Negotiating nursing

Negotiating nursing explores how the Queen Alexandra's Imperial Military Nursing Service (Q.A.s) salvaged men within the sensitive gender negotiations of what should and could constitute nursing work and where that work could occur. The book argues that the Q.A.s, an entirely female force during the Second World War, were essential to recovering men physically, emotionally and spiritually from the battlefield and for the war, despite concerns about their presence on the frontline. The book maps the developments in nurses’ work as the Q.A.s created a legitimate space for themselves in war zones and established nurses’ position as the expert at the bedside. Using a range of personal testimony the book demonstrates how the exigencies of war demanded nurses alter the methods of nursing practice and the professional boundaries in which they had traditionally worked, in order to care for their soldier-patients in the challenging environments of a war zone. Although they may have transformed practice, their position in war was highly gendered and it was gender in the post-war era that prevented their considerable skills from being transferred to the new welfare state, as the women of Britain were returned to the home and hearth. The aftermath of war may therefore have augured professional disappointment for some nursing sisters, yet their contribution to nursing knowledge and practice was, and remains, significant

Data Changes Everything - An Investigation Into The Acceptance Of Learning Analytics To Support Student Success

The development and implementation of learning analytics as a mechanism to support student success has been an emerging trend within Higher Education. Previous research identifies that learning analytics is an innovative educational development but recognises that little attention has been paid to evaluating its effectiveness or pedagogic usefulness. Researchers recognise that learning analytics is a new field in need of further research to aid its credibility within the educational arena. This research study provides a better understanding of learning analytics to support student success through the examination of opportunities and challenges of learning analytics from a multi-stakeholder perspective. This study also demonstrates how learning analytics can be successfully implemented within Higher Education. Through an interpretivist paradigm, this cross-sectional research study captures the unique experiences of students, academic staff and learning analytics experts. Data collected through twelve semi-structured interviews and three student focus groups enabled the researcher to gather a broad understanding of learning analytics from those involved and provides an holistic portrayal from this cultural group. The main findings of this study suggest that learning analytics need to have a clear context and purpose within Higher Education to ensure successful development, effectiveness and pedagogic usefulness. Effective organisational change, culture, academic and student engagement, ownership and motivation are paramount. Findings also indicate disparities in the implementation of learning analytics within Higher Education, which require resolution to ensure success, and there is some discussion about how challenges can be overcome to ensure effective institutional adoption and student success

"It's not just about the patient, it's the families too.": End of life care in the home environment

Introduction: Most people when asked say they would prefer to die at home. However, ‘Death in Usual Place of Residence’ (DiUPR) does not give any real insight into the quality and experiences of care received. Additionally, DiUPR involves other family members resident in the home environment and their needs, preferences and experiences also need consideration. Aim(s) and Method(s): The aim of this work was to explore the experiences of patients and informal caregivers receiving at-home care from a specialist palliative care service. We undertook individual interviews with 11 patients and 10 significant others. We used the Pictor technique, a novel interview tool used to sensitively explore networks of support and experiences of palliative care. Interviews were analysed thematically. Results: Caring for a loved one at home was acknowledged as draining, but participants were effusive about the excellent at-home professional support they received from the specialist service. The care provided evidently recognised the needs of both patients and their families. Effective co-ordination of care, including liaison with other services was especially appreciated. Conclusion(s): With increasing trends towards DiUPR, it is vital that there are sufficient well-resourced palliative care services available in the community to support both patients and their families at the end of life. Pictor is a useful means to obtain detailed insight into individual experiences of end of life care. Care co-ordination emerged as key concern for patients receiving End of Life Care and their families

Beyond the accusation of plagiarism

The paper explores the complexity of the notion of plagiarism from sociocultural and psychological perspectives. Plagiarism is a dynamic and multi-layered phenomenon (Russikoff et al., 2003; Sutherland-Smith, 2005) and needs to be understood in relation to a specific context of academic conventions and environment. Drawing upon the experiences of ten Chinese students on a pre-sessional course and subsequently their postgraduate courses, the paper investigates change in these students’ perceptions of plagiarism in a different academic community over time. Three English tutors who taught the students on the pre-sessional course were also interviewed to compare their judgment of plagiarism with the students’ own accounts of their writing experience. Early results from the study and an extensive review of the literature on plagiarism suggest that learning to write in an unfamiliar academic discourse requires, at the deepest level, the students’ cultural appropriation of their conceptual understanding of the way of writing and of the meaning of using the literature to develop their written argumentation. This learning process spans a developmental continuum involving the learners overcoming emotional tensions which arise from changes in their cognition, senses of identity and sociocultural values. A holistic and developmental perspective is thus required to understand changes in students’ perception of plagiarism as part of their wider adaptation to the academic conventions of their host countries

Impulsivity and Compulsivity in Anorexia Nervosa: Cognitive Systems Underlying Variation in Appetite Restraint from an RDoC Perspective

