Supporting communication for children with cerebral palsy in hospital: views of community and hospital staff.

OBJECTIVE: We aimed to investigate the views of allied health and nursing staff on supporting the communication of children with cerebral palsy (CP) and complex communication needs (CCN) in hospital. METHOD: We conducted 12 focus groups with 49 community- and hospital-based allied health professionals and hospital nurses. RESULTS: Participants reported having active roles in supporting children's seating, mobility, equipment, mealtime management and psychosocial needs, but not in supporting the children's communication in hospital. Participants described several environmental barriers to supporting children's augmentative and alternative communication (AAC) in hospital, and suggested a range of strategies to ease communication difficulties at the bedside. CONCLUSION: Results indicate a potential new role for community- and hospital-based health professionals in supporting nurses to implement AAC strategies at the bedside. Supporting nursing staff to remove environmental barriers and use communication technologies might create a more communicatively accessible hospital ward for children with CP and CCN.

Continuing professional development and the charity paradigm: interrelated individual, collective and organisational issues about continuing professional development.

This paper aims to highlight some issues and tensions that currently challenge the profession, individual nurses and their employers when considering the need for continuing professional development. The Nursing and Midwifery Council states the professional requirements for continuing professional development. However the nature and type required seems to be determined by the individual on the one hand and the organisation on the other, rather than an integral part of professional activity within the context of work. This can lead to a mismatch between personal and organisational goals. Views emerged from participants in a previous case study that focused on learning through work, about support available to nurses for professional development. The perceptions of nurses and their managers about learning through work were explored, using semi structured interviews, picture mapping and structured interviews. The 'Charity Paradigm' is presented as an outcome of major issues within an organisation. It underpins negative perceptions of individuals about employer support of continuing professional development. It is suggested that there is a need for collaborative collective approaches to structured development in order to meet both individual and organisational needs. This is also advocated in order to achieve life long learning and transformational learning within an organisation. The tension between individual personal ambitions and employer demands can adversely affect the professional development of the practitioner and the organisation that employs them. The personal perspectives of nurses and managers about learning within their organisation are therefore important to acknowledge in terms of positive and negative influences. It is also necessary to recognise the contribution of the employer as well as the identifiable charitable contribution of individual practitioners and the input from external contributors to the organisation.

Leadership development: a collaborative approach to curriculum development and delivery.

The Leadership Programme in the National Health Service, Lanarkshire, Scotland began in 2002. The programme has been endorsed by the employer, accredited by a higher education institution and approved by the National Health Service Education Board in Scotland as a recognised continuing professional development programme. The success of the programme is due to the combined efforts of the teaching team from the Practice Development Centre, the different stakeholders within the health service in Lanarkshire and Queen Margaret University College, Edinburgh. The focus of this article is the nature of the collaboration between the partners from the initial ideas to the initiation, validation and ongoing delivery of the programme. The article will provide an account of the criteria for partners and key features of the collaboration as well as quality assurance aspects. It will also draw upon the outcomes of the programme in terms of student views and achievement as well as the benefits to the partners.

Improving access to learning in the workplace using technology in an accredited course.

This article gives an account of a case study which seeks to explore the potential for using technology to deliver learning in the workplace: a syringe driver course for nurses. We provide a brief overview of workplace learning, continuing professional development and learning technology in the health sciences. The paper then draws upon a three-year project that involved the transition of a traditionally taught, institution-based face-to-face course to work-based learning using technology. Through the evaluation and discussion of the case study we address key issues that have emerged, such as, marketing of the product; in our case it was decided that the most cost-effective way to provide the course and recuperate some costs was to accredit the course by the Institution. Registered practitioners in the workplace assess learning and are linked to the quality assurance mechanisms of the Institution. We also consider some of the major barriers to implementation, highlighting critical areas for consideration for those undertaking a similar project. These include the lack of technical knowledge in the Group, which resulted in a steep learning curve for all members. This and numerous iterations of materials (including video and animations) lengthened the project considerably whilst technological advances meant other more sophisticated technological solutions that became available during the production process were incorporated. A cost benefit analysis would show that the product has been delivered across Scotland and production costs covered and that there have been unquantifiable gains, including improving the external profile of the academic institution and the NHS Trust, developing the technical skills of the Group and providing invaluable experience of working in a cross-disciplinary collaborative working environment.

Developing and accrediting a CPD framework.

This article describes the process to formally accredit existing in-house education courses in a continuing professional development (CPD) framework. The partnership was between two Lothian NHS organisations and a higher education institution (HEI). The nature of the partnership and the differing approaches taken by the organisations are discussed. The authors explore the context of learning in the NHS in relation to the different organisations, and describe the issues identified and the strategies used to address these. The benefits to all stakeholders are listed. Although this case study refers to an initiative in Scotland, the framework model for flexible and work-based education could be adopted across the UK.

Pre-extraction preparation (fresh, frozen, freeze-dried, or acetone powdered) and long-term storage of fruit and vegetable tissues: effects on antioxidant enzyme activity.

Activities of the antioxidant enzymes ascorbate peroxidase, catalase, dehydroascorbate reductase, glutathione reductase, guaiacol peroxidase, monodehydroascorbate reductase, and superoxide dismutase were assayed in honeydew (Cucumis melo L.) fruit and spinach (Spinacia oleracea L.) leaves either as fresh, frozen to -80 degrees C, frozen in liquid nitrogen, freeze-dried, or acetone powder, representing the various ways tissues are treated prior to enzyme extraction. Treated tissues were analyzed following treatment or stored for up to 8 weeks at -80 degrees C. Enzyme activities in fruit frozen with or without liquid nitrogen and leaves frozen with or without liquid nitrogen or freeze-dried were equal to those of fresh tissue. Enzyme activities in freeze-dried or acetone-powdered fruit and leaves and in acetone-powdered tissues were significantly higher or lower than those in fresh tissue. Enzyme activities in both tissues frozen with or without liquid nitrogen and stored for 8 weeks at -80 degrees C changed little; those in freeze-dried and acetone-powdered tissues, however, significantly increased/decreased over the same period. Fresh tissue should be used in antioxidant enzyme assays, but if storage is necessary, tissues should be placed directly into a -80 degrees C freezer.