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Good afternoon, everybody to see if there are people coming into your room. Yes, there are. Wow, that's great. Lots of people here already. Um If you didn't meet me earlier, my name is Alison Taylor. Um I'm one of the senior lecturers at the University of Brighton, uh working with Heather and the rest of the share planning team. Uh My background is, is children's nursing and I run that course at university and uh very exciting breakout session this afternoon on nursing and physio education that's got some great sessions. Um And to kick us off, we have Jenny Elson from the University of Plymouth who's going to some of her work on students and educators perspectives with the nursing on sustainability and climate change. So, over to you y when you're ready? Brilliant. Thank you so much Alison. And thanks for this opportunity to present my work, which is great. Um So yes, I'm a lecturer in nursing at Plymouth University. Um But I'm also a phd student. Um And as part of my P HDI have conducted a integrative review and that's where I'm going to be presenting today. My supervisors are Doctor Andy Nichols and Doctor Paul Warwick, also from the University of Plymouth and Professor Mary Elf from University in Sweden. So you probably don't need any background on this because you've been attending this conference all day. But just to say that climate change is said to be the most urgent public health threat of the 21st century. So as nursing educators, we have a duty to ensure that our programs reflect those changing needs development, priorities and expectation expectations in healthcare due to the climate crisis. Um So I've been working at the University of Plymouth for about 10 years and um I've been lucky enough to coming to a team where um which is very much driving within sustainability in nursing. And um a lot of our work um derives from the nurses project which was led by Professor Jared Richardson. Um And this study at the bottom there from 2021 is a study where we looked at um student nurses in year one and compared the cohort from 2014 and the COVID from 2019. And what we could see was that there's a real increase in awareness and positive attitudes towards um sustainability in health care and want and need to want to learn about climate change and sustainability in nursing. So we know that students want this information. Um But I was interested in finding out what kind of research has been done on this topic. So my aim for this um integrative review was to identify and synthesize research on the awareness, attitudes and action related to sustainability and climate change from the perspective of nursing students and educators globally. So I chose an integrative review design because that um allows for inclusion of qualitative and quantitative research. Um I've used the framework from with more and CFL which looks at problem identification, literature, search data, evaluation, data analysis and presentation. So I looked at seven different databases and such those up until the eighth of November 2022. Um I praised those studies that included using the mixed methods, appraisal tool. And I used a deductive content analysis based on E and Qing. Yes methodology. I'll tell you a little bit more about that shortly. So a lot of you will be um familiar with the lovely prism flow chart um which um looks complicated but it really shows the search process, sorry. So just to kind of break it down when I searched these seven databases, I found 1104 articles, but a lot of those were duplicates. So when you removed duplicates, I ended up with almost 500 records and I screened me and my team screened, screened those on um title and abstract and were able to exclude the majority as you do. So we found 63 full text articles. Um three of those we could not retrieve despite trying. So we read 60 full text articles and were able to exclude 32 of those. Um So ended up with 28 records from databases and also four additional records that we found from additional searches 32 in total. So we looked at how we um analyzed those um the findings. Um we looked at this framework from Lozano er which is um theoretical framework looking at what sustainability is. And Lozano says that sustainability has three components, awareness, attitudes and action. So those were the three main categories that um we used for this review in a deductive content analysis, you already have those main categories and then you look for information in the articles to kind of um categorize um into these main categories. And this is an example of how I did that. So for example, some of the literature said that um suggested that um students especially uh thought that climate change has negative consequences to human health. Um Some articles suggested that they thought that climate change can exacerbate socioeconomic inequalities. So that those kind of statements were all sort of um coded under a generic category, which was the state of the planet affect, affects human health and wellbeing. The reason it's quite vague is because some articles are actually suggested that some students thought that climate change was a good thing for health. So it was quite contradictory some of it, but it all talked about the fact that state of the planet affects human health and wellbeing. And in terms of sustainability, what is the awareness of sustainability? So some of the students said it's a human, right? Um Some said that sustainability is a shared site of responsibility. So that was all to do with an ethical and a moral aspect of sustainability. So these were the sort of categories that we then thought belonged to awareness and that was a quite a thorough and collaborative process. So here are the findings. So 32 papers, like I said, the majority of those 20 were quantitative scripted based on surveys, we had four included that were quantitative comparative. So that was either a pretest, post test design or a case control. Just sign three were mixed methods and only five were quantitative. So the articles that the earliest article that we found was from um Ethiopia, I think and that was from 2014 and then gradually there were more and more articles, the most articles that we found ah thank you um were from 2021 2022. There's a real increase over the last couple, 23 years in literature, which is really exciting. Um all were in English and from a range of countries as you can see listed here. So in terms of the awareness and the the attitudes and the action, there was lots of information, some um quite varied information, quite difficult to synthesize. But something that we really found was that articles that asked students whether they wanted to have sustainability education. 