a new species of laboulbenia ascomycota parasitic on an african fly diptera curtonotidae with a brief review of diptera associated species of the genus

A new parasitic fungus, Laboulbenia curtonoti sp. n., associated with the endemic Madagascan fly Curtonotum balachowskyi Tsacas (Diptera: Curtonotidae), is described and figured. The new species is one of the very few Laboulbeniales which penetrate the insect's cuticle by means of more-or-less developed rhizoids. A brief review of the 23 species of the genus Laboulbenia associated with Diptera is presented in a tabulated form

A systematic revision of selected genera of afrotropical curtonotidae (Diptera: schizophora: ephydroidea) : a phylogenetic approach

The first comprehensive phylogeny of the family Curtonotidae is presented based on molecular markers and morphology. This enabled assessment of evolutionary relatedness, species radiation and zoogeography. A revised classification of the world fauna of the family, based on the results of this study is outlined. Nomenclatural acts flowing from these analyses include: the recognition three new Afrotropical species of Axinota van der Wulp; four new species of a new genus, Tigrisomyia Kirk-Spriggs; and nineteen new species of Curtonotum (six Madagascan and thirteen African). Ten informal species-groups of Curtonotum are recognised. Identification keys are provided for the Afrotropical species of these genera and errors in previous interpretations and designation of type specimens are resolved. Species distributions are mapped and interpreted and discussion is made of the historical biogeographical significance of these distributions

Evaluation of a multidisciplinary adult integrated respiratory service in the UK.

Rationale, aims and objectives: Care integration, particularly for patients with long-term chronic conditions has been viewed as a key imperative for service improvement over the last decade [1]. In common with other industrialised nations, major care providers such as the National Health Service (NHS) in the United Kingdom (UK) have undertaken service evaluation to identify factors for effective integrated care in the context of increasing demand but also cost-constraints. The aim of this paper is to report on an early process evaluation of a newly established Adult Integrated Respiratory Service (AIRS) in three localities in England. Method: Applied qualitative methods using semi-structured interviews with clinical practitioners (n=19) plus focus group with service users (n=5). University research ethics approval was secured. Findings: Despite finding staff commitment and enthusiasm for a new regional approach, as well as a very positive acclaim from service users, the study highlighted personal and organisational issues and concerns during the first four months of service implementation. The analysis revealed four inter-related themes: service in transition; resistance to change; communication; and challenges to integrated working. The findings support conceptual and organisational elements of integrated care described elsewhere [2, 3]. The role of leadership and change management in the successful implementation of integrated care is explored. Conclusions: The findings from a regional adult integrated respiratory service evaluation in England highlights the potential of collective leadership with authentic involvement of all stakeholders to effect successful change to build locally owned models for integrated care. Further longitudinal research would yield valuable insights as the service evolves

Dorset Adult Integrated Care Service (DAIRS): Service Evalaution

EXECUTIVE SUMMARY This early process evaluation of the newly established Dorset Adult Integrated Respiratory Service (DAIRS) in three localities in Dorset was conducted by Bournemouth University using a mixed-methods approach. Our evaluation showed staff commitment and enthusiasm for a pan-Dorset approach to respiratory care and a very positive acclaim from service users. Mindful of the fact that DAIRS had been in operation for four months only, the evaluation flags up strengths and issues of concern at the initial stages of service implementation. Discussion of the findings has been linked with current thinking to emerge in the White Paper from NHS Improving Quality around service improvement and change management (Bevan & Fairman, 2014). Given that DAIRS has been commissioned in the first instance for a period of two years, this early evaluation will be valuable for stakeholders to address the issues raised in a timely manner. Recommendations 1. Build upon the high levels of satisfaction to engage service user users more widely in the on-going development of DAIRS. 2. Shared documentation needs to be agreed and implemented as soon as possible, including the DAIRS card. 3. DAIRS should be officially launched with appropriate information for different stakeholders: service users, community staff and non-DAIRS hospital staff. 4. The change process should be actively managed; concerns and challenges expressed by participants should be acknowledged and a supportive environment provided for collaborative problem-solving. 5. Consider selection and use of grass roots ‘change champions’ across the sites and disciplines to facilitate a more inclusive model of organisational change. 6. Further integration between localities should be explored particularly around staff education, as well as to facilitate on-going peer support. 7. New staff would benefit from being supernumerary for their first month and visiting neighbouring DAIRS localities. 8. Inclusion and exclusion criteria need to be revisited to ensure a shared understanding amongst DAIRS staff, particularly around co-morbidities. 9. Information and service provision concerning emotional support for service users and carers needs to be reviewed. 10. The current Single Point of Access System (SPOA) should be reviewed to improve compliance. 11. Information Technology (IT) systems and possibilities for joint DAIRS systems should be explored. 12. Perceived financial inequities need to be addressed in service planning. 13. Our evaluation provides a base-line for future work, a further more comprehensive evaluation after two years of DAIRS operation is needed to inform future funding and service development. Suggested factors to include: • Outcome data • Cross-locality service user involvement (avoiding winter peak time), using systematic PREM questionnaire distribution processes. • Community staff perspectives. • Input from related respiratory services, currently not part of DAIRS. • Investigation of impact of a differing skill mix across localities. • More detailed service user feedback. • Evaluation of staff education (DAIRS and non-DAIRS)

