A programme theory for liaison mental health services in England

Background: Mechanisms by which liaison mental health services (LMHS) may bring about improved patient and organisational outcomes are poorly understood. A small number of logic models have been developed, but they fail to capture the complexity of clinical practice. Method: We synthesised data from a variety of sources including a large national survey, 73 in-depth interviews with acute and liaison staff working in hospitals with different types of liaison mental health services, and relevant local, national and international literature. We generated logic models for two common performance indicators used to assess organisational outcomes for LMHS: response times in the emergency department and hospital length of stay for people with mental health problems. Results: We identified 8 areas of complexity that influence performance, and 6 trade-offs which drove the models in different directions depending upon the balance of the trade-off. The logic models we developed could only be captured by consideration of more than one pass through the system, the complexity in which they operated, and the trade-offs that occurred. Conclusions: Our findings are important for commissioners of liaison services. Reliance on simple target setting may result in services that are unbalanced and not patient-centred. Targets need to be reviewed on a regular basis, together with other data that reflect the wider impact of the service, and any external changes in the system that affect the performance of LMHS, which are beyond their control

RNAcentral : a hub of information for non-coding RNA sequences

RNAcentral is a comprehensive database of non-coding RNA (ncRNA) sequences, collating information on ncRNA sequences of all types from a broad range of organisms. We have recently added a new genome mapping pipeline that identifies genomic locations for ncRNA sequences in 296 species. We have also added several new types of functional annotations, such as tRNA secondary structures, Gene Ontology annotations, and miRNA-target interactions. A new quality control mechanism based on Rfam family assignments identifies potential contamination, incomplete sequences, and more. The RNAcentral database has become a vital component of many workflows in the RNA community, serving as both the primary source of sequence data for academic and commercial groups, as well as a source of stable accessions for the annotation of genomic and functional features. These examples are facilitated by an improved RNAcentral web interface, which features an updated genome browser, a new sequence feature viewer, and improved text search functionality. RNAcentral is freely available at https://rnacentral.org

Abstracts from the NIHR INVOLVE Conference 2017

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From the ground up: Improving pregnancy and birth experiences through the provision of extraordinary learning opportunities in Australia

Baldwin, AE ORCiD: 0000-0002-6325-4142; Capper, TS ORCiD: 0000-0003-3464-1423A collaborative project formally titled "Working together to improve pregnancy and birth experiences for women and provide extraordinary learning opportunities for midwifery students" was launched in April 2017, after several years of consultation and planning. The opportunity to adopt an integrated response to the needs of incarcerated pregnant women and the learning needs of midwifery students was identified and supported by the university offering a graduate-entry midwifery program, a women's correctional center, and a health service in a regional area of Australia. Incarcerated women who are pregnant require pregnancy, birth, and postnatal support distinct from their clinical care, while at the same time, midwifery students need to recruit pregnant women for continuity-of-care experiences. This article presents an overview of the implementation of the pilot project. It also discusses the project team and the challenges and successes of and unanticipated opportunities for practice modification and change. © 2018 International Association of Forensic Nurses

Correctional officers as participants: Action research in prisons

Baldwin, AE ORCiD: 0000-0002-6325-4142; Harvey, CL ORCiD: 0000-0001-9016-8840; Willis, EM ORCiD: 0000-0001-7576-971XAction research methodology is well-suited to engaging with marginalised groups to inform policy and guide practice. Prisons are complex institutions with hierarchies of power; social systems that demand a research approach suited to social structure. The pilot project to be evaluated is designed to promote positive pregnancy and birth experiences for pregnant female prisoners and provide extraordinary learning opportunities for midwifery students. The project team includes staff from a regional university, the local health service and the state run prison service. Very early in the project it became evident that in addition to management patronage, the project needed the practical support of the Custodial Correctional Officers. Thus, officers as project ‘champions’ were recruited. Custodial Correctional Officers play an integral role in these social systems and although they are perceived to have power over prisoners, they too are subject to controls and in some instances have minimal power. The study will be conducted in two stages, the first of which will involve the Custodial Correctional Officers as participants, focus on the outcomes to date and how this may inform policy and practice. This article justifies the use of action research methodology for this purpose. © The Author(s) 2019

Evaluating the efficacy and impact of the nursing and midwifery exchange program: A study protocol

