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While feedback is a key factor for improving student learning, little is known about how students understand and experience feedback within the classroom. This study analysed 193 New Zealand primary and secondary students’ survey responses alongside drawings of their understandings and experiences of feedback to examine how they experience, understand, and respond to feedback. It found that despite New Zealand’s strong commitment to student-centred Assessment for Learning practices, the majority of students still drew, selected, and endorsed teacher-led feedback practices, with pictures dominated by written comments or grades. However, they generally depicted and described this feedback as positive and constructive, suggesting that negative emotional responses to evaluative comments and grades may be lessened if students perceive such feedback will help them improve.

Peer- and self-assessment (PASA) are student-led assessment practices with the potential to positively affect achievement. Case studies of three New Zealand classrooms were examined to explore teacher and student perspectives of and purposes for PASA. Four themes (i.e., improvement, accountability, social interaction, and accuracy) were identified. Teachers cited mainly improvement purposes for PASA, with students primarily focused on accuracy and social interaction concerns. Data indicated that these teachers and students needed deeper understanding of how to use PASA for improvement and self-regulation purposes. This suggests teachers must provide concrete instruction in PASA and carefully manage interpersonal issues for successful implementation.

Cross-linked magnetic chitosan beads were prepared in presence of epichlorohydrin under alkaline conditions, and subsequently incubated with glutaraldehyde in order to obtain an activated support for covalent attachment of nucleoside 2'-deoxyribosyltransferase from Lactobacillus reuteri (LrNDT). Changing the amount of magnetite (Fe3O4) and epichlorohydrin (EPI) led to different macroscopic beads to be used as supports for enzyme immobilization, whose morphology and properties were characterized by scanning electron microscopy, spin electron resonance (ESR), and vibrating sample magnetometry (VSM). Once activated with glutaraldehyde, the best support was chosen after evaluation of immobilization yield and product yield in the synthesis of thymidine from 2'-deoxyuridine and thymine. In addition, optimal conditions for highest activity of immobilized LrNDT on magnetic chitosan were determined by response surface methodology (RSM). Immobilized biocatalyst retained 50 % of its maximal activity after 56.3 h at 60 °C, whereas 100 % activity was observed after storage at 40 °C for 144 h. This novel immobilized biocatalyst has been successfully employed in the enzymatic synthesis of 2'-deoxyribonucleoside analogues as well as arabinosyl-nucleosides such as vidarabine (ara-A) and cytarabine (ara-C). Furthermore, this is the first report which describes the enzymatic synthesis of these arabinosyl-nucleosides catalyzed by an immobilized nucleoside 2'-deoxyribosyltransferase. Finally, the attached enzyme to magnetic chitosan beads could be easily recovered and recycled for 30 consecutive batch reactions with negligible loss of catalytic activity in the synthesis of 2,6-diaminopurine-2'-deoxyriboside and 5-trifluorothymidine.; 2.505 JCR (2013) Q2, 61/165 Biotechnology & applied microbiology

Aim: The aim of this paper is to inform and advise researchers on the practical issues associated with involving stroke patients and their carers in research. Background: The involvement of patients and carers in research is increasingly recognised as important, yet researchers are often unclear on how to do this in practice. This is particularly evident in the field of stroke care, where there is limited information available about how to involve stroke patients and their carers in research effectively, or about the difficulties associated with this. Data source: Experience of developing a patient and carer advisory group. Review methods: This paper reflects on the process the authors undertook when developing a stroke patient and carer advisory group as part of a research study exploring the effect of interprofessional team working on the experiences and outcomes after stroke of patients and carers. Discussion: This paper discusses the challenges and the benefits of developing a stroke patient and carer and advisory group, and offers advice to other researchers undertaking a similar process. It aims to provide some practical suggestions that may aid researchers wishing to involve stroke patients and carers in their research. Conclusion: Stroke patients are likely to be older and have long-term physical disabilities or communication problems that may make their involvement in research more challenging to implement. However, with planning and consideration and the allocation of sufficient time and resources, stroke patients and their carers can be effectively involved, resulting in benefits to the research process and output, and to researchers, patients and carers. Implications for practice/research: Pay attention to planning and the practical details of involving stroke patients and their carers in research, ensuring that meetings are arranged in an accessible venue. Use straightforward language in all forms of communication. Listen carefully to their views and perspectives and be prepared to make changes to the study and revise methods if appropriate.

