Developing a workbook for primary care nursing students

There is a continuing need to prepare a nursing workforce that is adaptable within a range of care settings. The faculty of health at Staffordshire University seconded a lecturer practitioner for a 12-month period to conduct an audit on primary care placements. Mentors were involved in the audit in order to include their views and opinions alongside those of students

The efficacy of partnership evaluation and its impact on alliance transformation : a case study 12 months post evaluation

Partnerships involving higher education, governments, and industry have been recognised as important vehicles for engaging community, leveraging knowledge, and sharing potential resources. The critical need for these partnerships in rural and regional locations has been of particular note. Partnership evaluation can serve a critical function of informing continuous improvement and may therefore assist the evaluated agencies to work towards responsive transformational change. The ability for a partnership to adapt and change may aid in their sustainability. Despite the potentially important role of partnership evaluation, the development of tools that measure partnership are at an early stage. Partnership evaluation is rarely reflected upon in the published literature. Moreover, benefits and reflections of the efficacy of evaluations 12 months post analysis is rare in the published literature. Therefore, a brief review of partnership approaches and measurement tools are presented. The purpose of this paper is to reflect upon the efficacy of an evaluation conducted 12 months previously of a partnership between Deakin University, the Department of Health and Department of Human Services (Barwon South West Region), known as the Deakin/DH/DHS Strategic Alliance. This case study reviews several tools/metrics utilised. The efficacy of the evaluation tools is discussed. Those metrics, underlying the tools which contributed to positive change in partnerships are discussed.<br /

A tuberculosis contact investigation involving two private nursing homes in inner western Sydney in 2004

Australia has one of the lowest incidence rates of tuberculosis (TB) in the world, approximately five per 100,000 per year 1, although in some parts of the country the incidence is considerably higher. In the former Central Sydney Area Health Service the incidence rate in 2003 was 14 per 100,000 per year.2 The incidence is also higher in those aged 65 years and over1, a population that has declining immunocompetence due to a variety of factors.3 Furthermore, the subpopulation of this group (and, indeed, of people of any age) living in residential institutions such as nursing homes and hostels are at even greater risk of TB infection and disease due to their chronic ill health and multiple medical problems.3 Despite this, there are no guidelines in NSW regarding TB screening of the elderly, either in response to potential exposure or with regard to screening at entry to a residential facility. There are also very few reports in the literature of TB contact investigations in residential facilities. Those that have been published come from the United States and are concerned with TB in hospitals or correctional facilities.3,4,5,6 There has been one report of TB transmission in a school setting in Sydney7, but there is a paucity of Australian literature that clarifies what is required for contact investigations in the local residential care setting. This paper describes a contact investigation resulting from a case of active TB in a health care worker employed by a number of nursing homes in inner-western Sydney and highlights the need for policies with regard to TB screening of the elderly residing in nursing homes

Gender, Sexuality and Social Justice: What's Law Got to Do with It?

The contributions to this Edited Collection reveal the complexity of the deceptively simple question posed by its title: Gender, Sexuality and Social Justice: What’s Law Got to Do With It? Many of those involved in this publication are directly involved in and affected by the issues to which the Edited Collection’s title speaks. From activists working with women in Assam’s tea gardens in India or young lesbian, gay, bisexual and transgender leaders in Vietnam, to lawyers fighting the Anti-Homosexuality Bill in Uganda or the criminalisation of cross-dressing in Malaysia, to academics carefully re-reading Islamic Sharia or researchers assessing HIV prevention programmes in South Africa, the contributors to this Collection have first-hand knowledge and experience of the complexities of gender, sexuality and social justice. The product of this vast array of experience is a series of conversations that decisively indicate that the question of law’s relation to sexuality, gender and social justice does not have a single, simple answer. The increased legalisation of processes by which sexual, sexuality and gender justice is sought requires interrogation and careful scrutiny and, as the contributions in this collection show, the law is often an imperfect tool for achieving meaningful justice. Yet it is in these important and complex conversations that the scope for future action becomes tangible. In exploring different processes by which activists and other actors have worked for change, in interrogating what we mean when we talk about ‘solidarity’, and in questioning the usefulness and place of law, a picture of a complex but vibrant field of action for sexuality and gender justice begins to emerge. This Collection offers multiple routes to sexuality and gender justice and numerous suggestions of what sexuality and gender justice could be in a plurality of contexts. It also suggests that there are many potential pitfalls and barriers to justice or progress. What this Collection highlights, however, is that by listening carefully to each other and by paying careful attention to the needs of those working on the ground, we give ourselves the best chances of success, individually and collectively. The ongoing conversations in this Collection are part of this process. It has been a privilege to be part of them and we will watch how they develop further with interest and with hope.UK Department for International Developmen

