Bridging the divide: a survey of nurses' opinions regarding barriers to, and facilitators of, research utilization in the practice setting

Background. Many researchers have explored the barriers to research uptake in order to overcome them and identify strategies to facilitate research utilization. However, the research–practice gap remains a persistent issue for the nursing profession.

Aims and objectives. The aim of this study was to gain an understanding of perceived influences on nurses' utilization of research, and explore what differences or commonalities exist between the findings of this research and those of studies that have been conducted in various countries during the past 10 years.

Design. Nurses were surveyed to elicit their opinions regarding barriers to, and facilitators of, research utilization. The instrument comprised a 29-item validated questionnaire, titled Barriers to Research Utilisation Scale (BARRIERS Scale), an eight-item scale of facilitators, provision for respondents to record additional barriers and/or facilitators and a series of demographic questions.

Method. The questionnaire was administered in 2001 to all nurses (n = 761) working at a major teaching hospital in Melbourne, Australia. A 45% response rate was achieved.

Results. Greatest barriers to research utilization reported included time constraints, lack of awareness of available research literature, insufficient authority to change practice, inadequate skills in critical appraisal and lack of support for implementation of research findings. Greatest facilitators to research utilization reported included availability of more time to review and implement research findings, availability of more relevant research and colleague support.

Conclusion. One of the most striking features of the findings of the present study is that perceptions of Australian nurses are remarkably consistent with reported perceptions of nurses in the US, UK and Northern Ireland during the past decade.

Relevance to clinical practice. If the use of research evidence in practice results in better outcomes for our patients, this behoves us, as a profession, to address issues surrounding support for implementation of research findings, authority to change practice, time constraints and ability to critically appraise research with conviction and a sense of urgency.

Strategies for bridging sectors and silos : a training model in mental health promotion

Issue addressed: The determinants of individual and community mental health and wellbeing are diverse and many lie outside the sphere of action of the health sector. Developing the confidence and skills of these other sectors to contribute to improved mental health has been identified as a priority at State and national levels that requires the development of specific workforce capacity-building strategies. Methods: VicHealth developed and implemented a two day short course to raise the capacity of organisations from a range of sectors to contribute to the mental health and wellbeing of communities. The model of this short course was constructed to reflect the diverse sectors targeted, which included health, local government, community arts, sport and recreation, justice, and education. Results: Evaluation of the two year pilot program, with more than 1,000 participants, has identified a high degree of satisfaction with the content and delivery model of the course, with clear changes in knowledge, skills and practice having been achieved. Cross-sector understanding and collaborations between participants increased as a result of the course. Conclusions: Continuing demand for the course demonstrates clearly that mental health and well-being is relevant to the core business of a broad range of community and professional organisations. The course has increased the confidence and capacity of these sector representatives to take action on mental health as well as increased cross-sector dialogue and partnerships. The recruitment of trainers from diverse sectors was successful in promoting a key component of the program, which was the message that mental health promotion should be the business of all sectors.

Irreversible and bivalent ligands for selected G-protein coupled receptors

Derivatives of pharmaceutical compounds that could potentially bind irreversibly to a hypertension controlling receptor were synthesised to provide tools for studying this receptor. Also compounds that simultaneously activate two cardiovascular receptors with opposing cellular mechanisms were synthesised. This resulted in a desired partial reduction in the activity of one receptor.

Systemic activation of dendritic cells by toll-like receptor ligands or malaria infection impairs cross-presentation and antiviral immunity

The mechanisms responsible for the immunosuppression associated with sepsis or some chronic blood infections remain poorly understood. Here we show that infection with a malaria parasite (Plasmodium berghei) or simple systemic exposure to bacterial or viral Toll-like receptor ligands inhibited cross-priming. Reduced cross-priming was a consequence of downregulation of cross-presentation by activated dendritic cells due to systemic activation that did not otherwise globally inhibit T cell proliferation. Although activated dendritic cells retained their capacity to present viral antigens via the endogenous major histocompatibility complex class I processing pathway, antiviral responses were greatly impaired in mice exposed to Toll-like receptor ligands. This is consistent with a key function for cross-presentation in antiviral immunity and helps explain the immunosuppressive effects of systemic infection. Moreover, inhibition of cross-presentation was overcome by injection of dendritic cells bearing antigen, which provides a new strategy for generating immunity during immunosuppressive blood infections.

