Virtual worlds in Australian and New Zealand higher education: Remembering the past, understanding the present and imagining the future

3D virtual reality, including the current generation of multi-user virtual worlds, has had a long history of use in education and training, and it experienced a surge of renewed interest with the advent of Second Life in 2003. What followed shortly after were several years marked by considerable hype around the use of virtual worlds for teaching, learning and research in higher education. For the moment, uptake of the technology seems to have plateaued, with academics either maintaining the status quo and continuing to use virtual worlds as they have previously done or choosing to opt out altogether. This paper presents a brief review of the use of virtual worlds in the Australian and New Zealand higher education sector in the past and reports on its use in the sector at the present time, based on input from members of the Australian and New Zealand Virtual Worlds Working Group. It then adopts a forward-looking perspective amid the current climate of uncertainty, musing on future directions and offering suggestions for potential new applications in light of recent technological developments and innovations in the area.

Patient safety and gaps management by registered nurses

Patient safety is a global imperative aimed at reducing the incidence and impact of preventable adverse events in healthcare. This study has demonstrated how effective nursing surveillance and successful everyday nursing performance can bridge ‘gaps’ in the system of care, mitigate errors, and protect patients from suffering otherwise preventable harm.

Medication errors in ED: do patient characteristics and the environment influence the nature and frequency of medication errors?

Background: Medication safety is of increasing importance and understanding the nature and frequency of medication errors in the Emergency Department (ED) will assist in tailoring interventions which will make patient care safer. The challenge with the literature to date is the wide variability in the frequency of errors reported and the reliance on incident reporting practices of busy ED staff. Methods: A prospective, exploratory descriptive design using point prevalence surveys was used to establish the frequency of observed medication errors in the ED. In addition, data related to contextual factors such as ED patients, staffing and workload were also collected during the point prevalence surveys to enable the analysis of relationships between the frequency and nature of specific error types and patient and ED characteristics at the time of data collection. Results: A total of 172 patients were included in the study: 125 of whom patients had a medication chart. The prevalence of medication errors in the ED studied was 41.2% for failure to apply patient ID bands, 12.2% for failure to document allergy status and 38.4% for errors of omission. The proportion of older patients in the ED did not affect the frequency of medication errors. There was a relationship between high numbers of ATS 1, 2 and 3 patients (indicating high levels of clinical urgency) and increased rates of failure to document allergy status. Medication errors were affected by ED occupancy, when cubicles in the ED were over 50% occupied, medication errors occurred more frequently. ED staffing affects the frequency of medication errors, there was an increase in failure to apply ID bands and errors of omission when there were unfilled nursing deficits and lower levels of senior medical staff were associated with increased errors of omission. Conclusions: Medication errors related to patient identification, allergy status and medication omissions occur more frequently in the ED when the ED is busy, has sicker patients and when the staffing is not at the minimum required staffing levels.

Nurses' knowledge and attitudes regarding pain in Saudi Arabia

Unrelieved pain is a worldwide health care problem that can lead to unnecessary complications and increased health care expenditure. The aim of this study was to examine nurses' knowledge and attitudes toward pain in Saudi Arabia. A descriptive design was employed using the Nurses' Knowledge and Attitudes Survey regarding pain. The study took place in a tertiary teaching hospital in Saudi Arabia. All nurses employed in the hospital were eligible to participate. A total of 775 questionnaires were distributed to nurses working in acute care, intensive care, and nursing education and administration settings. In all, 593 respondents completed the questionnaires, representing a response rate of 76.5%. Data were analyzed using descriptive and inferential statistics. Most participants were from overseas (97.5%), speaking 23 different languages; 36.5% of nurses held a bachelors of science degree in nursing or the equivalent. The mean score of correctly answered items in was 16.9 (95% confidence interval, 16.6-17.31) out of a total possible score of 40. Nurses demonstrated some misconceived attitudes such as not giving the required dose of morphine to a smiling patient despite the patient being in pain. It is of concern that the findings identified problems of inadequate knowledge and inappropriate attitudes regarding pain assessment and management in Saudi Arabia. Considering these problems, the development of pain programs and policies affecting national and international nurses is highly imperative.

