Practice tutors’ readiness to support nursing students who require reasonable adjustments for clinical placement

Background: Preregistration nursing students (trainee nursing associates and student nurses) may have a disability or impairment that requires reasonable adjustments while they are on clinical placement. At The Open University, practice tutors support nursing students on clinical placement, which includes overseeing the facilitation of any such reasonable adjustments. However, they may not feel prepared to provide this support. Method: A qualitative approach with a broad interpretivist paradigm was adopted. Data were collected from three focus groups that included a total of 10 nursing practice tutors. Audio data were transcribed and analysed using complete coding followed by thematic analysis. Findings: Three main themes were identified – it's complex; impact of engagement; and a cohesive approach – along with associated subthemes. Conclusion: Despite their clear interest in helping nursing students who require reasonable adjustments for practice-based learning, practice tutors can be hindered by barriers resulting from a lack of both training and guidelines. The complexity of the practice tutor role and student issues can compound this. Consistency in practice tutor training is recommended, as well as regular access to peer support to address these difficulties and develop the skills and knowledge

Practice Tutors’ views on their readiness for supporting OU pre-registration nursing students who require reasonable adjustments for clinical placement

Background: In the United Kingdom, pre-registration nursing students (Trainee Nursing Associates and student nurses) include those with a disability or impairment who can require extra learning support to maximise their achievement of clinical proficiencies i.e. reasonable adjustments. At The Open University, Practice Tutors support nursing students in clinical placement which includes overseeing the facilitation of any reasonable adjustments for practice-based learning. It was proposed that, similarly to previously research reporting on other relevant stakeholders, Practice Tutors could feel unprepared in supporting these students. Method: Utilising a qualitative approach with a broad interpretivist paradigm, data was collected from three focus groups involving ten nursing Practice Tutors. Audio data was transcribed and analysed using ‘complete coding’ followed by thematic analysis. Findings: Three main themes were identified as ‘it’s complex’, ‘impact of engagement’ and ‘a cohesive approach’ along with associated sub-themes. Conclusion: Despite the obvious interest in helping their nursing students who require reasonable adjustments for clinical placement, Practice Tutors can be hindered by existing barriers. The complexity of the Practice Tutor role and student issues can further compound this situation. To help improve these current difficulties, consistency in Practice Tutor training and induction is recommended as well as regular access to peer support

Reasonable adjustments for student nurses in clinical placement in the United Kingdom: The perspectives of the associated Community of Practice on current criteria and procedure

Background: In the United Kingdom, pre-registration nursing students include those with a disability or impairment who can require extra learning support to maximise their achievement of clinical proficiencies. My earlier EdD research suggests a Community of Practice (CoP) related to facilitating these reasonable adjustments in clinical placement. This group of practitioners can optimise the clinical learning environment but are potentially hindered by limited evidence-based knowledge and a lack of national guidance. Research aim: To confirm the existence of this CoP and investigate the development of these practitioners’ reasonable adjustments capability. In addition, to seek the views from these individuals regarding the efficacy of current related criteria and procedures. Methodology: Using a broad interpretivist approach, semi-structured interviews elicited the opinions and experiences from 13 study participants, involved with supporting student nurse learning in clinical placement, from varying parts of the United Kingdom. All interview data were transcribed, coded and then thematically analysed in conjunction with the chosen theoretical lenses. Findings: Three main themes were identified- ‘lack of consistency’, ‘an experiential approach’, and ‘sharing good practice’. Conclusions: The Thesis findings confirm the emergence of a CoP associated with reasonable adjustments for student nurses in clinical placement, but with traits differing from those of a conventional CoP. A lack of both knowledge and national guidance can hinder the capability development of CoP members and can contribute towards negative attitudes within the CoP regarding the ability of these student nurses. Further research and investigation is recommended to fully understand this unique CoP and promote its existence to the wider nursing body

Young people with diabetes and their peers

Type 1 Diabetes (T1D) is amongst the most common form of chronic illness affecting young people in the UK. Self- management is crucial, but managing their T1D is often difficult for young people

Evaluation of the Effectiveness of Disseminating Workplace Health Promotion Resources to Businesses

Encouraging workplaces to undertake health promotion is important yet little is known of the types of information small and medium size workplaces would find useful. Two resources on workplace health promotion were mailed to 213 workplaces. The resources provided information on the benefits of workplace health promotion, suggestions for low-cost activities and components of a sustainable program. 62% of respondents rated the resources as either ‘very useful’ or ‘somewhat useful’. Workplaces in ‘contemplation’ and ‘preparation’ stages of change for engaging in WHP were most likely to have undertaken an activity to support the health and well-being of employees or be intending to, as a result of reading the resources .The findings of this study provide useful information on the reach and impact of dissemination of health promotion resources by mail to workplaces, and particularly small businesses

Diagnosis as a new beginning not an end: A participatory photovoice study on navigating an autism diagnosis in adulthood

