Supporting breastfeeding mothers on children’s wards: an overview

Just under half of all six-week-old babies in the UK are breastfed, and just under a quarter are still being breastfed at six months old so it is likely that children’s nurses will frequently encounter breastfed babies on children’s wards. Support for breastfeeding has traditionally been left to midwives but Department of Health guidance requires that all relevant staff have training in this practice. Children’s nurses need to understand the principles and practice of breastfeeding support including correct positioning and attachment, prevention and management of breastfeeding problems, mothers’ needs and safe use of breast pumps. Breastfeeding should be part of the curriculum for children’s nursing courses, including practical sessions to observe breastfeeding support in the clinical setting. Children’s nurses should be aware that literature and learning resources written for midwives might be appropriate for them to access to increase their understanding in this important area of practice.

Survival in 176 patients with inoperable non small cell lung cancer treated initially with chemotherapy in a district general hospital

In advanced non-small cell lung cancer (NSCLC) platinum based chemotherapy with second generation drugs improves median survival (MS) to 8 months and 29% and 10% at 1 and 2 years. Platinum with a third generation drug can improve survival further (BMJ 1995;311: 899) (Spiro et al. Thorax 2004;59:828 Big Lung Trial; N Engl J Med 2003;346:92 ECOG study). NICE now recommends chemotherapy with platinum and a third generation drug for inoperable NSCLC as the first treatment modality. Methods: We audited survival of 176/461 consecutive patients referred for at least 3 courses of platinum and either gemcitabine or vinorelbine from July 2001 to December 2005. Minimal follow up 17 months. Chemotherapy was given on site. Radical radiotherapy for stage IIIA, palliative radiotherapy and second line drugs were given as felt appropriate. Results: 64% were male. 30 (17%) were <55 years ; 66 (37.5%) age 55–65 years; 63 (35.8%) aged 66–75 and 16 (9.1%) >75 years. 5 (2.8%) were stage II; 46 (26%) stage IIIA; 68 (38%) stage IIIB and 55 (30.8%) stage IV. 68 (38%) had 0– 2 courses; 63 (36%) 3 courses and 44 (25%) had 4 or more.

Fostering 'habits of reflection, independent study and free inquiry': an analysis of the short-lived phenomenon of General/Liberal Studies in English vocational education and training

In 1957, 12 years after the end of World War II, the Ministry of Education issued Circular 323 to promote the development of an element of ‘liberal studies’ in courses offered by technical and further education (FE) colleges in England. This was perceived to be in some ways a peculiar or uncharacteristic development. However, it lasted over 20 years, during which time most students on courses in FE colleges participated in what were termed General or Liberal Studies classes that complemented and/or contrasted with the technical content of their vocational programmes. By the end of the 1970s, these classes had changed in character, moving away from the concept of a ‘liberal education’ towards a prescribed diet of ‘communication studies’. The steady decline in apprenticeship numbers from the late 1960s onwards accelerated in the late 1970s, resulting in a new type of student (the state-funded ‘trainee’) into colleges whose curriculum would be prescribed by the Manpower Services Commission. This paper examines the Ministry’s thinking and charts the rise and fall of a curriculum phenomenon that became immortalised in the ‘Wilt’ novels of Tom Sharpe. The paper argues that the Ministry of Education’s concerns half a century ago are still relevant now, particularly as fresh calls are being made to raise the leaving age from compulsory education to 18, and in light of attempts in England to develop new vocational diplomas for full-time students in schools and colleges.

Verstetigung und Verbreitung von E-Learning im Verbundstudium. Onlinebefragung als Promotor und Instrument zur Einbeziehung der Lehrenden bei der Entwicklung und Umsetzung

