The impact of surgical ward nurses practicing respiratory assessment on positive patient outcomes

Objective: A literature review to examine the incorporation of respiratory assessment into everyday surgical nursing practice; possible barriers to this; and the relationship to patient outcomes. Primary argument: Escalating demands on intensive care beds have led to highly dependent patients being cared for in general surgical ward areas. This change in patient demographics has meant the knowledge and skills required of registered nurses in these areas has expanded exponentially. The literature supported the notion that postoperative monitoring of vital signs should include the fundamental assessment of respiratory rate; depth and rhythm; work of breathing; use of accessory muscles and symmetrical chest movement; as well as auscultation of lung fields using a stethoscope. Early intervention in response to changes in a patient's respiratory health status impacts positively on patient health outcomes. Substantial support exists for the contention that technologically adept nurses who also possess competent respiratory assessment skills make a difference to respiratory care. Conclusions: Sub-clinical respiratory problems have been demonstrated to contribute to adverse events. There is a paucity of research knowledge as to whether respiratory education programs and associated inservice make a difference to nursing clinical practice. Similarly, the implications for associated respiratory educational needs are not well documented, nor has a research base been sufficiently developed to guide nursing practice. Further research has the potential to influence the future role and function of the registered nurse by determining the importance of respiratory education programs on post-operative patient outcomes.

Standing up and finding my voice through positive digital storytelling

‘Positive Stories’ is a digital storytelling initiative that took place in Adelaide in 2010–2011.1 This article describes participants’ experiences of creative self-representation and the thorny complications of mediating voice, particularly in situations where privacy and publicity are significant issues.

Exploring the effect of companion robots on emotional expression in older people with dementia : a pilot randomized controlled trial

This pilot study aimed to compare the effect of companion robots (PARO) to participation in an interactive reading group on emotions in people living with moderate to severe dementia in a residential care setting. A randomized crossover design, with PARO and reading control groups, was used. Eighteen residents with mid- to late-stage dementia from one aged care facility in Queensland, Australia, were recruited. Participants were assessed three times using the Quality of Life in Alzheimer’s Disease, Rating Anxiety in Dementia, Apathy Evaluation, Geriatric Depression, and Revised Algase Wandering Scales. PARO had a moderate to large positive influence on participants’ quality of life compared to the reading group. The PARO intervention group had higher pleasure scores when compared to the reading group. Findings suggest PARO may be useful as a treatment option for people with dementia; however, the need for a larger trial was identified.

Exploring emotional climate in preservice science teacher education

Classroom emotional climates are interrelated with students’ engagement with university courses. Despite growing interest in emotions and emotional climate research, little is known about the ways in which social interactions and different subject matter mediate emotional climates in preservice science teacher education classes. In this study we investigated the emotional climate and associated classroom interactions in a preservice science teacher education class. We were interested in the ways in which salient classroom interactions were related to the emotional climate during lessons centered on debates about science-based issues (e.g., nuclear energy alternatives). Participants used audience response technology to indicate their perceptions of the emotional climate. Analysis of conversation for salient video clips and analysis of non-verbal conduct (acoustic parameters, body movements, and facial expressions) supplemented emotional climate data. One key contribution that this study makes to preservice science teacher education is to identify the micro-processes of successful and unsuccessful class interactions that were associated with positive and neutral emotional climate. The structure of these interactions can inform the practice of other science educators who wish to produce positive emotional climates in their classes. The study also extends and explicates the construct of intensity of emotional climate.

Stigmergy within web modelling languages : positive feedback mechanisms

Stigmergy is a biological term originally used when discussing insect or swarm behaviour, and describes a model supporting environment-based communication separating artefacts from agents. This phenomenon is demonstrated in the behavior of ants and their food foraging supported by pheromone trails, or similarly termites and their termite nest building process. What is interesting with this mechanism is that highly organized societies are formed without an apparent central management function. We see design features in Web sites that mimic stigmergic mechanisms as part of the User Interface and we have created generalizations of these patterns. Software development and Web site development techniques have evolved significantly over the past 20 years. Recent progress in this area proposes languages to model web applications to facilitate the nuances specific to these developments. These modeling languages provide a suitable framework for building reusable components encapsulating our design patterns of stigmergy. We hypothesize that incorporating stigmergy as a separate feature of a site’s primary function will ultimately lead to enhanced user coordination.

