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The notion of common sense is invoked so frequently in contexts as diverse as everyday conversation, political debates, and evaluations of artificial intelligence that its meaning might be surmised to be unproblematic. Surprisingly, however, neither the intrinsic properties of common sense knowledge (what makes a claim commonsensical) nor the degree to which it is shared by people (its "commonness") have been characterized empirically. In this paper, we introduce an analytical framework for quantifying both these elements of common sense. First, we define the commonsensicality of individual claims and people in terms of the latter's propensity to agree on the former and their awareness of one another's agreement. Second, we formalize the commonness of common sense as a clique detection problem on a bipartite belief graph of people and claims, defining [Formula: see text] common sense as the fraction [Formula: see text] of claims shared by a fraction [Formula: see text] of people. Evaluating our framework on a dataset of [Formula: see text] raters evaluating [Formula: see text] diverse claims, we find that commonsensicality aligns most closely with plainly worded, fact-like statements about everyday physical reality. Psychometric attributes such as social perceptiveness influence individual common sense, but surprisingly demographic factors such as age or gender do not. Finally, we find that collective common sense is rare: At most, a small fraction [Formula: see text] of people agree on more than a small fraction [Formula: see text] of claims. Together, these results undercut universalistic beliefs about common sense and raise questions about its variability that are relevant both to human and artificial intelligence.
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Inteligência Artificial , Conhecimento , Humanos , PsicometriaRESUMO
Commentaries on the target article offer diverse perspectives on integrative experiment design. Our responses engage three themes: (1) Disputes of our characterization of the problem, (2) skepticism toward our proposed solution, and (3) endorsement of the solution, with accompanying discussions of its implementation in existing work and its potential for other domains. Collectively, the commentaries enhance our confidence in the promise and viability of integrative experiment design, while highlighting important considerations about how it is used.
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Dissidências e DisputasRESUMO
BACKGROUND: There is limited qualitative research focussed specifically on what it is like for children and young people with intellectual disabilities coming into hospital, with much of the evidence-base being about those with Autism Spectrum Condition or adults with intellectual disabilities. AIM: To share rich detail of the emotional and physical impact on children and young people with intellectual disabilities of attending hospital, from their own and their parent's perspective. METHODS: Talking Mats interviews, sticker survey and photography with children and young people with intellectual disabilities, and in-depth interviews, hospital diaries and photography with their parents. RESULTS AND CONCLUSIONS: The multiple and compounding layers of complexity surrounding hospital care of children and young people with intellectual disabilities resulted in challenges associated with loss of familiarity and routine, undergoing procedures, managing sensory overload, managing pain and having a lack of safety awareness. An individualised approach to their care is needed.
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Transtorno do Espectro Autista , Deficiência Intelectual , Adulto , Criança , Humanos , Adolescente , Deficiência Intelectual/psicologia , Pais/psicologia , Transtorno do Espectro Autista/terapia , Emoções , Pesquisa QualitativaRESUMO
The dominant paradigm of experiments in the social and behavioral sciences views an experiment as a test of a theory, where the theory is assumed to generalize beyond the experiment's specific conditions. According to this view, which Alan Newell once characterized as "playing twenty questions with nature," theory is advanced one experiment at a time, and the integration of disparate findings is assumed to happen via the scientific publishing process. In this article, we argue that the process of integration is at best inefficient, and at worst it does not, in fact, occur. We further show that the challenge of integration cannot be adequately addressed by recently proposed reforms that focus on the reliability and replicability of individual findings, nor simply by conducting more or larger experiments. Rather, the problem arises from the imprecise nature of social and behavioral theories and, consequently, a lack of commensurability across experiments conducted under different conditions. Therefore, researchers must fundamentally rethink how they design experiments and how the experiments relate to theory. We specifically describe an alternative framework, integrative experiment design, which intrinsically promotes commensurability and continuous integration of knowledge. In this paradigm, researchers explicitly map the design space of possible experiments associated with a given research question, embracing many potentially relevant theories rather than focusing on just one. The researchers then iteratively generate theories and test them with experiments explicitly sampled from the design space, allowing results to be integrated across experiments. Given recent methodological and technological developments, we conclude that this approach is feasible and would generate more-reliable, more-cumulative empirical and theoretical knowledge than the current paradigm-and with far greater efficiency.
