Introducing e-developers to support a university’s blended learning developments

Introducing technology in higher education raises questions about staff roles and the organisation of development practices. This article presents the findings from a case study that was undertaken to evaluate the effectiveness of introducing three centrally supported e-developers to work with academic teams to provide specialist support. The e-developer role is explained, and related to existing literature about learning technologists. The case illustrates how the e-developers worked collaboratively with academic staff and the perceptions of the academic staff, e-developers and educational technology leaders of the e-developer model used in a university in southwest London. The findings offer an opportunity to understand this kind of role, and the value of a model of staff development that does not involve taking academic staff out of the teaching area to become e-developers. The model supports ‘situative’ professional development, which helps promote technology integration into teaching and suggests that e-developers provided cost-effective mentorship which participants believed would have a positive impact on student learnin

Facilitating adjustments : evaluating a series of reasonable adjustments workshops for mainstream healthcare professionals

Introduction: Having experienced several nationally reported clinical incidents East Kent Hospitals (EKH) developed data that indicated that people with Intellectual Disability (ID) were at greater risk of being admitted via A&E, and repeatedly admitting, compared to the general population. Health Education England supported EKH to undertake workshops for doctors and other local non -ID specialist professionals on making adjustments for people with ID. Methods: A team of three experts by experience – including people with ID and family carers- and three ID Nurses were employed to develop and co-facilitate a series of workshops. Practice Development methods such as Fourth Generation Evaluation were employed and included in the learning outcomes and educational methods. Results: Nine workshops were held over a two years; 120 participants attended, only 10% had a medical background. A thematic analysis of participant’s data indicated an emerging concept, preparedness. Participants wished to be better prepared to make adjustments before the patient’s arrival. Implications: This evaluation is prescient as UK parliament is due to consult on education for all healthcare professionals on ID in light of #Oliverscampaign. It is recommended that responsibility for ID education resides with service providers, employing local experts, reflecting local data, and be experiential with a work-based project component. Local informatics systems ought to flag and alert staff of people with learning disabilities using services

An exploration of the experiences and self-generated strategies used when navigating everyday life with Long Covid.

BACKGROUND: Around one in ten people who contract Covid-19 report ongoing symptoms or 'Long Covid'. Without any known interventions to cure the condition, forms of self-management are routinely prescribed by healthcare professionals and described by people with the condition. However, there is limited research exploring what strategies are used to navigate everyday life with Long Covid, and experiences that initiate development of these strategies. Our study aimed to explore the range and influence of self-generated strategies used by people with Long Covid to navigate everyday life within the context of their own condition. METHODS: Forming part of the Long Covid Personalised Self-managemenT support co-design and EvaluatioN (LISTEN) project, we conducted a qualitative study using narrative interviews with adults who were not hospitalised with Covid-19. Participants aged over 18 years, who self-identified with Long Covid, were recruited from England and Wales. Data were analysed with patient contributors using a reflexive thematic analysis. RESULTS: Eighteen participants (mean age = 44 years, SD = 13 years) took part in interviews held between December 2021 and February 2022. Themes were constructed which depicted 1) the landscape behind the Long Covid experience and 2) the everyday experience of participants' Long Covid. The everyday experience comprised a combination of physical, emotional, and social factors, forming three sub-themes: centrality of physical symptoms, navigating 'experts' and the 'true colour' of personal communities, and a rollercoaster of psychological ambiguity). The third theme, personal strategies to manage everyday life was constructed from participants' unique presentations and self-generated solutions to manage everyday life. This comprised five sub-themes: seeking reassurance and knowledge, developing greater self-awareness through monitoring, trial and error of 'safe' ideas, building in pleasure and comfort, and prioritising 'me'. CONCLUSIONS: Among this sample of adults with Long Covid, their experiences highlighted the unpredictable nature of the condition but also the use of creative and wide ranging self-generated strategies. The results offer people with Long Covid, and healthcare professionals supporting them, an overview of the collective evidence relating to individuals' self-management which can enable ways to live 'better' and regain some sense of identity whilst facing the impact of a debilitating, episodic condition. TRIAL REGISTRATION: LISTEN ISRCTN36407216

