Combining and integrating life /social sciences and citizen trainers in Nurse Education - a N. Ireland initiative

Before commencement of the academic year 2012/2013 the social sciences, public health and the biomedical sciences were taught to separate modules. This reinforced the idea off separate disciplines certainly for some of the younger students and a failure to appreciate the interconnectedness (whole person) perspective on health; separately modules taught and assessed in separate silos. There was limited understanding by the lecturers of the other areas that they were not teaching to -reflecting perhaps a dis-coordinated approach to health sciences (Mason and Whitehead 2003). As a result of significant discussion and interdisciplinary negotiation the life, social sciences public health/ health education were drawn together in the one module for the academic year 2012/13. The module provides the undergraduate students with an introduction to an understanding of Life Sciences, psychology, sociology and public health and their contribution within the context of nursing and midwifery. Each week’s teaching seeks to reflect against the other module delivered in first year - addressing clinical skills. The teaching is developing innovative e-learning approaches, including the use of a virtual community. The intention is to provide the student with a more integrated understanding and teaching to the individual’s health and to health within a social context (Lin 2001; Iles- Shih 2011). The focus is on health promotion rather than disease management. The module runs in three phases across the student’s first-year and teachers to the field of adult mental health, learning disability, children’s nursing and the midwifery students -progressively building on the student’s clinical experience. The predominant focus of the module remains on health and reflecting aspects of life and social life within N. Ireland. One of the particular areas of interest and an area of particular sensitivity is engaging the students to the context of the Northern Ireland civil unrest (the Troubles); this involves a co-educational initiative with service users, only previously attempted with social work students (Duffy 2012). The service users are represented by WAVE an organisation offering care and support to bereaved, traumatised or injured as a result of the violent civil conflict `the Troubles’. The `Troubles’ had ranged over an extended period and apart from the more evident and visual impact of death and injury, the community is marked by a disproportionate level of civil unrest, the extremes of bereavement, imprisonment, displacement antisocial behaviour and family dysfunction (Coulter et al. 2012). As co-educators with the School of Nursing and Midwifery, WAVE deliver a core lecture (augmented by online material), then followed by tutorials. The tutorials are substantially led by those who had been involved with and experienced loss and trauma as a result of the conflict (Health Service users) as `citizen trainers’ and provide an opportunity for them to share their experience and their recollection of personal interaction with nursing and midwifery students; in improving their understanding of the impact of `The Troubles’ on patients and clients affected by the events (Coulter et al. 2012) and to help better provide a quality of care cognisant of the particular needs of those affected by `the Troubles’ in N.Ireland. This approach is relatively unique to nursing in N. Ireland in that it involves many of those directly involved with and injured by the `Troubles’ as `citizen trainers’ and clearly reflects the School’s policy of progressively engaging with users and carers of nursing and midwifery services as co-educators to students (Repper & Breeze 2006). Only now could perhaps such a sensitive level of training to student nurses and midwives be delivered across communities with potential educative lessons for other communities experiencing significant civil unrest and sectarian conflict.

Blending Art and Science in Nurse Education: The Benefits and Impact of Creative Partnerships

Blending Art and Science in Nurse Education: The Benefits and Impact of Creative Partnerships

This paper presents the benefits of an innovative education partnership between lecturers from the School of Nursing and Midwifery, Queens University Belfast and Arts Care, a unique Arts and Health Charity in Northern Ireland, to engage nursing students in life sciences

Nursing and Midwifery students often struggle to engage with life science modules because they lack confidence in their ability to study science.This project was funded by a Teaching Innovation Award from the School of Nursing and Midwifery, Queens University Belfast, to explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology. The project was facilitated through collaboration between Teaching staff from the School of Nursing and Midwifery and Arts Care, Northern Ireland. This unique Arts and Health Charity believes in the benefits of creativity to well being.

RESEARCH OBJECTIVE(S)
To explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology.

