Nursing students' and educators' perspectives on sustainability and climate change: An integrative review

AIM

To identify and synthesize research on the awareness, attitudes and action related to sustainability and climate change from the perspective of nursing students and educators globally.

DESIGN

Integrative review.

METHODS

The review was guided by Whittemore and Knafl. Included studies were appraised using the Mixed Methods Appraisal Tool. A deductive content analysis based on Elo and Kyngäs' methodology was employed.

DATA SOURCES

CINAHL, MEDLINE, EMBASE, Web of Science, British Education Index, GreenFILE and Scopus were searched up to the 8th November 2022.

RESULTS

Thirty-two studies were included in the review. Two studies included nursing educators in their samples, the rest focused solely on students. Findings suggest that whilst some students were aware of sustainability issues and felt that nurses have a responsibility to mitigate climate change, others showed limited awareness and believed that nurses have more important priorities. A global interest was seen among students for increased curricular content related to sustainability and climate change. Waste management and education of others were suggested actions students can take; however, barriers included lack of confidence and limited power.

CONCLUSION

There is a need for sustainability education within nursing curricula, accompanied by student support.

IMPLICATIONS FOR THE PROFESSION

The review acts as a starting point to make sustainable healthcare and climate change mitigation integral aspects of nursing.

IMPACT

Sustainability education within nursing curricula can positively impact on sustainable healthcare and climate change mitigation. More research is needed on the perspectives of nursing educators.

REPORTING METHOD

The review is reported according to the PRISMA guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Impact of the COVID-19 Pandemic on Academic Productivity in Oncology: A Journal-, Conference- and Author-level Analysis

PURPOSE/OBJECTIVE(S)

The objective of this study was to determine the impact of the COVID-19 pandemic on academic productivity in oncology as measured by conference abstracts, journal publications and individual authorship trends.

MATERIALS/METHODS

Using a reference time frame of 2018 to 2022, we obtained data on the number of abstracts and articles submitted and published from a selection of oncology conferences and journals. To assess individual authorship patterns, we randomly selected 200 articles from 2018 (i.e., the 'index paper') and tracked publications over subsequent years for the first or last authors. Linear time-trend analyses and independent two-sample t-tests were used to assess changes in academic productivity over time, and univariable and multivariable linear regression were used to analyze individual factors predictive of publication rates, including gender, continent, specialty, MD vs. non-MD, and career status (early if within 5 years of training completion vs. late for all others).

RESULTS

Data on submitted and published abstracts were available from 5 and 7 conferences, respectively. Both abstract categories demonstrated decreasing values over time but not statistically significant: conference submissions decreased from 15,308 in 2018 to 13,623 in 2022, (p = 0.11), and published abstracts decreased from 13,111 to 11,848, respectively (p = 0.16). Journal submissions were available from 6 journals and increased from 14,142 in 2018 to a peak of 20,241 in 2020 (2018 vs. 2020: p<0.001), and then declined to 15,650 in 2021. Journal publications from 10 journals showed no clear trends over time (p = 0.64). For the author-level analysis, of the 200 authors randomly selected, the majority were male (66.5%), from North America (55.5%), with an MD degree (80.9%, 131/162) and late career (86.6%, 129/149). Most common specialties included surgery (29%), radiation oncology (18.5%), epidemiology/public health (11%) and medical oncology (10%). For articles authored per year, there was no linear trend detected (p = 0.51), although mean number of publications per author peaked in 2020/2021 (papers/year for 2018-2022: 18.1, 18.1, 20.1, 21.2, 19.6). On univariable analysis, factors significantly associated with increasing publication rates were male gender, last author position on index paper, late career status, MDs, speciality of surgery or public/health epidemiology, and authors from Asia (all p<0.01). On multivariable analysis, factors remaining significantly predictive were late career status, MDs, specialty of surgeons or public health/epidemiologists, and authors from Asia (all p<0.01).

CONCLUSION

Conference submissions and publications trended downward from 2018 to 2022. Journal submissions peaked overall in 2020, but did not translate to increases in journal publication rates. Disparities in publication trends were found, based on speciality and geographic regions, including a negative impact on early-career researchers.

