Meaning and purpose in care home (nursing) life

Meaning and purpose in life are important aspects of the life experience of individuals. These aspects of life have often been studied using psychological and quantitative approaches addressing meaning and purpose across the life span. However, there is a dearth of studies of meaning and purpose in care home (nursing) life. This care sector has an important contribution to make nationally and internationally to the lives of older people who require long-term care. This study addresses the gap in the body of knowledge by exploring how to enhance meaning and purpose in the lives of care home (nursing) residents.This study of meaning and purpose in the lives of care home (nursing) residents was undertaken using an appreciative inquiry methodology. Two U.K. care homes (nursing) were the settings for the study; 20 residents and 25 members of staff were included in the sample of the study. The residents who participated in the study had moved into the care homes because of their physical disabilities. None of the residents who participated in the study had appreciable cognitive incapacity. Data were collected using life story interviews, structured interviews and focus groups. Data were constructed during the four stages of appreciative inquiry: Discovery, Dream, Design and Destiny. The data were analysed using the Framework Analysis approach. The findings of the study provide clear definitions of meaning and purpose in care home (nursing) life. The knowledge generated addresses the required focus on the creation of opportunities for residents to flourish and optimise their potential in order to enhance meaning and purpose in their lives. The ways in which care home staff can support residents enhance meaning and purpose in their care home experience through the physical setting, valuing of residents’ identities, the dynamics of relationships, the focus of activities and the component of care are articulated. This study presents the benefits of appreciative inquiry dialogue as a way of enhancing meaning and purpose in the lives of care home residents

Diversity and inclusiveness in dementia: Listening event report

This report provides feedback from a Listening Event held in Salford on March 10th, 2014 which explored issues in relation to diversity and inclusiveness and dementia and captured the views of professionals, service providers and people living in the Salford area. The aim of the event was to learn from and with people from different communities how we (Salford Institute for Dementia, Greater Manchester West Mental Health Foundation Trust, Alzheimer’s Society and other partner organisations) can meet the needs of people with dementia in a way that responds to diversity by promoting inclusivity

A day that unites all nurses

Comment article

Student experiences of nursing on the front line during the COVID-19 pandemic

This article provides the reflections of three University of Salford student nurses. Two have experience of working on the front line during the COVID-19 pandemic. One has now qualified as a registered nurse. The crucial role of students' personal tutors is also presented

Alcohol and cocaine use prior to suspected suicide: Insights from toxicology

Introduction This study investigates whether there is a relationship between alcohol and cocaine use in deaths where suicide by self-injury is the suspected cause of death. Methods Adults referred by coroners to the Imperial College London Toxicology Unit for toxicological analysis between 2012 and 2016 were reviewed for inclusion criteria. Those who died by self-injury reasoned to be deliberate were included in the analysis. Femoral blood alcohol concentration (BAC) and presence of cocaine or benzoylecognine (a metabolite of cocaine) in blood and/or urine were tabulated and odds ratios calculated. Results A total of 1722 decedents met inclusion criteria. BAC was ≥50 mg/dL in 29% of decedents. Cocaine was detected in 8.4% of cases. The likelihood of testing positive for cocaine increased with BAC and was most frequent between 100 and 199 mg/dL, consistent with moderate to severe intoxication (odds ratio 5.88, 95% confidence interval 3.80, 9.09; P ≤ 0.001) compared to those with BAC <10 mg/dL. Discussion and Conclusions This study demonstrates a correlation between increasing BAC and likelihood of cocaine use prior to suspected suicide, up to a level consistent with severe intoxication. Cocaine use was found in a high proportion of cases relative to the general population reporting regular use. This pattern of drug and alcohol use has previously been given little attention in suicide prevention strategies and clinical prioritisation

The illusion of competency versus the desirability of expertise: Seeking a common standard for support professions in sport

In this paper we examine and challenge the competency-based models which currently dominate accreditation and development systems in sport support disciplines, largely the sciences and coaching. Through consideration of exemplar shortcomings, the limitations of competency-based systems are presented as failing to cater for the complexity of decision making and the need for proactive experimentation essential to effective practice. To provide a better fit with the challenges of the various disciplines in their work with performers, an alternative approach is presented which focuses on the promotion, evaluation and elaboration of expertise. Such an approach resonates with important characteristics of professions, whilst also providing for the essential ‘shades of grey’ inherent in work with human participants. Key differences between the approaches are considered through exemplars of evaluation processes. The expertise-focused method, although inherently more complex, is seen as offering a less ambiguous and more positive route, both through more accurate representation of essential professional competence and through facilitation of future growth in proficiency and evolution of expertise in practice. Examples from the literature are also presented, offering further support for the practicalities of this approach

On the Importance of Countergradients for the Development of Retinotopy: Insights from a Generalised Gierer Model

During the development of the topographic map from vertebrate retina to superior colliculus (SC), EphA receptors are expressed in a gradient along the nasotemporal retinal axis. Their ligands, ephrin-As, are expressed in a gradient along the rostrocaudal axis of the SC. Countergradients of ephrin-As in the retina and EphAs in the SC are also expressed. Disruption of any of these gradients leads to mapping errors. Gierer's (1981) model, which uses well-matched pairs of gradients and countergradients to establish the mapping, can account for the formation of wild type maps, but not the double maps found in EphA knock-in experiments. I show that these maps can be explained by models, such as Gierer's (1983), which have gradients and no countergradients, together with a powerful compensatory mechanism that helps to distribute connections evenly over the target region. However, this type of model cannot explain mapping errors found when the countergradients are knocked out partially. I examine the relative importance of countergradients as against compensatory mechanisms by generalising Gierer's (1983) model so that the strength of compensation is adjustable. Either matching gradients and countergradients alone or poorly matching gradients and countergradients together with a strong compensatory mechanism are sufficient to establish an ordered mapping. With a weaker compensatory mechanism, gradients without countergradients lead to a poorer map, but the addition of countergradients improves the mapping. This model produces the double maps in simulated EphA knock-in experiments and a map consistent with the Math5 knock-out phenotype. Simulations of a set of phenotypes from the literature substantiate the finding that countergradients and compensation can be traded off against each other to give similar maps. I conclude that a successful model of retinotopy should contain countergradients and some form of compensation mechanism, but not in the strong form put forward by Gierer