Das Verbundstudium der nordrhein-westfälischen Fachhochschulen bietet über 3000 Studierenden die Möglichkeit, in einer Kombination von Präsenz- und Selbststudium neben dem Beruf zu studieren. Das Institut für Verbundstudien koordiniert und organisiert die Kooperationsprozesse der Hochschulen und engagiert sich mit seinem Bereich Hochschuldidaktik und Fernstudienentwicklung als Entwicklungs- und Kompetenzzentrum im Bereich der Neuen Medien und des E-Learnings. Zur Verbreitung und Verstetigung der digitalen Lehr- und Lernangebote sowie der Optimierung der Kooperations- und Supportstrukturen hat das Institut eine Onlinebefragung von 200 Lehrenden zur Situation und den Perspektiven des E-Learnings im Verbundstudium durchgeführt. Die Studie zeigt, dass für die Lehrenden auch zukünftig die gedruckte Lerneinheit das zentrale Element der Lehre sein wird. Sie sehen Bedarf zur Ergänzung und Anreicherung des Studiums sowie des Lernens und wünschen sich zur Unterstützung der Lehre ergänzende digitale Elemente vor allem in folgenden Bereichen: Kommunikation, Ergänzungen zu Lerneinheiten (Linklisten, Übungen, ergänzende Medien und Materialien), übergreifendes Glossar. Die Ergebnisse der Onlinebefragung sind die Grundlage des von den Gremien des Verbundstudiums beschlossenen E-Learning-Konzepts. Die von den Lehrenden gewünschten digitalen Elemente und Funktionen sind im Rahmen der Entwicklung durch den Bereich Hochschuldidaktik und Fernstudienentwicklung in der E-Learning-Umgebung VS-online umgesetzt worden. Zurzeit werden die bereitgestellten Elemente und Funktionen von den einzelnen Verbundstudiengängen mit Beiträgen und Inhalten gefüllt. (DIPF/Orig.)

Self-regulated learning and social media – a ‘natural’ alliance? Evidence on students’ self-regulation of learning, social media use and student-teacher relationship

Article is available at: http://www.tandfonline.com/doi/full/10.1080/17439884.2015.1064953.

Hoe ontwerpt u een effectieve MOOC? Voorbeelden uit de praktijk

Wat is kenmerkend voor het design van Massive Open Online Courses (MOOCs)? Wat maakt ontwerpen van MOOCs bijzonder uitdagend maar ook bijzonder interessant? In de workshop over MOOC Ontwerp gaat u actief op zoek naar antwoorden aan de hand van ervaringen met het ontwerpen en uitleveren van MOOCs in twee Europese projecten: EMMA en ECO.

Influences of the Oceans on Human Health and Well-Being

Human health and well-being are tied to the vitality of the global ocean and coastal systems on which so many live and rely. We engage with these extraordinary environments to enhance both our health and our well-being. But, we need to recognize that introducing contaminants and otherwise altering these ocean systems can harm human health and well-being in significant and substantial ways. These are complex, challenging, and critically important themes. How the human relationship to the oceans evolves in coming decades may be one of the most important connections in understanding our personal and social well-being. Yet, our understanding of this relationship is far too limited. This remarkable volume brings experts from diverse disciplines and builds a workable understanding of breadth and depth of the processes – both social and environmental – that will help us to limit future costs and enhance the benefits of sustainable marine systems. In particular, the authors have developed a shared view that the global coastal environment is under threat through intensified natural resource utilization, as well as changes to global climate and other environmental systems. All these changes contribute individually, but more importantly cumulatively, to higher risks for public health and to the global burden of disease. This pioneering book will be of value to advanced undergraduate and postgraduate students taking courses in public health, environmental, economic, and policy fields. Additionally, the treatment of these complex systems is of essential value to the policy community responsible for these questions and to the broader audience for whom these issues are more directly connected to their own health and well-being.

La existencia de necesidades de información y comportamiento informativo en los entrenadores en deportes de combate

Este trabajo tiene como propósito esencial, realizar un acercamiento para detectar e identificar las necesidades de información y el comportamiento informativo de entrenadores en deportes de combate. Para ello se aplicó un cuestionario a instructores de aikido, boxeo, esgrima, judo, karate, kendo, lima lama, lucha y taekwondo seleccionados mediante un muestreo no probabilístico por causalidad. En general encontramos que los principales temas de interés entre los instructores son: los programas de entrenamiento, nutrición y dietas de entrenamiento. Por otra parte, los entrenadores son más propensos a utilizar su experiencia, internet y cursos para obtener información. En contraste se nota que la biblioteca y los libros son poco usados.

Evaluation of extended training for general practice in Northern Ireland: qualitative study.