Contemporary nomenclature for anorexia nervosa (AN) describes the eating disorder as transdiagnostic, with overlapping facets of impulsivity and compulsivity contributing to variations in binge-purge, restrictive eating and maladaptive cognitions. It is important to understand how these facets interact, given that those diagnosed with AN often fluctuate and relapse–as opposed to maintaining a stable diagnosis—between Diagnostic and Statistical Manual version 5 (DSM-5) categories, over the life course. The National Institute of Health’s Research Domain Criteria (NIH RDoC) subscribes to the transdiagnostic view of mental disorders and provides progressive guidelines for neuroscience research. As such, using the RDoC guidelines may help to pinpoint how impulsivity and compulsivity contribute to the cognitive mechanisms underlying variations in appetite restraint in eating disorders and common psychiatric comorbidities such as anxiety and obsessive-compulsive disorder. Exploring impulsivity and compulsivity in AN from the perspective of the RDoC cognitive systems domain is aided by measures of genetic, molecular, cellular, neural, physiological, behavioural and cognitive task paradigms. Thus, from the standpoint of the RDoC measures, this chapter will describe some of the ways in which impulsivity and compulsivity contribute to the cognitive systems associated with appetite restraint in AN, with the aim of further clarifying a model of appetite restraint to improve treatment interventions

The Use of Wearable Technology to Measure Energy Expenditure, Physical Activity and Sleep Patterns in Dementia.

Project Description Unexplained weight loss is frequently observed in dementia leading to further cognitive decline, frailty and disability. Apparent mechanisms that could lead to weight loss (lower energy intake and/or higher expenditure) remain unresolved and may be different in the various stages and types of dementia. During the progression of the illness, the extent to which altered sleep duration and variable physical activity patterns (intermittent or constant pacing/lying down) could affect weight loss is unknown. We have used an innovative light weight physical activity monitor (Sensewear TM Armband, Body Media, Pittsburgh, PA) to objectively determine total energy expenditure (TEE), sleep duration, physical activity and number of steps in people with dementia living in care homes. The armband was placed around the left upper triceps for up to 7 days. The device measures tri-axial acceleration, skin temperature, galvanic skin response and heat flux and has been shown to be valid in resting, exercise and free-living conditions in older people. The mean age of the residents (n=20) was 78.5 (58-99) years, 50% were women with confirmed diagnosis of a range of dementia types. Body Mass Index (BMI) was 23.0 (range 13.7-30.0) kg/m2 with 40% classified as underweight, 50% normal range, 10% overweight. Duration of sleeping ranged from 0.4-12.5 (mean 5.9) hrs/d and time spent lying down was 1.0-16.0 (8.1) hrs/d. On average residents spent 17.4 (6.0-23.7) hrs/d undertaking sedentary activity. Sleeping duration was inversely related to body weight (r= -0.46, p<0.05) and TEE (r= -0.59, P<0.01). There was an inverse association between time lying down for both body weight (r= -0.45, p<0.05) and TEE (r= -0.62, p<0.01).TEE was positively correlated with number of steps per day (r= 0.45, p<0.05). There was no relationship between TEE or BMI and the amount of physical activity. Variable patterns of physical activity and sleep duration demonstrates the need to recognise the influence of these factors on meeting energy requirements and the challenge of providing appropriate food and nutrition within the care home environment. Thus wearable technology has the potential to offer real-time feedback to support better nutritional management and improve efforts to prevent weight loss in dementia

Understanding the strategies required to meet hydration needs of people living with dementia.

BackgroundDementia can increase the risk of dehydration as cognitive impairment and old age reduce the ability to recognise thirst. Dehydration can cause further deterioration in cognitive function and other health problems. There is no consensus on recommended fluid intakes for dementia but generally 1500 ml per day is regarded as sufficient. However the challenges of meeting appropriate hydration continue to be reported. The aim of this study, using quantitative and qualitative methods was to gain a deeper understanding of the strategies required to understand hydration needs of people living with dementia.MethodsQuantitative measures of fluid intake were recorded over a period of five days in residents (n=18) who were living in care homes. The mean age of the residents was 79 (104-58) years, 50% were women with a diagnosis of a range of dementia types. Qualitative research using a blend of nine focus groups and five semi structured interviews were conducted with all those involved in the care of people with dementia, including nurses, managers, chefs, care workers, family members, dietitians and speech and language therapists. Thematic analysis of transcripts enabled core themes to be explored.ResultsThe daily intake of fluid was 1065 ± 836 ml (mean ± 2 standard deviations). Fifteen (83%) residents did not meet the recommended fluid intake. The qualitative themes highlighted ways to overcome poor fluid intake and included alternative ways to improve hydration; a person centred approach to delivering fluid with a recognition of psychosocial and cultural influences; communication between front-line staff and key healthcare professionals.ConclusionsUsing this combined methodological approach, the results show that new strategies are needed to meet the hydration needs, with a person centred approach to care for people living with dementia. It is important to ensure all staff are well trained and competent to encourage sufficient fluid intake

The effect on biological performance and faecal microbiology of feeding finishing pigs on liquid diets fermented with lactic bacteria

Thirty-two Hermitage-Seaborough, Hybrid pigs, were allocated at 16 weeks of age to a randomized block design with four treatments and four replicates