The evolving emotional experience with portable interactive devices

Emotions play a significant role in people’s lives, including interactions with portable devices. The research aimed to understand the evolving emotional experience between people and portable interactive devices (PIDs). Activity Theory was the theoretical framework used to contextualise the research approach and findings. Two longitudinal experiments were conducted investigating emotional experiences with PIDs over six months. Experiment 1 focused on media / entertainment PIDs while Experiment 2 focused on medical / health PIDs. Mixed research methods consisting of diaries, interviews and codiscovery sessions were used to collect data. Results identified that more social interactions were experienced with media PIDs than medical PIDs. Different Task Categories, and their emotional responses, were also revealed including Features, Functional, Mediation and Auxiliary Categories. Functional and Mediation categories were characterised as overall positive while Features and Auxiliary Categories were characterised as overall negative. Further, the consequences of Negative Personal and Social interactions on the overall emotional experience were determined. For media PIDs, Negative Social experiences adversely impacted the evolving emotional experience. For medical PIDs, both Negative Social and Negative Personal experiences adversely impacted the evolving emotional experience. As a result of the findings the Designing for Evolving Emotional Experience framework was developed, outlining principles to promote positive, and avoid negative, emotional experiences with PIDs. Contributions to knowledge from the research include methodological contributions, advancing understanding of emotional experiences with PIDs, expanding the taxonomy of emotional interactions with PIDs and broadening emotion design theory and principles. The thesis concludes with an outline of implications to design research, design and related fields, future research potentials, as well as the positive contributions to designing for meaningful and enjoyable experiences in everyday life.

Towards positive organisation austerity : combining austerity measures with Positive Organisational Scholarship (POS)

The purpose of this paper is to explore the potential and value of positive management practices to address the pain and suffering that frequently accompanies periods of large-scale austerity in public sectors. Public managers are increasingly asked to implement severe austerity measures and at the same time to build service delivery capacity; contradictory tasks. We draw on and further develop Cameron’s (2012) model of Positive Leadership to identify seven positive shared leadership practices that, while not eliminating the pain and suffering associated with austerity measures at least offer some scope, compared to traditional public management practices, for managing the austerity-build capacity duality in ways that respond to those affected with compassion and respect. We draw on published reports of a large-scale austerity program to highlight the potential and value of positive shared leadership practices for creating what we refer to as positive organisational austerity. The paper contributes to the literature on public management response to crises in two main ways. First, the paper introduces and develops the concept of shared positive leadership (Cameron, 2012; Carson et al. 2007) as a way of managing in austerity. Second, the paper introduces the concept of positive organisational austerity as a means of highlighting a reorientation in thinking about austerity measures and their implementation.

High levels of BACH2 associated with lower levels of BCL2 transcript abundance in t(14;18)(q21;q34) translocation positive non-Hodgkin’s lymphoma

The t(14;18)(q21;q34) BCL2 translocation is a common genetic alteration in follicular and diffuse large B-cell lymphoma. However, it is not invariably associated with BCL2 gene overexpression due to undefined mechanisms that regulate expression from the proximal immunoglobulin heavy-chain (IgH) promoter. The BACH2 transcriptional repressor is able to modulate activity of this promoter. Here we have shown that, in tumor samples with BCL2 translocation, those with high levels of BACH2 had significantly lower BCL2 transcript abundance compared to those with low levels of BACH2. This indicates that BACH2 may be partially responsible for regulation of BCL2 expression from the t(14;18)(q21;q34) translocation.

A framework to better understand emotional experiences with portable interactive devices : preliminary trial

Two longitudinal experiments were conducted exploring emotional experiences with PIDs over six months including media and medial Portable Interactive Devices (PIDs). Results identifying the impact of negative social and personal interactions on the overall emotional experience as well as different task categories (Features, Functional, Mediation and Auxiliary) and their corresponding emotional responses have previously been reported [2,3,4,5]. This paper builds on these findings and presents the Designing for Evolving Emotional Experience (DE3) framework promoting positive (and deals with negative) emotional experiences with PIDs including a set of principles to better understand emotional experiences. To validate the DE3 framework a preliminary trial was conducted with five practicing industrial designers. The trial required them to consider initial design concepts using the DE3 framework followed by a questionnaire asking about their use of the framework for concept development. The trial aimed to analyse the effectiveness, efficiency and usefulness of the framework in assisting in the development of initial concepts for PIDs taking into account emotional experiences. Common themes regarding the framework are outlined including the ease of use, the effectiveness in focusing on the personal and social contexts and positive ratings regarding its use. Overall the feedback from the preliminary trial was encouraging with responses suggesting that the framework was accessible, rated highly and most importantly permitted designers to consider emotional experiences during concept development. The paper concludes with a discussion regarding the future development of the DE3 framework and the potential implications to design theory and the design discipline.

Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly expresses EBNA3A with conserved CD8+ T-cell epitopes

Post-transplantation lymphoproliferative disorders (PTLD) arise in the immunosuppressed and are frequently Epstein-Barr virus (EBV) associated. The most common PTLD histological sub-type is diffuse large B-cell lymphoma (EBV+DLBCL-PTLD). Restoration of EBV-specific T-cell immunity can induce EBV+DLBCL-PTLD regression. The most frequent B-cell lymphoma in the immunocompetent is also DLBCL. ‘EBV-positive DLBCL of the elderly’ (EBV+DLBCL) is a rare but well-recognized DLBCL entity that occurs in the overtly immunocompetent, that has an adverse outcome relative to EBV-negative DLBCL. Unlike PTLD (which is classified as viral latency III), literature suggests EBV+DLBCL is typically latency II, i.e. expression is limited to the immuno-subdominant EBNA1, LMP1 and LMP2 EBV-proteins. If correct, this would be a major impediment for T-cell immunotherapeutic strategies. Unexpectedly we observed EBV+DLBCL-PTLD and EBV+DLBCL both shared features consistent with type III EBV-latency, including expression of the immuno-dominant EBNA3A protein. Extensive analysis showed frequent polymorphisms in EBNA1 and LMP1 functionally defined CD8+ T-cell epitope encoding regions, whereas EBNA3A polymorphisms were very rare making this an attractive immunotherapy target. As with EBV+DLBCL-PTLD, the antigen presenting machinery within lymphomatous nodes was intact. EBV+DLBCL express EBNA3A suggesting it is amenable to immunotherapeutic strategies.

Promoting a more positive traffic safety culture in Australia : lessons learnt and future directions

Adopting a traffic safety culture approach, this paper identifies and discusses the ongoing challenge of promoting the road safety message in Australia. It is widely acknowledged that mass media and public education initiatives have played a critical role in the significant positive changes witnessed in community attitudes to road safety in the last three to four decades. It could be argued that mass media and education have had a direct influence on behaviours and attitudes, as well as an indirect influence through signposting and awareness raising functions in conjunction with enforcement. Great achievements have been made in reducing fatalities on Australia’s roads; a concept which is well understood among the international road safety fraternity. How well these achievements are appreciated by the general Australian community however, is not clear. This paper explores the lessons that can be learnt from successes in attitudinal and behaviour change in regard to seatbelt use and drink driving in Australia. It also identifies and discusses key challenges associated with achieving further positive changes in community attitudes and behaviours, particularly in relation to behaviours that may not be perceived by the community as dangerous, such as speeding and mobile phone use while driving. Potential strategies for future mass media and public education campaigns to target these challenges are suggested, including ways of harnessing the power of contemporary traffic law enforcement techniques, such as point-to-point speed enforcement and in-vehicle technologies, to help spread the road safety message.

Positive reappraisal improves heart rate variability during stressful work

Recent developments in wearable ECG technology have seen renewed interest in the use of Heart Rate Variability (HRV) feedback for stress management. Yet, little is know about the efficacy of such interventions. Positive reappraisal is an emotion regulation strategy that involves changing the way a situation is construed to decrease emotional impact. We sought to test the effectiveness of an intervention that used feedback on HRV data to prompt positive reappraisal during a stressful work task. Participants (N=122) completed two 20-minute trials of an inbox activity. In-between the first and the second trial participants were assigned to the waitlist control condition, a positive reappraisal via psycho-education condition, or a positive reappraisal via HRV feedback condition. Results revealed that using HRV data to frame a positive reappraisal message is more effective than using psycho-education (or no intervention)–especially for increasing positive mood and reducing arousal.