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This paper describes the evaluation of a two-day simulation training programme for staff designed to improve inpatient care and compassion in an older persons' unit. ObjectiveThe programme was designed to improve inpatient care for older people by using mixedmodality simulation exercises to enhance empathetic and compassionate care. MethodsHealthcare professionals took part in a) a one-day human patient simulation course with six scenarios and b) a one-day ward-based simulation course involving five one-hour exercises with integrated debriefing. A mixed-methods evaluation included observations of the programme, confidence rating scales and follow-up interviews with staff at 7-9 weeks post-training. ResultsObservations showed enjoyment of course but some anxiety and apprehension about the simulation environment. Staff self-confidence improved after human-patient simulation (t= 9; df = 56; p<.001) and ward based exercises (t= 9.3; df= 76; p<.001). Thematic analysis of interview data showed learning in teamwork and patient care. Participants thought that simulation had been beneficial for team practices such as calling for help and verbalising concerns and for improved interaction with patients.Areas to address in future include widening participation across multi-disciplinary teams, enhancing post-training support and exploring further which aspects of the programme enhance compassion and care of older persons.Published in BMJ Quality and Safety, 22, 6, 495-505 Ross, Anderson, Kodate et al. (2013) 3 ConclusionThe study demonstrated that simulation is an effective method for encouraging dignified careand compassion for older persons by teaching non-technical skills which focus on team skills and empathetic and sensitive communication with patients and relatives.

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As there are a number of high‐profile public inquiries into child death tragedies, ‘information sharing’ has now become a moral and political imperative across England and Wales for improving the welfare and protection of children. This paper discusses multi‐agency information practices, at the stage of referral, which were observed and documented in the day‐to‐day practice of child protection work. Drawing on transcribed, professional narrative accounts, a ‘jigsaw’ metaphor is used to describe the process of piecing information together to ascertain a ‘full’ picture of children and families lives. However, these accounts highlight that there is something of a mismatch between the jigsaw, as articulated in the conceptual abstract accounts, and jigsaw practices operating on the ground. It is argued that abstracting professional information practices from situated contexts creates impoverished understandings of these practices. Thus, reported findings in this paper highlight the inherent complexities of jigsaw practices in the ‘everyday’ of child protection work, which challenges objectivist assumptions about a stability of meaning, and further highlight that the ‘endpoint’ of reaching a ‘full’ picture of a child's life is not fixed, nor does it have the same meaning for all professionals, but rather it is a complex process involving sense‐making, translation in context and organizational relevance.

Stem cell therapies offer the potential for repair and regeneration of cardiac tissue. To facilitate evaluation of stem cell activity in vivo, we created novel dual-reporter mouse embryonic stem (mES) cell lines that express the firefly luciferase (LUC) reporter gene under the control of the cardiac sodium-calcium exchanger-1 (Ncx-1) promoter in the background of the 7AC5-EYFP mES cell line that constitutively expresses the enhanced yellow fluorescent protein (EYFP). We compared the ability of recombinant clonal cell lines to express LUC before and after induction of cardiac differentiation in vitro. In particular, one of the clonal cell lines (Ncx-1-43LUC mES cells) showed markedly enhanced LUC expression (45-fold increase) upon induction of cardiac differentiation in vitro. Further, cardiac differentiation in these cells was perpetuated over a period of 2-4 weeks after transplantation in a neonatal mouse heart model, as monitored by noninvasive bioluminescence imaging (BLI) and confirmed via postmortem immunofluorescence and histological assessments. In contrast, transplantation of undifferentiated pluripotent Ncx-1-43LUC mES cells in neonatal hearts did not result in detectable levels of cardiac differentiation in these cells in vivo. These results suggest that prior induction of cardiac differentiation in vitro enhances development and maintenance of a cardiomyocyte-like phenotype for mES cells following transplantation into neonatal mouse hearts in vivo. We conclude that the Ncx-1-43LUC mES cell line is a novel tool for monitoring early cardiac differentiation in vivo using noninvasive BLI.