Wound assessment tools and nurses’ needs: an evaluation study

The purpose of this study was to ascertain how well different wound assessment tools meet the needs of nurses in carrying out general wound assessment and whether current tools are fit for purpose. The methodology employed was evaluation research. In order to conduct the evaluation, a literature review was undertaken to identify the criteria of an optimal wound assessment tool which would meet nurses’ needs. Several freely available wound assessment tools were selected based on predetermined inclusion and exclusion criteria and an audit tool was developed to evaluate the selected tools based on how well they met the criteria of the optimal wound assessment tool. The results provide a measure of how well the selected wound assessment tools meet the criteria of the optimal wound assessment tool. No tool was identified which fulfilled all the criteria, but two (the Applied Wound Management tool and the National Wound Assessment Form) met the most criteria of the optimal tool and were therefore considered to best meet nurses’ needs in wound assessment. The study provides a mechanism for the appraisal of wound assessment tools using a set of optimal criteria which could aid practitioners in their search for the best wound assessment tool

Being in a dilemma: Experiencing birth in Zambia

Numerous publications investigating childbirth in sub-Saharan Africa have overlooked the psychological and emotional elements that women experience, in favour of physical dimensions, such as maternal mortality. The aim of this study was to explore childbirth experiences, in order to better understand how women in Zambia experience and give meaning to the phenomenon. An interpretive phenomenological approach was utilised. Through purposive sampling methods, fifty birthing women, aged between 16 and 38 years, from all the nine provinces of the country were recruited. Unstructured in-depth interviews were conducted. Analysis uncovered six structures. The main focus of this paper is 'Being in a dilemma'. The selection of this structure reflects its general interest and predominance in data analysis. It entailed experiencing the phenomenon without knowledge of whom or what one was going to encounter. The key themes were: 1) choosing where to birth, and 2) choosing the advice to adhere to. The findings illuminated a need for an attitudinal change in maternity care professionals, and a parallel need to build agency and autonomy in women. It is this intrinsic level that is undermining attempts to reduce high maternal mortality in Zambia.Department of HE and Training approved lis

”I was meant to be able to do this”: women’s experiences of breastfeeding. A phenomenological study

Introduction. There is strong evidence demonstrating that human breastmilk provides complete nutrition for human infants. While the rate of initiation of breastfeeding in the UK has increased steadily over the last 25 years, rates of exclusive breastfeeding in the early weeks and months over the same time period have shown only marginal increases. Method. An interpretive phenomenological approach informed by the philosophy of Martin Heidegger was adopted. The aim was to understand women’s experience of breastfeeding. Women were recruited from one city in the East Midlands in the UK, where the prevalence of breastfeeding is decreasing. Potential participants were recruited via health visitors at the primary birth visit. Ethical approval was received from the university and NHS research ethics committees. Data were collected between three and six months after the birth of their youngest child and analysis was guided by interpretive phenomenological principles. Findings. The women were found to be ill-prepared for the realities of breastfeeding and, for most women, the shock of this experience was overwhelming. In particular there was a lack of understanding and preparation for common problems and a lack of awareness of newborn behaviour. Misunderstandings of newborn behaviour resulted in the women blaming infantfeeding behaviours, such as crying, wakeful states and cluster feeding, on the specific method of infant-feeding. Frequent feeding cues were overwhelming and the women felt overawed by the sense of responsibility. It also led them to question their ability to provide an adequate milk supply. Discussion. The extent to which inadequate preparation for breastfeeding had a negative impact on the breastfeeding experiences of women in this study was a surprise. Antenatal education should focus more on preparing women for the realities. Education and support for breastfeeding women need to encompass infant-feeding cues and infant behaviours

Advances in the stochastic modelling of satellite-derived rainfall estimates using a sparse calibration dataset

As satellite technology develops, satellite rainfall estimates are likely to become ever more important in the world of food security. It is therefore vital to be able to identify the uncertainty of such estimates and for end users to be able to use this information in a meaningful way. This paper presents new developments in the methodology of simulating satellite rainfall ensembles from thermal infrared satellite data. Although the basic sequential simulation methodology has been developed in previous studies, it was not suitable for use in regions with more complex terrain and limited calibration data. Developments in this work include the creation of a multithreshold, multizone calibration procedure, plus investigations into the causes of an overestimation of low rainfall amounts and the best way to take into account clustered calibration data. A case study of the Ethiopian highlands has been used as an illustration

Incorporating satellite data into weather index-based insurance

What: Twenty-three people from six countries came together to discuss how drought insurance based on remotely sensed data can reduce the impact of weather shocks on some of the poorest people in the world. Participants were drawn from financial and agricultural sectors, nongovernmental and governmental organizations, and universities. When: 16–17 February 2016. Where: Reading, United Kingdo