100% of those articles suggested that yes, students did want that um information within the curriculum. And they also spoke a lot about the need for engaging ped pedagogical approaches to enable critical thinking and change agency. And that's where the action comes in. So in a in order to be able to do some make some changes in practice, they needed that kind of information and that um education that critical thinking, like I said, the majority of studies were based on quantitative research. There was limited in depth studies exploring the views of students. Um We did see a need for suggests um a need for su student support and empowerment. But again, that wasn't explored in any depth within the literature. And interestingly, only two studies were found that included nursing educators in the sample. So the majority was to do with students with very little on, on educators. So where does that take me? So I published this article finally, uh lengthy process as it is. Um but it was published in the Journal of Advanced Nursing in November last year. Um Like I said, this is part of my um my doctoral research. Um So I'm now doing the empirical um research study which comprises a smaller quantitative research in Sweden, but also a cross national qualitative study in England and Sweden. And in this qualitative study, I'm exploring nursing educators and students that was really interesting um results from that coming up, but I can't really reveal that yet yet because I'm still in, in the, in the data analysis. So many thanks to my supervisors and that's the end of my presentation. Thank you, Yenny. And yes, watch his space. I'll be very, very interested to hear the next um, next results in the next phase. Um Please do add your questions in the chat. Um Yenny has got to disappear now. Uh, so we'll, we'll send any questions on to her, but we might come back to them as part of a general discussion, um, as, as we're going to do at the end. So any questions, comments about any of the presentations this afternoon, please do add them and we will, um, collect them in our discussion at the end of this, um, this part of today. And thank you very much. She, she put her email in the chat there, um, for any direct contact. Fabulous. Ok. So next, uh, we have Sophia and Caitlyn who are joining us all the way from Australia. I don't know where in Australia and they are going to be discussing planetary health in nursing education, which we'll hear a bit more about again later with our University of Brighton students. But, uh, great. We've got the presentation ready to go. Where, whereabouts are you in the country? Um, I'm you go. So I'm, I'm on the sunny coast, um, which is like Queensland Fabulous. And I'm in which is Tasmania, the small island. Oh, wow. Is I, I've been to so, yeah, we won't keep you from your beds too much longer. Um, so I don't, you're gonna, you'll manage your, your time between you and I'll do a little two minutes again. So, um, when you're ready off, you go. Thank you. Um, well, thanks. Chair for the opportunity to present tonight. I'm Sophia. I'm the primary author and this is Caitlyn. She's a secondary author and she's also a registered nurse, Aita Ward and Samantha K are not here tonight, but they're also authors and our talk is on embedding planetary Health in nursing education. And um it's a rapid review. So the interest in this research originally stemmed from a developed understanding that many nurses report that they often feel that they have sub up suboptimal knowledge of planetary health and climate change. And we recognized here in Australia that this may be a result of them not having suppo it's supported in Bachelor of Nursing curriculum. The Sustainable Development Goals in Australia are required and that's a mandate from the Australian Nursing and Midwifery Accreditation Council, which is our um accrediting body here in, in Australia. But the problem is that this isn't planetary health or climate change specific. It's only as you know, part of the Sustainable Development Goals and it certainly not a mandatory inclusion to have climate change and Planetary Health in nursing curriculum. We do know that climate change is uh inclusion is supported by many Australian peak bodies. And this is something that's consistent internationally with many nursing organizations globally, creating fantastic resources for nursing education. We became a little bit curious because anecdotally we had um witnessed that there were many barriers to implementing planetary Health in curriculum and we wanted to see whether other researchers had um seen these patterns and observed content on documented barriers and enablers of curriculum change. Um So our research question was what are the barriers and enablers for academic stakeholders in implementing changes to undergraduates, university curriculum within English speaking OECD countries. Um And we uh included seven papers in total. So not too many. Um and importantly, none of them were specifically on planetary health integration into the nursing curriculum. We found two types of studies overall, those that were integrating new content and those that were changing the underlying teaching paradigm. So in this rapid review, we used the theoretical domains framework to complete a thematic analysis. The most frequently identified domains were skills which which mentioned across three of the papers, knowledge, which was mentioned across seven environmental context and resources, which was mentioned across five and social influences, which was mentioned across four. So for knowledge, academics really needed to know why the change was happening when there were purpose related issues, academics could then become reticent to change. They also needed to have a strong understanding of what content was being integrated. Um All the academics would struggle to integrate the content and would also believe that they weren't capable of doing it as a part of this. It was really important to have easy access to information which allowed the academics to refresh their understanding of in of the new concepts as needed. Um Next is environmental context and resources. So the academics really needed a supportive environment particularly from those higher up directly directing the change and particularly allowing academics to have time and flexibility given their already extremely busy schedules. It was really important to watch for burnout during this transition. As some of the universities lost valuable staff members, they also needed access to good education materials to reinforce whatever learning that they had done. And in some of the log resource contexts, they also needed access to basic things like electricity, internet and computers. Um Next is social influences. This was really important. The academics were really concerned about the impact on their students and having their students being negatively impacted by integrating new content. Um And also it was really important that they felt like they were being supported by their peers. Um And when peers weren't supportive, this threatened the morale of the change. And lastly, it was really important to have support from the higher ups through strong leadership and communication, which really positively impacted the change process. And then lastly, skills, it was commented on that um workshops combined with followups to ensure that they were implementing