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Expansive learning in practice: a rapid evaluation of a student nurse placement model (empirical research mixed methods)
Get PDFAim
The aim of this study was to document the process of the implementation and the perceived impact and sustainability of the Expansive Learning in Practice Model and its associated costs to inform future rollout.
Design
A mixed-method rapid evaluation was conducted, comprising both qualitative and economic workstreams to document the implementation of the Expansive Learning in Practice Model and its associated costs. Semi-structured interviews (n = 44) were carried out with student nurses, student assessors, and staff involved in the delivery of the Model. The qualitative workstream utilised a rapid cycle evaluation approach, where data were collected and analysed in parallel, and preliminary findings were shared with stakeholders as the study was ongoing. The quantitative workstream relied on routinely collected data about non-staff-related costs, staff-related costs, and data on students' participation.
Results
The main themes developed from the qualitative data included the organisation of the Expansive Learning Experiences, the supportive environment, the enhanced learning experience, and capacity building. Participants perceived that the model had a positive impact on student practice (including preparation and confidence) and on student nurse satisfaction. At the end of the programme, it is estimated that the programme will have cost about £523,572.
Conclusion
This model can be used as a framework for hospitals aiming to improve the learning experiences for student nurses. Improvements could be made by increasing staff buy-in and the streamlining of spoke opportunities. Future studies should focus on evaluating the long-term impact of the model, particularly the impact on generating student placement capacity. The evaluation also highlights the need for solutions for potential educational staff shortages, which could pose a risk to maintaining sufficient practice placement capacity for student nurses in healthcare settings.
Impact
Study participants perceived an improvement in student nurses' learning experiences and student nurse placement capacity as a result of the implementation of this model.
Reporting Method
The relevant EQUATOR guidelines followed for reporting were the GRAMM guidelines (Good Reporting of a Mixed Methods Study).
No Patient or Public Contribution
The study centred around student nurse and staff experiences
Early pregnancy loss perspectives 2: being present in recurrent miscarriage
No full textRecurrent miscarriage (RM) affects around 1% of people trying to conceive but remains under-recognised and poorly supported. Midwives play a pivotal role in transforming care by being present emotionally, physically, and professionally, with individuals navigating RM. This article explores the complex emotional, clinical, and systemic aspects of RM through a humanised lens. It highlights the need for compassionate communication, informed decision-making, and practical support tools that uphold dignity during miscarriage. By centring care around presence and autonomy, midwives can foster psychologically safe environments and improve outcomes for those experiencing loss
Osnove štambiljanja: nostalgija kao modalitet osjećaja u likovnoj umjetnosti i slikovnici
No full textThis paper proposes historical connections or “linking phenomena” (Volkan 1999) between select examples of 21st-century children’s literature and 20th-century avant-garde collage artworks that preceded them, in relation to an aesthetics of postage stamps and the ephemera of postal imagined geographies. Shaun Tan’s aesthetics of the postage and library stamp in Tales from Outer Suburbia (2008) and Migrations (ICPBS et al. 2019) seen in the light of artist Kurt Schwitters’ collage Opened by Customs (1937–1938) powerfully suggest what Alastair Bonnet (2016) calls “migrant nostalgia” in the “persistence of loss”. By presenting them together with Jacques Derrida’s (1987) discourse of the “parergon” and imaginative geographies of “worlding”, I propose that works of art and artwork for children’s literature carry strong correlations of how the motif of the stamp is used in deliberate discontinuity as a modality of feeling for present and future community building.U ovom se radu prikazuje postojanje povijesnih veza, odnosno „povezujućih fenomena“ (Volkan 1999) između odabranih primjera iz dječje književnosti u 21. stoljeću i avangardnih kolažnih umjetničkih djela iz 20. stoljeća koja su im prethodila s obzirom na estetiku poštanskih maraka i usputnih poštanskih primjera zamišljenih geografskih predjela. Estetika poštanskih maraka i knjižničnih pečata u Tales from Outer Suburbia [Priče iz Vanjskoga Prigrađa] (2009) i priloga Shauna Tana u djelu Migrations [Migracije] (2019) promatranoga u svjetlu kolaža Opened by Customs [Otvoreno na carini] (1937–1938) umjetnika Kurta Schwittersa, snažno upućuje na ono što Alastair Bonnet (2016) naziva Libri & Liberi • 2024 • 13 (2): 269 253–269 „migrantskom nostalgijom“ u „trajnosti gubitka“. Interpretirajući ih u osloncu na raspravu o parergonu Jacquesa Derride (1987) i na pojam imaginarnih svjetskih zemljovida, nastoji se objasniti da se djela likovne umjetnosti i vizualna umjetnost uklopljena u dječju književnosti snažno podudaraju u načinu na koji se koriste motivom poštanske marke u namjernom uspostavljanju diskontinuiteta kao modaliteta osjećaja za sadašnju i buduću izgradnju zajednica
From changing childbirth to better births: a critical discourse analysis of the influence of policy on professional identity
No full textMidwifery practice and the professional identity of midwives are influenced by policy and the discourses located both within the policy and wider society. Recent high-profile investigations into maternity care have highlighted the concerns with the quality of maternity care in the NHS and its long-term sustainability. This research sought to understand the views of those responsible for creating and implementing this policy. This paper discusses the findings of semi-structured interviews with policy actors about the influence of policy on midwifery identity.
