Nursing resources and patient outcomes in intensive care: a systematic review of the literature

Objectives: To evaluate the empirical evidence linking nursing resources to patient outcomes in intensive care settings as a framework for future research in this area. Background: Concerns about patient safely and the quality of care are driving research on the clinical and cost-effectiveness of health care interventions, including the deployment of human resources. This is particularly important in intensive care where a large proportion of the health care budget is consumed and where nursing staff is the main item of expenditure. Recommendations about staffing levels have been trade but may not be evidence based and may not always be achieved in practice. Methods: We searched systematically for studies of the impact of nursing resources (e.g. nurse-patient ratios, nurses' level of education, training and experience) on patient Outcomes, including mortality and adverse events, in adult intensive care. Abstracts of articles were reviewed and retrieved if they investigated the relationship between nursing resources and patient Outcomes. Characteristics of the studies were tabulated and the quality of the Studies assessed. Results: Of the 15 studies included in this review, two reported it statistical relationship between nursing resources and both mortality and adverse events, one reported ail association to mortality only, seven studies reported that they Could not reject the null hypothesis of no relationship to mortality and 10 studies (out of 10 that tested the hypothesis) reported a relationship to adverse events. The main explanatory mechanisms were the lack of time for nurses to perform preventative measures, or for patient surveillance. The nurses' role in pain control was noted by One author. Studies were mainly observational and retrospective and varied in scope from 1 to 52 units. Recommendations for future research include developing the mechanisms linking nursing resources to patient Outcomes, and designing large multi-centre prospective Studies that link patient's exposure to nursing care oil a shift-by-shift basis over time. (C) 2007 Elsevier Ltd. All rights reserved.

Trust, leadership and economic necessity in post-compulsory education

Trust is a complex concept that has increasingly been debated in academic research (Kramer and Tyler, 1996). Research on 'trust and leadership' (Caldwell and Hayes, 2007) has suggested, unsurprisingly, that leadership behaviours influence 'follower' perceptions of leaders' trustworthiness. The development of 'ethical stewardship' amongst leaders may foster high trust situations (Caldwell, Hayes, Karri and Bernal, 2008), yet studies on the erosion of teacher professionalism in UK post-compulsory education have highlighted the distrust that arguably accompanies 'new managerialism', performativity and surveillance within a climate of economic rationalisation established by recent deterministic skills-focused government agendas for education (Avis, 2003; Codd, 1999, Deem, 2004, DFES, 2006). Given the shift from community to commercialism identified by Collinson and Collinson (2005) in a global economic environment characterised by uncertainty and rapid change, trust is, simultaneously, increasingly important and progressively both more fragile and limited in a post compulsory education sector dominated by skills-based targets and inspection demands. Building on such prior studies, this conference paper reports on the analysis of findings from a 2007-8 funded research study on 'trust and leadership' carried out in post-compulsory education. The research project collected and analysed case study interview and survey data from the lifelong learning sector, including selected tertiary, further and higher education (FE and HE) institutions. We interviewed 18 UK respondents from HE and FE, including principals, middle managers, first line managers, lecturers and researchers, supplementing and cross-checking this with a small number of survey responses (11) on 'trust and leadership' and a larger number (241) of survey responses on more generalised leadership issues in post-compulsory education. A range of facilitators and enablers of trust and their relationship to leadership were identified and investigated. The research analysed the ways in which interviewees defined the concept of 'trust' and the extent to which they identified that trust was a mediating factor affecting leadership and organisational performance. Prior literature indicates that trust involves a psychological state in which, despite dependency, risk and vulnerability, trustors have some degree of confident expectation that trustees will behave in benevolent rather than detrimental ways. The project confirmed the views of prior researchers (Mayer, Davis and Schoorman, 1995) that, since trust inevitably involves potential betrayal, estimations of leadership 'trustworthiness' are based on followers' cognitive and affective perceptions of the reliability, competence, benevolence and reputation of leaders. During the course of the interviews it also became clear that some interviewees were being managed in more or less transaction-focused, performative, audit-dominated cultures in which trust was not regarded as particularly important: while 'cautious trust' existed, collegiality flourished only marginally in small teams. Economic necessity and survival were key factors influencing leadership and employee behaviours, while an increasing distance was reported between senior managers and their staff. The paper reflects on the nature of the public sector leadership and management environment in post-compulsory education reported by interviewees and survey respondents. Leadership behaviours to build trust are recommended, including effective communication, honesty, integrity, authenticity, reliability and openness. It was generally felt that building trust was difficult in an educational environment largely determined by economic necessity and performativity. Yet, despite this, the researchers did identify a number of examples of high trust leadership situations that are worthy of emulation.