the skills properly were really, really helpful. It was useful to have that practical and then that reinforcement afterwards. So when we think about the theme of fast tracking, resilient and environmentally sustainable systems, we know two things. One, it's absolutely pivotal that what we teach undergraduate students matches the needs arising from contemporary issues. And two that our approaches in planetary health, sustainability, climate change, either inside or outside a curriculum change must be centered around behavior change and translational science, which is what we were aiming to do with this literature review. What we did find interesting was that at the time that we conducted the study, which was um early last year, um there was really no um inclusion on barriers and enablers to the inclusion of planetary health in undergraduate curriculum change. And while there was papers in the medical field and there were nursing papers looking at post um postgraduate studies there, what we found is that there was a gap for nursing science for undergraduate nursing programs which may inform future research initiatives. So in conclusion, for those who are trying to change their curriculum, there really needs to be a shared vision for the change of what is happening and why academics need to be on side for the changes. And they really need to feel supported by their peers and those higher up. And as a part of the support, they need access to adequate resources that are easily available. And really importantly, lots of time. It's also potentially very useful to have direct mandates from directing councils on what to include. This is particularly important due to the enduring perception that planetary health is outside of healthcare's wheelhouse despite it being of paramount importance. Thanks for listening. Thank you very much. Indeed, Caitlyn and Sophia. Once again, please add any, any questions that you have into the chats and we will address those at the end. Um But our next uh and related presentation is right here in Brighton. Those speakers are very own nursing students from the University of Brighton, Sara Lama and Emma who are going to talk to you about their sustainability focused placement that they've been doing. So I shall hand over to you guys. Uh Hi, my name is Lama Adult Nursing student from University of Brighton. Uh I'm currently in my second year. Uh I'll introduce you to the K A placement which stands for quality assurance and practice learning. Um The only first started it in May 22 for both adults and mental health nursing students. Uh It's not the basement, it's virtual. Um It gives us lots of uh opportunities other than working from home uh to work alongside the other students where we create this amazing support network. Uh also to work alongside the researchers and uni lecturers and stuff. Um uh Some of us since it's virtual, but some of us has to go to the hospital each week we do a weekly check in. I find it really useful. Um So that we know uh what other students have been uh doing um and learn from their experience. Uh Personally, I really enjoyed this placement. Um It's mostly independent but uh I gain so many skills such as uh time management within this placement. Uh There's lots of uh projects. Uh One of them is sustainability, which you will get to know more from Sarah and Emma. Hello. Um I'm Sarah. I am a second year um student nurse. Um Let me just share my slides. Um So I'm gonna talk to you about an opportunity that we had as part of the um sustainability placement that we was on. Um We met with um uh an American nurse called Gina. Gina is from the Global Nurses Working Group. And um she's part of the Global Consortium on Climate and health Education. So we was um invited to help um do some collaboration with her to produce some education materials for um a website. Um So we were tasked with um writing a case study and some slide deck um in order to um put them on a website called Climate Health ed.org. So the idea of this website is to provide free resources designed for each level of the curriculum. It's evidence based and expert reviewed. Um The importance of this for nurses is that we address public health issues with the forefront on patient education and community engagement, Lama. And I focused our case studies on the adult population and air pollution for our nursing degree course. And um the the resources will be available later on in 2024. There are some medical resources that are available now. Um So anybody can access it. Um You can go on there and you can access loads of different a range of topics and they're all um the learning objectives are from the Planetary Health Report card. Um So you can access a repository and um get the open source materials they're free. Um And they, they can be used across the globe. Um And the website is Climate Health ed.org. Thank you very much. Hello, my name's um Emma and I'm a third year adult nursing student at the University of Brighton. Um And I'm actually on this uh Q APL placement at the moment. It's the second one I've done and it's a privilege to be working alongside. He, again, I'm gonna talk to you about the plant tree health report card very quickly. Um which is what I um led on um for the 2024 report along working with Sarah and Lama as well. So, the Planetary Health Report card is a student led initiative and it started in 2019 in California and it's um used with metrics so that you can measure how your university or um nursing or medical school are doing with sustainability. So it's broken down into five sections, um plant tree health research, outreach, student led initiatives and then your uh campus sustainability. So as it is student, l um you do have mentors that can help you. And at the University of Brighton, we've got Alison and Heather. Um but as students, we have to find the evidence to back up how we've met a metric. And here's an example of one here that's from Brighton. Um So once you've got your evidence, um it's then scored and this goes off to the Planetary health team and then they um score it and say whether they agree with how you've marked yourself or not. Um And the results were available online. This is from the um plan, you have report card summary. Um And this year um the University of Brighton were third with A B plus the um Planetary Health report card is such a fantastic tool to use if you do want to improve sustainability within your university because you can almost use it um as a checklist going through to see what your university are doing um or um areas of improvement and then each um section is scored and then you get an overall grade um at the end. So for Brighton this year, we um were with him. B so that was the percentage that we got. Um and it started in 2022 and Leonie um is here today. She's in the room and she um first started the Planet Health Report card at Brighton and then we've continued it on each year. If anyone is interested um in doing the Planetary Health report card at your university, it's free. It takes time. As long as you've got a team