Resilience amid Uncertainty: The on-going impacts of the COVID-19 pandemic on nonprofits in Washington State

This report represents the second phase of on-going research to understand how nonprofits in Washington State have responded to the twin public health crises of systemic racism and the COVID-19 pandemic. The first report focused on the initial phases of the pandemic from March to July 2020 and revealed that many nonprofits faced precarious financial and operational conditions precipitated by an increased demand for services and dwindling revenue sources. Our second phase sought to understand how nonprofits fared in the subsequent period, specifically to investigate (a) how nonprofits, especially organizations led by and serving communities of color, which bore the greatest burden of the twin pandemics, have been able to navigate, (b) the types of support that organizations have been able to access, what that support has allowed them to do (i.e. the needs it covered), the sufficiency of that support to meet organizational needs, and any challenges experienced in receiving support, and (c) the financial and operational outlook for the future of nonprofits in Washington State.We interviewed 37 nonprofit leaders located across Washington State from March to August 2021. Our sample included many of our 2020 survey respondents as well as nonprofits serving communities of color and rural communities. Our interviews revealed that nonprofits responded to the twin pandemics with resilience, compassion, and initiative.

Patient-centred care in general dental practice--a systematic review of the literature.

Journal ArticleResearch Support, Non-U.S. Gov'tReviewBACKGROUND: Delivering improvements in quality is a key objective within most healthcare systems, and a view which has been widely embraced within the NHS in the United Kingdom. Within the NHS, quality is evaluated across three key dimensions: clinical effectiveness, safety and patient experience, with the latter modelled on the Picker Principles of Patient-Centred Care (PCC). Quality improvement is an important feature of the current dental contract reforms in England, with "patient experience" likely to have a central role in the evaluation of quality. An understanding and appreciation of the evidence underpinning PCC within dentistry is highly relevant if we are to use this as a measure of quality in general dental practice. METHODS: A systematic review of the literature was undertaken to identify the features of PCC relevant to dentistry and ascertain the current research evidence base underpinning its use as a measure of quality within general dental practice. RESULTS: Three papers were identified which met the inclusion criteria and demonstrated the use of primary research to provide an understanding of the key features of PCC within dentistry. None of the papers identified were based in general dental practice and none of the three studies sought the views of patients. Some distinct differences were noted between the key features of PCC reported within the dental literature and those developed within the NHS Patient Experience Framework. CONCLUSIONS: This systematic review reveals a lack of understanding of PCC within dentistry, and in particular general dental practice. There is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient-centredness. Further research is necessary to understand the important features of PCC in dentistry and patients' views should be central to this research.NIH

Patient-centred care in general dental practice--a systematic review of the literature.

BACKGROUND: Delivering improvements in quality is a key objective within most healthcare systems, and a view which has been widely embraced within the NHS in the United Kingdom. Within the NHS, quality is evaluated across three key dimensions: clinical effectiveness, safety and patient experience, with the latter modelled on the Picker Principles of Patient-Centred Care (PCC). Quality improvement is an important feature of the current dental contract reforms in England, with "patient experience" likely to have a central role in the evaluation of quality. An understanding and appreciation of the evidence underpinning PCC within dentistry is highly relevant if we are to use this as a measure of quality in general dental practice. METHODS: A systematic review of the literature was undertaken to identify the features of PCC relevant to dentistry and ascertain the current research evidence base underpinning its use as a measure of quality within general dental practice. RESULTS: Three papers were identified which met the inclusion criteria and demonstrated the use of primary research to provide an understanding of the key features of PCC within dentistry. None of the papers identified were based in general dental practice and none of the three studies sought the views of patients. Some distinct differences were noted between the key features of PCC reported within the dental literature and those developed within the NHS Patient Experience Framework. CONCLUSIONS: This systematic review reveals a lack of understanding of PCC within dentistry, and in particular general dental practice. There is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient-centredness. Further research is necessary to understand the important features of PCC in dentistry and patients' views should be central to this research