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Virtual labs allow researchers to design high-throughput and macro-level experiments that are not feasible in traditional in-person physical lab settings. Despite the increasing popularity of online research, researchers still face many technical and logistical barriers when designing and deploying virtual lab experiments. While several platforms exist to facilitate the development of virtual lab experiments, they typically present researchers with a stark trade-off between usability and functionality. We introduce Empirica: a modular virtual lab that offers a solution to the usability-functionality trade-off by employing a "flexible defaults" design strategy. This strategy enables us to maintain complete "build anything" flexibility while offering a development platform that is accessible to novice programmers. Empirica's architecture is designed to allow for parameterizable experimental designs, reusable protocols, and rapid development. These features will increase the accessibility of virtual lab experiments, remove barriers to innovation in experiment design, and enable rapid progress in the understanding of human behavior.
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Projetos de Pesquisa , Pesquisadores , HumanosRESUMO
OBJECTIVE: The primary objective of this study was to track the incidence and progression of traumatic microbleeds (TMBs) for up to five years following traumatic brain injury (TBI). METHODS: Thirty patients with mild, moderate, or severe TBI received initial MRI within 48 h of injury and continued in a longitudinal study for up to five years. The incidence and progression of MRI findings was assessed across the five year period. In addition to TMBs, we noted the presence of other imaging findings including diffusion weighted imaging (DWI) lesions, extra-axial and intraventricular hemorrhage, hematoma, traumatic meningeal enhancement (TME), fluid-attenuated inversion recovery (FLAIR) hyperintensities, and encephalomalacia. RESULTS: TMBs were observed in 60% of patients at initial presentation. At one-year follow-up, TMBs were more persistent than other neuroimaging findings, with 83% remaining visible on MRI. In patients receiving serial MRI 2-5 years post-injury, acute TMBs were visible on all follow-up scans. In contrast, most other imaging markers of TBI had either resolved or evolved into ambiguous abnormalities on imaging by one year post-injury. CONCLUSIONS: These findings suggest that TMBs may serve as a uniquely persistent indicator of TBI and reinforce the importance of acute post-injury imaging for accurate characterization of persistent imaging findings.
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Lesões Encefálicas Traumáticas , Imageamento por Ressonância Magnética , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/diagnóstico por imagem , Hemorragia Cerebral/diagnóstico por imagem , Humanos , Estudos Longitudinais , NeuroimagemRESUMO
BACKGROUND: In response to multiple United Kingdom investigations and inquiries into the care of adults with learning disabilities, Mencap produced the Getting it Right Charter which campaigned for the appointment of a Learning Disability Liaison Nurse in every hospital. More recent best practice guidelines from the Care Quality Commission included the need for all children's units to have access to a senior learning disability nurse who can support staff and help them manage difficult situations. However, little evidence exists of the extent of learning disability nurse provision in children's hospitals or the nature and impact of this role. Here we report selected findings from a national mixed methods study of hospital care for children and young people with and without learning disabilities in England. The extent of learning disability nurse provision in children's hospitals is described and perceptions of staff working in hospitals with and without such provision is compared. METHODS: Semi-structured interviews were conducted with senior staff across 15 children's hospitals and an anonymous survey was sent to clinical and non-clinical staff with patient (children and young people) contact within these hospitals. The survey focused on six different elements of care for those with and without learning disability, with additional questions concerning identifying and tracking those with learning disabilities and two open-ended questions. RESULTS: Forty-eight senior staff took part in interviews, which included a subset of nine nurses and one allied health professional employed in a dedicted learning disability nurse role, or similar. Surveys were completed by 1681, of whom 752 worked in a hospital with dedicated learning disability nurse provision. We found evidence of limited and varied learning disability nurse provision which was valued by hospital staff and shown to positively impact their perceptions of being capable to care for children and young people with learning disabilities, but not shown to increase staff perceptions of capacity or confidence, or how children and young people are valued within the hospital, their safety or access to appointments. CONCLUSION: Further consideration must be given to how learning disability nurse roles within children's hospitals are best operationalised in practice to have the greatest impact on staff and families, as well as how we monitor and evaluate them to ensure they are being utilised effectively and efficiently. TRIAL REGISTRATION: The study has been registered on the NIHR CRN portfolio 20,461 (Phase 1), 31,336 (Phases 2-4).
