How do critical care nurses define the discharge planning process?

Background: Professional, political and organisational factors have focused attention on the discharge planning process in the Victorian health care sector. Discharge planning for patients, as part of continuity of care, is seen as a key concept in the delivery of nursing care. However, there is no question that discharge planning has emerged as a complex area of practice, and is, perhaps, most complex in the critical care area.

Aim: The study reported here is part of a larger thesis exploring critical care nurses’ perceptions and understanding of the discharge planning process in the health care system in the state of Victoria, Australia. As part of the survey participants were asked to define discharge planning as it related to the critical care environment in which they worked.

Methods: Utilising an exploratory descriptive approach, 502 Victorian critical care nurses were approached to take part in the study. The resultant net total of 218 participants completed the survey, which represented a net response rate of 43.4%. The data were analysed using quantitative and qualitative methodologies.

Findings: Three common themes emerged. A significant number of participants did not believe that discharge planning occurred in critical care, and therefore, thought that they could not provide a definition. There was uncertainty as to what the discharge planning process actually referred to in terms of discharge from critical care to the general ward or discharge from the hospital. There was an emphasis on movement of the patient to the general ward, which was considered in three main ways by first, getting the patient ready for transfer; second, ensuring a smooth transition to the ward and third, transfer of the patient to the ward often occurred because the critical care bed was needed for another patient.

Conclusion: The findings presented here suggest at a nursing level, the discharge planning process is not well understood and some degree of mutual exclusivity still remains. There is a need for further education of critical care nurses with regard to the underlying principles of the discharge planning process.

Guest editorial : In Journal of networks, v.7 n.3

Networking of computing devices has been going through rapid evolution and thus continuing to be an ever expanding area of importance in recent years. New technologies, protocols, services and usage patterns have contributed to the major research interests in this area of computer science. The current special issue is an effort to bring forward some of these interesting developments that are being pursued by researchers at present in different parts of the globe. Our objective is to provide the readership with some insight into the latest innovations in computer networking through this. This Special Issue presents selected papers from the thirteenth conference of the series (ICCIT 2010) held during December 23-25, 2010 at the Ahsanullah University of Science and Technology. The first ICCIT was held in Dhaka, Bangladesh, in 1998. Since then the conference has grown to be one of the largest computer and IT related research conferences in the South Asian region, with participation of academics and researchers from many countries around the world. Starting in 2008 the proceedings of ICCIT are included in IEEExplore. In 2010, a total of 410 full papers were submitted to the conference of which 136 were accepted after reviews conducted by an international program committee comprising 81 members from 16 countries. This was tantamount to an acceptance rate of 33%. From these 136 papers, 14 highly ranked manuscripts were invited for this Special Issue. The authors were advised to enhance their papers significantly and submit them to undergo review for suitability of inclusion into this publication. Of those, eight papers survived the review process and have been selected for inclusion in this Special Issue. The authors of these papers represent academic and/or research institutions from Australia, Bangladesh, Japan, Korea and USA. These papers address issues concerning different domains of networks namely, optical fiber communication, wireless and interconnection networks, issues related to networking hardware and software and network mobility. The paper titled “Virtualization in Wireless Sensor Network: Challenges and Opportunities” argues in favor of bringing in different heterogeneous sensors under a common virtual framework so that the issues like flexibility, diversity, management and security can be handled practically. The authors Md. Motaharul Islam and Eui-Num Huh propose an architecture for sensor virtualization. They also present the current status and the challenges and opportunities for further research on the topic. The manuscript “Effect of Polarization Mode Dispersion on the BER Performance of Optical CDMA” deals with impact of polarization mode dispersion on the bit error rate performance of direct sequence optical code division multiple access. The authors, Md. Jahedul Islam and Md. Rafiqul Islam present an analytical approach toward determining the impact of different performance parameters. The authors show that the bit error rate performance improves significantly by the third order polarization mode dispersion than its first or second order counterparts. The authors Md. Shohrab Hossain, Mohammed Atiquzzaman and William Ivancic of the paper “Cost and Efficiency Analysis of NEMO Protocol Entities” present an analytical model for estimating the cost incurred by major mobility entities of a NEMO. The authors define a new metric for cost calculation in the process. Both the newly developed metric and the analytical model are likely to be useful to network engineers in estimating the resource requirement at the key entities while designing such a network. The article titled “A Highly Flexible LDPC Decoder using Hierarchical Quasi-Cyclic Matrix with Layered Permutation” deals with Low Density Parity Check decoders. The authors, Vikram Arkalgud Chandrasetty and Syed Mahfuzul Aziz propose a novel multi-level structured hierarchical matrix approach for generating codes of different lengths flexibly depending upon the requirement of the application. The manuscript “Analysis of Performance Limitations in Fiber Bragg Grating Based Optical Add-Drop Multiplexer due to Crosstalk” has been contributed by M. Mahiuddin and M. S. Islam. The paper proposes a new method of handling crosstalk with a fiber Bragg grating based optical add drop multiplexer (OADM). The authors show with an analytical model that different parameters improve using their proposed OADM. The paper “High Performance Hierarchical Torus Network Under Adverse Traffic Patterns” addresses issues related to hierarchical torus network (HTN) under adverse traffic patterns. The authors, M.M. Hafizur Rahman, Yukinori Sato, and Yasushi Inoguchi observe that dynamic communication performance of an HTN under adverse traffic conditions has not yet been addressed. The authors evaluate the performance of HTN for comparison with some other relevant networks. It is interesting to see that HTN outperforms these counterparts in terms of throughput and data transfer under adverse traffic. The manuscript titled “Dynamic Communication Performance Enhancement in Hierarchical Torus Network by Selection Algorithm” has been contributed by M.M. Hafizur Rahman, Yukinori Sato, and Yasushi Inoguchi. The authors introduce three simple adapting routing algorithms for efficient use of physical links and virtual channels in hierarchical torus network. The authors show that their approaches yield better performance for such networks. The final title “An Optimization Technique for Improved VoIP Performance over Wireless LAN” has been contributed by five authors, namely, Tamal Chakraborty, Atri Mukhopadhyay, Suman Bhunia, Iti Saha Misra and Salil K. Sanyal. The authors propose an optimization technique for configuring the parameters of the access points. In addition, they come up with an optimization mechanism in order to tune the threshold of active queue management system appropriately. Put together, the mechanisms improve the VoIP performance significantly under congestion. Finally, the Guest Editors would like to express their sincere gratitude to the 15 reviewers besides the guest editors themselves (Khalid M. Awan, Mukaddim Pathan, Ben Townsend, Morshed Chowdhury, Iftekhar Ahmad, Gour Karmakar, Shivali Goel, Hairulnizam Mahdin, Abdullah A Yusuf, Kashif Sattar, A.K.M. Azad, F. Rahman, Bahman Javadi, Abdelrahman Desoky, Lenin Mehedy) from several countries (Australia, Bangladesh, Japan, Pakistan, UK and USA) who have given immensely to this process. They have responded to the Guest Editors in the shortest possible time and dedicated their valuable time to ensure that the Special Issue contains high-quality papers with significant novelty and contributions.

