Perceptions of clinical safety climate of the multicultural nursing workforce in Saudi Arabia : a cross-sectional survey

Purpose The purpose of this study is to explore the safety climate perceptions of the multicultural nursing workforce, and to investigate the influence of diversity of the multicultural nursing workforce on clinical safety in a large tertiary hospital in Saudi Arabia. Background Working in a multicultural environment is challenging. Each culture has its own unique characteristics and dimensions that shape the language, lifestyle, beliefs, values, customs, traditions, and patterns of behaviour, which expatriate nurses must come to terms with. However, cultural diversity in the health care environment can potentially affect the quality of care and patient safety. Method A mixed-method case study (survey, interview and document analysis) was employed. A primary study phase entailed the administration of the Safety Climate Survey (SCS). A population sampling strategy was used and 319 nurses participated, yielding a 76.8% response rate. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. Results The data revealed the nurses’ perceptions of the clinical safety climate in this multicultural environment was unsafe, with a mean score of 3.9 out of 5. No significant difference was found between the age groups, years of nursing experience and their perceptions of the safety climate in this context. A significant difference was observed between the national background categories of nurses and perceptions of safety climate. Conclusion Cultural diversity within the nursing workforce could have a significant influence on perceptions of clinical safety. These findings have the potential to inform policy and practice related to cultural diversity in Saudi Arabia.

Use of focus group technique to investigate infection control practice

Use of focus groups as a technique of inquiry is gaining attention in the area of health-care research. This paper will report on the technique of focus group interviewing to investigate the role of the infection control practitioner. Infection control is examined as a specialty area of health-care practice that has received little research attention to date. Additionally, it is an area of practice that is expanding in response to social, economic and microbiological forces. The focus group technique in this study helped a group of infection control practitioners from urban, regional and rural areas throughout Queensland identify and categorise their daily work activities. The outcomes of this process were then analysed to identify the growth in breadth and complexity of the role of the infection control practitioner in the contemporary health-care environment. Findings indicate that the role of the infection control practitioner in Australia has undergone changes consistent with and reflecting changing models of health-care delivery.

‘Working with the team’ : an exploratory study of improved type 2 diabetes management in a new model of integrated primary/secondary care

This study aimed to explore how a new model of integrated primary/secondary care for type 2 diabetes management, the Brisbane South Complex Diabetes Service (BSCDS), related to improved diabetes management in a selected group of patients. We used a qualitative research design to obtain detailed accounts from the BSCDS via semi-structured interviews with 10 patients. The interviews were fully transcribed and systematically coded using a form of thematic analysis. Participants’ responses were grouped in relation to: (1) Patient-centred care; (2) Effective multiprofessional teamwork; and (3) Empowering patients. The key features of this integrated primary/secondary care model were accessibility and its delivery within a positive health care environment, clear and supportive interpersonal communication between patients and health care providers, and patients seeing themselves as being part of the team-based care. The BSCDS delivered patient-centred care and achieved patient engagement in ways that may have contributed to improved type 2 diabetes management in these participants.

Biodiesel with controlled physicochemical properties, a means to further reduce diesel engine particle emissions

The issue of particle emissions from diesel engines is still a matter of concern due its deleterious effects both on human health and environment(Ristovski et al., 2012). Recently, International Agency for Research on Cancer (IARC) inclusion of diesel engine exhaust particles as carcinogenic to human health added a new margin on it. Apart from the use of after treatment technology, biodiesel is also considered as potential way to reduce particle emission alongside with other emissions(Xue, Grift, & Hansen, 2011). Global biodiesel production is still reasonably small compared to its counterpart fossil diesel, but even this small amount comes from a wide variety of feed stocks. Contrary to fossil diesel, the important physicochemical properties of biodiesel vary among different feed stocks(Hoekman, Broch, Robbins, Ceniceros, & Natarajan, 2012).

A review of the educational needs of nurses administering cancer chemotherapy in rural and remote areas of Queensland

This paper describes current issues in chemotherapy nursing practice in rural and remote Australia. There is a trend to refer chemotherapy clients back to their rural and remote health facility for treatment from major oncology centres in Australia. However, it is increasingly apparent that the majority of nurses administering chemotherapy in smaller centres lack the theoretical and clinical knowledge to ensure optimum client outcomes and nurse/client safety. There are also issues unique to rural and remote life which will influence optimum chemotherapy service delivery. The research program described in the paper will ascertain the education requirements of rural and remote nurses administering chemotherapy and the design and delivery of a chemotherapy education package specific to the rural and remote context. Similar programs will ensure the best standards of chemotherapy practice in non-metropolitan areas by enhancing the practical and theoretical knowledge base of rural and remote nurses.