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Atitude do Pessoal de Saúde , Hospitais Pediátricos , Deficiências da Aprendizagem/enfermagem , Papel do Profissional de Enfermagem , Adolescente , Criança , Análise de Dados , Inglaterra , Humanos , Entrevistas como Assunto , Admissão e Escalonamento de Pessoal , Pesquisa Qualitativa , Determinantes Sociais da Saúde , Adulto JovemRESUMO
Purpose: Aniridia is a congenital disorder caused by variants in the PAX6 gene. In this study, we assessed the involvement of PAX6 in patients with aniridia from Australasia and Southeast Asia. Methods: Twenty-nine individuals with aniridia from 18 families originating from Australia, New Caledonia, Cambodia, Sri Lanka, and Bhutan were included. The PAX6 gene was investigated for sequence variants and analyzed for deletions with multiplex ligation-dependent probe amplification. Results: We identified 11 sequence variants and six chromosomal deletions, including one in mosaic. Four deleterious sequence variants were novel: p.(Pro81HisfsTer12), p.(Gln274Ter), p.(Ile29Thr), and p.(Met1?). Ocular complications were associated with a progressive loss of visual function as shown by a visual acuity ≤ 1.00 logMAR reported in 65% of eyes. The prevalence of keratopathy was statistically significantly higher in the Australasian cohort (78.6%) compared with the Southeast Asian cohort (9.1%, p=0.002). Variants resulting in protein truncating codons displayed limited genotype-phenotype correlations compared with other variants. Conclusions: PAX6 variants and deletions were identified in 94% of patients with aniridia from Australasia and Southeast Asia. This study is the first report of aniridia and variations in PAX6 in individuals from Cambodia, Sri Lanka, Bhutan, and New Caledonia, and the largest cohort from Australia.
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Aniridia/genética , Deleção Cromossômica , Estudos de Associação Genética , Mosaicismo , Fator de Transcrição PAX6/genética , Adolescente , Adulto , Aniridia/diagnóstico , Aniridia/patologia , Sudeste Asiático , Australásia , Sequência de Bases , Criança , Estudos de Coortes , Éxons , Feminino , Expressão Gênica , Genótipo , Humanos , Padrões de Herança , Íntrons , Masculino , Pessoa de Meia-Idade , Fator de Transcrição PAX6/deficiência , Linhagem , FenótipoRESUMO
BACKGROUND: Children and young people (CYP) with learning disabilities (LD) are a vulnerable population with increased risk of abuse and accidental injury and whose parents have reported concerns about the quality, safety and accessibility of their hospital care. The Care Quality Commission's (CQC) view of best practice for this group of patients includes: access to senior LD nurse provision; a clearly visible flagging system for identifying them; the use of hospital passports; and defined communication strategies (Glasper, Comp Child Adolesc Nurs 40:63-67, 2017). What remains unclear is whether these recommendations are being applied and if so, what difference they are making. Furthermore, what we do not know is whether parental concerns of CYP with LD differ from parents of other children with long-term conditions. The aims of this study were to 1) describe the organisational context for healthcare delivery to CYP with LD and their families and 2) compare staff perceptions of their ability to identify the needs of CYP with and without LD and their families and provide high quality care to effectively meet these needs. METHODS: Individual interviews (n = 65) and anonymised online survey (n = 2261) were conducted with hospital staff working with CYP in 15 children's and 9 non-children's hospitals in England. The majority of interviews were conducted over the telephone and recorded and transcribed verbatim. Health Research Authority was obtained and verbal or written consent for data collection was obtained from all interview participants. RESULTS: The nature and extent of organisational policies, systems and practices in place within hospitals to support the care of CYP with LD differs across England and some uncertainty exists within and across hospitals as to what is currently available and accessed. Staff perceived that those with LD were included less, valued less, and less safe than CYP without LD. They also reported having less confidence, capability and capacity to meet the needs of this population compared to those without LD. CONCLUSION: Findings indicate inequality with regards the provision of high quality hospital care to children and young people with LD that meets their needs. There is a pressing need to understand the impact this has on them and their families. TRIAL REGISTRATION: The study has been registered on the NIHR CRN portfolio 20461 (Phase 1), 31336 (Phases 2-4).
