Evaluating the use of narrative pedagogy in person-centred care and human factors in perioperative practice education

Background: There is an international effort to develop understanding from human factors theory and implement this in healthcare to improve person-centred care and patient safety. Aim: This project aimed to evaluate the use of narrative pedagogy to teach human factors to perioperative personnel in the workplace. Methods: Using the action research model, an interactive learning session based on lessons from serious incidents was developed and delivered to perioperative staff in an NHS Trust within a practice development programme. Data were collected in the form of questionnaires and peer reviews to evaluate the learning session, and thematically analysed. Findings: The use of narrative pedagogy to explore human factors theory empowered participants to speak up, and this influenced the workplace safety culture. Conclusion: Narrative pedagogy reconnects healthcare employees with compassionate approaches to person-centred care, and this provides powerful motivation to improve the safety culture. Further studies should focus on different applications of narrative pedagogy in workplace learning, and creative approaches to teaching human factors. Implications for practice: • Narrative pedagogy can be a conduit to develop person-centred practice • Engaging staff through interactive practice development sessions can encourage expansive learning about human factors and their application in practice • Narrative pedagogy motivates healthcare staff to improve the safety culture in practic

Survival of \u3ci\u3eEnterococcus faecium\u3c/i\u3ein Turkey Litter Under Different Temperature and Moisture Combinations

Untreated poultry litter introduces a substantial load of fecal pathogens to the environment, impacting agriculture, public health and ecosystem function. There is substantial evidence that temperature and moisture are the primary drivers of fecal bacteria survival across ecosystems. However, both temperature and moisture effects have been shown to be modulated by the matrix in which the fecal bacteria are living. This context dependence highlights the importance of understanding fecal bacteria survival in a variety of matrices in order to implement effective waste management plans. In this study, we determined the survival patterns of Enterococcus faecium in post-use turkey litter under two levels of temperature (5°C, 30°C) and moisture (E. faecium abundance did not change over the course of 14 days. However, at 30°C, the low moisture treatment resulted in 23% decrease in E. faecium concentration over 14 days, while the high moisture treatment resulted in 16% growth over the course of the experiment. Since high temperature is usually sufficient to result in fecal bacteria decay in other matrices, this study highlights the context dependence of fecal bacteria survival. Furthermore, poultry litter waste-management plans should consider both temperature and moisture of litter storage conditions in order to mitigate litter impacts on public health

Approaches to therapy and prevention of frailty in the light of contemporary medicine

Over the last several decades, the growing number of patients with geriatric problems has become a serious challenge for primary care physicians. Frailty is an often encountered condition in older age. This is a state of increased vulnerability and loss of total physiological reserves, needed to maintain physiological and psychosocial homeostasis. Definition of physical frailty is based on the following criteria: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity, where 3 out of 5 these criteria confirms frailty. It is a dynamic, transitional process which constantly progresses, although it is potentially reversible. Frailty often co-exists with other severe diseases, affecting general well-being of the patient. Therefore, it is important for the family doctor to understand diagnosis and treatment to protect from an invasive procedure or potentially harmful medication, and prevent decline of functional independence. The aim of this review is to present current available treatment options and their effectiveness for frailty. Data from many observational studies were collected. The most beneficial seems to be combined multidisciplinary treatment including physical exercises, nutritional supplementation and cognitive training. Additionally, the further positive results of physical activity training on mobility, balance, coordination, muscle strength and reducing falls in frail elderly were also confirmed by many scientific reports. Pharmacological, nutritional, psychological and other interventions solely can also be helpful but the evidence is low. Preventive actions at many stages in the process leading to frailty can be applied

