Being ‘with woman’ in contemporary midwifery practice: one Trust's response to the Francis report

Whilst the Report of the Mid Staffordshire NHS Foundation Trust (Francis, 2013a) largely focussed on the failings in the nursing and medical professions, it was also a reminder to maternity services to review its systems and the quality of its care in line with the Code (NMC, 2015). This article will outline an initiative set up by two labour ward matrons at Kettering General Hospital Foundation Trust entitled ‘Back to Basics’. Sue and Kathy reviewed clinical practises in their maternity unit and put in place an initiative to raise standards of care and ensure best practice was recognised, maintained and disseminated

Opportunistic premise plumbing pathogens. A potential health risk in water mist systems used as a cooling intervention

Water mist systems (WMS) are used for evaporative cooling in public areas. The health risks associated with their colonization by opportunistic premise plumbing pathogens (OPPPs) is not well understood. To advance the understanding of the potential health risk of OPPPs in WMS, biofilm, water and bioaerosol samples (n = 90) from ten (10) WMS in Australia were collected and analyzed by culture and polymerase chain reaction (PCR) methods to detect the occurrence of five representative OPPPs: Legionella pneumophila, Pseudomonas aeruginosa, Mycobacterium avium, Naegleria fowleri and Acanthamoeba. P. aeruginosa (44%, n = 90) occurred more frequently in samples, followed by L. pneumophila serogroup (Sg) 2–14 (18%, n = 90) and L. pneumophila Sg 1 (6%, n = 90). A negative correlation between OPPP occurrence and residual free chlorine was observed except with Acanthamoeba, rs (30) = 0.067, p \u3e 0.05. All detected OPPPs were positively correlated with total dissolved solids (TDS) except with Acanthamoeba. Biofilms contained higher concentrations of L. pneumophila Sg 2–14 (1000–3000 CFU/mL) than water samples (0–100 CFU/mL). This study suggests that WMS can be colonized by OPPPs and are a potential health risk if OPPP contaminated aerosols get released into ambient atmosphere

Walking the Food Security Tightrope-Exploring the Experiences of Low-to-Middle Income Melbourne Households

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).There is limited evidence of how Australian low-to-middle income (AUD $40,000–$80,000) households maintain food security. Using a sequential explanatory mixed methods methodology, this study explored and compared the food security (FS) and insecurity (FIS) experiences of these households. An initial quantitative survey categorised participants according to food security status (the 18-item United States Department of Agriculture Household Food Security Survey Module) and income level to identify and purposefully select participants to qualitatively explore food insecurity and security experiences. Of the total number of survey participants (n = 134), 42 were categorised as low-to-middle income. Of these, a subset of 16 participants (8 FIS and 8 FS) was selected, and each participant completed an in-depth interview. The interviews explored precursors, strategies to prevent or address food insecurity, and the implications of the experience. Interview data were analysed using a thematic analysis approach. Five themes emerged from the analysis: (i) food decision experiences, (ii) assets, (iii) triggers, (iv) activation of assets, and (v) consequences and emotion related to walking the food security tightrope. The leverage points across all themes were more volatile for FIS participants. Low-to-middle income Australians are facing the challenges of trying to maintain or improve their food security status, with similarities to those described in lower income groups, and should be included in approaches to prevent or address food insecurity

Pathogenic potential of respirable spodumene cleavage fragments following application of regulatory counting criteria for asbestiform fibres

Health risks from exposure to lithium-bearing spodumene cleavage fragments are unknown. While asbestiform fibres can lead to fibrosis, mesothelioma and lung cancer, controversy remains whether non-asbestiform cleavage fragments, having equivalent dimensions, elicit similar pathologic responses. The mineralogy of respirable particles from two alpha (α) - spodumene concentrate grades (chemical and technical) were characterised using semi-quantitative X-ray diffraction (XRD). Particles were measured using scanning electron microscopy (SEM) and the dimensions (length [L], diameter [D], aspect ratio [AR]) applied to regulatory counting criteria for asbestiform fibres. Application of the current World Health Organization (WHO) and National Occupational Health and Safety Commission (NOHSC) counting criteria, L ˃ 5 µm, D ˂ 3 µm, AR ˃ 3 : 1, to 10 SEM images of each grade identified 47 countable particles in the chemical and 37 in the technical concentrate test samples. Of these particles, 17 and 16 in the chemical and technical test samples, respectively, satisfied the more rigorous, previously used Mines Safety and Inspection Regulations 1995 (Western Australia [WA]) criteria, L ˃ 5 µm and D ≤ 1 µm. The majority of the countable particles were consistent with α - spodumene cleavage fragments. These results suggest elongated α - spodumene particles may pose a health risk. It is recommended the precautionary principle be applied to respirable α - spodumene particles and the identification and control of dust hazards in spodumene extraction, handling and processing industries be implemented