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Atitude do Pessoal de Saúde , Serviços de Saúde da Criança/organização & administração , Disparidades em Assistência à Saúde , Deficiências da Aprendizagem/epidemiologia , Recursos Humanos em Hospital/psicologia , Criança , Inglaterra/epidemiologia , Pesquisas sobre Atenção à Saúde , Necessidades e Demandas de Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Pesquisa Qualitativa , Qualidade da Assistência à SaúdeRESUMO
PURPOSE: To report the refractive, topographic, and clinical outcomes 3 years after corneal collagen cross-linking (CXL) in eyes with progressive keratoconus. DESIGN: Prospective, randomized controlled trial. PARTICIPANTS: One hundred eyes with progressive keratoconus were randomized into the CXL treatment or control groups. METHODS: Cross-linking was performed by instilling riboflavin 0.1% solution containing 20% dextran for 15 minutes before and during the 30 minutes of ultraviolet A irradiation (3 mW/cm(2)). Follow-up examinations were arranged at 3, 6, 12, 24, and 36 months. MAIN OUTCOME MEASURES: The primary outcome measure was the maximum simulated keratometry value (Kmax). Other outcome measures were uncorrected visual acuity (UCVA; measured in logarithm of the minimum angle of resolution [logMAR] units), best spectacle-corrected visual acuity (BSCVA; measured in logMAR units), sphere and cylinder on subjective refraction, spherical equivalent, minimum simulated keratometry value, corneal thickness at the thinnest point, endothelial cell density, and intraocular pressure. RESULTS: The results from 48 control and 46 treated eyes are reported. In control eyes, Kmax increased by a mean of 1.20±0.28 diopters (D), 1.70±0.36 D, and 1.75±0.38 D at 12, 24, and 36 months, respectively (all P <0.001). In treated eyes, Kmax flattened by -0.72±0.15 D, -0.96±0.16 D, and -1.03±0.19 D at 12, 24, and 36 months, respectively (all P <0.001). The mean change in UCVA in the control group was +0.10±0.04 logMAR (P = 0.034) at 36 months. In the treatment group, both UCVA (-0.15±0.06 logMAR; P = 0.009) and BSCVA (-0.09±0.03 logMAR; P = 0.006) improved at 36 months. There was a significant reduction in corneal thickness measured using computerized videokeratography in both groups at 36 months (control group: -17.01±3.63 µm, P <0.001; treatment group: -19.52±5.06 µm, P <0.001) that was not observed in the treatment group using the manual pachymeter (treatment group: +5.86±4.30 µm, P = 0.181). The manifest cylinder increased by 1.17±0.49 D (P = 0.020) in the control group at 36 months. There were 2 eyes with minor complications that did not affect the final visual acuity. CONCLUSIONS: At 36 months, there was a sustained improvement in Kmax, UCVA, and BSCVA after CXL, whereas eyes in the control group demonstrated further progression.
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Colágeno/metabolismo , Substância Própria/metabolismo , Reagentes de Ligações Cruzadas/uso terapêutico , Ceratocone/tratamento farmacológico , Fotoquimioterapia , Refração Ocular/fisiologia , Acuidade Visual/fisiologia , Adulto , Contagem de Células , Paquimetria Corneana , Topografia da Córnea , Endotélio Corneano/patologia , Feminino , Seguimentos , Humanos , Pressão Intraocular , Ceratocone/fisiopatologia , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Riboflavina/uso terapêutico , Resultado do Tratamento , Raios Ultravioleta , Adulto JovemRESUMO
Traumatic brain injury impairs function of the glymphatic system, a perivascular network involved in waste clearance. Enlarged perivascular spaces visible on MRI are an emerging biomarker of glymphatic function. This study characterized enlarged perivascular spaces in acute head injury with 7â T MRI. Healthy controls (n = 8) and patients (n = 11) with mild traumatic brain injury underwent MRI within 7 days of injury and were evaluated for lifetime history of head injury, neurobehavioral symptoms and sleep disturbances. MRI-visible perivascular spaces were quantified and assessed according to published criteria. The number of enlarged perivascular spaces was significantly higher in traumatic brain injury patients than controls (P = 0.015). Among healthy controls, 6/8 scored 'none' or 'mild' on the perivascular space rating scale, while 10/11 patients scored 'moderate', 'frequent' or 'severe'. There was an inverse relationship between perivascular space number and number of lifetime head injuries. Patients with more prior head injuries exhibited fewer enlarged perivascular spaces (P = 0.014). These results indicate that mild head injury results in acute alterations in perivascular space number, and this effect is mediated by previous head injury history. Enlarged perivascular spaces may reflect a glymphatic response that is diminished after multiple head injuries, although this will require further study.
