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  • The good things in urban nature: A thematic framework for optimising urban planning for nature connectedness

    McEwan, Kirsten; Ferguson, Fiona J; Richardson, Miles; Cameron, Ross; University of Derby (2019-11-06)
    Green interventions which connect people with nature to improve wellbeing are increasingly being applied to tackle the current crisis in mental health. A novel Smartphone app intervention was evaluated amongst adults (n = 228) including (n = 53) adults with common mental health problems, with the aim to improve wellbeing through noticing the good things about urban nature. The app prompted participants once a day over 7 days to write notes about the good things they noticed in urban green spaces. Notes were thematically analysed and ten themes emerged. The three themes with the greatest representation were: i) wonder at encountering wildlife in day-to-day urban settings; ii) appreciation of street trees; and iii) awe at colourful, expansive, dramatic skies and views. Through combining the above themes with the pathways to nature connectedness this paper provides an extended framework of activities to inform activity programming, nature engagement media content, and ‘green health’ interventions. Moreover, the findings have strong implications for optimising city planning, design and management for the wellbeing of both humans and wildlife.
  • Testing real talk: an adaptable evidence-based communication skills intervention in end of life talk

    Watson, Sharan; Whittaker, Becky; Parry, Ruth; University of Derby; Loughborough University (BMJ Journals, 2019-11-17)
    Background Gaps in practice knowledge exist in initiating and navigating through difficult conversations; these new resources provide impactful, evidenced based learning opportunities in developing competence/confidence in engaging patients in end of life talk. Analysis of filmed data of patient consultations at a UK hospice provides the materials for ‘Real Talk’; a novel and flexible education intervention containing real-life video clips. Communication skills training is more likely to be effective in changing behaviours when it is experiential and interactive, being relevant to trainees’ practice. Aim Real Talk interventions were tested out to determine ongoing development of communication skills training for the health and social care workforce. Experienced palliative care doctors attended a three-day facilitated residential workshop in which they explored the Real Talk. Discussions linked to the evidence of communication strategies, reflective diaries and action planning provided opportunity for linking learning to their clinical and educator roles. 29 experienced palliative care doctors attended the workshop who completed a pre/post questionnaire (adapted from a validated tool) and reflective diaries. Delegates identified the most effective aspects of learning as: experiential small group work relating to Real Talk video clips, critiquing underpinning evidence of how clinicians navigate conversations in end of life care and the opportunity to reflect on learning and application to practice in a safe and stimulating environment Engagement and results of the workshop have provided a foundation on which to build flexible communication skills training beyond the hospice setting, in engaging patients in end of life talk. Providing interactive experiential learning, embedded in the evidence base underpinning Real Talk, is crucial for health and social care professionals to develop skills in communicating with patients facing the end of life. The launch of the online Real Talk resources is now recommending that this adaptable approach be skilfully facilitated in safe environments for enhancing skilled practice in end of life care.
  • Genetic haemochromatosis: A qualitative exploration of patients' experience of diagnosis in primary care

