‘Our surgeons want this to be short and simple’: practices of in-hospital medication review as coordinated sociomaterial actions

ABSTRACT

Medication review, a systematic assessment of a patient’s medicines by a health care professional, is intended to prevent medication-related harms. A critical element of medication review concerns whether medication review is conducted in a coordinated way. This article draws from a case example of implementing medication review in two surgical wards of a Swedish regional hospital and aims to analyse how medication review is being accomplished with respect to the coordination of its actions. Using a practice-based ethnographic approach, we present several coordination mechanisms by illustrating how practices are connected to materials involved in medication review. Also, we show how common orientations, ends, and understandings expressed in different medication review practices contribute to the coordination of the practices. In conclusion, this article highlights the complexity of establishing and sustaining medication review as a coordinated practice in routine health care. By closely examining sociomaterial connections, this article sheds new light on the neglected issue of artefacts and arrangements in constituting and transforming a highly complex medication practice.     

Developmental dynamics of early reading skill,literacy interest and readers’ self-concept within the first year of formal schooling

Previous studies have documented robust relationships between emergent literacy and later reading performance. A growing body of research has also reported associations between motivational factors and reading in early phases of reading development. However, there is less research about cross-lagged relationships between motivational factors and reading skills in beginning readers. To examine relationships between early reading skills, literacy interest and reader self-concept, we tested 1141 children twice during their first year of formal reading instruction in school. Cross-lagged analysis showed strong stability in reading skills and medium stability in literacy interest and reader self-concept over the first school year. We also found bidirectional relationships between reading skills and self-concept and between the motivational components of literacy interest and reader self-concept. In the final part of the article, we address the potential theoretical progress attainable through the use of cross-lagged designs in this field.     

Why forest gardening for children? Swedish forest garden educators' ideas,purposes, and experiences

Utilizing forest gardens as urban settings for outdoor environmental education in Sweden is a new practice. These forest gardens combine qualities of a forest, e.g., multi-layered polyculture vegetation, with those of a school garden, such as accessibility and food production. The study explores both the perceived qualities of forest gardens in comparison to other outdoor settings and forest garden educators' ideas, purposes, and experiences of activities in a three-year forest gardening project with primary school children. The data were collected through interviews and observations and analyzed qualitatively. Four reported ideas were to give children opportunities to: feel a sense of belonging to a whole; experience self-regulation and systemic dependence; experience that they can co-create with non-human organisms; and imagine possible transformation of places. Four pedagogical forest garden features are discussed.     

Using a situation awareness approach to determine decision-making behaviour in squash

Situation awareness (SA) refers to the awareness of all relevant sources of information, an ability to synthesise this information using domain knowledge gained from past experiences and the ability to physically respond to a situation. Expert-novice differences have been widely reported in decision-making in complex situations although determining the small differences in expert behaviour are more elusive. This study considered how expert squash players use SA to decide on what shot to play. Matches at the 2010 (n = 14) and 2011 (n = 27) Rowe British Grand Prix were recorded and processed using Tracker software. Shot type, ball location, players’ positions on court and movement parameters between the time an opponent played a shot prior to the player’s shot to the time of the opponent’s following shot were captured 25 times per second. Six SA clusters were named to relate to the outcome of a shot ranging from a defensive shot played under pressure to create time to an attempted winner played under no pressure with the opponent out of position. This new methodology found fine-grained SA differences in expert behaviour, even for the same shot type played from the same court area, beyond the usual expert-novice differences.     

Rethinking Sport for Development and Peace: the Capability Approach

In recent years, we have witnessed an upsurge in the attention given to Sport for Development and Peace (SDP). Yet, despite a burgeoning body of scholarship, SDP remains largely undertheorized. Emergent perspectives, however, point to the complex nature of SDP programmes. The purpose of this article is to assess how Sen’s Capability Approach – a normative framework rooted in human development – may help us better understand SDP at the conceptual level. In this paper, we analyse: (a) existing theories on SDP, (b) the Capability Approach and (c) implications of re-examining SDP through the Capability Approach. This includes an analysis of the applicability of the Capability Approach to SDP practice, policy and research. We conclude by suggesting that the Capability Approach provides a malleable normative framework that can promote conceptual clarity of SDP across a multitude of epistemological, theoretical and methodological perspectives.     

Developing ecological literacy in a forest garden: children’s perspectives

Today, cities become more dense, green spaces disappear and children spend less time outdoors. Research suggests that these conditions create health problems and lack of ecological literacy. To reverse such trends, localities are creating urban green spaces for children to visit during school time. Drawing on ideas in ecological literacy, this study investigates school children’s perspectives on a forest garden, a type of outdoor educational setting previously only scarcely researched. Data were collected through walk-and-talk conversations and informal interviews with 28 children aged 7 to 9. Many children in the study expressed strong positive feelings about the forest garden, the organized and spontaneous activities there, and caring for the organisms living there. We observed three aspects of learning in the data, potentially beneficial for the development of children’s ecological literacy: practical competence, learning how to co-exist and care, and biological knowledge and ecological understanding.     

Informing Institutional Management: institutional strategies and student retention

European universities are facing demands for better student retention, especially in countries where state funding is no longer based on the number of students, but on the number of graduates. An extensive literature on retention focuses on the characteristics of students who leave higher education without a degree. Much less is known about the measures taken by higher education institutions to encourage study progress. This article examines whether retention strategies are incorporated into the institutions’ overall strategies and the policies and activities developed by universities to foster study progress and enhance retention rates. The results suggest that the universities’ overall strategies and retention activities are loosely coupled and that the universities tend to use blanket measures addressing retention, regardless of why students are leaving.     

Lab Work and Learning in Secondary School Chemistry: The Importance of Teacher and Student Interaction

Laboratory work is considered essential in promoting students’ learning of science and of scientific inquiry. What the students perceive as important to learn from a regular laboratory exercise is probably affected by the teacher’s objectives. We study the extent to which one teacher’s objectives are fulfilled during lab work, and how teacher–student and student–student interactions contribute to developing learning experiences from the laboratory exercise. Do students encounter opportunities to learn in agreement with the teacher’s objectives? This explanatory single case study includes use of a palette of methods, such as pre- and post-interviews, observations and video documentation from an experienced secondary school teacher and her 8th grade (aged 13–14) students’ laboratory work. Our results point to the importance of teacher involvement to help students understand what to look for, how to do it and why. Especially teacher–student interactions during lab work seemed to influence what students perceived as important to learn. In the laboratory exercise in this case, the teacher helped the students to observe and to use their observations in their explanations. The lab work included learning experiences other than those addressed by the teacher, and the teacher’s intentions were partially fulfilled. Not only what the teacher says, but also how the teacher acts is important to help students understand what to learn from a laboratory exercise.