Scoping workplace aggression in nursing : findings from an Australian study

Aim This paper reports a study of workplace aggression among nurses in Tasmania, Australia. Background There is international concern about a perceived rise in occupational violence as a major worldwide public health problem, with associated financial costs. There is reason to suspect that aggression towards nurses is increasing. For example, increased illicit drug use puts nurses at the sharp end in managing patients admitted with drug-related problems. Such people are often resistant to healthcare intervention, and often have associated disorders, including mental illness. Despite this increased awareness, comprehensive data on occupational violence in nursing are not available. Method A specially designed questionnaire was sent to all nurses registered with the Nursing Board of Tasmania (n ¼ 6326) in November/December 2002, with 2407 usable questionnaires returned. The response rate was 38%. Findings A majority of respondents (63Æ5%) had experienced some form of aggression (verbal or physical abuse) in the four working weeks immediately prior to the survey. Patients/clients or their visitors were identified as the main perpetrators, followed by medical and nursing colleagues. Abuse influenced nurses’ distress, their desire to stay in nursing, their productivity and the potential to make errors, yet they were reluctant to make their complaints ‘official’. As well as reporting high levels of verbal and physical abuse, nurses were distressed because they could not provide the appropriate care to meet patients’ needs. Few working environments were free of aggression. Conclusion Future research should try to determine the specific factors, including staff characteristics and environment, associated with the high levels of aggression reported in ‘hot spots’ where, on the basis of the present results, many staff experience high levels of verbal and physical abuse. Unless managers take steps to improve the situation, attrition from the profession for this reason will continue.

Activation of the canonical Wnt signaling pathway induces cementum regeneration

Canonical Wnt signaling is important in tooth development but it is unclear whether it can induce cementogenesis and promote the regeneration of periodontal tissues lost due to disease. Therefore, the aim of this study is to investigate the influence of canonical Wnt signaling enhancers on human periodontal ligament cell (hPDLCs) cementogenic differentiation in vitro and cementum repair in a rat periodontal defect model. Canonical Wnt signaling was induced by (i) local injection of lithium chloride; (ii) local injection of sclerostin antibody; and (iii) local injection of a lentiviral construct overexpressing β-catenin. The results showed that the local activation of canonical Wnt signaling resulted in significant new cellular cementum deposition and the formation of well-organized periodontal ligament fibers, which was absent in the control group. In vitro experiments using hPDLCs showed that the Wnt signaling pathway activators significantly increased mineralization, alkaline phosphatase (ALP) activity, and gene and protein expression of the bone and cementum markers osteocalcin (OCN), osteopontin (OPN), cementum protein 1 (CEMP1), and cementum attachment protein (CAP). Our results show that the activation of the canonical Wnt signaling pathway can induce in vivo cementum regeneration and in vitro cementogenic differentiation of hPDLCs.

Strenthening information literacy through collaboration: Implications for AIM

Because of its size, its excellent VET history, and its emerging higher education provision, AIM is in a special position to be an exemplar of good practice in the VET-HE transition. Many dual sector providers, by virtue of their size, tend to focus on higher education, on the assumption that VET ‘competence’ implies that their VET entrants to HE are confident and capable in information literacy skills. While this is only one of the many challenges that such students face in their undergraduate programs, it is the most critical for most of them in their quest for academic success. All students (school leavers, gap-year participants, articulating, mature age) entering HE will face specific challenges. For articulating students, the nature of credit transfer arrangements will often mean they commence studies in units that are not designated first year units. In this case, the embedded support structures are not as prominent. The existing literature is not consistent in reports on the rates of completion, retention and attrition of articulating students. There is some evidence that VET-qualified students have higher retention rates than school leavers [1], but limited information literacy skills can lead to attrition [2].

Who are our repeating students? Profiling students persisting after failure

Research on attrition has focused on the economic significance of low graduation rates in terms of costs to students (fees that do not culminate in a credential) and impact on future income. For a student who fails a unit and repeats the unit multiple times, the financial impact is significant and lasting (Bexley, Daroesman, Arkoudis & James 2013). There are obvious advantages for the timely completion of a degree, both for the student and the institution. Advantages to students include fee minimisation, enhanced engagement opportunities, effectual pathway to employment and a sense of worth, morale and cohort-identity benefits. Work undertaken by the QUT Analytics Project in 2013 and 2014 explored student engagement patterns capturing a variety of data sources and specifically, the use of LMS amongst students in 804 undergraduate units in one semester. Units with high failure rates were given further attention and it was found that students who were repeating a unit were less likely to pass the unit than students attempting it for the first time. In this repeating cohort, academic and behavioural variables were consistently more significant in the modelling than were any demographic variables, indicating that a student’s performance at university is far more impacted by what they do once they arrive than it is by where they come from. The aim of this poster session is to examine the findings and commonalities of a number of case studies that articulated the engagement activities of repeating students (which included collating data from Individual Unit Reports, academic and peer advising programs and engagement with virtual learning resources). Understanding the profile of the repeating student cohort is therefore as important as considering the characteristics of successful students so that the institution might be better placed to target the repeating students and make proactive interventions as early as possible.

