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Exploring the role of nursing in implementation of collaborative integrated models of care in the community: a scoping review
Full text linkAbstractPurpose – Although the nursing role appears central in delivering collaborative models of care little is knownabout the experience of nurses within implementation of integrated nursing care.Design/methodology/approach – A scoping review to identify what is known about the experience of nursesimplementing integrated care in the community, incorporating thematic analysis utilising the Rainbow Model.Findings – Although noting a paucity of evidence, findings indicate implementation of integrated care modelsprovides both challenges and opportunities to nurses across all systems levels. Thematic analysis highlights adisproportionate lack of focus on organisational integration of nursing services within integrated care.Exploration of tacit attributes and network development is suggested to support nursing delivery of serviceswhich challenge traditional organisational and professional boundaries.Research limitations/implications – Limited research exploring experiences of nursesin implementing integratedcare suggests more rigorous mixed methods or qualitative research is indicated, including case studies exploringorganisational integration, nursing leadership strategies and how tacit attributes support collaborative working.Originality/value – Using a systems approach, applying the Rainbow Model within scoping review analysis,enabled exploration ofwhatis known about nursingwithin the contemporary context ofintegrated healthcare services.Keywords Community nurse, Community care, District nurse, Holistic care, Integrated care, Nursing modelsPaper type Literature review<br/
Cost-effectiveness analysis of two integrated early childhood development programs into Bangladeshi primary health-care services
Full text linkObjectives: This study presents results of a cost and cost-effectiveness analysis of two parenting interventions (group-based and pairs) integrated into primary health care centers in rural Bangladesh. Methods: A within-trial cost-effectiveness analysis was conducted for two trials of parenting interventions aiming tosupport child development through play and interactions. Eligible participants for both trials were underweight children aged 5–24 months. Participants in the control arms in both trials received standard health services. Intervention costs were estimated rom the provider perspective over the time horizon of each study (21 months for the group-based intervention; 24 months for the pair-based intervention). Incremental cost effectiveness ratios were estimated for all primary child development outcomes and presented in terms of cost per standard deviation improvements in the outcomes. A series of cost scenario analyses were conducted to assess the effect of changing cost assumptions on the cost and cost-effectiveness results. All results are presented in 2022 USD. Results: Total provider costs in the within-trial analysis were US 117,028 for the pair intervention. Estimated cost per child covered by the interventions was US136 for the pair intervention, reflecting likely economies of scale in delivery of the pair intervntion. An additional US61 and US$77 for group and pair interventions, respectively. Conclusion: The findings indicates that cost-efficiency and cost-effectiveness results for both interventions are comparable with the results from limited similar interventions in LMICs. However, implementation costs of the interventions will be substantially lower at scale due to lower monitoring costs, economies of scale, and full integration into the public health system.<br/
Environmental Product Declaration (EPD) of LUMIN® TRP Plywood
Full text linkThis study presents a comprehensive Lifecycle Assessment (LCA) of LUMIN® TRP Plywood (Mill 2), leading to the development of an Environmental Product Declaration (EPD) in accordance with EN 15804: 2012 + A2: 2019 and PCR 2019:14 v1.3.4. The cradle-to-gate analysis evaluates environmental impacts, including materials, transport, energy use, and end-of-life considerations, ensuring no process exclusions. The assessment highlights LUMIN's sustainable forest management practices in Uruguay, where eucalyptus plantations provide a reliable and environmentally responsible timber supply.The results indicate that per 1m³ of LUMIN® TRP Plywood, 410.46 kg CO₂e is emitted, reducing to -492.10 kg CO₂e when biogenic carbon uptake is considered. Resin usage is identified as the major environmental hotspot, contributing over 70% of greenhouse gas emissions, with transport playing a secondary role. Despite higher resin-related emissions, the biogenic carbon uptake of eucalyptus results in a strong environmental performance. The study underscores the significance of material selection, energy efficiency, and biomass utilisation in reducing the overall environmental impact of plywood production
Factors Associated with Weight Change in Adults with Severe Mental Illness: Results from a Large Cross-Sectional Survey
Full text linkBackground/objectives: Individuals with severe mental illness (SMI) have a reduced life expectancy of 15-25 years. This is due to a number of modifiable and non-modifiable risk factors. Levels of overweight and obesity in this group are 1.8 times higher than in the general population and diet quality is poor. Excess weight is linked to a range of serious long-term physical and mental health conditions. This paper presents the findings of a large cross-sectional survey of adults living with SMI. The survey aimed to understand the current weight, weight gain and diet quality of this group and secondly, to explore the association between weight change, diet quality, antipsychotic medication and weight management. Methods: Five hundred and twenty-nine participants (58% male, mean age 49.3) living with SMI completed the survey. Results: Results showed 42% of the sample were living with obesity and almost half reported having gained 6kg or more at least once in their adult life. Overall, 6% of the sample reported eating no fruit or vegetables and the same proportion had the highest consumption of carbonated drinks. There was no difference by weight category. Those taking antipsychotic medication and currently managing their weight were more likely to experience weight gain or fluctuation. Conclusions: These results suggest that excess weight and poor diet quality are a major problem in adults with SMI and that current weight management provision is ineffective in addressing the specific needs of people living with SMI
Investigating the relationship between language exposure and explicit and implicit language attitudes towards Welsh and English
Full text linkPositive attitudes toward regional/minority languages are an essential precondition to language maintenance/revitalization. We investigate implicit and explicit attitudes toward Welsh and English and their relationship with childhood and adolescent age exposure among adult Welsh speakers from northwest Wales. Results indicate that implicit and explicit attitude constructs diverge and therefore bear differentially on language maintenance/revitalization.Specifically, comparing speaker data from the Language and Social Background Questionnaire with results from two independent studies, employing the Attitudes towards Languages (AToL) Scale and an Implicit Association Task respectively, we show that the implicit measure reveals a positive correlation between attitudes and exposure in primary school age. Conversely, the AToL returned no statistically significant factors, suggesting differential sensitivity of the explicit and implicit measures.We argue that an understanding of both types of attitude constructs, and attending to exposure levels especially as they relate to intergenerational transmission, is necessary to implement an effective language maintenance/revitalization strategy
