Imperial College of Toronto

To explore behavioural indicators of compassionate nursing care from the perspectives of individuals with multimorbidities and complex needs. Complex patients are individuals with multimorbidity and/or mental health concerns, andoften with medication and drug-related problems requiring ongoing person-centered care, mental health interventions, and family and community resources. They are frequent consumers of health-care services and it is documented that these patients experience discrimination and substandard care. Compassionate care can improve patient care experiences and health outcomes. However, missing is the guidance on how to provide compassionate care for this population from the perspectives of complex patients. A qualitative descriptive approach was conducted in eastern Canada from December 2020-April 2021. The COREQ guidelines were followed for reporting. Data from in-person and virtual semi-structured interviews with 23 individuals having experiences as complex patients were analysed using reflexive thematic analysis. Among them 19 were homeless and lived in a shelter. Six indicators of compassionate nursing care were generated: sensitivity, awareness, a non-judgmental approach, a positive demeanour, empathic understanding, and altruism. Individuals perceived that nurses who acknowledge personal biases are better at providing compassionate care by manifesting compassion through their genuine and selfless interest in the complicated health problems and underlying socio-cultural determinants of each patient. Kindness, positivity, and a respectful nursing approach elicit openness and the sharing of heartfelt concerns. Comprehensive health assessment, dedicated efforts to know the patient as a human being, and listening to the patient's preferences can improve health outcomes among individuals with complex needs. Healthcare administrators can effect the change by supporting nurses to address complex health and social care needs with compassion. Patients and healthcare professionals helped in data collection at the community care centre.

China has a large and growing cardiovascular disease burden. Household air pollution (HAP) has been associated with higher blood pressure and is thought to increase risk of cardiovascular outcomes, though the empirical evidence is limited and mechanisms are unclear. We assessed personal HAP exposure, markers of arterial stiffness and function, and biological markers of oxidative stress in Chinese women cooking and heating with solid fuels. We enrolled 42 rural Chinese women (mean age=55±12) and measured their blood pressure and 24-hr exposure to PM2.5 and black carbon (BC) using personal gravimetric systems. In a subsample of women (n=25), we measured telomere length from buccal swabs, a biomarker linked to oxidative stress, and assessed pulse wave velocity (PWV) and augmentation index (AI) using a noninvasive device. To our knowledge, this is the first study to measure these important vascular endpoints in a rural, developing country setting. Women’s 24-hr BC exposure ranged from 1-129 ?g/m3 (mean: 21) and PM2.5 exposure ranged from 20-1365 ?g/m3 (mean: 207), far exceeding the WHO PM2.5 guideline (25 ?g/m3). Age-adjusted pollution exposure was associated with shorter telomere length (PM2.5: -0.4 per 10 ?g/m3 (95% CI:-0.9, 0.1); BC: -0.8 per 10-?g/m3 (95% CI:-3.0, 1.1). Higher PM2.5 exposure was associated with higher systolic blood pressure (3.0 mmHg, 95% CI:-3.4, 9.5), after adjusting for age, income, waist circumference and other covariates. Mean PWV (7.9±1.1 m/s) and AI (23.8±4.9%) values in our study subset increased with both higher blood pressure and age, but were lower than those observed in urban Chinese women. In multivariate models, a log-increase in PM2.5 exposure was associated with higher AI (2.2%; 95% CI:-1.4, 6.0), but lower PWV (-0.5 m/s; 95% CI:-1.2, 0.3). While these data are from a small initial assessment, they offer the possibility that changes in vascular function and stiffness from HAP exposure may impact cardiovascular risk, with oxidative stress potentially mediating this relationship.

Web 2.0 tools like blogs, Wikis, and podcasts are new to the vocabulary of language acquisition. Teachers and students who take full advantage of these emerging tools will participate in more dynamic, immediate, and communicative environments that provide opportunities for meaningful experiences through social constructivist learning. This chapter aims to bring perspectives rooted in educational theory to a domain too often dominated by the technological implications of its tools and argues that social constructivism is the pedagogical paradigm for learning and teaching facilitated by the next generation of Web technology. It reviews basic theoretical tenets and discusses their implications. Social constructivism lays the foundation for learning environments that foster the participation of students and teachers in today’s knowledge and information-based society to their full potential.

The author suggests that executive search practitioners would be naïve to believe that the revolution being enacted within their clients’ businesses will not ultimately embrace them. More pointedly, it is argued that supporting the client’s quest to create value for its customer base will, of necessity, be the primary driving force of ongoing competitiveness. Finally, it is suggested that migrating up the value ladder has the effect of devaluing many of the characteristics of perceived differentiation that have been the wellspring of success for those in the search community.

Tamrock’s hard rock mining equipment business in Australia is undergoing significant change. At the helm, Åke Annamatz, a high energy Swede, whose passion to serve the customer is matched only by the breadth of his international experience. What is outlined is the approach taken by Åke to bring a new team together. Åke’s story describes the overall context that framed the change agenda, what a shift to competing on value means in terms of culture, the value and principles underlying successful 360° feedback, the use of play as a high performance learning intervention, and the impact of a unique workshop conducted in Brisbane.