Language Literacy and Numeracy in TAFE Diploma of Nursing (Enrolled/Division 2 Nursing)

This project aimed to identify current Language Literacy and Numeracy (LLN) and Inclusive Teaching and Learning Practices in a TAFE Diploma of Nursing (Enrolled/Division 2 Nursing). The key purpose of the study was to make recommendations for improving inclusive teaching practice and learning outcomes of students and for reducing student attrition, thereby increasing the employability of graduates in the health industry subsequent to course completion.

Shaping development through mechanical strain: The transcriptional basis of diet-induced phenotypic plasticity in a cichlid fish

Adaptive phenotypic plasticity, the ability of an organism to change its phenotype to match local environments, is increasingly recognized for its contribution to evolution. However, few empirical studies have explored the molecular basis of plastic traits. The East African cichlid fish Astatoreochromis alluaudi displays adaptive phenotypic plasticity in its pharyngeal jaw apparatus, a structure that is widely seen as an evolutionary key innovation that has contributed to the remarkable diversity of cichlid fishes. It has previously been shown that in response to different diets, the pharyngeal jaws change their size, shape and dentition: hard diets induce an adaptive robust molariform tooth phenotype with short jaws and strong internal bone structures, while soft diets induce a gracile papilliform tooth phenotype with elongated jaws and slender internal bone structures. To gain insight into the molecular underpinnings of these adaptations and enable future investigations of the role that phenotypic plasticity plays during the formation of adaptive radiations, the transcriptomes of the two divergent jaw phenotypes were examined. Our study identified a total of 187 genes whose expression differs in response to hard and soft diets, including immediate early genes, extracellular matrix genes and inflammatory factors. Transcriptome results are interpreted in light of expression of candidate genesmarkers for tooth size and shape, bone cells and mechanically sensitive pathways. This study opens up new avenues of research at new levels of biological organization into the roles of phenotypic plasticity during speciation and radiation of cichlid fishes.

Traditional and geometric morphometrics detect morphological variation of lower pharyngeal jaw inCoris julis(Teleostei, Labridae)

In the present study, variation in the morphology of the lower pharyngeal element between two Sicilian populations of the rainbow wrasse Coris julis has been explored by the means of traditional morphometrics for size and geometric morphometrics for shape. Despite close geographical distance and probable high genetic flow between the populations, statistically significant differences have been found both for size and shape. In fact, one population shows a larger lower pharyngeal element that has a larger central tooth. Compared to the other population, this population also has medially enlarged lower pharyngeal jaws with a more pronounced convexity of the medial-posterior margin. The results are discussed in the light of a possible more pronounced durophagy of this population.

Study of surface evolution in the wheel-rail interface

This paper aims to trace surface evolution in the wheel-rail interface using data obtained from a twin-disc testing machine and the surface replication technique. Changes in the surface profile of the rail testing disc are explicitly analysed according to the wear mechanism, which helps elaborate a better understanding of the attrition of asperities during the wearing-in process of surface modification. The surface profile amplitude was seen to decrease during the initial running-in phase of the experiment cycle, and after reaching a saturation value, the profile amplitude then increased. Ultimately the results show that grinding will roughen the rail surface and the wheel-rail contact conditions will then remove this surface damage to some saturation value of the profile height. The variation in the rail surface profile beyond this point is then only dependant on the contact conditions which exist between the wheel and rail during normal operation.

Using the factors that have a positive impact on the retention of low socioeconomic students to prepare accelerated enrolled nurses for the science units of a nursing degree : a practice report

At a campus in a low socioeconomic (SES) area, our University allows enrolled nurses entry into the second year of a Bachelor of Nursing, but attrition is high. Using the factors, described by Yorke and Thomas (2003) to have a positive impact on the attrition of low SES students, we developed strategies to prepare the enrolled nurses for the pharmacology and bioscience units of a nursing degree with the aim of reducing their attrition. As a strategy, the introduction of review lectures of anatomy, physiology and microbiology, was associated with significantly reduced attrition rates. The subsequent introduction of a formative website activity of some basic concepts in bioscience and pharmacology, and a workshop addressing study skills and online resources, were associated with a further reduction in attrition rates of enrolled nursing students in a Bachelor of Nursing.