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BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic resulted in significant changes to education delivery. For many university programmes this has included a move from face-to-face to virtual and online learning and teaching. AIM: To gain insight into the experiences of students undertaking the community children's nursing specialist practitioner programme during the academic year 2020-21, when most learning and teaching was delivered using virtual and online methods as a consequence of the COVID-19 pandemic. METHOD: A survey questionnaire containing qualitative and quantitative questions was distributed to 28 students by programme leaders at three universities in England. Seven questionnaires were returned, yielding a 25% response rate. FINDINGS: Respondents' experience of online and virtual learning was generally positive, with benefits for work-life balance and the opportunity to revisit recorded lectures being particularly well regarded. Loss of opportunity for face-to-face engagement with fellow students and the teaching team were identified as disadvantages. CONCLUSION: There was strong student support for the provision of more flexible approaches to learning and teaching. Universities should recognise that failure to offer such flexibility could potentially affect recruitment and the viability of courses in the future.
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COVID-19 , Educação a Distância , Estudantes de Enfermagem , Humanos , Criança , COVID-19/epidemiologia , Pandemias , AprendizagemRESUMO
Understanding the scope, prevalence, and impact of the COVID-19 pandemic response will be a rich ground for research for many years. Key to the response to COVID-19 was the non-pharmaceutical intervention (NPI) measures, such as mask mandates or stay-in-place orders. For future pandemic preparedness, it is critical to understand the impact and scope of these interventions. Given the ongoing nature of the pandemic, existing NPI studies covering only the initial portion provide only a narrow view of the impact of NPI measures. This paper describes a dataset of NPI measures taken by counties in the U.S. state of Virginia that include measures taken over the first two years of the pandemic beginning in March 2020. This data enables analyses of NPI measures over a long time period that can produce impact analyses on both the individual NPI effectiveness in slowing the pandemic spread, and the impact of various NPI measures on the behavior and conditions of the different counties and state.
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COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/terapia , Curadoria de Dados , Pandemias , Políticas , VirginiaAssuntos
Lentes de Contato/efeitos adversos , Infecções Oculares Bacterianas/etiologia , Infecções por HIV/complicações , HIV , Kingella kingae/isolamento & purificação , Infecções por Neisseriaceae/etiologia , Procedimentos Ortoceratológicos/efeitos adversos , Lentes de Contato/microbiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/microbiologia , Humanos , Masculino , Infecções por Neisseriaceae/diagnóstico , Infecções por Neisseriaceae/microbiologiaRESUMO
AIM: To present the use of mind maps as a way of seeking participant verification of an emerging theoretical framework. DATA SOURCES: Exploratory interviews, based on three pre-identified study themes--impact, need for help and support, and meaning and/or sense-making--were carried out with the parents of three sub-groups of children with disabilities or complex health needs. These were: children with disabilities, children with life-limiting or life-threatening illnesses, and children dependent on technology. A random sample of participants was subsequently presented with a series of mind maps that represented the themes, categories and sub-categories (and the relationships between them) contained within a rich and complex dataset. Participants were invited to confirm or challenge elements of the mind maps to verify the researcher's interpretation of their experiences when caring for their children. DISCUSSION: Major areas of consistency were identified in the experience of parents of children across the three study sub-groups. CONCLUSION: Mind-maps are already well established as a tool for analysing complex data sets. This study offers a novel approach to the use of mind maps as a means of seeking participant verification of an emerging theoretical framework. IMPLICATIONS FOR RESEARCH/PRACTICE: The use of mind maps when seeking participant verification of qualitative data will require further testing.