Design and evaluation protocol for ‘DEALTS 2’: a simulation-based dementia education intervention for acute care settings.

Background There is a paucity of simulation-based dementia education programmes for acute care settings that support the development of interpersonal skills pertinent to good care. Moreover, few studies measure the effectiveness of such programmes by evaluating the persistence of practice change beyond the immediate timeframe of the workshops. We were commissioned by Health Education England (HEE) to develop and evaluate ‘DEALTS 2’, a national simulation-based education toolkit informed by the Humanisation Values Framework, developed at Bournemouth University and based on an experiential learning approach to facilitate positive impacts on practice. This paper describes the process of developing DEALTS 2 and the protocol for evaluating the impact of this intervention on practice across England. Methods Intervention development: Following an initial scoping exercise to explore the barriers and enablers of delivering the original DEALTS programme, we developed, piloted and rolled out DEALTS 2 across England through a Train the Trainer (TTT) model. Key stakeholders were asked to critically feedback during the development process. Evaluation design: Mixed methods approach underpinned by Kirkpatrick Model for evaluating effectiveness of training; assessing reaction, learning, behaviour and results. Evaluation forms and telephone interviews (quantitative and qualitative) with trainers that attended TTT workshops (n=196) and, once implemented in individual Trusts, the staff that the trainers train. Conclusions Evaluation of implementation and impact on care delivery for people with dementia will provide evidence of effectiveness. This will support the future development of simulation-based education programmes, amidst the current complexity of pressure in resource limited healthcare settings

Barriers and enablers to implementing ‘DEALTS2’ simulation-based train-the–trainer dementia training programme in hospital settings across England: a qualitative study.

Background Despite approaches to provide effective dementia training in acute care settings, little is known about the barriers and enablers to implement and embed learning into practice. We were commissioned by Health Education England to develop and evaluate a new dementia training intervention ‘Dementia training And Learning Through Simulation 2’ (DEALTS2), an innovative simulation toolkit to support delivery of dementia training in acute care across England. This study aimed to explore barriers and enablers experienced by trainers implementing DEALTS2 and extent to which it impacted on delivery of training and staff clinical practice. Methods We conducted twelve one-day DEALTS2 train-the-trainer (TTT) workshops across England in 2017 for National Health Service Trust staff employed in dementia training roles (n=199 trainers); each receiving a simulation toolkit. Qualitative data were collected through telephone interviews 6-8 months after TTT workshops with 17 of the trainers. Open ended questions informed by the Kirkpatrick model enabled exploration of implementation barriers, enablers, and impact on practice. Results Thematic analysis revealed six themes: four identified interrelated factors that influenced implementation of DEALTS2; and two outlined trainers perceived impact on training delivery and staff clinical practice, respectively: (i) flexible simulation and implementation approach (ii) management support and adequate resources (iii) time to deliver training effectively (iv) trainer personal confidence and motivation (v) trainers enriched dementia teaching practice (vi) staff perceived to have enhanced approach to dementia care. Trainers valued the DEALTS2 TTT workshops and adaptability of the simulation toolkit. Those supported by management with adequate resources and time to deliver effective dementia training, were likely to implement DEALTS2. Trainers described positive impacts on their teaching practice; and perceived staff had enhanced their approach to caring for people with dementia. Conclusions Trainers explained individual and organisational barriers and enablers during implementation of DEALTS2. The flexible simulation and implementation approach were key to supporting adherence of DEALTS2. To ensure wider implementation of DEALTS2 nationally, Trusts need to allocate appropriate time to deliver effective dementia training. Future research should measure staff behaviour change, patient perspectives of the intervention, and whether and how DEALTS2 has improved health and care outcomes