Autonomy-supportive pedagogical approach to sports coaching: Research, challenges and opportunities

There has been an increasing body of research on autonomy- or need-support specific to a coaching context that warrants some review of what we know and don't know, and what might be generative for future research. The previous studies reviewed within this article have shown consistent support for Self-determination theory with autonomy-supportive environments linked with adaptive outcomes, such as superior performance, enhanced self-worth, increased effort, and self-determined motivation; while controlling environments have been linked with increased attrition and extrinsic motivation or amotivation. In this way, much of the research in autonomy-supportive coaching has focused on the impact of coaching behaviours on athlete outcomes. While this is an important focus of inquiry, there has been a dearth of research examining those causal factors that impact coaches' pedagogical behaviours in the first case. This review underscores the need for future research to examine the antecedents to coaching behaviours, which is central to understanding the complexity and challenges in promoting an autonomy-supportive approach to sport coaching.

Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refi nements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2∙4 billion and 1∙6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537∙6 million in 1990 to 764∙8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114∙87 per 1000 people to 110∙31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013. Interpretation Ageing of the world’s population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to nonfatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.

“Success in (Surviving) Bioscience and Pharmacology” – an eBook to improve the retention of diploma nurses transitioning to a Bachelor of Nursing course

Diploma students transitioning into the NS40 BNursing (BN) course at QUT withdraw from the bioscience and pharmacology units, and leave the university at higher rates than traditional students. The diploma students, entering in second year, have missed out on 2 units of bioscience taught to the traditional students in their first year, and miss out on a 3rd unit of bioscience taught to the traditional students in their 2nd year. Instead the diploma students receive one specialized unit in bioscience only i.e. a bridging unit. As a consequence, the diploma students may not have the depth of bioscience knowledge to be able to successfully study the bridging unit (LSB111) or the pharmacology unit (LSB384). Our plan was to write an eBook which refreshed and reinforced diploma students’ knowledge of bioscience aiming to prepare them with the concepts and terminology, and to build a level of confidence to support their transition to the BN. We have previously developed an intervention associated with reduced attrition of diploma nursing students, and this was our starting point. The study skills part of the initial intervention was addressed in the eBook, by links to the specialist services and resources available from our liaison librarian and academic skills adviser. The introductory bioscience/pharmacology information provided by the previous intervention involved material from standard textbooks. However, we considered this material too difficult for diploma students. Thus, we created simplified diagrams to go with text as part of our eBook. The outcome is an eBook, created and made available to the diploma students via the Community Website: “Surviving Bioscience and Pharmacology”. Using simplified diagrams to illustrate the concise text, definition to explain the concepts, the focus has been on encouraging self-awareness and help-seeking strategies and building students who take responsibility for their learning. All the nursing students in the second semester LSB384 Pharmacology Unit have been surveyed face-to-face to get feedback on their engagement with the eBook resource. The data has not been analysed to date. An important consideration is that the website be evaluated by the diploma students as they come into bioscience in first semester (LSB111), the student population for whom the eBook is primarily intended. To get a good response rate we need to do a face-to-face survey. However, we have not been able to do this, as the co-ordinator of the unit has changed since we started the project, and the present co-ordinator will not allow us access to these students.

The introduction of an Inter-professional learning unit: staff and student perspectives

Background The School of Clinical Sciences comprises a number of health disciplines including podiatry, paramedic science, pharmacy, medical imaging and radiation therapy. A new inter-professional unit was introduced in 2014, which covered key introductory learnings applicable for future health practitioners. This study examined teaching staff and student perspectives about their experience with the new unit for first year students. Methods Qualitative interviews with teaching staff (n=9) and focus group interviews with students (5 groups which ranged in size from 4-30) were conducted. Extensive notes were taken during the interviews Issues emerging from the interviews were identified and organised according to themes and subthemes. Results Four major themes were identified namely: Something new; To be or not to be that is the question; Advantages of the new unit; and Areas for improvement. Previous staff experience with inter-professional learning (IPL) had been ad-hoc, whereas the new unit brought together several disciplines in a planned and deliberate way. There was strong philosophical agreement about the value of IPL but some debate about the extent to which the unit provided IPL experience. The unit was seen as assisting students’ social and academic adjustment to university and provided opportunity for professional socialisation, exposure to macro and micro aspects of the Australian health care system and various types of communication. For podiatry students it was their first opportunity to formally meet and work with other podiatry students and moved their identity from ‘university student’ to ‘podiatry student’. Other positives included providing the opportunity for staff and students to interact at an early stage with the perceived benefit of reducing attrition. Areas for unit improvement included institutional arrangements, unit administration aspects and assessment. Conclusion The unit was seen as beneficial by staff and students however, students were more polarised in their views than staff. There was a tension between feeling apart of and learning about one's own profession and feeling apart of and learning about the roles of other health professionals in relation to patient care and the health care system.