Assembly of 3-D network structures containing oxydiacetate and CeIII or CeIV

Reaction of CeCl₃·7H₂O with Na₂(oda) (oda = O(CH₂CO₂)₂²— oxydiacetate) in a 2:3 ratio gives the neutral cerium(III) complex [Ce₂(oda)₃(H₂O)₃]·9H₂O (1). Treatment of a 1:3 mixture of CeCl₃·7H₂O and H₂oda in water with 4 molar equivalents of NaOH also gives 1 but, with a larger excess of NaOH, the tri-sodium salt Na₃[Ce(oda)₃]·9H₂O (2) is isolated. Formation of a tri-ammonium analogue of 2 can be achieved by neutralisation of an aqueous solution of CeCl₃·7H₂O and H₂(oda) in a 1:3 ratio by NH₄OH, giving (NH₄)₃[Ce(oda)₃]·7H₂O (3). Use of the cerium(IV) reagent (NH₄)₂[Ce(NO₃)₆] with Na₂(oda) results in reduction to cerium(III) under ambient conditions and isolation of 1. However, in the absence of light this reaction yields crystals of the novel cerium(IV) heterobimetallic [Ce(oda)₃Na₄(NO₃)₂] (4). Each of these complexes exhibit a 3-D network structure having a common nine-coordinate [Ce(oda)₃]ⁿ— (n = 2 or 3) subunit, irrespective of the oxidation state of cerium. In 1, six [Ce(oda)₃]³— anions are connected, through bridging bidentate carboxylates, to a second Ce³⁺ site further coordinated by three water molecules. In contrast, the ammonium salt 2, displays isolated [Ce(oda)₃]³— anions, devoid of further carboxylate bonding, but enmeshed within a network of hydrogen-bonded NH₄⁺ cations and water molecules. The remarkable structure of 4 consists of infinite 2-D sheets of [Na₂(NO₃)]+ pillared by [Ce(oda)₃]^2— units, the connectivity arising by multidentate nitrate and carboxylate bridging.

Synthesis and structural diversity of rare earth anthranilate complexes

Four structural classes have been established for rare earth anthranilates, which have been prepared from the lanthanoid chloride or triflate and anthranilic acid (anthH) followed by pH adjustment to 4. [La(anth)3]n is a polymeric complex with nine coordinate lanthanum and bridging tridentate (O,O,O′) anthranilate ligands, whereas [Nd(anth)3(H2O)3] · 3H2O is monomeric with nine coordinate neodymium and solely chelating (O,O) anthranilate groups. Both chelating (O,O) and bridging bidentate (O,O′) ligands are observed in dimeric [Er2(anth)6(H2O)4] · 2H2O, in which erbium is eight coordinate and the water ligands are in a trans arrangement. A polymer is observed for [Yb(anth)3(H2O)]n with solely bridging bidentate (O,O′) ligands and seven coordination for ytterbium. The NH2 groups of the anthranilate ligands are not coordinated to the metal but is unusually involved in hydrogen-bond networks with water molecules for Ln = Er, Yb.