Effect of aluminum on the corrosion resistance of low-alloy steel in 10wt% sulfuric acid solution

The aqueous corrosion behavior of low-alloy steel with aluminum contents was examined in a 10 wt% H₂SO₄ (pH 0.13) solution using electrochemical techniques and surface analyses. The corrosion resistance of the new alloy steel was evaluated in terms of electrochemical parameters, such as passive current density, film, and charge transfer resistances. The results showed that a high Al content in the steel imparted better passivation behavior resulting in a lower corrosion rate. It related to the enrichment of iron carbonate and hydrocarbon by the dissolution of the carbide phase.

Regional integration 2.0 : facilitating regional integration and development with collaborative technologies

The current global economic instability and the vulnerability of small nations provide the impetus for greater integration between the countries of the South Pacific region. This exercise is critical for their survival. Past efforts of regional integration in the South Pacific have mostly failed. However, today’s IT collaborative capabilities provide the opportunity to develop a shared IT infrastructure to facilitate integration in the South Pacific. In developing an IT-backed model of regional integration, this study identifies and reports on the antecedents of the current stage for integration in the Pacific. We conducted interviews with twenty five individuals from various sectors and find that while most respondents were optimistic about the potential of IT-backed regional integration, significant challenges exists. The study identifies and discusses these challenges providing policy implications to stakeholders in the regional integration process. The findings will assist in suggesting a model of regional integration 2.0 for the Pacific region.

The obesogenic household: Factors influencing dietary gatekeeper satisfaction with family diet

The rise in obesity and its co-morbidities has focused the attention of researchers on factors that influence the consumption of a healthy diet. Obesogenic (obesity-promoting) environments are an important area of investigation and a significant opportunity for health interventions. In this research, we identify the home as just such an environment and argue that the dietary gatekeeper within the home has a significant influence on what a family eats and subsequently the health status of family members. We propose a model that relates dietary gatekeeper cognitions and food-related capabilities to food acquisition and transformation practices and subsequent diet outcomes. An online survey was completed by 326 US and 323 Australian dietary gatekeepers to test the relationships in the model. Our results suggest improving dietary gatekeepers’ capabilities, including their cooking confidence and nutritional confidence, and their food acquisition and food transformation practices can have positive health benefits for gatekeepers and their families. Implications for health policymakers and food marketers are presented.