Capacity building on agricultural insurance for aggregators in Northern Ghana

Farming is a risky business. Shocks such as drought, flood, pests or disease can make it difficult for farmers to invest in new productive options, such as seeds or fertilizer. These shocks are often regional, reverberating past the level of the individual smallholder. This makes it equally difficult for aggregators such as seed companies, input providers, agri-shops, seed growers and for commercial farmers, all of whom rely on the yields of a large number of smallholders or out-growers. Agricultural insurance is one way to mitigate this risk, unlocking new markets and making existing markets more profitable Most training on insurance is either designed for poor smallholder farmers, or for very large aggregators (e.g. a country-wide fertilizer company). Less attention has been paid to small and medium level aggregators, who might have tens or hundreds of acres, or have a relationship with a smaller number of out growers (tens to thousands). However, connecting with these stakeholders is one method of scaling insurance in a sustainable fashion. The local nature of many of the aggregators allows insurance to reach smallholders without personally visiting every village. The aggregators are also typically from the local communities and can act as champions for new initiatives. These same incentives for connecting with aggregators also hold true for other CCAFS and rural development initiatives. The aim of this workshop was to reach a group of local aggregators in rural Ghana with tailored insurance capacity building material, detailed in this report. A secondary aim was to gather their feedback about their experiences with agricultural insurance, along with jointly designed ideas about how insurance could more easily fit in with their practices

Reliability of an integrated ultrasound and stereophotogrammetric system for lower limb anatomical characterisation

Background. Lower extremity analysis for preoperative total knee and hip arthroplasty routines can increase surgery success rate and hence reduce associated costs. Current tools are limited by being invasive, limited to supine analysis, or too expensive. This study aimed to propose and validate a device, OrthoPilot®, based on the combined use of a stereophotogrammetric and ultrasound system which can in vivo and noninvasively measure varus/valgus, flexion/extension, femur and tibia torsion, and femur and tibia lengths. Methods. A phantom was measured by four operators to determine the resolution of the system. Interoperator variability was measured on three operators who measured the above six variables on both legs of three subjects in standing and supine positions. Intraoperator variability was assessed on data from three repeats from 9 subjects (18 legs). Results. All 6 variables were reliably detected on a phantom, with a resolution of 1 mm and 0.5° . Inter- and intraoperator consistency was observed for varus/valgus, flexion/extension, and length measurements on the healthy subjects in standing and supine positions (all ICC > 0.93). For torsion measurements, there was a considerable variation. Conclusion. The proposed system, when used on healthy subjects, allowed reliable measurements of key parameters for preoperative procedures in both supine and standing positions. Accuracy testing and further validation on patient populations will be the next step toward its clinical adoption

Weather-index based crop insurance as a social adaptation to climate change and variability in the Upper West Region of Ghana: Developing a participatory approach

Climate change and variability are major challenges to rain-fed crop production in Africa. This paper presents a report on a pilot project to test a concept for operationalizing weatherindex crop insurance as a social adaptation to the climate change and variability problem in the Upper West Region of Ghana. An analysis of long-term weather variables showed rising temperature of 1.7 oC over a period of 53 years as well as major shifts in rainfall patterns. Farmers face a new reality that cannot be addressed with their indigenous knowledge alone. The weather-index based crop insurance concept discussed herein was developed by combined effort of University of Ghana, the German International Cooperation (GIZ) and the Ghana National Insurance Commission (NIC) since 2010. This development was carried out via their filial, the Ghana Agricultural Insurance Pool (GAIP). The proposed concept sought to link various agricultural stakeholders such weather technical persons, farmers, agricultural extension officer, input dealers and other aggregators, and financial institutions as well as the insurance industry and focused on a participatory farmer led approach. The piloting of the concept was supported by the Climate Change and Food Security (CCAFs) project and was tested in the years 2012 and 2013 using a theatrical drama sketch in two districts in the Upper West Region of Ghana: Jirapa and Lawra. It was observed that training of farmers in the basic principles of weather (data collection, interpretation, etc.) facilitated the discussions on drought insurance, adding to the body of evidence supporting participatory design tools. The aim of this paper is to record this process and to put the results into recent context, through discussing them through the lens of insurance operations and research in Ghana. Ensuing discussions showed that although all stakeholders considered the participatory design tools to be meritorious, a number of logistical challenges were identified that need to be addressed for effective scaling. The study also highlighted the high spatial variability of rainfall in the Upper West region of Ghana, showing the necessity of satellite-derived rainfall products. Finally, the framework suggested in this report highlights the complexity and the institutional structures required to implement an effective insurance. In effect, our simple study has exposed the complexities and intricacies that must be overcome in establishing a sustainable insurance scheme in Ghana

Teaching hard things: The journalism ‘intro’

Teaching students the hardest skill in journalism – how to start your story - with the help of Pulp Fiction, Forrest Gump and Cool Runnings