Fluorescent and electrochemical sensing of (poly)phosphate nucleotides by ferrocene functionalised with two (ZnII-TACN-pyrene) complexes

The [Fc[BOND]bis{ZnII(TACN)(Py)}] complex, comprising two ZnII(TACN) ligands (Fc=ferrocene; Py=pyrene; TACN=1,4,7-triazacyclononane) bearing fluorescent pyrene chromophores linked by an electrochemically active ferrocene molecule has been synthesised in high yield through a multistep procedure. In the absence of the polyphosphate guest molecules, very weak excimer emission was observed, indicating that the two pyrene-bearing ZnII(TACN) units are arranged in a trans-like configuration with respect to the ferrocene bridging unit. Binding of a variety of polyphosphate anionic guests (PPi and nucleotides di- and triphosphate) promotes the interaction between pyrene units and results in an enhancement in excimer emission. Investigations of phosphate binding by 31P NMR spectroscopy, fluorescence and electrochemical techniques confirmed a 1:1 stoichiometry for the binding of PPi and nucleotide polyphosphate anions to the bis(ZnII(TACN)) moiety of [Fc[BOND]bis{ZnII(TACN)(Py)}] and indicated that binding induces a trans to cis configuration rearrangement of the bis(ZnII(TACN)) complexes that is responsible for the enhancement of the pyrene excimer emission. Pyrophosphate was concluded to have the strongest affinity to [Fc[BOND]bis{ZnII(TACN)(Py)}] among the anions tested based on a six-fold fluorescence enhancement and 0.1 V negative shift in the potential of the ferrocene/ferrocenium couple. The binding constant for a variety of polyphosphate anions was determined from the change in the intensity of pyrene excimer emission with polyphosphate concentration, measured at 475 nm in CH3CN/Tris-HCl (1:9) buffer solution (10.0 mM, pH 7.4). These measurements confirmed that pyrophosphate binds more strongly (Kb=(4.45±0.41)×106 M−1) than the other nucleotide di- and triphosphates (Kb=1–50×105 M−1) tested.

Making connections with nature : bridging the theory-practice gap in outdoor and environmental education

In this paper I describe my experience in attempting to assist tertiary students connect with the natural environment through outdoor and environmental education experiences. The paper addresses research conducted with students undertaking an outdoor and environmental education degree and focuses on the pedagogical methods employed in this context. I argue that outdoor and environmental education practitioners may benefit from moving away from a mode of teaching based upon 'generic' methods and look instead to a more local, specific and contextual form of education. By describing an outdoor and environmental education journey in a local, 'ordinary' place and students' experiences in unearthing the stories embedded in this place, I aim to provide some practical strategies to engage young people in a direct and meaningful way. The intention is to broaden the pedagogical possibilities related to facilitating experiences in natural environments and thus contribute to bridging the rhetoric/reality gap in outdoor education.

Angiotensin AT4 ligands are potent, competitive inhibitors of insulin regulated aminopeptidase (IRAP)

Angiotensin IV (Ang IV) exerts profound effects on memory and learning, a phenomenon ascribed to its binding to a specific AT4 receptor. However the AT4 receptor has recently been identified as the insulin-regulated aminopeptidase (IRAP). In this study, we demonstrate that AT4 receptor ligands, including Ang IV, Nle1-Ang IV, divalinal-Ang IV, and the structurally unrelated LVV-hemorphin-7, are all potent inhibitors of IRAP catalytic activity, as assessed by cleavage of leu-β-naphthylamide by recombinant human IRAP. Both Ang IV and divalinal–Ang IV display competitive kinetics, indicating that AT4 ligands mediate their effects by binding to the catalytic site of IRAP. The AT4 ligands also displaced [125I]-Nle1-Ang IV or [125I]-divalinal1-Ang IV from IRAP-HEK293T membranes with high affinity, which was up to 200-fold greater than in the catalytic assay; this difference was not consistent among the peptides, and could not be ascribed to ligand degradation. Although some AT4 ligands were subject to minor cleavage by HEK293T membranes, none were substrates for IRAP. Of a range of peptides tested, only vasopressin, oxytocin, and met-enkephalin were rapidly cleaved by IRAP. We propose that the physiological effects of AT4 ligands result, in part, from inhibition of IRAP cleavage of neuropeptides involved in memory processing.