An exploration of the experiences and self-generated strategies used when navigating everyday life with Long Covid

Background: Around one in ten people who contract Covid-19 report ongoing symptoms or ‘Long Covid’. Without any known interventions to cure the condition, forms of self-management are routinely prescribed by healthcare professionals and described by people with the condition. However, there is limited research exploring what strategies are used to navigate everyday life with Long Covid, and experiences that initiate development of these strategies. Our study aimed to explore the range and influence of self-generated strategies used by people with Long Covid to navigate everyday life within the context of their own condition. Methods: Forming part of the Long Covid Personalised Self-managemenT support co-design and EvaluatioN (LISTEN) project, we conducted a qualitative study using narrative interviews with adults who were not hospitalised with Covid-19. Participants aged over 18 years, who self-identified with Long Covid, were recruited from England and Wales. Data were analysed with patient contributors using a reflexive thematic analysis. Results: Eighteen participants (mean age = 44 years, SD = 13 years) took part in interviews held between December 2021 and February 2022. Themes were constructed which depicted 1) the landscape behind the Long Covid experience and 2) the everyday experience of participants’ Long Covid. The everyday experience comprised a combination of physical, emotional, and social factors, forming three sub-themes: centrality of physical symptoms, navigating ‘experts’ and the ‘true colour’ of personal communities, and a rollercoaster of psychological ambiguity). The third theme, personal strategies to manage everyday life was constructed from participants’ unique presentations and self-generated solutions to manage everyday life. This comprised five sub-themes: seeking reassurance and knowledge, developing greater self-awareness through monitoring, trial and error of ‘safe’ ideas, building in pleasure and comfort, and prioritising ‘me’. Conclusions: Among this sample of adults with Long Covid, their experiences highlighted the unpredictable nature of the condition but also the use of creative and wide ranging self-generated strategies. The results offer people with Long Covid, and healthcare professionals supporting them, an overview of the collective evidence relating to individuals' self-management which can enable ways to live ‘better’ and regain some sense of identity whilst facing the impact of a debilitating, episodic condition. Trial registration: LISTEN ISRCTN36407216

Monetary Compensation for Survivors of Torture: Some Lessons from Nepal

The Nepali Compensation Relating to Torture Act (1996) is one of the earliest pieces of specific anti-torture legislation adopted in the global South. Despite a number of important limitations, scores of Nepalis have successfully litigated for monetary compensation under the Act, on a scale relatively rare on the global human rights scene. Using a qualitative case study approach, this article examines the conditions under which survivors of torture are awarded compensation in Nepal, and asks what lessons does this have for broader struggles to win monetary compensation for torture survivors? We end by suggesting that there can be practical tensions between providing individual financial compensation and addressing wider issues of accountability

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

A Utilisation Focussed and Viable Systems Approach for Evaluating Technology Supported Learning

The paper uses a higher education case study to illustrate a participative theory of change approach to evaluating technology supported learning. The approach is informed by the Viable Systems Model (VSM) and utilisation-focussed evaluation and, falls within the tradition of facilitated modelling approaches to operational research. We argue that this approach worked well in engaging primary evaluation users in a process of collaborative action research to improving an educational development initiative and that the approach helped generate information relevant to answering its primary users’ questions, to inform their specific decisions and actions relevant to their quality enhancement responsibilities. Through a case study, concerning the evaluation of an educational development initiative in a large UK university, we illustrate how the VSM and utilisation-focussed evaluation could be used to: (a) conceptualise the connection between strategies and their components at different levels of organisation; (b) to clarify the role and interests of stakeholders in these strategies; and (c) to scope evaluation to be relevant to informing the decisions and actions of these stakeholders. The paper contributes to illustrate how VSM principles can underpin a theory of change approach to engaging primary stakeholders in planning an intervention and its evaluation in the context of educational development work, in order to improve evaluation to be more relevant to their needs. The paper should be of interest to researchers exploring the use of systems theory in evaluation, in particular in the context of educational development work in higher education