Pushing cultural competence boundaries in nutrition and dietetics training

A health workforce ready for safe practice is a government priority, and particularly critical to support indigenous communities closing ‘the gap’. Increased pressure exists on dietetic training programs for quality placements, with fewer opportunities for immersion in Aboriginal and Torres Strait Islander communities to demonstrate cultural competence. In 2012, Queensland University of Technology established a partnership with Apunipima Cape York Health Council with 56 weeks of dietetic placement for 8 students provided to achieve these aims. Clinical practice in Community Public Health Nutrition (CPHN) was structured in a standard 6 week placement, with Individual Case Management (ICM) and Foodservice Management (FSM) integrated across 8 weeks (4 each), with an additional 2 weeks ICM prior in a metropolitan indigenous health service. Students transitioned from urban to rural then remote sites, with new web-based technologies used for support. Strong learning opportunities were provided, with CPHN projects in antenatal and child health, FSM on standardisation of procedures in a 22 bed health facility, and ICM exposing students to a variety of cases via hospital in/outpatients, general clinics and remote community outreach. Supervisor focus group evaluation was positive, with CPHN and FSM enhancing capacity of service. Student focus group evaluation revealed placements exceeded expectations, with rating high, and strong confidence in cultural competence described. Students debriefed final and third year cohorts on their experiences, with increased awareness and enthusiasm for work with indigenous communities indicated by groups. With the success of this partnership, placements are continuing 2013, and new boundaries in dietetic training established.

Control of energy and matter at nanoscales : challenges and opportunities for plasma nanoscience in a sustainability age

Plasma nanoscience is an emerging multidisciplinary research field at the cutting edge of a large number of disciplines including but not limited to physics and chemistry of plasmas and gas discharges, materials science, surface science, nanoscience and nanotechnology, solid-state physics, space physics and astrophysics, photonics, optics, plasmonics, spintronics, quantum information, physical chemistry, biomedical sciences and related engineering subjects. This paper examines the origin, progress and future perspectives of this research field driven by the global scientific and societal challenges. The future potential of plasma nanoscience to remain a highly topical area in the global research and technological agenda in the age of fundamental-level control for a sustainable future is assessed using a framework of the five Grand Challenges for Basic Energy Sciences recently mapped by the US Department of Energy. It is concluded that the ongoing research is very relevant and is expected to substantially expand to competitively contribute to the solution of all of these Grand Challenges. The approach to controlling energy and matter at nano- and subnanoscales is based on identifying the prevailing carriers and transfer mechanisms of the energy and matter at the spatial and temporal scales that are most relevant to any particular nanofabrication process. Strong accent is made on the competitive edge of the plasma-based nanotechnology in applications related to the major socio-economic issues (energy, food, water, health and environment) that are crucial for a sustainable development of humankind. Several important emerging topics, opportunities and multidisciplinary synergies for plasma nanoscience are highlighted. The main nanosafety issues are also discussed and the environment- and human health-friendly features of plasma-based nanotech are emphasized.

Plasma nanofabrication and nanomaterials safety

The fast advances in nanotechnology have raised increasing concerns related to the safety of nanomaterials when exposed to humans, animals and the environment. However, despite several years of research, the nanomaterials safety field is still in its infancy owing to the complexities of structural and surface properties of these nanomaterials and organism-specific responses to them. Recently, plasma-based technology has been demonstrated as a versatile and effective way for nanofabrication, yet its health and environment-benign nature has not been widely recognized. Here we address the environmental and occupational health and safety effects of various zero- and one-dimensional nanomaterials and elaborate the advantages of using plasmas as a safe nanofabrication tool. These advantages include but are not limited to the production of substrate-bound nanomaterials, the isolation of humans from harmful nanomaterials, and the effective reforming of toxic and flammable gases. It is concluded that plasma nanofabrication can minimize the hazards in the workplace and represents a safe way for future nanofabrication technologies.

Case Studies in Bayesian Statistical Modelling and Analysis

Provides an accessible foundation to Bayesian analysis using real world models This book aims to present an introduction to Bayesian modelling and computation, by considering real case studies drawn from diverse fields spanning ecology, health, genetics and finance. Each chapter comprises a description of the problem, the corresponding model, the computational method, results and inferences as well as the issues that arise in the implementation of these approaches. Case Studies in Bayesian Statistical Modelling and Analysis: •Illustrates how to do Bayesian analysis in a clear and concise manner using real-world problems. •Each chapter focuses on a real-world problem and describes the way in which the problem may be analysed using Bayesian methods. •Features approaches that can be used in a wide area of application, such as, health, the environment, genetics, information science, medicine, biology, industry and remote sensing. Case Studies in Bayesian Statistical Modelling and Analysis is aimed at statisticians, researchers and practitioners who have some expertise in statistical modelling and analysis, and some understanding of the basics of Bayesian statistics, but little experience in its application. Graduate students of statistics and biostatistics will also find this book beneficial.

