The initiation and administration of drugs for advanced life support by critical care nurses in the absence of a medical practitioner

Current legislation does not permit the administration of first line resuscitation medications by suitably qualified Division 1 registered nurses (RNs) in the absence of a medical officer. This omission by the Drugs,  Poisons and Controlled Substances Act 1981 (Vic) and the Drugs, Poisons and The Controlled Substances Regulations 1995 (Vic) leaves many critical care nurses in a vulnerable legal position.

The primary aim of this study was to gauge the view of critical care nurses with respect to lobbying for change to the current legislation. In addition, the study aimed to explore and describe the educational preparation, practice perceptions and experiences of RNs working in critical care regarding cardiopulmonary resuscitation and the administration of first line advanced life support (ALS) medications in the absence of a medical officer. It was anticipated that data collected would demonstrate some of the dilemmas associated with the initiation and administration of ALS medications for practising critical care nurses and could be used to inform controlling bodies in order for them to gain an appreciation of the issues facing critical care nurses during resuscitation.

A mailout survey was sent to all members of the Victorian Branch of the Australian College of Critical Care Nurses (ACCCN). The results showed that the majority of nurses underwent an annual ALS assessment and had current ALS accreditation. Nurses indicated that they felt educationally prepared and were confident to manage cardiopulmonary resuscitation without a medical officer; indeed, the majority had done so. The differences in practice issues for metropolitan, regional and rural nurses were highlighted. There is therefore clear evidence to suggest that legislative amendments are appropriate and necessary, given the time critical nature of cardiopulmonary arrest. There was overwhelming support for ACCCN Vic. Ltd to lobby the Victorian government for changes to the law.

What are we scared of? The absence of sociology in current debates about drug treatments and policies

The official public policy related to recreational drug use and abuse in Australia is harm minimization or harm reduction. Definitions of harm minimization vary but a general statement is that harm minimization is a policy or programme intended to decrease adverse health, social and economic consequences of drug use, even though the user may continue to use psychoactive drugs. This type of definition is most often compared to a zero-tolerance policy that aims to eliminate all recreational drug abuse by legal and other means. Sociologists have historically scoffed at this latter policy. Unfortunately, what this has meant is that harm minimization in all its forms has not been the object of analytical work on the part of sociologists.

Portable sick leave in the Victorian building industry : managing cumulative employee benefits in the absence of employment security

The trend away from full-time permanent employment raises questions about the relevance of traditional approaches to managing and compensating employees. Employment in the Australian building industry is characterised by short-term, project-based employment. Employers and unions in the industry have adopted alternative compensation models to accommodate the short-term nature of employment, most notably through portable benefit schemes. In 1997, the Victorian building industry extended the range of portable benefits to include sick leave. Empirical evidence suggests a relationship between employee absence behaviour and accrual entitlement models. Research reported here supports this link, and suggests that both employers and employees can benefit from an alternative, portable, approach to accrued entitlements. Employers can benefit because employees may be less likely to take an instrumental approach to their entitlements. Employees benefit because they are able to accrue entitlements for the period they remain in the building industry, irrespective of the extent to which they change jobs.

An objective function based on Bayesian likelihoods of necessity and sufficiency for concept learning in the absence of labeled counter-examples

Supervised machine learning techniques generally require that the training set on which learning is based contain sufficient examples representative of the target concept, as well as known counter-examples of the concept; however, in many application domains it is not possible to supply a set of labeled counter-examples. This paper proposes an objective function based on Bayesian likelihoods of necessity and sufficiency. This function can be used to guide search towards the discovery of a concept description given only a set of labeled positive examples of the target concept, and as a corpus of unlabeled examples. Results of experiments performed on several datasets from the VCI repository show that the technique achieves comparable accuracy to conventional supervised learning techniques, despite the fact that the latter require a set of labeled counter-examples to be supplied. The technique can be applied in many domains in which the provision of labeled counter-examples is problematic.

Absence of industry effect in modelling corporate collapse in Australia

This paper investigates whether or not an industry effect is present when modelling corporate collapse in Australia. The investigation is motivated by a lack of consistency in the literature regarding such an effect. Moreover, this paper makes a unique contribution by applying an innovative methodological approach, called Multi-Level Modelling (MLM), for model derivation. Unlike the traditional two-step methodology used so far in the literature, MLM carries out model derivation and tests for an industry effect in a single step. Finally, the effectiveness of MLM is demonstrated using a sample of Australian publicly listed companies during the period 1989 to 2005; empirical results point to the absence of an industry effect.

The gift of absence

This thesis explores the different readings of sublimation offered by Jacques Lacan and Melanie Klein from the perspective of clinical work and with an emphasis on clinical cases. The distinction Lacan draws between maternal and feminine jouissance is pivotal in explaining the differences in their work.

