An exploration of how healthful relationships between students and clinical supervisors influence transformational learning: A person-centred inquiry

Background: There is an emerging body of knowledge regarding the influence of person-centred pre-registration curricula on student learning. However, a gap exists in our current knowledge regarding the attributes and foundations of healthful relationships and transformational learning in the context of practice learning. This PhD research based at the University of Wollongong NSW Australia, explored how healthful relationships between students and clinical supervisors influence transformational learning. Approach and Method: The blending of specific aspects of critical theory, person-centred practice research, and transformational learning theory underpinned this research. Embedded within a person-centred methodology, the research explored healthful relationships and their influence on transformational learning in the clinical practice context. Methods included reflection on practice using emoji, the use of Dadirri as a form of contemplation (Ungunmerr 1988) and reflection, critical dialogue and interviews. A creative synthesis of information collected across the PhD journey was undertaken. Findings: The findings from this research revealed the influence of healthful relationships on transformational learning in practice across three connected perspectives: personhood; belonging; and transformation. Information was synthesised to illuminate the crafting of healthful relationships between students and clinical supervisors in the context of practice. Further, understanding emerged of how healthful relationships influenced person-centred transformational learning from the perspectives of Knowing, Doing, Being and Becoming. The discoveries indicate that emotional preparation influences the ability to create healthful relationships that enable person-centred transformational learning in practice. Conclusions and Implications: There is a need for emotional preparation for practice for students and clinical supervisors to enable them to achieve person-centred transformational learning. Respecting personhood and enabling belonging to know self has the potential to lead to the creation of healthful relationships and improved clinical placement experience. Healthful relationships influence person-centred transformational learning by enabling an emotional connection of the mind and heart with an openness to learn. Keywords: curricula, Dadirri, emoji, healthful relationships, nursing education, person-centred, transformational learning

SEED Program: The development of a program that has enabled the learning and growth of staff in the response to a community crisis.

This paper aims to share a program that took a whole-hospital approach in considering the wellbeing of staff at a time of recovery following the 2019–2020 bushfires. The SEED Program enlisted a person-centred participatory methodology that was embedded within a transformational learning approach. This methodology included collaboration, authentic participation, critical reflection, critical dialogue and listening where the staff voice was the driving factor in the development of strategies for recovery. The SEED Program resulted in the development of five initiatives that included four strategies and a celebration event where staff celebrated their New Year’s Eve in February 2020. The four strategies included the establishment of a quiet room, coffee buddies, Wellness Warriors and 24/7 Wellness. The outcomes from the SEED Program resulted in the development of a more person-centred culture and transformation of staff perspectives in how they understood their role in their learning and learning of others in recovery and support at a time of crisis. The key learnings were the effect of authentic collaboration, the benefit from enabling authentic leadership at all levels within a hospital, and the power of a staff connection to the ‘CORE’ values of the hospital and Local Health District. In conclusion, the staff involved hold the hope that others may benefit from their experience of transformational learning in creating more person-centred workplace cultures while supporting each other to move forward during a crisis. The limitation of the SEED Program was that it was a bespoke practice innovation designed in the moment, responding to an identified need for the staff following a crisis in the local community rather than a formal research approach to meeting the needs of this group of staff

Incorporating the nursing and midwifery Aboriginal and Torres Strait Islander health curriculum framework into a BN program

When considering Aboriginal and Torres Strait Islander people\u27s culture, the appropriate approach with students should be to explore and reflect upon cultural safety initially followed by context, with an overlay of Aboriginal and Torres Strait Islander health throughout. * Learning outcomes should be reflective of this process throughout a curriculum - novice, intermediate and entry to practice, developing complexity throughout a degree to increase understanding and application. * Using the CATSINaM Nursing and Midwifery Aboriginal and Torres Strait Islander Health Curriculum Framework will facilitate progression and integration into curriculum. * How can I develop Aboriginal and non-Aboriginal partnerships to cocreate curriculum content

Eruptions from coronal hole bright points : observations and non-potential modeling

