Planning for Middle Level Clinical Experiences During a Crisis

This article describes the trials and tribulations that a middle level education program faced during the global pandemic and recommendations that others can take away from these experiences. The provided suggestions for middle level teacher education programs are specifically for the current pandemic, but can be used for other disasters as well. We advocate that educator preparation programs develop a plan to deal with possible school closers or other disruptions to their field placements to prepare for the next disaster. Some of the recommendations include: (a) create an emergency plan, (b) cultivate relationships, (c) prepare your candidates in the best practices of online teaching and educate them about online teaching platforms, (d) focus on the well-being of the candidates and not just ensuring that they complete the requirements, (e) consider relationship building skills when hiring field supervisors, (f) include strategies that help candidates understand how to deal with stress into your curriculum, and (g) adjust to situations on a case-to-case basis

Impact case studies submitted to REF2014: the hidden impact of nursing research

The UK’s Research Excellence Framework (REF) 2014 rated the research from 154 universities and the impact of research was evaluated in 6975 impact case studies. Nursing was returned within unit of Assessment (UoA) 3 which also included Dentistry, Pharmacy, Allied Health Professions, although nursing research was also submitted within other UoAs. The study aim was to collate and categorise available REF impact case studies involving nursing researchers or on topics of relevance to nursing. Using nurs* as a search term 469 case study entries were retrieved from the REF database and placed into three categories determined by the level of involvement of nurses. Some 80 impact case studies were submitted by nurses across 11 UoAs: the majority being in UoA3 (n=55). A further 50 revealed some relevant impact, though nurses did not have an obvious research role. A total of 248 case studies described actual or potential impact on health or social care but were not associated specifically with nursing. Nursing research has demonstrable impact, however there is a significant body of research with relevance for nursing that has not been associated with the profession in the REF. More attention should be paid to the ‘hidden impact’ of nursing research to ensure the full impact of nursing is recognised

Fault recovery for real-time, multi-tasking computer system

System and methods for providing a recoverable real time multi-tasking computer system are disclosed. In one embodiment, a system comprises a real time computing environment, wherein the real time computing environment is adapted to execute one or more applications and wherein each application is time and space partitioned. The system further comprises a fault detection system adapted to detect one or more faults affecting the real time computing environment and a fault recovery system, wherein upon the detection of a fault the fault recovery system is adapted to restore a backup set of state variables

Teaching Transitions: Techniques for Promoting Success Between Lessons

Presents suggestions on how teachers of exceptional children can help students transition from one activity to another. Enhancement of classroom management with explicit instruction and practice in behavioral expectations and routines; Planning for transitions; Revisiting and reviewing instruction

Neurobiological effects of probiotic-supplemented diets in acutely stressed male Long-Evans rats: Evidence of enhanced resilience

Introduction ~Considering that the human intestine is home to almost 100 trillion microorganisms including bacteria (Cryan, 2011), recent research has focused on the role of the microbiome in neurobiological functions such as stress, anxiety and coping responses. ~Focusing on animal models, previous findings indicate that modifications of the gut microbiota via antibiotics and certain probiotics alter the anxiety response via the vagus nerve & immune system mediation (MacQueen et al., 2017). ~Recently, the concept of Psychobiotics has been introduced to refer to the use of microbiota to positively influence mental health outcomes (Foster et al., 2017)

30-Day emergency department revisit rates among older adults with documented dementia

OBJECTIVES: Published literature on national emergency department (ED) revisit rates among older adults with dementia is sparse, despite anecdotal evidence of higher ED utilization. Thus we evaluated the odds ratio (OR) of 30-day ED revisits among older adults with dementia using a nationally representative sample. DESIGN: We assessed the frequency of claims associated with a 30-day ED revisit among Medicare beneficiaries with and without a dementia diagnosis before or at index ED visit. We used a logistic regression model controlling for dementia, age, sex, race, region, Medicaid status, transfer to a skilled nursing facility after ED, primary care physician use 12 months before index, and comorbidity. SETTING: A nationally representative sample of claims data for Medicare beneficiaries aged 65 and older who maintained continuous fee-for-service enrollment during 2015 and 2016. Only outpatient claims associated with an ED visit between January 2016 and November 2016 were included as a qualifying index encounter. PARTICIPANTS: We identified 240 249 patients without dementia and 54 622 patients for whom a dementia code was recorded in the year before the index encounter in 2016. RESULTS: Our results indicate a significant difference in unadjusted 30-day ED revisit rates among those with an ED dementia diagnoses (22.0%) compared with those without (13.9%). Our adjusted results indicated that dementia is a significant predictor of 30-day ED revisits (P \u3c .0001). Those with a dementia diagnosis at or before the index ED visit were more likely to have experienced an ED revisit within 30 days (OR = 1.27; 95% confidence interval = 1.24-1.31). CONCLUSION: Dementia diagnoses were a significant predictor of 30-day ED revisits. Further research should assess potential reasons why dementia is associated with markedly higher revisit rates, as well as opportunities to manage and transition dementia patients from the ED back to the community more effectively. J Am Geriatr Soc 67:2254-2259, 2019

