Nurses’ Learning and Conceptualization of Technology used in Practice

How nurses conceptualize and learn about health technology used in practice was examined in this qualitative, interpretive-descriptive study. Traditionally, conceptualizations of technology used in the nursing profession have been viewed from either socially- or technically- centric perspectives that have clouded the real nature of nurse-technology interactions. For instance, current perspectives examining nurses’ use of technology typically ignore or minimize socio-technical considerations impacting technology acceptance and adoption by nurses. A research approach that embraced the mingling of social and material (sociomaterial) actors was used to address the following research questions: (a) How do nurses conceptualize health technology used in practice?, and, (b) How do nurses learn about health technology used in practice? The theoretical lens of Actor-Network Theory (ANT) provided the overall perspective and guided elements of data collection and analysis. ANT is aligned to a relational ontology, whereby both human and non-human participants (or actors) are viewed in symmetry (or as equals) during data analysis. Privilege during the analysis was, therefore, not automatically prescribed to either the human or non-human actors. Interviews, documents, and direct observation of nurses constituted the majority of the data collected for this study. Using an iterative data analysis process, themes were generated related to nurses’ conceptualization of and learning about technology used in practice. Technology was conceptualized by nurses to possess variation in naming, roles, and also engendered notions of action or praxis. Learning technology by nurses possessed elements resembling both processes and products. From these learning processes and products, salient strategies (e.g., indispensability, semblance, habituation) were developed by nurses in order to negotiate and use various health technologies for practice. Ultimately, learning of health technology by nurses appeared to actively influence, modify, and shape the role of health technology, and its subsequent use by human actors. Therefore, how nurses learn about technology should be considered during the planning, development, and evaluation of future technologies. End-users, like nurses, will rarely use a health technology to its fullest capability unless learning is congruent with the environmental context surrounding the technological actor. In light of these findings, recommendations for nursing education and professional practice related to the role and interpretation of health technology used by nurses in 2013 is also discussed, along with implications for future research

Exoplanet atmosphere evolution: emulation with random forests

Atmospheric mass-loss is known to play a leading role in sculpting the demographics of small, close-in exoplanets. Understanding the impact of such mass-loss driven evolution requires modelling large populations of planets to compare with the observed exoplanet distributions. As the quality of planet observations increases, so should the accuracy of the models used to understand them. However, to date, only simple semi-analytic models have been used in such comparisons since modelling populations of planets with high accuracy demands a high computational cost. To address this, we turn to machine learning. We implement random forests trained on atmospheric evolution models, including XUV photoevaporation, to predict a given planet's final radius and atmospheric mass. This evolution emulator is found to have an RMS fractional radius error of 1$\%$ from the original models and is $\sim 400$ times faster to evaluate. As a test case, we use the emulator to infer the initial properties of Kepler-36b and c, confirming that their architecture is consistent with atmospheric mass loss. Our new approach opens the door to highly sophisticated models of atmospheric evolution being used in demographic analysis, which will yield further insight into planet formation and evolution.Comment: 5 pages, 3 figures. Submitted to MNRAS letter

Reproductive Compatibility among Populations and Host‐Associated Lineages of the Common Bed Bug (\u3cem\u3eCimex lectularius\u3c/em\u3e L.)

As populations differentiate across geographic or host‐association barriers, interpopulation fertility is often a measure of the extent of incipient speciation. The bed bug, Cimex lectularius L., was recently found to form two host‐associated lineages within Europe: one found with humans (human‐associated, HA) and the other found with bats (bat‐associated, BA). No unequivocal evidence of contemporary gene flow between these lineages has been found; however, it is unclear whether this is due to an inability to produce viable “hybrid” offspring. To address this question and determine the extent of compatibility between host‐associated lineages, we set up mating crosses among populations of bed bugs based on both their host association (human—HA vs. bat—BA) and geographic origin (North America vs. Europe). Within‐population fecundity was significantly higher for all HA populations (\u3e 1.7 eggs/day) than for BA populations (\u3c 1 egg/day). However, all within‐population crosses, regardless of host association, had \u3e 92% egg hatch rates. Contrary to previous reports, in all interlineage crosses, successful matings occurred, fertile eggs were oviposited, and the F1 “hybrid” generation was found to be reproductively viable. In addition, we evaluated interpopulation genetic variation in Wolbachia among host‐associated lineages. We did not find any clear patterns related to host association, nor did we observe a homogenization of Wolbachia lineages across populations that might explain a breakdown of reproductive incompatibility. These results indicate that while the HA and BA populations of C. lectularius represent genetically differentiated host‐associated lineages, possibly undergoing sympatric speciation, this is in its incipient stage as they remain reproductively compatible. Other behavioral, physiological, and/or ecological factors likely maintain host‐associated differentiation

