ObjectivesTo evaluate the usability and acceptability of an electronic consent pilot intervention for school-based immunisations and assess its impact on consent form returns and human papilloma ...virus (HPV) vaccine uptake.DesignMixed-methods theory-informed study applying qualitative methods to examine the usability and acceptability of the intervention and quantitative methods to assess its impact.Setting and participantsThe intervention was piloted in 14 secondary schools in seven London boroughs in 2018. Intervention schools were matched with schools using paper consent based on the proportion of students with English as a second language and students receiving free school meals. Participants included nurses, data managers, school-link staff, parents and adolescents.InterventionsAn electronic consent portal where parents could record whether they agreed to or declined vaccination, and nurses could access data to help them manage the immunisation programme.Primary and secondary outcome measuresComparison of consent form return rates and HPV vaccine uptake between intervention and matched schools.ResultsHPV vaccination uptake did not differ between intervention and matched schools, but timely consent form return was significantly lower in intervention schools (73.3% vs 91.6%, p=0.008). The transition to using electronic consent was not straightforward, while schools and staff understood the potential benefits, they found it difficult to adapt to new ways of working which removed some level of control from schools. Reasons for lower consent form return in e-consent schools included difficulties encountered by some parents in accessing and using the intervention. Adolescents highlighted the potential for electronic consent to by-pass their information needs.ConclusionsThe pilot intervention did not improve consent form return or vaccine uptake due to challenges encountered in transitioning to new working practice. New technologies require embedding before they become incorporated in everyday practice. A re-evaluation once stakeholders are accustomed with electronic consent may be required to understand its impact.
Soil samples from agricultural and adjacent forest soils in Northwest Ohio were collected and analyzed for As, Cr, Cu, Ni, Pb, and Zn. pH, Eh, electrical conductivity, and moisture content were also ...measured. Selected samples were also evaluated for grain size and X-rayed to identify clay minerals. In this region, soils contain a large proportion of fines (~32% clay and ~37% silt) with illite, dickite, and chlorite as the main clay minerals. Surface soils in the arable land are slightly acidic (pH ~5.6) while forest soils are near-neutral to slightly basic. All soils become more basic with depth. Soil Eh and electrical conductivity range from 300 to 450 mV and 100 to 375 μS, respectively. In the soil profiles, between 0 and 50 cm depth, As increases from 4.6 to 11 mg/kg, Cr increases from19 to 23 mg/kg and Ni increases 21 to 29 mg/kg. In contrast, Cu decreases from 23 to 17 mg/kg and Pb decreases from17 to 10 mg/kg. Surface enrichment of Cu and Pb can be the result of aerosol deposition, while the downward increase in As, Cr and Ni is related to pedogenic variation. The average concentration of Zn in the samples is 64 mg/kg and does not change with land-use or depth. With the exception of As, the concentration of metals in the agricultural soil is not significantly different from the concentration in forest soil. The concentration of As in the near-surface arable soil (5.6 mg/kg) is significantly different from the concentration of As in the near-surface forest soil (4.3 mg/kg). In both cases, deeper soils have similar As contents. The relative enrichment of As in the surface arable soil could indicate input from herbicides or pesticides. The upward increase in electrical conductivity is interpreted to show that the exchangeable fraction of each metal is higher in the surface soils. However, the near neutral pH and organic, clay-rich soils may limit the mobility. The concentration of these heavy metals and As in the soils are much lower than the limits set by the United States Environmental Protection Agency.
Abstract
The development of an empathetic approach when working with parents and families is fundamental to both social work and children’s nursing; however, opportunities to develop this are ...limited. RealCare Baby infant simulator dolls were used with the aim of enabling students to gain an empathetic insight into parenting. A qualitative, evaluation study involving semistructured interviews with 10 social work and 11 children’s nursing students was undertaken to evaluate experiences and views of infant simulator dolls, in relation to professional learning. Using reflexive thematic analysis of interview data, six key themes were identified: (1) positive experiences, (2) challenges, (3) impact on self, (4) empathy toward parents, (5) realism and (6) learning by reflection. All themes were evident from the participants’ accounts in the context of the parenting experience. In addition to the overall positive impact on students, practical and technical challenges were also identified. However, despite these difficulties, participants valued the learning experience gained from caring for a doll and many articulated how an empathetic understanding of the parenting role was enhanced. This will potentially enable social work and children’s nursing students to support parents more sensitively and empathetically.