Funding: DHM would like to thank the Science and Technology Facilities Council (UK) through the consolidated grant ST/N000609/1 and the European Research Council (ERC) under the European Union Horizon 2020 research and innovation program (grant agreement No. 647214).Context. We report on the third part of a series of studies on eruptions associated with small-scale loop complexes named coronal bright points (CBPs). Aims. A single case study of a CBP in an equatorial coronal hole with an exceptionally large size is investigated to extend our understanding of the formation of mini-filaments (MFs), their destabilisation and the origin of the eruption triggering the formation of jet-like features recorded in the extreme-ultraviolet (EUV) and X-ray emission. We aim to explore the nature of the so called micro-flares in CBPs associated with jets in coronal holes and mini coronal mass ejections in the quiet Sun. Methods. Co-observations from the Atmospheric Imaging Assembly (AIA) and Helioseismic Magnetic Imager (HMI) on board the Solar Dynamics Observatory (SDO), and GONG Halpha images are used together with a Non-Linear Force Free Field (NLFFF) relaxation approach, where the latter is based on a time series of HMI line-of-sight magnetograms. Results. A mini-filament (MF) that formed beneath the CBP arcade around 3–4 h before the eruption is seen in the Halpha and EUV AIA images to lift up and erupt triggering the formation of an X-ray jet. No significant photospheric magnetic flux concentration displacement (convergence) is observed and neither is magnetic flux cancellation between the two main magnetic polarities forming the CBP in the time period leading to the MF liftoff. The CBP micro-flare is associated with three flare kernels that formed shortly after the MF liftoff. No observational signature is found for reconnection beneath the erupting MF. The applied NLFFF modeling successfully reproduces both the CBP loop complex as well as the magnetic flux rope that hosts the MF. Conclusions. The applied NLFFF modellng is able to clearly show that an initial potential field can be evolved into a non-potential magnetic field configuration that contains free magnetic energy in the region that observationally hosts the eruption. The comparison of the magnetic field structure shows that the magnetic NLFFF model contains many of the features that can explain the dfferent observational signatures found in the evolution and eruption of the CBP. In future it may eventually indicate the location of destabilisation that results in the eruptions of flux ropes.Publisher PDFPeer reviewe

Eruptions from coronal bright points : a spectroscopic view by IRIS of a mini-filament eruption, QSL reconnection, and reconnection-driven outflows

Funding: The authors thank very much the referee for the very important comments and suggestions. MM and TW acknowledge DFG-grant WI3211/8-1. D.H.M. would like to acknowledge STFC for support via the Consolidated Grant SMC1/YST037. Open Access funding provided by the Max Planck Society.Context. Our study investigates a mini-filament eruption associated with cancelling magnetic fluxes. The eruption originates from a small-scale loop complex commonly known as a coronal bright point (CBP). The event is uniquely recorded in both the imaging and spectroscopic data taken with the Interface Region Imaging Spectrograph (IRIS). Aims. The investigation aims to gain a better understanding of the physical processes driving these ubiquitous small-scale eruptions. Methods. We analysed IRIS spectroscopic and slit-jaw imaging observations as well as images taken in the extreme-ultraviolet channels of the Atmospheric Imaging Assembly (AIA) and line-of-sight magnetic-field data from the Helioseismic Magnetic Imager (HMI) on board the Solar Dynamics Observatory. As the observations can only indicate the possible physical processes at play, we also employed a non-linear force-free field (NLFFF) relaxation approach based on the HMI magnetogram time series. This allowed us to further investigate the evolution of the magnetic-field structures involved in the eruption process. Results. We identified a strong small-scale brightening as a micro-flare in a CBP, recorded in emission from chromospheric to flaring plasmas. The mini-eruption is manifested via the ejection of hot (CBP loops) and cool (mini-filament) plasma recorded in both the imaging and spectroscopic data. The micro-flare is preceded by the appearance of an elongated bright feature in the IRIS slit-jaw 1400 Å images, located above the polarity inversion line. The micro-flare starts with an IRIS pixel size brightening and propagates bi-directionally along the elongated feature. We detected, in both the spectral and imaging IRIS data and AIA data, strong flows along and at the edges of the elongated feature; we believe that these represent reconnection outflows. Both edges of the elongated feature that wrap around the edges of the erupting MF evolve into a J-type shape, creating a sigmoid appearance. A quasi-separatrix layer (QSL) is identified in the vicinity of the polarity inversion line by computing the squashing factor, Q, in different horizontal planes of the NLFFF model.  Conclusions. This CBP spectro-imaging study provides further evidence that CBPs represent downscaled active regions and, as such, they may make a significant contribution to the mass and energy balance of the solar atmosphere. They are the sources of all range of typical active-region features, including magnetic reconnection along QSLs, (mini-)filament eruptions, (micro-)flaring, reconnection outflows, etc. The QSL reconnection site has the same spectral appearance as the so-called explosive events identified by strong blue- and red-shifted emission, thus providing an answer to an outstanding question regarding the true nature of this spectral phenomenon.Publisher PDFPeer reviewe