Seasonal variation in hospital encounters with hypoglycaemia and hyperglycaemia

Aim To assess whether rates of hospital encounters with hypoglycaemia and hyperglycaemia display seasonal variation. Methods Time series analyses of the monthly rates of hospital encounters (emergency room visits or inpatient admissions) with hypoglycaemia and hyperglycaemia from 2003 to 2012 using linked healthcare databases in Ontario, Canada. Results Over the study period, there were 129 887 hypoglycaemia and 79 773 hyperglycaemia encounters. The characteristics of people at the time of their encounters were similar across the seasons in 2008 (median age 68 years for hypoglycaemia encounters and 53 years for hyperglycaemia encounters; 50% female; 90% with diabetes). We observed moderate seasonality in both types of encounters (R2 autoregression coefficient 0.58 for hypoglycaemia; 0.59 for hyperglycaemia). The rate of hypoglycaemia encounters appeared to peak between April and June, when on average, there was an additional 49 encounters per month (0.36 encounters per 100 000 persons per month) compared with the other calendar months (5% increase). The rate of hyperglycaemia encounters appeared to peak in January, when on average, there was an additional 69 encounters per month (0.50 encounters per 100 000 persons per month) compared with the other calendar months (11% increase). Conclusions In our region, there is seasonal variation in the rate of hospital encounters with hypoglycaemia and hyperglycaemia. Our findings may help to highlight periods of vulnerability for people, may inform future epidemiological studies and may aid in the appropriate planning of healthcare resources

Comparison of bulk milk antibody and youngstock serology screens for determining herd status for Bovine Viral Diarrhoea Virus

BACKGROUND: This paper examines the use of Bulk Milk antibody (BM Ab), Youngstock (YS) serology (Check Tests) and Bulk Milk PCR (BM PCR) for determining the presence or absence of animals persistently infected (PI) with Bovine Viral Diarrhoea Virus (BVDV) within a herd. Data is presented from 26 herds where average herd sizes were 343 and 98 animals for dairy and beef units respectively. Seventeen herds had sufficient data to analyse using Receiver Operating Characteristic (ROC) and probability curves enabling calculation of the sensitivity and specificity of BM Ab and YS Check tests for determining the presence of PI animals within herds in this dataset. RESULTS: Using BM Ab to screen a herd for the presence of PI animals, achieved a herd level sensitivity and specificity of 80.00 % (44.39–97.48 %) and 85.71 % (42.13–99.64 %) respectively (95 % confidence intervals quoted). Sensitivity and specificity of YS Check Tests at a cut off of 3/10 Ab positive YS were 81.82 % (48.22–97.72 %) and 66.67 % (22.28–95.67 %) respectively (95 % confidence interval). These results were achieved by comparing the screening tests to whole herd PI searches that took place 1–19 months after the initial screen with a mean interval of 8 months. Removal of this delay by taking BM samples on the day of a whole herd test and simulating a YS Check Test from the herd test data produced improvements in the reliability of the Check Tests. BM Ab sensitivity and specificity remained unchanged. However, the Check Test sensitivity and specificity improved to 90.9 % (58.72–99.77 %) and 100 % (54.07–100 %) respectively (95 % confidence interval) at a cut of off 2.5/10 Ab positive animals. Our limited BM PCR results identified 5/23 dairy farms with a positive BM PCR result; two contained milking PIs, two had non-milking PIs and another had no PIs identified. CONCLUSIONS: Delaying a PI search following an initial herd screen decreased the diagnostic accuracy and relevance of our results. With careful interpretation, longitudinal surveillance using a combination of the techniques discussed can successfully determine farm status and therefore allow changes in BVDV status to be detected early, thus enabling prompt action in the event of a BVDV incursion

Neodymium and Erbium Coordination Environments in Phosphate Glasses

The local structures of Nd3+ and Er3+ ions in two series of rare-earth (RE) phosphate glasses with nominal compositions xR203-(1-x)P2O5, where R=Nd and Er and 0.05≤x≤0.28, have been characterized by LIII-edge extended x-ray-absorption fine-structure spectroscopy (EXAFS). The RE coordination number depends on the R2O3 content, decreasing from 9.0 (10) oxygen nearest neighbors in ultraphosphate compositions (x\u3c0.15) to 6.4 (9) oxygen nearest neighbors for the metaphosphate (x∼0.25) compositions. The average Er-O bond distance decreases from 2.29 (1) to 2.23 (1) Å, and the average Nd-O bond distance decreases from 2.40 (1) to 2.37 (1) Å over the same compositional range. The changes in coordination environments are consistent with the conversion of isolated RE polyhedra to clustered RE polyhedra sharing common oxygens as the number of available terminal oxygens per RE ion decreases with increasing x