An Antarctic research station as a source of brominated and perfluorinated persistent organic pollutants to the local environment

This study investigated the role of a permanently manned Australian Antarctic research station (Casey Station) as a source of contemporary persistent organic pollutants (POPs) to the local environment. Polybrominated diphenyl ethers (PBDEs) and poly- and perfluoroalkylated substances (PFASs) were found in indoor dust and treated wastewater effluent of the station. PBDE (e.g., BDE-209 26-820 ng g(-1) dry weight (dw)) and PFAS levels (e.g., PFOS 3.8-2400 ng g(-1) (dw)) in dust were consistent with those previously reported in homes and offices from Australia, reflecting consumer products and materials of the host nation. The levels of PBDEs and PFASs in wastewater (e.g., BDE-209 71-400 ng L(-1)) were in the upper range of concentrations reported for secondary treatment plants in other parts of the world. The chemical profiles of some PFAS samples were, however, different from domestic profiles. Dispersal of chemicals into the immediate marine and terrestrial environments was investigated by analysis of abiotic and biotic matrices. Analytes showed decreasing concentrations with increasing distance from the station. This study provides the first evidence of PFAS input to Polar regions via local research stations and demonstrates the introduction of POPs recently listed under the Stockholm Convention into the Antarctic environment through local human activities.

On exploratory factor analysis: a review of recent evidence, an assessment of current practice, and recommendations for future use

Exploratory factor analysis (hereafter, factor analysis) is a complex statistical method that is integral to many fields of research. Using factor analysis requires researchers to make several decisions, each of which affects the solutions generated. In this paper, we focus on five major decisions that are made in conducting factor analysis: (i) establishing how large the sample needs to be, (ii) choosing between factor analysis and principal components analysis, (iii) determining the number of factors to retain, (iv) selecting a method of data extraction, and (v) deciding upon the methods of factor rotation. The purpose of this paper is threefold: (i) to review the literature with respect to these five decisions, (ii) to assess current practices in nursing research, and (iii) to offer recommendations for future use. The literature reviews illustrate that factor analysis remains a dynamic field of study, with recent research having practical implications for those who use this statistical method. The assessment was conducted on 54 factor analysis (and principal components analysis) solutions presented in the results sections of 28 papers published in the 2012 volumes of the 10 highest ranked nursing journals, based on their 5-year impact factors. The main findings from the assessment were that researchers commonly used (a) participants-to-items ratios for determining sample sizes (used for 43% of solutions), (b) principal components analysis (61%) rather than factor analysis (39%), (c) the eigenvalues greater than one rule and screen tests to decide upon the numbers of factors/components to retain (61% and 46%, respectively), (d) principal components analysis and unweighted least squares as methods of data extraction (61% and 19%, respectively), and (e) the Varimax method of rotation (44%). In general, well-established, but out-dated, heuristics and practices informed decision making with respect to the performance of factor analysis in nursing studies. Based on the findings from factor analysis research, it seems likely that the use of such methods may have had a material, adverse effect on the solutions generated. We offer recommendations for future practice with respect to each of the five decisions discussed in this paper.

Teleconsultation/telediagnosis using teledentistry technology: a pilot feasibility study

This study assessed the feasibility of ateledentistry model for teleconsultation and telediagnosis inResidential Aged Care Facilities. Study feasibility was definedby the ability to develop remote treatment plans. Reliability ofthe remote assessments was assessed by comparing with thoseperformed by traditional face-to-face oral examinations. Anintraoral camera was operated by trained teledentistryassistants with the aim of screening residents for oral diseasesand pathological conditions. The model was supported bytraning and an instructional kit for the introral cameraoperators. The structure, content and delivery of the program,was evaluated. Residents’ views about the structure, contentand delivery of the program were also evaluated. A total of 50residents participated in this assessment. Results indicated thatthe proposed teledentistry approach for oral health screeningis feasible and reliable as an alternative to traditional oralhealth examination. Residents expressed high levels ofsatisfaction with the teledentistry service. This study providesan innovative solution towards closing the service delivery gapin the provision of sustainable oral health care services tounderserviced populations (e.g., nursing homes, rural areas).

