Implementing an e-learning Masters programme for Practice Development

Introduction – The need for more effective person centred care has been propositioned for a number of years (Dewar and Nolan 2013; McCormack, Dewing and McCance, 2011; Dewing, 2004) and Practice Development (PD) has been viewed as one way to embed this into organisational culture (Manley, Sanders, Cardiff and Webster, 2011). More recently multiple policy reports echo this call (Age UK, 2012; Willis Commission on Nursing, 2012; Parliamentary Health Service Ombudsman, 2011). Joint work between the Department of Nursing and England Centre for Practice Development at Canterbury Christ Church University has validated an innovative Masters level programme in Practice Development, utilising workplace and e-learning approaches to facilitate creativity in the work setting. Aim: This paper will briefly describe the programme and then explore the experiences and challenges of implementing a work based and e-learning Masters Practice Development and Innovation programme. Approach: Practice Development is built on the key principles of person-centredness, shared values and vision, transforming individuals and culture through active learning, facilitation and engagement (McCormack, Manley, Titchen 2013). Thus, the approach to the Masters programme reflects these principles and utilises facilitation methods to enable practice development to transform the learner and work setting. As part of this process we, as lecturers, have been developing our own values and beliefs and expanded our knowledge and skills so that we can positively impact on the learner experience and work as learning partners. The programme is, therefore, evolving to embody these principles and enable learners to incorporate them into practice. The programme is built around ten core Practice Development/Innovation principles and the process of Active Learning, which will be expanded on in the presentation. Our vision is to make this programme accessible to regional, national and international learners. The work-based and e-learning approaches make this achievable but bring challenges to ensure that the programme reflects the principles of Practice Development from a distance. This is further complicated by facilitating a range of learners from diverse clinical areas, experiences and cultures who have often been exposed to traditional forms of learning. Thus, facilitating the learners to engage with the material, and incorporate it into their own practice setting, has led to careful consideration of materials for the learners to access. As the programme is progressing areas are emerging that need to be thoughtfully considered and addressed to ensure development of learning. Considerations: Initial themes starting to emerge are: increasing lecturer knowledge and skills around both Practice Development and different tools for e-learning, learners previous experience of facilitation and willingness to take responsibility for their own learning, challenges of promoting active learning approaches online , enabling achievement of Masters level learning outcomes with a distance approach, new ways of working for individuals plus the organisational views around supporting learners in practice. These require both lecturers and learners to be motivated to learn and devote time to engage with material and processes. However, it also requires lecturers and learners to make choices and reflect on activities to assess the relevance and usefulness to their situation. The programme encourages learners to be creative and examine issues differently which takes time to engage with and progress. Conclusion: Evaluation of this programme is in its infancy. A key learning point is that transforming practice through Practice Development and innovation in the workplace also involves transforming University views on learning, engagement and creativity

The influence of anæsthesia on the restoration of the volume of the blood after hæmorrhage and after transfusion

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Patient and Public Involvement in the Design of Clinical Trials: An Overview of Systematic Reviews

Background Funders encourage lay-volunteer inclusion in research but this is not without controversy or resistance, given concerns of role confusion, exploratory methods and limited evidence about what value this brings to research. This overview explores these elements. Methods Eleven databases and gray literature were searched without date or language restrictions for systematic reviews of public involvement in clinical trials design. This systematic overview of patient and public involvement (PPI) included 27 reviews from which areas of good and bad practice were identified. PPI strengths, weaknesses, opportunities and threats were explored through use of meta-narrative analysis. Results Inclusion criteria was met by 27 reviews. Confidence in the findings was assessed using Cerqual, Nice-H, CASP for qualitative research and CASP systematic reviews. Quality ranged from high (n=7), medium (n=14) to low (n=6) in the reviews. Four reviews report the risk of bias. Public involvement roles were primarily in agenda setting, steering committees, ethical review, protocol development, and piloting. Research summaries, follow-up, and dissemination contained PPI, with lesser involvement in data collection, analysis, or manuscript authoring. Trialists report difficulty in finding, retaining, and reimbursing volunteers. Respectful inclusion, role recognition, mutual flexibility, advance planning and sound methods were reported as facilitating public involvement in research. Public involvement was reported to have increased the quantity and quality of patient relevant priorities and outcomes, enrollment, funding, design, implementation and dissemination. Challenges identified include lack of clarity within common language, roles and research boundaries; while logistical needs include extra time, training and funding, Researchers report struggling to report involvement and avoid tokenism. Conclusions Involving patients and the public in clinical trials design, can be beneficial but requires resources, preparation, training, flexibility and time. Issues to address include reporting deficits in the areas of risk of bias, study quality and conflicts of interests. There is a need for improved dissemination strategies to increase public involvement and health literacy. Improvements in funding, training, and reporting of PPI are needed to facilitate meaningful and effective PPI

