Patient group directions : the application and integration of knowledge in advancing nursing practice

Background: The introduction of Patient Group Directions (PGD) has changed significantly the way in which nurses can now administer prescription only medicines as a one-off for patients requiring this level of service. PGD’s are a written authority to administer drugs to patients that are not identified at the time of treatment. Aim: The aim of this project was to develop a PGD for use within an Outreach team to administer colloid boluses to patients presenting with hypovolemia. Method: Using a case exemplar this paper will discuss the development of a PGD using aspects of transitional change theory to highlight the potential barriers that were encountered. Implications for Practice: The implications for this PGD are wide reaching. First it now enables members from the nursing Outreach team to administer colloid fluid boluses to a prescribed patient cohort without the need for prescription. Second, it ensures the deteriorating patient has interventions initiated in a timely and appropriate manner to reduce inadvertent admission to high care areas. Last, it will improve inter-professional team-working and communication so much so that collaborative patient care reduces health costs and identifies earlier those patients requiring substantially greater nursing and medical input. Conclusion: The experience of developing a working PGD for fluid administration has meant that the Outreach team is able to respond to patients in a more effective way. In addition, it is the experience of developing this PGD that has enabled the team to contemplate other PGD’s in the execution of Outreach work.

A framework for model integration and holistic modelling of socio-technical systems

This paper presents a layered framework for the purposes of integrating different Socio-Technical Systems (STS) models and perspectives into a whole-of-systems model. Holistic modelling plays a critical role in the engineering of STS due to the interplay between social and technical elements within these systems and resulting emergent behaviour. The framework decomposes STS models into components, where each component is either a static object, dynamic object or behavioural object. Based on existing literature, a classification of the different elements that make up STS, whether it be a social, technical or a natural environment element, is developed; each object can in turn be classified according to the STS elements it represents. Using the proposed framework, it is possible to systematically decompose models to an extent such that points of interface can be identified and the contextual factors required in transforming the component of one model to interface into another is obtained. Using an airport inbound passenger facilitation process as a case study socio-technical system, three different models are analysed: a Business Process Modelling Notation (BPMN) model, Hybrid Queue-based Bayesian Network (HQBN) model and an Agent Based Model (ABM). It is found that the framework enables the modeller to identify non-trivial interface points such as between the spatial interactions of an ABM and the causal reasoning of a HQBN, and between the process activity representation of a BPMN and simulated behavioural performance in a HQBN. Such a framework is a necessary enabler in order to integrate different modelling approaches in understanding and managing STS.

Dynamics of industry architecture and firm’s capability development : role of knowledge integration within product innovation

Aligned with the decline of Marshalian view of industry as constituting homogeneous set of firms, the new perspective is emerging by concentrating more on dynamics of sectors as the building block of industrial changes. Based on new assumptions, much of the action in terms of strategy, technology, and knowledge development does not happen either among firms within a stable industry, or through the growth or decline of certain sectors compared to others. Instead, the action happens in terms of the definition, redefinition, drawing, and redrawing of the very nature of these sectors. Technology does not progress and develop within a sector; rather it shapes (and is shaped by) the encompassing architecture of multiple sectors.

Improving the teaching and learning of steel structural design

Engineering students are best able to understand theory when one explains it in relation to realistic problems and its practical applications. Teaching theory in isolation has led to lower levels of comprehension and motivation and a correspondingly higher rate of failure. At Queensland University of Technology, a number of new methods have been introduced recently to improve the teaching and learning of steel structural design at undergradt1ate level. In the basic steel structures subject a project-based teaching method was introduced in which the students were required to analyse, design and build the lightest I most efficient steel columns for a given target capacity. A design assignment involving simple, but real structures was also introduced in the basic steel structures subject. Both these exercises simulated realistic engineering problems from the early years of the course and produced a range of benefits. Improvements to the teaching and learning was also made through integration of a number of related structural engineering subjects and by the introduction of animated computer models and laboratory models. This paper presents the details of all these innovative methods which improved greatly the students' understanding of the steel structures design process.

