19683 research outputs found
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Gerontological educational interventions for student nurses: a systematic review of qualitative findings
No full textObjectives: This systematic review of qualitative studies explored interventions to improve student nurses’ knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. Methods: Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. Results: Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses’ knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. Conclusions: Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students’ negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses’ knowledge, attitudes, and willingness to work with older people, so that they can be replicated
Nation-Building without a Workforce: Immigration, Expertise, and State Ambitions in 1950s Venezuela
No full textNo description supplied.</p
Clinical and cost-effectiveness of earlier discharge from acute hospital after total joint arthroplasty
No full textBackground: Reducing length of stay has been proposed as a key component of policies that aim to meet demand and minimize costs associated with total joint arthroplasty. However, few studies explore shifting of healthcare utilization when length of stay is shortened. Methods: This retrospective cohort study examined patients undergoing primary, total hip and knee arthroplasty for osteoarthritis to simulate a policy-level institutional reduction in acute hospital stay by 1 day. Costs, quality of life, and rates of complications, readmission and discharge to inpatient rehabilitation were compared in patients with a three- and four-day length of acute stay. Balance was achieved using overlap-propensity weighting. Results: In total, 2023 patients were included. Earlier discharge from acute hospital was not associated with a change in odds of 90-day complications (OR: 0.85 [95% CI, 0.58 to 1.27]; P = 0.447), readmissions (OR: 1.11 [95% CI, 0.67 to 1.82]; P = 0.691), and emergency department presentations (OR: 1.07 [95% CI, 0.66 to 1.73]; P = 0.774). Earlier discharge from acute hospital was associated with an increase in odds of discharge to inpatient rehabilitation (OR: 2.16 [95% CI, 1.45 to 3.20]; P Conclusion: Earlier discharge was not associated with changes in 90-day complications, readmission, or ED presentations. However, an increase in utilization of inpatient rehabilitation was observed, offsetting early cost savings. Patients who were discharged from acute care on day three had no difference in costs compared to those discharged on day four.</p
Constitutional conventions: Theories, practices and dynamics
No full textThis book analyses constitutional conventions as a powerful but largely neglected framework for studying the law and politics of constitutions. Constitutional conventions are the unwritten rules that inform and circumscribe the political behaviour of individuals, organisations, and a political system. They are as important as the formal legal rules that define written constitutions and shape modern states; yet, unlike formal written rules, conventions have received only limited scholarly attention. This book considers conventions as a lens to theorise and to analyse the institutional dynamics of contemporary constitutions. Interrogating constitutional conventions in a wide variety of contexts - including in Westminster parliamentary systems, in presidential systems, and in non-democratic regimes - the book offers new perspectives for understanding diverse aspects of constitutional politics such as the capacity of conventions to constrain populists, how conventions influence constitutional transformation, how they reflect and reshape core democratic values such as citizenship and constitutional identity, and what they reveal about the character of authoritarian regimes. The book thus demonstrates how the dynamics of conventions shape the very character of constitutions. The book will be of interest to legal theorists, constitutional lawyers, and political scientists.</p
Microbial aerobic degradation of highly chlorinated pollutants in liquid media since 1967: A review of taxonomy and degradation efficiencies
No full textPersistent organic pollutants (POPs) are resistant to biological degradation, resulting in long-term ecological impacts. Numerous geographically diverse studies have isolated microbial strains from soils, sediments and sludges, with abilities to aerobically transform chlorinated POPs in liquid media. However, there remains little evidence that such isolates represent efficient POP degradation phylotypes, making it difficult to identify suitable targets for bioengineering efforts. With a focus on chlorinated POPs, we assessed the taxonomic diversity of soil-isolated culturable bacteria and fungi globally, and their POP degradation efficiencies in liquid culture. The Web of Science database was queried, yielding 321 observations of aerobic POP-transformation in cultures involving 14 different POPs. These observations were derived from 163 bacterial or fungal isolates across 78 studies conducted globally. Transformation efficiencies (% POP decrease per day) were adjusted for assay temperature and normalised. The taxonomic distribution of microbial isolates globally resembled a narrow, but likely stochastic subset of soil microorganisms. When water solubilities, octanol-water constants, vapour pressure and microbial transformation efficiencies in percent of POP reduction per day in liquid media were collated and normalised, no taxonomic marker for POP transformation efficiencies were found. The findings suggested that microbial transformation of chlorinated POPs was not associated with specific taxonomic lineages. However, certain strains across different microbial classes have evolved traits to metabolise specific POPs, particularly those with relatively high water solubility, and thus exhibit high transformation efficiencies. The stochastic taxonomic association with degradation efficiency suggested that any soil may have the potential for artificial community selection to enhance POP degradation.</p
A grounded theory exploration of sensory and kinaesthetic engagement with clay
No full textAbstract: Sensory- and kinaesthetic-based engagement with clay can influence emotional regulation, cognitive processing, and embodied self-awareness. This study aimed to explore how individuals experience sensory and kinaesthetic interactions with clay. A constructivist grounded theory approach was used. Observational data, checklist responses and participant reflections were collected and iteratively analysed to identify emerging themes and patterns of engagement. Participants engaged with a range of clay types, each offering diverse textures, levels of resistance, and sensory qualities. The participants’ engagement ranged from grounding and calming experiences to sensory challenges that required emotional and cognitive adjustment. Clay-based interventions can provide valuable opportunities for emotional regulation, self-reflection, and sensory integration in therapeutic contexts.</p
Nurses' and Midwives' Perceptions of Medication Errors in Children: A Scoping Review
No full textThis scoping review synthesizes the literature exploring nurses' and midwives' perceptions of medication errors in infants and children, with a focus on factors contributing to errors and barriers to reporting them. The Joanna Briggs Institute guidelines for conducting scoping reviews were followed. Seven databases were searched for studies published in English. Two independent reviewers completed the screening; a third reviewer resolved disagreements. Data were categorized and synthesized into a narrative summary. A total of 1307 records were initially identified, and 34 studies were included. Only two studies included midwives as participants, neither of which reported midwives' data separately from nurses. Factors contributing to medication errors included insufficient resources and interruptions, with nurses' workload cited most often. Barriers to reporting errors included negative feelings and nurses' fear of losing their practicing license. Nurses perceive that medication errors occur in their workplace and hospitals likely have different protocols for reporting and managing medication errors. There is a need for further research in diverse economic settings and an investigation into midwives' perceptions to enhance error reporting and management strategies. This review emphasizes the crucial role nurses and midwives play in preventing and reporting pediatric medication errors. The findings also suggest administrators should address workload pressures, resource shortages, and cultural barriers. A significant amount of attention is needed on midwives' perspectives; integrating them into medication safety initiatives and policy development, which would strengthen medication safety practices.</p
Risks and Benefits of Gastrostomy in Non-Motor Neurone Disease Progressive Neurological Diseases: A Systematic Review.