Teachers’ understandings of feedback probably influence the type and quality of feedback that they provide. The beliefs of 518 New Zealand practicing teachers about feedback were evaluated with the Teachers’ Conceptions of Feedback (TCoF) inventory and related to practices these teachers considered to be feedback. Nine feedback factors and four practices factors were found and models were statistically invariant between primary and secondary teachers. New Zealand teachers’ understandings of feedback were strongly focused on improving learning instead of enhancing student well-being. Similar factors are expected in other contexts, though agreement rates should reflect local policy priorities and cultural values.

Dietary carotene intake during the year before diagnosis was estimated for 96 men with lung cancer, 75 men with other epithelial cancers, and 97 hospital controls. Relative to those of men in the lowest third of carotene intake (less than 1,683 micrograms/day), the smoking-adjusted odds ratios for men in the middle (1,683-2,698 micrograms/day) and upper (greater than 2,698 micrograms/day) thirds of carotene intake were 0.67 and 0.45, respectively, for lung cancer (one-sided test for trend, p = 0.048) and 0.63 and 0.65, respectively, for other epithelial cancers (one-sided test for trend p = 0.074). The protective effect of estimated dietary carotene intake was considerably stronger than was the effect of total intake of carotene-rich vegetables and fruits (grams per day), providing some evidence that the protective factor is carotene itself rather than another component of vegetables and fruits.

The recent finding that many permanent and semipermanent hair dyes are strongly mutagenic in a laboratory test, together with the fact that single female hair-dressers had higher than expected death rates from breast-cancer in 1959-63, prompted a study into the use of hair dyes by patients with breast cancer and by matched controls. There was no difference between the patients and their controls in their use of hair dyes. There were also no significant differences between the two groups when the analysis was confinedto women who had used dyes over four years and over nine years before diagnosis. The only significant findings were a higher proportion of past or present smokers among women aged over 50 who used hair dyes and an association between hair dyes use and age at first pregnancy. Further epidemiological studies are clearly needed in view of the mutagenicity found in the Ames test, and the fact th and several human carcinogens are also mutagenic according to this test.

Researchers have always recognised the importance of disseminating the findings of their work, however, recently the need to proactively plan and drive the impact of those findings on the wider society has become a necessity. Firstly, this is because funders require evidence of return from investment and secondly and crucially because national research assessments are becoming powerful determinants of future funding. In research studies associated with nursing, impact needs to be demonstrated by showing the effect on a range of stakeholders including service users, patients, carers, the nursing workforce and commissioners. Engaging these groups is a well-known challenge influenced by lack of access to academic journals, lack of time to read long complex research papers and lack of opportunities to interact directly with the researchers. This needs to be addressed urgently to enable nursing research to increase the impact that it has on health delivery and the work of clinical practitioners. Social media is potentially a novel way of enabling research teams to both communicate about research as studies progress and to disseminate findings and research funders are increasingly using it to publicise information about research programmes and studies they fund. A search of the healthcare literature reveals that advice and guidance on the use of social media for research studies is not well understood or exploited by the research community. This paper, therefore, explores how using social networking platforms, notably Twitter™ offers potential new ways for communicating research findings, accessing diverse and traditionally hard-to-reach audiences, knowledge exchange at an exponential rate, and enabling new means of capturing and demonstrating research impact. The paper discusses approaches to initiate the setup of social networking platforms in research projects and considers the practical challenges of using Twitter™ in nursing and healthcare research. The discussion is illuminated with examples from our current research. In summary, we suggest that the use of social media micro-blogging platforms is a contemporary, fast, easy and cost effective way to augment existing ways of disseminating research which helps drive impact.

Tests and assessments are valued in society, especially when the cost of getting it right matters, for example, when they are used to certify people we need to trust in order to assure public safety and well-being (e.g., engineers, doctors, pilots, train drivers, electricians, teachers, etc.). Without such formal assessments, we would need to rely solely on the attestation of some individual who may well be subject to the influences of collusion, corruption, and cheating (which is why tests were devised in the first place). Alternatively, we might have to rely on free market processes which would take time to weed out incompetents; we know that deficient practitioners (e.g., peddlers of quackery, pseudo-medicine, or health fraud) may well harm unsuspecting and naive citizens (e.g., Gerald Shirtcliff ’s engineering work, produced under false engineering credentials, may have contributed to a building collapse in the 2011 Christchurch earthquake with significant loss of life; Howe, 2014). Hence, society needs confidence that learners and professionals can perform satisfactorily the responsibilities we assign them and we rely on validated evidence of those competencies before opportunities are given.

