Innovation in Education: Transition for Enrolled Nurses

This paper discusses an initiative for qualified Enrolled Nurses, particularly those in rural Western Australia, to complete an educational transition to Registered Nurse. The discussion outlines one innovative model involving a partnership between educational institutions to address the needs of this student group. The course was developed in response to an extension of a curriculum review of the Bachelor of Science (Nursing) in 1999. The key to the success of the program, and what makes it differ from other distance education courses for Enrolled Nurses upgrading their qualifications to Registered Nurse is the role and commitment of the mentors in the Satellite Learning Centres around the State who form this important partnership. The promotion of student support mechanisms through the Centres has been a positive aspect of the course, as this vulnerable group of students often struggle to complete tertiary studies. The additional pressures of family responsibilities and work commitments, making study a difficult option, compound this. However, the challenge for universities is to continue to provide Enrolled Nurses with an opportunity to embark on tertiary study programs that are accessible, flexible, and innovative, particularly for those students in rural Australia

A collaborative model of community health nursing practice

This paper discusses a strategic collaborative partnership between a Western Australian university and a community health service based on a Practice-Research Model. The partnership has involved a senior academic (0.2 FTE) working in the community health setting as a Nurse Research Consultant since 1998. The first section of the paper draws on the nursing literature on collaborative models and describes the broad background to the partnership and development of the Model. The second section presents in detail the results of a recent evaluation that involved a brief survey and follow-up interviews to determine community health nurses' understanding and perceptions of the partnership Model. Three main themes emerged from the interviews: (1) Advancement of learning. This theme captured the extent to which the Nurse Research Consultant position helped to educate nurses and promote and develop research and best-practice; (2) Job satisfaction and self-confidence. This encompassed the extent to which participants felt nursing management were supportive of their professional education and pursuit of best-practice solutions, and (3) Situational opportunity. This theme reflected the more negative comments expressed by participants and related mostly to the restricted availability of Nurse Research Consultant and a focus on mainstream research priorities. The results suggest that the partnership Model provided the nurses with the opportunity to develop an increased understanding of the role of research in clinical practice and confidence in their own ability to reflect on current nursing practice. This allowed them to identify clinical problems in order to deliver and evaluate best-practice solutions, as evidenced by a change in attitude from the previous evaluation. However, it was also noted that the operational performance of the Model needs continual monitoring to ensure that all nurses have equitable access opportunities

Assessing and evaluating student contribution to electronic discussions

Tutors in face-to-face teaching and learning contexts, evaluate students\u27 participation in order to provide assessment that contributes towards the students\u27 final grade. Similarly, in on-line learning environments, there is a perceived need to reward the quantity and quality of student interactivity. However, the different nature of the context presents new challenges. Specifically, without the visual cues and immediate feedback, so important in face-to-face communication, the evaluation of students\u27 contributions to on-line learning activities and interaction demands new instructional and assessment skills. A unit of study at an Australian university, using computer mediated communication, was reviewed to address questions related to the appropriateness of an on-line evaluative process.<br /

A Genetic Risk Score Distinguishes Different Types of Autoantibody-Mediated Membranous Nephropathy

INTRODUCTION: Membranous nephropathy (MN) is the leading cause of nephrotic syndrome in adults and is characterized by detectable autoantibodies against glomerular antigens, most commonly phospholipase A2 receptor 1 (PLA2R1) and thrombospondin type-1 domain containing 7A (THSD7A). In Europeans, genetic variation in at least five loci, PLA2R1, HLA-DRB1, HLA-DQA1, IRF4, and NFKB1, affects the risk of disease. Here, we investigated the genetic risk differences between different autoantibody states. METHODS: 1,409 MN individuals were genotyped genome-wide with a dense SNV array. The genetic risk score (GRS) was calculated utilizing the previously identified European MN loci, and results were compared with 4,929 healthy controls and 422 individuals with steroid-sensitive nephrotic syndrome. RESULTS: GRS was calculated in the 759 MN individuals in whom antibody status was known. The GRS for MN was elevated in the anti-PLA2R1 antibody-positive (N = 372) compared with both the unaffected control (N = 4,929) and anti-THSD7A-positive (N = 31) groups (p < 0.0001 for both comparisons), suggesting that this GRS reflects anti-PLA2R1 MN. Among PLA2R1-positive patients, GRS was inversely correlated with age of disease onset (p = 0.009). Further, the GRS in the dual antibody-negative group (N = 355) was intermediate between controls and the PLA2R1-positive group (p < 0.0001). CONCLUSION: We demonstrate that the genetic risk factors for PLA2R1- and THSD7A-antibody-associated MN are different. A higher GRS is associated with younger age of onset of disease. Further, a proportion of antibody-negative MN cases have an elevated GRS similar to PLA2R1-positive disease. This suggests that in some individuals with negative serology the disease is driven by autoimmunity against PLA2R1

A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity.

