How graduate nurses use protocols to manage patients` medications

Aims and objectives. The aim of the study was to determine how graduate nurses use protocols in their medication management activities. The objectives were to: examine the extent of adherence to various protocols in relation to medication activities and determine how the ward environment impacts on graduate nurses' use of protocols to manage patients' medications.
Background. Protocols help newly qualified nurses integrate new knowledge into practice and promote effective decision-making
Design. A descriptive prospective qualitative design was used.
Methods. Twelve graduate nurses involved in direct patient care in medical, surgical and specialty wards of a metropolitan teaching hospital participated in the study. Participant observations were conducted with the graduate nurses during a two-hour period when medications were being administered to patients. In-depth interviews were conducted with each nurse immediately after observations and demographic data were collected on participating nurses and patients in their care, including all medications prescribed. Protocols associated with medication management activities for the clinical settings were also transcribed.
Results. Six themes were evident from the data: availability and use of protocols, scrutinizing patients' identity before medication administration, double-checking certain medications before administration, writing incident reports, following specific policies and timing the administration of medications.
Conclusion. Graduate nurses adhered to protocols if they were perceived not to impede with other nursing activities. Participants were also more likely to follow protocols if they felt encouraged to make their own decisions and if there was a decreased likelihood that disciplinary action would be involved.
Relevance to clinical practice. Experienced health professionals should encourage graduate nurses to comply with medication protocols and to make clinically reasoned decisions about medication activities. By providing peer support and acting as role models, experienced health professionals can also demonstrate to graduate nurses how effective protocol use is an important component of quality patient care.

A qualitative study of environmental factors important for physical activity in rural adults

PURPOSE: Despite increasing evidence that the physical environment impacts on physical activity among urban-dwellers, little attention has been devoted to understanding this relationship in rural populations. Work in this area is further hindered by a lack of environmental measures specifically designed for rural settings. This qualitative study aimed to explore the salience of urban physical activity environment constructs among rural adults. METHODS: In 2011, 49 rural men and women from three distinct areas (coastal, animal-based farming, forestry/plant-based farming) of rural Tasmania, Australia, were purposively recruited to participate in semi-structured interviews. Interviews explored features of the built and social environment commonly examined in studies of urban adults, including functional characteristics (eg, lighting, footpaths, roads/verges), road and personal safety, availability and accessibility of places to be active, destinations, and aesthetics. Interviews were recorded, transcribed verbatim and analysed using a content-thematic approach using QSR NVivo software. FINDINGS: While some urban environmental constructs were salient to these rural adults, such as availability of and accessibility to places to be active, some constructs were operationalised differently, such as road safety (where large trucks and winding roads rather than traffic density was of concern), or were not considered relevant (eg, personal safety related to crime, availability of walkable destinations, aesthetics). CONCLUSIONS: The measurement of the physical environment in rural populations may require reconsideration and/or modification to ensure salience and appropriate quantification of associations with physical activity in future studies.

Impacts of an online-supported, resouce-based learning environment: does one size fit all?

This paper reports on the use of an online, resource-based learning (RBL) approach in first year psychology at Deakin University. Differences between on- and off-campus students that emerged are examined in the context of the learning goals and study approaches of the two student groups and their attitudes to using computers. Unlike the on-campus students who were less positive about working with computers and reported confusion about how and what to study for the unit, the off-campus students reported feeling confident they had a good study strategy and were more positive about computers. The off-campus students also reported that they spent more time working with electronic resources and attached greater value to them. While all students valued the prescribed resources, the off-campus students found some of the optional, electronic resources valuable because they added to the learning experience. These students also reported greater use of the computer-mediated communication available as part of the online learning environment, and valued this functionality more highly than did the on-campus students. These findings highlight the need to take into account learner characteristics when designing learning environments that cater for individual differences and preferences. While online-supported RBL approaches have the potential to cater to the diverse needs of students, learning environments need to be designed, structured and delivered so the learning experience can be customized to the needs of different student cohorts, while preserving the overarching, pedagogical goals.

Aquaculture effluent : impacts and remedies for protecting the environment and human health

Knowledge in the field of environmental health is growing rapidly. Within the context of external factors that define its boundaries, environmental health has evolved over time into a complex, multidisciplinary and ill-defined field with uncertain solutions. Many of the key determinants and solutions to environmental health lie outside the direct realm of health and are strongly dependent on environmental changes, water and sanitation, industrial development, education, employment, trade, tourism, agriculture, urbanization, energy, housing and national security. Environmental risks, vulnerability and variability manifest themselves in different ways and at different time scales. While there are shared global and transnational problems, each community, country or region faces its own unique environmental health problems, the solution of which depends on circumstances surrounding the resources, customs, institutions, values and environmental vulnerability. This work will contain critical reviews and assessments of environmental health practices and research that have worked in places and thus can guide programs and economic development in other countries or regions.

