Australian new graduate experiences during their transition program in a rural/regional acute setting

The transition process from student to Registered Nurse has been recognised as an important yet challenging time for newly graduated nurses. Knowledge about this experience from the nurse’s perspective, particularly in a rural setting, is limited. This paper reports the findings of a qualitative study of the experiences of newly graduated nurses working in a rural acute care facility in New South Wales. The study examined, from the perspective of the new nurse, the orientation and support which can help to facilitate the transition from student to registered nurse. Four themes emerged which were being supported, being challenged, reflections on being a new graduate, and reflections on a rural new graduate program. These findings contribute to what is know about the transition of new graduates in a rural facility and have implications for program improvements, specifically within the rural acute care environment. The findings are also relevant to students considering rural employment on graduation and for the recruitment and retention of New Graduate Registered Nurses in rural areas.

A longitudinal study of health-related quality of life, fatigue and physical activity in chronic kidney disease patients

This study assessed the health-related quality of life (HRQoL), fatigue and physical activity levels of 28 persons with chronic kidney disease (CKD) on initial administration of an erythropoietin stimulating agent, and at 3 months, 6 months and 12 months. The sample comprised of 15 females and 13 males whose ages ranged from 31 to 84 years. Physical activity was measured using the Human Activity Profile (HAP): Self-care, Personal/Household work, Entertainment/Social, Independent exercise. Quality of life was measured using the SF-36 which gives scores on physical health (physical functioning, role-physical, bodily pain and general health) and mental health (vitality, social functioning, role-emotional and emotional well-being). Fatigue was measured by the Fatigue Severity Scale (FSS). Across all time points the renal sample engaged in considerably less HAP personal/household work activities and entertainment/social activities compared to healthy adults. The normative sample engaged in three times more independent/exercise activities compared to renal patients. One-way Repeated measures ANOVAs indicated a significant change over time for SF-36 scales of role physical, vitality, emotional well-being and overall mental health. There was a significant difference in fatigue levels over time [F(3,11) = 3.78, p<.05]. Fatigue was highest at baseline and lowest at 6 months. The more breathlessness the CKD patient reported, the fewer activities undertaken and the greater the reported level of fatigue. There were no significant age differences over time for fatigue or physical activity. Age differences were only found for SF-36 mental health at 3 months (t=-2.41, df=14, p<.05). Those younger than 65 years had lower emotional well-being compared to those aged over 65. Males had poorer physical health compared to females at 12 months. There were no significant gender differences on mental health at any time point. In the management of chronic kidney disease, early detection of a person’s inability to engage in routine activities due to fatigue is necessary. Early detection would enable timely interventions to optimise HRQoL and independent exercise.

Heart beats and economic decisions : Observing mental stress in the ultimatum bargaining game

One aim of experimental economics is to try to better understand human economic decision making. Early research of the ultimatum bargaining game (Gueth et al., 1982) revealed that other motives than pure monetary reward play a role. Neuroeconomic research has introduced the recording of physiological observations as signals of emotional responses. In this study, we apply heart rate variability (HRV) measuring technology to explore the behaviour and physiological reactions of proposers and responders in the ultimatum bargaining game. Since this technology is small and non-intrusive, we are able to run the experiment in a standard experimental economic setup. We show that low o�ers by a proposer cause signs of mental stress in both the proposer and the responder, as both exhibit high ratios of low to high frequency activity in the HRV spectrum.

Effect of a novel compound from Lycopodium obscurum L. on osteogenic activity of osteoblasts in vitro

We investigated the potential of an extract of Lycopodium obscurum L.; stigmastane-3-oxo-21-oic acid (SA), to enhance osteogensis of mouse osteoblastic MC3T3-E1 cells. SA at a concentration of 16 µM was found to have no significant effect upon the viability of the cells, thus concentrations of 8 µM and 16 µM of SA were used in all further experiments. Both concentrations of SA had an inhibitory affect upon alkaline phosphatase activity (ALP) after 8 days incubation, however, after 16 days activity was restored to control levels. However Alizarin red S staining showed increased levels of mineralization for both concentrations after 16 days culture. Real time PCR showed inhibition of genes Runx2 and Osterix genes responsible for the up-regulation of ALP. However early time point (8 days) up-regulation of bone matrix mineralization genes OPN and OCN, and late time point (16 days) up-regulation of both Jun-D and Fra-2 mRNA expression was significantly enhanced. These results suggest a potential me-chanism of SA in enhancing bone fracture healing is through the up-regulating bone matrix minera-lization.

Development and validation of the consumer disillusionment toward marketing activity scale

This study examines disillusioned consumers. The theory proposes that this is a group learning to lower their expectations of firm integrity and who, to avoid being let down, ignore marketing activity directly from the firm. This kind of exchange orientation develops as a response to consistent failure in perceptions of firm integrity. The research includes six studies, including over 600 adult consumers, to outline the development and validation of a measure of consumer disillusionment toward marketing activity. Completing the process provides a valid and reliable four-item measure. In addition, the study includes the assessment of the nomological validity of the construct. The nomological validation includes using cue utilization theory to predict that disillusioned consumers favor advertising that provides evidence of verifiable integrity. The validation experiment uses print advertising containing high and low verifiable integrity stimuli. Results confirm the theory with disillusioned consumers focusing less on the firm as source of information. Further, these consumers respond more favorably than non-disillusioned consumers to third party endorsers who serve to verify the firm's attempts to show integrity.

