1,720,990 research outputs found
Management of Pressure Injury Prevention in Two New Zealand Residential Aged Care Facilities: A Case Study
No full textThe purpose of this study was to explore how pressure injury prevention is managed in residential aged care in New Zealand. Pressure injuries are costly and have negative physical, social and psychological consequences that impact significantly on quality of life. Residents in aged care are becoming more dependent with more complex needs. Frail older people have increased risk of developing pressure injuries and Registered Nurses and Health Care Assistants, with different and unique roles, are integral to the prevention of these injuries. The prevention of pressure injuries requires a comprehensive and multifactorial approach.
Exploratory case study methodology was used in this thesis to answer the question: How are pressure injuries prevented in residential aged care? Data were collected from Clinical Managers, Registered Nurses and Health Care Assistants working in two residential aged care facilities, and who provided pressure injury prevention intervention in their daily practice, using semi-structured interviews. Facility policies and guidelines related to pressure injury prevention and management were also analysed.
Two main themes were identified during data analysis and used to structure the presentation of findings. Firstly, “The Context of Residential Aged Care”, which captured the complex cultural dynamics within residential aged care which impact on how nurses and healthcare assistants work together to provide pressure injury prevention. The second theme, “Assessment and Interventions of Daily Practice”, encapsulated the complexity and multidimensional nature of providing care in relation to pressure injury prevention within the residential aged care environment.
The study identified barriers and facilitators in the prevention of pressure injuries and illustrate the interplay between provision of pressure injury prevention and organisational culture and structure. Implementation strategies to reduce pressure injuries must reflect organisational infrastructures that impact negatively on quality care while also acknowledging the increasing dependency and complexity involved in caring for frail older adults with the ultimate goal of reducing the incidence of pressure injuries in aged care
Optimising the Role of Nurse Practitioners in New Zealand
No full textBackground
Nurse Practitioners in New Zealand are highly skilled Registered Nurses with the qualifications to work independently, make autonomous decisions, and are authorised prescribers. However, despite the existence of the role for over 20 years, it has not fully realised its potential. Consequently, Nurse Practitioners have faced challenges in receiving organisational support, hindering their ability to achieve their maximum economic and clinical impact. Key challenges facing New Zealand’s health system include establishing sustainable models of care for individuals with long-term and complex health needs, addressing workforce shortages, and managing the repercussions of the COVID-19 pandemic. Therefore, it is time to develop new models of care and integrated inter-disciplinary primary healthcare teams, including Nurse Practitioners, to improve the coordination and provision of healthcare to the public. The development of new models of care will require an in-depth understanding of how Nurse Practitioners perform their role.
Aim
This research aims to identify the organisational opportunities for Nurse Practitioners to make decisions about the means and methods of performing their role.
Methods
A cross-sectional study was conducted. The study investigated the decision-making opportunities available to Nurse Practitioners, examining the potential influence of geographical location on their practice. The measurement tool utilised was the validated Job Content Questionnaire, and the Nurse Practitioners were requested to complete a 68-item self-administered online questionnaire. A convenience sample (n=169) represented 49% of the Nurse Practitioner workforce. The Job Content Questionnaire was assessed for reliability and construct validity using the co-efficient α and confirmatory factor analysis, respectively. Linear regression analyses were performed to determine the strength of the relationships between constructs measured by the Job Content Questionnaire.
Results
The study findings revealed that Nurse Practitioners perceive themselves as having more control over their decision-making when supported by their colleagues rather than supervisors. Nurse Practitioners perceive improved relationships with healthcare consumers if they feel an increase in support from their colleagues, which is mediated through the increased freedom they perceive themselves to have to make decisions about their practice. The study also found that when rural Nurse Practitioners had an increased perception of being valued and appreciated at work, they felt more secure in their jobs.
Discussion and Conclusions
These findings have implications for New Zealand’s healthcare policies, emphasising the importance of supporting Nurse Practitioners so that they can practice to the fullest extent of their capabilities and contribute to reducing healthcare access disparities within the population. Explicit inclusion of the Nurse Practitioner role in the workforce policies is necessary. The study recommends implementing a funded vocational training programme for novice Nurse Practitioners, potentially enhancing Nurse Practitioner-led practice growth in New Zealand
Adverse Childhood Experiences and Postnatal Depression, Anxiety, and Stress in Aotearoa
No full textBackground
Mental illness in the perinatal period can have far-reaching negative consequences. Maternal suicide is the leading cause of death in the perinatal period in Aotearoa, recording mortality rates five times higher per capita than in the United Kingdom. The deleterious effects of maternal depression, anxiety, and stress extend beyond the individual, with studies describing poorer physical, developmental, and emotional well-being in the children of affected mothers. Due to the significant burden that maternal mental illness presents intergenerationally, research that examines potential risk factors for maternal mental health (MMH) dysfunction is of paramount importance. A body of international literature examining mental health in the perinatal period has uncovered a significant relationship between experiences of early life adversity and later maternal mental illness.
Methods
Following a scoping review of the relevant literature, a cross-sectional study of 506 mothers was undertaken using established self-report-based assessment tools. Aotearoa mothers, in their first postnatal year, engaging with Whānau Āwhina services comprised the participant sample. The prevalence of adverse childhood experiences was measured using the Adverse Childhood Experiences-10 assessment tool (ACE-10). Postnatal mental health outcomes were assessed using the Patient Health Questionnaire 2+ (PHQ2+) screening for symptoms of depression and anxiety and the Depression Anxiety and Stress Scale-21 Scale (DASS-21), assessing for symptoms of depression, anxiety, and stress. Correlation analysis was undertaken to test for associations of the study’s key variables.
Results
Approximately 72% of the maternal study population reported an ACE score of one or more, with 25% of participants reporting four or more ACEs. The results from the DASS-21 revealed that 39% of participants reported symptoms of depression, 38.5% reported symptoms of anxiety, and 45.7% reported symptoms of stress at the time the survey was conducted. There were significant associations between many of the socio-demographic characteristics measured in the survey and the mother's mental health outcomes; however, ordinal and binomial logistic regression models revealed that even with controlling for significantly correlated socio-demographic variables by adding them into the regression model as covariates, maternal ACEs remained the strongest predictor of maternal depression, anxiety, and stress symptoms in the first postnatal year.
Conclusion
These findings contribute a uniquely Aotearoa maternal perspective to the international literature that acknowledges that maternal ACEs present a significant risk factor for maternal mental illness in the postnatal period. There are opportunities to apply the results of this study through universal maternal ACE assessment in clinical practice settings, applying a two-generation approach to addressing ACEs. Early maternal ACE assessment would provide maternal and child health services (MCHS) such as Whānau Āwhina with insights into which mothers are most at risk of poor MMH outcomes. There would also be an added benefit of early identification of children with an increased risk of intergenerational ACE consequences due to their mother's ACEs. Maternal ACE assessment would allow for dual healing and prevention pathways, where targeted supports informed by international ACE best practice guidelines could ultimately reduce the impact of harm for ACE-affected women and their children in Aotearoa
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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