A naturalistic inquiry of registered nurses' perspectives and expectations of psychodynamic therapeutic care in acute psychiatric inpatient facilities

Within contemporary inpatient mental health nursing practice, the psychodynamic model of care considered previously to be central to the nurse-patient relationship now seems a radical concept. It appears to exist only within primary care facilities and public health care practice settings. This naturalistic inquiry aimed to explicate mental health nurses' perspectives and expectations of providing psychodynamic therapeutic care in acute inpatient psychiatric facilities. Ten registered nurses working in acute inpatient mental health facilities were interviewed. Five themes emerged: a career for life, relating in a psychodynamic manner, swimming against the current, adopting a position of difference, and hopeful expectancy.

Use of face masks by non-scrubbed operating room staff : a randomized controlled trial.

Background: Ambiguity remains about the effectiveness of wearing surgical face masks. The purpose of this study was to assess the impact on surgical site infections when non-scrubbed operating room staff did not wear surgical face masks. Design: Randomised controlled trial. Participants: Patients undergoing elective or emergency obstetric, gynecological, general, orthopaedic, breast or urological surgery in an Australian tertiary hospital. Intervention: 827 participants were enrolled and complete follow-up data was available for 811 (98.1%) patients. Operating room lists were randomly allocated to a ‘Mask roup’ (all non-scrubbed staff wore a mask) or ‘No Mask group’ (none of the non-scrubbed staff wore masks). Primary end point: Surgical site infection (identified using in-patient surveillance; post discharge follow-up and chart reviews). The patient was followed for up to six weeks. Results: Overall, 83 (10.2%) surgical site infections were recorded; 46/401 (11.5%) in the Masked group and 37/410 (9.0%) in the No Mask group; odds ratio (OR) 0.77 (95% confidence interval (CI) 0.49 to 1.21), p = 0.151. Independent risk factors for surgical site infection included: any pre-operative stay (adjusted odds ratio [aOR], 0.43 (95% CI, 0.20; 0.95), high BMI aOR, 0.38 (95% CI, 0.17; 0.87), and any previous surgical site infection aOR, 0.40 (95% CI, 0.17; 0.89). Conclusion: Surgical site infection rates did not increase when non-scrubbed operating room personnel did not wear a face mask.

The use of visual analogue scales to assess motivation to eat in human subjects: a review of their reliability and validity with an evaluation of new hand-held computerized stsytems for temporal tracking of appetite ratings.

This present paper reviews the reliability and validity of visual analogue scales (VAS) in terms of (1) their ability to predict feeding behaviour, (2) their sensitivity to experimental manipulations, and (3) their reproducibility. VAS correlate with, but do not reliably predict, energy intake to the extent that they could be used as a proxy of energy intake. They do predict meal initiation in subjects eating their normal diets in their normal environment. Under laboratory conditions, subjectively rated motivation to eat using VAS is sensitive to experimental manipulations and has been found to be reproducible in relation to those experimental regimens. Other work has found them not to be reproducible in relation to repeated protocols. On balance, it would appear, in as much as it is possible to quantify, that VAS exhibit a good degree of within-subject reliability and validity in that they predict with reasonable certainty, meal initiation and amount eaten, and are sensitive to experimental manipulations. This reliability and validity appears more pronounced under the controlled (but more arti®cial) conditions of the laboratory where the signal : noise ratio in experiments appears to be elevated relative to real life. It appears that VAS are best used in within-subject, repeated-measures designs where the effect of different treatments can be compared under similar circumstances. They are best used in conjunction with other measures (e.g. feeding behaviour, changes in plasma metabolites) rather than as proxies for these variables. New hand-held electronic appetite rating systems (EARS) have been developed to increase reliability of data capture and decrease investigator workload. Recent studies have compared these with traditional pen and paper (P&P) VAS. The EARS have been found to be sensitive to experimental manipulations and reproducible relative to P&P. However, subjects appear to exhibit a signi®cantly more constrained use of the scale when using the EARS relative to the P&P. For this reason it is recommended that the two techniques are not used interchangeably

An examination of the factors that influence drivers’ willingness to use hand-held mobile phones