of people or team of students that are interested in sustainability. It's an absolute fantastic project to get involved in. And um if you put Planetary Health Report card into um the internet, it will bring that up. And also there is a summary as well that you can read. Thank you very much. Thanks summer. Perfect. Your time. You can see you've rehearsed that well done. Um Thanks guys. That was really, really interesting on all three threads um to the placement you've been doing. So once again, please um ask the three amigos anything you'd like to ask about their projects and their placement and we will come back to that at the end of this session. Ok. I do think we're still struggling to get, yes, we're still struggling to get Leoni um into this breakout area. And I'm not sure if FNA has arrived back yet. So we've got a question in the chat and I wondered if we could go to that first. So Kaitlin has a question for Emma, which is Caitlyn's curious about whether you think studentss would be interested in this work? And how do you encourage engagement with your peers for the um Planetary Health Report card are you referring to? Um, it's um it's such a, a fantastic thing to get involved in. Um, a as I said, this is the second year I've worked with he on the sustainability placement. We're really trying to promote our planetary health report card at the minute. And um we have a short round at the University of Brighton and we're hoping that it can be a discussion that's involved in that. And we're also thinking about having, um, information stands in our um caf cafeteria and canteen areas so that we can promote the planetary health report card as well that way. Yeah. Emma, did you find when you were completing the Planetary health report card? Did you ever find there were questions that were asked in the report card that either faculty or students weren't aware of? Um, I don't think so. I ii don't know um what's Sarah and Lama um might think as well. Um But there, there wasn't anything in there that, um I thought we're never gonna be able to answer that question or I'm never, we're never gonna be able to find, find any evidence for that. And I think because it's a team effort and, and you, you definitely have to have a team of people to, to do you, you could ii couldn't have done on my own without, without Sarah low 100% and also with Heather and Alison as well. Um And, and lots of lecturers joy. I know you, you know, you've been involved in helping provide evidence for it as well. And I think as long as you've got, um, people that want to be involved in it and, and people within your university or school that are interested in helping, then you're, you're always gonna be able to find the answer somewhere. Yeah. And I'd wonder if we could ask that question back actually to Sophia and Kaitlyn. Um because in, in your, the work that you've been doing to, to understand how teaching around sustainability needs to match contemporary issues, what did you find or in discussion with your peers, what did you find are the contemporary issues for students in Australia? And how might they be similar? Or I might, I must confess our focus um for the paper that we were working on um which was the rapid review was predominantly looking at the perspectives of academics. And that's not to say that student voice on this um issue isn't important cos it so is it must be very much um targeted. I think for us, what we were sort of observing was patterns of um nurses that were practicing, that were saying, you know, this is something that we really care about in our personal lives. It's interesting that there's no integration with our professional lives. It feels like we have to sort of almost switch off this um very much values driven, compassion towards sustainability and climate change. And, and planetary health when we go to work. Um And we sort of speculated that that was perhaps beginning um from curriculum where it really, here in Australia is not very much represented in our Bachelor of Nursing curriculum at all. So it's just so fantastic seeing the integration of the work that's been done um by yourselves and, and with Heather, with her expert guidance, I think it's just fantastic and really, really exciting work. Can I ask you a question to Caitlyn and, and Sophia on the, on the back of that? Um, you mentioned that your, forgive me, I don't know, I forget the name of your um your nursing government body. Um You said there's no mandatory inclusion for climate change or um financial health that there are for sustainable development goals. I wondered if there was any lobbying going on um, of your nursing regulator around that at all because we found AAA very similar issue in this country with the NMC. Yeah. Yes, there is. Um, that's being led by um sort of two initiatives. So Climate Action Nurses, which is the organization that I'm a part of, um, as well as the Planetary Health Nursing and Mid Midwifery Research and Education collab, which is led by distinguished Professor Tracy Levett Jones. Um, and collectively, we've been working with um, one of the peak bodies to, um, which is um the, the Council of Deans here in Australia for Nursing and midwifery education to lobby, um, and Mack for inclusion. Uh, and it's really interesting medical um, curriculum. Um, they are different, um, KT of fish, like, from, from, to my knowledge they've got, um, sustainability, climate change, country health included as a mandatory inclusion in their curriculum. So I feel that it's, it's coming, it's just one of those wins that we'll probably see in the next couple of years, hopefully. Mhm. Yeah. Um, so I have a question related to all of our students that have presented so far. Um So Emma Sarah Lama, Sophia and Kaitlyn, have any of you observed yet in your clinical placements, nurses having conversations with patients about sustainability and about um perhaps sustainable improvements people can make to how, how we live our lives, thinking about health promotion and preventing illness. Um And if you haven't, how do you feel, how would you feel about perhaps incorporating elements of sustainability in the health promotion work that you participate in as student nurses and when you become registrants? Double? I um I haven't come across any conversations um with healthcare professionals and patients um or actually with healthcare professionals. Um I have brought a few things up when I've been on placements about people wearing gloves when they don't need to and, and things like that. Um And um I did, I went on a spoke last week and the practice nurse said to me there, she went to reach for the gloves and then she put them back and she said, I don't actually need to wear them for this procedure. So I know that healthcare professionals are thinking about um sustainability. Um but it could be brought in. I mean, you could bring it into every, every conversation if you wanted to, you know, you could say you could say to the um patient, oh I II haven't got any gloves on because I don't need to wear them. and, you know, you, you could