    Mortimore, Gerri; Woodward, Amelia; University of Derby (Royal College of General Practitioner's Annual Primary Care Conference, 2019-10-24)
    Genetic haemochromatosis (GH) is the most common inherited genetic disorder in Caucasians (Bacon et al. 2011), and commonly affects Northern Europeans, especially those with Celtic or Nordic descent, with a ratio of approximately 1:220 - 250 people (Fitzsimmons et al. 2018; Phatak et al., 2008;). Despite the prevalence of GH only 1:5000 people are diagnosed with it (Haemochromatosis UK [HUK] 2019; British Liver Trust [BLT] 2017). In GH the body absorbs excess iron which can lead to systematic iron overload within the liver and other internal organs such as the pancreas, heart and joints; eventually causing inflammation and tissue damage. Early symptoms are non specific such as fatigue, abdominal and joint pain and as such, may be considered inconsequential by GP’s, resulting in a delay in diagnosis and treatment. To date there has been little research examining patient’s thoughts and experiences of being diagnosed with GH, a disorder which requires life long treatment with venesection, and which may lead to cirrhosis of the liver and increased risk of hepatocellular carcinoma (Ulvik 2015). Data was collected using semi-structured interviews with a sample of 22 patients with haemochromatosis who responded to a poster advertising the study. The interview covered their experience of diagnosis and treatment and the effect it was having on their lives. Patients had been diagnosed between a year and more than 30 years The interviews were recorded and transcribed verbatim. Analysis of the data was conducted using thematic analyis. Many of the patients felt that GPs lacked knowledge of genetic haemochromatosis and talked about how GPs were unable to give them any detailed information about the disease Early detection and treatment for GH depends on increased knowledge of GPs. This qualitative study identified that patients perceive there to be gaps in understanding GH diagnosis and treatment. Ensuring GPs are aware of GH and the strategies for diagnosis could result in improved patient care. These findings indicate that improved education for GPs regarding GH may be beneficial in order to improve patient care for this condition and potentially reduce delays in diagnosis.
  • Preparing students to care for patients at the end of life

    Westwood, Stacey; Brown, Michelle; University of Derby (Nursing Times, 2019-10)
    Student nurses complete placements in a variety of clinical settings and it is not possible to predict what situations they may encounter, which makes adequate preparation a challenge. They are likely to encounter death and dying during clinical placements from the very start of their education, without necessarily having adequate preparation for the experience. At the University of Derby, 59 first-year students in adult nursing who had completed their first placement evaluated their preparedness to encounter patients at the end of life. They generally found that they lacked training, support and confidence. This article discusses the results of the study and explores how pre-registration nursing education could be improved in this area.
  • The use of simulation and moulage in undergraduate diagnostic radiography education: A burns scenario

    Shiner, Naomi; University of Derby (Elsevier, 2019-01-08)
    There is a national drive to increase allied health professions simulation training. However, there is a paucity of literature within diagnostic radiography in relation to clinical simulation. No research could be found regarding the impact of simulation in radiography with complex clinical burns scenarios.This research aims to explore the perceptions of radiography undergraduate students regarding their preparedness for the complex care requirements in imaging examinations of clinical burns cases using a mixed methods approach. A small-scale simulation-based teaching session was developed in a Scottish HEI, using role play and moulage to create realism. Twenty-eight undergraduate student radiographers participated in the scenario. Students completed pre- and post-scenario questionnaires using Likert scale and free response data. Focus groups were undertaken three months after the simulation to obtain rich qualitative data. Common themes were identified via a process of initial coding and a 6-phase thematic analysis. Thematic analysis demonstrated a marked increased perception of preparedness post-scenario; students felt more prepared to undertake their role in the imaging of complex care patients (Likert scoring increased with both mode and median post-scenario). Common themes that were identified were patient centeredness, realism and learning. Within this limited pilot project, the use of simulation was an effective means of preparing students to understand their role within the complex care setting (with respect to the traumatic realism of burns) in preparedness for professional practice. Additionally, students related to the practical understanding of the complexity of human factors that exist within clinical practice.
  • Can simulation impact on first year diagnostic radiography students' emotional preparedness to encounter open wounds on their first clinical placement: A pilot study

    Shiner, Naomi; University of Derby (Elsevier, 2019-05-11)
    This study reports on the use of moulage within a simulation to introduce first year diagnostic radiography students to open wounds in preparation for clinical practice. A mixed-method quasi-experimental design was used. Visual Analogue Scales were used to capture state feelings at the point of seeing open wounds. Interpretative Phenomenological Analysis was used to draw themes from focus groups and an interview following clinical placement. The simulation reduced negative feelings whilst emotional preparedness, distraction and excitement increased. Five major themes were identified including emotional engagement, engagement with wound, building relationships, developing professional self and simulation impact. The use of moulage and a simulation provides an opportunity to explore initial reactions. Students actively reflect on this experience during clinical practice changing practice. The impact of open wounds can be long lasting and support from radiographers should allow these new experiences to be processed reducing the risk of burnout.
  • Is there a role for simulation based education within conventional diagnostic radiography? A literature review