METHODS AND METHODLOGY
Students participated in a series of workshops designed to explore the cells, tissues and organs of the human body through the medium of felt. Facilitated by an Arts Care artist, and following self-directed preparation, students discussed and translated their learning of the cells, tissues and organs of the human body into striking felt images. During the project students kept a reflective journal of their experience to document how participation in the project enhanced their learning and professional development

RESULTS
Creativity transformed and brought to life the students learning of the cells, tissues and organs of the human body.

The project culminated in the exhibition of a unique body of artwork which has been exhibited across Northern Ireland in hospitals and galleries and viewed by fellow students, teaching staff, nurses from practice, artists, friends, family and members of the public.

CONCLUSION
The impact of creativity learning strategies in nurse education should be further explored.

REFERENCES
Bennett, M and Rogers, K.MA. (2014) First impressions matter: an active, innovative and engaging method to recruit student volunteers for a pedagogic project. Reflections, Available online at: QUB, Centre for Educational Development / Publications / Reflections Newsletter, Issue 18, June 2014.

Chickering,A.W. and Gamson,Z.F. (1987) Seven principles for good practice in undergraduate education The American Association for Higher Education Bulletin, March. http://www.aahea.org/aahea/articles/sevenprinciples1987.htm, accessed 8th August 2014

Fell, P., Borland, G., Lynne, V. (2012) Lab versus lectures: can lab based practical sessions improve nursing students’ learning of bioscience? Health and Social Care Education 3:1, 33-38

Does social deprivation influence inter-group contact outcomes for pupils in Northern Ireland?

The education system in Northern Ireland is characterized by division, with
around 95% of the pupil population attending predominantly co-religionist
schools. In a society that is transitioning from a thirty year conflict that has been
framed by hostilities between the main Catholic and Protestant communities, reconciliation
interventions in education have sought to promote the value of intergroup
contact between pupils attending separate schools. Some qualitative research
suggests that such initiatives are more likely to have positive outcomes for
pupils from more middle class backgrounds than those from more disadvantaged
communitiesand areas that experienced high levels of conflict related incidents and deaths during the pre-ceasefire years. Drawing on contact theory and empirical evidence from a large scale quantitative study, we seek to examine this theory. Using free school meals as a proxy for social class, our findings are consistent in finding that there is a differential impact of contact for those from less affluent backgrounds, and we conclude by arguing that this should be reflected in policy responses.

The first major step in the peace process’? Exploring the impact of the Anglo-Irish Agreement on Irish Republican thinking

This article supports interpretations of the Anglo-Irish Agreement of 1985 as a significant factor contributing to the development of the Northern Ireland peace process. However, it also emphasises a certain serendipity in the Agreement's effect on northern nationalist, and more specifically republican, politics in the region. In particular, it stresses that a specific interpretation of the Agreement promoted by the Social Democratic and Labour Party inspired a dialogue with republicanism, encouraging an ongoing reappraisal within the latter about the nature of Britain's role in Northern Ireland. This, the article argues, reinforced the movement towards a more political approach that republicans had begun in the 1980s, and encouraged their eventual embrace of a constitutional strategy in the 1990s. However, in advancing this argument, the article notes that such an outcome was far from the minds of the British and Irish officials who negotiated the Anglo-Irish Agreement. The Agreement was intended to marginalise rather than accommodate republicans. Despite this, it provided an inadvertent incentive to draw militant republicanism into the democratic process in Northern Ireland.

Impact of average household income and damage exposure on post-earthquake distress and functioning: A community study following the February 2011 Christchurch earthquake.