always bring, bring a little bit of something in I, II don't know why people, I don't know if people are afraid to, maybe talk about it with, with patients. I, I'm, I'm not really sure but it is something that I must admit. II haven't heard much conversation at all with any of my clinical placements. Um, I agree with Emma as well. I haven't, I haven't witnessed anything yet but I do think there could be more, um, education, maybe, maybe even posters in the, um, where you mix up the medications just even on the back of the door. You know, do you need gloves? Question mark? Just to remind people that they don't actually need to wear them all the time, um, for every procedure. So, maybe just a little bit of nudging, um, might, might make you think. But I do think as well in different hospitals and different wards, um, things like recycling. I mean, I've, I've been on placement at the moment. And I couldn't find a recycling area. Um whereas, you know, a London Hospital I was in it was clear recycling normal waste um for patients and things. So I think it just varies depending on which hospital you're in. So that could definitely be improved, I would say, yeah, that could really be improved. I know that in the UK, recycling facilities are so often dependent on the council location and what recycling services are provided that health services can access via them. So, yeah, that's really interesting, Lamar Sophia and Kaitlyn. Do you have any insights that you want to share? Have you seen any patient conversations about sustainability? Maybe about patient travel to appointments or use of equipment, single use items. We've been talking about a lot this morning personally, I haven't observed it in my clinical practice. I know of some fantastic papers where they've um really outlined some of the initiatives that are being led by nurses um where they've initiated conversations with patients. And I really liked what you're sort of bringing in and tying in there about the health promotion aspects. I feel like that's such a an area that really um warrants further research in particular because the, we know that there's so many prohealth co benefits from um climate change mitigation as well as planetary health promotion and seeing. Um and having those conversations with patients, I think is such an important um aspect of the nurses role. Um Not just in primary health and public health settings, but also, um just in general clinical practice, um many strategies like, you know, integrating predominantly plant based whole food diets and things like that are great for the environment, but they're also really fantastic for health. Um and seeing the shift from nursing practice from downstream measures um towards the upstream public health thinking, I think is, is certainly the trajectory that we're on as a profession. Um And I'm actually not a nursing student. I'm in psychology. Um and there is a, there has been um not within my um I'm doing honors at the moment. Nothing's been mentioned there with, with sustainability and stuff, but there, I have been involved in um a couple of organizations and stuff that do really focus on eco anxiety and eco distress and how to manage that because it is a major concern amongst young people and it's really gonna be appearing a lot um more, it already is appearing a lot and it's gonna only get worse with, with time. So, um psychology is really important, but it's a very different um perspective to nursing, I guess because it's all about dealing with people's. Yeah. Thank you so much for sharing that insight, Sophia. I think you're absolutely right to mention the increasing rates of climate distress as, as a subset of anxiety that is becoming more and more prevalent amongst young people at the moment, especially when we're thinking about predictions that are currently being made for how are how our environments are going to be to live in um in the future? So, yeah, that's really interesting. Um Lama, how about you? Uh I haven't witnessed any conversation but in my current placement, I work in the kidney unit on dialysis and there is signs sustainability related all over the unit. So that's great to see. Yeah. Yeah, that is really great to see you. Thank you for sharing that. So I've just had a quick scroll through the chat and I can see that has left a link to the World Health Organization's leaflet on glove use, which is really useful. And Heather's also shared a link to a mental health nursing students video. Um This student created a simulated patient scenario about eco anxiety and mental health. So that's exactly what we've talked about. And Sarah has commented that recycling doesn't always happen on site where Sarah works. It's done at Merf sites and segregated by infrared and other technology. No, just um just linking back to what you were asking about previously and, and students and their experiences of having these conversations in practice. Certainly at the University of Brighton, we're building that into our conversations with students all the time in our clinical skills teaching. And you guys can tell me if you remember having these conversations with us as academics, you know, particularly in clinical skills teaching where you might be talking about blood use or some other aspect of sustaining practice and helping, you know, y work as well, helping people have the confidence to raise those same issues when they are out in clinical practice because sometimes it's a confidence thing, isn't it? And, and also very much a cultural thing because like one or two of you have said in some areas, you'll find loads of recycling going on in other areas, it doesn't appear to be happening at all. And so that could be because somebody's championing it and somebody is really taking that agenda forward in that particular area and other places where it's not happening, sometimes it's a bit harder to have those conversations. So by making this part of our course and hopefully embedding it more and more and more as we go forward, we're helping students to like they would question any other aspect of clinical practice. We would expect them to be critically thinking about anything in their practice. This is very much, you know, part of that conversation as well. Ok. So just an update about where we're at for our next speakers. Um We're still trying to get Leon into the room. We've got a copy of her slides now. So we might do that on Leon's behalf and we're going to try and get her access via her phone, Vena. Have you made it back? All right, just to say I am here as well. I'm doing lots of troubleshooting behind the scenes, but I thought FNA was in the room. Has she? She's done the school run and she's coming back? Oh, I see. Oh, she le um, oh, Leon, I think it's here. It's troubleshooting at its best nurses and physios and healthcare professionals. We can troubleshoot. Right. Um It looks like you're in the car, but never mind you're here. Not driving. Right. I'm not having, I'm pop up. I think I'm gonna need to share the slides. So let me, um, get that ready. Is that correct, Alison? That will go straight to a or go straight to the own? Is that, is that correct Alison in terms of timing? 