Programming with time : cyber-physical programming with Impromptu

The act of computer programming is generally considered to be temporally removed from a computer program's execution. In this paper we discuss the idea of programming as an activity that takes place within the temporal bounds of a real-time computational process and its interactions with the physical world. We ground these ideas within the con- text of livecoding -- a live audiovisual performance practice. We then describe how the development of the programming environment "Impromptu" has addressed our ideas of programming with time and the notion of the programmer as an agent in a cyber-physical system.

Cost-effectiveness analysis of a kidney and cardiovascular disease treatment program in an Australian Aboriginal population

The objective of the study was to assess, from a health service perspective, whether a systematic program to modify kidney and cardiovascular disease reduced the costs of treating end-stage kidney failure. The participants in the study were 1,800 aboriginal adults with hypertension, diabetes with microalbuminuria or overt albuminuria, and overt albuminuria, living on two islands in the Northern Territory of Australia during 1995 to 2000. Perindopril was the primary treatment agent, and other medications were also used to control blood pressure. Control of glucose and lipid levels were attempted, and health education was offered. Evaluation of program resource use and costs for follow-up periods was done at 3 and 4.7 years. On an intention-to-treat basis, the number of dialysis starts and dialysis-years avoided were estimated by comparing the fate of the treatment group with that of historical control subjects, matched for disease severity, who were followed in the before the treatment program began. For the first three years, an estimated 11.6 person-years of dialysis were avoided, and over 4.7 years, 27.7 person-years of dialysis were avoided. The net cost of the program was 1,210 dollars more per person per year than status quo care, and dialyses avoided gave net savings of 1.0 million dollars at 3 years and 3.4 million dollars at 4.6 years. The treatment program provided significant health benefit and impressive cost savings in dialysis avoided.

Community wide interventions for increasing physical activity (protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: Primary research objective To determine the effects of community wide, multi-strategic interventions upon community levels of physical activity. Secondary research objectives 1. To explore whether any effects of the intervention are different within and between populations, and whether these differences form an equity gradient. 2. To describe other health (e.g. cardiovascular disease morbidity) and behavioural effects (e.g. diet) where appropriate outcomes are available. 3. To explore the influence of context in the design, delivery, and outcomes of the interventions. 4. To explore the relationship between the number of components, duration, and effects of the interventions. 5. To highlight implications for further research and research methods to improve knowledge of the interventions in relation to the primary research objective.

Assessing Cardiovascular Risk in Regional Areas: The Healthy Hearts – Beyond City Limits Program

Background: Cardiovascular disease (CVD) is more prevalent in regional and remote Australia compared to metropolitan areas. The aim of Healthy Hearts was to determine age and sex specific CVD risk factor levels and the potential value of national risk clinics. Methods: Healthy Hearts was an observational research study conducted in four purposefully selected higher risk communities in regional Victoria, Australia. The main outcome measures were the proportion of participants with CVD risk factors with group comparisons to determine the adjusted likelihood of elevated risk factor levels. Trained personnel used a standardized protocol over four weeks per community to measure CVD risk factor levels, estimate absolute CVD risk and provide feedback and advice. Results: A total of 2125 self-selected participants were assessed (mean age 58 ± 15 years, 57% women). Overall, CVD risk factors were highly prevalent. More men than women had ≥ 2 modifiable CVD risk factors (76% vs. 68%, p < .001), pre-existing CVD (20 vs. 15%, p < .01) and a major ECG abnormality requiring follow-up (15% vs. 7%, p < .001) . Less men reported depressive symptoms compared to women (28% vs. 22%, p < .01). A higher proportion of women were obese (adjusted OR 1.36, 95% CI 1.13 to 1.63), and physically inactive (adjusted OR 1.32, 95% CI 1.07 to 1.63). Conclusions: High CVD risk factor levels were confirmed for regional Victoria. Close engagement with individuals and communities provides scope for the application of regional risk management clinics to reduce the burden of CVD risk in regional Australia.

Physical activity in the lives of those living with lymphoedema following cancer treatment

Background Despite recent evidence demonstrating that exercise neither increases risk of nor exacerbates lymphoedema, lymphoedema prevention and management advice cautions against ‘repetitive use’ or ‘overuse’ of the affected arm. It is plausible that this advice creates a barrier to participation in exercise and, more generally, physical activity (any daily activity [PA]). This study explored the relationship between lymphoedema and PA among people following cancer treatment. Methods Social constructionist grounded theory guided study design, development of interview questions and the qualitative data analysis approach undertaken. Data were collected via focus groups and telephone interviews. Results Five focus groups (n=16 participants) and 13 telephone interviews were completed. Participants (women n=26, men n=3) were aged 39-80 years and were experiencing mild to severe lymphoedema following treatment for a variety of cancers. Participants varied in how they defined PA. Its perceived importance was mostly associated with the ability to partake in daily activities, with only some participants highlighting its importance for lymphoedema management or more general health benefits. Most participants’ PA decreased after diagnosis, a consequence of confusion around appropriate PA and fear that PA could worsen lymphoedema symptoms. Conclusions Lymphoedema guidelines need to be more clear and specific when discussing the role of PA and exercise in the prevention and management of lymphoedema. It may be more appropriate to discuss ways to optimize safety when engaging in specific tasks rather than to highlight the need for avoidance of participating in certain activities.