Post-traumatic stress, depression and anxiety symptoms are common outcomes following earthquakes, and may persist for months and years. This study systematically examined the impact of neighbourhood damage exposure and average household income on psychological distress and functioning in 600 residents of Christchurch, New Zealand, 4–6 months after the fatal February, 2011 earthquake. Participants were from highly affected and relatively unaffected suburbs in low, medium and high average household income areas. The assessment battery included the Acute Stress Disorder Scale, the depression module of the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7), along with single item measures of substance use, earthquake damage and impact, and disruptions in daily life and relationship functioning. Controlling for age, gender and social isolation, participants from low income areas were more likely to meet diagnostic cut-offs for depression and anxiety, and have more severe anxiety symptoms. Higher probabilities of acute stress, depression and anxiety diagnoses were evident in affected versus unaffected areas, and those in affected areas had more severe acute stress, depression and anxiety symptoms. An interaction between income and earthquake effect was found for depression, with those from the low and medium income affected suburbs more depressed. Those from low income areas were more likely, post-earthquake, to start psychiatric medication and increase smoking. There was a uniform increase in alcohol use across participants. Those from the low income affected suburb had greater general and relationship disruption post-quake. Average household income and damage exposure made unique contributions to earthquake-related distress and dysfunction.

Risking peace in the ‘War against the Poor’? Social exclusion and the legacies of the Northern Ireland conflict

Discourses around poverty, dependency and austerity take a particular form when it comes to Northern Ireland which is seen as ripe for economic ‘rebalancing’ and public sector reduction. The Welfare Reform Act 2012 is pivotal in that it provides the muscle for disciplining claimants for a low-waged, flexible labour market. But the Northern Ireland Assembly has not passed the Act or agreed a budget and the return of Direct Rule beckons as a result. The article sheds light on the stand-off over the Welfare Reform Act using data from the 2012 PSE Survey. It demonstrates that the impact of violent conflict is imprinted on the population in terms of high rates of deprivation, poor physical and mental health, and significant differences between those experiencing little or no conflict, and those with ‘high’ experience. In ignoring these legacies of the conflict, the Westminster government is risking peace in its ‘war against the poor’.

Measuring burnout among UK social workers: A Community Care study

Preface Extract: This research was commissioned and funded by Community Care as part of our Stand Up For Social Work campaign. Previous surveys of readers had suggested caseloads, vacancies and stress levels were all on the increase. Community Care decided to do a more scientific examination of burnout on a large scale to assess the real impact of budget cuts and increasing demand on social workers across the UK.

The impact of an integral student engagement approach on teaching Operations and Supply Chain Management

In this study we investigate the influence of the implementation of multidimensional engagement on students’ academic, social and emotional outcomes in the teaching of Operations and Supply Chain Management (OSCM) modules. Next to the academic and behavioural engagement dimensions, which are traditionally used to engage students in OSCM courses, we also incorporate a cognitive dimension to enhance integral student engagement. Up to know, integral student engagement is not reported in the OSCM literature. Cognitive engagement is based on implementation of summative self- and peer-assessment of weekly assignments. Our investigation is based on action research, conducted in an OSCM module over two consecutive years. We found that, in general, multidimensional engagement results in higher levels of academic performance, development of relationships with academic staff and their peers and emotional satisfaction. These findings are discussed in relation to several contextual factors: nature of the study material, gender, and the home location of students.

Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: a qualitative-evidence synthesis

Background:
Prolonged mechanical ventilation is associated with a longer intensive care unit (ICU) length of stay and higher mortality. Consequently, methods to improve ventilator weaning processes have been sought. Two recent Cochrane systematic reviews in ICU adult and paediatric populations concluded that protocols can be effective in reducing the duration of mechanical ventilation, but there was significant heterogeneity in study findings. Growing awareness of the benefits of understanding the contextual factors impacting on effectiveness has encouraged the integration of qualitative evidence syntheses with effectiveness reviews, which has delivered important insights into the reasons underpinning (differential) effectiveness of healthcare interventions.

Objectives:
1. To locate, appraise and synthesize qualitative evidence concerning the barriers and facilitators of the use of protocols for weaning critically-ill adults and children from mechanical ventilation;

2. To integrate this synthesis with two Cochrane effectiveness reviews of protocolized weaning to help explain observed heterogeneity by identifying contextual factors that impact on the use of protocols for weaning critically-ill adults and children from mechanical ventilation;

3. To use the integrated body of evidence to suggest the circumstances in which weaning protocols are most likely to be used.