00, is it time for Leon to? Yes. Yes, it is. Welcome, Leon. And um, I'm sorry, you've had so much difficulty getting in, but you've made it and like Heather said, you've done it in the most, you know, off the cuff from the flyway, possible so well done. Um and while we let Leon get her breath back, uh I'll just let you know that she's a, a graduate of the University of Brighton as a children's nurse and she's now doing post graduate education uh to become a health visitor. So it's going to talk to you about her project. Just let me know when you went next slide season, I'll progress. Ok. Amazing. Thank you very much. I can't actually see myself. So if my hand goes off camera and um, you just see the scenery. I apologize for that. Um ok, so thank you for having me today to um present at the share conference. It's really nice to come back as a presenter this time. Um So, um this project was undertaken as part of the project management and leadership through work based learning module for the post registration specialist community public health nursing course for health visiting. Um You can move to the next slide. Thank you, Heather. Um So the project aim was to produce an evidence-based health education resource raising awareness amongst clients using the health visiting service about the sources of indoor air pollution. The links to climate change and its effects on child health. An accessible and equitable resource would need to be would be required offering practical and affordable suggestions to improve indoor air quality at home. As the project was initiated as part of the ski course, it would also need to support professional development of project management and leadership skills towards the role of a qualified health visitor. Uh Next slide, please, Heather. So I approached this project by making observations and practice having stakeholder discussions and a review of stat statistical data to identify current challenges and opportunities for a service improvement project. These activities help to identify indoor air quality as a suitable topic and inform the need for a literature search evaluation and review of the contemporary evidence. Project management tools were used to drive the project forward and a change management model was identified to support the changes that would be necessary in practice. Um Next slide please heather. So the topic of indoor air quality is underpinned by guidelines, policy and legislation. The literature shows that people in the UK spend most of their time indoors, particularly babies and preschool Children and most of this time is indoors at home. So poor indoor air quality is linked to health concerns with pregnant people and infants being particularly vulnerable. Climate change is worsening indoor air quality because severe weather resulting from climate change risks damage to buildings and flooding which may increase dampen mold in homes. And additionally improvements to insulation of homes in in in an attempt to reduce CO2 emissions may actually prevent air pollutants from escaping the building resulting in higher concentrations of air pollution indoors. And it may also increase the risk of damp and mold when moisture is unable to escape the building. Deprivation widens health inequality because people with so low socioeconomic status are more likely to live in areas of high outdoor air pollution which can infiltrate homes and they're more likely to live in properties affected by damp and mold. For example, there is a air quality management area in my practice area due to traffic pollution and dampen mold is frequently raised as a concern by families in our practice area. The literature identifies a need for health education on indoor air quality and health visitors are ideally placed to deliver this, there is already good practice with tobacco smoke, discussions in health visiting, but staff often have limited knowledge about other sources of indoor air pollution, indoor air pollution. Um So um next slide please, Heather. So the four D project management model was used to drive the project forward. It's been adapted here to show you the different activities involved at each stage of the model. And this learning process supported development of project management skills. Next slide, please. Heather and the three step change management model was identified as a tool to support the change process which would be necessary in practice to improve discussions about indoor air quality and a force field analysis was also undertaken. Um And it helped to identify the driving forces and restraining forces for change. And the last line, please, Heather. So stakeholder feedback helps to identify that an article for the health for under fives website would be an accessible format for the health education resource. The website article is currently sitting in draft format and awaiting the next steps required before it can be published. Once it's published, it will provide families with a useful resource of health education about indoor air quality and will also support professional led discussions in practice. These discussions may help families to improve indoor air quality at home and build resilience to the impact of climate change on indoor air quality. And then the last slide is just my references. Um Apologies for the text being so small. There was quite a lot to fit on that one. Fabulous. Thank you very much. Indeed. You said nurses weren't creative and good at improvising. So that's great. Um I believe that was now with us. So, yes, I'm here very much. Welcome back. Ok, we'll take um questions for the last two presentations at the end. So, are you ok, uploading your slides. Yes, I am. Give me a moment. So while she's doing that, please again, add any more questions to the chat. Uh And we will address those at the end of venous presentation. So while the slide deck is uh uploading, may I just say that I know that in the earlier presentations have been research presentations. This was um just an initiative uh that a few colleagues uh thought of in order to enhance awareness and advocacy primarily for the environment. Um So I'm ready, Alison if you want. Um I can't see your slides in my Oh, yes. There it is. There it is. Ok. There you go. I've got a little sign to show you as you saw. So I'll give you two. I have my time. But thank you. Um So thank you for having me. Thank you, Heather Alison and the rest of the team. It's uh truly a pleasure to be able to share this with you. And um you might find me moving quickly through the slides and because I intend that I can show you as much of the work as possible if you are later interested to see some videos um that the students produced or listen to some of the poems. I'm very happy to share it later on. So um this was something that was planned between um a colleague of mine and I from the University of Scranton in the USA Professor Laurie um who is uh unfortunately not able to join us today. Um We