Environment, resource sustainability and sustainable behaviour: exploring perceptions of students in South West Victoria

The movement toward a sustainable future has begun in many parts of the world, as the seriousness of the environmental problems faced by the planet become more widely recognised. Waste reduction, improved efficiency of energy use, water saving devices and changes in modes of transport are the first steps in the transition to a sustainable future. The students of today will be the decision makers of tomorrow and, thus, can have a significant effect on future development and the environmental
impacts of that development. If students today are to become active participants in the environmental decision-making process, education for sustainability becomes a key component in ensuring sustainable futures. There is a need to establish data describing students’ attitudes toward environmental and resource sustainability issues so that challenges to implementing sustainable development policy can be better recognised. The aims of this study were to identify the perceptions of students in
the south west region of Victoria regarding environment and resource sustainability, and to identify their level of participation in sustainable behaviours. A survey of students has found that global environmental issues perceived by students as being in urgent need of attention were access to freshwater, loss of tropical rainforest and exhaustion of natural resources. At the local level the most urgent issues identified were water pollution, salinization and soil degradation, and clearing of native vegetation. Students perceive that Australians are overusing natural resources. They indicated particular concern for the sustainability of fossil fuels, water, coastal environments and fisheries resources. The results of this study indicate that students are responding to concerns for the environment and resource sustainability by embracing some forms of sustainable behaviour. However, as educators we need to ensure that
the link is made between environment and resource sustainability and the implementation of policies that will further encourage sustainable behaviour.

Balancing environmental impacts and benefits of wastewater reuse

Wastewater reuse is being widely promulgated to help address the global freshwater resource crisis. It can assist in reducing extraction of freshwater from the environment, and reuse of wastewater lessens the need for environmental discharge, which is clearly beneficial to receiving waters. But the practice itself also has the potential to be detrimental to natural and human environments: soil structure can become degraded, aquifers may be polluted, and human health may be threatened. The challenge facing natural resource managers is to identify the potential benefits and risks, and to achieve an appropriate balance. This paper describes environmental benefits and threats concomitant with the reuse of wastewater. We frequently draw upon examples from China and Australia-two countries that face particularly daunting water resource
challenges-but the principles can be.extended far beyond these geographical bounds and are applicable to
many parts of the world.

Games geeks in context: developing the environment to engage creative expression

This paper explores the importance of purpose built combined technological and social collaborative environments in supporting the development of creativity in a cohort of students not generally associated with creative abilities. A supportive and nurturing environment provides these university students with a community where they can share knowledge and ideas, and subsequently engage in creative activities and behaviours. Such an environment directly impacts on the levels of engagement with which students� participate in their learning process. The authors draw on findings derived from a study of first year computer science students enrolled in a games design and development unit at an Australian university. This paper will focus on the ways in which the participants negotiate and regulate the exercise of power and control in the environment in order to enhance their own creative expression.

Monitoring ecological impacts: concepts and practice in flowing waters

Monitoring Ecological Impacts provides the tools needed to design  assessment programs that can reliably monitor, detect and allow  management of human impacts on the natural environment. The procedures described are well-grounded in inferential logic. Step-by-step guidelines and flow diagrams provide clear and useable protocols, which are applicable to real situations.

Is the Genuine Progress Indicator really genuine? Considering well-being impacts of exports and imports

The Genuine Progress Indicator (GPI) is estimated as if nations operate within a closed economy. Therefore, in terms of coverage, the GPI is most analogous to Gross Domestic Product (GDP). Indeed, within the relevant literature, these two indicators are most often contrasted. However, consideration should be given to adapting the GPI, so it has more in common with Gross National Income (GNI). As with GDP, the GPI is concerned only with a particular physical location. Yet, it may be more effective if the GPI was freed from these physical boundaries in a similar manner to GNI. The GPI should be concerned more with the 'ownership' of the costs and benefits associated with economic growth than with the 'location' of those costs and benefits. Those that derive the most benefit from exploitation of the environment are often physically removed from the location of that damage. The GPI does not consider the net consumers of the negative externalities of environmental costs, merely the producers. Currently, however, the structure of the GPI allows a nation to enjoy, without penalty, the benefits of importing goods from countries which bear a disproportionately large cost of environmental degradation. This results in an overstatement of the real progress experienced by the county importing 'dirty goods'. This paper will investigate how certain GPI adjustments may be adapted to overcome this present shortcoming. However, the purpose of this paper is not only to empirically implement this new approach, but also to stimulate debate as to its potential merit.