Autistic people diagnosed in adulthood often report that the experience can be life-changing, but there are issues with the diagnostic pathway. Few studies consider the views of people currently seeking diagnosis or contextualise the experience of diagnosis around developing an autistic identity. In this qualitative participatory study, we explored experiences of navigating an autism diagnosis in adulthood in the UK. We recruited six women (aged 21–46 years) who were seeking diagnosis, who worked with the academic researchers across four sessions to develop the study, share their experiences and analyse the themes. In one session, they completed a semi-structured interview alongside photovoice, a community-based action method, to explain and reflect on their experiences. We used reflexive thematic analysis to identify patterns, with four key themes identified: (1) ‘everything shattered’, (2) ‘being seen’, (3) ‘understanding not judgement, please’ and (4) ‘here’s a leaflet, off you go’. The themes reflected a desire for change and improved support for both diagnosis and developing autistic identity. Following photovoice methodology, together we identified actions to improve adult diagnosis, including involving autistic people in making improvements to the diagnostic criteria, for key professional and community groups to listen more to autistic people and for diagnostic support services to be flexible and appreciative of wider neurodivergence and intersectionality

Current practice in academic workload allocation processes in Australia

Embarking on a large-scale research project to investigate aspects of academic workload management, it was first necessary to gain some understanding of current practice in that context within Australia. With that aim a pilot survey was conducted in 2013 that targeted Deans of Science on the one hand, and workload managers on the other. Survey questions covered three key areas related to workload management: models and rules; process and policy; and systems and software. Comparisons between different types of university, different allocation models for teaching, research and service components of academic workload, and different sizes of academic unit were explored. While the number of responses in absolute terms was relatively limited, and hence the outcomes were not always statistically testable or generalisable, broad trends were readily identifiable.  This paper reports on the method and outcomes of the survey, and describes how the information that was obtained has informed the development of an in-depth research project

Children’s ages of consent to non-urgent heart surgery: The views of two paediatric cardiology teams

Paediatric cardiology practitioners and related experts report unusually young ages when they begin to inform children about their non-urgent heart surgery and begin to respect children's consent or refusal. Research methods included observations in two paediatric cardiology units, audio-recorded interviews with 45 experts, and qualitative data analysis. Significantly younger ages were cited than are usually recommended in the clinical and legal literature. Interviewed practitioners took seriously children's consent to or refusal of a heart transplant from around 6 years, and a child's firm refusal of induction of anaesthesia from around 4 years, when surgery might be postponed

Hybrid assembly of an agricultural slurry virome reveals a diverse and stable community with the potential to alter the metabolism and virulence of veterinary pathogens

Background: Viruses are the most abundant biological entities on Earth, known to be crucial components of microbial ecosystems. However, there is little information on the viral community within agricultural waste. There are currently ~ 2.7 million dairy cattle in the UK producing 7–8% of their own bodyweight in manure daily, and 28 million tonnes annually. To avoid pollution of UK freshwaters, manure must be stored and spread in accordance with guidelines set by DEFRA. Manures are used as fertiliser, and widely spread over crop fields, yet little is known about their microbial composition. We analysed the virome of agricultural slurry over a 5-month period using short and long-read sequencing. Results: Hybrid sequencing uncovered more high-quality viral genomes than long or short-reads alone; yielding 7682 vOTUs, 174 of which were complete viral genomes. The slurry virome was highly diverse and dominated by lytic bacteriophage, the majority of which represent novel genera (~ 98%). Despite constant influx and efflux of slurry, the composition and diversity of the slurry virome was extremely stable over time, with 55% of vOTUs detected in all samples over a 5-month period. Functional annotation revealed a diverse and abundant range of auxiliary metabolic genes and novel features present in the community, including the agriculturally relevant virulence factor VapE, which was widely distributed across different phage genera that were predicted to infect several hosts. Furthermore, we identified an abundance of phage-encoded diversity-generating retroelements, which were previously thought to be rare on lytic viral genomes. Additionally, we identified a group of crAssphages, including lineages that were previously thought only to be found in the human gut. Conclusions: The cattle slurry virome is complex, diverse and dominated by novel genera, many of which are not recovered using long or short-reads alone. Phages were found to encode a wide range of AMGs that are not constrained to particular groups or predicted hosts, including virulence determinants and putative ARGs. The application of agricultural slurry to land may therefore be a driver of bacterial virulence and antimicrobial resistance in the environment. [MediaObject not available: see fulltext.

Children’s understanding and consent to heart surgery: Multidisciplinary teamwork and moral experiences

Mainstream law and ethics literature on consent to children’s surgery contrasts with moral experiences of children and adults observed in two heart surgery centres. Research interviews were conducted with 45 practitioners and related experts, and with 16 families of children aged 6 to 15, admitted for non-urgent surgery, as well as an online survey. Thematic data analysis was informed by critical realism and childhood studies. Impersonal adult-centric mainstream literature assumes young children cannot consent. It is based on dichotomies: adult/child, competent/incompetent, respect or protect children, inform or distract them, use time swiftly or flexibly, verbal/non-verbal communication, respect or control children and reason/emotion. Through their moral experiences, adults and children resolve these seeming dichotomies. Through understanding young children’s reasoning and emotions about complex distressing decisions related to heart surgery, adults share knowledge, control, trust and respect with them. They see children’s consent or refusal before non-urgent surgery as a shared personal moral experience within the child’s life course, beyond mere legal compliance. Adults help children to understand and ‘want’ the surgery that offers things they value: better health or to ‘be more like their friends’. If children are not convinced, sometimes surgery is postponed or occasionally cancelled.</br