decided that students, we need to collect students from around the world. And our previous research collaborators have been in Pakistan and in Bangladesh. So we kind of joined forces. Um Earlier on, I worked together with Laurie in uh the U A in the University of Shah. And then we moved ways and I came to the UK, she went to the US and we thought this is a good opportunity to get ourselves colleagues, but at the same time, students together. So I will start in order of succession. So Pakistan, Bangladesh USA England. So you can see student work successively in um from different parts of the world. Uh beginning with uh Pakistan, this was the RIFA International University. And although these were all allied Health professionals, all from physio courses or doctor of physio courses or M se physiotherapy, um primarily the target audience and the people who attended were physiotherapists. And this agenda has been passed on to the Environmental Physiotherapy Association, Philip Merrick in particular. And they are very strong on the sustainability agenda. Currently, we have a task force that's working on how we can embed this within the curriculum. So just to show you pictures, it was held on the eighth of November. We had an online forum much like the one we have now and students joined us from all over. This is the university, gives you a bit of an overview about the university but goes mainly to artwork and they held an exhibition and you can see some of the exhibits students had um and presented to their colleagues um and they made old drew paintings. So it was mainly expression through art. So art could be in the form of media, pictures, poems, um videos, either or. So that's that one. And if you then have the video, she talks about it, this is another one and you will see this is quite in the literal sense of the environment rather than implied sense as we would think in health care. So some more from the same university and then we have some from the universe from the BHP which is the Bangladesh Health Professions Institute. So over the next one minute, I'll take you through some of those. This is a huge institution with mainly a PS or allied health professions um and a bit about the institution, but that campus is really beautiful, has a lot of greenery and sustainability on campus and they carry out generally a lot of initiatives. So here are some of the physio students participating in those initiatives and then participating in some drawings. Um a born and she, she um relates this recites this poem. Now, the poem some more about Mother Nature um relating it to a mother and talking about nature. So that was a snapshot on Bangladesh moving now to the deputy students at the University of Scranton in the US and they had a little bit of a different take. It was part of their assessment. So they used it as a project and I will show you examples where they have gone out into the environment and used it as a project where they talk about biodiversity and they create art in the form of uh jars like connecting physio to nature. So art jars and talking about grounding and how we can ground ourselves to Mother Nature. Um And this was a very interesting one where they talk about the big Yellow Taxi and talks about original artwork where they've taken pictures of the whole city and uh they, they shown examples where people are careful of the environment and where they aren't a little bit about the wildlife and from waste to wellness and a picture again, a very beautiful one there. Um a little bit about the environmental Wellness Wheel and the fight for our future toxic impact of the environment and how physiotherapy impacts the environment. So this was a youtube video. It's an interesting watch where they created a video on how they can uh deal with sort of environmental change and sustainability. More about a project on health care waste and some of their DP D students from Brighton, of course, we had the Planetary Health Report card, which you are aware of, which was done by our physio students. Um and which rated us on those parameters that we have. And again, some artwork from our students where they talked about sustainability in physiotherapy and in practice, especially in clinics or hospitals and breathing a lot of breathing because we do a lot of breathing and a poem then from them. And so feedback, we didn't analyze data formally. This wasn't a formal research project, but all students indicated, it triggered them to consider the environment, they loved the creative nature and gave them something outside the box to do. And this was combined into an overall presentation and video that was shared with the E PTA and they enjoyed the use of creativity as they enjoyed meeting studentss and boundary uh across different boundaries and countries challenges were timing, we face a lot of challenge with the timing of the event and having everyone to uh to connect technical challenges from the low middle income countries. We have fewer students attending the session and I think we need more initiatives that embed wellness uh not only educationally but also clinically um in all A H PS but also physiotherapy. Um So this is just a simple method. It isn't very complicated and sometimes it's the simplicity of these kind of methods that attract students at the outset. And then from then on, we have an agenda created and what our student who created the Planetary Health presented this to all the students. Um And they really enjoyed the Planetary Health Report and in their respective countries, they all wanted to implement something similar. So thank you for having me. It was a pleasure. Thanks, Dina. Really interesting. Love you to see some creativity and something a little bit different for our last presentation. So there's a question that's coming from Nadia at the end. Um This initiative seems to be a low threshold method to increase awareness of sustainability and climate friendliness. In addition, learning in a creative form is an excellent way to perpetuate this and trigger reflection. Awesome. Uh Yeah, absolutely. And, and I as an educator, I often think we just don't do enough of this stuff and, and we need to create room for it um as we are trying to do for sustainability. So getting that creativity lens is really wonderful, so well done. Thank you. Yeah, they enjoyed it. I mean, it just gives them a break from the monotony and I think that's important as well as connecting them. So they said the real benefit uh actually, in addition to that was connecting them and they, so we are all physio students. We are located in four different time zones all around the world. And that connection that we are connecting on a common theme, a common agenda was really for me, the crux of the whole um sort of uh fantastic. So any more questions, we've got eight minutes left of our session. Does anyone want to ask anything else or put any more comments in the chat for Leo or for Rina or are the speakers? If they're still here? We may go back um Before we finish, na asks where the artworks, etcetera used in context