Evaluation of contextual influences on the medication administration practice of paediatric nurses

Aim. This paper is a report of a study conducted to explore the impact of preidentified contextual themes (related to work environment and socialization) on nursing medication practice. Background. Medication administration is a complex aspect of paediatric nursing and an important component of day-to-day nursing practice. Many attempts are being made to improve patient safety, but many errors remain. Identifying and understanding factors that influence medication administration errors are of utmost importance. Method. A cross-sectional survey was conducted with a sample of 278 paediatric nurses from the emergency department, intensive care unit and medical and surgical wards of an Australian tertiary paediatric hospital in 2004. The response rate was 67%. Result. Contextual influences were important in determining how closely medication policy was followed. Completed questionnaires were returned by 185 nurses (67%). Younger nurses aged <34 years thought that their medication administration practice could be influenced by the person with whom they checked the drugs (P = 0·001), and that there were daily circumstances when it was acceptable not to adhere strictly to medication policy (P < 0·001), including choosing between following policy and acting in the best interests of the child (P = 0·002). Senior nurses agreed that senior staff dictate acceptable levels of medication policy adherence through role modelling (P = 0·01). Less experienced nurses reported greater confidence with computer literacy (P < 0·001). Conclusions. Organizations need to employ multidisciplinary education programmes to promote universal understanding of, and adherence to, medication policies. Skill mix should be closely monitored to ensure adequate support for new and junior staff.

Factors influencing paediatric nurses' responses to medication administration

Objective: To evaluate the importance of contextual and policy factors on nurses’ judgment about medication administration practice.---------- Design: A questionnaire survey of responses to a number of factorial vignettes in June 2004. These vignettes considered a combination of seven contextual and policy factors that were thought to influence nurses’ judgments relating to medication administration.---------- Participants: 185 (67% of eligible) clinical paediatric nursing staff returned completed questionnaires.--------- Setting: A tertiary paediatric hospital in Brisbane, Australia.---------- Results: Double checking the patient, double checking the drug and checking the legality of the prescription were the three strongest predictors of nurses’ actions regarding medication administration.--------- Conclusions: Policy factors and not contextual factors drive nurses’ judgment in response to hypothetical scenarios.

How to tell the difference between production and consumption : a case study in Doctor Who fandom

A television series is tagged with the label "cult" by the media, advertisers, and network executives when it is considered edgy or offbeat, when it appeals to nostalgia, or when it is considered emblematic of a particular subculture. By these criteria, almost any series could be described as cult. Yet certain programs exert an uncanny power over their fans, encouraging them to immerse themselves within a fictional world.In Cult Television leading scholars examine such shows as The X-Files; The Avengers; Doctor Who, Babylon Five; Star Trek; Xena, Warrior Princess; and Buffy the Vampire Slayer to determine the defining characteristics of cult television and map the contours of this phenomenon within the larger scope of popular culture.Contributors: Karen Backstein; David A. Black, Seton Hall U; Mary Hammond, Open U; Nathan Hunt, U of Nottingham; Mark Jancovich; Petra Kuppers, Bryant College; Philippe Le Guern, U of Angers, France; Alan McKee; Toby Miller, New York U; Jeffrey Sconce, Northwestern U; Eva ViethSara Gwenllian-Jones is a lecturer in television and digital media at Cardiff University and co-editor of Intensities: The Journal of Cult Media.Roberta E. Pearson is a reader in media and cultural studies at Cardiff University. She is the author of the forthcoming book Small Screen, Big Universe: Star Trek and Television.

Binjiang urban centre and transport interchange

This project is the result of a collaborative design process involving QUT School of Design, and AREN Consulting and ZIAD (Zheijiang Provincial Institute of Architectural Design and Research). This major urban initiative explores new standards for multi-function urban centres. The sophisticated integration of transit interchange with retail, commercial and residential functions provides a dramatic mix of social activities. The large site is formed into a raised and terraced urban garden, with the transit centre and retail shopping precinct housed below this landscaped roof. Towering above this ‘hill’ are five building blocks housing the commercial and residential accommodations. These environmentally low-impact buildings are topped with a high-tech greenhouse roof or photovoltaic cells.

