Building and sustaining collaboration in cross sector e-learning development

This chapter will focus on the process of building and sustaining collaborative reusable e-learning object development across three educational sectors, Higher Education (HE), the UK National Health Service (NHS) and Further Education (FE) Colleges, using the LOLA project as a case study. A qualitative evaluation of ‘process’ ran alongside the entirety of the LOLA project. This chapter reports the findings of this qualitative research, and analyses how collaboration was achieved between the diverse institutions who were project partners. The strengths of this approach included the commitment of the team members to collaboration, while practical challenges included the location of the team members, but also wider issues in the institutions involved, and in particular, the role of the Media Developer and the perception of it by other team members

Increasing cardiac pyruvate dehydrogenase flux during chronic hypoxia improves acute hypoxic tolerance

The pattern of metabolic reprogramming in chronic hypoxia shares similarities with that following myocardial infarction or hypertrophy, however the response of the chronically hypoxic heart to subsequent acute injury, and the role of metabolism is not well understood. Here, we determined the myocardial tolerance of the chronically hypoxic heart to subsequent acute injury, and hypothesised that activation of a key regulator of myocardial metabolism, the pyruvate dehydrogenase complex (PDC), could improve hypoxic tolerance. Mouse hearts, perfused in Langendorff mode, were exposed to 30min of hypoxia, and lost 80% of prehypoxic function (p=0.001), with only 27% recovery of pre-hypoxic function with 30min of re-oxygenation (p=0.046). Activation of the PDC with infusion of 1mM dicholorocacetate (DCA) during hypoxia and re-oxygenation did not alter function. Acute hypoxic tolerance was assessed in hearts of mice housed in hypoxia for 3wks. Chronic hypoxia reduced cardiac tolerance to subsequent acute hypoxia, with recovery of function 22% of pre-acute hypoxic levels, vs 39% in normoxic control hearts (p=0.012). DCA feeding in chronic hypoxia (per os, 70mg/kg/day) doubled cardiac acetylcarnitine content, and this fell following acute hypoxia. This acetylcarnitine use maintained cardiac ATP and glycogen content during acute hypoxia, with hypoxic tolerance normalised. In summary, chronic hypoxia renders the heart more susceptible to acute hypoxic injury, which can be improved by activation of the PDC and pooling of acetylcarnitine. This is the first study showing functional improvement of the chronically hypoxic heart with activation of the PDC, and offers therapeutic potential in cardiac disease with a hypoxic component

Expressions 2003-2004

https://openspace.dmacc.edu/expressions/1024/thumbnail.jp

The Homeobox Protein CEH-23 Mediates Prolonged Longevity in Response to Impaired Mitochondrial Electron Transport Chain in C. elegans

Recent findings indicate that perturbations of the mitochondrial electron transport chain (METC) can cause extended longevity in evolutionarily diverse organisms. To uncover the molecular basis of how altered METC increases lifespan in C. elegans, we performed an RNAi screen and revealed that three predicted transcription factors are specifically required for the extended longevity of mitochondrial mutants. In particular, we demonstrated that the nuclear homeobox protein CEH-23 uniquely mediates the longevity but not the slow development, reduced brood size, or resistance to oxidative stress associated with mitochondrial mutations. Furthermore, we showed that ceh-23 expression levels are responsive to altered METC, and enforced overexpression of ceh-23 is sufficient to extend lifespan in wild-type background. Our data point to mitochondria-to-nucleus communications to be key for longevity determination and highlight CEH-23 as a novel longevity factor capable of responding to mitochondrial perturbations. These findings provide a new paradigm for how mitochondria impact aging and age-dependent diseases

Novice Nurses’ Experiences Caring for Acutely Ill Patients during a Pandemic

The Coronavirus pandemic erupted in 2020 and new graduate registered nurses (RNs) found themselves caring for those with devastating illness as they were transitioning into nursing practice. The purpose of this study was to describe the experience of novice nurses working in acute care settings during a pandemic. This qualitative phenomenological study of novice nurses working in facilities providing acute care for COVID-19 patients was conducted in Phoenix, Arizona, USA. Purposive sampling identified 13 participants for interviews. Data were analyzed using thematic analysis. Eight themes emerged: Dealing with death, Which personal protective equipment (PPE) will keep us safe?, Caring for high acuity patients with limited training, Difficulties working short-staffed, Everything is not okay, Support from the healthcare team, Nursing school preparation for a pandemic, I would still choose nursing. Novice nurses felt challenged by the experience and were at times overwhelmed and struggling to cope. Support from peers and coping skills learned during nursing school helped them continue to work during a critical time. Data from this study suggest that some participants may have been experiencing symptoms of anxiety, depression, or post-traumatic stress disorder, and findings provide foundational insights for nursing education and psychological interventions to support the nursing workforce

Going paperless at the emergency department: A socio-technical study of an information system for patient tracking

Purpose: The purpose of this study was to examine nurses' attitudes and reflection on the transformation of their workpractices after the implementation of an Emergency Department Information System (EDIS). Methods: A qualitative study using interviews, mainly with nurses, conducted four years after the implementation of an EDIS at the emergency department (ED) of a large university hospital in Midlands, UK. Results: The introduction of waiting time targets for patients attending EDs and the spatial expansion of these clinical settings so as to support increasing numbers of attendances challenged the viability of paper records and whiteboards in the management of patient flows within the department. They also fostered the use of an information system for accumulating information and coordinating the activities of the multidisciplinary team. While whiteboards were abolished, paper still plays a role in nursing practice in response to issues of confidentiality, personal safety, ergonomics, computer literacy, interoperability, relationship with patients and overdependence on EDIS. Conclusions: ED information systems can have a major impact on organisational practices particularly as new service models of care are gradually introduced in EDs. Considering their spatio-temporal implications while treating the technology as an artifact with trans-formative, rather than supportive or substitutive, power enhances our understanding of the implementation challenges that need to be addressed during the reshaping of the sociotech-nical network

Implementation of an Emergency Department Information System: A Qualitative Study of Nurses’ Attitudes and Experience

This article explores the reactions of nurses toward the implementation of an emergency department information system. Semistructured interviews were conducted with 22 nurses, and data were analyzed using thematic analysis. The results suggest that despite some initial apprehensions nurses were positive in their attitudes and interactions with clinical information systems supportive of their practice, especially in respect of performance targets. Issues of digital work environment design, system availability, and peer support during preliminary interactions were also involved in the formation of their views. Implementation teams addressing these issues have greater chances of maintaining the attitudes that contribute to the successful use of these systems. © 2012 Lippincott Williams & Wilkins