Exploring the sociocultural experiences of student veterinary nurses in the clinical learning environment through the lens of situated learning theory.

BACKGROUND: Student veterinary nurses (SVNs) complete significant time in clinical placements and this training can have a positive or negative impact on the development of professional skills and identity. METHODS: A cross-sectional design, using semi-structured interviews, explored 12 SVNs' experiences of clinical placements. Interpretative phenomenological analysis was used to explore each individual participant's experience, prior to the identification of themes across participants' experiences. RESULTS: Most students reported a sense of belonging within the practice team, which fostered engagement. Clinical supervisors were considered key role models and vital support for student progress. Students reported conflict between the demands of the practice and the requirements of their student status. Some poor interpersonal interactions led to reduced confidence. LIMITATIONS: The results may not reflect experiences of the diversity of student demographics, such as those students with protected characteristics, as described in the Equality Act 2010, who may encounter specific workplace challenges. CONCLUSION: To ensure parity and positive experiences, accredited educational institutes can plan regular engagement with student feedback and support of the training practice. Training practice teams can ensure they are meeting the student's needs and fostering a positive learning environment by adhering to the RCVS Framework for Veterinary Nurse Education and Training, which will, in turn, benefit the whole team. Clinical supervisors can play a convening role in increasing belonging and participation within the clinical learning environment.

Alcohol-related harm to others in England: a cross-sectional analysis of national survey data.

OBJECTIVES: To estimate the prevalence, the frequency and the perpetrators of alcohol-related harm to others (AHTO) and identify factors associated with experiencing harm and aggressive harm. DESIGN: Cross-sectional survey. SETTING: England. PARTICIPANTS: Adults (general population) aged 16 and over. OUTCOME MEASURES: Percentage of respondents who experienced harm. Socioeconomic and demographic factors associated with the outcomes. Outcomes were (1) experienced harm/did not experience harm and (2) experienced aggressive harm (physically threatened, physically hurt and forced/pressured into something sexual)/did not experience an aggressive harm (no aggressive harm plus no harm at all). RESULTS: Data to support a response rate calculation were not collected; 96.3% of people surveyed completed the AHTO questions. The weighted sample was 4874; 20.1% (95% CI 18.9 to 21.4, N=980) reported experiencing harm in the previous 12 months and 4.6% (95% CI 4.0 to 5.4, N=225) reported experiencing an aggressive harm. Friends and strangers were the dominant perpetrators. Most harms (74.8%) occurred less than monthly. Factors associated with experiencing harm were: younger age (p<0.001), drinking harmfully/hazardously (p<0.001), white British (p<0.001 compared to other white groups and Asian groups and p=0.017 compared to black groups), having a disability (p<0.001), being educated (p<0.001 compared to no education) and living in private rented accommodation (p=0.004 compared with owned outright). Being in the family stage of life (defined as having children in the household) had significantly lower odds of harm (p=0.006 compared to being single), as did being retired (p<0.001 compared to being employed). Factors associated with experiencing an aggressive harm were similar. CONCLUSIONS: This exploratory study, using data collected through the Alcohol Toolkit Survey, shows that AHTO affects 20.1% of the population of England. Even apparently minor harms, like being kept awake, can have a negative impact on health, while aggressive harms are clearly of concern. Using a standard methodology to measure harm across studies would be advantageous. Policies that focus on alcohol must take into consideration the impact of drinking on those other than the drinker.

The cost of emergency hospital admissions for falls on snow and ice in England during winter 2009/10: a cross sectional analysis.

BACKGROUND: In the UK, the 2009/10 winter was characterised by sustained low temperatures; grit stocks became depleted and surfaces left untreated. We describe the relationship between temperature and emergency hospital admissions for falls on snow and ice in England, identify the age and gender of those most likely to be admitted, and estimate the inpatient costs of these admissions during the 2009/10 winter. METHODS: Hospital Episode Statistics were used to identify episodes of emergency admissions for falls on snow and ice during winters 2005/06 to 2009/10; these were plotted against mean winter temperature. By region, the logs of the rates of weekly emergency admissions for falls on snow and ice were plotted against the mean weekly temperature for winters 2005/06 to 2009/10 and a linear regression analysis undertaken. For the 2009/10 winter the number of emergency hospital admissions for falls on snow and ice were plotted by age and gender. The inpatient costs of admissions in the 2009/10 winter for falls on snow and ice were calculated using Healthcare Resource Group costs and Admitted Patient Care 2009/10 National Tariff Information. RESULTS: The number of emergency hospital admissions due to falls on snow and ice varied considerably across years; the number was 18 times greater in 2009/10 (N = 16,064) than in 2007/08 (N = 890). There is an exponential increase [Ln(rate of admissions) = 0.456 - 0.463*(mean weekly temperature)] in the rate of emergency hospital admissions for falls on snow and ice as temperature falls. The rate of admissions in 2009/10 was highest among the elderly and particularly men aged 80 and over. The total inpatient cost of falls on snow and ice in the 2009/10 winter was 42 million GBP. CONCLUSIONS: Emergency hospital admissions for falls on snow and ice vary greatly across winters, and according to temperature, age and gender. The cost of these admissions in England in 2009/10 was considerable. With responsibility for health improvement moving to local councils, they will have to balance the cost of public health measures like gritting with the healthcare costs associated with falls. The economic burden of falls on snow and ice is substantial; keeping surfaces clear of snow and ice is a public health priority.