"Never let a good crisis go to waste": Positives from disrupted maternity care in Australia during COVID-19.

OBJECTIVE: Due to the COVID-19 pandemic, a number of changes to maternity care were rapidly introduced in all countries, including Australia, to reduce the risk of infection for pregnant women and their care providers. While many studies have reported on the negative effects of these changes, there is a paucity of evidence on factors which women and their providers perceived as positive and useful for future maternity care. DESIGN: Data was analysed from the Birth in the time of COVID-19 (BITTOC 2020) study survey. Conventional content analysis and descriptive statistics were used to analyse the data and examine which aspects of COVID-amended care women experienced as positive. Data from women were compared to data from midwives. SETTING: This project took place in Australia in 2020-2021. PARTICIPANTS: The survey was distributed to women who gave birth and midwives who worked in Australia during the COVID-19 pandemic (March 2020 onwards). MEASUREMENTS AND FINDINGS: Women reported a variety of positives from their maternity care during COVID-19. These included both care-related factors as well as contextual factors. The most commonly mentioned positives for pregnant and postnatal women were care-related, namely fewer visitors in hospital, having increased access to telehealth services. These were also the most commonly reported positives by midwives. Having midwifery continuity of care models, giving birth at home and having their partner work from home were also highlighted by women as positives. KEY CONCLUSIONS: Despite the negative effect of COVID-19-related restrictions on maternity care, a variety of changes were viewed as positive by both women and midwives, with strong agreement between the two groups. IMPLICATIONS FOR PRACTICE: These findings provide evidence to support the inclusion of these positive elements of care and ensure that the lessons learned from the pandemic are utilised to improve maternity care in Australia going forward

Multiparous women's confidence to have a publicly-funded homebirth: A qualitative study

Background: Hospital birth is commonly thought to be a safer option than homebirth, despite many studies showing similar rates of safety for low risk mothers and babies when cared for by qualified midwives with systems of back-up in place. Recently in Australia, demand has led to the introduction of a small number of publicly-funded homebirth programs. Women's confidence in having a homebirth through a publicly-funded homebirth program in Australia has not yet been explored. Aim: The aim of the study was to explore the reasons why multiparous women feel confident to have a homebirth within a publicly-funded model of care in Australia. Methods: Ten multiparous English-speaking women who chose to have a homebirth with the St George Hospital Homebirth Program were interviewed in the postnatal period using semi-structured, open-ended questions. Interviews were transcribed, then a thematic analysis was undertaken. Results: Women, having already experienced a normal birth, demonstrated a strong confidence in their ability to give birth at home and described a confidence in their bodies, their midwives, and the health system. Women weighed up the risks of homebirth through information they gathered and integration with their previous experience of birth, their family support and self-confidence. Discussion: Women choosing publicly-funded homebirth display strong confidence in both themselves to give birth at home, and their belief in the health system's ability to cope with any complications that may arise. Implications for practice: Many women may benefit from access to publicly-funded homebirth models of care. This should be further investigated. © 2010 Australian College of Midwives

Apollo experience report: Simulation of manned space flight for crew training

Through space-flight experience and the development of simulators to meet the associated training requirements, several factors have been established as fundamental for providing adequate flight simulators for crew training. The development of flight simulators from Project Mercury through the Apollo 15 mission is described. The functional uses, characteristics, and development problems of the various simulators are discussed for the benefit of future programs

Nursing churn and turnover in Australian hospitals: Nurses perceptions and suggestions for supportive strategies

Background: This study aimed to reveal nurses' experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories.Method: A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories.Results: Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options.Conclusion: Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover. © 2014 Dawson et al.; licensee BioMed Central Ltd

‘Being the bridge and the beacon’: a qualitative study of the characteristics and functions of the liaison role in child and family health services in Australia

© 2016 John Wiley & Sons Ltd Aims and objectives: This article explores the characteristics and functions of the liaison role in child and family health services in Australia. Background: Liaison roles are increasingly being used to improve communication between health services and professionals and to facilitate access to support for individuals and families in need. Nurses are commonly, although not always, the professionals who undertake these roles. Research on the role and outcomes of liaison positions in child and family health services is limited in Australia and internationally. Design: A qualitative interpretive design informed this study. Interviews and focus groups were conducted with 40 liaison and other health professionals, primarily nurses, working with families with newborn and young children in two Australian States. Data were analysed thematically. Results: Three major themes were identified reflecting the importance of defining the role and tasks which included building bridges between services and professionals, supporting families during transition between services and supporting clinicians. Several facilitators and barriers were identified, including concerns about sustainability of the roles. Conclusions: Professionals working in a liaison role in child and family health services emphasise that these positions have the potential to link services and professionals, thereby providing more effective care pathways for children and families especially for those with complex and multiple vulnerabilities. While a few children and family health services in Australia provide liaison services, the extent of liaison support and the outcomes for families in Australia is unknown. Relevance to clinical practice: Nurses working with children and families are the most likely health professionals to undertake a liaison role. In many nursing contexts, liaison roles are relatively new and those in the role have the responsibility to define the key purpose of their role. Liaison roles are multifaceted requiring the nurse to have excellent communication and negotiation skills to effectively link diverse professionals and services, while simultaneously engaging with and supporting vulnerable families and children. Nurses in these roles also support and educate clinical colleagues

Big end bearing losses with thermal cavitation flow under cylinder deactivation

The paper presents a mixed thermo-hydrodynamic analysis of elliptic bore bearings using combined solution of Navier–Stokes, continuity and energy equations for multi-phase flow conditions. A vapour transport equation is also included to ensure continuity of flow in the cavitation region for the multiple phases as well as Rayleigh–Plesset to take into account the growth and collapse of cavitation bubbles. This approach removes the need to impose artificial outlet boundary conditions in the form of various cavitation algorithms which are often employed to deal with lubricant film rupture and reformation. The predictions show closer conformance to experimental measurements than have hitherto been reported in the literature. The validated model is then used for the prediction of frictional power losses in big end bearings of modern engines under realistic urban driving conditions. In particular, the effect of cylinder deactivation (CDA) upon engine bearing efficiency is studied. It is shown that big-end bearings losses contribute to an increase in the brake specific fuel consumption with application of CDA contrary to the gains made in fuel pumping losses to the cylinders. The study concludes that implications arising from application of new technologies such as CDA should also include their effect on tribological performance

Cataclysmic Variables and Other Compact Binaries in the Globular Cluster NGC 362: Candidates from Chandra and HST

Highly sensitive and precise X-ray imaging from Chandra, combined with the superb spatial resolution of HST optical images, dramatically enhances our empirical understanding of compact binaries such as cataclysmic variables and low mass X-ray binaries, their progeny, and other stellar X-ray source populations deep into the cores of globular clusters. Our Chandra X-ray images of the globular cluster NGC 362 reveal 100 X-ray sources, the bulk of which are likely cluster members. Using HST color-magnitude and color-color diagrams, we quantitatively consider the optical content of the NGC 362 Chandra X-ray error circles, especially to assess and identify the compact binary population in this condensed-core globular cluster. Despite residual significant crowding in both X-rays and optical, we identify an excess population of H{\alpha}-emitting objects that is statistically associated with the Chandra X-ray sources. The X-ray and optical characteristics suggest that these are mainly cataclysmic variables, but we also identify a candidate quiescent low mass X-ray binary. A potentially interesting and largely unanticipated use of observations such as these may be to help constrain the macroscopic dynamic state of globular clusters.Comment: 6 pages, 6 figures, to appear in the proceedings of the conference "Binary Star Evolution: Mass Loss, Accretion, and Mergers," Mykonos, Greece, June 22-25, 201