Background Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing. Methods Reviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised. Results Nine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant. Conclusions In making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave. Trial registration PROSPERO Registration 17 March 2015: CRD42015017613. Electronic supplementary material The online version of this article (10.1186/s12913-017-2707-0) contains supplementary material, which is available to authorized users.

Results 158 potentially relevant papers were published between 1973 and 2014; 85 primary research studies and 10 reviews were included. These addressed 5 themes: risks to patients, patient experience, risks to staff, staff experience and impact on the organisation of work. Evidence of the effects of 12-hour shift patterns is inconclusive in all 5 themes, with some studies demonstrating positive impacts and others negative or no impacts.

This discursive paper is a structured analysis of four completed national and regional studies carried out in the UK. It sets out retrospectively to explore the impact of key contextual, professional and personal features and mechanisms on innovation and outcomes in nursing and the extent to which these are common or diverge across the studies (cases). As successive governments across the world turn their attention to developing nursing as a means of increasing productivity and effectiveness in health care, there is a need for evidence to inform workforce policy and planning about the circumstances that enable positive levers and mechanisms, which influence outcomes to operate. This analysis takes advantage of recent conceptual work on organisational governance and incentives by asking new questions of established data to illuminate our understanding of the pathway to innovation in nursing. Data from the four evaluations (cases) were aggregated and explored thematically within Davies et al.’s framework (Studying health care organisations — links between governance, incentives and outcomes: a review of the literature. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO). http://www.sdo.nihr.ac.uk/files/project/66-final-report.pdf, 2005) of governance, incentives and outcomes. The themes were grouped into three categories: contextual, professional and personal, and interrogated by inter-researcher scrutiny. Taking account of the limitations of comparing studies carried out for different purposes and in different policy circumstances, there are compelling messages emerging about the organisational support, professional leadership and factors that motivate change and innovation in nursing. The analysis suggests that separating governance from incentives oversimplifies what is a complex interplay between organisational governance and the professional and personal enabling factors supporting innovation. The nature of these relationships deserves further study.

The use of chitosan for the encapsulation of active components has gained interest in the last years due to its mucous adhesiveness, non-toxicity, biocompatibility and biodegradability. The benefits of encapsulating active agents in a polymer matrix include their protection from the surrounding medium or processing conditions and their controlled release. In this study chitosan nanoparticles and microspheres were obtained for the encapsulation of yerba mate. Nanoparticles were prepared by ionic gelation of chitosan hydrochloride and sodium tripolyphosphate. The active components were added to the sodium tripolyphosphate solution and this was added dropwise to the chitosan hydrochloride solution while stirring. Microspheres were prepared by the spray-drying method. In this case, antioxidants were added to the chitosan solution and the mixture was spray-dried. The effect of the encapsulating systems on the active compound stability and its release properties was analyzed. The products obtained allowed to control the release of natural antioxidants and therefore these encapsulating methods are a promising technique for nutraceutical and cosmetic applications.

Within the Asia-Pacific community, the New Zealand Ministry of Education has been one of few educational authorities to adopt an Assessment for Learning (AfL) framework and actively promote formative uses of assessment. This paper reports the results of a qualitative study in which eleven New Zealand secondary teachers in two focus groups discussed their conceptions of assessment and feedback. These data were examined to see how teachers defined and understood assessment and feedback processes to identify how these conceptions related to AfL perspectives on assessment. Categorical analysis of these data found teachers identified three types of assessment (formative, classroom teacher–controlled summative and external summative) with three distinct purposes (improvement, reporting and compliance, irrelevance). Feedback was seen as being about learning, grades and marks, or behaviour and effort; these types served the same purposes as assessment with the addition of an encouragement purpose. This study showed that although these New Zealand teachers appeared committed to AfL, there was still disagreement amongst teachers as to what practices could be deemed formative and how to best implement these types of assessment. Additionally, even in this relatively low-stakes environment, they noted tension between improvement and accountability purposes for assessment.