Potato cyst nematodes Globodera rostochiensis and G. pallida

Innovate UK. Grant Number: 105653 (RESOLVE) Rural and Environment Science and Analytical Services Division. Grant Number: WP2.1 Scottish Funding Council. Grant Number: ODA GCRF XFC105Taxonomy: Phylum Nematoda; class Chromadorea; order Rhabditida; suborder Tylenchina; infraorder Tylenchomorpha; superfamily Tylenchoidea; family Heteroderidae; subfamily Heteroderinae; Genus Globodera. Biology: Potato cyst nematodes (PCN) are biotrophic, sedentary endoparasitic nematodes. Invasive (second) stage juveniles (J2) hatch from eggs in response to the presence of host root exudates and subsequently locate and invade the host. The nematodes induce the formation of a large, multinucleate syncytium in host roots, formed by fusion of up to 300 root cell protoplasts. The nematodes rely on this single syncytium for the nutrients required to develop through a further three moults to the adult male or female stage. This extended period of biotrophy?between 4 and 6 weeks in total?is almost unparalleled in plant?pathogen interactions. Females remain at the root while adult males revert to the vermiform body plan of the J2 and leave the root to locate and fertilize the female nematodes. The female body forms a cyst that contains the next generation of eggs. Host range: The host range of PCN is limited to plants of the Solanaceae family. While the most economically important hosts are potato (Solanum tuberosum), tomato (Solanum lycopersicum), and aubergine (Solanum melongena), over 170 species of Solanaceae are thought to be potential hosts for PCN (Sullivan et al., 2007). Disease symptoms: Symptoms are similar to those associated with nutrient deficiency, such as stunted growth, yellowing of leaves and reduced yields. This absence of specific symptoms reduces awareness of the disease among growers. Disease control: Resistance genes (where available in suitable cultivars), application of nematicides, crop rotation. Great effort is put into reducing the spread of PCN through quarantine measures and use of certified seed stocks. Useful websites: Genomic information for PCN is accessible through WormBase ParaSite.Publisher PDFPeer reviewe

Seismic data reveal eastern Black Sea Basin structure

Rifted continental margins are formed by progressive extension of the lithosphere. The development of these margins plays an integral role in the plate tectonic cycle, and an understanding of the extensional process underpins much hydrocarbon exploration. A key issue is whether the lithosphere extends uniformly, or whether extension varies\ud with depth. Crustal extension may be determined using seismic techniques. Lithospheric extension may be inferred from the waterloaded subsidence history, determined from\ud the pattern of sedimentation during and after rifting. Unfortunately, however, many rifted margins are sediment-starved, so the subsidence history is poorly known.\ud To test whether extension varies between the crust and the mantle, a major seismic experiment was conducted in February–March 2005 in the eastern Black Sea Basin (Figure 1), a deep basin where the subsidence history is recorded\ud by a thick, post-rift sedimentary sequence. The seismic data from the experiment indicate the presence of a thick, low-velocity zone, possibly representing overpressured sediments. They also indicate that the basement and\ud Moho in the center of the basin are both several kilometers shallower than previously inferred. These initial observations may have considerable impact on thermal models of the petroleum system in the basin. Understanding\ud the thermal history of potential source rocks is key to reducing hydrocarbon exploration risk. The experiment, which involved collaboration between university groups in the United Kingdom, Ireland, and Turkey, and BP and\ud Turkish Petroleum (TPAO), formed part of a larger project that also is using deep seismic reflection and other geophysical data held by the industry partners to determine the subsidence history and hence the strain evolution of\ud the basin