This article explores some of the issues surrounding numerical competence for potential pre-registration children's nursing students, with examples of success and failure, at the University of ...Hertfordshire. With poor numerical ability causing concern in the UK, and the effect of low competence on patient safety when calculating drug dosages in healthcare, this article considers some of the literature surrounding numerical ability, confidence and anxiety, along with considering whether a 'C' grade at GCSE is a suitable marker for assessing numerical competence before starting a pre-registration nursing programme.
This is a study of the scientific component of an effort to restore an urban river by removing a low-head dam. The Secor Dam is owned by a local government entity near Toledo, Ohio. The proposed ...removal of the last structure impeding flow on the Ottawa River has broad appeal, but the owner is concerned about liability issues, particularly potential changes to the flood regime, the presence of contaminated sediments behind the dam, and possible downstream transport of reservoir sediments. Assessing sediment contamination involved sediment sampling and analysis of trace metals and organic contaminants. Forecasting sediment transport involved field methods to determine the volume and textural properties of reservoir and upstream sediment and calculations to determine the fate of reservoir sediments. Forecasting changes in the flood regime involved HEC-RAS hydrological models to determine before and after dam removal flood scenarios using LiDAR data imported into an ArcGIS database. The resulting assessment found potential sediment contamination to be minor, and modeling showed that the removal of the dam would have minimal impacts on sediment transport and flood hazards. Based on the assessment, the removal of the dam has been approved by its owners.
Numerical simulation of fluid explusion from geopressured sediments using a one-dimensional finite difference model shows that large volumes of fluid can be transported through a fractured seal ...during short-lived (<100 year) expulsion events. In this model, abnormal fluid pressures are maintained by an impermeable seal. When the fluid pressure exceeds 85% of the lithostatic pressure, a vertical fracture opens in the seal, providing a permeable pathway from the geopressured sediments into the overlying section. Fluid pressure in the seal decreases as fluid flows through the fracture, closing the fracture as sediments in the seal compact. Once the fracture closes, the seal remains impermeable until fluid flowing from deeper in the section increases fluid pressure to the fracture criteria, a process that takes 10 000–500 000 years. Fractures emplaced in relatively incompressible seals, such as compacted and/or cemented sediments, remain open for 20–50 years; fluid fluxes through the seal integrated over the life of these events are 1−5×107 kg/m2, and temperatures in the overlying sediments are increased by 5–20°C. These temperature anomalies decay to less than half their original value in 300 years, suggesting that the thermal anomalies observed in wells that are attributed to fluid expulsion formed in response to a very recent or currently active event.
Christopher James Rowland Roberts, Sheila
BMJ (Online),
06/2014, Letnik:
348, Številka:
jun09 15
Journal Article
Recenzirano
Chris had developed an interest in a medical career when quite young, and in 1953 he gained a place at Guy's Hospital Medical School. While working as a locum in the summer of 1962 in Kingston ...Hospital he was introduced to a partner in a Surbiton practice, and in due course he joined the Central Surgery Group Practice and remained a partner there for 32 years During those years he became much involved in medical politics.
To examine the role of members of the NHS England Youth Forum (NHSEYF) and the strategies used to influence health service provision for children and young people.
An evaluative mixed-methods study ...was commissioned by NHS England and undertaken by the University of Hertfordshire between July 2015 and September 2016. Data collection comprised activity logs, a form of questionnaire, and semi-structured interviews.
The analysis of the activity logs revealed that the young people were undertaking a wide range of activities across England. Seven themes emerged from the interviews: the young people; motivation; commitment; community (the local area as well as a community spirit); knowledge experts; youth workers; and funding. In summary, the members of the NHSEYF were committed to their role and their work was having a positive effect on health service provision.
The NHSEYF has developed rapidly and successfully. It is enabling the voice of young people to be heard.
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