Improving automatic speaker verification using SVM techniques

Automatic recognition of people is an active field of research with important forensic and security applications. In these applications, it is not always possible for the subject to be in close proximity to the system. Voice represents a human behavioural trait which can be used to recognise people in such situations. Automatic Speaker Verification (ASV) is the process of verifying a persons identity through the analysis of their speech and enables recognition of a subject at a distance over a telephone channel { wired or wireless. A significant amount of research has focussed on the application of Gaussian mixture model (GMM) techniques to speaker verification systems providing state-of-the-art performance. GMM's are a type of generative classifier trained to model the probability distribution of the features used to represent a speaker. Recently introduced to the field of ASV research is the support vector machine (SVM). An SVM is a discriminative classifier requiring examples from both positive and negative classes to train a speaker model. The SVM is based on margin maximisation whereby a hyperplane attempts to separate classes in a high dimensional space. SVMs applied to the task of speaker verification have shown high potential, particularly when used to complement current GMM-based techniques in hybrid systems. This work aims to improve the performance of ASV systems using novel and innovative SVM-based techniques. Research was divided into three main themes: session variability compensation for SVMs; unsupervised model adaptation; and impostor dataset selection. The first theme investigated the differences between the GMM and SVM domains for the modelling of session variability | an aspect crucial for robust speaker verification. Techniques developed to improve the robustness of GMMbased classification were shown to bring about similar benefits to discriminative SVM classification through their integration in the hybrid GMM mean supervector SVM classifier. Further, the domains for the modelling of session variation were contrasted to find a number of common factors, however, the SVM-domain consistently provided marginally better session variation compensation. Minimal complementary information was found between the techniques due to the similarities in how they achieved their objectives. The second theme saw the proposal of a novel model for the purpose of session variation compensation in ASV systems. Continuous progressive model adaptation attempts to improve speaker models by retraining them after exploiting all encountered test utterances during normal use of the system. The introduction of the weight-based factor analysis model provided significant performance improvements of over 60% in an unsupervised scenario. SVM-based classification was then integrated into the progressive system providing further benefits in performance over the GMM counterpart. Analysis demonstrated that SVMs also hold several beneficial characteristics to the task of unsupervised model adaptation prompting further research in the area. In pursuing the final theme, an innovative background dataset selection technique was developed. This technique selects the most appropriate subset of examples from a large and diverse set of candidate impostor observations for use as the SVM background by exploiting the SVM training process. This selection was performed on a per-observation basis so as to overcome the shortcoming of the traditional heuristic-based approach to dataset selection. Results demonstrate the approach to provide performance improvements over both the use of the complete candidate dataset and the best heuristically-selected dataset whilst being only a fraction of the size. The refined dataset was also shown to generalise well to unseen corpora and be highly applicable to the selection of impostor cohorts required in alternate techniques for speaker verification.

The phenomenon of resilience as described by adults who have experienced mental illness

Aim: This paper is a report of a study to explore the phenomenon of resilience in the lives of adult patients of mental health services who have experienced mental illness. ---------- Background: Mental illness is a major health concern worldwide, and the majority experiencing it will continue to battle with relapses throughout their lives. However, in many instances people go on to overcome their illness to lead productive and socially engaged lives. Contemporary mental health nursing practice primarily focuses on symptom reduction, and working with resilience has not generally been a consideration. ---------- Method: A descriptive phenomenological study was carried out in 2006. One participant was recruited through advertisements in community newspapers and newsletters and the others using the snowballing method. Information was gathered through in-depth individual interviews which were tape-recorded and subsequently transcribed. Colaizzi's original seven-step approach was used for data analysis, with the inclusion of two additional steps. ---------- Findings: The following themes were identified: Universality, Acceptance, Naming and knowing, Faith, Hope, Being the fool and Striking a balance, Having meaning and meaningful relationships, and 'Just doing it'. The conceptualization identified as encapsulating the themes was 'Viewing life from the ridge with eyes wide open', which involved knowing the risks and dangers ahead and making a decision for life amid ever-present hardships. ---------- Conclusion: Knowledge about resilience should be included in the theoretical and practical education of nursing students and experienced nurses. Early intervention, based on resilience factors identified through screening processes, is needed for people with mental illness.