Environmental Analysis of the Caddo River and its Tributaries: Comparison of Water Quality During 1992 with 1974-75

Environmental data related to water quality of the Caddo River and its tributaries were collected from March - October, 1992, and compared with data from August, 1974 - May, 1975. Bacterial, chemical and physical parameters were investigated at six river locations and thirteen tributary sites. Ammonia, nitrates, soluble phosphorus, turbidity and fecal coliform were significantly lower, and sodium and potassium were significantly higher in 1992 than during the previous study. Bacterial loading exceeded EPA criteria at some locations during both studies

Self, interpersonal and organisational acts of compassion amongst nurses during times of acute stress: A qualitative analysis

Background: There is a global shortage of nurses and new strategies are required to recruit, support and retain this staff group. Organisational culture can have a significant impact on staff wellbeing and commitment. Recent years have seen attempts to foster a compassionate culture across healthcare systems. However, little is known about how nurses initiate self-care and how they feel cared for by their organisation, particularly in times of acute stress and need. Aims: This paper aims to address the research question, ‘In what ways do nurses experience compassion (or not) during times of acute stress?’, identifying where and how compassionate acts were enacted by individuals, within teams or organisations. Methods: Semi-structured interviews were conducted with 50 UK National Health Service (NHS) nurses in a longitudinal qualitative study (between March 2020 and September 2022). Results: Three themes were derived from our narrative analysis including: (1) Learning and practising self-compassion; (2) The presence and absence of interpersonal compassion; and (3) Organisational (non) compassionate acts. Findings indicate that self-compassion requires permission and discipline, often being unfamiliar terrain for nurses. Interpersonal compassion can buoy nurses during challenging times but can often be absent across teams. Nurses’ experiences of organisational acts of compassion were limited, and they often felt de-valued, unsupported and replaceable. Conclusions: Compassionate acts are enacted across three levels (self, team and organisation). To retain staff, particularly in acutely stressful or challenging situations, organisations, and those responsible for nursing management and policy need to foster a systems-based approach to compassionate culture.<br/

Psychological impact of the Covid-19 pandemic on nurses and midwives

In response to findings of the Impact of Covid-19 on Nurses survey study, conducted in 2020, a subsequent study explored nurses’ qualitative experiences of the pandemic; this article discusses the results. Most participants struggled to transition to new working practices in altered care settings with more critically ill patients, and most experienced high levels of stress and psychological distress. Key themes included duty and fear, resilience and stigma, changing public responses, nurses’ voices, and leaving the profession. There is an urgent need to support and restore nurses’ psychological wellbeing, and to improve their working conditions to enhance retention rates

Speaking up during the COVID-19 pandemic: Nurses' experiences of organizational disregard and silence.

AIM: To critically examine nurses' experiences of speaking up during COVID-19 and the consequences of doing so. DESIGN: Longitudinal qualitative study. METHODS: Participants were purposively sampled to represent differing geographical locations, specialities, settings and redeployment experiences. They were interviewed (remotely) between July 2020 and April 2022 using a semi-structured interview topic guide. RESULTS: Three key themes were identified inductively from our analysis including: (1) Under threat: The ability to speak up or not; (2) Risk tolerance and avoidance: Consequences of speaking up; and (3) Deafness and hostility: Responses to speaking up. Nurses reported that their attempts to speak up typically focused on PPE, patient safety and redeployment. Findings indicate that when NHS Trusts and community services initiated their pandemic response policies, nurses' opportunities to speak up were frequently thwarted. CONCLUSION: Accounts presented in this article include nurses' feeling a sense of futility or of suffering in silence in relation to speaking up. Nurses also fear the consequences of speaking up. Those who did speak up encountered a 'deaf' or hostile response, leaving nurses feeling disregarded by their organization. This points to missed opportunities to learn from those on the front line. IMPACT: Speaking up interventions need to focus on enhancing the skills to both speak up, and respond appropriately, particularly when power, hierarchy, fear and threat might be concerned. PATIENT OR PUBLIC CONTRIBUTION: Nurses working clinically during COVID-19 were involved in the development of this study. Participants were also involved in the development of our interview topic guide and comments obtained from the initial survey helped to shape the study design