Teacher actions can influence how students engage at school, making it relevant to understand their conceptions of student engagement and how to facilitate it. Reviews of existing literature suggested that a distinction between engagement in schooling and engagement in learning might help differentiate between social and academic outcomes. Data from a phenomenographic study of 20 Australian teachers were analysed to show how teacher thinking related to this distinction. While some teachers held complex conceptions centred on promoting cognitive engagement and student learning, others aligned with engagement in schooling, focusing on generating participation and emphasising positive student affective experiences.

Phenomenographers have developed two frameworks to enhance the study of conceptions. The first framework creates a distinction between what and how aspects; the second level of this framework also includes the act, direct object, and indirect object. This framework allows the conception to be analysed separately from the actions and intentions related to it. The second framework creates a distinction between referential and structural aspects which allows the parts and contexts of the conception to be identified; its second level includes the internal and external horizons. This article traces the origins of these frameworks and reviews 56 studies that have utilised them, examining similarities and differences in their usage. The review found heterogeneous definitions and usages of these frameworks, often with weak links to theory. It concluded by evaluating the utility of these frameworks, identifying that while they may not be strongly grounded in theory, when clearly defined, they can provide a method to ‘think apart’ important distinctions within conceptions.

State funded systems of health care in advanced economies are under severe pressure as a result of ageing populations, rising public expectations and increasing demands for health care. In the UK, ...

The aim of this study was to first evaluate whether the chitosan hydrochloride-genipin crosslinking reaction is influenced by factors such as time, and polymer/genipin concentration, and second, to develop crosslinked drug loaded microspheres to improve the control over drug release. Once the crosslinking process was characterized as a function of the factors mentioned above, drug loaded hydrochloride chitosan microspheres with different degrees of crosslinking were obtained. Microspheres were characterized in terms of size, morphology, drug content, surface charge and capacity to control in vitro drug release. Clarithromycin, tramadol hydrochloride, and low molecular weight heparin (LMWH) were used as model drugs. The obtained particles were spherical, positively charged, with a diameter of 1-10 microm. X-Ray diffraction showed that there was an interaction of genipin and each drug with chitosan in the microspheres. In relation to the release profiles, a higher degree of crosslinking led to more control of drug release in the case of clarithromycin and tramadol. For these drugs, optimal release profiles were obtained for microspheres crosslinked with 1 mM genipin at 50 °C for 5 h and with 5 mM genipin at 50 °C for 5 h, respectively. In LMWH microspheres, the best release profile corresponded to 0.5 mM genipin, 50 °C, 5 h. In conclusion, genipin showed to be eligible as a chemical-crosslinking agent delaying the outflow of drugs from the microspheres. However, more studies in vitro and in vivo must be carried out to determine adequate crosslinking conditions for different drugs.

Chitosan is a natural polymer composed of randomly distributed -(1-4)-linked D-glucosamine (deacetylated unit) and Nacetyl-D-glucosamine (acetylated unit). It has been described as a non-toxic, biodegradable and biocompatible polymer with very interesting biological properties, such as permeation-enhancing and mucoadhesive properties, anticoagulant and antimicrobial activity and so on. Chitosan has been used in several areas such as biomedical, pharmaceutical and biotechnological fields as well as in the food industry. Recently, there has been a growing interest in the modification of chitosan to improve its solubility in physiological conditions, to introduce new applications or to improve chitosan biological properties. Research and development on a variety of amphiphilic copolymers containing hydrophobic and hydrophilic segments, have been very active due to their spontaneous self-assembly behaviour in aqueous media These smart transitions often lead to diverse functional compartment structures like micelles, vesicles and gels, which represent promising applications in the field of biotechnology and pharmaceutics. The aim of the present paper is to review the latest advances in the synthesis of chitosan amphiphilic derivatives with a special emphasis in their applications.

Across Australia, recent policy initiatives have focused on student engagement in school and in learning. Although teachers play a significant role in the implementation of these policy reforms, little research has looked at student engagement from teachers’ perspectives or sought to identify and understand the strategies teachers report using to promote engagement in their classrooms. The study reported in this paper utilised a phenomenographic approach to investigate teacher conceptions of how to facilitate student engagement. Semi‐structured interviews were used to gather data and a phenomenographic process of analysis was employed to identify qualitative differences between participant understandings. The data from this qualitative study indicated that teachers hold diverse understandings about how to facilitate student engagement; three categories described teachers’ ways of engaging students. In the first category, teachers conceptualised delivering set activities and discipline to students to promo...