Exploring barriers, motivators and solutions to achieve a healthy lifestyle among undergraduate student nurses

BACKGROUND

Many preregistration student nurses tend to be overweight or obese and have unhealthy lifestyles.

AIMS

This study aimed to quantify the prevalence of these issues, to identify barriers to adopting a healthy lifestyle as well as potential solutions, and to explore the use of smartphone health apps.

METHODS

An online questionnaire examined diet and physical activity habits, general health and attitudes to eHealth. An in-class questionnaire with a new sample assessed current lifestyle, barriers to healthier living, support needed to achieve goals and the use of health apps.

FINDINGS

Half of student nurses were overweight or obese and only 41% met the recommended levels of physical activity. An in-class questionnaire revealed that more than half of them wanted to have a better diet and to exercise more.

CONCLUSION

Generally, student nurses were not satisfied with their current lifestyles. A lack of motivation and time were the most frequently reported barriers; an intervention focusing on motivational support could be an acceptable and effective means of achieving and sustaining positive behaviour change.

The use of inter-professional education (IPE) healthcare law and ethics scenario based learning sessions amongst nursing, midwifery and law students: A qualitative investigation

BACKGROUND

The Nursing and Midwifery Council (NMC, 2018) require registrants to practice ethically and lawfully. Nevertheless, in 2019-2020, the NMC received 5704 referrals regarding registrants' fitness to practice, many of these referrals related to registrants' criminality, clinical competence, and misconduct. Additionally, litigation within healthcare remains a concern. NHS Resolution (2020) reported costs of payments relating to clinical negligence schemes of £2324.2 million in 2019/20. This paper discusses a qualitative investigation of healthcare law and ethics teaching and learning within undergraduate midwifery and nursing curricula and the use of scenario based (inter-professional education) IPE sessions amongst nursing, midwifery and law students.

METHODS

Two scenario based IPE sessions attended by nursing, midwifery and law students were delivered in addition to existing curricula. Scenarios were based on real life cases. Students collaborated to identify means of managing legal and ethical issues arising from the scenarios. Sessions were facilitated by lecturers from the schools of law, midwifery and nursing. Semi structured interviews were completed with IPE session participants and academics with an interest in healthcare law and ethics (students n = 3, academic staff n = 3). Thematic content analysis was applied to interview data. Findings Scenario based IPE sessions are valued by participants who claim they are effective in enabling the development of knowledge and understanding of healthcare law and ethics while providing insight into the application of theory in practice. Participants claimed that healthcare law and ethics was a fundamental part of caring professions and essential to nursing and midwifery curricula.

CONCLUSION

Substantial numbers of nurses and midwives are called to account by their professional body and in law for issues related to their practice, with significant financial and personal costs. Healthcare law and ethics remains fundamental to professional practice with IPE scenario based sessions offering a means to develop knowledge and enable students to consider ethical, legal and professional issues.

Awareness and attitudes towards sustainability and climate change amongst students and educators in nursing: A systematic integrative review protocol

Aim

This review identifies and synthesizes literature related to the awareness of and attitudes towards sustainability and climate change from the perspective of nursing students and educators.

Design

A systematic integrative review.

Methods

The review will follow the five stages outlined by Whittemore and Knafl: problem identification, literature search, data evaluation, data analysis and presentation. The data analysis will be based on inductive content analysis developed by Elo and Kyngäs. Principles of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) will also inform the review process.

Results

This review will offer insights about sustainability and climate change in relation to an important target population: the future nursing workforce and those educating its members. Findings might inform curriculum development, potentially contributing to a nursing profession that looks after the health of the planet and the health of the population inhabiting it.