Diversity and clonotypic composition of influenza-specific CD8+ TCR repertoires remain unaltered in the absence of Aire

TCR repertoire diversity is important for the protective efficacy of CD8⁺ T cells, limiting viral escape and cross-reactivity between unrelated epitopes. The exact mechanism for selection of restricted versus diverse TCR repertoires is far from clear, although one thought is that the epitopes resembling self-peptides might select a limited array of TCR due to the deletion of autoreactive TCR. The molecule Aire promotes the expression of tissue-specific Ag on thymic medullary epithelial cells and the deletion of autoreactive cells, and in the absence of Aire autoreactive cells persist. However, the contribution of Aire-dependent peptides to the selection of the Ag-specific TCR repertoire remains unknown. In this study, we dissect restricted (D^bNP₃₆₆%⁺CD8⁺) and diverse (D^bPA₂₂₄%⁺CD8⁺, K^dNP₁₄₇%⁺CD8⁺) TCR repertoires responding to three influenza-derived peptides in Aire-deficient mice on both B6 and BALB/c backgrounds. Our study shows that the number, qualitative characteristics and TCR repertoires of all influenza-specific, D^bNP₃₆₆%⁺CD8⁺, D^bPA₂₂₄%⁺CD8⁺ and K^dNP₁₄₇%⁺CD8⁺ T cells are not significantly altered in the absence of Aire. This provides the first demonstration that the selection of an Ag-specific T-cell repertoire is not significantly perturbed in the absence of Aire.

Extraction of silver(i) from aqueous solutions in the absence and presence of copper(ii) with a methimazole-based ionic liquid

The ionic liquid (IL) 2-butylthiolonium bis(trifluoromethanesulfonyl)amide, [mimSBu][NTf₂], facilitates the efficient extraction of silver(i) from aqueous media via interaction with both the cation and anion components of the IL. Studies with a conventional aqueous-IL two phase system as well as microextraction of silver(i) by a thick IL film adhered to an electrode monitored in situ by cyclic voltammetry, established that [mimSBu][NTf₂] can extract electroactive silver(i) ions from an aqueous solution. The pH of the aqueous phase decreases upon addition of [mimSBu]⁺, which is attributed to partial release of the hydrogen attached to the N(3) nitrogen atom of the imidazolium ring. The presence of silver(i) further increase the acidity of the aqueous phase as a consequence of coordination with the IL cation component. Voltammetric and ¹H and ¹³C NMR techniques have been used to establish the nature of the silver(i) complexes extracted, and show that the form of interaction with the IL differs from that outlined previously for the extraction of copper(ii). Insights on the competition established when silver(i) is extracted in the presence of copper(ii) are provided. Finally, it is noted that metallic silver can be directly electrodeposited at the electrode surface after extraction of silver(i) into [mimSBu][NTf₂] and that back extraction of silver(i) into aqueous media is achieved by addition of an acidic aqueous solution.

Absence makes the heart grow fonder SPOKEN WORD

Absence Makes the Heart Grow Fonder is a female voice (British) saying the proverb where the voice has been manipulated to sound arrhythmic and robotic. A good piece for a non-human (robot or like) saying a proverb that goes to the heart of sentience.

Post-exercise muscle glycogen repletion in the extreme : effect of food absence and active recovery

Glycogen plays a major role in supporting the energy demands of skeletal muscles during high intensity exercise. Despite its importance, the amount of glycogen stored in skeletal muscles is so small that a large fraction of it can be depleted in response to a single bout of high intensity exercise. For this reason, it is generally recommended to ingest food after exercise to replenish rapidly muscle glycogen stores, otherwise one's ability to engage in high intensity activity might be compromised. But what if food is not available? It is now well established that, even in the absence of food intake, skeletal muscles have the capacity to replenish some of their glycogen at the expense of endogenous carbon sources such as lactate. This is facilitated, in part, by the transient dephosphorylation-mediated activation of glycogen synthase and inhibition of glycogen phosphorylase. There is also evidence that muscle glycogen synthesis occurs even under conditions conducive to an increased oxidation of lactate post-exercise, such as during active recovery from high intensity exercise. Indeed, although during active recovery glycogen resynthesis is impaired in skeletal muscle as a whole because of increased lactate oxidation, muscle glycogen stores are replenished in Type IIa and IIb fibers while being broken down in Type I fibers of active muscles. This unique ability of Type II fibers to replenish their glycogen stores during exercise should not come as a surprise given the advantages in maintaining adequate muscle glycogen stores in those fibers that play a major role in fight or flight responses.