Crew Resource Management and Its Possible Role in Nursing Risk Management

Crew Resource Management (CRM) was introduced within the aviation industry in the late 1970s after an aircraft ran out of fuel whilst the pilots were trying to solve an undercarriage problem. To reduce such errors and ultimately lower the probability of failure and the severity of risks that occur, training in CRM was rolled out across the whole industry. It has been successful over the last few years in major reductions in the number of crashes and fatalities in the commercial aviation sector. Nursing has similar concerns in that errors can ultimately result in fatalities. There are parallels in the needs and expectations of pilots and nurses to assess risk, reduce risk and deliver reliable and dependable professional services. In this paper the parallels of pilots and nurses demands are compared to assess if the lessons learned in aviation can assist nurses deliver procedures with lower risks. The analysis will draw on the demands and expectations and how they both deal with risk, challenging errors and ensuring that identified risks are not overlooked or ignored. Finally, suggestions of adopting, sharing and benchmarking between these two industries can adopt best practices so that both industries can learn from each other

The Therapeutic Engagement Questionnaire (TEQ): a service user-focused mental health nursing outcome metric

Therapeutic engagement (TE) has been described as the crux of mental health nursing but despite its perceived importance, to date, there is no measurement tool that captures it as a result,there is no way of determining the contribution of mental health nursing interaction to service user recovery, in mental health settings or the wider care quality agenda

The Therapeutic Engagement Questionnaire (TEQ): a service user-focused mental health nursing outcome metric

Background: Therapeutic engagement (TE) has been described as the crux of mental health nursing but despite its perceived importance, to date, there is no measurement tool that captures it. As a result, there is no way of determining the contribution of mental health nursing interaction to service user recovery, in acute inpatient mental health settings or the wider care quality agenda. / Methods: To develop and validate a TE measurement tool in partnership with Service Users (SUs) and Registered Mental Health Nurses (RMHNs). The TEQ was developed in 3 stages: 1) item generation (and pre-testing), 2) item reduction using Principal Component Analysis (PCA), and 3) validation across Mental Health Trusts in England. / Results: The final questionnaire has two versions, (SU and RMHN version), each scored within two contexts (1–1 SU-RMHN interactions and overall environment and atmosphere of the ward) and includes 20 items with two sub-scales (care interactions and care delivery). Psychometric evaluation of the TEQ shows high inter-scale correlations (0.66–0.95 SU; 0.57–0.90 RMHN), sound sub-scale internal consistency (> 0.95), concurrent validity (> 0.60) and adequate score variability for both versions of the TEQ. In summary, the TEQ behaves well as a measurement tool. / Conclusions: The TEQ can determine the collaborative and empathic nature of RMHN-SU interactions, capture if SUs are treated with dignity and respect and recognise that the principles of the recovery approach are being respected. The TEQ can also provide robust monitoring of nursing activity, offer opportunity for transparency of activity, feed into healthcare organizations’ key performance indicators and provide reassurance about the nature and quality of nurses’ work

Energy and force analysis of Ti-6Al-4V linear friction welds for computational modeling input and validation data

The linear friction welding (LFW) process is finding increasing use as a manufacturing technology for the production of titanium alloy Ti-6Al-4V aerospace components. Computational models give an insight into the process, however, there is limited experimental data that can be used for either modeling inputs or validation. To address this problem, a design of experiments approach was used to investigate the influence of the LFW process inputs on various outputs for experimental Ti-6Al-4V welds. The finite element analysis software DEFORM was also used in conjunction with the experimental findings to investigate the heating of the workpieces. Key findings showed that the average interface force and coefficient of friction during each phase of the process were insensitive to the rubbing velocity; the coefficient of friction was not coulombic and varied between 0.3 and 1.3 depending on the process conditions; and the interface of the workpieces reached a temperature of approximately approximately 1273 K (1000 °C) at the end of phase 1. This work has enabled a greater insight into the underlying process physics and will aid future modeling investigations.EPSRC, Boeing Company, Welding Institut

Structural and functional characterisation of human RNA helicase DHX8 provides insights into the mechanism of RNA-stimulated ADP release.

DHX8 is a crucial DEAH-box RNA helicase involved in splicing and required for the release of mature mRNA from the spliceosome. Here, we report the biochemical characterisation of full-length human DHX8 and the catalytically active helicase core DHX8Δ547, alongside crystal structures of DHX8Δ547 bound to ADP and a structure of DHX8Δ547 bound to poly(A)6 single-strand RNA. Our results reveal that DHX8 has an in vitro binding preference for adenine-rich RNA and that RNA binding triggers the release of ADP through significant conformational flexibility in the conserved DEAH-, P-loop and hook-turn motifs. We demonstrate the importance of R620 and both the hook-turn and hook-loop regions for DHX8 helicase activity and propose that the hook-turn acts as a gatekeeper to regulate the directional movement of the 3' end of RNA through the RNA-binding channel. This study provides an in-depth understanding of the activity of DHX8 and contributes insights into the RNA-unwinding mechanisms of the DEAH-box helicase family

