The 'middle bit' : how to appraise qualitative research

The Nursing & Midwifery Council (2015) states that all registered nurses must ‘practice in-line with best available evidence’. Whilst there are clinical guidelines that are used to inform clinical practice, these often apply to medical rather than nursing interventions. Accordingly nurses must develop their critical appraisal skills to enable them to evaluate the available published research and consider to what extent findings might inform their clinical practice. A starting point for this process is an understanding of the characteristics of qualitative research and the key concepts that can guide the appraisal of a qualitative study. This paper provides and overview of the key points and frameworks for consideration in appraising qualitative evidence

Myocardial tagging by Cardiovascular Magnetic Resonance: evolution of techniques--pulse sequences, analysis algorithms, and applications

Cardiovascular magnetic resonance (CMR) tagging has been established as an essential technique for measuring regional myocardial function. It allows quantification of local intramyocardial motion measures, e.g. strain and strain rate. The invention of CMR tagging came in the late eighties, where the technique allowed for the first time for visualizing transmural myocardial movement without having to implant physical markers. This new idea opened the door for a series of developments and improvements that continue up to the present time. Different tagging techniques are currently available that are more extensive, improved, and sophisticated than they were twenty years ago. Each of these techniques has different versions for improved resolution, signal-to-noise ratio (SNR), scan time, anatomical coverage, three-dimensional capability, and image quality. The tagging techniques covered in this article can be broadly divided into two main categories: 1) Basic techniques, which include magnetization saturation, spatial modulation of magnetization (SPAMM), delay alternating with nutations for tailored excitation (DANTE), and complementary SPAMM (CSPAMM); and 2) Advanced techniques, which include harmonic phase (HARP), displacement encoding with stimulated echoes (DENSE), and strain encoding (SENC). Although most of these techniques were developed by separate groups and evolved from different backgrounds, they are in fact closely related to each other, and they can be interpreted from more than one perspective. Some of these techniques even followed parallel paths of developments, as illustrated in the article. As each technique has its own advantages, some efforts have been made to combine different techniques together for improved image quality or composite information acquisition. In this review, different developments in pulse sequences and related image processing techniques are described along with the necessities that led to their invention, which makes this article easy to read and the covered techniques easy to follow. Major studies that applied CMR tagging for studying myocardial mechanics are also summarized. Finally, the current article includes a plethora of ideas and techniques with over 300 references that motivate the reader to think about the future of CMR tagging

Resilience Education and Training

Gilligan (2000) describes resilience as process which engenders a sense of strength and confidence to succeed despite individual challenges faced and Noble and McGraph, (2011a; p.79) define it as "the ability to persist, cope adaptively and bounce back after encountering change, challenges, setback, disappointments, difficult situations or adversity and to return to a reasonable level of wellbeing". It has been suggested that these challenges can be controlled by an individual’s behaviours, thoughts and actions which, can be taught (American Psychological Association, 2018). However, Wu et al (2013) argue that developing resilience in individuals requires several ‘factors’ not least, an understanding of the genetic, epigenetic, developmental, psychological and neurochemical processes, as these can contribute to how an individual can cope with and develop resilience in the face of stress and trauma. In this way, resilience education and training is about building the capacities to cope as well as adapt to changes in generative ways, and includes a diverse range of strategies to develop personal purpose, confidence, flexibility and social support networks