BACKGROUND: In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. MAIN BODY: We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. CONCLUSION: In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

The role of mothers and fathers in the sexuality education of their children: a cross sectional study.

This study examined the roles of mothers and fathers in the sexuality education of their sons and daughters. Specifically, the research investigated the sexuality knowledge, attitudes and skills of parents to provide education to their pre-school (5 years of age) or year seven (12 years of age) children. Investigation of parents' active participation in the sexuality education of their children and analysis of the factors which determined their involvement was the main objective of the study. The comfort level of parents in their communication with their children and plans for further sexuality education were also considered. Predictive models of sexuality communication were empirically tested and from this a conceptual model was derived which explicates sexuality education in the home.The research involved both a qualitative and quantitative approach to the investigation of parents' contribution to the future sexual health of their children. The first phase of the study involved focus group interviews with 11 parents to discuss their issues and concerns in providing sexuality education. Thematic analysis of the focus groups and review of the literature informed development of the instrument used in the second phase of the study.Face validity of the instrument was established and 371 parents participated in phase two of the study. One hundred and ninety five (195) mothers and 176 fathers responded voluntarily to an anonymous, self-administered questionnaire on their involvement in their child's sexuality education.In the second phase of the study the instrument used included demographic data and general questions regarding sexuality education. A sexuality knowledge and attitude scale was included as well as qualitative questions concerning parents' skills in sexuality education pertaining to three relevant scenarios. Parents' teaching practices, plans for future sexuality education and a Likert scale of comfort levels was also part of the instrument.Demographic data was consistent with the general population except with respect to income and education which were both higher than expected. Most parents (95%) stated that the home should be the primary place for sexuality education. However, less than half (36%) initiated frequent discussion with their child.Results showed that generally parents had a satisfactory knowledge of sexuality (M= 2 1) but that mothers had more knowledge of sexuality than fathers. Parents' sexuality attitudes tended toward the conservative end of the continuum with fathers more liberal in their attitudes than mothers. The study revealed a small positive correlation between knowledge and attitudes which showed that parents with more knowledge had more liberal attitudes.Mothers' and fathers' skills in sexuality education varied, demonstrating some uncertainty in this aspect of parenting. Most parents (63%) were not appropriate in their response to their child's questions about 'how babies are made', and provided their child with no factual information. Although most parents (76%) had observed their child's 'genital play' the majority (75%) were unaware of their child's 'sex play' behaviours. Parents' skills in responding to their child's genital play and sex play revealed that few (less than 16%) demonstrated complete acceptance of their child's sexual behaviour. Curiously, parents stated that they were generally comfortable when presented with all situations. The findings indicate a need for community based parent education which focuses on enhancing parents' sexuality knowledge, attitudes and skills.Generally small percentages of parents talked to their children about various sexuality topics with the factual topics such as body differences, birth, reproduction and obscene words the most frequently discussed. Other topics, of a more sensitive or intimate nature, such as contraception, sexually transmissible diseases, abortion, dating, intimate relationships, masturbation, petting and wet dreams were discussed by fewer parents. Not unexpectedly, parents communicated more with their year seven child than their pre-schooler, but the ages at which topics were introduced varied widely. This suggests parents require guidelines for their role which promote early, open and unreserved communication. The timing of sexuality education is also crucial to ensure that sexuality is as integral to the individual as numeracy and literacy and is approached in the same manner.For almost all topics mothers communicated more than fathers for both the pre-school and year seven groups. In contrast to the literature, pre-school mothers communicated equally with both genders and fathers communicated more with their sons, while by year seven, both mothers and fathers communicated more with their sons than their daughters. The topics discussed with sons and daughters appeared to differ with both mothers and fathers discussing physiological and protective issues with daughters and conversing about sexual behaviours with sons. Gender was a significant factor in sexuality education and strategies to promote equality relating to both parents and children are required.Many parents severely overestimated their plans for communicating with their children about sexuality. Most parents of pre-school children planned to discuss all sexuality topics by the time their children were 12 years old, but in reality this was not evident when compared with the year seven group. Few children initiated frequent communication (37%) with their parents but when they did it was usually with their mother.For the overall sample, the communication of sexuality was predicted by parents' attitudes to teaching sexuality, their perceived preparation, the church as a source of sexual learning and their teaching skills. The predictors however, varied depending on the gender of the parent and the age group being considered and different models explained between 14% and 46% of the variance of communication.No previously published research in Australia has investigated the role of mothers and fathers as sexuality educators. This study has contributed to the increasing body of knowledge in sexuality which aims to educate children more comprehensively for sexual health in adulthood. The conceptual framework derived from the literature and the findings of the study is anticipated to be of benefit to health professionals, school teachers and sexuality educators as they work with parents to promote sexual health