    Shiner, Naomi; University of Derby (Elsevier, 2018-02-07)
    Simulation based education is advancing, but is there a role for it in Diagnostic Radiography? The aim of this literature review was to understand the use of simulation within conventional diagnostic radiography education to raise awareness of this pedagogical approach. Objectives were to identify the prevalence and stage of delivery in education; understand the variation of simulation and learning objectives informing its use; and review the perceptions of those using simulation in education and practice. The literature review used a systematic search strategy. Library Plus, CINAHL, ScienceDirect, Medline and Google Scholar were reviewed resulting in 703 articles. Inclusion and exclusion criteria were applied with initial review of title and abstract resulting in 22 articles. Fifteen articles were selected following full text review. Simulation was used for both pre-and post-registration education. Themes included inter-professional education, use of computer software and improving patient/practitioner interactions. Increased confidence and understanding of professional roles were common outcomes. Simulation is a valuable pedagogical approach for diagnostic radiography education. Staff training and careful implementation of each stage is required to achieve desired learning outcomes.
  • An overview of the types and applications of simulation-based education within diagnostic radiography and ultrasound at two higher education institutions

    Shiner, Naomi; Pantic, V; University of Derby; University of Leeds (The Society of Radiographers: Deeson Publishing, 2019-06-02)
    The aim of this research was to explore the use of SBE across two HEIs delivering diagnostic radiography and ultrasound programmes; to inform, inspire and encourage educators across HEIs and in clinical practice to implement the use of SBE to support students in their learning.
  • Patient involvement in pressure ulcer prevention and adherence to prevention strategies: An integrative review

    Ledger, Lisa; Worsley, Peter; Hope, Jo; Schoonhoven, Lisette; University of Derby; University of Southampton; Utrecht University (Elsevier, 2019-10-14)
    Chronic wounds including pressure ulcers represent a significant burden to patients and healthcare providers. Increasingly patients are required to self-manage their care but patient adherence to prevention strategies is a significant clinical challenge. It is important to increase understanding of the factors affecting patients’ ability and willingness to follow pressure ulcer prevention interventions. To investigate from a patient perspective the factors affecting adherence to pressure ulcer prevention strategies. Integrative Literature Review Data Sources: A systematic search of electronic databases (Athens, Pub Med, Web of Science, Science Direct, AMED, CINAHL, Cochrane Library, PsychInfo, Google Scholar, Delphis) was initially conducted in May 2017 (repeated August 2018). The methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) principles. The Noticing, Collecting, Thinking (NCT) model of qualitative data analysis was used to identify key themes. A total of twelve studies met the inclusion criteria and were included in the review. The majority of studies were qualitative and three key themes were identified: i) individual/daily lifestyle considerations, ii) patient involvement in the decision-making process, and iii) pain and/or discomfort. There is limited research that focuses on the patient view of factors affecting adherence to prevention measures, particularly in community settings. Individual and daily lifestyle considerations and involvement in decision-making around pressure ulcer care are important aspects from the patient perspective. Further research is necessary to explore which factors affect patient adherence in order to improve clinical practice and support patient involvement in preventative strategies.
  • Expressing suchness: on the integration of writing into a dance practice

    Collard-Stokes, Gemma; University of Derby (Intellect, 2019-07-01)
    This article details the unique pairing of dance and writing, the likes of which are often considered two very different beasts. It examines how approaches to movement improvisation have been used to form and inform innovative methods of entering into the act of writing from the experience of dance. The argument authenticates the current renewed appreciation for the possibilities of writing to enable further creative critical engagement. Consequently, the meeting of creativity and criticality is one in which the dancer playfully explores and examines the suchness of one’s dancing. Suchness is therefore understood as the unique sum of qualities experienced by the dancer – the point at which clarity and closeness facilitate connection through the images, feelings and sensations evoked by dance. In summary, the article outlines the relationship between dance and writing, before exploring the methods used to facilitate a dancer’s assimilation and validation of what happens for them when they dance.
  • How can arts-based research in dramatic performance illuminate understanding of the therapeutic relationship?