Objective To evaluate participants' perceptions of the impact on them of an additional six months' training beyond the standard 12 month general practice vocational training scheme. Design Qualitative study using focus groups. Setting General practice vocational training in Northern Ireland. Participants 13 general practitioner registrars, six of whom participated in the additional six months' training, and four trainers involved in the additional six months' training. Main outcome measures: Participants' views about their experiences in 18 month and 12 month courses. Results Participants reported that the 12 month course was generally positive but was too pressurised and focused on examinations, and also that it had a negative impact on self care. The nature of the learning and assessment was reported to have left participants feeling averse to further continuing education and lacking in confidence. In contrast, the extended six month component was reported to have restimulated learning by focusing more on patient care and promoting self directed learning. It developed confidence, promoted teamwork, and gave experience of two practice contexts, and was reported as valuable by both ex-registrars and trainers. However, both the 12 and 18 month courses left participants feeling underprepared for practice management and self care. Conclusions 12 months' training in general practice does not provide doctors with the necessary competencies and confidence to enter independent practice. The extended period was reported to promote greater professional development, critical evaluation skills, and orientation to lifelong learning but does not fill all the gaps.

Approved Social Work Training in Northern Ireland: Using Research to Examine Competence-Based Learning and Influence Policy Change

This article reports on how research activity helped describe and analyse ASW (Approved Social Worker) learning experience as well as acting as a catalyst for change and development in policy and practice in Northern Ireland. The paper contextualizes the study by outlining the legislation, the main features of the ASW role and the approach to ASW training in Northern Ireland, and by reviewing the literature on the efficacy and value of competence-based learning. While the findings do not provide conclusive evidence that a competence-based approach is inherently more effective than previous courses, they do indicate that candidates who were trained in this way were moderately more satisfied than those who had participated in non-competence based programmes. The research also highlights the importance of the interrelationship between training, practice experience and support in developing and sustaining competence. The paper concludes with a review of the recommendations arising from the study and an analysis of the developments in training and regulations relating to practice experience and re-approval of ASWs since publication of the research. The study is of contemporary interest given the proposed changes to the role of ASWs/Mental Health Officers in the context of the reviews of UK mental health law.

Towards Improving the Utilisation of University Teaching Space

There is a perception that teaching space in universities is a rather scarce resource. However, some studies have revealed that in many institutions it is actually chronically under-used. Often, rooms are occupied only half the time, and even when in use they are often only half full. This is usually measured by the ‘utilization’ which is defined as the percentage of available ‘seat-hours’ that are employed. Within real institutions, studies have shown that this utilization can often take values as low as 20–40%. One consequence of such a low level of utilization is that space managers are under pressure to make more efficient use of the available teaching space. However, better management is hampered because there does not appear to be a good understanding within space management (near-term planning) of why this happens. This is accompanied, within space planning (long-term planning) by a lack of experise on how best to accommodate the expected low utilizations. This motivates our two main goals: (i) To understand the factors that drive down utilizations, (ii) To set up methods to provide better space planning. Here, we provide quantitative evidence that constraints arising from timetabling and location requirements easily have the potential to explain the low utilizations seen in reality. Furthermore, on considering the decision question ‘Can this given set of courses all be allocated in the available teaching space?’ we find that the answer depends on the associated utilization in a way that exhibits threshold behaviour: There is a sharp division between regions in which the answer is ‘almost always yes’ and those of ‘almost always no’. Through analysis and understanding of the space of potential solutions, our work suggests that better use of space within universities will come about through an understanding of the effects of timetabling constraints and when it is statistically likely that it will be possible for a set of courses to be allocated to a particular space. The results presented here provide a firm foundation for university managers to take decisions on how space should be managed and planned for more effectively. Our multi-criteria approach and new methodology together provide new insight into the interaction between the course timetabling problem and the crucial issue of space planning.