External quality assessment of cytomegalovirus DNA detection on dried blood spots

<p>Abstract</p> <p>Background</p> <p>Testing for viral DNA in neonatal blood dried on paper (DBS) has proved a valid means of diagnosing congenital CMV infection with both clinical and epidemiological relevance. To assess the quality of the detection of CMV-DNA on DBS in laboratories performing this test a proficiency panel consisting of nine samples with two blood spots on each filter paper was produced and distributed. Six samples were derived from whole blood, negative for CMV DNA and antibody, and spiked with cell-grown CMV Towne in various concentrations (7.3 × 10²– 9.6 × 10⁵copies/ml), one was a CMV positive clinical specimen (3.9 × 10⁶copies/ml), and two samples were CMV-negative whole blood.</p> <p>Results</p> <p>The 27 responding laboratories from 14 countries submitted 33 datasets obtained by means of conventional PCR (n = 5) or real-time PCR (n = 28) technologies. A correct positive result was reported in at least 91% of datasets in samples with a viral load of 8.8 × 10⁴copies/ml or higher. However only 59% and 12% identified the 9.4 × 10³and 7.3 × 10²copies/ml samples, respectively, correctly as positive. False positive results were reported by 9% of laboratories and in 11% of datasets.</p> <p>Conclusion</p> <p>These results indicate a clear need for improvement of methods as sensitivity and false-positivity still appear to be a major problem in a considerable number of laboratories.</p

Empowering aged care nurses to deliver person-centred care: Enabling nurses to shine

** From PubMed via Jisc Publications Router. ** History: received 31-05-2017; revised 30-03-2018; accepted 22-05-2018.In this paper, the authors will describe the journey of registered nurses across a series of workshops as part of a research project that was undertaken in a regional aged care service in New South Wales, Australia. The aim of the project was to empower the participant registered nurses to positively influence the health care workplace culture within the residential care home by raising consciousness about their own practice. Registered nurses were actively involved in this reconnaissance phase of a participatory action research project through practice development principles and methods. Registered nurses determined the content and the outcomes of the overall program. The researchers evaluated the impact of a series of workshops, designed to develop skills and knowledge using nominal group technique. Results revealed registered nurses perceived they were empowered to flourish, and developed an understanding of the uniqueness of their role. A shared understanding of the role of the registered nurse in the aged care setting was fundamental in enabling them to feel empowered to lead their team and contribute positively to the workplace culture. Overall, the outcomes of this project have positively impacted workplace culture.sch_nur31pub5395pu

Leading wellness in healthcare:A qualitative study of leadership practices for wellness in hospital settings

Ways of dealing with workplace stress and enhancing healthcare workers wellness are sought globally. The aim of this study was to explore healthcare leaders\u27 practice in relation to the implementation of a workplace wellness program called SEED in the context of multiple crises (bushfires and COVID-19) affecting a local health district in New South Wales, Australia. Practice theory informed interviews (n = 23), focus groups (n = 2) and co-analysis reflexive discussions (n = 2) that were conducted with thirteen leaders and twenty healthcare workers. A pragmatic approach to program implementation for healthcare workers\u27 wellness explored the process and actions that resulted from leadership practice in an inductive thematic analysis. Preliminary themes were presented in the co-analysis sessions to ensure the lived experiences of the SEED program were reflected and co-interpretation of the data was included in the analysis. Three key themes were identified. 1) Leading change-implementing a wellness program required leaders to try something new and be determined to make change happen. 2) Permission for wellness-implicit and explicit permission from leaders to engage in wellness activities during worktime was required. 3) Role-modelling wellness-leaders viewed SEED as a way to demonstrate leadership in supporting and caring for healthcare workers. SEED provided a platform for leaders who participated to demonstrate their leadership practices in supporting wellness activities. Leadership practices are critical to the implementation of healthcare wellness programs. The implementation of SEED at a time of unprecedented crisis gave leaders and healthcare workers opportunities to experience something new including leadership that was courageous, responsive and authentic. The study highlighted the need for workplace wellness programs to intentionally include leaders rather than only expect them to implement them. The practices documented in this study provide guidance to others developing, implementing and researching workplace wellness programs