The natural history of internalizing behaviours from adolescence to emerging adulthood: findings from the Australian Temperament Project

BACKGROUND: The aims of the study were to describe the patterning and persistence of anxiety and depressive symptoms from adolescence to young adulthood and to examine long-term developmental relationships with earlier patterns of internalizing behaviours in childhood. METHOD: We used parallel processes latent growth curve modelling to build trajectories of internalizing from adolescence to adulthood, using seven waves of follow-ups (ages 11-27 years) from 1406 participants of the Australian Temperament Project. We then used latent factors to capture the stability of maternal reported child internalizing symptoms across three waves of early childhood follow-ups (ages 5, 7 and 9 years), and examined relationships among these patterns of symptoms across the three developmental periods, adjusting for gender and socio-economic status. RESULTS: We observed strong continuity in depressive symptoms from adolescence to young adulthood. In contrast, adolescent anxiety was not persistent across the same period, nor was it related to later depressive symptoms. Anxiety was, however, related to non-specific stress in young adulthood, but only moderately so. Although childhood internalizing was related to adolescent and adult profiles, the associations were weak and indirect by adulthood, suggesting that other factors are important in the development of internalizing symptoms. CONCLUSIONS: Once established, adolescent depressive symptoms are not only strongly persistent, but also have the potential to differentiate into anxiety in young adulthood. Relationships with childhood internalizing symptoms are weak, suggesting that early adolescence may be an important period for targeted intervention, but also that further research into the childhood origins of internalizing behaviours is needed.

How dynamic capabilities drive performance in the Indian IT industry : the role of information and co-ordination

This study examines key issues and effects of capability management on a fast-growing area of knowledge-intensive global business services – IT outsourcing and offshoring. An exploratory study is undertaken of Indian companies providing complex process-oriented offshore IT services to their global customers. The analysis of the data related to the service provider side shows that developing dynamic capabilities is strongly driven by management and top-clients and results in the development of business processes and in establishing a strategic partnership with the client organization. Key findings are that information exchange and coordination are the key to a leveraging firm performance.

Identifying capabilities for the IT function to create agility in information systems

In this paper, we identify the necessary capabilities of the IT function to create agility in existing information systems. Agility is the ability to quickly sense and respond to environment perturbations. We contrast the agility perspective from a widely used industry framework with research perspectives on agility in the IS literature. We suggest Beer’s Viable System Model (VSM) is a useful meta-level theory to house agility elements from IS research literature, and apply VSM principles to identify the capabilities required of the IT function. Indeed, by means of a survey of 34 organisations, we confirm that the meta-level theory better correlates with reported agility measures than existing practice measures do on their own. From a research perspective, the incorporation of the VSM mechanism helps to explain ‘why’ the IT function is capable of creating agility. From a practical perspective of ‘how’, the findings point to a new set of capabilities of the IT function for future versions of the industry frameworks to enable agility.

Agility in information systems : enabling capabilities for the IT function

This research identifies how the IT function can create agility in existing information systems. Agility is the capability to quickly sense and respond to environmental perturbations. We contrasted perspectives on agility from a widely used industry framework and that of the IS research literature. Beer’s Viable System Model was a useful meta-level theory to house agility elements from IS research and it introduced cybernetic principles to identify the processes required of the IT function. Indeed, our surveys of 70 organizations confirmed that the applied theory better correlates with reported agility than does existing industry best practice.

The research conducted two quantitative surveys to test the applied theory. The first survey mailed a Likert-type questionnaire to the clients of an Australian IT consultancy. The second survey invited international members of professional interest groups to complete a web-based questionnaire. The responses from the surveys were analyzed using partial-least-squares modeling. The data analysis positively correlated the maturity of IT function processes prescribed by the VSM and the likelihood of agility in existing information systems. We claim our findings generalize to other large organizations in OECD member countries.

The research offers an agility-capability model of the IT function to explain and predict agility in existing information systems. A further contribution is to improve industry ‘best practice’ frameworks by prescribing processes of the IT function to develop in maturity.