Teachers’ conceptions of assessment are important as they shape their usage of assessment practices. This study used a phenomenographic approach to examine the various purposes a sample of 26 New Z...

Chitin and its deacetylated derivative chitosan are natural polymers composed of randomly distributed � -(1-4)- linked D-glucosamine (deacetylated unit) and N-acetyl-D-glucosamine (acetylated unit). Chitin is insoluble in aqueous media while chitosan is soluble in acidic conditions due to the free protonable amino groups present in the D-glucosamine units. Due to their natural origin, both chitin and chitosan can not be defined as a unique chemical structure but as a fam- ily of polymers which present a high variability in their chemical and physical properties. This variability is related not only to the origin of the samples but also to their method of preparation. Chitin and chitosan are used in fields as different as food, biomedicine and agriculture, among others. The success of chitin and chitosan in each of these specific applica- tions is directly related to deep research into their physicochemical properties. In recent years, several reviews covering different aspects of the applications of chitin and chitosan have been published. However, these reviews have not taken into account the key role of the physicochemical properties of chitin and chitosan in their possible applications. The aim of this review is to highlight the relationship between the physicochemical properties of the polymers and their behaviour. A functional characterization of chitin and chitosan regarding some biological properties and some specific applications (drug delivery, tissue engineering, functional food, food preservative, biocatalyst immobilization, wastewater treatment, molecular imprinting and metal nanocomposites) is presented. The molecular mechanism of the biological properties such as biocompatibility, mucoadhesion, permeation enhancing effect, anticholesterolemic, and antimicrobial has been up- dated.

SUMMARY A woman aged 40 who had given birth to seven mentally retarded children was diagnosed as having phenylketonuria. Her blood phenylalanine was 18mg/100ml. All the children were microcephalic and retarded in growth, and characteristic facies, skeletal and ear abnormalities were found. Two of the children had Fallot's tetralogy, and one of these two had infantile spasms. Mild diffuse abnormalities were present in the electroencephalograms of four of the children. The findings reinforce the need for careful dietary treatment of pregnant women with phenylketonuria. RESUME Chez une femme de 40 ans ayant donne naissance a sept enfants arrieres mentaux, on a pu porter le diagnostic de phenylcetonurie. Son taux sanguin de phenylalanine etait de 18mg/100ml. Tous les enfants etaient microcephaliques, retardes dans leur croissance, et presentaient un facies caracteristique, des anomalies du squelette et de l'oreille. Deux des enfants avaient une tetralogie de Fallot et chez l'un de ces deux derniers, on notait des spasmes infantiles. Des anomalies diffuses moderees etaient presentes sur les eeg de quatre des enfants. Ces fails renforcent la necessite d'un traitement dietetique soigneux chez les femmes enceintes presentant une phenylcetonurie. ZUSAMMENFASSUNG Eine Frau im Alter von 40 Jahren, die sieben geistig retardierte Kinder geboren hatte, wurde als Phenylketonurikerin diagnostiziert. Ihr Blutphenylalaninspiegel betrug 18mg/100ml. Alle Kinder waren mikrocephal, mindenvuchsig und hatten eine charakteristische Facies und Skelett-und Ohrmisbildungen. Zwei der Kinder hatten eine Fallot'sche Tetralogie und eines davon hatte Neugeborenenkrampfe. Leichte diffuse Veranderungen im eeg fanden sich bei vier Kindern. Die Befunde machen erneut sehr deutlich, das eine sorgfaltige diatetische Uberwachung einer schwangeren Frau mit einer Phenylketonurie erforderlich ist. RESUMEN Una mujer de 40 anos que habia dado a luz siete ninos mentalmente retardados fue diagnosticada de fenilcetonuria. La fenilalanina de su sangre era de 18mg/100ml. Todos los ninos eran microcefalicos y con crecimiento retardado, con facies caracteristica y anomalias esqueleticas y de oreja. Dos de los ninos tenian tetralogia de Fallot y uno de estos dos tenia espasmos infantiles. Habian anomalias difusas ligeras en los eeg de cuatro de los ninos. Los hallazgos refuerzan la necesidad de un cuidadoso tratamiento dietetico de las gestantes con fenilcentonuria.

