Reflections on partnership and co-creation in an EU project: GNurseSim Intercultural Simulation for Caring for Elderly Patients

Reflection within practice-based professions such as nursing allows for personal introspection and critical analysis of situations in order to make sense of practice and ultimately to improve it. It is a core tenet of nurse education to enable sensemaking of actions, emotions, consequences and ultimately, learning. Practice healthcare environments, patients (elderly or otherwise) and staff co-exist in an extremely broad and complex way. Navigating and developing these environments involves reciprocal relationships between professionals, people using services, and communities to enhance care. The term ‘knowledge mobilisation’ is used in the healthcare literature to describe the active, iterative and collaborative process of creating, sharing and using research evidence (Melville-Richards et al 2019). This involves a range of ‘co’-approaches which are used interchangeably within literature i.e. co-production, co-creation and co-design. In this case-based study, a key influence was ‘co-creation’, where students are considered as equal partners rather than consumers of education and where teachers and learners challenge their assumptions as well as perceptions of their respective roles in education. A successful learner-teacher partnership is defined as ‘a collaborative, reciprocal process through which all participants have the opportunity to contribute equally, although not necessarily in the same way, to curricular or pedagogical conceptualization, decision-making, implementation, investigation, or analysis’ (Cook-Sather et al, 2014, pp 6–7). This EU funded project (GNurseSim Intercultural Simulation for Caring for Elderly Patients) provided a practical opportunity to work in partnership with students and shape their own, peers’ and teachers’ learning and clinical practice perspectives

GNurseSIM intercultural simulation for caring for elderly patients: Reflections on co-creation of artefacts

This case study presents the experiences and perceptions of nursing lecturers and students jointly co-creating video simulation artefacts for an Intercultural Care for Elderly Patients. Context Globally, the number of elderly over the age of 80 is expected to triple by 2050 up to 426 million. Complexities with cultural perceptions of disorders or healthy ageing impact on access to and appropriate care or health promotion. Global movements mean it is likely diverse elderly patients will encounter as culturally diverse nurses and carers with varied perceptions of elderly and careneeds. Simulation can supplement situated learning to explore complex topics such as intercultural care. An EU funded project: GNurseSIM European consortium (7 partners across 5 countries) was the driver of developing simulations. Method This UK case study resulted from student reflections, piloting and evaluation and learning from the co-creation approach and scenarios. Results Reflective narratives reveal an awareness of the breadth of culture expression, fallibility of assumptions, self-development and being a ‘professional’ that translate into practice. Conclusion The experience of partnership in building these simulation videos point to a deep and transformative learning experience through student co-creation. This approach offers means to develop professional attributes otherwise challenging to teach

Opioid modulation of GABA release in the rat inferior colliculus

Background: The inferior colliculus, which receives almost all ascending and descending auditory signals, plays a crucial role in the processing of auditory information. While the majority of the recorded activities in the inferior colliculus are attributed to GABAergic and glutamatergic signalling, other neurotransmitter systems are expressed in this brain area including opiate peptides and their receptors which may play a modulatory role in neuronal communication.Results: Using a perfusion protocol we demonstrate that morphine can inhibit KCl-induced release of [H-3] GABA from rat inferior colliculus slices. DAMGO ([D-Ala(2), N-Me-Phe(4), Gly(5)ol]-enkephalin) but not DADLE ([D-Ala2, D-Leu5]-enkephalin or U69593 has the same effect as morphine indicating that mu rather than delta or kappa opioid receptors mediate this action. [H-3]GABA release was diminished by 16%, and this was not altered by the protein kinase C inhibitor bisindolylmaleimide I. Immunostaining of inferior colliculus cryosections shows extensive staining for glutamic acid decarboxylase, more limited staining for mu opiate receptors and relatively few neurons co-stained for both proteins.Conclusion: The results suggest that mu-opioid receptor ligands can modify neurotransmitter release in a sub population of GABAergic neurons of the inferior colliculus. This could have important physiological implications in the processing of hearing information and/or other functions attributed to the inferior colliculus such as audiogenic seizures and aversive behaviour

Observation of HCN hyperfine line anomalies towards low- and high-mass star-forming cores