Baldwin, AE ORCiD: 0000-0002-6325-4142; Byrne, AJ ORCiD: 0000-0002-8679-8310; Harvey, CL ORCiD: 0000-0001-9016-8840Objective The following research protocol evaluates the Queensland Health Nursing and Midwifery Exchange Program (NMEP) and evaluates how exposure to diverse clinical settings, may impact the nursing and midwifery workforce on individual and organisational levels. Design This protocol details a mixed methodology allowing for both quantitative and qualitative data. The study is being undertaken in three stages; a survey of the participating nurses and midwives; a systematic review; and a Delphi study with an expert review group. Setting The study is a Queensland wide study across rural/remote, regional and metropolitan locations. Subjects This study will follow approximately 70 nurses and midwives employed by Queensland Health from diverse areas and streams at various stages within their clinical career. Interventions Nurses and Midwives participate in a three or six-month professional exchange to a rural/remote or metropolitan location. Main outcome measure(s) This study will evaluate the impact and sustainability of the NMEP program through measurement of burnout, job embeddedness, job strain, job satisfaction and attrition through a series of surveys. In addition to this, a systematic review and Delphi with executive experts will be conducted to consider a future pathway/model for nursing and midwifery exchange. Results This study has commenced and will be completed September of 2019. Conclusion The NMEP program is one novel approach to nursing and midwifery workforce concerns and looks to present excellent opportunities for the crossover of skills and ideas related to clinical, professional and service integration between metropolitan and rural practice. © 2019, Australian Nursing Federation. All rights reserved

(Table T1) Cenozoic and Mesozoic biostratigraphic datums of ODP Hole 210-1276A

Sediments recovered from Ocean Drilling Program Leg 210 Hole 1276A range in age from Early Cretaceous (earliest Albian) to Paleogene (earliest Oligocene). In this study, samples were processed and analyzed for micropaleontological and palynological content, as well as sedimentary components. Core recovery from this site was good (85% between 800 and 1725.16 meters below seafloor), and the majority of samples processed yielded microfossils of some nature. Although none of the major groups are consistently present in all samples, calcareous nannofossils, agglutinated benthic foraminifers, and radiolarians do occur in many samples. The best age constraints for Hole 1276A are provided by calcareous nannofossils and dinoflagellate cysts. Age-diagnostic planktonic foraminifers are more commonly found in redeposited turbidite sandstones rather than in the autochthonous pelagic mudrocks. The depositional environments of the sediments have been interpreted as varying in oxygenation but having been deposited at abyssal depths (>2000 m) near or below the calcite carbonate depth (CCD). Almost uninterrupted deepwater deposition since the Aptian is evidenced both by the evolutionary succession of biota recovered from the sediments and by the sedimentary history of turbidites and gravity flow deposits derived from neritic and bathyal sources on the adjacent margin. A condensed interval recorded in the Turonian-Maastrichtian is likely associated with sediment starvation at times of high global sea level. A disconformity and condensed interval in the lower middle Eocene (~48.5-43.7 Ma) is associated with a change in global sea level and may be associated with invigorated deepwater current activity. Anoxic conditions affected the deep seafloor of the North Atlantic during Oceanic Anoxic Event (OAE) 1b (earliest Albian, ~112 Ma) and OAE2 (Cenomanian-Turonian boundary interval, ~93.5 Ma). Cooling during the early Turonian followed the vast carbon burial associated with OAE2 based on calcareous nannofossil assemblages. The recovery of a nearly complete Cretaceous-Paleogene boundary transition represents one of the deepest-water records of the end-Cretaceous event known. Another important paleontological discovery from Hole 1276A was the redeposited large-size benthic foraminifers of Campanian-Maastrichtian and latest Paleocene-early Eocene ages, which point to a nearby source of shallow, warm-water carbonates during these two periods of global warmth

Developing a community-based nursing and midwifery career pathway: A narrative systematic review

Harvey, CL ORCiD: 0000-0001-9016-8840; Hegney, DG ORCiD: 0000-0003-1267-1760© 2019 Harvey et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Community nursing and midwifery is changing in response to a shift in care from hospital to home, brought about by increasing costs to care because of an aging population and increasing chronicity. Until now, community nursing positions and scope of practice has been dependent on service focus and location, which has led to the role being unclearly defined. Lack of appeal for a career in community practice and a looming workforce shortage necessitates a review into how community nursing and midwifery transition to practice is supported. Methods This review sought to identify, assess and summarize available evidence relating to transitioning into community nursing and midwifery practice as a speciality. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A narrative synthesis was then undertaken on papers that examined community nursing and midwifery pathway perspectives which define, and enable or inhibit a contemporary pathway. Thematic analysis used a theoretical framework developed for early career and rapid transition to nursing specialty practice. Results There is a paucity of research that identifies community nursing and midwifery as a discreet scope of practice. Twelve papers were eventually included in the review. Verbatim findings were extracted from the papers and clustered into categories based on the chosen theoretical framework. Major themes were ‘the self’ (professional and personal); ‘transition processes’; and, a ‘sense of belonging’. Sub themes included narrative identifying inhibitors and enablers in each theme. Discussion No definition of community practice or pathway was identified in nursing, although midwifery was clearly defined. Community nursing practice was described as generalist in nature although specialist knowledge is required. Being part of the community in the professional sense and personal sense was considered important. The importance of transition was identified where pre-entry exposure to community practice was seen as important. Stages in transition to practice were recognised as pre-entry; incomer; insider; and, a sense of belonging. The process of transition should be planned and individualised acknowledging past experience whilst acknowledging the specialist nature of community-based practice