Search

Aim:\ud To explore the variation in mental health nursing students’ understanding of recovery.\ud \ud Background:\ud In mental health practice clinical understanding of recovery has been challenged with a new understanding based on the individualised experiences of the person, often referred to as personal recovery. Despite international policy endorsement, practice has been slow to embrace the principles of personal recovery and little is known about student nurses’ understanding of the concept.\ud \ud Design:\ud Qualitative phenomenographic study\ud \ud Method~:\ud In-depth semi-structured interviews including discussion of a clinical scenario, were conducted with 13 pre-registration student nurses. Data was analysed iteratively using a seven stage phenomenographic framework, identifying categories of description and the outcome space.\ud \ud Results:\ud Analysis revealed a branched outcome space with four qualitatively distinct ways of understanding recovery. Branch one can be broadly aligned to clinical recovery and contains one category only, ‘Recovery as Clinical Improvement’. It is distinctly different from branch two which contains three categories on a continuum, which represent more and less complete ways of understanding personal recovery: ‘Recovery as Making Progress’, ‘Recovery as Managing to Live Well’ and ‘Recovery as Learning to Live Differently’. Most participants demonstrated understanding in the less sophisticated categories.\ud \ud Conclusion:\ud Recovery is central to mental health nursing, yet this study suggests it is a problematic concept for students. Features of personal recovery can be found in the second branch of the outcome space, with the most sophisticated category ‘Learning to Live Differently’ best representing the principles of recovery espoused in nursing literature and international policy. Phenomenography has allowed a more complex picture to emerge, replacing the dichotomy between clinical and personal recovery and enabling a differentiation between more and less complete ways of understanding personal recovery. This study addresses the lack of attention given to student nurse experiences of recovery. The insights support educators, both in clinical and academic settings, to address personal recovery in more explicit way where partial understanding can be explored.

Background Pilot studies are more commonly associated with quantitative research, and their use is under-reported in qualitative approaches. This paper discusses the value of undertaking a pilot study in a doctoral research project to examine nursing students' understanding of recovery in mental health by adopting what is called a phenomenographic approach, which in research is concerned with the variation in how particular phenomena are experienced. Aim To explore the usefulness of three different methods of collecting data - interviewing, completed exam papers and a written response to a scenario - and the Dahlgren and Fallsberg ( 1991 ) framework for phenomenographic data analysis. Discussion Methodological issues experienced during the collection and analysis of data in the project are discussed. Conclusion The pilot study provided an opportunity for valuable insights to be gained into the methodological issues related to phenomenography and to revise the research plan for the larger study. Implications for practice While it may not be generalised to other qualitative studies, this paper may help others undertaking studies that adopt this approach and points to the general value of pilot studies in qualitative research.

BackgroundPeople with pulmonary fibrosis often experience a protracted time to diagnosis, high symptom burden and limited disease information. This review aimed to identify the supportive care needs reported by people with pulmonary fibrosis and their caregivers.MethodsA systematic review was conducted according to PRISMA guidelines. Studies that investigated the supportive care needs of people with pulmonary fibrosis or their caregivers were included. Supportive care needs were extracted and mapped to eight pre-specified domains using a framework synthesis method.ResultsA total of 35 studies were included. The most frequently reported needs were in the domain of information/education, including information on supplemental oxygen, disease progression and prognosis, pharmacological treatments and end-of-life planning. Psychosocial/emotional needs were also frequently reported, including management of anxiety, anger, sadness and fear. An additional domain of “access to care” was identified that had not been specified a priori; this included access to peer support, psychological support, specialist centres and support for families of people with pulmonary fibrosis.ConclusionPeople with pulmonary fibrosis report many unmet needs for supportive care, particularly related to insufficient information and lack of psychosocial support. These data can inform the development of comprehensive care models for people with pulmonary fibrosis and their loved ones.

Objective To achieve consensus amongst health professionals and people with interstitial lung disease (ILD) on core educational topics for pulmonary rehabilitation (PR) in ILD. Methods Health professionals with expertise in ILD and/or PR took part in a 2-round online Delphi process. Potential educational topics for PR were rated on a 4-point Likert scale with anchors of ‘completely unimportant’ and ‘very important’. Results of each Delphi round were discussed and refined by focus groups of people with ILD, to achieve final approval of topics. Results Health professional participants (n = 43) represented six disciplines from five continents. Focus group participants (n = 10) had a range of ILDs and disease severity. Consensus was reached on six core education topics: (1) Staying well with ILD; (2) Keeping fit and strong after PR; (3) Oxygen Therapy; (4) Managing breathlessness and cough; (5) Overcoming fatigue; (6) Managing anxiety, depression and panic. Conclusion This study has identified core educational topics for people with ILD who undertake PR, incorporating the perspectives of both patients and health professionals. This is a step towards comprehensive PR for people with ILD. Practice implications This study provides PR clinicians with guidance on ILD-specific education topics that can be delivered in existing PR programs.

