Practical guidelines: Lung transplantation in patients with cystic fibrosis

There are no European recommendations on issues specifically related to lung transplantation (LTX) in cystic fibrosis (CF). The main goal of this paper is to provide CF care team members with clinically relevant CF-specific information on all aspects of LTX, highlighting areas of consensus and controversy throughout Europe. Bilateral lung transplantation has been shown to be an important therapeutic option for end-stage CF pulmonary disease. Transplant function and patient survival after transplantation are better than in most other indications for this procedure. Attention though has to be paid to pretransplant morbidity, time for referral, evaluation, indication, and contraindication in children and in adults. This review makes extensive use of specific evidence in the field of lung transplantation in CF patients and addresses all issues of practical importance. The requirements of pre-, peri-, and postoperative management are discussed in detail including bridging to transplant and postoperative complications, immune suppression, chronic allograft dysfunction, infection, and malignancies being the most important. Among the contributors to this guiding information are 19 members of the ECORN-CF project and other experts. The document is endorsed by the European Cystic Fibrosis Society and sponsored by the Christiane Herzog Foundation. 

Guidance on the management of diarrhoea during cancer chemotherapy

Diarrhoea induced by chemotherapy in cancer patients is common, causes notable morbidity and mortality, and is managed inconsistently. Previous management guidelines were based on poor evidence and neglect physiological causes of chemotherapy-induced diarrhoea. In the absence of level 1 evidence from randomised controlled trials, we developed practical guidance for clinicians based on a literature review by a multidisciplinary team of clinical oncologists, dietitians, gastroenterologists, medical oncologists, nurses, pharmacist, and a surgeon. Education of patients and their carers about the risks associated with, and management of, chemotherapy-induced diarrhoea is the foundation for optimum treatment of toxic effects. Adequate—and, if necessary, repeated—assessment, appropriate use of loperamide, and knowledge of fluid resuscitation requirements of affected patients is the second crucial step. Use of octreotide and seeking specialist advice early for patients who do not respond to treatment will reduce morbidity and mortality. In view of the burden of chemotherapy-induced diarrhoea, appropriate multidisciplinary research to assess meaningful endpoints is urgently required.

Practical Lattice-Based Digital Signature Schemes

Digital signatures are an important primitive for building secure systems and are used in most real-world security protocols. However, almost all popular signature schemes are either based on the factoring assumption (RSA) or the hardness of the discrete logarithm problem (DSA/ECDSA). In the case of classical cryptanalytic advances or progress on the development of quantum computers, the hardness of these closely related problems might be seriously weakened. A potential alternative approach is the construction of signature schemes based on the hardness of certain lattice problems that are assumed to be intractable by quantum computers. Due to significant research advancements in recent years, lattice-based schemes have now become practical and appear to be a very viable alternative to number-theoretic cryptography. In this article, we focus on recent developments and the current state of the art in lattice-based digital signatures and provide a comprehensive survey discussing signature schemes with respect to practicality. Additionally, we discuss future research areas that are essential for the continued development of lattice-based cryptography.

Practical Spectrum Aggregation for Secondary Networks with Imperfect Sensing

We investigate a collision-sensitive secondary network that intends to opportunistically aggregate and utilize spectrum of a primary network to achieve higher data rates. In opportunistic spectrum access with imperfect sensing of idle primary spectrum, secondary transmission can collide with primary transmission. When the secondary network aggregates more channels in the presence of the imperfect sensing, collisions could occur more often, limiting the performance obtained by spectrum aggregation. In this context, we aim to address a fundamental query, that is, how much spectrum aggregation is worthy with imperfect sensing. For collision occurrence, we focus on two different types of collision: one is imposed by asynchronous transmission; and the other by imperfect spectrum sensing. The collision probability expression has been derived in closed-form with various secondary network parameters: primary traffic load, secondary user transmission parameters, spectrum sensing errors, and the number of aggregated sub-channels. In addition, the impact of spectrum aggregation on data rate is analysed under the constraint of collision probability. Then, we solve an optimal spectrum aggregation problem and propose the dynamic spectrum aggregation approach to increase the data rate subject to practical collision constraints. Our simulation results show clearly that the proposed approach outperforms the benchmark that passively aggregates sub-channels with lack of collision awareness.

Book Review: Working with loss and grief: a theoretical and practical approach

THE UPDATED second edition of this text begins with an overview of theories underpinning loss and grief, followed by a comprehensive outline of the author’s ‘range of response to loss’ (RRL) model, which emerged from her own research and experience. The RRL model provides a framework to explore variability in how people respond to grief, and case studies are used to demonstrate its application in practice. This is followed by an outline of the author’s ‘adult attitude to grief’ scale, which can be used to map a person’s grief and generate a grief profile.

Blending Art and Science in Nurse Education: The Benefits and Impact of Creative Partnerships

Blending Art and Science in Nurse Education: The Benefits and Impact of Creative Partnerships

This paper presents the benefits of an innovative education partnership between lecturers from the School of Nursing and Midwifery, Queens University Belfast and Arts Care, a unique Arts and Health Charity in Northern Ireland, to engage nursing students in life sciences

Nursing and Midwifery students often struggle to engage with life science modules because they lack confidence in their ability to study science.This project was funded by a Teaching Innovation Award from the School of Nursing and Midwifery, Queens University Belfast, to explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology. The project was facilitated through collaboration between Teaching staff from the School of Nursing and Midwifery and Arts Care, Northern Ireland. This unique Arts and Health Charity believes in the benefits of creativity to well being.

