Developing nurse-sensitive outcomes in acute inpatient mental health settings—A systematic review

Background: While nurse-sensitive outcomes (NSOs) are well established in numerous health settings, to date there is no indicator suite of NSOs for inpatient mental health settings. Aim: To assess the relationship between nursing variables and patient outcomes in acute inpatient mental health settings to determine which outcomes can be used as indicators of the quality of nursing care. Methods: Databases accessed were CINAHL, MEDLINE, PsycINFO and EMBASE, last searched in May 2022. The review followed the 2020 PRISMA checklist for systematic reviews. Papers published between 1995 and 2022, conducted in acute mental health care units were included. The quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool. A meta-analysis was not possible because of the large number of variables and measurement inconsistencies. Results: A total of 57 studies were reviewed. Studies were categorised according to whether they found a significant or non-significant relationship between nurse variables and patient outcomes. Seven outcomes—aggression, seclusion, restraint, absconding, pro-re-nata medications, special observations and self-harm—were identified. For each outcome, there were significant findings for several nurse variables indicating that all included outcomes could be used as NSOs. However, evidence for aggression, seclusion and restraint use as suitable NSOs was more robust than the evidence for self-harm, absconding, pro-re-nata medications and special observations. Conclusion: All the seven outcomes can all be used to develop an NSO indicator suite in mental health inpatient settings. More work is needed to establish high-quality studies to clearly demonstrate the relationship between these outcome measures and changes in nurse variables such as nurse staffing, skill mix, work environment, nurse education and nurse experience. Patient and Public Contribution: Patient or public contribution was not possible because of the type of the variables being explored

Illuminating Lesser Garth Cave, Cardiff: the human remains and post-Roman archaeology in context

During a series of relatively poorly documented excavations carried out during 1912–14 and 1963–64 human bone was recovered from Lesser Garth Cave near Cardiff. Published reports of the cave investigations focused on the artefactual evidence, and the wide range of possible dates and interpretations concerning the human bones have failed to provide a reliable basis for understanding the significance of the remains within the cave’s biography. This paper presents new scientific evidence regarding the human remains including findings from full osteological analysis, targeted carbon, nitrogen, oxygen and strontium isotope analysis and a programme of radiocarbon dating. Analysis records seven individuals, with a minimum of five if the fifty-year excavation gap is ignored. The radiocarbon dates suggest intermittent human presence in the cave from the post-Roman to the postmedieval periods. The paper also offers a reappraisal of post-Roman artefacts, and re-assessment of this site in the context of the diverse ways in which caves are now understood to have been used during this period

The Mary Rose site - geophysical evidence for palaeo-scour marks

Chirp sub-bottom imaging of scour pits around the original position of the Mary Rose

The thing about replicas - why historic replicas matter

Reproduction of archaeological material was a significant and serious enterprise for antiquarians and museums in the long nineteenth century. Embedding many stories and embodying considerable past human energy, behind their creation, circulation, use and after-life lies a series of specific social networks and relationships that determined why, when and in what circumstances they were valued, or not. Summarising the context of their production, circulation and changing fortunes, this paper introduces the ways in which they are important and the specific benefits and aspects of a biographical approach to their study. Beyond the evidential, the study of existing replicas provides a historical and contemporary laboratory in which to explore the concepts of value and authenticity, and their application in cultural heritage and collections management, offering us a richer insight into the history of ourselves as archaeologists and curators

Spirit, mind and body: the archaeology of monastic healing

Archaeology and material culture are used in this chapter to consider how monastic experience responded to illness, ageing and disability. The approach taken is influenced by the material study of religion, which interrogates how bodies and things engage to construct the sensory experience of religion, and by practice-based approaches in archaeology, which examine the active role of space and material culture in shaping religious agency and embodiment. The archaeology of monastic healing focuses on the full spectrum of healing technologies, from managing the body in order to prevent illness, through to the treatment of the sick and preparation of the corpse for burial

Writing in Britain and Ireland, c. 400 to c. 800

No abstract available

‘Fire Burn and Cauldron Bubble’: Iron Age and Early Roman Cauldrons of Britain and Ireland

‘A man can live to 50 but a cauldron will live to 100’ – Old Kazakh sayingThis paper presents a re-examination of Iron Age and early Roman cauldrons, a little studied but important artefact class that have not been considered as a group since the unpublished study of Loughran of 1989. Cauldrons are categorised into two broad types (projecting-bellied and globular) and four groups. New dating evidence is presented, pushing the dating of these cauldrons back to the 4th centurybc. A long held belief that cauldrons are largely absent from Britain and Ireland between 600 and 200bcis also challenged through this re-dating and the identification of cauldrons dating from 600–400bc. Detailed examination of the technology of manufacture and physical evidence of use and repair indicates that cauldrons are technically accomplished objects requiring great skill to make. Many have been extensively repaired, showing they were in use for some time. It is argued that owing to their large capacity cauldrons were not used every day but were instead used at large social gatherings, specifically at feasts. The social role of feasting is explored and it is argued that cauldrons derive much of their significance from their use at feasts, making them socially powerful objects, likely to be selected for special deposition.This is the author's accepted manuscript. The final version is published by CUP in Proceedings of the Prehistoric Society: http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9392057&fileId=S0079497X14000073

Population genomics of the Viking world.

The maritime expansion of Scandinavian populations during the Viking Age (about AD 750-1050) was a far-flung transformation in world history1,2. Here we sequenced the genomes of 442 humans from archaeological sites across Europe and Greenland (to a median depth of about 1×) to understand the global influence of this expansion. We find the Viking period involved gene flow into Scandinavia from the south and east. We observe genetic structure within Scandinavia, with diversity hotspots in the south and restricted gene flow within Scandinavia. We find evidence for a major influx of Danish ancestry into England; a Swedish influx into the Baltic; and Norwegian influx into Ireland, Iceland and Greenland. Additionally, we see substantial ancestry from elsewhere in Europe entering Scandinavia during the Viking Age. Our ancient DNA analysis also revealed that a Viking expedition included close family members. By comparing with modern populations, we find that pigmentation-associated loci have undergone strong population differentiation during the past millennium, and trace positively selected loci-including the lactase-persistence allele of LCT and alleles of ANKA that are associated with the immune response-in detail. We conclude that the Viking diaspora was characterized by substantial transregional engagement: distinct populations influenced the genomic makeup of different regions of Europe, and Scandinavia experienced increased contact with the rest of the continent