An Evaluation of Videos used to Support Clinical Skills Teaching for Pre-registration Student Nurses

The NMC suggest that to ensure high quality patient care it is essential that student nurses develop competence in a range of clinical skills (NMC, 2010a). The aim of this project was to determine whether nursing students perform the skills of infection prevention; hand washing; aseptic technique and vital signs measurement more competently in an Observed Structured Clinical Examination (OSCE), when traditional face-to-face teaching is enhanced with the availability of skills videos via an e-learning platform. The study employed a randomised controlled design. An intervention group were taught face-to-face in the clinical skills lab and had the teaching supplemented by access to clinical skills videos. The control group received the same classroom face-to-face teaching but did not have access to the videoed blended e-learning resources. Student nurses of mixed gender and ages (n=229) were invited to volunteer to participate in the inhouse study. Eighty-eight students consented and were evenly divided by random allocation to the intervention group (n=44) and to the control group (n=44). The mean score for all clinical skills was higher in the OSCEs in the intervention group who viewed the videos, this was not, however, statistically significant as the results were >.05

Factors contributing to the commission of errors and omission of standard nursing practice among new nurses

Every year, millions of medical errors are committed, costing not only patient health and satisfaction, but thousands of lives and billions of dollars. Errors occur in many areas of the healthcare environment, including the profession of nursing. Nurses provide and delegate patient care and consequently, standard nursing responsibilities such as medication administration, charting, patient education, and basic life support protocol may be incorrect, inadequate, or omitted. Although there is much literature about errors among the general nurse population and there is indication that new nurses commit more errors than experienced nurses, not much literature asks the following question: What are the factors contributing to the commission of errors, including the omission of standard nursing care, among new nurses? Ten studies (quantitative, qualitative, and mixed-mode) were examined to identify these factors. From the 10 studies, the researcher identified the three themes of lack of experience, stressful working conditions, and interpersonal and intrapersonal factors. New nurses may not have had enough clinical time, may develop poor habits, may not turn to more experienced nurses and other professionals, may be fatigued from working too many hours with not enough staffing, may not be able to concentrate at work, and may not give or receive adequate communication. Based on these findings and discussion, suggested implications for nursing practice include extended clinical experience, skills practice, adherence to the nursing process, adherence to medications standards such as the five rights and independent double verification, shorter working hours, adequate staffing, no-interruption and no-phone zones, creating a culture of support, electronically entered orders, translation phones, read-backs, and standardized handoff reports

From Instability to Civil Liberties: Nonviolent Resistance in Afghanistan

When people have a fundamental issue at stake, giving in is not an option. For these types of conflict, when people’s rights are being violated, when their countries are occupied, or when they are oppressed and humiliated, they need a powerful way to persist and fight back. Oftentimes when people are left with no choice they will use the terrible and destructive nature of violence. For decades nonviolent resistance (NVR) movements have been associated with Gandhi and Martin Luther King, but people have been using nonviolent action for years. In fact, NVR has been a part of political life for millennia. From the time of 11th-century conqueror Mahmud of Ghazni to Abdul Ghaffar Khan, a Pakistan born proponent of nonviolence, to social change created by modern Afghan women\u27s resistance groups, nonviolent revolution has been a part of the rich history of the Kingdom of Afghanistan (Pal, 2002 & PBS News Desk, 2021). Historically there have been numerous case studies of groups that rose to challenge corruption by authorities, demand social reforms, and demonstrate against violent and authoritarian regimes. The following thesis aims to focus on the historical antecedents of the Afghanistan government and use comparative research of violence and nonviolence both in and out of the country. Data from foundational research in the field of nonviolence will be used to support the claim. This is used to both understand the ongoing oppression and direct evidence gathered to understand actions that have pushed back against these rules. The data collection organizes evidence of acts of nonviolence and civil resistance in the country. The data gathered will be organized into qualitative and quantitative graphics. Qualitative data can be broken down by category and attributes of the nonviolent tactics used and quantitative data aims to translate these to maps and charts to show where and how effective these campaigns are over time

The legal and policy framework for contextual safeguarding approaches: a 2020 update on the 2018 legal briefing

This briefing considers the extent to which changes made to Working Together to Safeguard Children in 2018, and the existing legislative underpinning that guidance, provide a sufficient policy and practice framework for adopting a Contextual Safeguarding approach. It presents the key messages that emerged from a legal roundtable held in 2020, alongside emergent data from the Contextual Safeguarding programme