Impact of ‘DEALTS2’ education intervention on trainer dementia knowledge and confidence to utilise innovative training approaches: A national pre-test – post-test survey

Background Gaps in acute care staff knowledge, skills, and attitudes towards dementia exist. Innovative training approaches that improve the delivery of care for people with dementia are needed. We were commissioned by Health Education England to develop and evaluate a new dementia education intervention ‘Dementia Education And Learning Through Simulation 2’ (DEALTS2), a simulation toolkit to enhance delivery of dementia training nationally across England. Objectives Evaluate differences in trainer dementia knowledge scores pre and post training, satisfaction with DEALTS2 Train-The-Trainer (TTT) workshops and simulation toolkit, confidence to use training approaches, and spread of implementation. Design A questionnaire survey using a pre-test – post-test design with measures completed: before (pre-test); after (T1); and 12 months post training (T2). Setting Twelve one-day DEALTS2 TTT workshops delivered across England in 2017. Participants National Health Service Trust staff employed in dementia training roles (n=199 trainers). Methods Trainers attended DEALTS2 TTT workshops and received the simulation toolkit. Data were collected between 2017 and 2018 using a questionnaire capturing differences in dementia knowledge scores, Likert scales and closed-ended questions measured satisfaction, confidence and implementation. Data were analysed using quantitative methods. Results Response rate was 92% (n=183) at pre-test/T1 and 26% (n=51) at T2. Trainer dementia knowledge scores increased from pre-test to T1 (p < 0.001) and were retained after 12 months in 5 of the 6 areas measured (pre-test to T2, p < 0.002); largest gains in ‘humanised approaches to dementia care’. 96% (n=176/183) were satisfied with DEALTS2 TTT workshops and simulation toolkit; 66.7% (n=34/51) felt confident to deliver dementia training informed by DEALTS2. Adherence rates were good with 45% (n=23/51) using the innovative training approaches within twelve months. Conclusions The results show DEALTS2 effectively increased trainer dementia knowledge and confidence to utilise innovative dementia training approaches. Implementation of DEALTS2 varied across organisations, therefore further research should explore factors determining successful implementation

Service User/Carers contribution to Value Based Recruitment in a Pre-registration Adult Nursing Programme.