Predicting frequent COPD exacerbations using primary care data

This study was funded by an unrestricted grant from the Respiratory Effectiveness Group (REG; www.effectivenessevaluation.org). Access to data from the Optimum Patient Care Research Database was co-funded by Research in Real-Life Ltd (RiRL, Cambridge, UK). The authors would like to thank Dr John Bukowski of WordsWorld Consulting for editorial assistance drafting this manuscript. Additional editorial support was provided by Elizabeth V Hillyer, DVM, funded by RiRL.Peer reviewedPublisher PD

School-Based Nutrition and Physical Activity Program for Rural Elementary School Students: A Pilot Study

Children who eat unhealthy diets and engage in limited physical activity are susceptible to adverse health effects, such as obesity. This pilot intervention study examined the immediate impact of a health education program, Get Charmed, which used a short-run incentive program as a strategy for motivating rural elementary school students to learn about physical activity and healthy eating behaviors. We assessed kindergarten through fifth grade students’ knowledge of physical activity, healthy eating, and water consumption, at baseline and immediately following the intervention. Get Charmed is a six-week program geared toward elementary-aged children, with aims to increase participants’ knowledge and awareness around healthier lifestyle behaviors. A pre-post evaluation assessed knowledge about healthy eating, physical activity, and hydration among elementary school-aged children (n = 22) enrolled in grades k-5. Frequencies were calculated for the number of correct responses for each item. A series of Wilcoxon signed rank tests were performed to assess changes in knowledge from baseline to post-test. Average knowledge scores for the 3rd-5th grade students increased from 15.56 (± 1.88) to 16.78 (± 1.20), which was statistically significant (z = -2.41, p = 0.016). Average baseline knowledge for the kindergarten to 2nd grade students increased from 9.54 (± 1.66) to 10.46 (± 0.66). For the kindergarten to 2nd grade students, a statistically significant proportion of participants (six out of 13 participants) increased knowledge (z = -1.98, p = 0.048). Implementing Get Charmed with short-run incentives in rural school-based settings is a practical and economical approach to introducing new foods while increasing rural elementary students’ knowledge in the areas of physical activity, nutrition, and hydration

Computational modeling and analysis of hippocampal-prefrontal information coding during a spatial decision-making task

We introduce a computational model describing rat behavior and the interactions of neural populations processing spatial and mnemonic information during a maze-based, decision-making task. The model integrates sensory input and implements working memory to inform decisions at a choice point, reproducing rat behavioral data and predicting the occurrence of turn- and memory-dependent activity in neuronal networks subserving task performance. We tested these model predictions using a new software toolbox (Maze Query Language, MQL) to analyse activity of medial prefrontal cortical (mPFC) and dorsal hippocampal (dCA1) neurons recorded from six adult rats during task performance. The firing rates of dCA1 neurons discriminated context (i.e., the direction of the previous turn), whilst a subset of mPFC neurons was selective for current turn direction or context, with some conjunctively encoding both. mPFC turn-selective neurons displayed a ramping of activity on approach to the decision turn and turn-selectivity in mPFC was significantly reduced during error trials. These analyses complement data from neurophysiological recordings in non-human primates indicating that firing rates of cortical neurons correlate with integration of sensory evidence used to inform decision-making

Emissions performance of high moisture wood fuels burned in a residential stove

A study has been made of the effect of fuel moisture content on emissions from a wood burning domestic stove. Two fuel types were studied: beech which is a hardwood, and spruce which is a softwood. The moisture contents investigated were for a freshly felled wood, a seasoned wood and a kiln dried wood. The effect of the moisture measurement method was considered using a commercial electrical conductivity probe moisture meter which was compared with laboratory analysis by drying in an oven at 105 °C. It was shown that the probe can significantly underestimate the actual moisture content in certain cases. Correlations were made of the burning rate, the Emission Factors for the formation of gaseous and particulate pollutants as a function of the moisture content. We also studied the ratio of Black Carbon to Total Carbon (BC/TC) to obtain information on the organic content of the particles. The NOₓ emissions from this type of stove were only dependent on the fuel-nitrogen content and not on the moisture content