OpenLearn Research Report 2006-2008

This report takes the experience of OpenLearn over its two-years of operation to reflect on what it means to offer free resources and the issues that we have been able to explore and learn from. The structure of the document is: (1) The OpenLearn initiative - an overview (2) OpenLearn research methods (3) Designing for Open Content (4) Types of user of OpenLearn (5) OpenLearn modes of us

Potential economic impacts from improving breastfeeding rates in the UK

This article has been made available through the Brunel Open Access Publishing Fund.RATIONALE: Studies suggest that increased breastfeeding rates can provide substantial financial savings, but the scale of such savings in the UK is not known. OBJECTIVE: To calculate potential cost savings attributable to increases in breastfeeding rates from the National Health Service perspective. DESIGN AND SETTINGS: Cost savings focussed on where evidence of health benefit is strongest: reductions in gastrointestinal and lower respiratory tract infections, acute otitis media in infants, necrotising enterocolitis in preterm babies and breast cancer (BC) in women. Savings were estimated using a seven-step framework in which an incidence-based disease model determined the number of cases that could have been avoided if breastfeeding rates were increased. Point estimates of cost savings were subject to a deterministic sensitivity analysis. RESULTS: Treating the four acute diseases in children costs the UK at least £89 million annually. The 2009-2010 value of lifetime costs of treating maternal BC is estimated at £959 million. Supporting mothers who are exclusively breast feeding at 1 week to continue breast feeding until 4 months can be expected to reduce the incidence of three childhood infectious diseases and save at least £11 million annually. Doubling the proportion of mothers currently breast feeding for 7-18 months in their lifetime is likely to reduce the incidence of maternal BC and save at least £31 million at 2009-2010 value. CONCLUSIONS: The economic impact of low breastfeeding rates is substantial. Investing in services that support women who want to breast feed for longer is potentially cost saving

“I Keep Hearing Reports on the News That it's a Real Problem at the Moment”: Public Health Nurses’ Understandings of Sexting Practices Among Young People

Over the past decade, the potential harms regarding young people's use of technology have attracted mounting political, media and research attention worldwide. One practice engaged in by many young people is that of “sexting” and the sharing of partially, or complete nude images (“selfies”). Such images are not always retained within private spaces and are prone to be shared, with significant psychosocial consequences for young people involved. A significant risk is the hidden nature of some online interactions, with potential for grooming and child sexual exploitation. As key professionals working with young people, public health nurses have potential to educate and explore the risks with them. Yet to date, to our knowledge there has been no research in relation to public health nurses’ understandings of the practices involved or their potential harms. A qualitative study was undertaken drawing theoretically on the common‐sense model (CSM) to frame the analysis. Eighteen semi‐structured interviews were conducted with public health nurses in a region of England in 2016. Data were analysed through thematic analysis, and mapped to the five domains of CSM. Public health nurses’ understandings of young people's sexting practices were shaped largely by media reports, rather than scientific, disciplinary knowledge. Sexting did not resonate with many public health nurses’ own experiences of being a young person and was therefore difficult to understand. All were able to express an opinion about the causes and consequences of sexting and we present these as a “perceived hierarchy of risk”. All public health nurses acknowledged the importance of their role in dealing with harm reduction associated with sexting among young people, but they need education and support to do this effectively and confidently. Findings can be transferred carefully to many contexts and countries because sexting is a practice among young people that transcends geographical boundaries

创新教学报告2015 —探索教学、学习与评价的新形式 [Innovating Pedagogy 2015]

本报告提出了在教学应用方面呈现端倪的“十大创新教学法”，包括跨界学习、论证学习、随机 学习、基于情境的学习、计算思维、利用远程实验室在科学实验中学习、具身学习、适应性教学、情绪分析 和隐性评价，预期这些方法有可能在教育实践中，尤其是在学校后继续教育中引发重大变革

The theory of agency and breastfeeding

Objective: In this paper, we apply psychological agency theory to women’s interviews of their breastfeeding experiences to understand the role of agency in relation to breastfeeding initiation, maintenance and duration. Design: Qualitative, video interviews were collected from 49 women in the UK from a wide range of ethnic, religious, educational and employment backgrounds about their breastfeeding experiences. We undertook secondary analysis of the data focusing on their accounts of vulnerability and agency. Findings: Women’s agency was impacted by a variety of factors including their own vulnerability, knowledge, expectations and experience, the feeding environment and the support of health professionals in sharing decision-making and dealing with uncertainty. Conclusion: Health professionals as co-agents with women are well positioned to maintain, enhance or restore women’s sense of agency. Breastfeeding goals should be included in women’s birth plans. Training related to agency, continuity of care, and staffing and workload management supported by national breastfeeding policies could improve breastfeeding rates and experiences