Benchmarking school nursing practice: the North West Regional Benchmarking Group

It is essential that the quality of care is reviewed regularly through robust processes such as benchmarking to ensure all outcomes and resources are evidence-based so that children and young people’s needs are met effectively. This article provides an example of the use of benchmarking in school nursing practice. Benchmarking has been defined as a process for finding, adapting and applying best practices (Camp, 1994). This concept was first adopted in the 1970s ‘from industry where it was used as a structured approach to quality measurement and improving services’ (Royal College of Nursing (RCN), 2014: 5). The first ‘paediatric clinical benchmarking group was set up in the North West in 1994 in response to the Chief Nursing Officer requiring a quality tool for paediatric practice’ (RCN, 2007: 2). Since this initial benchmarking group being developed the North West has continued to lead the way in benchmarking in other areas of clinical practice such as cardiac surgery, neonatal and neurosurgery. The benefits of benchmarking include (RCN, 2007): reflective practice; sharing of innovative practice; reducing duplication and repetition; promoting a bottom up approach to quality improvement; evidence base for outcomes and resources; providing an avenue for implementing change in practice

Why “intergenerational feminist media studies”?

Feminism and generation are live and ideologically freighted issues that are subject to a substantial amount of media engagement. The figure of the millennial and the baby boomer, for example, regularly circulate in mainstream media, often accompanied by hyperbolic and vitriolic discourses and affects of intergenerational feminist conflict. In addition, theories of feminist generation and waves have been and continue to be extensively critiqued within feminist theory. Given the compelling criticisms directed at these categories, we ask: why bother examining and foregrounding issues of generation, intergeneration, and transgeneration in feminist media studies? Whilst remaining sceptical of linearity and familial metaphors and of repeating reductive, heteronormative, and racist versions of feminist movements, we believe that the concept of generation does have critical purchase for feminist media scholars. Indeed, precisely because of the problematic ways that is it used, and the prevalence of it as a volatile, yet only too palpable, organizing category, generation is both in need of continual critical analysis, and is an important tool to be used—with care and nuance—when examining the multiple routes through which power functions in order to marginalize, reward, and oppress. Exploring both diachronic and synchronic understandings of generation, this article emphasizes the use of conjunctural analysis to excavate the specific historical conditions that impact upon and create generation. This special issue of Feminist Media Studies covers a range of media forms—film, games, digital media, television, print media, as well as practices of media production, intervention, and representation. The articles also explore how figures at particular lifestages—particularly the girl and the aging woman—are constructed relationally, and circulate, within media, with particular attention to sexuality. Throughout the issue there is an emphasis on exploring the ways in which the category of generation is mobilized in order to gloss sexism, racism, ageism, class oppression, and the effects of neoliberalism

New constraints on atmospheric CO2 concentration for the Phanerozoic

Earth's atmospheric CO2 concentration (ca) for the Phanerozoic Eon is estimated from proxies and geochemical carbon cycle models. Most estimates come with large, sometimes unbounded uncertainty. Here, we calculate tightly constrained estimates of ca using a universal equation for leaf gas exchange, with key variables obtained directly from the carbon isotope composition and stomatal anatomy of fossil leaves. Our new estimates, validated against ice cores and direct measurements of ca, are less than 1000 ppm for most of the Phanerozoic, from the Devonian to the present, coincident with the appearance and global proliferation of forests. Uncertainties, obtained from Monte Carlo simulations, are typically less than for ca estimates from other approaches. These results provide critical new empirical support for the emerging view that large (~2000-3000 ppm), long-term swings in ca do not characterize the post-Devonian and that Earth's long-term climate sensitivity to ca is greater than originally thought. Key Points A novel CO2 proxy calculates past atmospheric CO2 with improved certainty CO2 is unlikely to have exceeded ~1000 ppm for extended periods post Devonian Earth's long-term climate sensitivity to CO2 is greater than originally thought

Safety, immunogenicity, and efficacy of a COVID-19 vaccine (NVX-CoV2373) co-administered with seasonal influenza vaccines: an exploratory substudy of a randomised, observer-blinded, placebo-controlled, phase 3 trial

Background: Safety and immunogenicity of COVID-19 vaccines when co-administered with influenza vaccines have not yet been reported. Methods: A sub-study on influenza vaccine co-administration was conducted as part of the phase 3 randomised trial of NVX-CoV2373’s safety and efficacy; ~400 participants meeting main study entry criteria, with no contraindications to influenza vaccination, were enroled. After randomisation to receive NVX-CoV2373 or placebo, sub-study participants received an open-label influenza vaccine at the same time as the first dose of NVX-CoV2373. Reactogenicity was evaluated for 7 days post-vaccination plus monitoring for unsolicited adverse events (AEs), medically-attended AEs (MAAEs), and serious AEs (SAEs). Vaccine efficacy against COVID-19 was assessed. Findings: Sub-study participants were younger (median age 39; 6.7 % ≥65 years), more racially diverse, and had fewer comorbid conditions than main study participants. Reactogenicity events more common in co-administration group included tenderness (70.1% vs 57.6%) or pain (39.7% vs 29.3%) at injection site, fatigue (27.7% vs 19.4%), and muscle pain (28.3% vs 21.4%). Rates of unsolicited AEs, MAAEs, and SAEs were low and balanced between the two groups. Co-administration resulted in no change to influenza vaccine immune response, while a reduction in antibody responses to the NVX-CoV2373 vaccine was noted. Vaccine efficacy against COVID-19 was 87.5% (95% CI: -0.2, 98.4) in those 18-<65 years in the sub-study while efficacy in the main study was 89.8% (95% CI: 79.7, 95.5).  Interpretation: This is the first study to demonstrate safety, immunogenicity, and efficacy of a COVID-19 vaccine when co-administered with influenza vaccines