Social work and complex care systems: The case of people hospitalised with a disability

Health and hospital system reforms prioritise efficiency. However, initiatives can impact on people with new or existing disabilities who require time to maximise functional independence. With greater demands for shorter hospital stays social workers face increasing pressure to facilitate discharge. This paper reports findings from research identifying factors contributing to extended stays for adults with disabilities. We sought to better understand patient characteristics and discharge planning challenges by analysing a clinical data set of 80 patients and qualitative interviews with five experienced hospital social workers. Three key factors are identified: issues around rehabilitation services; assessment and planning for community care; and availability of and access to discharge options. Strategies to reduce length of stay are reported. We argue that building collaborative partnerships and working across multiple, complex systems and disciplines are vital to ensure these patients access appropriate community-based resources within the current health reform environment.

Strategic tillage in no-till farming systems in Australia’s northern grains-growing regions: I. Drivers and implementation

Development of no-tillage (NT) farming has revolutionized agricultural systems by allowing growers to manage greater areas of land with reduced energy, labour and machinery inputs to control erosion, improve soil health and reduce greenhouse gas emission. However, NT farming systems have resulted in a build-up of herbicide-resistant weeds, an increased incidence of soil- and stubble-borne diseases and enrichment of nutrients and carbon near the soil surface. Consequently, there is an increased interest in the use of an occasional tillage (termed strategic tillage, ST) to address such emerging constraints in otherwise-NT farming systems. Decisions around ST uses will depend upon the specific issues present on the individual field or farm, and profitability and effectiveness of available options for management. This paper explores some of the issues with the implementation of ST in NT farming systems. The impact of contrasting soil properties, the timing of the tillage and the prevailing climate exert a strong influence on the success of ST. Decisions around timing of tillage are very complex and depend on the interactions between soil water content and the purpose for which the ST is intended. The soil needs to be at the right water content before executing any tillage, while the objective of the ST will influence the frequency and type of tillage implement used. The use of ST in long-term NT systems will depend on factors associated with system costs and profitability, soil health and environmental impacts. For many farmers maintaining farm profitability is a priority, so economic considerations are likely to be a primary factor dictating adoption. However, impacts on soil health and environment, especially the risk of erosion and the loss of soil carbon, will also influence a grower’s choice to adopt ST, as will the impact on soil moisture reserves in rainfed cropping systems.

Untersuchungen zu biologischen Schadstoffeffekten bei Nordseefischen: Langzeitdaten zum Auftreten von Lebertumoren bei der Kliesche (Limanda limanda)

Data are presented on the spatial distribution and long-term temporal trends in the occurrence of neoplastic liver lesions of North Sea dab (Limanda limanda) in the period 1988 to 2001, obtained in the framework of the regular fish disease monitoring programme carried out by the German Federal Research Centre for Fishery. Highest prevalences consistently recorded in the first part of the period occurred in the German Bight, at the Dogger Bank and at sampling sites off Humber and Wash. In contrast, stations in the northern North Sea (e.g. in the Firth of Forth area) were always characterised by low prevalences. Particularly during the first years of observation, a clear and general decrease in prevalence could be observed, that was most pronounced in the hot spot areas German Bight and Dogger Bank compared to the Firth of Forth. Current data reveal that, due to the decrease, spatial differences between sampling sites are now much less obvious than at the beginning of the studies. Limited chemical data available suggest that the temporal decrease in prevalence of liver tumours and their precursor stages generally correspond with the decrease in organic contaminants in dab livers as well as in water and sediments. However, the spatial variation in prevalence recorded can not entirely be explained by contaminant levels. For instance, the prevalence was continuously low in the Firth of Forth area wheras the contaminant levels in dab were comparatively high. The opposite feature was observed at the Dogger Bank. Future studies will therefore address the role of other host- and site-specific factors potentially involved in the aetiology of the disease.

Entgiftungsstoffwechsel der Nordsee-Kliesche (Limanda limanda)

In the framework of monitoring programmes organized under several sea protection conventions (HELSINKI Conv., OSPAR Conv.) the contracting parties are requested to develop appropriate techniques for Biological-Effect- Monitoring. In following these recommendations the Institut for Fisheries Ecology studies the 7-ethoxyresorufin- O-deethylase (EROD) activity in the liver of dab. EROD represents one enzyme of the cytochrome P-450 species, also called mixed function oxygenases (MFO), which is induced by certain organic contaminants, e.g. PCBs. On the other hand, an influence of natural factors like season, temperature or spawning on the EROD activity may be possible. The present study represents an insight into the status of the EROD activity in North Sea dab. Ultimately, we intend to decide if EROD activity is an appropriate tool to detect effects of contaminants. The EROD activity in the liver of 687 dabs, caught in the North Sea at different seasons in 1995 and 1996 with the fishery research vessel “Walther Herwig III”, has been determined and the data obtained have been statistically evaluated. The logarithmically transformed values of the EROD activity are following approximately a normal distribution. Due to the wide variation of the enzyme activities and due to the small number of samples minor differences between samples are not detectable. Nevertheless, comparing the enzyme activities at different sites of the North Sea, some significant differences have been identified. A model for the discription of seasonal variations of EROD activity, developed at the Biologische Anstalt Helgoland, could be helpful for interpretation.