    Bird, Drew; University of Derby (Intellect, 2019-10-01)
    This article explores how Heuristic Inquiry (HI), harnessed for arts-based research using solo performance, deepened the author’s understanding of the therapeutic relationship. The research explores the rehearsal and devising process of nine performances to explore barriers to a playful encounter with the audience and client using the myth of Psyche and Cupid. Themes of seeking approval, technique and shame are considered as potential obstacles to forging a co-creative therapeutic alliance.
  • A smartphone app for improving mental health through connecting with urban nature

    McEwan, Kirsten; Richardson, Miles; Sheffield, David; Ferguson, Fiona; Brindley, Paul; University of Sheffield; University of Derby (MDPI, 2019-09-12)
    In an increasingly urbanised world where mental health is currently in crisis, interventions to increase human engagement and connection with the natural environment are one of the fastest growing, most widely accessible, and cost-effective ways of improving human wellbeing. This study aimed to provide an evaluation of a smartphone app-based wellbeing intervention. In a randomised controlled trial study design, the app prompted 582 adults, including a subgroup of adults classified by baseline scores on the Recovering Quality of Life scale as having a common mental health problem (n = 148), to notice the good things about urban nature (intervention condition) or built spaces (active control). There were statistically significant and sustained improvements in wellbeing at one-month follow-up. Importantly, in the noticing urban nature condition, compared to a built space control, improvements in quality of life reached statistical significance for all adults and clinical significance for those classified as having a mental health difficulty. This improvement in wellbeing was partly explained by significant increases in nature connectedness and positive affect. This study provides the first controlled experimental evidence that noticing the good things about urban nature has strong clinical potential as a wellbeing intervention and social prescription.
  • A heuristic model of supervision using small objects to develop the senses

    Bird, Drew; University of Derby (Iris Publishers, 2019-07-31)
    The research explores how the conceptual frame of Heuristic inquiry can inform non-verbal exploration in psychotherapy supervision practices. The author explores their practice as a dramatherapist and how small objects can broaden the awareness of the supervisees own relationship patterns. Small objects helped to re-conceptualise the therapeutic dynamic using metaphor and make conscious parts of the supervisee experience they had been unaware.
  • Liver ultrasound scans.

    Mortimore, Gerri; Mayes, JP; University of Derby (Mark Allen Group, 2019)
    Ultrasound scans can be used in a variety of settings to examine internal organs, muscle, joints, tendons and lesions or to monitor foetal growth and development during pregnancy. Ultrasound, is arguably the most frequently requested form of imaging especially within the gastroenterology department. However, to elucidate a cause of abdominal pain, distension, jaundice, abnormal liver function tests; abdominal ultrasound is one of the easiest, quick and cost-effective ways to do so. In addition, ultrasound can assist the practitioner to rule out other considered differential diagnoses. Since the advent of advanced clinical practitioner roles, nurses are increasingly taking on advanced clinical roles within the field of gastroenterology. With these advanced roles, nurses and other allied health professionals, can act autonomously in the assessment, diagnosis and treatment of patients, which includes the ability to order different tests and investigations, which can comprise of radiological and ultrasound requests. However, it is not just the ordering and requesting of radiological and ultrasound scans, but the requirement to understand the scan report and the ability to deal with the findings in an appropriate and timely fashion, that is vital for improving patient care. This article will focus on abdominal ultrasound, with emphasis on liver ultrasound scans. It will discuss what an ultrasound scan is, and some of the terminology used in liver ultrasound reports. In addition, it will compare ultrasound images of normal liver to abnormal and explore the importance of background information which should be presented on the request form, to aid the sonographer or radiologist in their interpretation of the scan.
  • Nutrition and malnutrition in liver disease: an overview.