Within the UK, the patients’ voice is becoming more powerful politically, due to the recognition of the importance of their voice in service development and delivery (Department of Health (DoH) 2008). This commitment towards hearing individual voices has been further endorsed in the National Health Service (NHS) Constitution (DoH 2009), and Liberating the NHS (DoH 2010). All of these reports highlight the need for the NHS to utilise the voices of its users in assessing the quality of the care provided, recognising that individuals are best placed to judge their experiences. This focus on engagement with service users has transcended into nurse preparatory programmes. Indeed the regulatory body for nursing in the UK (Nursing Midwifery Council NMC) highlight one of its core standards for education is that Higher Education Institutions (HEI’s) clearly demonstrate how service users/carers contribute to both programme design and delivery (NMC 2010). A further consideration within the UK nurse education is an increased focus on value based recruitment. A re-focus on values within the NHS was one of the areas identified in the Francis Report (2013). In 2014, Health Education England (HEE) published their Value Based Recruitment Framework in which they articulate how future recruitment of healthcare practitioners will focus on how applicants’ individual values and behaviours align with the core values of the NHS Constitution (DoH 2009). HEIs are expected to comply with the guidance published from HEE as 50% student nurse programmes are based in healthcare settings. As part of reviewing our admissions process in light of the requirements of values based recruitment we decided we would like to include service users/carers more formally into our recruitment process. We have a long established link with service users within the university (coordinated by 2 part time designated staff), which includes engagement in both curriculum development and review, delivery of education as well as assisting us in the past in designing interview questions. In addition, service users and carers have been successfully engaged in social work interviews at the university for a number of years; however the numbers of candidates are very small. We sought inspiration from a study by Rhodes & Nyawata (2011) who evaluated involvement of service users in the recruitment of ninety child health and adult field nursing students and we wondered if we could implement that within our adult student nursing programme which interviews several hundreds of candidates each year. This paper will present our experience of implementing an initiative which enabled service users and carers to formally contribute towards the interviewing of pre-registration adult student nurses. It will explore some of the highlights and the challenges we experienced during the last year. Lastly, it will reflect upon our experience of how service users and carers are a fundamental aspect of value based recruitment. References Department of Health. (2008) High Quality Care for All (Darzi Report). Department of Health. Department of Health. (2009) The NHS Constitution. Department of Health. Department of Health. (2010) Equity and Excellence: Liberating the NHS. Department of Health. Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry; Executive Summary. London. Health Education England. (2014) Value Based Recruitment Framework. Available from: http://hee.nhs.uk/wp-content/blogs.dir/321/files/2014/10/VBR-Framework.pdf (accessed 07/02/15) Nursing Midwifery Council. (2010) Standards for Pre-registration Education. London: Nursing Midwifery Council. Rhodes, C., and Nyawata, I. (2011) Service user and carer involvement in student nurse selection: Key stakeholder perspectives. Nurse Education Today, 31, 439-443

Humanising the interview process: an evaluation of Service User/Carers contribution to value based recruitment in a Pre-registration Adult Nursing Programme.

Within the UK there has been move towards value based recruitment (VBR) as a response to some highly publicised poor standards of care with the National Health Service (Francis 2013). In 2014, Health Education England (HEE) published their VBR Framework which articulated how recruitment of healthcare practitioners needed to focus on how applicants’ individual values/behaviours aligned with core values of the NHS Constitution (DoH 2013). Higher Education Institutes were expected to comply as 50% of student nurse programmes are based in healthcare settings. During 2014-2015 the pre-registration adult nursing team redesigned the interview process to increase a focus on VBR: integral to this, we felt was the inclusion of Service Users/Carers within the interview process. Following training SU/Carers graded applicants in a group activity alongside academic and practice partners. There have been few research studies published evaluating SU/Carers engagement in Pre-registration Adult Nursing interviews probably due to the challenges of implementing SU/Carer engagement in the large cohort numbers that adult nursing attracts. This mixed-method evaluation analysed the perspectives of differing stakeholders (Candidates, SU/Carers, Academics and Practice Partners) regarding the role SU/Carer engagement in Adult Nursing Pre-registration interviews. Early findings from candidates have highlighted they value the involvement of SU/Carers in the interview process, SU/Carers add a “human dimension” ensuring a focus on the heart of nursing and its value base rather than the role of nursing and associated nursing tasks. This paper will present the full evaluation identifying areas of good practice, some of the challenges as well recommendations for future work. References Department of Health. (2013) NHS Constitution. Department of Health: London. Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry; Executive Summary. London. Health Education England. (2014) Value Based Recruitment Framework. Available from: http://hee.nhs.uk/wp-content/blogs.dir/321/files/2014/10/VBR-Framework.pdf (accessed 07/02/15

Service user engagement in healthcare education as a mechanism for value based recruitment: An evaluation study

Within the United Kingdom (UK) there is an increasing focus on Values Based Recruitment (VBR) of staff working in the National Health Service (NHS) in response to public inquiries criticising the lack of person-centred care. All NHS employees are recruited on the basis of a prescribed set of values. This is extended to the recruitment of student healthcare professionals, yet there is little research of how to implement this. Involving Service Users in healthcare educational practice is gaining momentum internationally, yet involvement of service users in VBR of ‘would be’ healthcare professionals remains at an embryonic phase. Adult nurses represent the largest healthcare workforce in the UK, yet involvement of service users in their recruitment has received scant attention. This paper is an evaluation of the inclusion of service users in a VBR of 640 adult student nurses