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Pesquisa em Enfermagem Clínica/métodos , Pesquisa Metodológica em Enfermagem/métodos , Participação do Paciente/psicologia , Relações Pesquisador-Sujeito/psicologia , Confiança/psicologia , Humanos , Pesquisa QualitativaRESUMO
The plasma-facing components of future fusion reactors, where the Eurofer97 is the primary structural material, will be assembled by laser-welding techniques. The heterogeneous residual stress induced by welding can interact with the microstructure, resulting in a degradation of mechanical properties and a reduction in joint lifetime. Here, a Xe+ plasma focused ion beam with digital image correlation (PFIB-DIC) and nanoindentation is used to reveal the mechanistic connection between residual stress, microstructure, and microhardness. This study is the first to use the PFIB-DIC to evaluate the time-resolved multiscale residual stress at a length scale of tens of micrometers for laser-welded Eurofer97. A nonequilibrium microscale residual stress is observed, which contributes to the macroscale residual stress. The microhardness is similar for the fusion zone and heat-affected zone (HAZ), although the HAZ exhibits around ~30% tensile residual stress softening. The results provide insight into maintaining structural integrity for this critical engineering challenge.
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As machine learning is used to make strides in medical diagnostics, few methods provide heuristics from which human doctors can learn directly. This work introduces a method for leveraging human observable structures, such as macroscale vascular formations, for producing assessments of medical conditions with relatively few training cases, and uncovering patterns that are potential diagnostic aids. The approach draws on shape grammars, a rule-based technique, pioneered in design and architecture, and accelerated through a recursive subgraph mining algorithm. The distribution of rule instances in the data from which they are induced is then used as an intermediary representation enabling common classification and anomaly detection approaches to identify indicative rules with relatively small data sets. The method is applied to seven-tesla time-of-flight angiography MRI (n = 54) of human brain vasculature. The data were segmented and induced to generate representative grammar rules. Ensembles of rules were isolated to implicate vascular conditions reliably. This application demonstrates the power of automated structured intermediary representations for assessing nuanced biological form relationships, and the strength of shape grammars, in particular for identifying indicative patterns in complex vascular networks.
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BACKGROUND: An 8-month rotation programme was implemented for five nurses employed in two kinds of children's palliative care environments: hospital wards and hospices. This study reports the views of the nurses completing the rotation. The research drew on appreciative inquiry and involved a pre- and post-rotation interview and questionnaire. Thematic analysis of the interviews revealed seven themes: adjusting to the rotation programme; support mechanisms; being safe; new knowledge and skills; knowledge exchange; misconceptions; future plans. These were supported by the questionnaire findings. Although the nurses identified some frustration at having to undertake competency assessments relating to previously acquired skills, as well as being out of their 'comfort zone', all the participants highly recommended the programme. They commented very positively on the support they received and the overall learning experience as well as the new insight into different aspects of care. In addition, they were able to share their newfound knowledge and expertise with others.
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Atitude do Pessoal de Saúde , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/educação , Recursos Humanos de Enfermagem/educação , Enfermagem Pediátrica/educação , Competência Clínica , Humanos , Satisfação no Emprego , Londres , Avaliação de Programas e Projetos de SaúdeRESUMO
Retention of staff presents major challenges within children's palliative care; this has substantial implications for children, families and the nursing workforce. To address this, a programme was undertaken that provided pathways of professional development for senior nurses working in this field. This study reports the views of nurses completing this programme, the overall project manager (PM) and the day-to-day programme lead (PL) as well as factors that influence nurse retention within children's palliative care nursing. The study drew on an Appreciative Inquiry approach that comprised of interviews with the PM and PL as well as focus groups and questionnaires with senior nurses from the children's palliative care sector, who participated in the training programme. Thematic analysis of data from interviews and focus groups revealed factors influencing nurse retention: speciality, positivity and making a difference, support, provision of adequate resources, tailored education/professional development and resilience. These themes were supported by the questionnaire findings. The programme was perceived as having a positive influence on nurse retention within the children's palliative care workforce. In addition, it was felt to be very beneficial in terms of shared learning and development. Participants highlighted the need for similar opportunities in the future.