Advanced fingerling production: seasonal ponds

(4pp.)

Advanced fingerling production in perennial ponds

(4 pp.)

Assistência paliativa em oncologia na perspectiva do familiar: contribuições da enfermagem

O estudo emergiu da minha experiência profissional como enfermeira de um serviço especializado em cuidados paliativos em oncologia. A abordagem paliativa exige da equipe maior interação, não apenas na realização de procedimentos terapêuticos necessários naquele momento, mas, sobretudo, em orientar adequadamente, quanto aos cuidados realizados com pacientes que se encontram em estado de doença avançada, bem como promover a adesão terapêutica do familiar, através de ações interdisciplinares. Estudo de natureza qualitativa com referencial teórico metodológico na fenomenologia sociológica de Alfred Schutz, que tem como enfoque o significado da ação. Nesse sentido, as vivências e as ações dos familiares constituem fontes de significados subjetivos das experiências adquiridas, ao cuidar de um familiar em tratamento paliativo em oncologia. A partir dessas reflexões, o objeto de estudo é a experiência vivida pela família em cuidar de pessoa em tratamento paliativo em oncologia e tem como objetivo compreender a perspectiva de cuidar do familiar de pessoa em tratamento paliativo em oncologia. O cenário onde foi realizado o estudo é o Instituto Nacional de Câncer/MS, situado no município do Rio de Janeiro, na Unidade de Cuidados Paliativos/HCIV. Os sujeitos participantes foram, 20 familiares de pacientes em tratamento paliativo em oncologia. A apreensão das falas, deu-se mediante entrevista fenomenológica, guiada por meio da questão orientadora: como você está vivendo a experiência de cuidar de seu familiar em tratamento paliativo em oncologia? O estudo permitiu compreender que o familiar de pessoa em tratamento paliativo em oncologia se mostrou como aquele que ajuda, apóia, estando junto, não abandonando, dando apoio e representando a família, na perspectiva de enfrentar suas próprias dificuldades diante do tratamento paliativo em oncologia e tentar entender a abordagem paliativa que tem como foco reduzir a dor, superando o rótulo de terminal. Portanto, oferecer uma forma de compreender o cuidado desse familiar, situado no mundo institucional, possibilitando apreender o vivido e os significados que alicerçam esta prática conduz a um comportamento, ações e relações, ou seja, um modo de pensar que oriente o individuo no seu cotidiano para ser e estar com o outro nessa fase da vida. Nesse sentido, a escuta e a comunicação se constituem como os pilares do cuidar dos familiares em cuidados paliativos em oncologia. A inserção da família durante todo o processo é fundamental para os cuidados realizados com a pessoa, evidenciando para o enfermeiro a importância de atender às expectativas de ambos, agindo como facilitador na implementação do cuidar. Assim sendo, as ações de enfermagem podem contribuir e auxiliar a família a descobrir suas próprias soluções para as situações que envolvem o suporte às necessidades apresentadas.

Advanced applications of a computational design synthesis method

From modelling to manufacturing, computers have increasingly become partners in the design process, helping automate many phases once carried out by hand. In the creative phase, computational synthesis methods aim at facilitating designers' task through the automated generation of optimally directed design alternatives. Nevertheless, applications of these techniques are mainly academic and industrial design practice is still far from applying them routinely. This is due to the complex nature of many design tasks and to the difficulty of developing synthesis methods that can be easily adapted to multiple case studies and automated simulation. This work stems from the analysis of implementation issues and obstacles to the widespread use of these tools. The research investigates the possibility to remove these obstacles through the application of a novel technique to complex design tasks. The ability of this technique to scale-up without sacrificing accuracy is demonstrated. The successful results confirm the possibility to use synthesis methods in complex design tasks and spread their commercial and industrial application.

Qualitative evaluation of KA24 (Knowledge Access 24)

Durbin, J. & Urquhart, C. (2003). Qualitative evaluation of KA24 (Knowledge Access 24). Aberystwyth: Department of Information Studies, University of Wales Aberystwyth. Sponsorship: Knowledge Access 24 (NHS)