Wide-band spectral power fluctuations characterize the response of simulated cortical networks to increasing stimulus intensity

The hippocampus is an anatomically distinct region of the medial temporal lobe that plays a critical role in the formation of declarative memories. Here we show that a computer simulation of simple compartmental cells organized with basic hippocampal connectivity is capable of producing stimulus intensity sensitive wide-band fluctuations of spectral power similar to that seen in real EEG. While previous computational models have been designed to assess the viability of the putative mechanisms of memory storage and retrieval, they have generally been too abstract to allow comparison with empirical data. Furthermore, while the anatomical connectivity and organization of the hippocampus is well defined, many questions regarding the mechanisms that mediate large-scale synaptic integration remain unanswered. For this reason we focus less on the specifics of changing synaptic weights and more on the population dynamics. Spectral power in four distinct frequency bands were derived from simulated field potentials of the computational model and found to depend on the intensity of a random input. The majority of power occurred in the lowest frequency band (3-6 Hz) and was greatest to the lowest intensity stimulus condition (1% maximal stimulus). In contrast, higher frequency bands ranging from 7-45 Hz show an increase in power directly related with an increase in stimulus intensity. This trend continues up to a stimulus level of 15% to 20% of the maximal input, above which power falls dramatically. These results suggest that the relative power of intrinsic network oscillations are dependent upon the level of activation and that above threshold levels all frequencies are damped, perhaps due to over activation of inhibitory interneurons.

Development and integration of a solar powered unmanned aerial vehicle and a wireless sensor network to monitor greenhouse gases

Measuring gases for environmental monitoring is a demanding task that requires long periods of observation and large numbers of sensors. Wireless Sensor Networks (WSNs) and Unmanned Aerial Vehicles (UAVs) currently represent the best alternative to monitor large, remote, and difficult access areas, as these technologies have the possibility of carrying specialized gas sensing systems. This paper presents the development and integration of a WSN and an UAV powered by solar energy in order to enhance their functionality and broader their applications. A gas sensing system implementing nanostructured metal oxide (MOX) and non-dispersive infrared sensors was developed to measure concentrations of CH4 and CO2. Laboratory, bench and field testing results demonstrate the capability of UAV to capture, analyze and geo-locate a gas sample during flight operations. The field testing integrated ground sensor nodes and the UAV to measure CO2 concentration at ground and low aerial altitudes, simultaneously. Data collected during the mission was transmitted in real time to a central node for analysis and 3D mapping of the target gas. The results highlights the accomplishment of the first flight mission of a solar powered UAV equipped with a CO2 sensing system integrated with a WSN. The system provides an effective 3D monitoring and can be used in a wide range of environmental applications such as agriculture, bushfires, mining studies, zoology and botanical studies using a ubiquitous low cost technology.

Basic personal values underlie and give coherence to political values: A cross national study in 15 countries

Do the political values of the general public form a coherent system? What might be the source of coherence? We view political values as expressions, in the political domain, of more basic personal values. Basic personal values (e.g., security, achievement, benevolence, hedonism) are organized on a circular continuum that reflects their conflicting and compatible motivations. We theorize that this circular motivational structure also gives coherence to political values. We assess this theorizing with data from 15 countries, using eight core political values (e.g., free enterprise, law and order) and ten basic personal values. We specify the underlying basic values expected to promote or oppose each political value. We offer different hypotheses for the 12 non-communist and three post-communist countries studied, where the political context suggests different meanings of a basic or political value. Correlation and regression analyses support almost all hypotheses. Moreover, basic values account for substantially more variance in political values than age, gender, education, and income. Multidimensional scaling analyses demonstrate graphically how the circular motivational continuum of basic personal values structures relations among core political values. This study strengthens the assumption that individual differences in basic personal values play a critical role in political thought.

Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: A qualitative study

Background Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs) in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists’ involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers’ views on the integration of pharmacists within private GP clinics in Malaysia. Methods A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10. Results A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1) pharmacists’ role viewed mainly as supplying medications, 2) readiness to accept pharmacists in private GP clinics, 3) willingness to pay for pharmacy services, and 4) concerns about GPs’ resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs’ reluctance were perceived as barriers to integration. Conclusion This study provides insights into consumers’ perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in providing integrated and collaborative primary care services to consumers, barriers to pharmacist integration need to be addressed.

GABAA and NMDA receptors contribute to synaptic integration in lateral amygdala neurons

In classical fear conditioning a neutral conditioned stimulus (CS), is paired with an aversive unconditioned stimulus (US). The CS thereby acquires the capacity to elicit a fear response. This type of associative learning is thought to require co-activation of principal neurons in the lateral nucleus of the amygdala (LA) by two sets of synaptic inputs...

