Pressure to place patients at the centre of care has humanised health research.

The tone of research has changed, says Janet Scammell, Associate Professor (Nursing), Bournemouth University, and it is important that nurses consider the extent of user involvement when undertaking or citing research

Graduate Students and the Academic Library: What does the Future Hold?

"I began my sabbatical research with what seemed a defined but narrow focus: the information literacy needs of graduate students. The Information Literacy Standards of the Association of Colleges and Research Libraries (ACRL) provided a reasonable foundation upon which to build, and a qualitative research design, sampling a number of graduate students at Carleton University, is a productive strategy. My project has since evolved in unexpected but distinctly broader and more challenging directions. I found, through ongoing reviews of existing literature, as well as through my own personal experience and discussions with colleagues, that some work has already been done to identify the concerns and needs of graduate students. Further, I discovered that there is a growing body of research aimed at identifying gaps and suggesting best practices." (from introduction

Elizabeth Smart: The Shifting Boundary between Nature and Art

Elizabeth Smart 's writings--her theory and practice of art-- present patterns of change and constancy. Art, initially constituted in an entw

Why do nurses leave or stay? Nurse retention - a global issue.

The shortage of registered nurses is a global concern and so understanding and developing innovative and effective ways to prepare, recruit and retain nurses has become critical. As nurse shortages compromise healthcare systems, workers’ wellbeing, patient care and the reputation of the profession, it is as much an issue for nurse educators as for health service providers. This plenary session describes a collaboration between a UK University and a large health service provider to develop and test an innovative evidence-based model for improving nurse retention: TRACS (Transition, Resilience, Authentic leadership, Commitment, Support). This is a mixed method study with six phases across two years. Phase 1 involved analyzing current evidence and collecting base line data (retention, recruitment, job satisfaction, exit interviews). It revealed that absentee (sickness) rates, monthly staff turnover, % of vacant posts were highest in the Older Person’s Medicine (OPM) directorate. Phase 2 employed two tools (PES-NWI and Maslach) to survey the practice environment and perceptions of burnout in two directorates, Surgical and OPM (response rate= 44%). Results indicated that nurses perceived supportive managers, teamwork and staff development were most strongly linked with a positive practice environment. Lack of staff/resources had the most negative effect. Nurses within OPM reported higher levels of burnout than those within the surgical directorate. Phase 3 involved consultation with a range of staff and patients to co-create a retention strategy to inform the TRACS toolkit. We will explore interventions and the final evaluative phases of the study. Evidence-based strategies to address nurse retention are a priority. The TRACS model involves strong collaboration between service providers and nurse educators and aims to strengthen loyalty, recruitment and transition in a competitive employment market

Learning about the complexity of humanised care: findings from a longitudinal study of nurse students’ perceptions