The effect of transition to specialty practice programs on Australian emergency nurses' professional development, recruitment and retention

BACKGROUND: To date, emergency nursing Transition to Specialty Practice Program (TSPP) evaluations have been single-site observational studies. The aim of this paper was to examine the professional development, recruitment and retention outcomes of Australian emergency nursing TSPPs. METHODS: An explanatory sequential design was used. Data were collected via online surveys and interviews of emergency Nurse Unit Managers and Nurse Educators. Survey data from EDs with TSPPs and EDs without TSPPs were compared. Qualitative data were analysed using content analysis. RESULTS: Data were collected from 118 EDs, and 13 interviews. TSPPs were offered in 72.1% of EDs. EDs with TSPPs had higher proportions of nurses with postgraduate qualifications (Mdn 28.3% vs. 22.1%, p=0.45) and Clinical Specialists (Mdn 16.4% vs. 6.3%, p=0.04). The median proportion of currently rostered nurses with TSPP completion was 34.2% in EDs with TSPPs introduced in 2000-2005 indicating ED high levels of retention. CONCLUSION: Emergency nursing TSPPs have had a positive effect on nursing professional development, recruitment and retention. To ensure consistency in outcomes and optimise reliability of emergency nursing skills and knowledge, a national emergency nursing TSPP framework is needed.

Measurement and assessment of hand functionality via a cloud-based implementation

This book constitutes the proceedings of the 13th International Conference on Smart Homes and Health Telematics, ICOST 2015, held in Geneva, Switzerland, in June 2015.

The construction of a subset of ICNP® for patients with dementia: a Delphi consensus and a group interview study

BACKGROUND: The International Classification for Nursing Practice (ICNP®) 2013 includes over 4000 concepts for global nursing diagnoses, outcomes and interventions and is a large and complex set of standardised nursing concepts and expressions. Nurses may use subsets from the ICNP as concepts and expressions for research, education and clinical practice. The objective of this study was to identify and validate concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia.

METHOD: The process model for developing ICNP subsets was followed, according to the guidelines adopted by the International Council of Nursing (ICN). To identify relevant and useful concepts for the subset, a modified form of the Delphi method was used. Six nurses working in healthcare services in three municipalities in Norway with postgraduate education in geriatric psychiatry and dementia care participated in two Delphi sessions. The participants reviewed and scored the concepts included in the suggested subset and had an opportunity to rewrite them and offer alternatives. To validate the subset after the Delphi study, a group interview was conducted with six other nurses with postgraduate education in geriatric psychiatry and dementia care. The group interview was recorded and transcribed, and summative content analysis was used.

RESULTS: Suitable concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia were identified. In total, 301 concepts were identified, including 77 nursing diagnoses, 78 outcomes and 146 nursing interventions. An increased focus on concepts to describe basic psychosocial needs such as identity, comfort, connection, inclusion and engagement was recommended by nurses in the validation process.

CONCLUSIONS: Relevant and pre-formulated nursing diagnoses, goals and interventions were identified, which can be used to develop care plans and facilitate accuracy in the documentation of individuals with dementia. The participants believed that it may be difficult to find formulations for all steps of the nursing process. In particular, nursing diagnoses and psychosocial needs are often inadequately documented. The participants highlighted the need for the subset to contain essential information about psychosocial needs and communication.