At the start of 2018, multiple incidents of dog illnesses were reported following consumption of marine species washed up onto the beaches of eastern England after winter storms. Over a two-week period, nine confirmed illnesses including two canine deaths were recorded. Symptoms in the affected dogs included sickness, loss of motor control, and muscle paralysis. Samples of flatfish, starfish, and crab from the beaches in the affected areas were analysed for a suite of naturally occurring marine neurotoxins of dinoflagellate origin. Toxins causing paralytic shellfish poisoning (PSP) were detected and quantified using two independent chemical testing methods in samples of all three marine types, with concentrations over 14,000 µg saxitoxin (STX) eq/kg found in one starfish sample. Further evidence for PSP intoxication of the dogs was obtained with the positive identification of PSP toxins in a vomited crab sample from one deceased dog and in gastrointestinal samples collected post mortem from a second affected dog. Together, this is the first report providing evidence of starfish being implicated in a PSP intoxication case and the first report of PSP in canines.

Current evidence does not provide definitive answers regarding the benefits (or otherwise) of oxygen therapy for ILDhttp://ow.ly/4qr830dCYm4

This review aims to establish the impact of oxygen therapy on dyspnoea, health-related quality of life (HRQoL), exercise capacity and mortality in interstitial lung disease (ILD).We included studies that compared oxygen therapy to no oxygen therapy in adults with ILD. No limitations were placed on study design or intervention type. Two reviewers independently evaluated studies for inclusion, assessed risk of bias and extracted data. The primary outcome was dyspnoea.Eight studies evaluated the acute effects of oxygen (n=1509). There was no effect of oxygen therapy on modified Borg dyspnoea score at end exercise (mean difference (MD) −0.06 units, 95% CI −0.24–0.13; two studies, n=27). However, effects on exercise outcomes consistently favoured oxygen therapy. One study showed reduction in dyspnoea at rest with oxygen in patients who were acutely unwell (MD visual analogue scale 30 mm versus 48 mm, pThis systematic review showed no effects of oxygen therapy on dyspnoea during exercise in ILD, although exercise capacity was increased. Future trials should evaluate whether acute improvements in exercise capacity with oxygen can be translated into improved physical activity and HRQoL.

We have recently shown that anxiety and depression are common comorbidities for people with interstitial lung disease (ILD). In a cross-sectional single-centre study, the prevalence of anxiety was 31% and the prevalence of depression was 23% [1]. Anxiety and depression were not related to physiological parameters; however, dyspnoea and number of comorbidities were important contributors. The aims of this study were to determine the frequency of prolonged anxiety and depression among sufferers of idiopathic pulmonary fibrosis (IPF), and factors contributing to their persistence., Prolonged anxiety and depression occur frequently in IPF and strongly relate to dyspnoea and cough http://ow.ly/iWxV30cLCfl

Noticing is integral to the everyday practice of nurses; it is the precursor for clinical reasoning, informing judgement and the basis of care. By noticing the nurse can pre-empt possible risks or support subtle changes towards recovery. Noticing can be the activity that stimulates action before words are exchanged, pre-empting need. In this article, the art of noticing is explored in relation to nursing practice and how the failure to notice can have serious consequences for those in care.

