ACCCN Workforce Standards for Intensive Care Nursing: Systematic and evidence review, development, and appraisal

Background: The intensive care nursing workforce plays an essential role in the achievement of positive healthcare outcomes. A growing body of evidence indicates that inadequate nurse staffing and poor skill mix are associated with negative outcomes for patients, and potentially compromises nurses’ ability to maintain the safety of those in their care. In Australia, the Australian College of Critical Care Nurses (ACCCN) has previously published a position statement on intensive care staffing. There was a need for a stronger more evidence based document to support the intensive nursing workforce. Objectives: To undertake a systematic and evidence review of the evidence related to intensive care nurse staffing and quality of care, and determine evidence-based professional standards for the intensive care nursing workforce in Australia. Methods: The National Health and Medical Research Council standard for clinical practice guidelines methodology was employed. The English language literature, for the years 2000-2015 was searched. Draft standards were developed and then peer- and consumer-reviewed. Results: A total of 553 articles was retrieved from the initial searches. Following evaluation, 231 articles met the inclusion criteria and were assessed for quality using established criteria. This evidence was used as the basis for the development of ten workforce standards, and to establish the overall level of evidence in support of each standard. All draft standards and their subsections were supported multi-professionally (median score >6) and by consumers (85–100% agreement). Following minor revisions, independent appraisal using the AGREE II tool indicated that the standards were developed with a high degree of rigour. Conclusion: The ACCCN intensive care nursing nurse workforce standards are the first to be developed using a robust, evidence-based process. The standards represent the optimal nurse workforce to achieve the best patient outcomes and to maintain a sustainable intensive care nursing workforce for Australia

Session 1: Eugenics Narrative and Reproductive Engineering

Proceedings of the Pittsburgh Workshop in History and Philosophy of Biology, Center for Philosophy of Science, University of Pittsburgh, March 23-24 2001 Session 1: Eugenics Narrative and Reproductive Engineerin

Coyote (Canis latrans) use of marine resources in coastal California: A new behavior relative to their recent ancestors

Coyotes ( Canis latrans) are known to consume marine foods, but the importance and persistence of marine subsidies to coyotes is unknown. Recent access to a marine subsidy, especially if gained following apex predator loss, may facilitate coyote expansion along coastal routes and amplify the effects of mesopredator release. Our goal was to quantify and contextualize past and present marine resource use by coyotes on the central coast of California via stable isotope analysis. We measured δ13C and δ15N values in coyotes, their competitors, and their food resources at two modern sites, seven archaeological sites spanning in age from ~3000 to 750 BP, and from historical (AD 1893–1992) coyote and grizzly bear hair and bone sourced from coastal counties. We found evidence for marine resource use by modern coastal California coyotes at one site, Año Nuevo, which hosts a mainland northern elephant seal ( Mirounga angustirostris) breeding colony. Seals and sea lions account for ~20% of Año Nuevo coyote diet throughout the year and this marine subsidy likely positively impacts coyote population size. Isotopic data suggest that neither historic nor prehistoric coyotes consumed marine-derived foods, even at sites near ancient mainland seal rookeries. Marine resource use by some contemporary California coyotes is a novel behavior relative to their recent ancestors. We hypothesize that human alteration of the environment through extirpation of the California grizzly bear and the more recent protection of marine mammals likely enabled this behavioral shift

Teaching autonomy

A key factor in the transition to university is the enculturation of new students into both the discipline they are studying and effective study practices. Most significantly, students, whatever their chosen discipline, must learn to become autonomous learners. Too often this process is either left to chance or seen as a natural attribute of the higher education learning system rather than a particular skill that must be learnt and can be taught. In this article we discuss one particular approach to designing ‘structured autonomy’ into a first year core media studies module. We argue that the notion of autonomy needs to be considered as a central component of learning, teaching and assessment strategies and, moreover, that an integrated approach towards these factors has the additional benefit of contributing towards a more holistic first year experience for students

Regional Working in the East of England: Using the UK National Standards for Public Involvement

