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Survey of healthcare professional and parental experience in accessing support for breastfeeding during an acute hospital admission
No full textPlay and Creativity as Extra-Curricular Festivities: A Case Study Following the Winchester Play and Creativity Festival
Get PDFThe University of Winchester has completed the second annual Play and Creativity Festival in April 2018 and is preparing for the 2019 Festival. The Play and Creativity Festival brings together staff and students for a week of playful and creative events, which happen all across campus in both familiar and new spaces. The Play and Creativity Festival team organised the event, pulled together a programme for all the Festival’s sessions and lead on marketing and promotion. Throughout the Festival students were also engaged as champions alongside staff within each faculty, galvanising support and inspiring session leaders. This paper will provide a case study of its practice, tracking its developments and looking to the future of The Play and Creativity Festival
The impact of upper-limb position on estimated central blood pressure waveforms
Get PDFPulse wave analysis (PWA) utilizes arm blood pressure (BP) waveforms to estimate aortic waveforms. The accuracy of central BP waveform estimation may be influenced by assessment site local haemodynamics. This study investigated whether local haemodynamic changes, induced via arm tilting ±30° relative to heart level, affect estimated central systolic BP (cSBP) and arterial wave reflection (central augmentation index, cAIx; aortic backward pressure wave, Pb). In 20 healthy adults (26.7 years [SD 5.2], 10 F) brachial BP waveforms were simultaneously recorded on experimental and control arms. The experimental arm was randomly repositioned three times (heart level, −30° heart level, +30° heart level), while the control arm remained fixed at heart level. For the experimental arm, arm repositioning resulted in a large (partial eta-squared > 0.14) effect size (ES) change in SBP (ES = 0.75, P < 0.001), cSBP (ES = 0.81, P < 0.001), and cAIx (ES = 0.75, P = 0.002), but not Pb (ES = 0.06, P = 0.38). In the control arm, cAIx (ES = 0.22, P = 0.013) but not SBP or cSBP significantly changed. Change in experimental arm cSBP was partially explained by brachial systolic blood velocity (P = 0.026) and mean diameter (P = 0.012), while change in cAIx was associated with brachial retrograde blood velocity (P = 0.020) and beta stiffness (P = 0.038). In conclusion, manipulation of assessment site local haemodynamics, including the blood velocity profile and local arterial stiffness, had a large effect on estimated cSBP and cAIx, but not on Pb. These findings do not invalidate PWA devices but do suggest that the accuracy of the estimated aortic pressure waveform is dependent on stable peripheral haemodynamics.</p
Developing the social, political, economic and criminological awareness of cybersecurity experts: A proposal and discussion of non-technical topics for inclusion in cybersecurity education.
Get PDFBarriers and facilitators to participating in physical activity for adults with breast cancer receiving adjuvant treatment:A qualitative metasynthesis
Get PDFObjective: Physical activity can improve the health and well-being of individuals receiving adjuvant treatment for breast cancer, but engagement in physical activity can be low. This review synthesises the barriers and facilitators to engaging with and participating in physical activity whilst receiving treatment. Methods: The metasynthesis of qualitative studies is reported in line with the PRISMA statement. We systematically searched eight databases (MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, British Library, OpenGrey, and Conference Proceedings Citation Index) from inception to November 30, 2017. A total of 1276 abstracts were retrieved and screened by two reviewers independently. Data from eligible studies were extracted and critically appraised. As this review concerns qualitative studies only, a CER-QUAL GRADE assessment was completed. Results: A total of 13 studies were included. Four clear themes emerged (side effects of treatment, beliefs about physical activity, focus on health not illness, and social factors) each containing both barriers and facilitators. Key facilitators to participating in physical activity during adjuvant treatment included positive physical benefits, improvements in psychological well-being, and increased self-esteem and empowerment. Further, having a knowledgeable instructor, tailored information, and a supportive environment were important to women undergoing treatment. Main barriers included fatigue and pain, as well as work and caring responsibilities. Conclusions: Incorporating physical activity into treatment regimens is important. Focusing on being less sedentary and providing accurate, tailored information should be prioritised within future interventions. Having a supportive environment and accounting for the particular barriers or facilitators to engagement identified here should aid the success of future interventions.</p