Hand-held mobile phone use while driving is illegal throughout Australia yet many drivers persist with this behaviour. This study aims to understand the internal, driver-related and external, situational-related factors influencing drivers’ willingness to use a hand-held mobile phone while driving. Sampling 160 university students, this study utilised the Theory of Planned Behaviour (TPB) to examine a range of belief-based constructs. Additionally, drivers’ personality traits of neuroticism and extroversion were measured with the Neuroticism Extroversion Openness-Five Factor Inventory (NEO-FFI). In relation to the external, situational-related factors, four different driving-related scenarios, which were intended to evoke differing levels of drivers’ reported stress, were devised for the study and manipulated drivers’ time urgency (low versus high) and passenger presence (alone versus with friends). In these scenarios, drivers’ willingness to use a mobile phone in general was measured. Hierarchical regression analyses across the four different driving scenarios found that, overall, the TPB components significantly accounted for drivers’ willingness to use a mobile phone above and beyond the demographic variables. Subjective norms, however, was only a significant predictor of drivers’ willingness in situations where the drivers were driving alone. Generally, neuroticism and extroversion did not significantly predict drivers’ willingness above and beyond the TPB and demographic variables. Overall, the findings broaden our understanding of the internal and external factors influencing drivers’ willingness to use a hand-held mobile phone while driving despite the illegality of this behaviour. The findings may have important practical implications in terms of better informing road safety campaigns targeting drivers’ mobile phone use which, in turn, may contribute to a reduction in the extent that mobile phone use contributes to road crashes.

Use of IP addresses for high rate flooding attack detection

High-rate flooding attacks (aka Distributed Denial of Service or DDoS attacks) continue to constitute a pernicious threat within the Internet domain. In this work we demonstrate how using packet source IP addresses coupled with a change-point analysis of the rate of arrival of new IP addresses may be sufficient to detect the onset of a high-rate flooding attack. Importantly, minimizing the number of features to be examined, directly addresses the issue of scalability of the detection process to higher network speeds. Using a proof of concept implementation we have shown how pre-onset IP addresses can be efficiently represented using a bit vector and used to modify a “white list” filter in a firewall as part of the mitigation strategy.

The influence of fatalistic beliefs on risky road use behavior in developing countries

There is little discussion of fatalism in the road safety literature, and limited research. However, fatalism is a potential barrier to participation in health-promoting behaviours, particularly among the populations of developing countries and to some extent in developed countries. Many people still believe in divine discretion and magical powers as causes of road crashes in different parts of the world. Fatalistic beliefs and beliefs in mystical powers and superstition appear to influence perceptions of crash risk and consequently lead people to take risks and neglect safety measures. Fatalistic beliefs may cause individuals to be resigned to risks because they cannot do anything to reduce these risks.

Axisymmetric shell structures for multi-use

Shell structures find use in many fields of engineering, notably structural, mechanical, aerospace and nuclear-reactor disciplines. Axisymmetric shell structures are used as dome type of roofs, hyperbolic cooling towers, silos for storage of grain, oil and industrial chemicals and water tanks. Despite their thin walls, strength is derived due to the curvature. The generally high strength-to-weight ratio of the shell form, combined with its inherent stiffness, has formed the basis of this vast application. With the advent in computation technology, the finite element method and optimisation techniques, structural engineers have extremely versatile tools for the optimum design of such structures. Optimisation of shell structures can result not only in improved designs, but also in a large saving of material. The finite element method being a general numerical procedure that could be used to treat any shell problem to any desired degree of accuracy, requires several runs in order to obtain a complete picture of the effect of one parameter on the shell structure. This redesign I re-analysis cycle has been achieved via structural optimisation in the present research, and MSC/NASTRAN (a commercially available finite element code) has been used in this context for volume optimisation of axisymmetric shell structures under axisymmetric and non-axisymmetric loading conditions. The parametric study of different axisymmetric shell structures has revealed that the hyperbolic shape is the most economical solution of shells of revolution. To establish this, axisymmetric loading; self-weight and hydrostatic pressure, and non-axisymmetric loading; wind pressure and earthquake dynamic forces have been modelled on graphical pre and post processor (PATRAN) and analysis has been performed on two finite element codes (ABAQUS and NASTRAN), numerical model verification studies are performed, and optimum material volume required in the walls of cylindrical, conical, parabolic and hyperbolic forms of axisymmetric shell structures are evaluated and reviewed. Free vibration and transient earthquake analysis of hyperbolic shells have been performed once it was established that hyperbolic shape is the most economical under all possible loading conditions. Effect of important parameters of hyperbolic shell structures; shell wall thickness, height and curvature, have been evaluated and empirical relationships have been developed to estimate an approximate value of the lowest (first) natural frequency of vibration. The outcome of this thesis has been the generation of new research information on performance characteristics of axisymmetric shell structures that will facilitate improved designs of shells with better choice of shapes and enhanced levels of economy and performance. Key words; Axisymmetric shell structures, Finite element analysis, Volume Optimisation_ Free vibration_ Transient response.