Plain English summary: Involving patients and members of the public to help shape and carry out research is recommended in health research in the United Kingdom (UK). There are a number of regional networks of Patient and Public Involvement (PPI) groups, which support the collaboration between researchers, patients and public members. We are a group of researchers, patients and public members who came together via a PPI regional network in the East of England to collaborate on a research study about the extent of feedback from researchers to PPI contributors.The aim of this paper is to use the recently developed UK National Standards for Public Involvement to structure our thinking about what worked well and what did not, within our recently completed study. We believe this paper is one of the first to use the National Standards to structure a retrospective reflection on PPI within a study.Our findings showed that there are benefits of regional working, including easier access to public members and bringing together researchers, public members and those who run PPI groups for research collaboration. The main challenges included involvement of people before studies are funded and working across organisations with different payment processes.The National Standards for Public Involvement has provided a useful framework to consider how best to involve patients and members of the public in research and could be a helpful structure to reflect on successes and challenges in individual projects and also regional, national or international comparisons of PPI in research. Abstract: Background Regional networks of Patient and Public Involvement (PPI) organisations, including academic institutions, health and social care services, charities, patient and public groups and individuals, can play an important part in carrying out health research. In the UK, recommendations by the National Institute of Health Research (NIHR) encourage the use of regional, collaborative networks with shared resources and training. Methods The newly developed UK National Standards for Public Involvement were used as a framework for a retrospective reflection of PPI within a recently completed research study which focused on feedback from researchers to PPI contributors. PPI contributors, those running PPI groups (PPI leads) and researchers involved in the study have contributed to this reflection by completing evaluation forms throughout the research alongside notes of meetings and co-authors' final reflections. Results Results revealed a number of successes where the regional network was particularly useful in bringing together PPI contributors, those who lead PPI groups and researchers. The regional network helped researchers to get in touch with patients and members of the public. Challenges included involving people before funding and bureaucratic and financial barriers when working across different organisations in the region. The importance of working together in flexible, informal ways was key and on-going support for the PPI contributors was vital for continued involvement, including emotional support not just monetary. The first four National Standards of inclusive opportunities, working together, support and learning and communications were particularly useful as means of structuring our reflections. Conclusions To our knowledge, this is one of the first research studies to use the UK National Standards for Public Involvement as a framework to identify what worked well and the challenges of PPI processes. It is suggested that as more reflective papers are published and the National Standards are more widely used in the UK, many lessons can be learnt and shared on how to improve our Patient and Public Involvement within research studies. Evaluations or reflections such as these can further enhance our understanding of PPI with implications for regional, national and international comparisons.Peer reviewedFinal Published versio

Morton, Gould, and Bias: A Comment on The Mismeasure of Science

Stephen Jay Gould famously used the work of Samuel George Morton (1799–1851) to illustrate how unconscious racial bias could affect scientific measurement. Morton had published measurements of the average cranial capacities of different races, measurements that Gould reanalyzed in an article in Science [1] and then later in his widely read book The Mismeasure of Man [2]. During the course of this reanalysis, Gould discovered prima facie evidence of unconscious racial bias in Morton’s measurements. More than 30 years later, Lewis et al. published a critique of this analysis [3], denying that Morton’s measurements were biased by his racism. Instead, they claim that their “results falsify Gould’s hypothesis that Morton manipulated his data to conform with his a priori views.” We believe this is mistaken, and our comment will explain why

Ports and Ladders: The Nature and Relevance of Internal Labor Markets in a Changing World

[Excerpt] Many believe that the nature of careers has changed dramatically in the past twenty years. One scholar writes that internal labor markets have been \u27demolished\u27, while a human resources manager at Intel comments that, in contrast to the past, today, \u27You own your own employability. You are responsible\u27 (Knoke 2001: 31). The idea of the \u27boundaryless career\u27 seems increasingly popular (Arthur and Rousseau 1996). If it is in fact true that the old rules for organizing work have disappeared, this would represent a fundamental change for employees. It would also have major implications for how scholars think about the labor market. Not surprisingly, the reality is more complicated, with evidence of both change and stability in the nature of the employment relationship. In this chapter we discuss the nature of these developments and their implications for the internal labor market literature

Managing resources in erratic environments: an analysis of pastoralist systems in Ethiopia, Niger, and Burkina Faso

This study analyzes the links between risk and the kinds of property rights that have evolved to provide the mobility necessary to raise livestock in drought-prone countries in this case Burkina Faso, Ethiopia, and Niger. The study also evaluates the impact of cooperation on resource management in these environments. The express purpose of this research is to contribute to the current debate on resource management in highly variable environments, focusing on the impact of climate variability on and the role of cooperation in resource management. More specifically, a conceptual framework is developed to analyze the impact of climatic variability and cooperative capacity on land allocation patterns, stock densities, and patterns of herd mobility. Overall, the empirical results suggest that effective policies for sustainable land management and crisis-response plans may require the design and implementation of mechanisms to increase cooperative capacity.Range management Ethiopia, Range management Niger, Range management Burkina Faso, Pastoral systems,