Search methods:
We used a range of search terms identified with the help of the SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) mnemonic. Where available, we used appropriate methodological filters for specific databases. We searched the following databases: Ovid MEDLINE, Embase, OVID, PsycINFO, CINAHL Plus, EBSCOHost, Web of Science Core Collection, ASSIA, IBSS, Sociological Abstracts, ProQuest and LILACS on the 26th February 2015. In addition, we searched: the grey literature; the websites of professional associations for relevant publications; and the reference lists of all publications reviewed. We also contacted authors of the trials included in the effectiveness reviews as well as of studies (potentially) included in the qualitative synthesis, conducted citation searches of the publications reporting these studies, and contacted content experts.

We reran the search on 3rd July 2016 and found three studies, which are awaiting classification.

Selection criteria:
We included qualitative studies that described: the circumstances in which protocols are designed, implemented or used, or both, and the views and experiences of healthcare professionals either involved in the design, implementation or use of weaning protocols or involved in the weaning of critically-ill adults and children from mechanical ventilation not using protocols. We included studies that: reflected on any aspect of the use of protocols, explored contextual factors relevant to the development, implementation or use of weaning protocols, and reported contextual phenomena and outcomes identified as relevant to the effectiveness of protocolized weaning from mechanical ventilation.

Data collection and analysis:
At each stage, two review authors undertook designated tasks, with the results shared amongst the wider team for discussion and final development. We independently reviewed all retrieved titles, abstracts and full papers for inclusion, and independently extracted selected data from included studies. We used the findings of the included studies to develop a new set of analytic themes focused on the barriers and facilitators to the use of protocols, and further refined them to produce a set of summary statements. We used the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) framework to arrive at a final assessment of the overall confidence of the evidence used in the synthesis. We included all studies but undertook two sensitivity analyses to determine how the removal of certain bodies of evidence impacted on the content and confidence of the synthesis. We deployed a logic model to integrate the findings of the qualitative evidence synthesis with those of the Cochrane effectiveness reviews.

Main results:
We included 11 studies in our synthesis, involving 267 participants (one study did not report the number of participants). Five more studies are awaiting classification and will be dealt with when we update the review.

The quality of the evidence was mixed; of the 35 summary statements, we assessed 17 as ‘low’, 13 as ‘moderate’ and five as ‘high’ confidence. Our synthesis produced nine analytical themes, which report potential barriers and facilitators to the use of protocols. The themes are: the need for continual staff training and development; clinical experience as this promotes felt and perceived competence and confidence to wean; the vulnerability of weaning to disparate interprofessional working; an understanding of protocols as militating against a necessary proactivity in clinical practice; perceived nursing scope of practice and professional risk; ICU structure and processes of care; the ability of protocols to act as a prompt for shared care and consistency in weaning practice; maximizing the use of protocols through visibility and ease of implementation; and the ability of protocols to act as a framework for communication with parents.

Authors' conclusions:
There is a clear need for weaning protocols to take account of the social and cultural environment in which they are to be implemented. Irrespective of its inherent strengths, a protocol will not be used if it does not accommodate these complexities. In terms of protocol development, comprehensive interprofessional input will help to ensure broad-based understanding and a sense of ‘ownership’. In terms of implementation, all relevant ICU staff will benefit from general weaning as well as protocol-specific training; not only will this help secure a relevant clinical knowledge base and operational understanding, but will also demonstrate to others that this knowledge and understanding is in place. In order to maximize relevance and acceptability, protocols should be designed with the patient profile and requirements of the target ICU in mind. Predictably, an under-resourced ICU will impact adversely on protocol implementation, as staff will prioritize management of acutely deteriorating and critically-ill patients.