‘Policy actors’ were defined as individuals involved in the creation or implementation of maternity policy, recognising that there are multiple potential actors concerned with the collective issue a policy address. Participants were located using purposeful sampling technique based on their engagement in and understanding of, recent and current policy that affects UK midwifery, as this enabled selection of appropriate participants to provide data in line with the research question posed.
Individual interviews were conducted using a topic guide developed following a policy analysis of two midwifery policy documents, Changing Childbirth (1993) and Better Births (2015). A ‘semi-structured’ approach to the interviews was used explore the participants experiences of policy in maternity services as well as developing and implementing policy and how this influences the midwifery profession. Interviews were conducted over Microsoft teams, recorded and then transcribed to facilitate the analysis.
Critical discourse analysis was used to analyse the date. The criteria set out by Parker (2002) for distinguishing discourses, which considers ten points with which to interrogate the text, was adopted to analyse the data. These criteria provide prompts to consider the historical context of discourses and how discourses support institutions, reproduce power relations and ideology.
Analysis of the interviews demonstrate discourses that influence the professional identity and roles of midwives, including neoliberal discourses, discourses of normality and risk, as well as questions around the sustainability around models of practice and implementation of policy recommendations
Unlocking the metabolic potential of endophytic fungi through epigenetics: a paradigm shift for natural product discovery and plant-microbe interactions
No full textMicrobial metabolic pathways, including those of endophytic fungi, offer significant potential for synthesizing secondary metabolites, regardless of their ecological niche. These pathways can be modulated at the molecular level through genome and epigenome manipulation. The metabolic activation of fungal endophytes using epigenetics presents an exciting frontier in science, paving the way for advanced biotechnological applications and enhancing our understanding of these microorganisms' roles in ecosystems. This review examines the significant role of epigenetics in the biosynthesis of secondary metabolites from fungal endophytes, which is vital for drug discovery. Our primary focus centers on studies that explore the epigenetic modulation of endophytic fungi up until December 2024. Acknowledging the rapidly evolving landscape of epigenetic research in this field, which has limited examples for endophytic fungi, we provide crucial foundational insights into fungal epigenetics and relate these insights to the broader context of plant–microbe interactions and endophytic fungal epigenetics, supported by relevant examples. Key mechanisms, such as histone acetylation, histone methylation, and DNA methylation, are discussed alongside recent advances in small-molecule epigenetic modulators that can activate silent biosynthetic gene clusters (BGCs). Further, chromatin-dependent regulation of these BGCs and methods for probing chromatin modifications and secondary metabolism in fungi are discussed. The role of CRISPR-Cas9 genome editing, combined with epigenetic strategies, is highlighted, showcasing its ability to alter the metabolite profiles of fungal endophytes. Finally, we explore how artificial intelligence (AI), machine learning (ML), and deep learning (DL) innovations are transforming research in chemical epigenomics at the plant–microbe interface.
