"Maintenance and sustenance": challenges and opportunities and growing food in primary schools in the London Borough of Southwark and the Royal Borough of Greenwich

This report presents a detailed picture of the challenges and opportunities for food growing as an educational activity, with a focus on local Southwark and Royal Greenwich schools from research surveys, focus groups and interviews. Survey information comprises an adjusted total of 80 schools, 47 of which came from the two South London target boroughs. The maintenance and sustenance of growing food requires consideration of local challenges and of wider national responsibilities when thinking about the business case for growing food in schools

Natural health awareness: maintaining the health of the planet by maintaining optimum personal health (multimedia version)

As consumerism grows year on year, there are impacts not only on sustainability but also on human health. Economic structures push people away from physical activities such as walking, playing, gardening, singing and cleaning because they do not have an impact on economic growth or involve consumption. Instead consumers are offered an incredible range of labour saving devices from cars and artificial grass to powerful chemicals, which allow cleaning to occur without ‘moving a muscle’. Entertainment is delivered conveniently at the push of a button, and food supplied frozen in a plastic tray, allowing the sedentary consumer to simultaneously eat and be entertained. At the same time, however, buying into this sort of lifestyle leads to debt and stressful employment to repay the debt, often requiring sitting in front of a computer screen for long hours or repetitive movements on a production line. All this is terribly bad for health, but bad health itself supports even more industry and consumption as medical corporations supply products and services to keep people going, despite the inhuman conditions in which they live their lives. And conventional medicine itself has a strong negative environmental impact through all the machines, hospitals, medicines, instruments and products it depends on

Refiguring risk in medicine and healthcare: Crafting wild narratives

Risk does not exist. It is an invention rather than a reality yet it arguably underpins Western societal structures. Etymologically it is a relatively recent word and one whose origins appear obscure. In Chinese medicine, its relationship to fear locates its influence in the kidneys, with adrenaline. Its various contemporary uses and meanings suggest a hybrid origin, a becoming that melds European commerce and Arabic belief systems with a sense of looking back upon Classical Graeco-Roman heroic identity, for conceptually it has been re-grounded in traditional and gendered Western practices. Its engendered aspects have led to its particular appearance in male-dominated narratives about bravery and adventures in pursuit of finance, treasures or goals. Its possible Arabic origins identify something that is accorded by God rather than chance. In this century, Beck’s work on ‘Risk Society’ associates management of risk with Weber’s Western consumer materialism and Protestantism. The concept of risk has therefore become an instrument of economics and political and material social governance and yet, Janus-like, it also constitutes a medium or process, a threshold locus for re-thinking or trialling - and potentially validating - an emergent individual identity, sometimes successfully, sometimes with horrifying consequences. On the one hand risk, associated with scientific measures, can be ‘managed’ while chance, serendipity and opportunity are ‘wild’ options that are not ‘managed’ but fast acquiring marginal eco-credentials. In this, mainstream Western society operates from the kidney position, from fear of a future intangible. Risk offers a means of transformation, a promise of value and ultimately a mediation of death or failure, but it equally avoids one of the huge realities of life - uncertainty. This paper explores some of the complex cultural and scientific framings of risk that seeks to weight the dice, debating its use as purveyor or guarantor of safety in medical contexts

Nurse Supervisors and Certified Nursing Assistants: Leadership Characteristics and Job Satisfaction

Significant costs are associated with the turnover rate of certified nursing assistants (CNAs) in skilled nursing facilities (SNFs), and turnover impacts the quality of care for residents of the SNFs through disruption of care. The purpose of this quantitative cross-sectional study was to identify the leadership characteristics of supervisors most associated with the job satisfaction (JS) of CNAs in SNFs. Herzberg\u27s dual factor theory was used as the theoretical framework to explain the relationship between the leadership characteristics and the associated JS. The research question was used to examine the independent variables of trust, teamwork, supportive supervision, leader-follower relationships, and empowerment of supervisors in SNFs that help predict the dependent variable, JS of CNAs. A random sampling of the population of CNAs from 120-bed SNFs located in Florida completed online surveys that included the Organizational Trust Inventory, the Conditions for Work Effectiveness Questionnaire II, and the Benjamin Rose Nurse Assistant Job Satisfaction Scale. Multiple linear regression was used to analyze data to determine the effects of the leadership characteristics on the JS of CNAs in SNFs. Results indicated that the increased levels of trust negatively impact the JS of the CNAs, whereas increased levels of empowerment increase JS. Implementing strategies to address the needs of CNAs positively impacts society by improving the lives of the workers and increasing CNA retention, thus improving the lives of vulnerable members of society through enhanced quality of care

