Pressure ulcers in the adult intensive care unit : a literature review of patient risk factors and risk assessment scales

Background: Critically ill patients are at high risk for pressure ulcer (PrU) development due to their high acuity and the invasive nature of the multiple interventions and therapies they receive. With reported incidence rates of PrU development in the adult critical care population as high as 56%, the identification of patients at high risk of PrU development is essential. This paper will explore the association between PrU development and risk factors. It will also explore PrU development and the use of risk assessment scales for critically ill patients in adult intensive care units. Method: A literature search from 2000 to 2012 using the CINHAL, Cochrane Library, EBSCOHost, Medline (via EBSCOHost), PubMed, ProQuest and Google Scholar databases was conducted. Key words used were: pressure ulcer/s; pressure sore/s; decubitus ulcer/s; bed sore/s; critical care; intensive care; critical illness; prevalence; incidence; prevention; management; risk factor; risk assessment scale. Results: Nineteen articles were included in this review; eight studies addressing PrU risk factors, eight studies addressing risk assessment scales and three studies overlapping both. Results from the studies reviewed identified 28 intrinsic and extrinsic risk factors which may lead to PrU development. Development of a risk factor prediction model in this patient population, although beneficial, appears problematic due to many issues such as diverse diagnoses and subsequent patient needs. Additionally, several risk assessment instruments have been developed for early screening of patients at higher risk of developing PrU in the ICU. No existing risk assessment scales are valid for identification high risk critically ill patient,with the majority of scales potentially over-predicting patients at risk for PrU development. Conclusion: Research studies to inform the risk factors for potential pressure ulcer development are inconsistent. Additionally, there is no consistent or clear evidence which demonstrates any scale to better or more effective than another when used to identify the patients at risk for PrU development. Furthermore robust research is needed to identify the risk factors and develop valid scales for measuring the risk of PrU development in ICU.

The application of the parallel track model in community health promotion : a literature review

The parallel track model is one of the several models that are used in health promotion programmes that focus on community empowerment. It is unique in that it explicitly incorporates an empowerment approach with a top-down health programme. Since its development in 1999-2000 the model has been used in various health programmes in both developed and developing countries. The aim of this review is to examine the nature and extent of the application of this model and its contribution to promoting health. A review of the literature published between 2000 and 2011 was conducted. Nine results matched the inclusion criteria and revealed that the model has been mostly applied to disadvantaged communities to address health determinants, such as poverty and health literacy. This review found that the model had a positive impact on specific health outcomes such as health literacy and community capacity. We concluded that the parallel track model has the most potential for building capacity for community health promotion and appears to be the least useful for interventions focusing on health behaviour change within a limited time frame.

Exploring shared services from an IS perspective : a literature review and research agenda

Shared services have gained significance as an organizational arrangement, in particular for support functions, to reduce costs, increase quality and create new capabilities. The Information Systems (IS) function is amenable to sharing arrangements and information systems can enable sharing in other functional areas. However, despite being a promising area for IS research, literature on shared services in the IS discipline is scarce and scattered. There is still little consensus on what shared services is. Moreover, a thorough understanding of why shared services are adopted, who are involved, and how things are shared is lacking. In this article, we set out to progress IS research on shared services by establishing a common ground for future research and proposing a research agenda to shape the field based on an analysis of the IS literature. We present a holistic and inclusive definition, discuss the primacy of economic-strategic objectives so far, and introduce conceptual frameworks for stakeholders and the notion of sharing. We also provide an overview of the theories and research methods applied. We propose a research agenda that addresses fundamental issues related to objectives, stakeholders, and the notion of sharing to lay the foundation for taking IS research on shared services forward.

Desperately seeking Asia through China: Reading ‘China’ in the Australian Curriculum: History through children’s literature

This paper considers how Asia can be meaningfully studied and understood in the first national history curriculum to be implemented in Australia. Its focus is on how empathy might be conceptualised as part of the process of becoming ‘Asia literate’ and the ways in which an empathetic understanding can be developed in the Australian Curriculum: History by engaging students with children’s literature. We argue that stories about Chinese experiences in Australia from particular episodes in the nation’s past can be utilised for their potential to prompt historical inquiry and empathetic engagement in the classroom.

The legacy of Ian Hunter's work on literature education and the history of reading practices : some preliminary remarks

Ian Hunter's early work on the history of literature education and the emergence of English as school subject issued a bold challenge to traditional accounts that have in the main focused on English either as knowledge of a particular field or as ideology. The alternative proposal put forward by Hunter and supported by detailed historical analysis is that English exists as a series of historically contingent techniques and practices for shaping the self-managing capacities of children. The challenge for the field is to advance this historical work and to examine possible implications for English teaching.

