Educating School Nurses to Improve Bowel Continence in Children with Spina Bifida

Children born with spina bifida, a neural tube defect, can have associated loss of bowel control resulting in bowel incontinence. The National Patient Spina Bifida Registry found that 87% of those living with spina bifida had bowel incontinence, and less than 30% were bowel continent (Sawin et al., 2015; Wiener et al., 2017). Unfortunately, providers may never start a child living with spina bifida on a bowel management program. Evidence suggests that children with spina bifida should begin a bowel management program early, using a stepwise approach. School nurses, who interact with children living with spinal bifida while attending school, have an opportunity to provide support to children living with bowel incontinence but may lack knowledge and skills on bowel management. This evidence-based practice project aimed to educate school nurses in a county school district about the best bowel management guidelines for children attending school with spina bifida. The project’s goal was to improve the lives of children with spina bifida, especially in school, by motivating school nurses to play a more active role in the child’s bowel management routines towards increasing bowel continence. The Iowa Model of Evidence-Based Practice guided the steps of the project. Eighty-six school nurses received education about spina bifida and bowel management asynchronously via an online voiceover PowerPoint presentation. Nurses completed a pre-and post-knowledge test, and a significant improvement (p \u3c 0.001) in test scores by approximately three points was seen from the pre-test to the post-test. Educating school nurses about spina bifida and bowel management made them better prepared to support and manage bowel incontinence in children living with spina bifida

Eyes on the enterprise: problematising the concept of a teaching-research nexus in UK higher education

Existing research into the relationship between teaching and research in higher education is mainly normative and atheoretical, resulting in assumptions of a close and beneficial connection between them. We problematise the idea of a nexus by undertaking a critical examination of the concept through the lens of educational ideologies to theorise the changes over time that shape the ways teaching and research are practised. Two hundred seven academic staff in the Humanities and Social Sciences were surveyed in 10 universities in England and Wales; the universities were identified as having strength in teaching, research, or in both. Along with analysis of interviews with senior managers at these universities, findings suggest that systemic forces which separate teaching and research are evident in institutional contexts with implications for the idea of a nexus. While the nexus may exist in theory, in practice, we argue that teaching and research can be pulled in different directions by institutional priorities. Furthermore, in institutions which adopt an enterprise ideology, there are signs of a nascent nexus emerging between research and innovation

Reproducibility of a novel model of murine asthma-like pulmonary inflammation

Sensitization to cockroach allergens (CRA) has been implicated as a major cause of asthma, especially among inner-city populations. Endotoxin from Gram-negative bacteria has also been investigated for its role in attenuating or exacerbating the asthmatic response. We have created a novel model utilizing house dust extract (HDE) containing high levels of both CRA and endotoxin to induce pulmonary inflammation (PI) and airway hyperresponsiveness (AHR). A potential drawback of this model is that the HDE is in limited supply and preparation of new HDE will not contain the exact components of the HDE used to define our model system. The present study involved testing HDEs collected from various homes for their ability to cause PI and AHR. Dust collected from five homes was extracted in phosphate buffered saline overnight. The levels of CRA and endotoxin in the supernatants varied from 7·1 to 49·5 mg/ml of CRA and 1·7–6  µ g/ml of endotoxin in the HDEs. Following immunization and two pulmonary exposures to HDE all five HDEs induced AHR, PI and plasma IgE levels substantially higher than normal mice. This study shows that HDE containing high levels of cockroach allergens and endotoxin collected from different sources can induce an asthma-like response in our murine model.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75467/1/j.1365-2249.2004.02461.x.pd

Precision metering of microliter volumes of biological fluids in micro-gravity

Concepts were demonstrated and investigated for transferring accurately known and reproducible microliter volumes of biological fluids from sample container onto dry chemistry slides in microgravity environment. Specific liquid transfer tip designs were compared. Information was obtained for design of a liquid sample handling system to enable clinical chemical analysis in microgravity. Disposable pipet tips and pipet devices that were designed to transfer microliter volumes of biological fluid from a (test tube) sample container in 1-G environment were used during microgravity periods of parabolic trajectories of the KC-135 aircraft. The transfer process was recorded using charge coupled device camera and video cassette equipment. Metering behavior of water, a synthetic aqueous protein solution, and anticoagulated human blood was compared. Transfer of these liquids to 2 substrate materials representative of rapidly wettable and slowly wettable dry chemistry slide surface was compared

