Transition to practice programs: what Australian and New Zealand nursing and midwifery graduates said. A Graduate eCohort Sub-Study

Aim: To describe what Australian and New Zealand graduates said about the Nurse Entry to Practice program. Background: The Nurse Entry to Practice is a structured programme that offers professional and educational support for graduate nurses in their first year of practice. Method: The qualitative research described and reported herein constitutes a sub-study of the Graduate e-Cohort Study. This qualitative sub-study describes the responses to one on-line survey question offered in 2013 which asked about issues around gaining employment. Only those responses related to the Nurse Entry to Practice program by 197 recently graduated Australian and New Zealand nursing and midwifery students as they transitioned into professional practice are presented. Results: Graduates looking for jobs in the year 2009 and 2010 were positive about their uptake of a Nurse Entry to Practice program. At the time the programs were a viable and plentiful option in which the graduate could take a program associated with a final undergraduate clinical placement. This resulted in these graduates remaining in the ward or organisation where the program was undertaken. This consequence was reported more widely by 2008 graduates, 2009 graduates from New Zealand but was not reported at all by 2010 graduates. Nurses or midwives looking for a job in 2011 reported less on a Nurse Entry to Practice program and when they did they indicated that the program was hard to get into. Conclusion: This research offers educators, employers and administrators insights into improving the transition experience for recently graduated nurses and midwives

Exploring facilitators and barriers to nurses’ uptake of postgraduate education in Australia

Background Nursing education is designed to prepare competent nurses to meet the current and future healthcare needs of society. Nurses require advanced education to increase their ability to influence patient care positively (Cotterill-Walker, 2012), deliver optimal care (Robert Wood Johnson Foundation, 2013) and improve patient outcomes (Girot & Albarran, 2012). Therefore, it is important to understand registered nurses’ attitudes towards postgraduate education. To advance the profession and provide excellent patient care, barriers that hinder nurses from undertaking advanced education should be identified and then properly addressed. Identifying the facilitators that influence nurses to advance their education will help healthcare organisations and healthcare educators to develop programs that will promote an environment that supports education advancement. Aim The primary aim of this research was to explore registered nurses’ attitudes towards postgraduate education in Australia. Methods This research followed a sequential mixed-methods approach design that included development of an instrument (questionnaire- Nurses Attitudes towards Postgraduate Education [NATPGE]), an online survey and telephone interviews. Phase One comprised a survey, the Nurses’ Attitudes Towards Postgraduate Education (NATPGE) instrument developed for this research, which was given to a sample of registered nurses in Australia to explore the barriers to and facilitators of postgraduate specialty education. Phase Two comprised an interpretative study, which took a translational research approach in which qualitative data were collected through telephone interviews with registered nurses to contextualise the Phase One survey findings. The planned and deliberate synthesis of the findings, through discussion, from these two phases has direct implication to postgraduate education for specialty practice in Australia. Results Phase One (survey) was the final stage of the instrument development that used data-reduction techniques and the results of the survey showing the nurses’ attitudes towards postgraduate education. Principal Component Analysis was performed on all 14 NATPGE items. Accounting for 52.5% of the variance of the scale, the analysis identified a three-factor solution for 14 items: ‘facilitators’; ‘barriers’; and ‘professional recognition’. Qualitative analysis of the data from Phase Two, the interpretative study, showed three broad conceptualisations of registered nurses’ attitudes towards postgraduate education: ‘facilitators’; ‘barriers’ and ‘professional recognition’. Conclusion Understanding the factors that affect registered nurses’ attitudes towards postgraduate education will help educators identify areas for change to attract registered nurses to pursue postgraduate education. The overall results from this research provide a composite understanding of the facilitators of and barriers to postgraduate education for Australian nurses