Sound the alarm: health and safety risks associated with alarm response for salaried and retained metropolitan firefighters

Responding to an emergency alarm poses a significant risk to firefighters' health and safety, particularly to cardiovascular health, physical and psychological stress, and fatigue. These risks have been largely categorised for salaried firefighters working 'on station'. Less is known about the factors that contribute to these risks for the vast number of non-salaried personnel who serve in retained roles, often deploying from home. The present study investigated the alarm response procedure for Australian metropolitan fire fighters, identifying common and divergent sources of risk for salaried and retained staff. There were significant differences in procedure between the two workgroups and this resulted in differences in risk profile between groups. Sleep and fatigue, actual response to the alarm stimulus, work-life balance and trauma emerged as sources of risk experienced differently by salaried and retained firefighters. Key findings included reports of fatigue in both groups, but particularly in the case of retained firefighters who manage primary employment as well as their retained position. This also translated into a poor sense of work-life balance. Both groups reported light sleep, insufficient sleep or fragmented sleep as a result of alarm response. In the case of salaried firefighters, this was associated with being woken on station when other appliances are called. There were risks from physical and psychological responses to the alarm stimulus, and reports of sleep inertia when driving soon after waking. The findings of this study highlight the common and divergent risks for these workgroups, and could be used in the ongoing management of firefighters' health and safety.

Motivating sustainable goal choices and providing effective feedback

Overconsumption of natural resources and the associated environmental hazards are one of today’s most pressing global issues. In the western world, individual consumption in homes and workplaces is a key contributor to this problem. Reflecting the importance of individual action in this domain, this thesis focuses on studying and influencing choices related to sustainability and energy consumption made by people in their daily lives. There are three main components to this work. Firstly, this thesis asserts that people frequently make ineffective consumption reduction goal choices and attempts to understand the rationale for these poor choices by fitting them to goalsetting theory, an established theoretical model of behavior change. Secondly, it presents two approaches that attempt to influence goal choice towards more effective targets, one of which deals with mechanisms for goal priming and the other of which explores the idea that carefully designed toys can exert influence on children’s long term consumption behavior patterns. The final section of this thesis deals with the design of feedback to support the performance of environmentally sound activities. Key contributions surrounding goals include the finding that people choose easy sustainable goals despite immediate feedback as to their ineffectiveness and the discussion and study of goal priming mechanisms that can influence this choice process. Contributions within the design of value instilling toys include a theoretically grounded framework for the design of such toys and a completed and tested prototype toy. Finally, contributions in designing effective and engaging energy consumption feedback include the finding that negative feedback is best presented verbally compared with visually and this is exemplified and presented within a working feedback system. The discussions, concepts, prototypes and empirical findings presented in this work will be useful for both environmental psychologists and for HCI researchers studying eco-feedback.

A violência no contexto de um serviço de urgência: análise do processo de cuidar na visão das vítimas e profissionais de saúde em Natal/RN

Exploratory descriptive study, with a quantitative approach and prospective data, performed in Pronto Socorro Clóvis Sarinho (PSCS), in Natal/RN, aiming to analyze care given by the nursing and medical staff to victims of violence attended to in an emergency hospital in Natal/RN; to identify care given by the nursing and medical staff as viewed by the victims; to compare data observed during the process of care with the victim s view on the care given by the nursing and medical staff; to identify the existing knowledge on violence and the process of caring for victims and its relation with prejudice; to identify obstacles and perspectives for prevention during the process of caring for victims in the emergency services. The population consisted of 97 physicians, 16 nurses, 75 nursing technicians and assistants and 365 victims of violence, with data collected from April to May 2009. Out of 188 professionals, 52.1% are female; 32% were aged 41 to 50; 99.5% had given care to a victim of violence; 90.4% reported to have given care to patients under custody; among these, 17.3% felt prejudice; 55.3% stated they don t provide different care for assaulted victims and assailants, however 44.7% stated they do; 86.7% feel their workplace is unsafe; 61.7% denied the existence of any obstacle and 38.3% reported the existence of obstacles; among these, 26.1% referred to inadequate facilities; 37.8% believe reinforcing security and professional training are the main solutions. Among the 365 researched violence victims, 82.2% were assaulted; male (69.6%); aged 18 to 24 (24.9%); hailing from the Greater Natal area (89.9%); on 19.7% the event happened on Saturday; during the night (48.8%); victim of physical assault (61.4%); produced by body force (27.7%); 24.4% were injured in the head and neck. 57% had used some drug, among which alcohol was predominant (75.5%). On 621 observations performed during the victim care process, when compared to the report of assaulted victims, there was a statistical difference, at 5% significance level, regarding reception, resistance from the professionals, questioning about the violent event, providing of guidance, interaction with the patient and the understanding of receiving proper care, and care resolution. In comparisons involving the observed and the assailant victims reports, there was a statistical difference regarding the resence of resistance from the professionals, performance of necessary procedures and the nteraction with the patient and the understanding of receiving proper care and 58.1% reported the nursing team was the one that provided the best care. We conclude that professionals had lready given care to assailant patients, acknowledge the importance of knowing how the vent took place and acquired this preparation during their practice. The most often referred bstacles that hinder assistance were: inadequate facilities, material deficit and lack of rofessional preparation. As solutions for these problems, they cited the reinforcement of ecurity and professional training