Elite groups are interesting as they frequently are powerful (in terms of position, knowledge and influence) and enjoy considerable authority. It is important, therefore, to involve them in research concerned with understanding social contexts and processes. This is particularly pertinent in healthcare, where considerable strategic development and change are features of everyday practice that may be guided or perceived as being guided, by elites. This paper evolved from a study investigating the availability and role of nurses whose remit involved leading nursing research and development within acute NHS Trusts in two health regions in Southern England. The study design included telephone interviews with Directors of Nursing Services during which time the researchers engaged in a reflective analysis of their experiences of conducting research with an `elite' group. Important issues identified were the role of gatekeepers, engagement with elites and the use of the telephone interview method in this context. The paper examines these issues and makes a case for involving executive nurses in further research. The paper also offers strategies to help researchers design and implement telephone interview studies successfully to maximise access to the views and experiences of `hard to reach groups', such as elites, while minimising the associated disruption.

Internationally, educational stakeholders are concerned with the high levels of student disengagement, evidenced by early school leaving, poor student behaviour, and low levels of academic achievement. The solution, student engagement, is a contested concept, theorised in a variety of different ways within academic literature. To further understand this concept, a phenomenographic study was conducted to map secondary school teachers’ conceptions of student engagement. Six qualitatively different ways of understanding student engagement were found. This research indicates that teachers do not hold similar understandings of what student engagement means. If the concept of engagement is to become educationally fruitful, the term must be more explicitly defined in educational research and government policy documents to promote shared understandings amongst stakeholder groups.

Aim : To determine whether the Northwick Park Care Needs Assessment (NPCNA) could be used to estimate nursing staff requirements in an inpatient rehabilitation setting. Design : Retrospective analysis of NPCNA data in comparison with nursing staff provision over a six-month period from 1 April 2003 to 30 September 2003. Setting : A specialist neurorehabilitation unit. Methods : Daily care requirements for the ward were calculated at two-week intervals by summing the NPCNA care-hour estimates for all inpatients. Nursing staff hours provided were identified from the unit's duty rota and agency records for each corresponding period. Results : In total, 271 care-hour recordings were extracted from 59 patients. There was a poor relationship between the calculated total ward care-hour requirements and nursing staff hours provided (Pearson's r = 0.31, P = 0.29); but staff hours provided fell significantly short of estimated daily care requirements (mean shortfall 6.2 hours/day, SD 8.6 (95% confidence interval (CI) 0.73, 11.1), P = 0.03)). The shortfall was most obvious during peak care periods in the morning and at bedtime, which resonates with experience reported by nursing staff that they are overstretched at these times. A marked discrepancy between qualified nursing staff hours provided and NPCNA-estimated `special nursing' care requirements highlights a failure to address important facets of the rehabilitation nursing role. Conclusions : The NPCNA, which was designed to assess only direct care needs in a community setting, requires the further development of a new algorithm before it could be used to estimate nursing staff requirements in a rehabilitation ward setting.

OBJECTIVES: To determine whether transfer to a nursing-led inpatient unit (NLIU) prior to discharge from hospital can improve clinical outcome and reduce length of stay and readmission rate for medically stable post-acute patients assessed as requiring inpatient care. METHOD: Retrospective secondary data analysis of individual patient data (n=471) from a programme of three, purposefully replicated, pragmatic randomized controlled trials. Patients were referred to the NLIU by their consultant (attending doctor/surgeon) for nursing-led subacute/post-acute care and randomly allocated to a treatment group for planned transfer to the NLIU for the remainder of their hospital stay or to a control group for traditional consultant-led care in acute wards. Outcome measures were physical function (Barthel Index), length of stay, discharge destination, mortality, psychological well-being (General Health Questionnaire-12), health-related distress (Nottingham Health Profile Distress Index), incidence of complications and readmission within 7, 28, 90 and 180 days. RESULTS: Patients allocated to the NLIU showed greater improvement in physical function (P

