Job satisfaction, stress and burnout in haemodialysis nurses

Haemodialysis nurses provide health care for people with end stage kidney disease leading to a unique, intense and complex interaction between nurses and patients. This study involved the development of a model which explains the relationships between the work environment, job satisfaction, stress and burnout of haemodialysis nurses in Australia and New Zealand. Results from this study identified that haemodialysis nurses, while being satisfied by their jobs, were also experiencing high levels of burnout. This study's novel contribution could lead to improving the retention of the nursing workforce which is crucial due to the growing global burden of chronic disease.

“They are like family”: The emotional cost experienced by nurses when caring for haemodialysis patients

Background Haemodialysis (HD) nursing is characterised by frequent, intense interactions with patients over long periods of time resulting in a unique nurse-patient relationship. Due to the life-limiting nature of end-stage renal failure, nurses are likely to have repeated exposures to the death of patients with whom they have formed relationships. Repeated exposure to patient death translates into frequent grief experiences. There is scant literature on the psychological impact of patient death for nurses working in the HD setting. Aims To explore HD nurses experiences of patient death and coping mechanisms used. Methods A sequential mixed method study investigating job satisfaction, stress and burnout found that HD nurses had high levels of stress and burnout. These results were explored in more detail during 8 semi-structured interviews with HD nurses. Interviews were audio-recorded, transcribed verbatim and subjected to thematic analysis. Results Three themes were identified that highlight the stress experienced by nurses when a haemodialysis patient dies. The first theme, “quazi-family” describes the close relationship which forms between nurses and patients. The “complicated grief” theme outlines the impact of death on HD nurses, and the final theme, “remembrance” explains some of the coping mechanisms used in the grieving process. Conclusion Nurses develop individual coping mechanisms to accommodate the grief and loss experienced when a “close” patient dies. The grieving process caused by the death of patient’s needs to be recognised by nurses and nurse managers as causing psychological stress and strain.

An evaluation of the effectiveness of Value-at-Risk (VaR) models for Australian banks under Basel III

This study compares Value-at-Risk (VaR) measures for Australian banks over a period that includes the Global Financial Crisis (GFC) to determine whether the methodology and parameter selection are important for capital adequacy holdings that will ultimately support a bank in a crisis period. VaR methodology promoted under Basel II was largely criticised during the GFC for its failure to capture downside risk. However, results from this study indicate that 1-year parametric and historical models produce better measures of VaR than models with longer time frames. VaR estimates produced using Monte Carlo simulations show a high percentage of violations but with lower average magnitude of a violation when they occur. VaR estimates produced by the ARMA GARCH model also show a relatively high percentage of violations, however, the average magnitude of a violation is quite low. Our findings support the design of the revised Basel II VaR methodology which has also been adopted under Basel III.

Is there a link between poverty and food security?

This paper addresses the gap in economic theory underlying the multidimensional concept of food security and observed data by deriving a composite food security index using the latent class model. The link between poverty and food security is then examined using the new food security index and the robustness of the link is compared with two unidimensional measures often used in the literature. Using Vietnam as a case study, it was found that a weak link exists for the rural but not for the urban composite food security index. The unidimensional measures on the other hand show a strong link in both the rural and urban regions. The results on the link are also different and mixed when two poverty types given by persistent and transient poverty are considered. These findings have important policy implications for a targeted approach to addressing food security.

Effectiveness of on-line resources to enhance student learning and engagement

BACKGROUND For engineering graduates to be work-ready with marketable skills they must not only be well-versed with engineering science and its applications, but also able to adapt to using commercial software that is widely used in engineering practice. Hydrological/hydraulic modelling is one aspect of engineering practice which demands the ability to apply fundamentals into design and construction using software. The user manuals for such software are usually tailored for the experienced engineer but not for undergraduates who typically are novices to concepts of modelling and software tools. As the focus of a course such as Advanced Water Engineering is on the wider aspects of engineering application of hydrological and hydraulic concepts, it is ineffective for the lecturers to direct the students to user manuals as students have neither the time nor the desire to sift through numerous pages in a manual. An alternative and efficient way to demonstrate the use of the software is enabling students to develop a model to simulate real-world scenario using the tools of the software and directing them to make informed decisions based on outcomes. PURPOSE Past experience of the lecturer showed that the resources available for the students left a knowledge gap leading to numerous student queries outside contact hours. The purpose of this study is to assess how effective purpose-built video resources can be in supplementing the traditional learning resources to enhance student learning. APPROACH Short-length animated video clips comprising guided step-by-step instructions were prepared using screen capture software to capture screen activity and later edited to focus on specific features using pop-up annotations; Vocal narration was purposely excluded to avoid disturbances due to noise and allow different learning paces of individual students. The video clips were made available to the students alongside the traditional resources/approaches such as in-class demonstrations, guideline notes, and tips for efficient and error-free procedural descriptions. The number of queries the lecturer received from the student cohort outside the lecture times was recorded. An anonymous survey to assess the usefulness and adequacy of the courseware was conducted. OUTCOMES While a significant decline in the number of student queries was noted, an overwhelming majority of the survey respondents confirmed the usefulness of the purpose-developed courseware. CONCLUSIONS/RECOMMENDATIONS/SUMMARY The survey and lecturer’s experience indicated that animated demonstration video clips illustrating the various steps involved in developing hydrologic and hydraulic models and simulating design scenarios is an effective supplement for traditional learning resources. Among the many advantages of the custom-made video clips as a learning resource are that they (1) highlight the aspects that are important to undergraduate learning but not available in the software manuals as the latter are designed for more mature users/learners; (2) provide short, to-the point communication in a step-by-step manner; (3) allow students flexibility to self-learn at their own pace; (4) enhance student learning; and (5) enable time savings for the lecturer in the long term by avoiding queries of a repetitive nature. It is expected that these newly developed resources will be improved to incorporate students’ suggestions before being offered to future cohorts of students. The concept can also be expanded to other relevant courses where animated demonstrations of key modelling steps are beneficial to student learning.