The role of human resource practices in developing knowledge and learning capabilities for innovation : a study of IT service providers in India

This paper examines the role of human resource practices in the development of knowledge and learning capabilities for innovation for information technology service providers (ITSP) in India. Developing knowledge and learning capabilities for innovation has been the subject of much attention from industry, governments and researchers. However, the questions surrounding how human resource practices influence the development of knowledge and learning capabilities that lead to organizational innovation remains unclear; particularly for knowledge intensive firms in developing countries. The study draws from the experience of 11 of the largest ITSPs in India and based on in-depth interviews. The findings suggest that while traditional human resource practices are important, senior executives should take a strategic approach in developing human resource practices with knowledge and learning capabilities as central piece for organizational innovation.

Managing Indian IT professionals for global competitiveness: the role of human resource practices in developing knowledge and learning capabilities for innovation

Little is known about how human resource practices contribute towards the competitiveness of people based-knowledge intensive organisations in developing countries. This paper examines the role of human resource practices in developing knowledge and learning capabilities for innovation in the Indian information technology services sector. The study draws from the experience of a sample of 11 of the largest information technology service providers (ITSPs) in India and is based on in-depth interviews. The main finding suggests that the talent management architecture of ITSPs that comprises human resource practices and the development of knowledge and learning capabilities is the main drivers of innovation. A conceptual framework showing the link between human resource practices, knowledge and learning capabilities and innovation of ITSPs is developed followed by the limitations of the study and avenues for future research.

"When I saw walking I just kind of took it as wheeling": interpretations of mobility-related items in generic, preference-based health state instruments in the context of spinal cord injury

Background : In health economic analyses, health states are typically valued using instruments with few items per dimension. Due to the generic (and often reductionist) nature of such instruments, certain groups of respondents may experience challenges in describing their health state. This study is concerned with generic, preference-based health state instruments that provide information for decisions about the allocation of resources in health care. Unlike physical measurement instruments, preference-based health state instruments provide health state values that are dependent on how respondents interpret the items. This study investigates how individuals with spinal cord injury (SCI) interpret mobility-related items contained within six preference-based health state instruments.

Methods : Secondary analysis of focus group transcripts originally collected in Vancouver, Canada, explored individuals’ perceptions and interpretations of mobility-related items contained within the 15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index (HUI), Quality of Well-Being Scale Self-Administered (QWB-SA), and the 36-item Short Form health survey version 2 (SF-36v2). Ritchie and Spencer’s ‘Framework Approach’ was used to perform thematic analysis that focused on participants’ comments concerning the mobility-related items only.

Results : Fifteen individuals participated in three focus groups (five per focus group). Four themes emerged: wording of mobility (e.g., ‘getting around’ vs ‘walking’), reference to aids and appliances, lack of suitable response options, and reframing of items (e.g., replacing ‘walking’ with ‘wheeling’). These themes reflected item features that respondents perceived as relevant in enabling them to describe their mobility, and response strategies that respondents could use when faced with inaccessible items.

Conclusion : Investigating perceptions to mobility-related items within the context of SCI highlights substantial variation in item interpretation across six preference-based health state instruments. Studying respondents’ interpretations of items can help to understand discrepancies in the health state descriptions and values obtained from different instruments. This line of research warrants closer attention in the health economics and quality of life literature.

Problem-based learning and masculinities : unique opportunities for Mr. Fix It? Well, maybe

I watched a smoker of 30 years being admitted to the Coronary Care unit following an acute Myocardial Infarction (heart attack). The message from the male clinician was simple, accurate, but somewhat behaviourist: " the death of part of your heart muscle is the result of your smoking, if you don’t stop smoking the damage will continue and you will die." A global, proactive and humanistic consultation demonstrating an understanding of the man’s addiction to a legal and accessible drug and illuminating prevention strategies may have been more appropriate. Maybe the interaction was about competing masculinities, the risk taker and the problem solver. The irony? As I left the hospital that night I observed the same clinician strategically positioned in a secluded hospital doorway drawing heavily on a cigarette. Hypocrite? No, invincible late 20’s male? Maybe. Smoking was someone else’s problem – at least today.

In my 16 years as a clinician such scenarios are common. Clinical practice based predominantly on problem solving potentiates hegemonic masculine approaches to treating men in clinical practice, often justified by limited health resources and increasing patient acuity. Ironically, Problem-based Learning (PBL) curriculums commonly used in health sciences higher education encourages, nurtures and rewards such problem solving approaches. As a teaching academic with current clinical practice it occurs to me that health science education and PBL has an opportunity if not obligation to empower clinicians to establish holistic approaches to male health presentations.

This paper explores the interconnections of Problem-based Learning (PBL) curriculums, health promotion, male nurses’ health-related behaviours and the implications and specificities of masculinity. The pilot study offers an insight into the perceptions of three male nurses that completed undergraduate nursing studies in PBL curriculums. The data obtained introduces some connections that could be illuminated by further research.