The characteristics and in-sewer transport potential of solids derived from domestic food waste disposers

This study aims to assess the transportability of food waste disposer particles within a sewer system. A series of laboratory studies has examined the physical characteristics of solid particles derived from domestic food waste disposers. Particle size distributions and maximum settling velocity characteristics were measured for 18 common food types, and stored in a publicly accessible database. Particle size distributions are shown to fit well with a 2-parameter Gamma distribution. Settling velocity is generally higher for larger particles, except when particle density and sphericity change. For most food types, particle specific gravity was close to unity. Egg shell particles had a significantly higher specific gravity. This information, combined with the particle size data have been used to show that there is a very low likelihood of food waste particle deposition in sewers during normal operational flows, other than temporary transient deposits of egg shell particles.

The use of inter-professional education (IPE) healthcare law and ethics scenario based learning sessions amongst nursing, midwifery and law students: An evaluation

BACKGROUND

Litigation and disciplinary action taken by the Nursing and Midwifery Council (NMC) against nurses' remains a concern with costs of claims against the NHS increasing by 72% over the five years up to 2015/16 with almost £1.5 billion spent in one year alone. Additionally, 5476 referrals regarding registrants' fitness to practice were made to the NMC in 2016-2017. The aims of this paper are to discuss how a pair of scenario based IPE sessions focussed on healthcare law and ethical topics were introduced as an addition to the existing nursing and midwifery curricula and to report the evaluation of these sessions.

METHODS

Two scenario based sessions attended by nursing, midwifery and law students were delivered as an addition to existing nursing, midwifery and law curricula. The scenarios were based on real life cases and students collaborated to identify means of managing legal and ethical issues arising from the scenarios. These sessions were facilitated by lecturers from the schools of law, midwifery and nursing.

FINDINGS

All attending students completed an evaluation questionnaire. Student evaluations indicated that the experience of working through the scenarios with their colleagues from other disciplines had enabled them to gain further knowledge and understanding around healthcare law and ethics. Student evaluations indicated a high level of engagement and interest in the subject and also drew attention to the supportive structure of the IPE sessions.

CONCLUSION

Nurses and midwives continue to be called to account by both their professional body and in law for issues related to their practice. A way to enable students to consider this and aid their preparation for clinical and professional practice is through the use of clinically and professionally relevant healthcare law and ethics scenarios in IPE sessions.

"Of Mice and Measures": A Project to Improve How We Advance Duchenne Muscular Dystrophy Therapies to the Clinic

A new line of dystrophic mdx mice on the DBA/2J (D2) background has emerged as a candidate to study the efficacy of therapeutic approaches for Duchenne muscular dystrophy (DMD). These mice harbor genetic polymorphisms that appear to increase the severity of the dystropathology, with disease modifiers that also occur in DMD patients, making them attractive for efficacy studies and drug development. This workshop aimed at collecting and consolidating available data on the pathological features and the natural history of these new D2/mdx mice, for comparison with classic mdx mice and controls, and to identify gaps in information and their potential value. The overall aim is to establish guidance on how to best use the D2/mdx mouse model in preclinical studies.

Comparing the costs of Alternative models of End-Of-Life Care

Objectives: This study explores the financial consequences of decreased acute care utilization and expanded community-based care for patients at the end of life in England. Method: A Markov model based on cost and utilization data was used to estimate the costs of care for cancer and organ failure in the last year of life and to simulate reduced acute care utilization. Results: We estimated at £1.8 billion the cost to the taxpayer of care for the 127,000 patients dying from cancer in 2006. The equivalent cost for the 30,000 people dying from organ failure was £553 million. Resources of £16 to £171 million could be released for cancer. Conclusion: People generally prefer to die outside hospital. Our results suggest that reducing reliance on acute care could release resources and better meet peoples’ preferences. Better data on the cost-effectiveness of interventions are required. Similar models would be useful to decision-makers evaluating changes in service provision.

Survival of patients with subglottic squamous cell carcinoma

Objective

Subglottic squamous cell carcinoma is a rare subsite of laryngeal cancer that behaves more aggressively and portends a worse prognosis. Using a population-based cancer registry, our objective was to report overall survival (os) and laryngectomy-free survival (lfs) in patients diagnosed with subglottic squamous cell carcinoma, and to determine whether primary laryngectomy results in improved survival.