with patients. Um Now one of them, uh the B HPI the Bangladesh Health Professions Institute is actually um spinal cord injury Institute. So it is situated within the institute. The students are never on their own. It's almost like a hospital come come university kind of set up. So I'm pretty sure II I'm pretty sure they were especially because they were exhibiting it and then the exhibitions, patients on wheelchairs, they tend to come around. So, yes, most definitely. But then the patients themselves do a lot and I've been to the campus in Bangladesh and I can vouch for it and I see them on wheelchairs doing gardening and things like that and it's really wonderful and I think we don't do enough uh with all the beauty around us here. Thank you. It's the right way. Lots of positive comments about all of the the artwork. Sorry. Is there anything else you wanted to ask. Um I wanted to thank you so much, Dina for sharing the examples of student artwork. I think it's really, um as a Alison said, it's made me reflect on those opportunities. We have to let students explore content in our curriculum in a much more creative way. And I love the connections that you've built from two nursing schools on different sides of the world coming together. And I think that really neatly, that sort of contributes to the theme that Kaitlyn and Sophia were talking about, about how their research found that they wanted their teaching material to be matched to those contemporary issues and those contemporary issues need to be things that we're talking about together. And so I think that your project in how you've um enabled a, a dialogue to happen between students to discuss their concerns and their fear and their challenges they face in their practice through a medium of art that is more creative, more expressive. It allows us to explore those contemporary issues in a really different way, which I think is really interesting. Did you have vina any studentss who um chose not to engage in the creative side of the project? And how did you respond to that? Oh, a lot. And II mean, I don't know about the other institutions, but in, at Brighton, I can tell you I had to actually walk into a physio class and request the lecturer to give them some time prior to the session because unless it was a part of their mainstream lesson time, I'm sure II kept a day where they could come in, there were art materials they could come in. No one showed up. And so I walked into a classroom, asked the lecturer, can you begin 15 minutes late? And I told the students, this lecturer is gonna come 15 minutes late. Here's all the uh brushes, the pains. Why don't we use this time to do something creative? So it was planned in a way, but then those that didn't engage, went into groups and they combined into groups and kind of gave ideas to their friends. So there were those with the eye and who could draw, right? And that's why from Brighton, for example, you see a lot of static pictures because these were things that they developed them. However, when they attended this event, they realized we could have been creative in other ways and they're like, oh, we could have done a glass jar, we could have done a video and that for me was enough to uh sort of put in the seed for next time, Joanna. Um So that was something and also I think not everything needs to be very formal as informal learning. And sometimes these kind of incidental learning methods give us more much like we would do with our Children. Yeah, I really like that idea of just some time that is not, not focused on assessment, not targeted at a specific piece of the curriculum that you need to teach, but to give students space to explore ideas. And yeah, there, there can sometimes be hesitancy with people not wanting to um perhaps express themselves in a creative way because it makes you feel vulnerable, doesn't it? If you, when you're sharing something that you have created and you're inviting feedback from others, you get this sense of um yeah, it's exposing a vulnerability and something really personal about you because it's your feelings, your thoughts that are displayed there for others to see. Um So yeah, that's an interesting thought for me to have about how um how we can use art to explore these subjects, but in a way that doesn't exclude people that don't want to participate in it. Um So Nadia says in participatory research, there's a method called Photo Voice, which could be a nice way to integrate students views and their reality. So that's really interesting. Thank you, Vena for putting your email address in the chat there as well so that people can contact you and learn more about your work. I would be happy to share if anybody wants to listen to the videos, there's more, it's public. Uh Alison, it's been put on uh the physiotherapy Congress. So it's a public um link and a presentation. So I'm happy to share that. II wonder whether we can put that on our sustainability great. Yeah. Um, I don't know if, um, if you're still here. Um, uh, but just wondering how you've, um, discussed your, your findings and your project with your colleagues in your, in your health team team. How that's gone down? Yeah. Hi, I'm Alison. Yes. So I did a presentation to my team last week during one of our, um, quality days where all the staff got together and, um, it was really well received. And um quite a few staff members have asked me to um like I said, the, the website article is still in draft format um as you're probably aware for things to be published, um public facing on the NHS, there's certain um checks that it had to go through first. Um But a lot of the staff members have asked me for the information that's included in that article so they can start putting that into their toolkits um to have these discussions. And um it was just really interesting to um hear their feedback and um a lot of them not sort of knowing that damp and mold is a big issue that we, we have discussions with, with our families. Um You see it in the news quite often as well. There's always news articles but not drawing those links between how climate change is going to impact on that. Um So yeah, it was really, really good to share the information. It was very well received. Brilliant. Thank you and for anyone interested in in, in the links between uh climate change and child health, which is, you know, a, a huge area of concern for the future of Children and children's health. The Royal College of Pediatrics and Child Health has got some really useful resources. Um And there's a newsletter that you can subscribe to um um for that side uh point people towards that for more information. We're at the end of our time, we're one minute over. So, thank you very much indeed, to all our speakers. Uh I believe we have a very short pause. I've now lost my program. Um Our next session is at four o'clock and we've got our third keynote speaker, Professor Henrique Barros will be speaking for half an hour then. So thank you ever so much for all your contributions and your comments and questions and enjoy the rest of the day.