Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study

Objectives
This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients.

Design
Mixed-method multi-centre study.

Setting
High fidelity simulated acute clinical environment in three Australian universities.

Participants
A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study.

Method
In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance.

Results
Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%.

Conclusions
Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.

Evolving epidemiology of injecting drug use-associated infective endocarditis: a regional centre experience

INTRODUCTION AND AIMS: Injecting drug use (IDU) is a major risk factor for infective endocarditis (IE). An understanding of the epidemiology of IE and IDU is vital for delivery of health care for this disease. Our aim was to examine the rates of IDU-associated IE (IDU-IE) in a single centre over the last 12 years. DESIGN AND METHODS: Retrospective analysis of two cohorts of consecutive patients (n = 226) admitted with IE from 2002 to 2013. Numbers of cases and rates of IE were compared between two cohorts (2002-2006 and 2009-2013). Rate ratios were calculated using Poisson distributions. Poisson regression was used to examine relationship over time. RESULTS: One hundred thirty cases of endocarditis were seen in the first observation period (6 IDU-IE) and 96 in the second observation period (15 IDU-IE). The estimated incidence rate of IE had fallen from 10.1 to 6.45 per 100, 000 person-years [rate ratio 0.64, 95% confidence interval (CI) 0.48, 0.85]. In contrast, the estimated incidence rate of IDU-E has risen from 0.48 to 0.79 per 100, 000 person-years (rate ratio 1.65, 95% CI 0.59, 4.57). Incidence rate regression suggests that the number of IDU-IE cases is expected to increase by a factor of 1.25 (95%CI 1.09-1.44) for each increase of 1 year. DISCUSSION AND CONCLUSIONS: Over the last decade, there has been a decrease in incidence rate and total number of cases of IE but a rise in rate and number of cases of IDU-IE. This may indicate increasing IDU or increased rates of endocarditis in intravenous drug users in this region. This finding may inform health-care planning in the area.

Reductions in the Prevalence and Incidence of Geohelminth Infections following a City-wide Sanitation Program in a Brazilian Urban Centre

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Serology, isolation, and molecular detection of Leptospira spp. from the tissues and blood of rats captured in a wild animal preservation centre in Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Availability and Use of Audiovisual and Electronic Resources by Distance Learning Students in Nigerian Universities: a Case Study of National Open University of Nigeria (NOUN), Ibadan Study Centre

This study investigated the availability and use of audiovisual and electronic resources by distance learning students at the National Open University of Nigeria (NOUN). A questionnaire was administered tothe distance learning students selected across the various departments of the NOUN. The findings revealed that even though NOUN made provision for audiovisual and electronic resources for students' use, a majority of the audiovisual and electronic resources are available through personal provision by the students.The study also revealed regular use of audiovisual and electronic resources by the distance learning students. Constraints on use include poor power supply, poor infrastructure, lack of adequate skill, and high cost of access.

Osteoporosis and bisphosphonates-related osteonecrosis of the jaw: Not just a sporadic coincidence - a multi-centre study

Bisphosphonates (BPs) are powerful drugs that inhibit bone metabolism. Adverse side effects are rare but potentially severe such as bisphosphonate-related osteonecrosis of the jaw (BRONJ). To date, research has primarily focused on the development and progression of BRONJ in cancer patients with bone metastasis, who have received high dosages of BPs intravenously. However, a potential dilemma may arise from a far larger cohort, namely the millions of osteoporosis patients on long-term oral BP therapy.

Mapping species distributions : A comparison of skilled naturalist and lay citizen science recording

Acknowledgements We are grateful to Elaine O’Mahony, Imogen Pearce, Richard Comont, Anthony McCluskey and other BBCT staff for the many hours of BeeWatch species identification and for all people who submitted sightings to BeeWatch, OPAL, BWARS and the various local recording schemes and societies. We thank the NBN for allowing us to download the bumblebee records without strings attached, and the Essex, Greater London, Cumbria and Sussex based recording centres for providing records upon request. Finally, we are indebted to Tom August and two anonymous reviewers for their valuable critique on an earlier version of this work.

The role of automated feedback in training and retaining biological recorders for citizen science

© 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Acknowledgments The authors thank H. H. Nguyen for his early development work on the BeeWatch interface; E. O'Mahony, I. Pearce, and R. Comont for identifying numerous photographed bumblebees; B. Darvill, D. Ewing, and G. Perkins for enabling our partnership with the Bumblebee Conservation Trust; and S. Blake for his investments in developing the NLG feedback. The study was part of the Digital Conservation project of dot.rural, the University of Aberdeen's Digital Economy Research Hub, funded by RCUK (grant reference EP/G066051/1).

Preferences and consumer habits related to bread in the centre of Portugal

Purpose – Bread is one of the most consumed foods in the world, and its main function is to provide nutrients and energy for the body. Thus, the purpose of this paper was to raise awareness about the consumption habits of bread and consumer preferences in the region of Viseu (centre of Portugal), assessing the extent to which the preferences and consumption habits differ based on individual variables. Design/methodology/approach – The study was conducted by means of a questionnaire by direct interviewing. The questionnaire included sections aimed at gathering information about demographics, consumption habits and preferences related to bread. The sample consisted of 500 consented respondents. Findings – The results showed significant differences between genders regarding the type of bread eaten: women consumed less wheat bread (52 per cent against 62 per cent; p 0.029) and less unsalted bread (0.3 per cent against 3 per cent; p 0.023), but more whole bread (25 per cent against 11 per cent; p 0.001) and more bread with cereal grains (23 per cent against 11 per cent; p 0.001), thus revealing a trend for a nutritionally more adequate choice. Accordingly, women valued more the composition of the bread when purchasing it (p 0.001). It was also observed a trend for a lower consumption of wheat bread among classes with more advanced studies (47 per cent on university graduates against 60 per cent on nongraduates; p 0.004). Originality/value – This work is innovative because it was the first time the preferences and consuming habits of a sample of Portuguese population regarding bread were accessed, altogether. The results hereby obtained may be of importance both to understand the nutritional importance of bread in the diet of the Portuguese and also for the industry and manufacturers to better correspond to the buying preferences.