PREPARE Study: Patient satisfaction survey with care provided in the low clearance clinic

Background Formalised predialysis care has been shown to extend the wellness of individuals with advanced chronic kidney disease, slow disease progression and increase the uptake of home dialysis. Predialysis care, incorporating multidisciplinary input is also vital in delaying the onset of end-stage kidney disease and reducing hospital admissions; thereby decreasing financial demands on health budgets. Predialysis care should include comprehensive information provision and predialysis education. This empowers patients to choose self-care strategies and therapies.

Self-management support for people with chronic kidney disease: Patient perspectives

Background Self-management of chronic kidney disease (CKD) is crucial for health outcomes and people need to be effectively supported by healthcare professionals (HCPs). Some programmes designed to improve self-management have been implemented, but people with the disease are rarely consulted regarding what they desire from these programmes. Objectives To provide a synthesis of the literature on preferences for self-management support of people with CKD. Design An integrative review. Methods Four databases (MedLine, CINAHL, PsycARTICLES and PsycINFO) were searched using relevant search terms. Results The search strategy identified 1,913 records, of which 12 studies met inclusion criteria. Ten themes were identified as important areas to be addressed by self-management interventions. In addition, patient suggestions for implementation of such interventions are discussed. Conclusion The principles of a person-centred approach ought to frame the support provided by HCPs when supporting those with CKD to better self-manage.

Regulating against corporate phoenix activity

This paper considers the adequacy and efficiency of existing legal and regulatory frameworks to deal with corporate phoenix activity. Phoenix activity, which is often triggered by a solvency crisis, is estimated to cost the Australian economy up to $3 billion each year. Despite the raft of piecemeal Australian legislation directed at this activity, phoenix activity does not appear to be abating. This paper considers regulatory approaches to detection and enforcement of the underlying law. This study reveals and explores a perception that the law is deficient, and the tension that exists between the adequacy of the law and the regulatory approach.

Working covariance model selection for generalized estimating equations

We investigate methods for data-based selection of working covariance models in the analysis of correlated data with generalized estimating equations. We study two selection criteria: Gaussian pseudolikelihood and a geodesic distance based on discrepancy between model-sensitive and model-robust regression parameter covariance estimators. The Gaussian pseudolikelihood is found in simulation to be reasonably sensitive for several response distributions and noncanonical mean-variance relations for longitudinal data. Application is also made to a clinical dataset. Assessment of adequacy of both correlation and variance models for longitudinal data should be routine in applications, and we describe open-source software supporting this practice.

Fluorescence-polarization studies on binding of 4-methylumbelliferyl beta-D-galactopyranoside to Ricinus communis (castor-bean) agglutinin

The binding of Ricinus communis (castor-bean) agglutinin 1 to saccharides was studied by equilibrium dialysis and fluorescence polarization by using the fluorescently labelled sugar 4-methylumbelliferyl beta-D-galactopyranoside. No appreciable change in ligand fluorescence of 4-methylumbelliferyl beta-D-galactopyranoside was considerably polarized on its binding to the lectin. The association constants obtained by Scatchard analysis of equilibrium-dialysis and fluorescence-polarization data do not differ much from each other, and at 25 degrees C, Ka = 2.4 (+/- 0.2) X 10(4)M-1. These values agree reasonably well with that reported in the literature for Ricinus agglutinin 1. The number of binding sites obtained by the different experimental procedures is 1.94 +/- 0.1 per molecule of 120 000 daltons and is equal to the reported value of 2. The consistency in the values of Ka and number of binding sites indicate the absence of additional subsites on Ricinus agglutinin 1 for its specific sugars. In addition, the excellent agreement between the binding parameters obtained by equilibrium dialysis and fluorescence polarization indicate the potential of ligand-fluorescence-polarization measurements in the investigation of lectin-sugar interactions.

Presence of nucleoside triphosphates and calcium associated with mycobacteriophage I3

The association of nucleoside triphosphate molecules and calcium ions with purified particles of mycobacteriophage I3 has been documented. The content of nucleoside triphosphate has been determined to be 118 molecules per phage particle by equilibrium dialysis against labelled ATP or 148 molecules per phage particle by the direct determination of labelled nucleoside triphosphate.The concentration of bound Ca2+ exhibited a high degree of variation between different batches, which may be due to the nonspecific binding of Ca2+ by the virus particles. However, the tightly bound Ca2+ not removable by dialysis against calciumspecific chelating agent, showed a constant value of 2985 atoms/phage particle.