HCN is becoming a popular choice of molecule for studying star formation in both low- and high-mass regions and for other astrophysical sources from comets to high-redshift galaxies. However, a major and often overlooked difficulty with HCN is that it can exhibit non-local thermodynamic equilibrium (non-LTE) behaviour in its hyperfine line structure. Individual hyperfine lines can be strongly boosted or suppressed. In low-mass star-forming cloud observations, this could possibly lead to large errors in the calculation of opacity and excitation temperature, while in massive star-forming clouds, where the hyperfine lines are blended due to turbulent broadening, errors will arise in infall measurements that are based on the separation of the peaks in a self-absorbed profile. The underlying line shape cannot be known for certain if hyperfine anomalies are present. We present a first observational investigation of these anomalies across a range of conditions and transitions by carrying out a survey of low-mass starless cores (in Taurus & Ophiuchus) and high-mass protostellar objects (in the G333 giant molecular cloud) using hydrogen cyanide (HCN) J=1-0 and J=3-2 emission lines. We quantify the degree of anomaly in these two rotational levels by considering ratios of individual hyperfine lines compared to LTE values. We find that all the cores observed show some degree of anomaly while many of the lines are severely anomalous. We conclude that HCN hyperfine anomalies are common in both lines in both low-mass and high-mass protostellar objects, and we discuss the differing hypotheses for the generation of the anomalies. In light of the results, we favour a line overlap effect for the origins of the anomalies. We discuss the implications for the use of HCN as a dynamical tracer and suggest in particular that the J=1-0, F=0-1 hyperfine line should be avoided in quantitative calculations.Comment: 17 pages, 8 figure

Chromosome 9p deletion in clear cell renal cell carcinoma predicts recurrence and survival following surgery

BACKGROUND: Wider clinical applications of 9p status in clear cell renal cell carcinoma (ccRCC) are limited owing to the lack of validation and consensus for interphase fluorescent in situ hybridisation (I-FISH) scoring technique. The aim of this study was to analytically validate the applicability of I-FISH in assessing 9p deletion in ccRCC and to clinically assess its long-term prognostic impact following surgical excision of ccRCC. METHODS: Tissue microarrays were constructed from 108 renal cell carcinoma (RCC) tumour paraffin blocks. Interphase fluorescent in situ hybridisation analysis was undertaken based on preset criteria by two independent observers to assess interobserver variability. 9p status in ccRCC tumours was determined and correlated to clinicopathological variables, recurrence-free survival and disease-specific survival. RESULTS: There were 80 ccRCCs with valid 9p scoring and a median follow-up of 95 months. Kappa statistic for interobserver variability was 0.71 (good agreement). 9p deletion was detected in 44% of ccRCCs. 9p loss was associated with higher stage, larger tumours, necrosis, microvascular and renal vein invasion, and higher SSIGN (stage, size, grade and necrosis) score. Patients with 9p-deleted ccRCC were at a higher risk of recurrence (P=0.008) and RCC-specific mortality (P=0.001). On multivariate analysis, 9p deletion was an independent predictor of recurrence (hazard ratio 4.323; P=0.021) and RCC-specific mortality (hazard ratio 4.603; P=0.007). The predictive accuracy of SSIGN score improved from 87.7% to 93.1% by integrating 9p status to the model (P=0.001). CONCLUSIONS: Loss of 9p is associated with aggressive ccRCC and worse prognosis in patients following surgery. Our findings independently confirm the findings of previous reports relying on I-FISH to detect 9p (CDKN2A) deletion

Studying Reinforcement Learning Using Electronic Communication

Developers agree that concurrent communication are an interesting new topic in the field of probabilistic complexity theory, and futurists concur. Given the current status of wireless information, physicists particularly desire the understanding of Lamport clocks, demonstrates the natural importance of software engineering. SiselVizir, our new solution for collaborative modalities, is the solution to all of these problems

Emerging Opportunities in Library Services: Planning for the Future of Scholarly Publishing

In 2007, the Columbia University Libraries/Information Services (CUL/IS) established the Center for Digital Research and Scholarship (CDRS) to explore and provision new research support services for the university in all areas of scholarly communication, including online scholarly publishing. One of six organizations comprising the Digital Programs and Technology Services group within CUL/IS, CDRS assists faculty, students, staff, and university affiliates with their scholarly communication and digital research needs through a suite of services: publishing support, digital research repository, conference websites and video recording, research data management, and more. Nine of its 17 full-time employees belong to a production team comprising developers, designers, and project managers from diverse academic and professional backgrounds, only one of whom holds a master’s degree in library science. CDRS seeks publishing partnerships with a variety of on-campus groups and individuals and embraces partnerships with allied organizations such as scholarly presses and societies as well. A proponent of eliminating barriers to the progress of research, CDRS advocates for open access (OA) publishing models. This is exemplified by Tremor and Other Hyperkinetic Movements, the peer-reviewed, faculty-run OA journal now indexed in PubMed, which CDRS publishes. To help offset the OA journal publication costs, Tremor authors pay an article processing fee, although waivers and alternative methods of funding are available. In practice, CDRS’ approach to publishing support is business model–neutral, however,and OA is not a requirement for partnership. The journals program at CDRS has been successful, providing publishing support to 16 journals using the Open Journal Systems or WordPress platforms and interactive tools such as blogs and wikis in subject areas ranging from sciences to the humanities. A strategy for keeping this service sustainable and scalable has been the adoption of a tiered structure based on design and customization needs to control flow. Projects can take anywhere from one week for a barebones installation to over 17 weeks for the Premier service