Obstacles that prevent nurse practitioners in New Zealand fulfilling their roles

The nurse practitioner (NP) position has not been embraced as eagerly as other new health practitioner roles in New Zealand (NZ), and there is little research about the role in the country. A study was carried out to find out more about the contribution NPs are making to primary health care, regardless of healthcare setting. Using a mixed-methods approach, the study mapped the contributions of NPs against indicators from a results-based model for primary health care developed by Watson et al (2009). The findings demonstrate that NPs are essential to maintaining the population’s health in a cost-constrained healthcare environment and highlight the need for national policymakers and local decision makers to give the role a higher profile and to provide more resources and support

Opportunities and barriers perceived by secondary school agriculture teachers in implementing the GPS cows learning module

© 2019, International Journal of Innovation in Science and Mathematics Education. Within the agriculture sector the use of digital technologies is rapidly expanding. There is a growing shortage of skilled people considering a career within this sector to support the uptake of agricultural technology. The GPS Cows program is designed to improve secondary school student's knowledge and skills of emerging agricultural technologies. It highlights a range of opportunities and potential career options available to students in agriculture. This collaborative project combines the expertise and passion of researchers, industry professionals and educators in both Australia and the USA. A pilot workshop was run with ten teachers from nine Queensland and New South Wales secondary schools. Teachers participated in lectures and practical workshops, developed data analysis skills and took part in a World Café style focus group. The focus group findings highlighted that for the GPS Cows program to be implemented in secondary school classrooms, excellent resources from the GPS Cows team are needed, combined with ongoing support and guidance. Nevertheless, the participating teachers felt that their students would both engage and enjoy participating in the GPS Cows program and realise the opportunities the agricultural sector offers

Mid-infrared spectroscopy coupled with chemometrics to identify spectral variability in Australian barley samples from different production regions

Mid-infrared spectroscopy coupled with chemometrics was used to identify spectral differences in malt barley associated with region (e.g. rainfall, temperature and sunlight). The observed differences in the MIR spectra confirmed that different environmental conditions of the region they are grown, explain or modulate changes in the chemical composition of the grain. Principal component analysis (PCA) was performed to identify underlying patterns and correlations in the data set. Partial least squares (PLS) regression with cross-validation was applied to develop models to predict the regions using the weather variables, the MIR fingerprint region and a combination of both. The PLS model with the combined data predicted the growing location with the standard error of cross-validation (SECV) of 3.38%, an R2 value of 0.53, a slope of 0.52 and a bias of 0.23. The exploratory approach demonstrated the usefulness of chemometrics to identify differences and similarities based on the MIR spectra. The results provided a solid foundation for hypothesising the overall degree of biochemical similarity and or difference among the samples and a quantifiable method to screen samples for further analysis

The reliability of a portable steam sauna pod for the whole-body passive heating of humans

IntroductionPassive heating is receiving increasing attention within human performance and health contexts. A low-cost, portable steam sauna pod may offer an additional tool for those seeking to manipulate physiological (cardiovascular, thermoregulatory and sudomotor) and perceptual responses for improving sporting or health profiles. This study aimed to 1) report the different levels of heat stress and determine the pods’ inter-unit reliability, and 2) quantify the reliability of physiological and perceptual responses to passive heating.MethodIn part 1, five pods were assessed for temperature and relative humidity (RH) every 5 min across 70 min of heating for each of the 9 settings. In part 2, twelve males (age: 24 ± 4 years) completed two 60 min trials of passive heating (3 × 20 min at 44 °C/99% RH, separated by 1 week). Heart rate (HR), rectal (Trectal) and tympanic temperature (Ttympanic) were recorded every 5 min, thermal comfort (Tcomfort) and sensation (Tsensation) every 10 min, mean arterial pressure (MAP) at each break period and sweat rate (SR) after exiting the pod.ResultsIn part 1, setting 9 provided the highest temperature (44.3 ± 0.2 °C) and longest time RH remained stable at 99% (51±7 min). Inter-unit reliability data demonstrated agreement between pods for settings 5–9 (intra-class correlation [ICC] >0.9), but not for settings 1–4 (ICC 0.05) were observed for Trectal, Ttympanic, Tsensation or Tcomfort, however HR (+3 b.min−1) and MAP (+4 mmHg) were greater in visit 1 vs. 2 (p < 0.05).ConclusionPortable steam sauna pods generate reliable heat stress between-units. The highest setting (44 °C/99% RH) also provides reliable but modest adjustments in physiological and perceptual responses.</p