Ethnic and socioeconomic variation in incidence of congenital heart defects

Introduction: Ethnic differences in the birth prevalence of congenital heart defects (CHDs) have been reported; however, studies of the contemporary UK population are lacking. We investigated ethnic variations in incidence of serious CHDs requiring cardiac intervention before 1 year of age. Methods: All infants who had a cardiac intervention in England and Wales between 1 January 2005 and 31 December 2010 were identified in the national congenital heart disease surgical audit and matched with paediatric intensive care admission records to create linked individual child records. Agreement in reporting of ethnic group by each audit was evaluated. For infants born 1 January 2006 to 31 December 2009, we calculated incidence rate ratios (IRRs) for CHDs by ethnicity and investigated age at intervention, antenatal diagnosis and area deprivation. Results: We identified 5350 infants (2940 (55.0%) boys). Overall CHD incidence was significantly higher in Asian and Black ethnic groups compared with the White reference population (incidence rate ratios (IRR) (95% CIs): Asian 1.5 (1.4 to 1.7); Black 1.4 (1.3 to 1.6)); incidence of specific CHDs varied by ethnicity. No significant differences in age at intervention or antenatal diagnosis rates were identified but affected children from non-White ethnic groups were more likely to be living in deprived areas than White children. Conclusions: Significant ethnic variations exist in the incidence of CHDs, including for specific defects with high infant mortality. It is essential that healthcare provision mitigates ethnic disparity, including through timely identification of CHDs at screening, supporting parental choice and effective interventions. Future research should explore the factors underlying ethnic variation and impact on longer-term outcomes

Mortality with congenital heart defects in England and Wales, 1959–2009: exploring technological change through period and birth cohort analysis

BackgroundTechnological advances in surgery, intensive care and medical support have led to substantial decrease in mortality for children with congenital heart defects (CHDs) over the last 50 years.MethodsUsing routinely-collected mortality and population data for England and Wales from 1959 to 2009, the authors investigated age, period and birth cohort trends in child mortality attributable to CHDs.ResultsThe total number of deaths with CHDs at all ages between 1959 and 2009 was 61 903 (33 929 (55%) males). Absolute numbers of CHD-related deaths in children (under age 15 years) fell from 1460 in 1959 to 154 in 2009. Infants (aged under 1 year) comprised over 60% of all deaths due to CHD during the 5-year period 1959–1963, but this fell to 22% by 2004–2008. Age-standardised death rates have declined for both sexes but, despite narrowing sex differences, males continue to have higher death rates. Successive birth cohorts have experienced improved death rates in the first year of life; however, declining mortality across all age-groups has only been observed for birth cohorts originating after 1989. Poisson regression modelling predicts continuing generational decline in mortality.ConclusionsDeath rates attributable to CHDs have fallen dramatically with advances in paediatric cardiac surgery and intensive care, largely due to decreased mortality in infants aged under 1 year. Initially, mortality in later childhood rose as infant deaths fell, suggesting death was delayed beyond infancy. Children born within the last 20 years experienced lower mortality throughout childhood.</jats:sec

Dose response of the 16p11.2 distal copy number variant on intracranial volume and basal ganglia.

Carriers of large recurrent copy number variants (CNVs) have a higher risk of developing neurodevelopmental disorders. The 16p11.2 distal CNV predisposes carriers to e.g., autism spectrum disorder and schizophrenia. We compared subcortical brain volumes of 12 16p11.2 distal deletion and 12 duplication carriers to 6882 non-carriers from the large-scale brain Magnetic Resonance Imaging collaboration, ENIGMA-CNV. After stringent CNV calling procedures, and standardized FreeSurfer image analysis, we found negative dose-response associations with copy number on intracranial volume and on regional caudate, pallidum and putamen volumes (β = -0.71 to -1.37; P &lt; 0.0005). In an independent sample, consistent results were obtained, with significant effects in the pallidum (β = -0.95, P = 0.0042). The two data sets combined showed significant negative dose-response for the accumbens, caudate, pallidum, putamen and ICV (P = 0.0032, 8.9 × 10-6, 1.7 × 10-9, 3.5 × 10-12 and 1.0 × 10-4, respectively). Full scale IQ was lower in both deletion and duplication carriers compared to non-carriers. This is the first brain MRI study of the impact of the 16p11.2 distal CNV, and we demonstrate a specific effect on subcortical brain structures, suggesting a neuropathological pattern underlying the neurodevelopmental syndromes

Structured heterogeneity in Scottish stops over the 20th Century

How and why speakers differ in the phonetic implementation of phonological contrasts, and the relationship of this ‘structured heterogeneity’ to language change, has been a key focus over fifty years of variationist sociolinguistics. In phonetics, interest has recently grown in uncovering ‘structured variability’—how speakers can differ greatly in phonetic realization in nonrandom ways—as part of the long-standing goal of understanding variability in speech. The English stop voicing contrast, which combines extensive phonetic variability with phonological stability, provides an ideal setting for an approach to understanding structured variation in the sounds of a community’s language that illuminates both synchrony and diachrony. This article examines the voicing contrast in a vernacular dialect (Glasgow Scots) in spontaneous speech, focusing on individual speaker variability within and across cues, including over time. Speakers differ greatly in the use of each of three phonetic cues to the contrast, while reliably using each one to differentiate voiced and voiceless stops. Interspeaker variability is highly structured: speakers lie along a continuum of use of each cue, as well as correlated use of two cues—voice onset time and closure voicing—along a single axis. Diachronic change occurs along this axis, toward a more aspiration-based and less voicing-based phonetic realization of the contrast, suggesting an important connection between synchronic and diachronic speaker variation