Clinical autonomy and nurse/physician collaboration in emergency nurses

Aim: To investigate clinical autonomy and Nurse/Physician collaboration among emergency nurses and the relationship between these concepts, personal characteristics and organisational influences. Background: Nurses have been identified as having a significant role in addressing the challenges of providing modern healthcare. Emergency nurses have reported competence in a wide range of emergency care skills. However, there is evidence that Emergency Department (ED) nurses may have lower levels of clinical autonomy than other areas of practice. Levels of clinical autonomy appear to be influenced by levels of collaboration with physicians and the organisations in which nurses work Methods: A descriptive correlational study using a survey design with a purposive convenience sample of 141 ED staff nurses (response 70.9%) from 3 EDs in Ireland. Data were collected using the Dempster Practice Behaviours Scale (DPBS) the Nurse/Physician Collaboration Scale (NPCS) and the newly developed Organisational Influences on Nursing Scale. Demographic information was also sought from participants. Results: Participants were largely female (87%), relatively young (mean age 35.57, SD=7.83) and educated to degree level (48%) or higher (31%) with 40% posessing specialist emergency nursing qualifications. Participants reported moderate levels of clinical autonomy and Nurse/Physician collaboration. No relationships were found between sample characteristics and clinical autonomy and Nurse/Physician collaboration among emergency nurses. Relationships were found between levels of clinical autonomy and Nurse/Physician collaboration (r=-0.395, n=100, p<0.001), and organisational influence on nursing (r=0.455, p<0.001) and also between Nurse/Physician collaboration and organisational influence on nursing (r=-0.413, p<0.001). Discussion: Clinical autonomy of nurses has been linked with quality outcomes in healthcare. The quest for quality in modern healthcare in a challenging environment should acknowledge that strategies need to focus beyond education and skills provision and include essential elements such as Nurse/Physician collaboration and the organisational influence on nursing to ensure the greater involvement of nurses in patient care.

Language legislation in Ireland and the United Kingdom: Exploring the gaps between theory and practice

The central objective in this thesis is to explore the gaps between the normative justifications advanced for language rights and language legislative protection and the effective realisation of those rights and legislative provisions in practice. This objective is achieved by examining the scope and application of language rights and legislative provisions within language legislation in Ireland and the United Kingdom. Drawing on Canadian jurisprudence advocating for language rights to be recognised as “purposeful”, the thesis considers the extent to which Ireland and the United Kingdom have limited the acceptance of positive obligations as they relate to the provision of language services in the public sphere. In arguing that language rights are distinct in nature, the thesis suggests that in order for language rights to be effectively realised, an approach to language rights and language legislation more generally must be underpinned by a substantive vision of equality, otherwise language rights and legislative provisions merely amount to symbolic recognition and vacuous rhetoric as opposed to being substantive and enabling rights and provisions. Having said that, the thesis also recognises and elucidates the practical difficulties that arise in the realisation of language rights and language legislative provisions and in doing so seeks to stimulate further dialogue about the nature and limits of language rights and language legislation.

Self-neglect: a case study and implications for clinical practice

Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.

Specialist and primary care physicians' views on barriers to adequate preparation of patients for renal replacement therapy: a qualitative study.

BACKGROUND: Early preparation for renal replacement therapy (RRT) is recommended for patients with advanced chronic kidney disease (CKD), yet many patients initiate RRT urgently and/or are inadequately prepared. METHODS: We conducted audio-recorded, qualitative, directed telephone interviews of nephrology health care providers (n = 10, nephrologists, physician assistants, and nurses) and primary care physicians (PCPs, n = 4) to identify modifiable challenges to optimal RRT preparation to inform future interventions. We recruited providers from public safety-net hospital-based and community-based nephrology and primary care practices. We asked providers open-ended questions to assess their perceived challenges and their views on the role of PCPs and nephrologist-PCP collaboration in patients' RRT preparation. Two independent and trained abstractors coded transcribed audio-recorded interviews and identified major themes. RESULTS: Nephrology providers identified several factors contributing to patients' suboptimal RRT preparation, including health system resources (e.g., limited time for preparation, referral process delays, and poorly integrated nephrology and primary care), provider skills (e.g., their difficulty explaining CKD to patients), and patient attitudes and cultural differences (e.g., their poor understanding and acceptance of their CKD and its treatment options, their low perceived urgency for RRT preparation; their negative perceptions about RRT, lack of trust, or language differences). PCPs desired more involvement in preparation to ensure RRT transitions could be as "smooth as possible", including providing patients with emotional support, helping patients weigh RRT options, and affirming nephrologist recommendations. Both nephrology providers and PCPs desired improved collaboration, including better information exchange and delineation of roles during the RRT preparation process. CONCLUSIONS: Nephrology and primary care providers identified health system resources, provider skills, and patient attitudes and cultural differences as challenges to patients' optimal RRT preparation. Interventions to improve these factors may improve patients' preparation and initiation of optimal RRTs.