Conscientiousness and laboriousness as academic achievement predictors in a Spanish students sample

To understand academic performance of students, the variable of conscientiousness from personality inventory Big Five, has been recognized as an important key. The aim of this paper is to analyze the relationship established between the personality factor conscientiousness itself and two of its facets, laboriousness and planning, with academic performance, and observe if there are genre differences in consciousness personality factor. A total of 456 Spanish students of high school and college participated in the study. They were requested to answer a personality report and a self inform questionnaire. The results show that both conscientiousness as a personality dimension and the consideration of laboriousness facet are able to predict academic performance, especially with regard to student’s exam marks, classroom attendance and dedication to study. The genre variable pointed out that feminine genre is more conscious than male in that personality factor. From a practical perspective, these results indicate that the establishment of a routine of continuous work is suitable for improving student grades and their adaptation to the educational environment.

Stylistics, criticism and mythrepresentation again: squaring the circle with Ray Mackay's subjective solution for all problems

This article is a response to an article by Ray Mackay (1996) which constitutes an attack on stylistic analysis in general, and the writings of the above authors and Ron Carter in particular. Mackay's article (in Language and Communication) accuses stylistics of 'scientificness' and claims that its attempt to provide objective analyses of literary texts is futile.1 We suggest that Mackay has misrepresented what stylisticians have said about objectivity, and that his understanding of objectivity, science and the nature of text-interpretative argument is seriously flawed.

Teaching stylistics: analysing cohesion and narrative structure in a short story by Ernest Hemingway

The main aim of this article is to propose an exercise in stylistic analysis which can be employed in the teaching of English language. It details the design and results of a workshop activity on narrative carried out with undergraduates in a university department of English. The methods proposed are intended to enable students to obtain insights into aspects of cohesion and narrative structure; insights, it is suggested, which are not as readily obtainable through more traditional techniques of stylistic analysis. The text chosen for analysis is a short story by Ernest Hemingway comprising only 11 sentences. A jumbled version of this story is presented to students who are asked to assemble a cohesive and well-formed version of the story. Their (re)constructions are then compared with the original Hemingway version. Much interest, it is argued, lies in the ways in which the students justify their own versions in terms of their expectations about well-formedness in narrative. The activity is also intended to encourage students to see literary texts as a valuable means of providing insights into the subtleties of linguistic form and function.

Teaching and Learning Guide for 'Modern Problems of Editing...'

Companion piece to my earlier article in Literature Conmpass: 'Modern Problems of Editing: The Two Texts of Doctor Faustus'. Provides a model for a module based on the topic of that article.

Social Accounting Research as If The World Matters: An essay in postalgia and a new absurdism

This essay is intended as a self-reflective, auto-critique of the ‘social accounting community’. The essay is directed at the academic community of accountants concerned with social accounting. This `community' is predominantly concerned with English language accounting journals and is preoccupied with the social and environmental practices of the larger private sector organisations. The essay is motivated by a concern over our responsibilities as academics in a world in crisis and a concern that social accounting is losing its energy and revolutionary zeal. This community's social accounting endeavours have taken place in almost complete ignorance of the activities and developments in non accounting communities and, in particular, developments in the public and third sectors. The essay reaches out to the public and third sector work and literature as an illustration of one of the ways in which ‘our’ social accounting can try to prevent itself from becoming moribund.

Encouraging and equipping students to engage critically with science in the news: what can we learn from the literature?

Many educational reforms have as one of their key goals the promotion of scientific literacy and they encourage engagement with science in the news as one aspect of this. The research indicates teachers using the news do so for a variety of reasons, sometimes with tangential links to the promotion of scientific literacy. Demonstrating the relevance of science to the world beyond the classroom or making links to socio-scientific issues and promoting discussion on ethical dilemmas are all seen as potential reasons for engaging with science–related news. However, media related issues are often not addressed. Increasingly the need for a more comprehensive approach, including, for example, teaching about media awareness in the context of science reporting, is highlighted. The steady growth of literature describing the use of science-related news along with research studies charting students’ responses to science news media has stimulated discussion and study of pedagogical issues and prompted this review. Key literature relevant to students’ engagement with science-related news reports has been contextualised and reviewed to identify core issues for teachers, teacher educators and curriculum planners. These are listed under the headings of curriculum, pedagogy and assessment, the implications are considered and directions for further research suggested.

Estudantes chineses em Portugal : valores, família e escolaridade

Dissertação de mestrado, Ciências da Educação (Educação Intercultural), Universidade de Lisboa, Instituto de Educação, 2014

The Professional Legitimacy of the Taiwan-educated versus US-educated Taiwanese English Teachers

Thesis (Ph.D.)--University of Washington, 2015