Genshanmen Urban Centre and Transport Interchange

This project is the result of a collaborative design process involving QUT School of Design, and AREN Consulting and ZIAD (Zheijiang Provincial Institute of Architectural Design and Research). This project is the submission prepared by the above partnership for an invited international design competition, promoted by Hangzhou City, China. ---------- This major urban design and architecture project is for a large transport oriented development on the new Hangzhou Subway system. The development, covering several city blocks, includes the provision of residential, retail, education, commercial, and transport infrastructure; integrated with rail, bus and ferry systems. ---------- The design strategies are based on the development or artificial land forms; the cutting of new canals, raising of the ground plane, and metaphoric reference to the Yellow Mountains (explored in the detail of the central ‘ridge’ of built form). Further to this, the project explores the integration of sustainable technologies and philosophies with large scale building projects in a subtropical context.

Towards universal high quality early childhood education

The Australian Government has committed $970 million over 5 years to fund the expansion of preschool education and has established a National Early Childhood Education Partnership Agreement with States and Territories to achieve universal preschool access by 2013. The Partnership Agreement acknowledges the role of State and Territory Government in preschool education, and different approaches to preschool provision. It also recognises differences in current preschool participation rates across states and territories. This paper offers snapshots of a number of different models of preschool provision, spanning traditional sessional approaches to some integrated and innovative approaches within the long day care context. The paper explores the newer long day care model and offers recommendations for the delivery of preschool education within this different context.

Eucharistic rituals in Catholic primary schools in the Archdiocese of Brisbane : a study of administrators' conceptions

The focus of this study is the celebration of Eucharist in Catholic primary schools within the Archdiocese of Brisbane. The context of the contemporary Australian Catholic primary school embodies certain 'problematical realities' in relation to the time-honoured way in which school Eucharistic rituals have been celebrated. These contemporary realities raise a number of issues that impact on school celebrations of Eucharist. The purpose of this study is to explore administrators' differing conceptions of school Eucharistic rituals in an attempt to investigate some of these issues and assist members of individual school communities as they strive to make celebrations of Eucharist appropriate and meaningful for the group gathered. The phenomenographic research approach was adopted, as it is well suited to the purpose of this study and the nature of the research question. Phenomenography is essentially a study of variation. It attempts to map the 'whole' phenomenon under investigation by describing on equal terms all conceptions of the phenomenon and establishing an ordered relationship among them. The purpose of this study and the nature of the research question necessitate an approach that allows the identification and description of the different ways in which administrators' experience school Eucharistic rituals. Accordingly, phenomenography was selected. Members of the Administration Team, namely the principal, the APRE (Assistant to the Principal Religious Education) and, in larger primary schools, the AP A (Assistant to the Principal Administration) share responsibility for leading change in Catholic primary schools in the Archdiocese of Brisbane. In practice, however, principals delegate the role of leading the development of the school's religion program and providing leadership in the religious life of the school community to the APRE (Brisbane Catholic Education, 1997). Informants in this study are nineteen APREs from a variety of Catholic primary schools in the Archdiocese of Brisbane. These APREs come from schools across the archdiocese, rather than from within one particular region. Several significant findings resulted from this study. Firstly, the data show that there are significant differences in how APREs' experience school Eucharistic rituals, although the number of these qualitatively different conceptions is quite limited. The study identifies and describes six distinct yet related conceptions of school Eucharistic rituals. The logical relationship among these conceptions (the outcome space) is presented in the form of a diagram with accompanying explication. The variation among the conceptions is best understood and described in terms of three dimensions of the role of Eucharist in the Catholic primary school and is represented on the model of the outcome space. Individual transcripts suggest that individual APREs tend to emphasise some conceptions more than others. It is the contention of the present study that change in the practice of school Eucharistic rituals is unlikely to occur until all of a school community's conceptions are brought out into the open and articulated. As leaders of change, APREs need to be alerted to their own biases and become aware of alternative ways of conceiving school Eucharistic ritual. It is proposed that the different categories of description and dimensions, represented by the model of the outcome space, can be used to help in the process of articulating a school community's conceptions of Eucharist, with the APRE as facilitator of this process. As a result, the school community develops a better understanding of why their particular school does what it does in relation to school Eucharistic rituals.