Suckling and allosuckling in river buffalo calves and its relation with weight gain

The aim of the present study was to investigate if river buffalo calves (Bubalus bubalis) have equal access to all cows and if milk is thus equally available to all of them. We recorded suckling/allosuckling behaviour and weight gain (WG) of 29 calves (14 males and 15 females), with special consideration to their sex, birth order (BO) and age. Cows' nursing behaviour and milli production (MP) were also considered. While males tended to be born earlier than females during this study, this was not the trend in the overall herd records. The cows' MP was not effected by the calves' sex. However, bull-calves presented greater mean WG, and mean times spent in individual filial (IF) and in communal nonfilial (CNF) suckling than heifer-calves, which showed greater communal filial (CF) suckling than the former during the first 4 months of life. The WG was associated with IF for bull-calves (r = 0.680 and 0.765, respectively, for the periods from birth to 4th and 8th months of age), and to CNF for heifer-calves (r = 0.628, for the period from birth to 8th month). Results from multiple regression analysis showed independent effects of each suckling category on the calf WG, and such effects were variable according to the calf's sex. BO was negatively correlated to calves' WG (bull-calves: r(s) = - 0.873 and - 0.799, from birth to 4th and gth months, respectively; heifer-calves: r(s) = - 0.531 from birth to 4th month). Specifically for bull-calves, there was a positive correlation between BO and MP (r(s) = 0.528 and 0.633, from birth to 4th and 8th months of age, respectively). The correlation between BO and IF was negative in both sexes, indicating that calves that were born early had more opportunities to suckle individually from their mothers. For heifer-calves, BO was positively correlated with CF (two periods), and negatively with CNF (from birth to 8th month of age), suggesting that heifer-calves were most often accompanied by other calves during suckling when they were born later. The data taken together indicate that sex and/or BO influenced decisively social interactions during suckling, promoting differential development among the calves. In animal husbandry, if a homogenous WG is desired, these factors have to be taken into consideration. (C) 2000 Elsevier B.V. B.V. All rights reserved.

Effect of adding macro and micro minerals in pig feces fed diets with different levels of probiotic

O objetivo deste trabalho foi avaliar dietas contendo diferentes doses (0, 100, 200 e 300 ppm) de probiótico sobre a produção diária de fezes (PDF) e teor de macro e microminerais nas fezes de suínos, nas fases de creche e de crescimento e no período total. A PDF, como porcentagem do peso vivo, somente apresentou diferença estatística (P<0,05) na fase inicial 1. Os teores de macro e microminerais excretados nas fezes não apresentaram diferença (P>0,05) entre tratamentos, a exceção de cálcio e sódio na fase inicial 1 e cálcio, zinco e níquel no período total. A adição de um poliprobiótico às dietas, não afetou a produção de fezes dos suínos nas fases de creche e de crescimento. Entretanto, a presença de microrganismos, adicionados (níveis de 200 e 300 ppm) às dietas reduziu a excreção fecal de cálcio, zinco e níquel.