The realities of storing carbon dioxide - A response to CO2 storage capacity issues raised by Ehlig-Economides & Economides

In a recent publication, Ehlig-Economides & Economides (2010) have sought to demonstrate that carbon dioxide capture and storage (CCS) is not technically or economically feasible, based on a supposed lack of underground storage capacity. We consider this to be a serious misrepresentation of the scientific, engineering and operational facts surrounding CCS. Ehlig-Economides & Economides raise a number of storage related issues: reservoir boundaries, capacity, pressure management, storage integrity, dissolution and storage in depleted reservoirs. We take each one in turn, highlighting specific errors in the paper but also drawing attention to more general background issues. Finally, we discuss in more detail some inconsistencies in the paper surrounding the reservoir engineering calculations

Assessment of student competency in a simulated speech-language pathology clinical placement

“This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Speech-Language Pathology on 30 August 2013, available online: http://wwww.tandfonline.com/10.3109/17549507.2013.809603.” http://dx.doi.org/10.3109/17549507.2013.809603.Clinical education programs in speech-language pathology enable the transition of students’ knowledge and skills from the classroom to the workplace. Simulated clinical learning experiences provide an opportunity to address the competency development of novice students. This study reports on the validation of an assessment tool designed to evaluate speech-language pathology students’ performance in a simulated clinical placement. The Assessment of Foundation Clinical Skills (AFCS) was designed to link to concepts and content of COMPASS®: Competency Assessment in Speech Pathology, a validated assessment of performance in the workplace. It incorporates units and elements of competency relevant to the placement. The validity of the AFCS was statistically investigated using Rasch analysis. Participants were 18 clinical educators and 130 speech-language pathology students undertaking the placement. Preliminary results support the validity of the AFCS as an assessment of foundation clinical skills of students in this simulated clinical placement. All units of competency and the majority of elements were relevant and representative of these skills. The use of a visual analogue scale which included a pre-Novice level to rate students’ performance on units of competency was supported. This research provides guidance for development of quality assessments of performance in simulated placements

Evaluation of a structured preceptorship programme

Preceptorship is a period in which newly qualified staff nurses receive support from an experienced nurse to smooth their transition into the service. District nurses (DNs) from the authors' trust informally expressed the need for a better transition between the completion of district nursing education and entry into the workforce. Hence, a structured preceptorship programme was developed and delivered. This article describes this service initiative and its evaluation by preceptors (n=14) and preceptees (newly qualified DNs; n=13). Both groups valued having a structured preceptorship programme. Preceptees agreed that having a named preceptor was very important, and preceptors felt that the role which they played was rewarding. Both groups felt that the role of the DN was a specialist role and that the preceptorship programme helped to support newly qualified staff make the transition into qualified DNs, clinical team leaders and, ultimately, caseload holders. A large-scale study of DN practice is required to develop a national consensus on the structure and content of preceptorship programmes for district nursing

Meeting the needs of people with aphasia, their families and speech-language pathologists: tensions in the goal-setting process

Goal-setting is an integral part of rehabilitation and it has been proposed that poor outcomes may be attributed to a mismatch between the goals of clients and the rehabilitation team (van den Broek, 2005). The aim of this multisite qualitative study was to describe the goals of 50 people with aphasia and their family members and compare these to their treating speech-language pathologists’ goals. In-depth interviews revealed the primary tensions in the process revolved around the importance of the clinical relationship, the influence of context, the translation of goals, hope, information, and family members as clients