RESEARCH OBJECTIVE(S)
To explore creative ways of engaging year one undergraduate nursing students in learning anatomy and physiology.

METHODS AND METHODLOGY
Students participated in a series of workshops designed to explore the cells, tissues and organs of the human body through the medium of felt. Facilitated by an Arts Care artist, and following self-directed preparation, students discussed and translated their learning of the cells, tissues and organs of the human body into striking felt images. During the project students kept a reflective journal of their experience to document how participation in the project enhanced their learning and professional development

RESULTS
Creativity transformed and brought to life the students learning of the cells, tissues and organs of the human body.

The project culminated in the exhibition of a unique body of artwork which has been exhibited across Northern Ireland in hospitals and galleries and viewed by fellow students, teaching staff, nurses from practice, artists, friends, family and members of the public.

CONCLUSION
The impact of creativity learning strategies in nurse education should be further explored.

REFERENCES
Bennett, M and Rogers, K.MA. (2014) First impressions matter: an active, innovative and engaging method to recruit student volunteers for a pedagogic project. Reflections, Available online at: QUB, Centre for Educational Development / Publications / Reflections Newsletter, Issue 18, June 2014.

Chickering,A.W. and Gamson,Z.F. (1987) Seven principles for good practice in undergraduate education The American Association for Higher Education Bulletin, March. http://www.aahea.org/aahea/articles/sevenprinciples1987.htm, accessed 8th August 2014

Fell, P., Borland, G., Lynne, V. (2012) Lab versus lectures: can lab based practical sessions improve nursing students’ learning of bioscience? Health and Social Care Education 3:1, 33-38

Differences Between Irish and Australian Psychiatric Nurses' Family Focused Practice in Adult Mental Health Services

Psychiatric nurses’ practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses’ family focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

How Critical Care Nurses' Role and Education Affect Organ Donation

Organ and tissue dysfunction and failure cause high mortality rates around the world. Tissue and organs transplantation is an established, cost-effective, life-saving treatment for patients with organ failure. However, there is a large gap between the need for and the supply of donor organs. Acute and critical care nurses have a central role in the organ donation process, from identifying and assessing potential donors and supporting their families to involvement in logistics. Nurses with an in-depth knowledge of donation understand its clinical and technical aspects as well as the moral and legal considerations. Nurses have a major role to play in tackling organ and tissue shortages. Such a role cannot be adequately performed if nurses are not fully educated about donation and transplant. Such education could be incorporated into mandatory training and completed by all nurses.

Imagining the Future: An Existential and Practical Activity

In an attempt to elucidate people’s own imaginings and hopes for the future, I consider the relationship between the following concepts and activities: imagining; the future; hope; the existential human condition; and practical activity. I ask: ‘How do people experience and act on a desire for a different future?’

Managing pain medications in long-term care: nurses' views

The purpose of this study was to explore nurses' perceptions of their current practices related to administering pain medications to long-term care (LTC) residents. A cross-sectional survey design was used, including both quantitative and open-ended questions. Data were collected from 165 nurses (59% response rate) at nine LTC homes in southern Ontario, Canada. The majority (85%) felt that the medication administration system was adequate to help them manage residents' pain and 98% felt comfortable administering narcotics. In deciding to administer a narcotic, nurses were influenced by pain assessments, physician orders, diagnosis, past history, effectiveness of non-narcotics and fear of making dosage miscalculations or developing addictions. Finally, most nurses stated that they trusted the physicians and pharmacists to ensure orders were safe. These findings highlight nurses' perceptions of managing pain medications in LTC and related areas where continuing education initiatives for nurses are needed.

Perceptions of high involvement work practices and burnout: investigating the mediating role of procedural justice and role overload and the moderating role of colleague support

Purpose
The purpose of this paper is to investigate the impact of employees’ perceptions of high involvement work practices (HIWPs) on burnout (emotional exhaustion and depersonalisation) via the mediating role of role overload and procedural justice. Further, perceived colleague support was hypothesised to moderate the effects of role overload and procedural justice on these outcomes.

Design/Methodology
The study was conducted on a random sample of unionised registered nurses (RNs) working in the Canadian public health care sector, stratified by mission and size of the institution to ensure representativeness. Of the 6546 nurses solicited, 2174 returned a completed questionnaire, resulting in a response rate of 33.2%. To test our hypotheses we conducted structural equation modelling (SEM) in Mplus version 6.0 (Muthen and Muthen, 1998 – 2010) with Maximum Likelihood (ML) estimation.

Results
The results showed that procedural justice and role overload fully mediated the influence of HIWPs on burnout. Moreover, colleague support moderated the effects of procedural justice and role overload on emotional exhaustion but not depersonalisation.

Limitations
The study used a cross-sectional research design and is conducted among one occupational group (i.e. nurses).

Research/Practical Implications
The findings question the dark side of HRM in the health care context. They also contribute to the lack of theoretical and empirical work dedicated to understanding the ‘black box’ problem (Castanheira and Chambel, 2010).

Originality/Value
The study employs a well-known theoretical perspective from the occupational health psychology literature to the HR field in order to contribute to the lack of theorising in the HR-well-being link.