Identifying social vulnerability profiles for coastal flood using supervised and unsupervised machine learning: a case study of Lekki peninsula, Lagos, Nigeria
Get PDFCoastal flooding disproportionately impacts households based on pre-existing vulnerability characteristics. Identifying these vulnerabilities is critical for effective flood risk reduction. Despite its significance, there is a paucity of techniques for identifying suitable Social Vulnerability Indicators at a local scale. This study investigates an evidence-based indicator approach to rank factors contributing to social vulnerability to coastal flooding using a purposive sample of 1,334 flood-affected households in Lekki Peninsula, Nigeria. By integrating the Expectation Maximization Algorithm with Support Vector Regression (EM-SVR), and employing permutation feature importance, we identified distinct social vulnerability clusters and their associated indicator profiles. The findings reveal that a substantial (over 60%) of the case study had moderate level of vulnerability, with clusters of similar rankings exhibiting variations in indicator profiles. Also, significant differences within the wards were observed across all areas, especially in Ajiran/Osapa and Maroko/Okun Alfa. The EM-SVR models were evaluated using various metrics, which revealed that the EM-SVR achieved a high R-squared accuracy across the seven clusters, ranging from 88.8% to 95.7% for the training set and 90.2% to 96.1% for the testing set. Furthermore, the models demonstrated a low Mean Absolute Error, ranging from 0.051 to 0.075 for training and 0.051 to 0.077 for testing. Financial instability, poor social networks, lack of insurance, and pre-existing health conditions consistently emerged as the most influential indicators across clusters. These findings offer actionable insight for decision-makers by providing a well-structured and targeted approach to identifying vulnerable households and enhancing mitigation strategies
A single-stage differential amplifier using organic electrochemical transistors
Get PDFOrganic electrochemical transistors (OECTs) are attractive devices, particularly for biomedical applications. The inherent quality of OECTs in amplifying signals, combined with the possibility of directly interfacing with biological tissue, make them unique candidates to replace recording electrodes with the added advantage of providing on-site amplification (and thus allowing them to be counted as active electrodes). While most amplifiers using OECTs are transconductance amplifiers, having voltage-to-voltage amplification is more desirable in many applications to make the output compatible with any downstream conditioning circuit. Differential recording of physiological signals has the benefit of rejecting the common-mode noise sourcing from the environment or the body itself while amplifying the desired signal. Here the considerations for and challenges of designing an OECT-based differential amplifier are discussed and a three-transistor amplifier is proposed that can provide a common-mode rejection ratio of up to ≈20 dB. To demonstrate its advantage, a differential amplifier is used to record ECG signals from a human volunteer, and the collected data is compared with recordings from a Wheatstone bridge OECT amplifier, showing the improved signal-to-noise ratio, gain, and power consumption
Facilitation of children’s agency as dialogic education: examples from practice and reflection on practice, including a critical comparison with neo-Vygotskian methodologies
Get PDFBased on a thorough consideration of the pedagogical and sociological literature, combined with the authors’ reflection on their own pedagogical practice, this article discusses the circular relationships between facilitation of children’s agency and dialogue in educational contexts. The first section of the article responds to the question: ‘What are we talking about?’, ‘What do we mean by facilitation?’ The second section compares facilitation and neo-vygotskian pedagogies, arguing that the former is more apt to sustain dialogic pedagogical practices. The third section discusses real examples of the use of facilitation, taken from pedagogical research undertaken by the authors in English primary schools. The examples presented in the second part of the article show the translation of facilitation from methodology to practice, focusing on an important facilitative action: minimal feedback. In its final section, the article argues that facilitation can position children as authors of valid knowledge, as they author narratives that share experiences and emotions. Facilitation is discussed as a form of dialogical communication, and a methodology to secure the sustainability of dialogic pedagogical practice. The article concludes by proposing facilitation as a methodology that can fulfill the ambition to transform educational interactions into social contexts where dialogical pedagogy can flourish
Self-reflective practice, autoethnography, storytelling, and critical incident analysis in exploratory nursing and midwifery research: facing social illnesses and borderline personality disorder
Get PDFBackground:
Hospitals are experiencing a surge in social admissions, saturating beds required for more severe pathologies. Nurses, midwives, and other health care workers can explore this issue by using self-reflective practice to research this phenomenon in depth. This study presents primary qualitative research methods in nursing and midwifery to explore novel hospital presentations.
Materials and Methods:
The study was conducted from February 2023 to January 2024. We describe the theoretical and practical applications of qualitative inquiry, including Kolb’s self-reflective practice, storytelling, autoethnography, and critical incident analysis, to improve research practice in nursing and generate practice-based evidence and strategies for policy.
Results:
We crafted and analyzed four prototypical vignettes of people who typically present with social illnesses, epitomized by borderline personality disorder and its impact. By merging patient stories with nurses’ autoethnographies, we can expand insider views and research tools in qualitative research.
Conclusions:
Qualitative exploratory analysis provided robust and convincing accounts of how nurses and midwives can face and relate to problematic situations in health care. Nurses can use both patients’ narratives and their own to extract salient points and guidance for understanding, theorizing, changing, and policymaking