Chemical approach to aspirin hypersensitivity

Rabbits and guinea pigs were immunized with functionalized aspirin-protein conjugates prepared by coupling 5-N-Succinylamino aspirin to BSA and BGG using a water soluble carbodiimide (EDC). Two populations of antibodies, one specific to functionalized aspirin and the other exclusively specific to salicylic acid were detected. These antibodies were fractionated and separated on affinity polymers suitably prepared with 5-N-succinylamino salicylic acid and 5-N-succinylamino-2-ethoxy benzoic acid as the ligands. The isolated and purified antibodies were electrophoretically homogeneous. The physico chemical interactions between the antibodies and the respective haptens were studied by radio-immunoassay, equilibrium dialysis and fluorescence quenching techniques.

Lagöversättning som process och produkt : Revideringar och institutioner vid lagöversättning till svenska i Finland

The thesis studies the translation process for the laws of Finland as they are translated from Finnish into Swedish. The focus is on revision practices, norms and workplace procedures. The translation process studied covers three institutions and four revisions. In three separate studies the translation process is analyzed from the perspective of the translations, the institutions and the actors. The general theoretical framework is Descriptive Translation Studies. For the analysis of revisions made in versions of the Swedish translation of Finnish laws, a model is developed covering five grammatical categories (textual revisions, syntactic revisions, lexical revisions, morphological revisions and content revisions) and four norms (legal adequacy, correct translation, correct language and readability). A separate questionnaire-based study was carried out with translators and revisers at the three institutions. The results show that the number of revisions does not decrease during the translation process, and no division of labour can be seen at the different stages. This is somewhat surprising if the revision process is regarded as one of quality control. Instead, all revisers make revisions on every level of the text. Further, the revisions do not necessarily imply errors in the translations but are often the result of revisers following different norms for legal translation. The informal structure of the institutions and its impact on communication, visibility and workplace practices was studied from the perspective of organization theory. The results show weaknesses in the communicative situation, which affect the co-operation both between institutions and individuals. Individual attitudes towards norms and their relative authority also vary, in the sense that revisers largely prioritize legal adequacy whereas translators give linguistic norms a higher value. Further, multi-professional teamwork in the institutions studied shows a kind of teamwork based on individuals and institutions doing specific tasks with only little contact with others. This shows that the established definitions of teamwork, with people co-working in close contact with each other, cannot directly be applied to the workplace procedures in the translation process studied. Three new concepts are introduced: flerstegsrevidering (multi-stage revision), revideringskedja (revision chain) and normsyn (norm attitude). The study seeks to make a contribution to our knowledge of legal translation, translation processes, institutional translation, revision practices and translation norms for legal translation. Keywords: legal translation, translation of laws, institutional translation, revision, revision practices, norms, teamwork, organizational informal structure, translation process, translation sociology, multilingual.

Feeding mode of Australian infants in the first 12 months of life: An assessment against national breastfeeding indicators

Background: In 2011, Australia published a set of 6 population-level indicators assessing breastfeeding, formula use, and the introduction of soft/semisolid/solid foods. Objectives: This study aimed to report the feeding practices of Australian infants against these indicators and determine the predictors of early breastfeeding cessation and introduction of solids. Methods: Mother–infant dyads (N = 1470) were recruited postnatally in 2 Australian capital cities and regional areas of 1 state between February 2008 and March 2009. Demographic and feeding intention data were collected by self-completed questionnaire at infant birth, with feeding practices (current feeding mode, age of breastfeeding cessation, age of formula and/or solids introduction) reported when the infant was between 4 and 7 months of age, and around 13 months of age. Multiple logistic regression was used to determine the predictors of breastfeeding cessation and solids introduction. Results: Although initiation of breastfeeding was almost universal (93.3%), less than half of the infants were breastfed to 6 months (41.7%) and 33.3% were receiving solids by 4 months. Women who were socially disadvantaged, younger, less educated, unpartnered, primiparous, and/or overweight were most likely to have ceased breastfeeding before 6 months of age, and younger and/or less educated women were most likely to have introduced solid food by 4 months of age. Not producing adequate milk was the most common reason provided for cessation of breastfeeding. Conclusion: The feeding behaviors of Australian infants in the first 12 months fall well short of recommendations. Women need anticipatory guidance as to the indicators of breastfeeding success and the tendency of women to doubt the adequacy of their breast milk supply warrants further investigation.

Rationale of Length Scale-Down Model Span Testing of Transmission Lines

Length scale-down (LS) model tests have been traditionally employed for laboratory studies on aeolian vibration of transmission line conductors. The span adopted is normally 30 m and is recommended by the relevant Indian, as well as other, standards. The traditionally adopted length of the LS model is reexamined herein to establish the rationale behind the choice. Based on the theoretical studies discussed, certain guidelines for the choice of model span of conductor are emphasized. In addition, the adequacy of the LS span as a tool for predicting the performance of the full span is reestablished.