GABAa receptors contribute to synaptic integration in lateral amygdala neurons

In classical fear conditioning a neutral conditioned stimulus (CS) such as a tone, is paired with an aversive unconditioned stimulus (US) such as a shock. The CS thereby acquires the capacity to elicit a fear response. This type of associative learning is thought to require co-activation of principle neurons in the lateral nucleus of the amygdala (LA) by two sets of synaptic inputs, a weak CS and a strong US...

Basic Religious Charities

Just over 44,000 registered charities filed their first Annual Information Statement (AIS) return with the Australian Charities and Not-for-profits Commission (ACNC) before the end of October 2014. Of these, 10,918 charities self-identified as Basic Religious Charities (BRCs). These are usually, but not always, unincorporated religious congregations which receive no or little government funding. Having a central agency for reporting, in the form of the ACNC, having access to information supplied in the AIS by registered organisations has allowed access to new measures of charities and their activities. In September 2014 the ACNC, in conjunction with Curtin University Not-for-profit Initiative, released a high-level report on the first AIS, and the data were also made available digitally through the Australian Government Data Repository. This factsheet builds on that report by focusing on BRCs.

Antioxidants in Athlete's Basic Nutrition: Considerations towards a Guideline for the Intake of Vitamin C and Vitamin E

Antioxidants in acute physical exercise and exercise training remain a hot topic in sport nutrition, exercise physiology and biology, in general (Jackson, 2008; Margaritis and Rousseau, 2008; Gomez-Cabrera et al., 2012; Nikolaidis et al., 2012). During the past few decades, antioxidants have received attention predominantly as a nutritional strategy for preventing or minimising detrimental effects of reactive oxygen and nitrogen species (RONS), which are generated during and after strenuous exercise (Jackson, 2008, 2009; Powers and Jackson, 2008). Antioxidant supplementation has become a common practice among athletes as a means to (theoretically) reduce oxidative stress, promote recovery and enhance performance (Peternelj and Coombes, 2011). However, until now, requirements of antioxidant micronutrients and antioxidant compounds for athletes training for and competing in different sport events, including marathon running, triathlon races or team sport events involving repeated sprinting, have not been determined sufficiently (Williams et al., 2006; Margaritis and Rousseau, 2008). Crucially, evidence has been emerging that higher dosages of antioxidants may not necessarily be beneficial in this context, but can also elicit detrimental effects by interfering with performance-enhancing (Gomez-Cabrera et al., 2008) and health-promoting training adaptations (Ristow et al., 2009). As originally postulated in a pioneering study on exercise-induced production of RONS by Davies et al. (1982) in the early 1980s, evidence has been increasing in recent years that RONS are not only damaging agents, but also act as signalling molecules for regulating muscle function (Reid, 2001; Jackson, 2008) and for initiating adaptive responses to exercise (Jackson, 2009; Powers et al., 2010). The recognition that antioxidants could, vice versa, interact with the signalling pathways underlying the responses to acute (and repeated) bouts of exercise has contributed important novel aspects to the continued discussion on antioxidant requirements for athletes. In view of the recent advances in this field, it is the aim of this report to examine the current knowledge of antioxidants, in particular of vitamins C and E, in the basic nutrition of athletes. While overviews on related topics including basic mechanisms of exercise-induced oxidative stress, redox biology, antioxidant defence systems and a summary of studies on antioxidant supplementation during exercise training are provided, this does not mean that this report is comprehensive. Several issues of the expanding and multidisciplinary field of antioxidants and exercise are covered elsewhere in this book and/or in the literature. Exemplarily, the reader is referred to reviews on oxidative stress (Konig et al., 2001; Vollaard et al., 2005; Knez et al., 2006; Powers and Jackson, 2008; Nikolaidis et al., 2012), redox-sensitive signalling and muscle function (Reid, 2001; Vollaard et al., 2005; Jackson, 2008; Ji, 2008; Powers and Jackson, 2008; Powers et al., 2010; Radak et al., 2013) and antioxidant supplementation (Williams et al., 2006; Peake et al., 2007; Peternelj and Coombes, 2011) in the context with exercise. Within the scope of the report, we rather aim to address the question regarding requirements of antioxidants, specifically vitamins C and E, during exercise training, draw conclusions and provide practical implications from the recent research.