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Modelling end-of-life care practices: Factors associated with critical care nurse engagement in care provision

Objective To identify factors associated with critical care nurses’ engagement in end-of-life care practices. Methods Multivariable regression modelling was undertaken on 392 responses to an online self-report survey of end-of-life care practices and factors influencing practice by Australian critical care nurses’. Univariate general linear models were built for six end-of-life care practice areas. Results Six statistically significant (p < 0.001) models were developed: Information sharing F(3, 377) = 40.53, adjusted R2 23.8%; Environmental modification F(5, 380) = 19.55, adjusted R2 19.4%; Emotional support F(10, 366) = 12.10, adjusted R2 22.8%; Patient and family centred decision making F(8, 362) = 17.61 adjusted R2 26.4%; Symptom management F(8, 376) = 7.10, adjusted R2 11.3%; and Spiritual support F(9, 367) = 14.66, adjusted R2 24.6%. Stronger agreement with values consistent with a palliative approach, and greater support for patient and family preferences were associated with higher levels of engagement in end-of-life care practices. Higher levels of preparedness and access to opportunities for knowledge acquisition were associated with engagement in the interpersonal practices of patient and family centred decision making and emotional support. Conclusion This study provides evidence for interventions to address factors associated with nurse engagement to increase participation in all end-of-life care practice areas.

The experience of Indigenous students in a Bachelor of Nursing Program in Australia: cultural safety and decolonising nurse education

Background In Australia significant health inequalities, such as an 11year life expectancy gap, impact on the continent’s traditional owners, the Aboriginal peoples and Torres Strait Islanders. Evidence suggests links between improved Indigenous health and a greater proportion of Indigenous people employed in all sectors. Achieving a greater proportion of Indigenous people in health services and in the health education workforce, requires improved higher education completion rates. Currently Indigenous people are under-represented in higher education and attrition rates amongst those who do participate are high. We argue these circumstances make health and education matters of social justice, largely related to unexamined relations of power within universities where the pedagogical and social environment revolve around the norms and common-sense of the dominant culture. Project Research at Queensland University of Technology in 2010-2012, aimed to gain insights into attrition/retention in the Bachelor of Nursing. A literature review on Indigenous participation in higher education in nursing contextualised a mixed methods study. The project examined enrolment, attrition and success by an analysis of enrolment data from 1984-2012. Using Indigenous Research Assistants we then conducted 20 in-depth interviews with Indigenous students followed by a thematic analysis seeking to gain insights into the impact of students’ university experience on retention. Our findings indicate that cultural safety, mentorship, acceptance and support are crucial in student academic success. They also indicate that inflexible systems based on ethnocentric assumptions exacerbate the structural issues that impact on the students’ everyday life and are also part of the story of attrition. The findings reinforced the assumption that educational environments and processes are inherently cultural and political. This perspective calls into question the role of the students’ cultural experience at university in attrition rates. A partnership between the School of Nursing and the Indigenous Education Unit is working to better support Indigenous students.

Factors influencing sustainability of health service innovation, emergency nurse practitioner service

Escalating health care delivery costs and consumer expectations have led to a range of health service and workforce innovations in the provision of high quality cost effective patient care. This research has operationalised a theoretical framework to examine factors that influence sustainability of health service innovations, in particular, emergency nurse practitioner service. The results of this research will inform health service policy and practice for future implementation of innovative workforce models and add to the understanding of factors that influence sustainability.

A randomised controlled clinical trial of a post-discharge, nurse-led educational intervention to reduce anxiety and enhance self-efficacy in percutaneous coronary intervention (PCI) patients within the first week post-discharge: A pilot study

This research investigated the efficacy of a post-discharge nurse-led clinic, for patients who underwent a cardiovascular interventional procedure in Australia. A randomised controlled clinical trial measured the effects of the clinic on patient confidence to self-manage and minimise psychological distress given the strong link between anxiety, depression and coronary heart disease. Hospitalisation for the procedure is short and stressful, and patients may wait up to 7-64 days for post-discharge review. This study provides preliminary quantitative and qualitative evidence that nurse-led clinics undertaken within the first week post-percutaneous coronary intervention may fill a much-needed gap for patients during a potentially vulnerable period.

Negative differential resistance in GaN nanocrystals above room temperature

Negative differential resistance (NDR) has been observed for the first time above room temperature in gallium nitride nanocrystals synthesized by a simple chemical route. Current-voltage characteristics have been used to investigate this effect through a metal-semiconductor-metal (M-S-M) configuration on SiO2. The NDR effect is reversible and reproducible through many cycles. The threshold voltage is similar to 7 V above room temperature.