WFPC2 Images of the Central Regions of Early-Type Galaxies - I. The Data

We present high resolution R-band images of the central regions of 67 early-type galaxies obtained with the Wide Field and Planetary Camera 2 (WFPC2) aboard the Hubble Space Telescope (HST). Our sample strikingly confirms the complex morphologies of the central regions of early-type galaxies. In particular, we detect dust in 43 percent of all galaxies, and evidence for embedded stellar disks in a remarkably large fraction of 51 percent. In 14 of those galaxies the disk-like structures are misaligned with the main galaxy, suggesting that they correspond to stellar bars in S0 galaxies. We analyze the luminosity profiles of the galaxies in our sample, and classify galaxies according to their central cusp slope. To a large extent we confirm the clear dichotomy found in previous HST surveys: bright, boxy ellipticals with shallow inner cusps (`core' galaxies) on one hand and faint, disky ellipticals with steep central cusps (`power-law' galaxies) on the other hand. The advantages and shortcomings of classification schemes utilizing the extrapolated central cusp slope are discussed, and it is shown that this cusp slope might be an inadequate representation for galaxies whose luminosity profile slope changes smoothly with radius rather than resembling a broken power-law. In fact, we find evidence for an `intermediate' class of galaxies, that cannot unambiguously be classified as either core or power-law galaxies, and which have central cusp slopes and absolute magnitudes intermediate between those of core and power-law galaxies.Comment: 44 pages, 7 Postscript figures. Accepted for publication in the Astronomical Journal. The associated Appendix with figures of luminosity profiles, contour plots and isophotal parameters for all galaxies is available at http://www.astro.washington.edu/rest/centralpro

Investigation of Biofuel as a Potential Renewable Energy Source

An accelerating global energy demand, paired with the harmful environmental effects of fossil fuels, has triggered the search for alternative, renewable energy sources. Biofuels are arguably a potential renewable energy source in the transportation industry as they can be used within current infrastructures and require less technological advances than other renewable alternatives, such as electric vehicles and nuclear power. The literature suggests biofuels can negatively impact food security and production; however, this is dependent on the type of feedstock used in biofuel production. Advanced biofuels, derived from inedible biomass, are heavily favoured but require further research and development to reach their full commercial potential. Replacing fossil fuels by biofuels can substantially reduce particulate matter (PM), carbon monoxide (CO) emissions, but simultaneously increase emissions of nitrogen oxides (NOx), acetaldehyde (CH3CHO) and peroxyacetyl nitrate (PAN), resulting in debates concerning the way biofuels should be implemented. The potential biofuel blends (FT-SPK, HEFA-SPK, ATJ-SPK and HFS-SIP) and their use as an alternative to kerosene-type fuels in the aviation industry have also been assessed. Although these fuels are currently more costly than conventional aviation fuels, possible reduction in production costs has been reported as a potential solution. A preliminary study shows that i-butanol emissions (1.8 Tg/year) as a biofuel can increase ozone levels by up to 6% in the upper troposphere, highlighting a potential climate impact. However, a larger number of studies will be needed to assess the practicalities and associated cost of using the biofuel in existing vehicles, particularly in terms of identifying any modifications to existing engine infrastructure, the impact of biofuel emissions, and their chemistry on the climate and human health, to fully determine their suitability as a potential renewable energy source

Viability PCR shows that non-ocular surfaces could contribute to transmission of Chlamydia trachomatis infection in trachoma.

BACKGROUND: The presence of Chlamydia trachomatis (Ct) DNA at non-ocular sites suggests that these sites may represent plausible routes of Ct transmission in trachoma. However, qPCR cannot discriminate between DNA from viable and non-viable bacteria. Here we use a propodium monoazide based viability PCR to investigate how long Ct remains viable at non-ocular sites under laboratory-controlled conditions. METHODS: Cultured Ct stocks (strain A2497) were diluted to final concentrations of 1000, 100, 10 and 1 omcB copies/μL and applied to plastic, woven mat, cotton cloth and pig skin. Swabs were then systemically collected from each surface and tested for the presence Ct DNA using qPCR. If Ct DNA was recovered, Ct viability was assessed over time by spiking multiple areas of the same surface type with the same final concentrations. Swabs were collected from each surface at 0, 2, 4, 6, 8 and 24 hours after spiking. Viability PCR was used to determine Ct viability at each timepoint. RESULTS: We were able to detect Ct DNA on all surfaces except the woven mat. Total Ct DNA remained detectable and stable over 24 hours for all concentrations applied to plastic, pig skin and cotton cloth. The amount of viable Ct decreased over time. For plastic and skin surfaces, only those where concentrations of 100 or 1000 omcB copies/μL were applied still had viable loads detectable after 24 hours. Cotton cloth showed a more rapid decrease and only those where concentrations of 1000 omcB copies/μL were applied still had viable DNA detectable after 24 hours. CONCLUSION: Plastic, cotton cloth and skin may contribute to transmission of the Ct strains that cause trachoma, by acting as sites where reservoirs of bacteria are deposited and later collected and transferred mechanically into previously uninfected eyes