Modelling the Contribution of Knowledge Management towards Achieving Orgnisational Business Objectives

Knowledge management (KM) continues to receive mounting interest within the construction industry due to its potential to offer solutions for organisations seeking competitive advantage. This paper presents a KM input-process-output conceptual model comprising unique and well-defined theoretical constructs representing KM practices and their internal and external determinants in the context of construction. The paper also presents the underlying principles used in operationally defining each construct using extant KM literature, and offers a number of testable hypotheses that capture the inter-relationships between the identified constructs.

Numerical techniques for simulating a fractional mathematical model of epidermal wound healing

A number of mathematical models investigating certain aspects of the complicated process of wound healing are reported in the literature in recent years. However, effective numerical methods and supporting error analysis for the fractional equations which describe the process of wound healing are still limited. In this paper, we consider the numerical simulation of a fractional mathematical model of epidermal wound healing (FMM-EWH), which is based on the coupled advection-diffusion equations for cell and chemical concentration in a polar coordinate system. The space fractional derivatives are defined in the Left and Right Riemann-Liouville sense. Fractional orders in the advection and diffusion terms belong to the intervals (0, 1) or (1, 2], respectively. Some numerical techniques will be used. Firstly, the coupled advection-diffusion equations are decoupled to a single space fractional advection-diffusion equation in a polar coordinate system. Secondly, we propose a new implicit difference method for simulating this equation by using the equivalent of Riemann-Liouville and Grünwald-Letnikov fractional derivative definitions. Thirdly, its stability and convergence are discussed, respectively. Finally, some numerical results are given to demonstrate the theoretical analysis.

Nurses’ role in caring for people with a comorbidity of mental illness and intellectual disability : A literature review

This article examines literature on the role of the nurse caring for people with a dual disability (DD) of intellectual disability and mental illness. A search of the literature between 2000 and 2010 resulted in a total of 21 articles that met the inclusion criteria. Seven key categories of the role of the nurse were identified: (i) advocacy/health promotion (including working with family); (ii) assessment/case management; (iii) behavioural interventions; (iv) communication; (v) leadership and the nurse’s role within the multidisciplinary team; (vi) functions regarding medication administration; and (vii) safety/risk management. There is a paucity of research about the role of nurses working with people with DD, although a number of opinion-based articles exist. This article identifies a need for the role of the nurse working in DD to be more clearly articulated and for the development of evidence to guide best practice.

People with ID as active participants in nursing research : a literature review.

Aim: The movement from a medical model of disability to a more social model implies an imperative to include the views of people with ID in research regarding their care. Contemporary quality processes in improving care require consumer involvement at many levels and in doing so have shown better outcomes. A New Zealand research study is being undertaken utilizing focus groups with people with ID to understand their experiences during a psychiatric inpatient admission. The primary focus of this presentation will concern the literature review, undertaken as part of the study, of research in which people with ID have participated. Method: The literature review was conducted using a variety of electronic databases and search terms to identify studies with people with ID as active participants. Results: Only a few studies have been undertaken with people with ID as participants. While these studies demonstrate numerous benefits in including the voice of the person with ID this still remains absent from much of the research discourse. Conclusion: It is accepted and indeed advocated that people with ID have the same rights as others in regard to choosing whether or not they wish to participate in research. High response rates in the few identified studies indicated that people with ID are eager to be consulted. It is recommended that the unique needs of people with ID be taken into account in the research evidence base for future services.

An overview of level I evidence for the management of radiation dermatitis literature

Background: Despite the technologic advances, radiation dermatitis is still a prevalent and distressing symptom in patients with cancer undergoing radiotherapy. Systematic reviews (SRs) are regarded as level I evidence providing direction for clinical practice and guidelines. This overview aims to provide a critical appraisal of SRs published on interventions for the prevention/management of radiation dermatitis. Methodology: We searched the following electronic databases: MEDLINE, CINAHL, EMBASE, and the Cochrane Library (up to Feb 2012). We also hand-searched reference lists of potentially eligible articles and a number of key journals in the area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using the “A Measurement Tool to Assess Systematic Reviews” (AMSTAR). Results: Of 1837 potential titles, six SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/non-steroidal topical agents, systematic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews may create biases to the overall results or recommendations for clinical practice. Conclusions and implications: An up-to-date high quality SR in preventing/managing radiation dermatitis is needed to guide practice and direction for future research. Clinicians or guideline developers are recommended to critically evaluate the information of SRs in their decision making.

