting from its superior efficacy in treating complicated, positive schizophrenia symptoms, including violence and aggression, Clozapine may be better situated to prevent aggressive incidents among Forensic Patients with a history of aggression. Answering the clinical question has led to reflection and application of new recommendations of pharmaceutical interventions in a forensic setting

A Description of the Risk for Delirium in Residents Living with Diabetes in Long-Term Care Homes Across Ontario

Aim: The aim of this study was to explore risk factors of delirium for residents with diabetes in LTC in Ontario. Scope: Residents in long term care (LTC) are vulnerable to negative outcomes related to diabetes, including delirium. Understanding factors related to the risk of delirium for residents with diabetes provides the foundation for mitigation of delirium in this population. Methods: A population-based retrospective secondary analysis was conducted using a dataset from the Resident Assessment Instrument – Minimum Data Set of residents living in LTC settings in Ontario between April 1, 2019, and March 31, 2020.  Findings: Results showed that delirium was significantly associated with diabetes. Additionally, residents with diabetes had a higher occurrence of other delirium risk factors, including behavioural symptoms of dementia and the use of multiple medications, such as analgesics and psychotropic medications. Conclusions: Strategies to mitigate delirium in this population should be implemented

A Description of the Risk for Delirium in Residents Living with Diabetes in Long-Term Care Homes Across Ontario

Aim: The aim of this study was to explore risk factors of delirium for residents with diabetes in LTC in Ontario. Scope: Residents in long term care (LTC) are vulnerable to negative outcomes related to diabetes, including delirium. Understanding factors related to the risk of delirium for residents with diabetes provides the foundation for mitigation of delirium in this population. Methods: A population-based retrospective secondary analysis was conducted using a dataset from the Resident Assessment Instrument – Minimum Data Set of residents living in LTC settings in Ontario between April 1, 2019, and March 31, 2020.  Findings: Results showed that delirium was significantly associated with diabetes. Additionally, residents with diabetes had a higher occurrence of other delirium risk factors, including behavioural symptoms of dementia and the use of multiple medications, such as analgesics and psychotropic medications. Conclusions: Strategies to mitigate delirium in this population should be implemented

Examining the Risk of Delirium Among Residents with Diabetes in Long-Term Care Homes Across Ontario

Aim: To examine risk factors for delirium in residents with diabetes in Ontario’s LTC homes. Scope: Residents in long-term care (LTC) are vulnerable to negative outcomes related to diabetes, including delirium. Understanding factors related to the risk of delirium for residents with diabetes provides the foundation for the mitigation of delirium in this population. Methods: A population-based retrospective analysis of the RAI-MDS dataset (2019–2020) was conducted. Findings: Diabetes was associated with a statistically significant increased risk of delirium (Odds Ratio: 1.073, CI 1.038–1.109), compounded by polypharmacy. Conclusions: Comprehensive delirium mitigation strategies are needed for this vulnerable population. Strategies to mitigate delirium in this population should be implemented

Impact of Nurse Residency Programs on Retention and Job Satisfaction: An Integrative Review

Objects: Retention of new nurses is vital within the context of the nursing shortage Canada is currently facing. Nurse residency programs (NRP) need to be explored to better understand their role in combating the nursing shortage. The aim of this study is to explore current nurse residency programs and their impacts on retention and job satisfaction with the aim to inform development of similar programs in Canada.  Methods: The study utilized Whittemore and Knafl’s integrative review methodology to review current literature on nurse residency programs in The United States of America with focuses on retention rates, job satisfaction and intent to leave. Overall, this article drew on seven distinct research studies. Findings: The literature review found that Nurse Residency Programs (NRP) can improve retention rates however, this may be due to contracts signed upon beginning of NRP. Job satisfaction for newly licensed registered nurses (NLRNs) participating in NRP also showed improvements but their impact on reducing turnover intention is unclear and needs further study. Conclusion: The impact of nurse residency programs on retention and job satisfaction has some positive effects, but the strength of this relationship remains unclear and would benefit from further research

Impact of Nurse Residency Programs on Retention and Job Satisfaction: An Integrative Review

Retention of new nurses is vital within the context of the nursing shortage Canada is currently facing. Nurse residency programs need to be explored to better understand their role in combating the nursing shortage. The study utilized Whittemore and Knafl’s integrative review methodology to review current literature on nurse residency programs in The United States of America and focuses on retention rates, job satisfaction and intent to leave as a means for understanding the role of nursing residency programs within the Canadian nursing context. The literature review found that Nurse Residency Programs (NRP) can improve retention and job satisfaction for newly licensed registered nurses (NLRNs), but their impact on reducing turnover intention is unclear and needs further study

Impact of Nurse Residency Programs on Retention and Job Satisfaction: An Integrative Review

Retention of new nurses is vital within the context of the nursing shortage Canada is currently facing. Nurse residency programs need to be explored to better understand their role in combating the nursing shortage. The study utilized Whittemore and Knafl’s integrative review methodology to review current literature on nurse residency programs in The United States of America and focuses on retention rates, job satisfaction and intent to leave as a means for understanding the role of nursing residency programs within the Canadian nursing context. The literature review found that Nurse Residency Programs (NRP) can improve retention and job satisfaction for newly licensed registered nurses (NLRNs), but their impact on reducing turnover intention is unclear and needs further study