Oceanographic Variability in Cumberland Bay, South Georgia, and Its Implications for Glacier Retreat

South Georgia is a heavily glaciated sub-Antarctic island in the Southern Ocean. Cumberland Bay is the largest fjord on the island, split into two arms, each with a large marine-terminating glacier at the head. Although these glaciers have shown markedly different retreat rates over the past century, the underlying drivers of such differential retreat are not yet understood. This study uses observations and a new high-resolution oceanographic model to characterize oceanographic variability in Cumberland Bay and to explore its influence on glacier retreat. While observations indicate a strong seasonal cycle in temperature and salinity, they reveal no clear hydrographic differences that could explain the differential glacier retreat. Model simulations suggest the subglacial outflow plume dynamics and fjord circulation are sensitive to the bathymetry adjacent to the glacier, though this does not provide persuasive reasoning for the asymmetric glacier retreat. The addition of a postulated shallow inner sill in one fjord arm, however, significantly changes the water properties in the resultant inner basin by blocking the intrusion of colder, higher salinity waters at depth. This increase in temperature could significantly increase submarine melting, which is proposed as a possible contribution to the different rates of glacier retreat observed in the two fjord arms. This study represents the first detailed description of the oceanographic variability of a sub-Antarctic island fjord, highlighting the sensitivity of fjord oceanography to bathymetry. Notably, in fjords systems where temperature decreases with depth, the presence of a shallow sill has the potential to accelerate glacier retreat

Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): a qualitative study of experiences of COVID-19 among people who inject drugs

BACKGROUND: : People who inject drugs (PWID) are a high-risk group for COVID-19 transmission and serious health consequences. Restrictions imposed in the UK in response to the pandemic led to rapid health and housing service alterations. We aimed to examine PWID experiences of: 1) challenges relating to the COVID-19 public health measures; 2) changes to opioid substitution therapy (OST) and harm reduction services; and 3) perceived effects of COVID-19 on drug use patterns and risk behaviour. METHODS: : Telephone semi-structured interviews were conducted with 28 PWID in Bristol, Southwest of England. Analysis followed a reflexive thematic analysis. RESULTS: : Concern about COVID-19 and adherence to public health guidance varied. Efforts made by services to continue providing support during the pandemic were appreciated and some changes were preferred, such as less frequent OST collection, relaxation of supervised consumption and needle and syringe programmes (NSP) home delivery. However, remote forms of contact were highlighted as less beneficial and more difficult to engage with than in-person contact. Public health guidance advising people to ‘stay home’ led to increased isolation, boredom, and time to ruminate which impacted negatively on mental health. Lockdown restrictions directly impacted on sources of income and routine. Changes in drug use were explained as a consequence of isolation and fewer interactions with peers, problems accessing drugs, reduced drug purity and reduced financial resources. CONCLUSION: : This study captures the significant impacts and challenges of the COVID-19 pandemic on the lives of PWID. While rapid adaptations to service delivery to help mitigate the risks of COVID-19 were appreciated and some changes such as relaxation of supervised daily OST consumption were viewed positively, barriers to access need further attention. Going forwards there may be opportunities to harness the positive aspects of some changes to services