Objectives:To evaluate the effectiveness of interventions used to support self-management, and to explore patients’ experiences after acute coronary syndrome in relation to self-management. Design:Scoping review. Data sources Keyword search of CINAHL Plus, Medline, the Cochrane Library, and PsycINFO databases for studies conducted with adult population and published in English between 1993 and 2014. Review methods: From title and abstract review, duplicated articles and obviously irrelevant studies were removed. The full texts of the remaining articles were assessed against the selection criteria. Studies were included if they were original research on 1) effectiveness of self-management interventions among individuals following acute coronary syndrome; or 2) patients’ experience of self-managing recovery from acute coronary syndrome. Results 44 articles (19 quantitative and 25 qualitative) were included. Most studies were conducted in western countries and quantitative studies were UK centric. Self-management interventions tended to be complex and include several components, including education and counselling, goal setting and problem solving skills which were mainly professional-led rather than patient-led. The review demonstrated variation in the effectiveness of self-management interventions in main outcomes assessed - anxiety and depression, quality of life and health behavioural outcomes. For most participants in the qualitative studies, acute coronary syndrome was unexpected and the recovery trajectory was a complex process. Experiences of making adjustment and adopting lifestyle changes following acute coronary syndrome were influenced by subjective life experiences and individual, sociocultural and environmental contexts. Participants’ misunderstandings, misconceptions and confusion about disease processes and management were another influential factor. They emphasised a need for ongoing input and continued support from health professionals in their self-management of rehabilitation and recovery, particularly during the initial recovery period following hospital discharge. Conclusions:Evidence of the effectiveness of self-management interventions among people with acute coronary syndrome remains inconclusive. Findings from the patients’ experiences in relation to self-management following acute coronary syndrome provided important insights into what problems patients might have encountered during self-managing recovery and what support they might need, which can be used to inform the development of self-management interventions. Theoretical or conceptual frameworks have been minimally employed in these studies and should be incorporated in future development and evaluation of self-management interventions as a way of ensuring clarity and consistency related to how interventions are conceptualised, operationalised and empirically studied. Further research is needed to evaluate self-management interventions among people following acute coronary syndrome for sustained effect and within different health care contexts.

This study utilised role theory to investigate teacher aide roles within regional schools in Queensland, Australia. Twenty primary schoolteacher aides were interviewed; data were triangulated with 27 teacher aides' responses to a follow-up questionnaire and interviews with 6 administrative staff. Data suggest that classroom instructional support roles and small group instruction dominate teacher aide work; they also perform many non-instructional roles and work individually with students with diverse needs. School leaders must reconsider the roles expected of these professionals given their position, professional training and remuneration, better supporting teacher aides through improved communication, collaboration and sustained professional learning opportunities.

While creativity can be present with other aspects that constitute giftedness, it can also emerge as a distinct, separate strength that overshadows the presence of other areas. The creatively gifted child is often a divergent, lateral thinker in a convergent, sequentially ordered world.

While teacher aides often provide individual and group reading instruction for at-risk readers, research suggests these interventions may not always bring about reading gains. This Australian study investigated upper primary school teacher aides’ definitions of reading, drawing on semi-structured interview responses and written definitions examined via categorical analysis. The analysis identified six categories classifying participant understandings: Translating, Making sense, Contextualising meaning, Generating an affective response, Using texts for practical purposes, and Growing as a person, with Making sense the most prevalent actual definition. Definitions did not include critical understandings of reading or digital reading practices. The study identifies that teacher aides require better conceptual understandings of reading, especially within upper primary or secondary contexts. However, if teacher aides are expected to obtain further educational credentials or professional learning, careful consideration is also needed about how these increased expectations should impact teacher aide status, working conditions, and remuneration in schools.

Social Studies is an overarching term with widening, ever-changing applications that has few defined boundaries and touches upon a plethora of academic disciplines related to the ways in which society operates.According to The American Heritage Dictionary (Houghton Mifflin Company, 2000) the term, “Social Studies” is“A course of study including geography, history, government, and sociology, taught in secondary and elementary schools.”

The scene was from an unusual project for severely disadvantaged gifted children during 1985 and 1986 that made a difference, brought about change, and had longterm results. This chapter describes the field-based ethnographic research, the teacher training component, and the identification methods that preceded the curriculum project design and implementation.

Gifted children often demonstrate advanced ability in language arts early (Clark, 1992; Sousa, 2009), comprehend verbal implications, utilize sophisticated language and linguistic subtleties such as intonation, are able to argue convincingly, and develop writing, reading, and spelling skills rapidly (Stage & Wagner, 1992).