Background, including underpinning literature and, wherever possible, the international relevance of the research The rise in elderly populations with complex long-term conditions is a global phenomenon (World Health Organisation, 2011). However evidence has emerged internationally around concerns about quality of care, particularly for older people (Katz 2011; Organisation for Economic Cooperation and Development, 2013). It has been argued that in target-driven care environments, there is the potential for care professionals to lose sight of the person receiving the care and focuses on task-completion, resulting in dehumanising care cultures (Galvin and Todres 2013). Educating nurse students to effectively as well as compassionately deliver complex care to vulnerable people represents considerable challenges. Following a number of high profile examples of poor quality care in the United Kingdom (UK) (Francis 2013), health profession education providers now follow professional body guidelines that mandate that values for compassionate practice clearly underpin curricula. Limited evidence exists however, concerning the impact of this initiative over time. This paper reports on a study that evidences the impact on students of an education programme based on a humanising care philosophy in shaping the students’ value base as they progress through their education programmes. Aim(s) and/or research question(s)/research hypothesis(es) . This paper reports on a five-phase longitudinal study exploring the impact of an undergraduate-nursing curriculum based on a humanising care philosophy on the values of individual students. Research methodology/research design, any ethical issues, and methods of data collection and analysis The study uses a qualitative longitudinal approach to understanding the beliefs and values of student nurses from the day of entry, through their education programme to completion. Focusing on two cohorts of students one year apart, data were collected by individual interview at commencement and completion and by focus groups at the end of their first placement and at the end of their first and second years. This presentation reports up to the end of the programme for the first cohort and end of second year for the second cohort. Ethics approval was gained for the entire project. At each stage of the process, students were formally invited to participate and on-going individual consent was gained. The audio-recordings were transcribed verbatim and analysed thematically. Key findings and recommendations By the end of their first placement, both groups were very similar in the expression of their values and to some extent presented a rather negative view of their experiences. However students from both groups became more articulate in expressing their values particularly in relation to their placement experience, as they moved through their programme. Four on-going and developing themes emerged from the data: personal journey, impact of the curriculum, impact of practice and values development. Overall, although each cohort followed two distinct curricula, there were few differences between the groups at each stage. Reasons for this will be discussed. Both groups felt they had become less judgmental, that the curriculum had empowered them to challenge practice and enhanced their confidence. Students also reported that their mentors (placement supervisors) role modelled authentic compassionate care in practice. Over time students’ insight into the complexity of caring developed and their understanding of the importance of practice that respected patient individuality deepened. This study has evidenced the strong link between curriculum and its impact on the evolving values of nursing students. Whilst this paper reports on a local study from one university in the UK, transferability of findings to other settings can be judged; it is argued that the insights will have resonance for nurse educators more widely as well as other health professional disciplines. References Commissioning Board Chief Nursing Officer and Department of Health Chief Nurse Advisor (2012). Compassion in Practice: Nursing, Midwifery and Care Staff. Our vision and strategy. Retrieved 22nd January 2016 from: http://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdf Francis Inquiry, (2013). Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive summary. Crown Copyright: London. Galvin, K., Todres, L. (2013). Caring and Well-Being: A Lifeworld Approach. Routledge: Abingdon, Oxon. Katz, P.R. (2011). An International Perspective on Long Term Care: Focus on Nursing Homes. Journal of American Medical Directors Association. 12 (7): 487-492 OECD (2013) OECD Reviews of Health Care Quality: Denmark. Retrieved 7th Retrieved 22nd January 2016 from: http://www.oecd.org/els/health-systems/ReviewofHealthCareQualityDENMARK_ExecutiveSummary.pdf WHO (2011) Global Health and Ageing. Retrieved 22nd January 2016 from: http://www.who.int/ageing/publications/global_health.pdf Key words: (5) • Nurse education • Professional values • Humanising care • Curriculum • Longitudinal qualitative research 3 key points to indicate how your work contributes to knowledge development within the selected theme • Nursing students were able to clearly articulate values that underpin humanised care • This study provides evidence for the strong link between curriculum and its impact on the evolving values of nursing students • The curriculum is one factor in embedding humanised values in nursing students; further research is required

Development of a Coherent Doppler Lidar for Precision Maneuvering and Landing of Space Vehicles

A coherent Doppler lidar has been developed to address NASAs need for a high-performance, compact, and cost-effective velocity and altitude sensor onboard its landing vehicles. Future robotic and manned missions to planetary bodies require precise ground-relative velocity vector and altitude data to execute complex descent maneuvers and safe, soft landing at a pre-designated site. This lidar sensor, referred to as a Navigation Doppler Lidar, meets the required performance of landing missions while complying with vehicle size, mass, and power constraints. Operating from over five kilometers altitude, the lidar obtains velocity and range precision measurements with 2 cm/sec and 2 meters, respectively, dominated by the vehicle motion. After a series of flight tests onboard helicopters and rocket-powered free-flyer vehicles, the Navigation Doppler Lidar is now being ruggedized for future missions to various destinations in the solar system

The contribution of spinal glial cells to chronic pain behaviour in the monosodium iodoacetate model of osteoarthritic pain

<p>Abstract</p> <p>Background</p> <p>Clinical studies of osteoarthritis (OA) suggest central sensitization may contribute to the chronic pain experienced. This preclinical study used the monosodium iodoacetate (MIA) model of OA joint pain to investigate the potential contribution of spinal sensitization, in particular spinal glial cell activation, to pain behaviour in this model. Experimental OA was induced in the rat by the intra-articular injection of MIA and pain behaviour (change in weight bearing and distal allodynia) was assessed. Spinal cord microglia (Iba1 staining) and astrocyte (GFAP immunofluorescence) activation were measured at 7, 14 and 28 days post MIA-treatment. The effects of two known inhibitors of glial activation, nimesulide and minocycline, on pain behaviour and activation of microglia and astrocytes were assessed.</p> <p>Results</p> <p>Seven days following intra-articular injection of MIA, microglia in the ipsilateral spinal cord were activated (p < 0.05, compared to contralateral levels and compared to saline controls). Levels of activated microglia were significantly elevated at day 14 and 21 post MIA-injection. At day 28, microglia activation was significantly correlated with distal allodynia (p < 0.05). Ipsilateral spinal GFAP immunofluorescence was significantly (p < 0.01) increased at day 28, but not at earlier timepoints, in the MIA model, compared to saline controls. Repeated oral dosing (days 14-20) with nimesulide attenuated pain behaviour and the activation of microglia in the ipsilateral spinal cord at day 21. This dosing regimen also significantly attenuated distal allodynia (p < 0.001) and numbers of activated microglia (p < 0.05) and GFAP immunofluorescence (p < 0.001) one week later in MIA-treated rats, compared to vehicle-treated rats. Repeated administration of minocycline also significantly attenuated pain behaviour and reduced the number of activated microglia and decreased GFAP immunofluorescence in ipsilateral spinal cord of MIA treated rats.</p> <p>Conclusions</p> <p>Here we provide evidence for a contribution of spinal glial cells to pain behaviour, in particular distal allodynia, in this model of osteoarthritic pain. Our data suggest there is a potential role of glial cells in the central sensitization associated with OA, which may provide a novel analgesic target for the treatment of OA pain.</p