Physicochemical, Electrochemical, and Spectroscopic Characterization of Zinc-Based Room-Temperature Molten Electrolytes and Their Application in Rechargeable Batteries

Room-temperature zinc ion-conducting molten electrolytes based on acetamide, urea, and zinc perchlorate or zinc triflate have been prepared and characterized by various physicochemical, spectroscopic, and electrochemical techniques. The ternary molten electrolytes are easy to prepare and can be handled under ambient conditions. They show excellent stability, high ionic conductivity, relatively low viscosity, and other favorable physicochemical and electrochemical properties that make them good electrolytes for rechargeable zinc batteries. Specific conductivities of 3.4 and 0.5 mS cm(-1) at 25 degrees C are obtained for zinc-perchlorate-and zinc-triflate-containing melts, respectively. Vibrational spectroscopic data reveal that the free ion concentration is high in the optimized composition. Rechargeable Zn batteries have been assembled using the molten electrolytes, with gamma-MnO2 as the positive electrode and Zn as the negative electrode. They show excellent electrochemical characteristics with high discharge capacities. This study opens up the possibility of using acetamide-based molten electrolytes as alternate electrolytes in rechargeable zinc batteries. (C) 2009 The Electrochemical Society.

A green protocol for room temperature synthesis of silver nanoparticles in seconds

We describe here a rapid, energy-efficient, green and economically scalable room temperature protocol for the synthesis of silver nanoparticles. Tannic acid, a polyphenolic compound derived from plant extracts is used as the reducing agent. Silver nanoparticles of mean size ranging from 3.3 to 22.1 nm were synthesized at room temperature by the addition of silver nitrate to tannic acid solution maintained at an alkaline pH. The mean size was tuned by varying the molar ratio of tannic acid to silver nitrate. We also present proof of concept results demonstrating its suitability for room temperature continuous flow processing.

Synthesis of ZnO Nanoneedles on Flexible Polymer Substrates at Room Temperature by Activated Reactive Evaporation

ZnO nanoneedles were successfully deposited on flexible polymer substrates at room temperature by activated reactive evaporation. Neither a catalyst nor a template was employed in this synthesis. These synthesized needles measured 500 - 600 nm in length and its diameter varied from 30 - 15 nm from the base to the tip. The single-crystalline nature of the nanoneedle was observed by high-resolution transmission electron microscopy studies. The Raman studies on these nanoneedles had shown that they are oxygen deficient in nature. A possible growth mechanism has been proposed here, in which the nanoneedles nucleate and grow in the gas phase by vapor-solid mechanism.

Magnesium ion conducting, room temperature molten electrolytes

Room temperature, magnesium ion conducting binary molten electrolyte consisting of acetamide and magnesium perchlorate has been prepared and characterized. The molten liquid is very stable and shows high ionic conductivity, of the order of several mS cm(-1) at 25 degrees C with other favourable physicochemical properties. Vibrational spectroscopic studies reveal that the free ion concentration is higher than that of ion pairs and aggregates in the melt. The electrochemical reversibility of magnesium deposition and dissolution is demonstrated using voltammetry and impedance studies. Preliminary studies on rechargeable batteries assembled using gamma-MnO2 and Mg metal as the electrodes together with the molten electrolyte show high discharge capacity.

Cu2+-induced room temperature hydrogen release from ammonia borane

Mechanical stirring of ammonia borane with CuCl2 in the solid state resulted in the release of hydrogen at room temperature through the intermediacy of [NH4](+)[BCl4](-).

Reducing luminance contrast on the window wall and users’ interventions in an office room

High luminance contrast between windows and surrounding surfaces could cause discomfort glare, which could reduce office workers’ productivity. It might also increase energy usage of buildings due to occupants’ interventions in lighting conditions to improve indoor visual quality. It is presumed that increasing the luminance of the areas surrounding the windows using a supplementary system, such Light Emitting Diodes (LEDs), could reduce discomfort glare. This paper reports on the results of a pilot study in a conventional office in Brisbane, Australia. The outcomes of this study indicated that a supplementary LED system could reduce the luminance contrast on the window wall from values in the order of 24:1 to 12:1. The results suggest that this reduction could significantly reduce discomfort glare from windows, as well as diminishing the likelihood of users’ intention to turn on the ceiling lights and/ or to move the blind down.

Multicarrier conduction and Boltzmann transport analysis of heavy hole mobility in HgCdTe near room temperature

Magnetotransport measurements in pulsed fields up to 15 T have been performed on mercury cadmium telluride (Hg1-xCdxTe, x similar to 0.2) bulk as well as liquid phase epitaxially grown samples to obtain the resistivity and conductivity tensors in the temperature range 220-300 K. Mobilities and densities of various carriers participating in conduction have been extracted using both conventional multicarrier fitting (MCF) and mobility spectrum analysis. The fits to experimental data, particularly at the highest magnetic fields, were substantially improved when MCF is applied to minimize errors simultaneously on both resistivity and conductivity tensors. The semiclassical Boltzmann transport equation has been solved without using adjustable parameters by incorporating the following scattering mechanisms to fit the mobility: ionized impurity, polar and nonpolar optical phonons, acoustic deformation potential, and alloy disorder. Compared to previous estimates based on the relaxation time approximation with outscattering only, polar optical scattering and ionized impurity scattering limited mobilities are shown to be larger due to the correct incorporation of the inscattering term taking into account the overlap integrals in the valence band.