A systematic review of the literature comparing the practices of dispensing and non-dispensing doctors

Objectives: Some doctors perform the dual roles of prescribing and dispensing pharmaceuticals. The dispensing doctors (DDs) role may give rise to prescribing behaviours that vary from those of non-DDs. The aim of this review was to systematically and comparatively appraise the research evidence related to the practices of DDs. Methods: A systematic search of bibliographic databases and reference lists from selected papers were the sources of the data. Inclusion criteria were papers published in English, between 1970 and 2008 that provided quantitative data comparing the practices of DDs and non-DDs. At least two of the authors abstracted data from all eligible papers using a purpose-made data extraction form. Results: Twenty-one papers were included in this review. Evidence indicated that DDs prescribed more pharmaceutical items and less often generically than non-DDs. There was limited evidence to suggest that DDs prescribed less judiciously and were associated with poor dispensing standards. Patient convenience and access to pharmaceuticals were main reasons for doctors to dispense. Conclusion: DDs can fill an important gap in the provision of pharmaceuticals for their patients especially where health workforce shortages exist. There was evidence the dispensing role influenced prescribing. Patient convenience should be balanced against scarce medical resources, being utilised for dispensing.

Is quality more important if you’re quirky? A review of the literature on differential susceptibility to childcare environments

Evidence concerning the impact of child care on child development suggests that higher-quality environments, particularly those that are more responsive, predict more favourable social and behavioural outcomes. However, the extent of this effect is not as great as might be expected. Impacts on child outcomes are, at best, modest. One recent explanation emerging from a new theoretical perspective of development, differential susceptibility theory, is that a minority of children are more reactive to both positive and negative environments, while the majority are relatively unaffected. These 'quirky' children have temperamental traits that are more extreme, and are often described in research studies as having 'difficult temperaments'. This paper reviews the literature on such children and argues for the need for further research to identify components of childcare environments that optimise the potential of these more sensitive, quirky individuals.

Empathy : narrative empathy and children's literature

The term empathy has only existed in English for a little over a hundred years, but the idea of feeling with another person is an old one. Because of its perceived connection to moral behaviour, empathy and its development are of great interest to educators, policy makers, psychologists, and philosophers. Reading children’s literature is often considered important for developing (among other things) children’s ethical and empathic understandings of society and its people. However, claims as to the impact of reading on readers’ ability to become more empathic, tolerant, and better people are divided. While many readers may attribute positive influences that authors and texts have had on shaping their attitudes and actions, there is no guarantee that a desirable affective and cognitive response will follow the reading experience. The complexity of readers and texts refuses to be reduced to simple universal statements about the capacity of narrative empathy to create a particular kind of empathic reader or person: fiction that engages a reader with the emotional plight of a character does not necessarily translate into actions in the real world towards people who are similarly suffering, marginalized, or victimized. This chapter asks: Does children’s literature foster empathy? There are two implicit features of this question: one concerns narrative empathy; the other concerns empathic reader response. The discussion will focus on how a selection of ‘multicultural’ picture books attempts to create narrative empathy by focussing on cultural and spatial differences.

(Re)imagining the world : children's literature's response to changing times

(Re)Imagining the world: Children’s Literature���s Response to Changing Times considers how writers of fiction for children imagine ‘the world’, not one universal world, but different worlds: imaginary, strange, familiar, even monstrous worlds. The chapters in this collection discuss how fiction for children engages with some of the changes brought about by new technologies, information literacy, consumerism, migration, politics, different family structures, cosmopolitanism, and new and old monsters. They also invite us to think about how memory shapes our understanding of the past, and how fiction engages our emotions, our capacity to empathize, our desire to discover, and what the future may hold. The contributors bring different perspectives from education, postcolonial studies, literary criticism, cultural studies, childhood studies, postmodernism, and the social sciences. With a wide coverage of texts from different countries, and scholarly and lively discussions, this collection is itself a testament to the power of the human imagination and the significance of children’s literature in the education of young people.

Confidence in the police : balancing public image with community safety : a comparative review of the literature

Examining the evolution of British and Australian policing, this comparative review of the literature considers the historical underpinnings of policing in these two countries and the impact of community legitimacy derived from the early concepts of policing by consent. Using the August 2011 disorder in Britain as a lens, this paper considers whether, in striving to maintain community confidence, undue emphasis is placed on the police's public image at the expense of community safety. Examining the path of policing reform, the impact of bureaucracy on policing and the evolving debate surrounding police performance, this review suggests that, while largely delivering on the ideal of an ethical and strong police force, a preoccupation with self-image may in fact result in tarnishing the very thing British and Australian police forces strive to achieve – their standing with the public. This paper advocates for a more realistic goal of gaining public respect rather than affection in order to achieve the difficult balance between maintaining trust and respect as an approachable, ethical entity providing firm, confident policing in this ever-evolving, modern society.