4.1 IntroductionThe use of coercive measures generally has negative effects on patients. To help prevent its use, professionals need insight into what nurses believe about coercion and which staff determinants may influence its application. There is need for an integrated review on both attitude and influence of nurses on the use of coercion.4.2 AimTo summarize literature concerning attitude of nurses towards coercive measures and the influence of staff characteristics on the use of coercive measures.4.3 MethodSystematic review.4.4 ResultsThe attitude of nurses changed during the last two decades from a therapeutic to a safety paradigm. Nurses currently view coercive measures as undesirable, but necessary to deal with aggression. Nurses express the need for less intrusive interventions, although familiarity probably influences its perceived intrusiveness. Literature on the relation between staff characteristics and coercive measures is inconclusive.4.5 DiscussionNurses perceive coercive measures as unwanted but still necessary to maintain safety on psychiatric wards. Focussing on the determinants of perception of safety might be a promising direction for future research.4.6 Implications for practiceMental health care could improve the focus on the constructs of perceived safety and familiarity with alternative interventions to protect patients from unnecessary use of coercive interventions.
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Background: Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, we examined their interactions in the clinic, looking for “good practice”. Methods: We used the video-reflexive ethnographic method in 9 midwifery practices and 2 obstetric units. Findings: We conducted 16 meetings where participants reflected on video recordings of their clinical interactions. We found that informal strategies facilitate communication and collaboration: “talk work” – small talk and humour – and “work beyond words” – familiarity, use of sight, touch, sound, and non-verbal gestures. When using these strategies, participants noted that it is important to be sensitive to context, to the values and feelings of others, and to the timing of care. Our analysis of their ways of being sensitive shows that good communication and collaboration involves “paradoxical care”, e.g., concurrent acts of “regulated spontaneity” and “informal formalities”. Discussion: Acknowledging and reinforcing paradoxical care skills will help caregivers develop the competencies needed to address the changing demands of health care. The video-reflexive ethnographic method offers an innovative approach to studying everyday work, focusing on informal and implicit aspects of practice and providing a bottom up approach, integrating researchers, professionals and parents. Conclusion: Good communication and collaboration in maternity care involves “paradoxical care” requiring social sensitivity and self-reflection, skills that should be included as part of professional training.
This paper proposes an amendment of the classification of safety events based on their controllability and contemplates the potential of an event to escalate into higher severity classes. It considers (1) whether the end-user had the opportunity to intervene into the course of an event, (2) the level of end-user familiarity with the situation, and (3) the positive or negative effects of end-user intervention against expected outcomes. To examine its potential, we applied the refined classification to 296 aviation safety investigation reports. The results suggested that pilots controlled only three-quarters of the occurrences, more than three-thirds of the controlled cases regarded fairly unfamiliar situations, and the flight crews succeeded to mitigate the possible negative consequences of events in about 71% of the cases. Further statistical tests showed that the controllability-related characteristics of events had not significantly changed over time, and they varied across regions, aircraft, operational and event characteristics, as well as when fatigue had contributed to the occurrences. Overall, the findings demonstrated the value of using the controllability classification before considering the actual outcomes of events as means to support the identification of system resilience and successes. The classification can also be embedded in voluntary reporting systems to allow end-users to express the degree of each of the controllability characteristics so that management can monitor them over time and perform internal and external benchmarking. The mandatory reports concerned, the classification could function as a decision-making parameter for prioritising incident investigations.
The seaweed aquaculture sector, aimed at cultivation of macroalgal biomass to be converted into commercial applications, can be placed within a sustainable and circular economy framework. This bio-based sector has the potential to aid the European Union meet multiple EU Bioeconomy Strategy, EU Green Deal and Blue Growth Strategy objectives. Seaweeds play a crucial ecological role within the marine environment and provide several ecosystem services, from the take up of excess nutrients from surrounding seawater to oxygen production and potentially carbon sequestration. Sea lettuce, Ulva spp., is a green seaweed, growing wild in the Atlantic Ocean and North Sea. Sea lettuce has a high nutritional value and is a promising source for food, animal feed, cosmetics and more. Sea lettuce, when produced in controlled conditions like aquaculture, can supplement our diet with healthy and safe proteins, fibres and vitamins. However, at this moment, Sea lettuce is hardly exploited as resource because of its unfamiliarity but also lack of knowledge about its growth cycle, its interaction with microbiota and eventually, possible applications. Even, it is unknown which Ulva species are available for aquaculture (algaculture) and how these species can contribute to a sustainable aquaculture biomass production. The AQULVA project aims to investigate which Ulva species are available in the North Sea and Wadden Sea which can be utilised in onshore aquaculture production. Modern genomic, microbiomic and metabolomic profiling techniques alongside ecophysiological production research must reveal suitable Ulva selections with high nutritional value for sustainable onshore biomass production. Selected Ulva spp lines will be used for production of healthy and safe foods, anti-aging cosmetics and added value animal feed supplements for dairy farming. This applied research is in cooperation with a network of SME’s, Research Institutes and Universities of Applied Science and is liaised with EU initiatives like the EU-COST action “SeaWheat”.
Sea Lettuce, Ulva spp. is a versatile and edible green seaweed. Ulva spp is high in protein, carbohydrates and lipids (respectively 7%-33%; 33%-62% and 1%-3% on dry weight base [1, 2]) but variation in these components is high. Ulva has the potential to produce up to 45 tons DM/ha/year but 15 tons DM/ha/year is more realistic.[3, 4] This makes Ulva a possible valuable resource for food and other applications. Sea Lettuce is either harvested wild or cultivated in onshore land based aquaculture systems. Ulva onshore aquaculture is at present implemented only on a few locations in Europe on commercial scale because of limited knowledge about Ulva biology and its optimal cultivation systems but also because of its unfamiliarity to businesses and consumers. The objective of this project is to improve Ulva onshore aquaculture by selecting Ulva seed material, optimizing growth and biomass production by applying ecophysiological strategies for nutrient, temperature, microbiome and light management, by optimizing pond systems eg. attached versus free floating production and eventually protoype product development for feed, food and cosmetics.