Methods

This retrospective population-based study considered patients with a new diagnosis of squamous cell carcinoma in the province of Ontario over a 15-year period (1995-2009). The Ontario Cancer Registry was examined for patients with the diagnosis of interest during the period of interest. Linked population-based databases were used to obtain patient demographics, comorbidity measures, staging, survival, and primary treatment with laryngectomy.

Results

Of 4927 patients identified to have laryngeal carcinoma, 89 were defined as having primary subglottic carcinoma (1.8%). In the subglottic cohort, 68 patients were men (76.4%), and mean age at diagnosis was 68 years (interquartile range: 60-77 years). The 5-year os was 47.2%, and the 5-year lfs was 31.5%. In 13 patients (15%), the primary treatment was laryngectomy, which, compared with primary radiation, did not predict for improved os. No differences in os or lfs were observed during the 15-year study period (os p = 0.42, lfs p = 0.83).

Conclusions

The survival of patients with subglottic carcinoma is poor and has remained stable over time (1995-2009). Compared with primary radiation, primary treatment with laryngectomy does not appear to improve os.

Secular trends in the survival of patients with laryngeal carcinoma, 1995-2007

BACKGROUND

Recent reports suggest a decline over time in the survival of patients newly diagnosed with laryngeal cancer in spite of developments in treatment practices. Our study set out to determine whether the survival of patients with laryngeal cancer in Ontario has changed over time.

METHODS

This population-based cohort study of patients diagnosed with laryngeal cancer in the province of Ontario between 1995 and 2007 used data extracted from linked provincial administrative and registry databases. Its main outcomes were overall survival, laryngectomy-free survival, and survival ratio relative to an age- and sex-matched general population.

RESULTS

The 4298 patients newly diagnosed with laryngeal cancer during the period of interest were predominantly men (n = 3615, 84.1%) with glottic cancer (n = 2787, 64.8%); mean age in the group was 66 years (interquartile range: 59-74 years). Patient demographics did not significantly change over time. Overall, 5-year survival was 57.4%; laryngectomy-free survival was 45.4%. Comparing patients from three eras (1995-1998, 1999-2003, 2004-2007) and adjusting for age, sex, and comorbidity status, we observed no differences in overall survival or laryngectomy-free survival over time. The 5-year relative survival ratio for patients with laryngeal cancer compared with an age- and sex-matched group from the general population was 81.1% for glottic cancer and 44.5% for supraglottic cancer.

CONCLUSIONS

In patients with a new diagnosis of laryngeal cancer, overall and laryngectomy-free survival have remained unchanged since the mid-1990s. New methods to improve survival and the rate of laryngeal preservation in this patient population are needed.

A non-invasive acoustical method to measure the mean roughness height of the free surface of a turbulent shallow water flow

In this paper, the directivity of the airborne sound field scattered by a dynamically rough free flow surface in a flume is used to determine the mean roughness height for six hydraulic conditions in which the uniform depth of the turbulent flow. The nonlinear curve fitting method is used to minimize the error between the predicted directivity and directivity data. The data fitting algorithm is based on the averaged solution for the scattered sound pressure as a function of angle which is derived through the Kirchhoff integral and its approximations. This solution takes into account the directivity of the acoustic source. For the adopted source and receiver geometry and acoustic frequency it is shown that the contribution from the stationary phase point (single specular point on the rough surface) yields similar results to those which can be obtained through the full Kirchhoff's integral. The accuracy in the inverted mean roughness height is comparable to that achieved with an array of conductive wave probes. This method enables non-invasive estimation of the flow Reynolds number and uniform flow depth.

Extracorporeal membrane oxygenation: look out for a retrieval team coming to a hospital near you!

In 2011 the Department of Health commissioned five hospitals in England to provide extracorporeal membrane oxygenation (ECMO) to adults with severe respiratory failure. This review will explain the principles underlying ECMO, describe the circuitry used and discuss the care of a patient receiving support. We hope that it will be of use should a patient at your hospital be considered a candidate for ECMO.