Molecular expression patterns in the synovium and their association with advanced symptomatic knee osteoarthritis

Objective: Osteoarthritis (OA) is a major source of knee pain. Mechanisms of OA knee pain are incompletely understood but include synovial pathology. We aimed to identify molecular expression patterns in the synovium associated with symptomatic knee OA.Design: Snap frozen synovia were from people undergoing total knee replacement (TKR) for advanced OA, or from post-mortem (PM) cases who had not sought help for knee pain. Associations with OA symptoms were determined using discovery and validation samples, each comprising TKR and post mortem (PM) cases matched for chondropathy (Symptomatic or Asymptomatic Chondropathy). Associations with OA were determined by comparing age matched TKR and PM control cases. Real-time quantitative PCR for 96 genes involved in inflammation and nerve sensitisation used TaqMan® Array Cards in discovery and validation samples, and protein expression for replicated genes was quantified using Luminex bead assay.Results: Eight genes were differentially expressed between asymptomatic and symptomatic chondropathy cases and replicated between discovery and validation samples (P3-fold change). Of these, matrix metalloprotease (MMP)-1 was also increased whereas interleukin-1 receptor 1 (IL1R1) and vascular endothelial growth factor (VEGF) were decreased at the protein level in the synovium of symptomatic compared to asymptomatic chondropathy cases. MMP1 protein expression was also increased in OA compared to PM controls.Conclusion: Associations of symptomatic OA may suggest roles of MMP1 expression and IL1R1 and VEGF pathways in OA pain. Better understanding of which inflammation-associated molecules mediate OA pain should inform refinement of existing therapies and development of new treatments

Functional outcome and complications following surgery for Dupuytren’s disease: a multi-centre cross-sectional study

Variables associated with recurrent Dupuytren’s disease, or a ‘diathesis’, have been investigated, but those associated with functional outcome and complications are less well studied. Outcomes 1 or 5 years after an aponeurotomy, fasciectomy or dermofasciectomy were assessed by patient interview and examination at five UK centres. A total of 432 procedures were studied. The reoperation rate did not differ at 1 year (p = 0.396, Chi-square test with Monte Carlo simulation), but was higher after aponeurotomy in the 5-year group (30%, versus 6% after fasciectomy and 0% after dermofasciectomy, p = 0.003, Chi square test with Monte Carlo simulation). Loss of function (DASH>15) did not differ between procedures at 5 years, even when reoperation and other variables were controlled. Diabetes, female gender and previous ipsilateral surgery were associated with poorer function in logistic regression analysis. The variables associated with poor function after treatments differ from diathesis variables. Aponeurotomy had lower complication rates than fasciectomy and dermofasciectomy. This may counterbalance the former’s higher recurrence rate and explain why aponeurotomy demonstrated similar long-term functional outcome compared with excisional surgery in this study

Targeting the D-series resolvin receptor system for the treatment of osteoarthritic pain

Objective: Pain is a major symptom of osteoarthritis (OA); current analgesics either do not offer adequate pain relief or are associated with serious side effects. Herein we have investigated the therapeutic potential of targeting the resolvin receptor system to modify OA pain and pathology. Methods: Gene expression of two resolvin receptors (ALX and ChemR23) was quantified in synovia and medial tibial plateau collected from patients at joint replacement for OA. Two models of OA joint pain were used for mechanistic studies. Gene expression in the periphery and CNS were quantified. Effects of exogenous administration of the D-series resolvin precursor 17(R)-hydroxy Docosahexaenoic Acid (17(R)-HDoHE on pain behaviour, joint pathology, spinal microglia and astroglyosis were quantified. Plasma levels of relevant lipids, resolvin D2, 17R-HDoHE and arachidonic acid was determined in rats using LC-MS-MS. Results: There was a positive correlation between resolvin receptor and IL6 expression in human OA synovia and medial tibial plateau. In the rat, synovia gene expression of ALX was positively correlated with IL1β, TNFα and COX2. Treatment with 17(R)-HDoHE reversed established pain behaviour in two models of OA pain, but not joint pathology. This was associated with a significant elevation in plasma levels of resolvin D2 and a significant reduction in astrogliosis in the spinal cord in the MIA model. Conclusion: Our preclinical data demonstrate robust analgesics effects of activating the D series resolvin pathways in two different animal models of OA. Our data support a predominant central mechanism of action in this clinically relevant model of OA pain