No full textObjectives: This review aimed to synthesise current evidence on the effects of gastrostomy in Parkinson's disease (PD) and parkinsonism, Multiple Sclerosis (MS) and Huntington's disease (HD). Purpose: Evidence regarding the risks and benefits of gastrostomy insertion and use in progressive neurological diseases, excluding Motor Neurone Disease (MND), is lacking, causing gastrostomy decision-making discussions to arise as a matter of debate in practice. Methods: Three databases (Web of Science, Ovid Medline and Embase) were searched for research on the impacts of gastrostomy, including survival, complication rates, nutrition changes, in adults with progressive neurological diseases, excluding MND. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist: Primary Research, and a narrative synthesis was conducted. Results: Twelve (n = 12) studies were eligible for inclusion, with either retrospective cohort (n = 12) or cross-sectional (n = 1) design, examining the effects of percutaneous endoscopic gastrostomy (PEG) (n = 8), radiologically inserted gastrostomy (RIG) (n = 1) or gastrostomy not further defined (n = 4) in adults with PD (n = 6), parkinsonism (n = 3), MS (n = 3), or HD (n = 3). There was variability in outcomes and comparators with inconclusive results. Quality was assessed as positive (n = 3) or neutral (n = 9). Gastrostomy appears to be associated with increased care needs in the population of interest. Conclusions: Gastrostomy insertion and use in this cohort is poorly investigated. High-quality prospective studies, especially with well-defined nutrition-related outcome measures, and robust statistical analyses are needed to determine the potential benefits of gastrostomy in this population. </p
Coordinating for maritime security: Southeast Asia’s evolving institutions
No full textThis paper provides a comprehensive and comparative mapping of Indonesia’s Maritime Security Agency (BAKAMLA), Thailand’s Maritime Enforcement Command Centre (Thai-MECC), and the Philippines’ National CoastWatch Centre (NCWC). It explores the implications of their structures for their state’s maritime security governance and identifies promising practices and ongoing obstacles to coordination. It finds that each structure differs significantly in that they are grounded in different regulatory bases, have different degrees of independence from existing agencies, or have reached different degrees of institutionalisation. Despite overall variation, the findings highlight that they face common challenges to their legitimacy, authority, and problem-solving potential. These common challenges – along with some promising practices enacted to mitigate them – suggest that while there is no one-size fits all solution to maritime security coordination, there are several shared considerations to be made as they continue to evolve.</p
A policy analysis of active travel in public healthcare organizations, Victoria Australia
No full textHealthcare organizations contribute directly and indirectly to global greenhouse gas emissions and consequently to degradation of the environment and poor human health. Active travel has known positive effects on both the health of the environment and humans. Within Australia, healthcare organizations are significant employers and while efforts to reduce the impact of healthcare organizations on the environment are growing, there remains little advancement in increasing rates of active travel among healthcare staff. This study describes active travel policies in the public healthcare sector within the State of Victoria in Australia through a systematic analysis of publicly facing documents. A qualitative document analysis approach was adopted to investigate Victorian public healthcare organization’s policies for active travel. Organizational websites, environmental policies, health promotion pages, and vision and mission statements were analysed for active travel policies and content. Of the 21 healthcare organizations investigated, none had a specific policy on active travel for its employees. Many organizations had environmental sustainability policies, with some policies referencing the need to transition staff into more sustainable commute modes. The inclusion of measurable policy objectives was mostly absent. There is a paucity of policies that would enable an increase in active travel in the major publicly funded Victorian healthcare organizations in Australia, despite the majority of organizations signing on to the Global Green and Healthy Hospitals Initiative, which highlights patient and staff transport as one of the ten sustainability goals. Without clear and actionable policy, healthcare organizations will remain at a difficult crossroads where their culture fails to reflect the health promoting advice they provide to their community. However, with this knowledge, opportunities such as improving end of trip facilities and the development of robust facilitative policy can be undertaken.</p