Dissertação (mestrado)—Universidade de Brasília, Centro de Excelência em Turismo, Programa de Pós-Graduação em Turismo, 2013. A Ilha pernambucana de Fernando de Noronha (FN), um dos principais destinos turísticos do Brasil, está a beira de um colapso socioambiental, segundo o Estudo de Capacidade de Suporte (ECS) e Indicadores de Sustentabilidade de Fernando de Noronha (FN), feito pelo Ministério do Meio Ambiente (MMA), em 2009. Noronha opera com uma sobrecarga de cerca de 2000 pessoas e se desenvolve privilegiando o crescimento do turismo e a preservação da natureza em detrimento da qualidade de vida dos moradores. Este quadro de dilaceramento socioambiental pode ser revertido se a comunidade, administração e turistas mudarem seus padrões de comportamento e se mobilizarem para transformar o destino de Noronha. Tendo como inspiração e base o programa Noronha +20 (2011), um projeto construído na Ilha de forma participativa com o objetivo de promover a gestão socioambiental sustentável de FN, esta pesquisa buscou analisar como seria possível mobilizar a comunidade a participar dos processos decisórios na administração insular. Ao pesquisar o histórico de mobilização na Ilha, uma bela história veio à tona: o movimento “SOS Noronha”, quando toda a comunidade lutou contra a anexação da Ilha a Pernambuco em 1988. Desde então, a comunidade está desunida, perdeu a esperança e vontade de batalhar pelo bem comum e pouco se envolve nos projetos e nas decisões que estão relacionadas diretamente ao seu futuro. Como resgatar esse sentimento que uniu a Ilha inteira em 1988 e usar o aprendizado desse movimento para mobilizar os jovens, única geração ainda capaz de iniciar esse necessário processo de transformação socioambiental? Para buscar essa resposta, pesquisei ferramentas de comunicação para mobilizar os atores envolvidos e produzi com os alunos do ensino fundamental e médio da Escola Arquipélago, única escola da Ilha, um documentário sobre a mobilização de 1988. Mobilizar trabalhando o afeto, a cidadania e a auto-estima são algumas descobertas dessa experiência compartilhada com cerca de 20 jovens noronhenses. A transmissão de saberes entre as gerações e o resgate histórico obtidos com essa pesquisa podem contribuir para propor estratégias visando um planejamento participativo voltado ao desenvolvimento sustentável de Noronha, cenário onde seria possível pensar na retomada do crescimento populacional, no turismo sustentável e, acima de tudo, na melhoria da qualidade de vida dos filhos da Ilha. ______________________________________________________________________________ ABSTRACT Fernando de Noronha, an island located neartheast coast of Brazil, in the state of Pernambuco -Fernando de Noronha (FN); one of Brazil’s main touristic spots is at the edge of socio environmental collapse, according by the Study of Support Capacity (or Estudo de Capacidade de Suporte (ECS), in Portuguese) and local indicators of sustainability, done by the Ministry of Natural Environment, in 2009. Noronha operates with an overflow of about 2000 people and develops itself favoring the growth of tourism and the conservation of nature in detriment of the local habitant’s quality of life. This situation of socio environmental shattering could be reverted if the community, local administration and tourists changed their behavior patterns and mobilized themselves to change Noronha’s destiny. Having as an inspiration and ground base the program Noronha +20 (2011)- one of the first projects built on the island in a participative way and with the goal of promoting a sustainable socio environmental management in FN, this research analyzed how it would be possible to mobilize the community for the participation in the decisive processes of the insular administration. While searching the mobilization history of the island, a handy story came to surface: the “SOS Noronha” movement. A movement when the whole community fought in vain against the island’s annexation to the state of Pernambuco, in 1988. Since then, the community has been split, lost all hope and will of battling for the common good and has little involvement in projects and decisions that are directly related to their future. How to redeem this feeling that united the whole island in 1988 and use the lessons learned from this movement to gather the young – only generation still capable of starting the necessary processes of socio environmental transformation? To find this answer, I produced, together with the Escola Arquipélago students, a documentary about the 1988’s mobilization. To mobilize working with affection, citizenship and self-esteem are some of the discoveries of this experience shared with about 20 young Noronhenses (people from FN). The passing on of knowledge between generations and the historical rescue attained with this research could contribute to suggest strategies seeking a participative planning, aimed at the sustainable development of Noronha, a scenario where it would be possible to think about the resumption of the population’s growth, sustainable tourism, and, above all, the improvement of the island’s quality of life.

The quality movement in medicine has prompted a shift from a "name, shame, blame" approach to medical errors to one in which each error is regarded as an opportunity to prevent future patient harm. This new culture of patient safety requires the involvement of all members of the health care team and learned skill sets related to quality improvement. A root cause analysis identifies the sources of medical errors, allowing system changes that reduce the risk. In large organizations, sentinel events and signals prompt chart reviews and reduce the reliance on voluntary reporting. Failure mode analysis prompts the development of safety nets in the case of a system failure. The second part of this two-part series on patient safety examines how the culture of patient safety is taught, how medical errors and threats to patient safety can be identified, and how engineering tools can be used to improve patient care. It also examines efforts to measure clinical effectiveness and outcomes in the practice of medicine.After completing this learning activity, participants should be able to improve patient safety through an understanding of both the beneficial and adverse consequences of quality reporting, apply safety engineering tools to the practice of dermatology, and be able to establish a quality improvement plan for a dermatologic practice.

Communities of users are employing 3-D online virtual worlds for legitimate health related information exchange and social interaction. In order for care to be effectively delivered, the patient needs a transparent adaptation of real world practices into the virtual space. In this paper, we present our experience translating the clinical practice of teaching elicitation of the Relaxation Response in the real world to the virtual world Second Life. Process, challenges and outcome will be described.

Four cows, all giving milk low in solids-not-fat, were used for the experiment:1. The change from winter rations to pasture produced a decided increase in the solids-not-fat percentage and milk yield.2. Well-balanced rations fed to the cows during two lactations showed a small rise in the milk yield and solids-not-fat during the second lactation, but did not increase the solids-not-fat to above the 8·50 per cent, limit.3. Feeding a high protein ration of albuminoid ratio 1:2·76 produced no change in milk yield or casein, decreased the solids-not-fat and lactose, and increased the total milk nitrogen and albumin and globulin nitrogen.4. Feeding a high carbohydrate ration of albuminoid ratio 1:9·90 did not affect milk yield, fat or ash, but decreased slightly the solids-not-fat.