Nursing praxis, compassionate caring and interpersonal relations: an observational study.

Background: The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests, treat and manage a range of patient conditions. The CIN role is focused on the waiting room and to 'communicate the wait', initiate diagnostics or treatment and follow-up for waiting room patients. We aim to explore what emergency nurses' do in their extended practice role in observable everyday life in the emergency department (ED).

Domains of practice and Advanced Practice Nursing in Australia.

A key component of workforce reform is the international growth in Advanced Practice Nursing (APN) roles. This study evaluated one APN role in Australia, the Clinical Nurse Consultant (CNC). All 56 CNCs employed in a tertiary hospital in New South Wales took part in the study.

Nurses' experiences and expectations of family and carers of older patients in the emergency department.

Background: Older people are often accompanied by family/carers to the emergency department (ED). Few studies investigate nurses' experiences of interacting with these family/carers.

Aim: This study was an exploration of the experiences and expectations that ED nurses have of family and carers accompanying the older adult patient.

Insulin modulates the electrical activity of subfornical organ neurons.

Insulin plays a crucial role in the regulation of energy balance. Within the central nervous system, hypothalamic nuclei such as the arcuate and ventromedial nuclei are targets of insulin; however, insulin may only access these nuclei after transport across the blood-brain barrier. Neurons of the subfornical organ are not protected by the blood-brain barrier and can rapidly detect and respond to circulating hormones such as leptin and ghrelin.

Increased density of dystrophin protein in the lateral versus the vermal mouse cerebellum.

Dystrophin, present in muscle, also resides in the brain, including cerebellar Purkinje neurons. The cerebellum, although historically associated with motor abilities, is also implicated in cognition. An absence of brain dystrophin in Duchenne muscular dystrophy (DMD) and in the mdx mouse model results in cognitive impairments.

The influence of a motivational climate intervention on participants' salivary cortisol and psychological responses.

Research in achievement goal perspective theory suggests that the creation of a caring/task-involving (C/TI) climate results in more advantageous psychological and behavioral responses relative to an ego-involving (EI) climate; however, research has not yet examined the physiological consequences associated with psychological stress in relation to climate. Given the possible health and fitness implications of certain physiological stress responses, it is critical to understand this association. Thus, the purpose of this study was to examine whether an EI climate procures increases in the stress-responsive hormone cortisol, as well as negative psychological changes, following the learning of a new skill, compared with a C/TI climate.

A model to create an efficient and equitable admission policy for patients arriving to the cardiothoracic ICU.

Objective: To develop queuing and simulation-based models to understand the relationship between ICU bed availability and operating room schedule to maximize the use of critical care resources and minimize case cancellation while providing equity to patients and surgeons.

Design: Retrospective analysis of 6-month unit admission data from a cohort of cardiothoracic surgical patients, to create queuing and simulation-based models of ICU bed flow. Three different admission policies (current admission policy, shortest-processing-time policy, and a dynamic policy) were then analyzed using simulation models, representing 10 yr worth of potential admissions.

An update on progress and the changing epidemiology of causes of childhood blindness worldwide.

Purpose: To summarize the available data on pediatric blinding disease worldwide and to present current information on childhood blindness in the United States.

Methods: A systematic search of world literature published since 1999 was conducted. Data also were solicited from each state school for the blind in the United States.

Managing the wait: clinical initiative nurses' perceptions of an extended practice role.

Introduction: The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests and treat and manage a range of patient conditions. In 2010, the New South Wales Ministry of Health redefined the focus of the CIN role to be on waiting room patients. The new CIN role was now focused on the waiting room and to 'communicate the wait', initiate diagnostics and or treatment and follow-up for waiting room patients.

An in vivo subject-specific 3D functional knee joint model using combined MR imaging.

Purpose: We aim to quantitatively characterise the knee joint function in vivo under body-weight-bearing conditions via subject-specific models extracted from magnetic resonance (MR) data, in order to better understand the knee joint kinematic function in 3D.

Methods: Six healthy volunteers without any record of knee abnormality were scanned using a combined MR imaging strategy to record quasi-squatting motion and 3D knee anatomy. After a semi-automatic segmentation to delineate tibio-femoral articulation components, motion data were mapped to the anatomical data using a bi-rigid registration in order to achieve six degrees of freedom.

The role and functions of Clinical Nurse Consultants, an Australian advanced practice role: a descriptive exploratory cohort study.

Background: The NSW Health Policy Directive (NSW Department of Health, 2000) lists clinical service and consultancy; clinical leadership; research; education; clinical services planning and management as the five domains of practice for nurses appointed as Clinical Nurse Consultants (CNCs), an Australian advanced practice nurse (APN) role. However, there is no clear definition of what is meant by advanced practice in the Australian nursing context. Nowhere is this more evident than in differentiating between the roles of Clinical Nurse Consultants (CNCs) and Nurse Practitioners (NP) in NSW.

Development of a tool to describe the role of the clinical nurse consultant in Australia.

Aims And Objectives: To develop a tool for defining and measuring the role characteristics and responsibilities of an advanced practice nursing role in Australia.

Background: Internationally, there is considerable confusion about the precise role responsibilities of advanced practice nursing positions. In Australia, the clinical nurse consultant is an advanced practice role with five nominated domains of practice.

The prevalence and triage characteristics of patients presenting with infection to one tertiary referral hospital.