Simulation of the supply capability of sheep on the Mitchell grass downs of north west Queensland

Sheep in western Queensland have been predominantly reared for wool. When wool prices became depressed interest in the sheep meat industry, increased. For north west Queensland producers, opportunities may exist to participate in live sheep and meat export to Asia. A simulation model was developed to determine whether this sheep producing area has the capability to provide sufficient numbers of sheep under variable climatic conditions while sustaining the land resources. Maximum capacity for sustainability of resources (as described by stock numbers) was derived from an in-depth study of the agricultural and pastoral potential of Queensland. Decades of sheep production and climatic data spanning differing seasonal conditions were collated for analysis. A ruminant biology model adapted from Grazplan was used to simulate pregnancy rate. Empirical equations predict mortalities, marking rates, and weight characteristics of sheep of various ages from simple climatic measures, stocking rate and reproductive status. The initial age structure of flocks was determined by running the model for several years with historical climatic conditions. Drought management strategies such as selling a proportion of wethers progressively down to two-tooth and oldest ewes were incorporated. Management decisions such as time of joining, age at which ewes were cast-for-age, wether turn-off age and turning-off rate of lambs vary with geographical area and can be specified at run time. The model is run for sequences of climatic conditions generated stochastically from distributions based on historical climatic data correlated in some instances. The model highlights the difficulties of sustaining a consistent supply of sheep under variable climatic conditions.

Toxicity of dioxin to developing teeth and salivary glands : An experimental study

Dioxins are ubiquitous environmental poisons having unequivocal adverse health effects on various species. The majority of their effects are thought to be mediated by the aryl hydrocarbon receptor (AhR). Developing human teeth may be sensitive to dioxins and the most toxic dioxin congener, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), is developmentally toxic to rodent teeth. Mechanisms of TCDD toxicity can be studied only experimentally. The aim of the present thesis work was to delineate morphological end points of developmental toxicity of TCDD in rat and mouse teeth and salivary glands in vivo and in vitro and to characterize their cellular and molecular background. Mouse embryonic teeth and submandibular gland explants were grown in organ culture without/with TCDD at various concentrations, examined stereomicroscopically and processed for histological examination. The effects of TCDD on cellular mechanisms essential for organogenesis were investigated. The expression of various genes eliciting the response to TCDD exposure or involved in tooth and salivary gland development was studied at the mRNA and/or protein levels by in situ hybridization and immunohistochemistry. Association of the dental effects of TCDD with the resistance of a rat strain to TCDD acute lethality was analyzed in two lactationally exposed rat strains. The effect of TCDD on rat molar tooth mineralization was studied in tissue sections. TCDD dose- and developmental stage-dependently interfered with tooth formation. TCDD prevented early mouse molar tooth morphogenesis and altered cuspal morphology by enhancing programmend cell death, or apoptosis, in dental epithelial cells programmed to undergo apotosis. Cell proliferation was not affected. TCDD impaired mineralization of rat molar dental matrices, possibly by specifically reducing the expression of the mineralization-related dentin sialophosphoprotein gene shown in cultured mouse teeth. The impaired mineralization of rat teeth was accompanied by decreased expression of AhR and the TCDD-inducible xenobiotic-metabolozing enzyme P4501 A1 (CYP1A1), suggesting mediation of the TCDD effect by the AhR pathway. The severe interference by TCDD with rat incisor formation was independent of the genotypic variation of AhR determining the resistance of a rat strain to TCDD acute lethality. The impairment by TCDD of mouse submandibular gland branching morphogenesis was associated with CYP1A1 induction and involved blockage of EGF receptor signalling. In conclusion, TCDD exposure is likely to have activated the AhR pathway in target organs with the consequent activation of other signalling pathways involving developmentally regulated genes. The resultant phenotype is organ specific and modified by epithelial-mesenchymal interactions and dependent on dose as well as the stage of organogenesis at the time of TCDD exposure. Teeth appear to be responsive to TCDD exposure throughout their development.