Exploration: ‘I Learned to Play Again’ The Integration of Active Play as a Learning Experience for Sports Coaching Undergraduates
No full textEvaluation of implementation of fasting guidelines for enterally fed critical care patients
No full textBackground & aims: Critically ill adults have increased nutrition risk. Prior to procedures patients are often fasted, leading to nutritional deficits. The use of fasting guidelines may therefore help reduce deficits from accumulating. The aim of this work was to determine the impact on nutrition support delivery following the implementation of fasting guidelines in addition to characterizing staff knowledge of the guidelines. Design: Retrospective data were collected on n = 74 patients at two different time points; prior to launch of fasting guidelines and post launch, with regards to estimated nutritional requirements, nutritional targets, volume of enteral nutrition (EN) delivered and periods of fasting. Clinical variables of interest were collected for up to 14 days. Questionnaires assessing staff knowledge/barriers to usage of the fasting guidelines were administered to ICU staff. Setting: 3 ICUs (General, Cardiac and Neurosciences) within University Hospital Southampton NHS Foundation Trust. Patients: Mechanically ventilated adults in an ICU and receiving exclusive EN. Measurements and main results: Comparison was made between pre- and post-guideline implementation with statistically significant improvements in the % EN delivered (76.4 ± 11.8 vs. 84.1 ± 10.8 (p = 0.0009)) and duration of feeds withheld (41.5 ± 26.6 vs. 27.6 ± 20.8 h (p = 0.02)). There were non-significant improvements pre- and post-implementation in the % of energy and protein delivered (80.7 ± 16.4 vs. 86.5 ± 17.3 (p = 0.15 (NS)); 74 ± 18.3 vs. 79 ± 18.5 (p = 0.15 (NS))). 77% of staff were familiar with the guidelines, whilst 42% requested further education. The main barriers to guideline compliance were delays and unpredictable timing of procedures, and differing guidance from senior staff and non-ICU teams. Conclusions: Implementation of fasting guidelines led to significant improvements in EN delivery and reduced duration of feed breaks. The use of fasting guidelines is a positive step towards increasing nutrition delivery in the ICU. Further staff education and better planning around procedures is required to promote further adherence to the fasting guidelines
Forms of Education:Rethinking Educational Experience Against and Outside the Humanist Legacy
No full textorms of Education analyses the basic tenets of the humanist legacy in terms of its educational ethos, examining its contradictions and its limits, as well as the extent of its capture of educational thought. It develops a broader conception of educational experience, which challenges and exceeds those limits.This book deflates the compulsion to educate. It delegitimises the imposition of any particular practice in education. It defines education, openly and non-restrictively, as the (de)formation of non-stable subjects, arguing that education does not require specific formations, nor the formation of specific forms, only that form does not cease being formed in the experience of the non-stable subject. Exploding and pluralising what amounts to ‘education’, this book rethinks what might still be called educational experience against and outside the ethos of the humanist legacy that confines its meaning.This book will be of interest to scholars and postgraduate students in the fields of philosophy of education, educational theory, history of education and sociology of education.<br/
Silicone-based adhesive removers for preventing peristomal skin complications caused by mechanical trauma.
No full textPeristomal skin complications (PSCs) are reported by 77% of people with a stoma, with a serious impact on patient quality of life and healthcare resources. PSCs are usually caused by irritant contact dermatitis from stoma effluent or skin stripping from mechanical trauma to the stratum corneum caused by removal of the ostomy appliance. The risk of mechanical trauma is higher in neonates, young infants and older adults, who have more fragile, friable skin. The incidence and impact of PSCs can be reduced with an appropriate appliance change routine. Mechanical trauma is reduced by minimising the frequency of appliance changes and using an adhesive remover wipe or spray. In adult ostomates, silicone-based solvents are considered the first choice, as they are skin-friendly and sting-free, and they release the adhesive from the skin quickly and evaporate within seconds, without leaving a residue. However, for neonates, wipes and specialist paediatric oil-based adhesive removers are advised instead. The efficacy of adhesive removers, and silicone-based solvents in particular, at maintaining skin integrity and reducing discomfort has been reported by both stoma care nurses and people with a stoma