The juxtaposition of nursing autonomy and health care policy in nursing care delivery

This paper presents the findings of a survey that was conducted in New Zealand examining the perceptions of nurses in regard to missed care opportunities. The study replicated the work of Kalisch et al (2009) using their Missed Care Survey undertaken in the USA and the Adelaide study (Hamilton et al). The survey used an 8-step method of concept analysis which found that missed care conceptualised within the Missed Nursing Care Model, is defined as “any aspect of required patient care that is omitted (either in part or in whole) or delayed” (Kalisch et al 2009; 1509). Overall findings support the Kalisch study indicating that much of the missed care related to systemic issues in three main areas; ineffective methods for determining staffing levels; competing demands that reduce time for patient care, and skill mix. More specifically this paper examines three themes within the areas identified and these are; the age of nurses in relation to care that is missed; overtime and the working of ‘extra’ shifts that are seen as part of the business as usual within normal working allocations, and concurrent with that, the he analysis of data suggesting that overtime and illness are closely correlated; and finally the element of ‘no longer caring’ manifested in significant care being missed

Aberrant work environments, rationed care as system failure or missed care as skills failure?

Missed’ care has emotional, professional and legal connotations because, as one participant from our study noted, the environment can change so quickly and staffing is not allocated to accommodate this. This study used the MISSCARE survey distributed to nurses in New Zealand to find out what care was routinely missed, and why they missed it. The analysis of data returned from 199 nurses revealed that nurses routinely miss care and become frustrated because they are unable to use the knowledge and skill to provide the care; rather they are forced to prioritise care, some of which is either delayed or consciously missed. Whilst this study supported findings of previous research, the emergence of presenteeism as a factor that affects nurses missing care, was highlighted. This has wider implications to the nursing workforce related to their ability to provide safe and effective care, as well as to the organisations in terms of both budget and safety in care provision

Silver Clinic: protocol for a feasibility randomised controlled trial of comprehensive geriatric assessment for people living with HIV and frailty

  Introduction Many people ageing with HIV are also living with multiple comorbidities and geriatric syndromes including frailty and cognitive deterioration. These complex needs can be challenging to meet within existing HIV care services. This study investigates the acceptability and feasibility of screening for frailty and of using a comprehensive geriatric assessment approach, delivered via the Silver Clinic, to support people living with HIV affected by frailty. Methods and analysis Mixed-methods, parallel-group, randomised, controlled feasibility trial aiming to recruit 84 people living with HIV≥50, identified as frail. Participants will be recruited from the HIV unit at the Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK. Participants will be randomised 1:1 to receive usual HIV care or the Silver Clinic intervention, which uses a comprehensive geriatric assessment approach. Psychosocial, physical and service use outcomes will be measured at baseline, 26 weeks and 52 weeks. Qualitative interviews will be conducted with a subset of participants from both arms. Primary outcome measures include recruitment and retention rates and completion of clinical outcome measures. These will be used in conjunction with a priori progression criteria and the qualitative data (acceptability of trial procedures and intervention) to determine the feasibility and design of a definitive trial. Ethics and dissemination This study has been approved by East Midlands—Leicester Central Research Ethics Committee (reference 21/EM/0200). All participants will receive written information about the study and be required to provide informed consent. Results will be disseminated via peer-reviewed journals, conferences and community engagement. Trial registration number ISRCTN14646435.</p