A review of the effectiveness and meaningfulness of education interventions to enable children, young people and their families to self-care for their gastrostomy tubes in the community.

A systematic review of qualitative and quantitative evidence of the effectiveness and meaningfulness of education interventions to enable children, young people and their families to self-care for their gastrostomy tubes in the community

Understanding nurses’ decision-making when managing weaning from mechanical ventilation: a study of novice and experienced critical care nurses in Scotland and Greece.

Aim and objectives To examine how nurses collect and use cues from respiratory assessment to inform their decisions as they wean patients from ventilatory support. Background Prompt and accurate identification of the patient's ability to sustain reduction of ventilatory support has the potential to increase the likelihood of successful weaning. Nurses' information processing during the weaning from mechanical ventilation has not been well-described. Design A descriptive ethnographic study exploring critical care nurses' decision-making processes when weaning mechanically ventilated patients from ventilatory support in the real setting. Methods Novice and expert Scottish and Greek nurses from two tertiary intensive care units were observed in real practice of weaning mechanical ventilation and were invited to participate in reflective interviews near the end of their shift. Data were analysed thematically using concept maps based on information processing theory. Ethics approval and informed consent were obtained. Results Scottish and Greek critical care nurses acquired patient-centred objective physiological and subjective information from respiratory assessment and previous knowledge of the patient, which they clustered around seven concepts descriptive of the patient's ability to wean. Less experienced nurses required more encounters of cues to attain the concepts with certainty. Subjective criteria were intuitively derived from previous knowledge of patients' responses to changes of ventilatory support. All nurses used focusing decision-making strategies to select and group cues in order to categorise information with certainty and reduce the mental strain of the decision task. Conclusions Nurses used patient-centred information to make a judgment about the patients' ability to wean. Decision-making strategies that involve categorisation of patient-centred information can be taught in bespoke educational programmes for mechanical ventilation and weaning. Relevance to clinical practice Advanced clinical reasoning skills and accurate detection of cues in respiratory assessment by critical care nurses will ensure optimum patient management in weaning mechanical ventilation

Every picture tells a story: using selfie-inspired activities to enhance social relations and encourage self-reflexivity.

This chapter explores the results of a study in Thailand that capitalised on the popularity of the selfie, providing second-year English language students with an opportunity to practise their oral presentation and speaking skills. The selfie was used not in the usual sense of online picture-sharing, but as a visual aid in a face-to-face interaction, thus serving as a “currency for social interaction” (van Dijck 2008, p.62) and communication device (Saltz, 2014). Mining the rich insights gained from the Thai study, this chapter presents another selfie-inspired activity adapted for a different context and purpose at a UK university. Initially designed to facilitate recall of students’ names linked with faces, the initiative evolved into an effective conversation starter. It is suggested that both selfie-inspired initiatives have led to serendipitous results, such as encouraging self-reflexivity among the students and promoting the development of “rapid intimacy” in the classroom (Victoria 2011, p.72). Indeed, creating a space for students to share their personal stories and enact different identities can help enrich the learning and teaching experience. This chapter also demonstrates how aspects of visual methodologies can be employed as a resource for theorising visual data, such as the selfie, for classroom application.