Effect of Solvent Extraction Parameters on the Recovery of Oil From Spent Coffee Grounds for Biofuel Production

Spent coffee grounds (SCG) are a potentially valuable source of lipids for sustainable production of biofuels. However, there are several feedstock properties and solvent extraction parameters that can impact on the oil yield and quality, potentially reducing the possible environmental benefits of deriving oils from this waste stream. This study presents results of laboratory and pilot plant scale experimental investigations into lipid recovery from spent coffee, determining the effects of solvent extraction variables including duration, SCG-to-solvent ratio and SCG residual moisture. SCG samples from both the industrial production of instant coffee and retail coffee shops were characterized in terms of moisture content, particle size distribution and oil content to identify the impact of these variables on the efficiency of lipid recovery by solvent extraction. The dry weight oil content of the instant SCG samples ranged from 24.2 to 30.4% w/w, while the retail SCG samples contained considerably lower amounts of lipids with their oil content ranging between 13.4 and 14.8% w/w. The highest oil yields were found at an extraction duration of 8 h, while a moisture content of ~2% w/w led to increased yields relative to completely dry samples. A pattern of increasing acidity with decreasing extraction duration was observed, suggesting preferential extraction of free fatty acids (FFA), with the fatty acid (FA) profile of the oil found to be similar to lipids commonly utilized for biofuel production

Altered expression of caspases-4 and -5 during inflammatory bowel disease and colorectal cancer : diagnostic and therapeutic potential

Caspases are a group of proteolytic enzymes involved in the co-ordination of cellular processes, including cellular homeostasis, inflammation and apoptosis. Altered activity of caspases, particularly caspase-1, has been implicated in the development of intestinal diseases, such as inflammatory bowel disease (IBD) and colorectal cancer (CRC). However, the involvement of two related inflammatory caspase members, caspases-4 and -5, during intestinal homeostasis and disease has not yet been established. This study demonstrates that caspases-4 and -5 are involved in IBD-associated intestinal inflammation. Furthermore, we found a clear correlation between stromal caspase-4 and -5 expression levels, inflammation and disease activity in ulcerative colitis patients. Deregulated intestinal inflammation in IBD patients is associated with an increased risk of developing CRC. We found robust expression of caspases-4 and -5 within intestinal epithelial cells, exclusively within neoplastic tissue, of colorectal tumours. An examination of adjacent normal, inflamed and tumour tissue from patients with colitis-associated CRC confirmed that stromal expression of caspases-4 and -5 is increased in inflamed and dysplastic tissue, while epithelial expression is restricted to neoplastic tissue. In addition to identifying caspases-4 and -5 as potential targets for limiting intestinal inflammation, this study has identified epithelial-expressed caspases-4 and -5 as biomarkers with diagnostic and therapeutic potential in CRC

Abnormal distribution of CD8 subpopulation in B-chronic lymphocytic leukemia identified by flow cytometry

We studied the occurrence of T-cell subpopulations for patients with B-cell chronic lymphocytic leukemia. The CD8+ population was divided into CD8+ suppressor (CD8a+) and CD8+ cytotoxic (CD8b+) lymphocytes using difference in orthogonal light scattering.\ud \ud Average CD4+/CD8+ratios determined for all patients were decreased. For individual patients this sometimes was not true. In contrast CD4+/CD8a+ ratios were markedly increased in all individual patients. The CD8+ lymphocytes appeared to consist mainly of CD8b+lymphocytes. Moreover the CD8b+/CD8+ ratio correlated with clinical stage: untreated patients (stage 0 of Rai) have smaller CD8b+/CD8+ ratios than patients with advanced stages of Rai