    Mortimore, Gerri; University of Derby (Mark Allen Group, 2019-07-17)
    The term malnutrition is generally understood to refer to a deficiency of nutrition, and it is rarely appreciated that malnutrition can also result from excesses in nutritional status. Relatively recent clinical practice guidelines (CPG) from the European Association for the Study of the Liver (EASL) (Merli et al, 2019) acknowledged that malnutrition includes both nutritional surplus and deficiency, but stated that, for the purpose of the CPG, malnutrition would be referred to as undernutrition.
  • Primary Biliary Cholangitis: an update on treatment.

    Mortimore, Gerri; University of Derby (Mark Allen Group, 2019-07-17)
    Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is a chronic but progressive disease that, over many years, causes damage to bile ducts, leading to cholestasis and, in some patients, cirrhosis. The rate at which PBC progresses varies from person to person, but significant damage takes decades to occur. It predominately affects women aged 40–60 years with a female to male ratio of 9:1, but can affect anyone from the age of 20. There is no cure for PBC other than liver transplant, but medications can be given to slow down disease progression and for the treatment of symptoms. Health professionals should monitor for complications, including the development of osteoporosis, vitamin deficiencies and liver cirrhosis, which caries the associated complications of portal hypertension, varices and ascites
  • On Being a Male Dramatherapist

    Holmwood, Clive; University of Derby (Routledge, 2019-07-11)
    This chapter seeks to consider from a phenomenological, systemic and attachment based perspective both training in a female dominated profession and the impact of being a male dramatherapist working with families and children for the last 20 years. It will consider from a philosophical and pragmatic perspective such questions as should male therapists work with young female survivors of sexual abuse? Can male therapists build a more positive therapeutic relationship with adolescent males who have sexually offended? To what extent can the male arts therapists represent a positive role model to adolescents with absent fathers? This chapter will attempt to lift the lid on taboos around what being a male arts therapist is really about and what they should or should not be doing in their work and why by revisiting assumptions about the role of the male therapist and maleness in the therapeutic space. It will begin to delve into areas that the male taboos around the subject areas has never ventured before.
  • Online learning as a vehicle for social change.

    Robertshaw, David; University of Derby (2016-07)
    Online learning as a vehicle for social change, how education can change lives. David looks at how the introduction of MOOCs (Massive Open Online Courses is changing the face of education and making it accessible for everyone to learn.
  • Changing attitudes with a MOOC on dementia

    Kotera, Yasuhiro; Robertshaw, David; University of Derby (Sciendo, 2019-07-12)
    Dementia is one of the most significant issues of our time and there are varying prevailing attitudes towards dementia, including negative stigma and perception. Massive open online courses (MOOCs) are a widely available online learning resource accessed for free which may present an opportunity to address prevailing attitudes. We conducted a questionnaire before and after a six-week MOOC where participants learned about dementia. We collected data using a survey instrument and analysed them with statistical testing. Although there was no statistically significant change between pre- and post-MOOC questionnaires, the change was observed in some questions and for particular groups. Our findings indicate this MOOC has a greater effect on changing the attitudes of non-healthcare workers, older people and those living in the United Kingdom. We recommend further analysis of MOOC as a change intervention and consideration of their application in other disciplines.
  • Primary biliary cholangitis: symptoms, diagnosis and treatment

    Mortimore, Gerri; University of Derby (MA Healthcare, 2019-06)
    Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is a chronic but progressive disease that, over many years, causes damage to bile ducts, leading to cholestasis and, in some patients, cirrhosis. The rate at which PBC progresses varies from person to person, but significant damage takes decades to occur. It predominately affects women aged 40–60 years with a female to male ratio of 9:1, but can affect anyone from the age of 20. There is no cure for PBC other than liver transplant, but medications can be given to slow down disease progression and for the treatment of symptoms. Health professionals should monitor for complications, including the development of osteoporosis, vitamin deficiencies and liver cirrhosis, which caries the associated complications of portal hypertension, varices and ascites.

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