Scherzo I-III
Get PDFar gyfer clarinét, feiolin, sielo a phiano ar ôl darluniau tryptich gan yr artist Chris Holleyfor clarinet, violin , cello and piano after the tryptich paintings by artist Chris Holle
Football Fans and Betting (FFAB): a feasibility study and randomised pilot trial of a group-based intervention to reduce gambling involvement among male football fans
Full text linkThis study addresses an urgent and growing public health problem: gambling among the high-risk population of male sports bettors. Sports betting is a big growth area for the gambling industry. It has dramatically increased since the 2005 Gambling Act, and men who watch football have become a key target for industry advertising. This trades on men's passion for football to draw them into gambling and to encourage them to believe their knowledge of the sport will give them an advantage. We believe it is important to counterbalance these trends with interventions that prevent the harms of gambling. These harms affect finances, interpersonal relations, health and wellbeing, and impact on vulnerable people the most. To date, there are no independent, national initiatives that exist to prevent gambling harm, either among the general population, or among this target group. The goal of this research is to carry out a pilot study of a new programme - Football Fans and Betting (FFAB). It aims to support men who gamble regularly and who may be experiencing harms to reduce how much time and money they spend on betting, and so improve their wellbeing. FFAB draws on learning from the highly successful Football Fans in Training (FFIT) programme, which our team's research has shown to be very effective for men. FFIT used the appeal of football clubs to provide a supportive space for men to learn new techniques for weight reduction and healthy living. Through group sessions led by football coaches, they developed a toolkit of behaviour change skills such as self-monitoring and goal setting, in a supportive environment that enabled mutual learning. We believe that many of these features, particularly the draw of the football club, and the sociable, group-based context of the programme, can help inform a programme to reduce involvement with gambling. We are being guided in this by people who have direct experience of gambling, including organisations that provide treatment for people with gambling problems, and people who are in recovery from gambling addiction. FFAB will be delivered in three phases. In the first, we will talk to gamblers, sports fans and team coaches and use this information to refine materials for the programme. In the second stage, specially trained coaches will deliver the programme in group sessions in 2 clubs to see if it works. Base on feedback from this second phase, we will roll out the programme in a further 2 football clubs in England.The sessions will support men to set personalised targets for reductions in the time and money they spend gambling, and will also cover important issues such as: explaining how gambling works; looking at impacts on health and relationships, industry tactics; and what people can do to reduce their betting. We will measure changes in gambling behaviour by looking at differences in how much time and money people spend on betting between the start and end of the programme.. At the end, we will use our professional networks in the fields of gambling, sport, public health, and policy to communicate our findings to a wide general audience
Exploring the Use of the Picture Exchange Communication System (PECS) in Special Education Settings
Full text linkThe Picture Exchange Communication System (PECS) is an Augmentative and Alternative Communication (AAC) system which is widely used to support children with developmental disabilities. In the present study, we surveyed individuals responsible for implementing PECS in special educational settings in the United Kingdom (N=283). We explored knowledge of and adherence to the intervention, with a view to identifying training and support needs. Specifically, we examined participants' knowledge, implementation accuracy, training experiences, access to resources, and attitudes towards PECS. We developed hierarchical logistic regression models to explore the association between training experience and both knowledge and use of PECS. We pre-registered our methods, predictions and the analysis plan on the Open Science Framework (OSF).We found considerable variation in practitioner knowledge and implementation of PECS. Formal training predicted greater knowledge and more accurate implementation when practitioner role and the degree of setting support were accounted for. While PECS was rated by a large majority to be effective and practical, many participants identified that time and the availability of resources were barriers to implementation. We also found that the purpose of PECS was not always fully understood by practitioners, and we identified some consistent gaps in knowledge and implementation. This study contributes new information regarding the real-world use of PECS in educational settings and offers new insights for supporting practitioners. [Abstract copyright: © 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Adsorption of strontium from aqueous solution using ethyl butyl phosphonate (EBP) silica
Full text link• Adsorption of Sr by ethyl butyl phosphonate silica was demonstrated for the first time.• Hydrodynamic adsorption was possible, with reasonable capacity, at a high flow-rate.• Optimal operating pH and maximum adsorption capacity were quantified.• The silica shows greater capacity for Sr than for transition metals.• Evidence suggests that the silica matrix directly interacts with the adsorption process; not just the functional group
Conducting large‐scale mixed‐method research on harm and abuse prevention with children under 12: Learning from a UK feasibility study
Full text linkThis paper reports on a feasibility study for an evaluation of a UK primary school‐based prevention programme that addresses multiple forms of abuse and neglect, identifying research design and ethical issues and exploring research practice. For this feasibility study, 194 children aged 6–11 years completed a baseline survey and 113 did so following the intervention. Eight focus groups were undertaken with 52 children and nine interviews with school staff. We highlight key considerations for conducting large‐scale mixed‐method research on sensitive topics with younger children, a focus that is largely absent from the extant research methods literature. The feasibility study showed that younger children can contribute their views on sensitive topics in ways that are measurable, replicable and reliable, contesting ideas that certain topics are too sensitive to explore with younger children