Digital professionalism on social media: The opinions of undergraduate nursing students

From PubMed via Jisc Publications RouterSocial media are a suite of popular online technologies that enable people to share and co-create digital content. Evidence suggests some nursing students utilise social media inappropriately but there is limited literature on nursing students' opinions of professionalism in online environments. This study aimed to examine the opinions of nursing students in relation to digital professionalism on social media. A descriptive, cross-sectional study was conducted with undergraduate nursing students in the United Kingdom (n = 112). An existing self-reported questionnaire was adapted for data collection. This was distributed to adult nursing students enrolled across all four years of a Bachelor of Nursing programme. Data were analysed using descriptive statistics. Many nursing students were heavy social media users (n = 49, 44%), with Facebook, Instagram, and Snapchat being the most popular applications. Nursing students were also aware of the professional nursing regulator, the Nursing and Midwifery Council, guidelines on responsible social media use (n = 48, 43%). Nursing students' responses to various digitally professional scenarios revealed agreement that posts about alcohol or sexually explicit content, along with comments about colleagues or patients were inappropriate. However, there were mixed views around taking photographs at work, with some nursing students across all four years of the degree programme perceiving this to be satisfactory behaviour. The opinions of nursing students towards digital professionalism on social media are somewhat aligned with professional standards, although students can hold varying views on the subject. More research on how nursing students employ social media is warranted to ensure their opinions match their actual practice in online environments. It is also recommended to educate nursing students about the professional values and behaviours required on social media and how best to communicate, interact, and share information on the various online platforms, to minimise personal and organisational risk. [Abstract copyright: Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.]111pubpu

Inaugural Artificial Intelligence for Public Health Practice (AI4PHP) Retreat: Ontario, Canada

The Artificial Intelligence (AI) for Public Health Practice Retreat was a hybrid event held in October 2022 in London, Ontario to achieve three main goals: 1) Identify both the goals of public health practitioners and the tasks that they undertake as part of their practice to achieve those goals that could be supported by AI, 2) Learn from existing examples and the experience of others about facilitators and barriers to AI for public health, and 3) Support new and strengthen existing connections between public health practitioners and AI researchers. The retreat included a keynote presentation, group brainstorming exercises, breakout group activities, case studies, and interspersed breaks for networking and reflection. There were 38 attendees from across Ontario, and a guest speaker from New York. Major themes that emerged from discussions included the need for greater attention to AI applications in public health given the potential benefits and enthusiasm; rigorous data collection, data quality, and data accessibility as a foundational factor that needs urgent attention; and the need for an equitable systems-thinking approach to AI amidst the breadth of public health functions, interventions, and population-based applications. Attendees expressed a desire for continued engagement and collaboration between public health practice and AI researchers

Exploring the role of the nurse manager in supporting point-of-care nurses’ adoption of electronic health records: protocol for a qualitative research study

Introduction: An increasing number of electronic health record (EHR) systems have been implemented in clinical practice environments where nurses work. Findings from previous studies have found that a number of intended benefits of the technology have not yet been realised to date, partially due to poor system adoption among health professionals such as nurses. Previous studies have suggested that nurse managers can support the effective adoption and use of the technology by nurses. However, no known studies have identified what role nurse managers have in supporting technology adoption, nor the specific strategies that managers can employ to support their staff. Therefore, the purpose of this research is to better understand the role of the nurse manager in point-of-care nurses’ use of EHRs, and to identify strategies that may be effective in supporting clinical adoption. Methods and analysis This study will use a qualitative descriptive design. Interviews with both nurse managers and point-of-care nursing staff will be conducted in a Canadian mental health and addiction healthcare organisation where an EHR has been implemented. A semistructured interview guide will be used, and interviews will be audio recorded. Transcripts will be analysed using a directed content analysis technique. Strategies to ensure the trustworthiness of the data analysis procedure and findings will be employed. Ethics and dissemination Ethical approval for this study has been obtained. Dissemination strategies may include a paper submission to a peer-reviewed journal, a conference submission and meetings to share findings with the study site leadership team. Findings from this research will be used to inform a future study which aims to assess levels of competencies and perform a psychometric analysis of the Nursing Informatics Competency Assessment for the Nurse Leader instrument in a Canadian context