Diffusion Co-Policy for Synergistic Human-Robot Collaborative Tasks

Modeling multimodal human behavior has been a key barrier to increasing the level of interaction between human and robot, particularly for collaborative tasks. Our key insight is that an effective, learned robot policy used for human-robot collaborative tasks must be able to express a high degree of multimodality, predict actions in a temporally consistent manner, and recognize a wide range of frequencies of human actions in order to seamlessly integrate with a human in the control loop. We present Diffusion Co-policy, a method for planning sequences of actions that synergize well with humans during test time. The co-policy predicts joint human-robot action sequences via a Transformer-based diffusion model, which is trained on a dataset of collaborative human-human demonstrations, and directly executes the robot actions in a receding horizon control framework. We demonstrate in both simulation and real environments that the method outperforms other state-of-art learning methods on the task of human-robot table-carrying with a human in the loop. Moreover, we qualitatively highlight compelling robot behaviors that demonstrate evidence of true human-robot collaboration, including mutual adaptation, shared task understanding, leadership switching, and low levels of wasteful interaction forces arising from dissent.Comment: IEEE Robotics and Automation Letters (RA-L), 2023. 8 pages, 7 figures, 3 tables. Supplementary material at https://sites.google.com/view/diffusion-co-policy-hr

NATPGE: understanding registered nurses’ attitudes towards post graduate education

Nursing education is a dynamic process designed to enable nurses to competently meet the healthcare needs of society. Health system restructuring has been associated with diminishing postgraduate specialist nursing numbers worldwide. Valid instruments that monitor and evaluate nurses’ attitudes to gauge educational barriers and facilitators are a central component in planning effective education, and have been unavailable. Overall both the CE and the RNs ranked the NATPGE, using the CVI, as a realistic training platform that would be useful for evaluating RNs’ attitudes towards postgraduate education. The comments received from the CE resulted in some minor changes to the wording of some items for better clarity and simplicity. No particular concerns were raised about any of the items by the CE. The CE was agreeable that the items were arranged in a positively and negatively worded sequence, which was intentional as to prevent response bias. The present research indicates very good content and face validity and whilst the test-retest reliability overall was moderate, several individual questions did have poor kappa values

Exploring registered nurses’ attitudes towards postgraduate education

Background: Studies have shown specialty nurses require a higher level of academic knowledge that will enable individuals to combine the science and art of nursing. Specialist nurses require advanced education to increase their ability to positively influence patient care, leading to improved care delivery and improved patient outcomes. Despite the increased requirement for PGE for advanced practice, little has been reported on the barriers. Method: The NATPGE (Nurses’ Attitudes Towards Postgraduate Education) instrument was administered to 1632 registered nurses from the Nurses and Midwives e-Cohort Study (NMeS) across Australia, with a response rate of 35.9% (n=568). Data reduction techniques using principal component analysis with varimax rotation was used. Results: Accounting for 52.5% of the variance of the scale, the analysis identified a three-factor solution for 14 items: ‘facilitators’; ‘professional recognition’; and ‘barriers’. The one higher order factor, representing facilitators to postgraduate education; accounting for 28.5% of the variance: (1) improves knowledge; (2) increases nurses’ confidence in clinical decision making; (3) enhances nurses’ careers; (4) improves critical thinking; (5) improves nurses’ clinical skill; and (6) increased job satisfaction. Conclusions: The findings from our research demonstrated that registered nurses’ pursue postgraduate education because of the consequent influence on patient care, patient outcomes as well as on quality and safety of patient care; and possibilities of career advancement. These findings have the potential clinical and research applications to support registered nurses’ pursuit of postgraduate education

GPU Accelerated Prognostics

Prognostic methods enable operators and maintainers to predict the future performance for critical systems. However, these methods can be computationally expensive and may need to be performed each time new information about the system becomes available. In light of these computational requirements, we have investigated the application of graphics processing units (GPUs) as a computational platform for real-time prognostics. Recent advances in GPU technology have reduced cost and increased the computational capability of these highly parallel processing units, making them more attractive for the deployment of prognostic software. We present a survey of model-based prognostic algorithms with considerations for leveraging the parallel architecture of the GPU and a case study of GPU-accelerated battery prognostics with computational performance results

Functional analysis of germline <em>VANGL2</em> variants using rescue assays of <em>vangl2</em> knockout zebrafish