Optimized cross-slot flow geometry for microfluidic extension rheometry

A precision-machined cross-slot flow geometry with a shape that has been optimized by numerical simulation of the fluid kinematics is fabricated and used to measure the extensional viscosity of a dilute polymer solution. Full-field birefringence microscopy is used to monitor the evolution and growth of macromolecular anisotropy along the stagnation point streamline, and we observe the formation of a strong and uniform birefringent strand when the dimensionless flow strength exceeds a critical Weissenberg number Wicrit 0:5. Birefringence and bulk pressure drop measurements provide self consistent estimates of the planar extensional viscosity of the fluid over a wide range of deformation rates (26 s1 "_ 435 s1) and are also in close agreement with numerical simulations performed by using a finitely extensible nonlinear elastic dumbbell model

Bubble kinematics in a sheared foam

We characterize the kinematics of bubbles in a sheared two-dimensional foam using statistical measures. We consider the distributions of both bubble velocities and displacements. The results are discussed in the context of the expected behavior for a thermal system and simulations of the bubble model. There is general agreement between the experiments and the simulation, but notable differences in the velocity distributions point to interesting elements of the sheared foam not captured by prevalent models

Understanding and developing procedures for video-based assessment in medical education

Introduction Novel uses of video aim to enhance assessment in health-professionals education. Whilst these uses presume equivalence between video and live scoring, some research suggests that poorly understood variations could challenge validity. We aimed to understand examiners’ and students’ interaction with video whilst developing procedures to promote its optimal use. Methods Using design-based research we developed theory and procedures for video use in assessment, iteratively adapting conditions across simulated OSCE stations. We explored examiners’ and students’ perceptions using think-aloud, interviews and focus group. Data were analysed using constructivist grounded-theory methods. Results Video-based assessment produced detachment and reduced volitional control for examiners. Examiners ability to make valid video-based judgements was mediated by the interaction of station content and specifically selected filming parameters. Examiners displayed several judgemental tendencies which helped them manage videos’ limitations but could also bias judgements in some circumstances. Students rarely found carefully-placed cameras intrusive and considered filming acceptable if adequately justified. Discussion Successful use of video-based assessment relies on balancing the need to ensure station-specific information adequacy; avoiding disruptive intrusion; and the degree of justification provided by video’s educational purpose. Video has the potential to enhance assessment validity and students’ learning when an appropriate balance is achieved

Developing a community-based intervention to improve quality of life in people with colorectal cancer: a complex intervention development study

Objectives: To develop and pilot a theory and evidence-based intervention to improve quality of life (QoL) in people with colorectal cancer. Design: A complex intervention development study. Setting: North East Scotland and Glasgow. Participants: Semistructured interviews with people with colorectal cancer (n=28), cancer specialists (n=16) and primary care health professionals (n=14) and pilot testing with patients (n=12). Interventions: A single, 1 h nurse home visit 6–12 weeks after diagnosis, and telephone follow-up 1 week later (with a view to ongoing follow-up in future). Primary and secondary outcome measures: Qualitative assessment of intervention feasibility and acceptability. Results: Modifiable predictors of QoL identified previously were symptoms (fatigue, pain, diarrhoea, shortness of breath, insomnia, anorexia/cachexia, poor psychological well-being, sexual problems) and impaired activities. To modify these symptoms and activities, an intervention based on Control Theory was developed to help participants identify personally important symptoms and activities; set appropriate goals; use action planning to progress towards goals; self-monitor progress and identify (and tackle) barriers limiting progress. Interview responses were generally favourable and included recommendations about timing and style of delivery that were incorporated into the intervention. The pilot study demonstrated the feasibility of intervention delivery. Conclusions: Through multidisciplinary collaboration, a theory-based, acceptable and feasible intervention to improve QoL in colorectal cancer patients was developed, and can now be evaluated

Feel My Pain: Design and Evaluation of Painpad, a Tangible Device for Supporting Inpatient Self-Logging of Pain

Monitoring patients' pain is a critical issue for clinical caregivers, particularly among staff responsible for providing analgesic relief. However, collecting regularly scheduled pain readings from patients can be difficult and time-consuming for clinicians. In this paper we present Painpad, a tangible device that was developed to allow patients to engage in self-logging of their pain. We report findings from two hospital-based field studies in which Painpad was deployed to a total of 78 inpatients recovering from ambulatory surgery. We find that Painpad results in improved frequency and compliance with pain logging, and that self-logged scores may be more faithful to patients' experienced pain than corresponding scores reported to nurses. We also show that older adults may prefer tangible interfaces over tablet-based alternatives for reporting their pain, and we contribute design lessons for pain logging devices intended for use in hospital settings