The Teaching Space Allocation Problem with splitting

A standard problem within universities is that of teaching space allocation which can be thought of as the assignment of rooms and times to various teaching activities. The focus is usually on courses that are expected to fit into one room. However, it can also happen that the course will need to be broken up, or ‘split’, into multiple sections. A lecture might be too large to fit into any one room. Another common example is that of seminars or tutorials. Although hundreds of students may be enrolled on a course, it is often subdivided into particular types and sizes of events dependent on the pedagogic requirements of that particular course. Typically, decisions as to how to split courses need to be made within the context of limited space requirements. Institutions do not have an unlimited number of teaching rooms, and need to effectively use those that they do have. The efficiency of space usage is usually measured by the overall ‘utilisation’ which is basically the fraction of the available seat-hours that are actually used. A multi-objective optimisation problem naturally arises; with a trade-off between satisfying preferences on splitting, a desire to increase utilisation, and also to satisfy other constraints such as those based on event location and timetabling conflicts. In this paper, we explore such trade-offs. The explorations themselves are based on a local search method that attempts to optimise the space utilisation by means of a ‘dynamic splitting’ strategy. The local moves are designed to improve utilisation and satisfy the other constraints, but are also allowed to split, and un-split, courses so as to simultaneously meet the splitting objectives.

El razonamiento moral como elemento constitutivo de la competencia ética: dilemas reales e hipotéticos en profesores de educación secundaria en México

El objetivo del presente texto es la indagación del razonamiento moral en los profesores de secundaria como un elemento de la competencia ética. Se realizó con dilemas morales hipotéticos (analizados y probados previamente para su validación y cuya fiabilidad se obtuvo a través del alfa de Cronbach) y con dilemas reales. Se aplicó a 264 profesores, miembros de la comunidad académica de la Escuela Normal Superior de Michoacán, México. Se analizó a través del programa estadístico Aquad 6. Entre los descubrimientos se encuentra una presencia mayoritaria de conflictos entre las normas éticas interpersonales con las normas de conformidad social y con las normas institucionales particulares. También que la justicia y la protección contra daños a los alumnos son valores presentes en los dilemas reales y una prevalencia en el razonamiento convencional de los profesores

Social networks and cooperative learning in a MOOC

MOOCs are changing the educational landscape and gaining a lot of attention in scientific literature. However, the pedagogical design of these proposals has been called into question. It is precisely MOOCs’ social aspect, i.e. the interaction between course participants and the support for learning processes that has become one of the main topics of interest. This article presents the results of a research project carried out at the University of the Basque Country, which focused in cooperative learning and the intensive use of social networks in a MOOC. Significant data was compiled through Likert-type surveys, revealing that the use of both external and internal social networks in a massive open online course is a factor that is evaluated positively by students. We argue that the use of social networks as a learning strategy in a MOOC has an influence on academic performance and on the students' success rate. Furthermore, the participants’ age also has a bearing on the social networks they use, and we have found that the younger members tend to work with external networks such as Twitter or personal blogs, whereas the older students are more inclined to use forums from the Chamilo or Ning platforms.

Chromosomal rearrangements affecting biofilm production and antibiotic resistance in a Staphylococcus epidermidis strain causing shunt-associated ventriculitis.

Ziebuhr W, Dietrich K, Trautmann M, Wilhelm M. Institut für Molekulare Infektionsbiologie, Würzburg, Germany. w.ziebuhr@mail.uni-wuerzburg.de During two clinical courses of shunt-associated meningitis in a 3-month-old child, five multiresistant S. epidermidis isolates were obtained and analyzed with regard to biofilm production and antibiotic susceptibility. Three S. epidermidis strains, which were initially isolated from the cerebrospinal fluid, produced biofilms on polystyrene tissue culture plates. Following antibiotic treatment and subsequent exchange of the shunt system, sterilization of the CSF was achieved. However, after three weeks a relapse of the infection occurred. The two S. epidermidis isolates obtained now were biofilm negative, but showed an identical resistance pattern as those from the previous infection, except that resistance to rifampicin and increased mininal inhibitory concentrations of aminoglycoside antibiotics had emerged. DNA fingerprinting by PFGE indicated the clonal origin of all isolates. However, some DNA rearrangements and differences in the IS256-specific hybridization patterns could be identified in the isolates from the second infection period that led to altered biofilm formation and increased expression of aminoglycoside resistance traits. The data evidence that variation of biofilm expression occurs in vivo during an infection and highlight the extraordinary genome flexibility of pathogenic S. epidermidis.