\ua9 The Author(s) 2023. Published by Oxford University Press. Developmental studies have shown that the evolutionarily conserved Wnt Planar Cell Polarity (PCP) pathway is essential for the development of a diverse range of tissues and organs including the brain, spinal cord, heart and sensory organs, as well as establishment of the left-right body axis. Germline mutations in the highly conserved PCP gene VANGL2 in humans have only been associated with central nervous system malformations, and functional testing to understand variant impact has not been performed. Here we report three new families with missense variants in VANGL2 associated with heterotaxy and congenital heart disease p.(Arg169His), non-syndromic hearing loss p.(Glu465Ala) and congenital heart disease with brain defects p.(Arg135Trp). To test the in vivo impact of these and previously described variants, we have established clinically-relevant assays using mRNA rescue of the vangl2 mutant zebrafish. We show that all variants disrupt Vangl2 function, although to different extents and depending on the developmental process. We also begin to identify that different VANGL2 missense variants may be haploinsufficient and discuss evidence in support of pathogenicity. Together, this study demonstrates that zebrafish present a suitable pipeline to investigate variants of unknown significance and suggests new avenues for investigation of the different developmental contexts of VANGL2 function that are clinically meaningful

Salivary ammonia levels and Tannerella forsythia are associated with rheumatoid arthritis: A cross sectional study

The aim of this paper is to evaluate the relationship of salivary ammonium levels and the presence of bacteria with rheumatoid arthritis (RA) clinical disease activity in a cross‐sectional study of Mexican patients. From a periodontal and disease activity standpoint, 132 consecutive RA patients fulfilling clinical criteria were evaluated. Ammonia levels (including peptidyl arginine deiminase activity) were evaluated by colorimetric assay and the presence of Porphyromonas gingivalis, Tannerella forsythia, and Prevotella intermedia was evaluated by polymerase chain reaction (PCR) technique. After a multivariate analysis, adjusting for clinical and serological parameters, a significant association was only observed between severe periodontitis and probing depth with high RA disease activity. Additionally, in contrast to P. gingivalis, the presence of T. forsythia was significantly associated with high disease RA activity even after multivariable adjustment analysis. There was also a significant increase in ammonium levels in the high RA activity group and a significant correlation between salivary ammonia and RA disease activity but not with autoantibody titers. Similarly, we observed a significant increase in the ammonium levels derived from the cultures of P. gingivalis and T. forsythia, with respect to P. intermedia and S. gordonii cultures, or even healthy donors. These results suggest that RA activity is associated with severe periodontitis, high salivary ammonium levels and the presence of T. forsythia

The clinical and molecular spectrum of galactosemia in patients from the Cape Town region of South Africa

BACKGROUND: The objective of this study was to document the clinical, laboratory and genetic features of galactosemia in patients from the Cape Town metropolitan region. METHODS: Diagnoses were based on thin layer chromatography for galactosuria/galactosemia and assays of erythrocyte galactose-1-phosphate uridyltransferase (GALT) and galactokinase activities. Patients were screened for the common S135L and Q188R transferase gene mutations, using PCR-based assays. Screening for the S135L mutation in black newborns was used to estimate the carrier rate for galactosemia in black South Africans. RESULTS: A positive diagnosis of galactosemia was made in 17 patients between the years 1980 to 2001. All had very low or absent galactose-1-phosphate uridyltransferase (GALT) activity, and normal galactokinase levels. The mean age at diagnosis was 5.1 months (range 4 days to 6.5 months). A review of 9 patients showed that hepatomegaly (9/9), and splenomegaly, failure to thrive, developmental delay, bilateral cataracts (6/9) were the most frequent features at diagnosis. Six had conjugated hyperbilirubinemia. Four experienced invasive E. coli infection before diagnosis. Ten patients were submitted to DNA analysis. All 4 black patients and 2 of mixed extraction were homozygous for the S135L allele, while all 3 white patients were homozygous for the Q188R allele. The remaining patient of mixed extraction was heterozygous for the Q188R allele. The estimated carrier frequency of the S135L mutation in 725 healthy black newborns was 1/60. CONCLUSIONS: In the absence of newborn screening the delay in diagnosis is most often unacceptably long. Also, carrier frequency data predict a galactosemia incidence of approximately 1/14 400 for black newborns in the Cape Metropole, which is much higher than the current detection rate. It is thus likely that many patients go undetected