Emotional response to images of wind turbines: A psychophysiological study of their visual impact on the landscape

Social acceptance for wind turbines is variable, providing a challenge to the implementation of this energy source. Psychological research could contribute to the science of climate change. Here we focus on the emotional responses to the visual impact of wind turbines on the landscape, a factor which dominates attitudes towards this technology. Participants in the laboratory viewed images of turbines and other constructions (churches, pylons and power-plants) against rural scenes, and provided psychophysiological and self-report measures of their emotional reactions. We hypothesised that the emotional response to wind turbines would be more negative and intense than to control objects, and that this difference would be accentuated for turbine opponents. As predicted, the psychophysiological response to turbines was stronger than the response to churches, but did not differ from that of other industrial constructions. In contrast with predictions, turbines were rated as less aversive and more calming compared with other industrial constructions, and equivalent to churches. Supporters and non-supporters did not differ significantly from each other. We discuss how a methodology using photo manipulations and emotional self-assessments can help estimate the emotional reaction to the visual impact on the landscape at the planning stage for new wind turbine applications.

Moving Out of Conflict: Negotiating Social Identity in Response to Segregation in Northern Ireland

This paper examines the impact of territoriality on young people’s everyday experiences in Northern Ireland’s segregated communities. It shows how urban encounters are reproduced through negotiating differences and the ways in which living in divided communities escalates moods of social inequality and spatial imbalances. The empirical study undertaken in the city of Derry shows how individuals and community groups position and identify themselves under the impact of social segregation. Building on Gordon Allport’s (1954) theories of contact, I explain how people in Derry have established their own sense of belonging, of who they are, based on their group memberships which eventually became an important source of pride and selfesteem. They also presented their own intertextual references as a cause of routine survival and belonging, allowing them to be more constructive about their future. Under deeply rooted segregation in Northern Ireland, the young generations are sought to provide lasting change to foster peace and integration between the two communities.

Social housing tenants, Climate Change and sustainable living: A study of awareness, behaviours and willingness to adapt

Despite a focus in the UK on providing sustainable housing in recent years, it is unlikely that targets set to reduce resource consumption in housing will be achieved without a greater focus on human behaviour. It is necessary to understand the actions of people occupying dwellings, as it is invariably the occupants rather than the buildings that decided whether or not to consume resources. In this paper the authors present a pilot study where 53 social housing tenant households in Northern Ireland were interviewed to ascertain their perceptions of Climate Change, their current behaviours and their willingness to reduce energy and water consumption in the home. The intention was to explore links between perceptions and reported behaviour as well as perceptions and willingness to reduce resource consumption. Results show that 77% of tenants believed Climate Change to be an important issue; 57% accepted that it is up to the individual to take responsibility for tackling Climate Change; and demonstrated a strong desire to make a difference to reduce their impact. The researchers identified both passive (devices) and active (behaviours) resource savings currently in place and established where further resource reduction was feasible based on tenants' willingness to alter their behaviours.

Comparing Social Work Students' Perceptions of Risk Using Online Discussion Fora: Lessons Learned from a European Pilot Project

Comparisons of international child welfare systems have identified two basic orientations to practice; a ‘child protection’ orientation and a ‘child welfare’ orientation, which are founded upon fundamentally different values and assumptions regarding the family, the origins of child care problems, and the proper role of the state in relation to the family. This paper describes a project which sought to compare how undergraduate social work students from three European Universities perceive risk in referrals about the welfare of children and to explore the impact of different cultural, ideological and educational contexts on the way in which risk is constructed by students. Students from Northern Ireland, Germany and Poland examined three vignettes via ten online discussion fora each of which provided a narrative summary of their discussion. The paper presents some findings from the analysis of the qualitative data emerging from the student discussions and draws out the lessons learned in terms of how the project was designed and implemented using online discussion fora.

Not all social cleavages are the same: On the relationship between religious diversity and party system fragmentation

Most studies examining the relationship between social cleavages and party system fragmentation maintain that higher levels of social diversity lead to greater party system fragmentation. However, most aggregate-level studies focus on one type of social cleavage:ethnic diversity. In order to develop a better understanding of how different cleavages impact electoral competition, this paper considers another type of social cleavage: religious diversity.Contrary to previous literature, higher levels of religious diversity provide incentives for cross-religious cooperation, which in turn reduces party system fragmentation. Using a cross national data set of elections from 1946-2011, the results show that, in contrast to most studies examining the effects of social cleavage diversity on the number of parties, higher religious diversity is associated with lower levels of party system fragmentation.