Impacts of atrazine in aquatic ecosystems

A portion of all herbicides applied to forests, croplands, road sides, and gardens are inevitably lost to water bodies either directly through runoff or indirectly by leaching through groundwater into ephemeral streams and lakes. Once in the aquatic environment, herbicides may cause stress within aquatic communities and radically alter community structure. Atrazine is one of the most effective and inexpensive herbicides in the world and is consequently used more frequently than any other herbicide. Atrazine is frequently detected in aquatic waters, and has been known to affect reproduction of aquatic flora and fauna, which in turn impacts on the community structure as a whole. This paper presents a summary of the reported direct and indirect impacts of atrazine on aquatic organisms and community structure. The information can be used for developing improved management guidelines and legislation. It is concluded that a single universal maximum limit on the atrazine application in catchments, as suggested by many regulatory authorities, does not provide adequate protection of the aquatic environment. Rather, it is advocated that flexible limits on the application of atrazine be developed in line with the potential risk of contamination to surface and subsurface water and fragility of the aquatic environment.

Online interaction impacts on learning: teaching the teachers to teach online

This paper explores the importance of interaction in the online teaching environment and the important role of staff development in developing teacher presence online. Professionally developing staff to use information and communication technologies is viewed from the standpoint of diffusion of innovation, moving from early adopters to mainstream majority, and targeting staff development at this latter group. Approaches to staff development using information and communication technologies are described, and recommendations for staff development for online teaching are made.

Surviving suppression : no detectable impacts of Class A foam on soil invertebrates and some Australian native plants

Firefighting foams (Class A foams) are an effective and widespread firefighting tool which are frequently used in environmentally sensitive areas. Firefighting foams are known to be ecologically damaging in aquatic environments, however their impacts at the plant species or ecosystem level are relatively unknown. Reports of shoot damage to plants, suppressed flowering, and changes in plant community composition suggested that the ecological damage caused by their use may be unacceptable. However, applications of foam to seedlings of some Australian plant species from representative and widespread families, showed no detectable impacts on a range of vegetative growth characteristics. Application of 1.0% foam to heathland soils showed no detectable impacts on soil invertebrate Orders sampled over several months. The results are encouraging for the continued use of Class A foam as a fire suppression technique.

Building surfaces and their effect on the urban thermal environment

Use of high reflectance surfaces reduces the amount of solar radiation absorbed through building envelopes and urban structures and thus keeping their surfaces cooler. The cooling energy savings by using high reflectance surfaces have been well documented. Higher surface temperatures add to increasing the ambient temperature as convection intensity is higher. Such temperature increase has significant impacts on the air conditioning energy utilization in hot climates. This study makes use of numerical simulations to analyze the effect of commonly used building materials on the air temperature. A part of the existing CBD (Central Business District) area of Singapore was selected for the study. A series of Computational Fluid Dynamics (CFD) simulations have been carried out using the software CFX-5.6. It was found that at low wind speeds, the effect of materials on the air temperature was significant and the temperature at the middle of a narrow canyon increased up to 2.5[degrees]C with the facade material having lower reflectance.

Effect of materials on the urban thermal environment a CFD simulation approach

Use of high albedo materials reduces the amount of solar radiation absorbed through building envelops and urban structures and thus keeping their surfaces cooler. The cooling energy savings by using high albedo materials have been well documented. Higher surface temperatures add to increasing the ambient temperature as convection intensity is higher. Such temperature increase has significant impacts on the air conditioning energy utilization in hot climates. This study makes use of a parametric approach by varying the temperature of building facades to represent commonly used materials and hence analyzing its effect on the air temperature through a series of CFD (Computational Fluid Dynamics) simulations. A part of the existing CBD (Central Business District) area of Singapore was selected for the study. Series of CFD simulations have been carried out using the software CFX-5.6. Wind tunnel experiments were also conducted for validation. It was found that at low wind speeds, the effect of materials on the air temperature was significant and the temperature at the middle of a narrow canyon increased up to 2.52°C with the façade material having lowest albedo.