Background: Globally, severe infection and or sepsis is a problem that is costing billions of dollars, using hundreds of hospital beds, and often results in patient death. Any infection can potentially develop a sepsis health trajectory if left unrecognised and unmanaged.

Methods: We conducted a 12 month retrospective descriptive exploratory study.

An ethnography: Understanding emergency nursing practice belief systems.

Background: Further insight is needed to better understand how beliefs impact on contemporary Australian Emergency Department (ED) triage nursing practice. Specifically, how do cultural notions drive beliefs that give shape to nursing practice?

Methods: Ethnography was the methodological framework used to explore triage practice. A purposeful sample of 10 Triage Nurses across four EDs was selected.

Expanding the role of practice nurses in Australia.

Like other countries, Australia is looking to reforms in the primary health care sector to meet the growing demand for care. Expansion of the role of practice nurses (PNs) is one way in which this demand may be met. To date the Federal Australian government has played a significant role in encouraging growth in the PN workforce.

Pre-hospital pain management patterns and triage nurse documentation.

Introduction: Little is known about the public's preferences for pain management prior to attending an Emergency Department (ED). Therefore, the aim of the study was to explore (i) triage documentation of pre-hospital analgesic patterns for patients presenting in pain; (ii) patient documented explanations for not self administering an analgesic in the pre-hospital setting; (iii) triage nurse documentation of pain descriptors and or pain scores; and (iv) the disposition of ED patients presenting in pain.

Method: A 2-week retrospective exploratory review was conducted.

Role of hepcidin in iron metabolism and potential clinical applications.

The relatively recent discovery of hepcidin has stimulated renewed research interest in iron metabolism and iron-related disorders, emphasizing the importance of this hormone in many normal and pathologic processes. Important questions still remain to be answered; however, research to date offers promising diagnostic and therapeutic implications for both humans and veterinary species.

The Werner syndrome protein is distinguished from the Bloom syndrome protein by its capacity to tightly bind diverse DNA structures.

Loss of Werner syndrome helicase-exonuclease (WRN) or of its homolog Bloom syndrome helicase (BLM) results in different inherited disorders. Whereas Werner syndrome is characterized by premature onset of aging and age-associated diseases, Bloom syndrome involves developmental abnormalities and increased predisposition to diverse malignancies. To identify biochemical differences between WRN and BLM that might contribute to the dissimilar outcomes of their loss, we compared their abilities to unwind and bind in vitro diverse DNA structures.

Strengthening the nursing and midwifery unit manager role: an interim programme evaluation.

Aims: An interim evaluation was conducted on the professional development components of the New South Wales (NSW) Health 'take the lead' ('ttl') programme, an initiative aimed at enhancing nursing/midwifery unit managers' (N/MUM) skills.

Background: Previous research has highlighted the importance of strong nurse leaders, and shown that training programmes may assist in improving leadership skills. The NSW Nursing and Midwifery Office (NaMO) developed the 'ttl' programme for N/MUMs with the intention of improving hospital quality by strengthening nurse leadership.

Work pressure and patient flow management in the emergency department: findings from an ethnographic study.

Objectives: In this hypothesis-generating study, we observe, identify, and analyze how emergency clinicians seek to manage work pressure to maximize patient flow in an environment characterized by delayed patient admissions (access block) and emergency department (ED) crowding.

Methods: An ethnographic approach was used, which involved direct observation of on-the-ground behaviors, when and where they happened. More than 1,600 hours over a 12-month period were spent observing approximately 4,500 interactions across approximately 260 emergency physicians and nurses, emergency clinicians, and clinicians from other hospital departments.

Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis.

Background: Venous Thromboembolism (VTE) is a cause of hospital mortality and managing its morbidity is associated with significant expenditure. Uptake of evidenced based guideline recommendations intended to prevent VTE in hospital settings is sub-optimal. This study was conducted to explore clinicians' attitudes and the clinical environment in which they work to understand their reluctance to adopt VTE prophylaxis guidelines.

Is Asian ethnicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of the literature.

Objective: To undertake a systematic review of the literature to determine whether Asian ethnicity is an independent risk factor for severe perineal trauma in childbirth.

Method: Ovid Medline, CINAHL, and Cochrane databases published in English were used to identify appropriate research articles from 2000 to 2010, using relevant terms in a variety of combinations. All articles included in this systematic review were assessed using the Critical Appraisal Skills Programme (CASP) 'making sense of evidence' tools.

Protein C activity in dogs: adaptation of a commercial human colorimetric assay and evaluation of effects of storage time and temperature.

Objectives of this study were to adapt a commercial human protein C (PC) colorimetric assay for use in dogs and to investigate effects of various storage conditions. The human assay was modified by using pooled canine plasma for calibration and by increasing the activation time. PC activity was measured in fresh canine plasma and in plasma stored under various conditions.

Nursing in general practice: organizational possibilities for decision latitude, created skill, social support and identity derived from role.

Aim: This article is a report of a study to describe the factors that support organizational opportunities for practice nurse decision-making and skill development for nurses employed in general practice in New South Wales, Australia.

Background: Corresponding to the availability of subsidies from the Australian universal health insurer (Medicare), there has been an increase in the number of nurses employed in general practice. Currently, there is no Australian evidence as to the organizational possibilities for these practice nurses to make decisions, develop their own skills and abilities, derive identity from their role or how their role is influenced by social support.