Exploring strategies for promoting the use of research findings in practice

Following the integration of nurse and midwifery education into institutions of higher education in the United Kingdom, a number of studies have shown that a defined clinical framework for nursing and midwifery lecturers in practice areas is lacking. The aim of this study was to explore strategies that nurse and midwifery lecturers from one higher education institution in south east England can use to work collaboratively with nurses and midwives to promote the utilization of research findings in practice. A cross-sectional survey using a structured questionnaire was sent to a sample of 60 nurse and midwifery lecturers and 90 clinical managers. Response rates of 67% (40) and 69% (62) respectively were obtained. The main strategies suggested were to make clinical staff more aware of what research exist in their specialties; to help them to access research information from research databases; and to critically appraise this information. Other strategies were for teachers to run research workshops on site; to undertake joint research projects with clinical staff; to set up journal clubs or research interest groups; and to help formulate clinical guidelines and protocols which are explicitly research-based.

Increasing research evidence in practice: a possible role for the consultant nurse

Aims: To determine the extent to which clinical nursing practice has adopted research evidence. To identify barriers to the application of research findings in practice and to propose ways of overcoming these barriers. Background: Way back in 1976, nursing and midwifery practice started adopting research evidence. By 1990s, there was some transparency of research evidence in practice, but more could have been done to widen its adoption. Many barriers were identified which could hinder implementation of the evidence in practice, and the effort to remove these remains weak. Evaluation: 25 research articles from across Europe and America were selected, and scrutinized, and recommendations analysed. Findings: Many clinical practitioners report a lack of time, ability and motivation to appraise research reports and adopt findings in practice. The clinical environment was not seen as research friendly as there were a general lack of research activities and facilities locally. There was a clear lack of research leadership in practice. Implication for nursing management: This paper reviewed the research evidence from several published research papers and provides consultant nurses with practical suggestions on how to enhance research evidence application in their practice. It recommends how consultant nurses can make their practice more research transparent by providing the required leadership, creating a research-friendly organization, developing a clear research agenda and facilitating staff develop a local research framework for reading research and implementing research evidence in their practice.

Exploring strategies for promoting the use of research findings in practice

Following the integration of nurse and midwifery education into institutions of higher education in the United Kingdom, a number of studies have shown that a defined clinical framework for nursing and midwifery lecturers in practice areas is lacking. The aim of this study was to explore strategies that nurse and midwifery lecturers from one higher education institution in south east England can use to work collaboratively with nurses and midwives to promote the utilization of research findings in practice. A cross-sectional survey using a structured questionnaire was sent to a sample of 60 nurse and midwifery lecturers and 90 clinical managers. Response rates of 67% (40) and 69% (62) respectively were obtained. The main strategies suggested were to make clinical staff more aware of what research exist in their specialties; to help them to access research information from research databases; and to critically appraise this information. Other strategies were for teachers to run research workshops on site; to undertake joint research projects with clinical staff; to set up journal clubs or research interest groups; and to help formulate clinical guidelines and protocols which are explicitly research-based.

Drug calculations part 1: a critique of the formula used by nurses

The role of mathematics is integral to nursing practice, and careful and accurate calculations are important to help prevent medication errors. This two-part article examines different methods for solving drug calculation problems. The first part critiques the commonly taught nursing drug calculation formula. Part 2, to be published next week, explores a range of other methods that are used in practice to calculate drug dosages.

Can effective teaching and learning strategies help student nurses to retain drug calculation skills?

Student nurses need to develop and retain drug calculation skills in order accurately to calculate drug dosages in clinical practice. If student nurses are to qualify and be fit to practise accurate drug calculation skills, then educational strategies need to not only show that the skills of student nurses have improved but that these skills have been retained over a period of time. A quasi-experimental approach was used to test the effectiveness of a range of strategies in improving retention of drug calculation skills. The results from an IV additive drug calculation test were used to compare the drug calculation skills of student nurses between two groups of students who had received different approaches to teaching drug calculation skills. The sample group received specific teaching and learning strategies in relation to drug calculation skills and the second group received only lectures on drug calculation skills. All test results for students were anonymous. The results from the test for both groups were statistically analysed using the Mann Whitney test to ascertain whether the range of strategies improved the results for the IV additive test. The results were further analysed and compared to ascertain the types and numbers of errors made in each of the sample groups. The results showed that there is a highly significant difference between the two samples using a two-tailed test (U=39.5, p<0.001). The strategies implemented therefore did make a difference to the retention of drug calculation skills in the students in the intervention group. Further research is required into the retention of drug calculation skills by students and nurses, but there does appears to be evidence to suggest that sound teaching and learning strategies do result in better retention of drug calculation skills.

Advanced scrub practitioner toolkit

Toolkit for operating department staff and operating departments for role development NAASP (National Association Of Assistants In Surgical Practice) advanced practitioner toolkit provides outline strategies and a framework within the advanced scrub practitioner (ASP) role can be developed. this document defines the range of knowledge and skills required and sets the standards of practice for the ASP.