Nurse Supervisors and Certified Nursing Assistants: Leadership Characteristics and Job Satisfaction

Significant costs are associated with turnover among certified nursing assistants (CNAs) in skilled nursing facilities (SNFs), and turnover impacts quality of care for residents of SNFs through disruption of care. The purpose of this study was identification of leadership characteristics of supervisors associated with job satisfaction of CNAs in SNFs. Results indicated that increased levels of trust negatively impact the job satisfaction of the CNAs, whereas increased levels of empowerment increase job satisfaction. These findings may help improve the lives of the workers and increase CNA retention, thus improving the lives of vulnerable members of society through enhanced quality of care.https://scholarworks.waldenu.edu/symposium2019/1030/thumbnail.jp

Identifying Contributors to Acute Stroke Transfer Delays from Lower to Higher Level Stroke Centers

The intricate process of efficiently transferring patients within the healthcare setting has proven to be complex however, it is a critical component to ensure timely access to essential medical interventions. Navigating these complexities presents a multifaceted challenge that is not fully understood. For patients suffering a stroke, these transfer delays may render them ineligible for treatment and left with disabling disability. This collective work aims to identify contributors to delays in transfer from lower to higher levels of care in the acute stroke populations. Three papers emerged from this thesis. First, a narrative review of the literature published between January 1996 to April 2020 found that several factors are associated with improved stroke outcomes. The availability of resources such as vascular neurologists or dedicated stroke units, training ambulance personnel in the early identification of stroke symptoms and stroke management, and focusing on internal performance efficiencies in the emergency department to administer clot busing medication for the treatment of ischemic stroke have all improved outcomes. However significant gaps in knowledge of what contributes to delays exist with no objective data available on stroke transfer delays in the published literature. Summation from the narrative review was used to develop a qualitative study. Web-based interviews with stroke coordinators at primary stroke centers were conducted where they discussed their lived experience in transferring patients from a primary stroke center to a higher level of care. The results were published in Stroke: Vascular and Interventional Neurology journal in March of 2023. Comprising the narrative review of the known causes of transfer delays and gaps in knowledge and the collective insight of stroke coordinators at primary stroke centers across the United States, a data collection instrument was designed and tested at primary stroke centers on patients that required transfer to a higher level of care. The instrument was divided into two main sections. The first section consisted of time process indicators that included information pertinent to activities associated with patient presentation, evaluation, and diagnostic work-up in the emergency department until departure to the higher level of care hospital. The second section consisted of 24-Likert scale questions designed to understand the transferring team’s perception of the quality and timeliness of the entire transfer process. The data collection instrument allowed us to examine the contributors to door-in, door-out (DIDO) times at a granular level. The median DIDO time for the overall sample was 130 minutes which exceeds the recommended DIDO time of less than 120 minutes. The greatest single contributor to DIDO time was from transport request to actual transport departure times which alone was responsible for 38% or 49.5 minutes of the total DIDO time. Collectively, these papers have broadened knowledge of why transfer delays exist when moving acute stroke patients from lower to higher level of hospital services. Continued work to further identify contributors to transfer delays within each category is warranted, along with development of interventions to improve efficiency across the entire system of care. In conclusion, delays in transfer continue to be one of the leading causes for stroke treatment ineligibility due to worsening irreversible brain damage. Improving stroke systems of care will improve treatment eligibility, reduce stroke related disability and death, and reduce the financial burden of post-stroke care

The Impact of Social-Emotional Team Huddles on Educational Leaders\u27 Wellbeing: An Improvement Science Study

Teachers and administrators have been leaving the education industry with nearly half of educators hired living within their first five years in the classroom. Burnout and stress contribute most significantly to the high attrition rates. One research-based strategy that has been deemed impactful is creating a culture of wellness and establishing trusting relationships in the workplace. These relationships may be achieved through engagement structures, inclusive environments, and strong leadership attributes that foster one-to-one connections. The method researched in this improvement science in practice methodology is the implementation of bi- monthly team huddles with a department of education administrators. Included in each team huddle were social-emotional wellbeing activities that elicited engagement with one another, ample opportunities for individual voices to be brought into the learning space, and a understanding of personal strengths and how they attribute to the overall team. The results showed that well-being activities did yield both higher pleasantness and energy in team huddles conducted and overall identification of self-care strategies in the workplace were improved from intentional time spent cultivating the learning. Future implications would encourage facilitators to seek additional qualitative data to find out more detailed information attributed to specific facets of the team huddle that deemed positive or negative for the participant