This chapter is directed to development of programs for students who demonstrate unusual gifts and talents in specific areas. Gifted children with special talents are as different from other gifted children as are gifted from average children. According to Osborn (1996), the intellectually gifted can be defined as those within an IQ range of 120 to 160+, with the range from mildly gifted to exceptionally gifted.

Increasing numbers of HIV-positive young people are transitioning from paediatric to adult services. According to the latest Collaborative HIV Paediatric Study (CHIPS) report1 there are 1873 children with vertically acquired HIV (HIV acquired by mother-to-child transmission) in UK and Ireland, with 595 young people transitioning to adult services. There have been 50–100 young people transferring each year between 2007 and 2013, with a median age of 17.5 (interquartile range 16.6–18.3) years.1 Those aged >15 years have increased from

Objective : In order to determine whether post-acute intermediate care in nursing-led inpatient units (NLUs) is effective in preparing patients for discharge from hospital we conducted a systematic review of the evidence. Review methods : The Cochrane Library, Effective Practice and Organisation of Care specialist register, Medline, Cinahl, Embase, British Nursing Index and the HMIC databases were searched for all available dates up to mid-2003. The science and social science citation indices were searched for papers that cited key works. Authors of papers were asked to identify additional research. Randomised controlled trials, controlled clinical trials, controlled before and after studies and interrupted time-series designs that compared the NLU to usual post-acute inpatient care for adults were included in the review. Studies were assessed for quality. Statistical meta-analysis on the results of controlled trials was performed. Sensitivity analyses were conducted to determine the impact of methodological quality on conclusions. Outcomes : Outcomes considered were mortality, institutionalisation after discharge, functional status early readmission, length of inpatient stay and cost. Results : Nine random or quasi-random controlled trials involving 1669 patients were reviewed. Quality was variable. The mean age of patients in all studies was over 70 years. There was no statistically significant difference in inpatient mortality between NLU and usual inpatient care (OR 1.10, 95% CI 0.56–2.16). The NLU was associated with reduced odds of discharge to institutional care (OR 0.44 95% CI 0.22–0.89), better functional status at discharge (SMD 0.37, 95% CI 0.20–0.54) and reduced odds of early readmission (OR 0.52 95% CI 0.34–0.80). Length of stay until discharge home was increased by 5.13 days (WMD) (95% CI–0.5–10.76 days). At longest follow up (3–6 months) there was no statistically significant difference in the proportion of patients in institutional care (OR 0.97, 95% CI 0.60–1.58). The results were not generally sensitive to study quality. Conclusions : The NLU successfully functions as a form of intermediate care, so far there is no evidence of adverse outcome from the lower level of routine medical care. However, more research is required to confirm safety. Patients discharged from NLUs have higher levels of function although it is unclear if the benefit is simply a product of an increased stay. There is no evidence of benefit over the longer term.

In nineteenth-century France, science and religion have often been portrayed as irredeemably opposed to one another. This article seeks to revise this interpretation by showing how these apparently dissonant views intermingled in the study of hysteria. Through a survey of attitudes towards Catholicism and in their treatment of Catholic patients, the article shows how French psychiatrists and neurologists were deeply indebted to religious iconography and experience, despite their vehement anti-clericalism. Because of their hatred of the church, they focused on the treatment of female hysterics who manifested ‘religious’ symptoms – demonopathy, mystical states, and stigmata – in order to amass conclusive evidence of Catholic ‘superstition’. Their preoccupation with such patients meant, however, that they paradoxically re-embedded Catholicism into their scientific practice by incorporating religious motifs, bodily poses, and iconography into their diagnosis of hysteria. At the same time, their disdain for the Catholic religious imagination meant that they refused to explore the fantasies of their subjects. For physicians like Jean-Martin Charcot and the more subtle Pierre Janet – a contemporary and competitor of Sigmund Freud – fantasies of bodily suffering, unearthly physical perfection, and an array of Catholic maternal fantasies associated with images of Mary and Christ were all nothing more than delusions, not the stuff from which an appreciation or understanding of the ‘unconscious’ could emerge. The result was that French physicians offered no psychodynamic transformation or symbolic reinterpretation of their words or physical symptoms, a resistance that was one reason among many for their hostility to psychoanalysis.