Nurses' career choice and satisfaction with mental health transition-to-practice programs : A cross sectional study

Introduction: Globally, there are consistent issues recruiting staff into the mental health nursing workforce. In Australia, recent efforts to expand the workforce include recruitment of a wider range of nurses in addition to new graduates into mental health transition-to-practice programs. Understanding the career motivations of nurses entering the field is an important element of recruitment and retention. Aim: To describe nurses' satisfaction with their mental health transition program and identify factors influencing their choice of mental health as a career. Methods: An online cross-sectional survey with questions on program satisfaction and career choice was responded to by n = 55 enrolled and registered nurses in a mental health transition program. Results: Nurses reported overall high satisfaction with their program and identified increased time release for professional development and being supernumerary as necessary to support role development. Almost 25% of nurses reported personal experience of mental illness as an influence in choosing a mental health career. Discussion: Mental health transition programs are important in recruitment and retention and need to be tailored to the needs of a wide range of nurses and include support for staff wellbeing. Implications for Practice: Tailored transition programs can help strengthen role clarity, and support staff retention

Reconfiguração dinâmica de dispositivos analógicos programáveis : conceitos e aplicações

Os Dispositivos Analógicos Programáveis, mais conhecidos como Field Programmable Analog Arrays, FPAAs, são circuitos integrados tipicamente baseados em amplificadores operacionais (ou outro dispositivo analógico similar) com alguns recursos computacionais incorporados, os quais possibilitam um novo método para prototipagem de sistemas analógicos. Este trabalho visa o estudo de tais dispositivos, abordando conceitos, especificações, possibilidades de utilização e com ênfase em uma nova possibilidade para circuitos analógicos: a reconfiguração dinâmica. Para demonstrar o funcionamento desta técnica, o trabalho aborda a implementação de um sistema de controle analógico com reconfiguração dinâmica utilizando o FPAA AN221E04 da Anadigm Company.The Field Programmable Analog Array, FPAAs, are integrated circuits based on operational amplifiers (or another similar analog device) with some computer resources incorporated, which enable a new method for analog system prototyping. This paper aims the study of these devices, addressing concepts, specifications, potential uses and emphasizing a new possibility for analog circuits: dynamic reconfiguration. To show this technique, the paper discusses the implementation of an analog control system with dynamic reconfiguration using the FPAA AN221E04 from Anadigm Company

Rewilding wetlands: beaver as agents of within-habitat heterogeneity and the responses of contrasting biota

Ecosystem engineers can increase biodiversity by creating novel habitat supporting species that would otherwise be absent. Their more routine activities further influence the biota occupying engineered habitats. Beavers are well-known for transforming ecosystems through dam building and are therefore increasingly being utilised for habitat restoration, adaptation to climate extremes, and in long term rewilding. Abandoned beaver ponds develop into meadows or forested wetlands that differ fundamentally from other terrestrial habitats and thus increase landscape diversity. Active beaver ponds, by contrast, are superficially similar to other non-engineered shallow wetlands, but ongoing use and maintenance might affect how beaver ponds contribute to aquatic biodiversity. We explored the 'within-habitat' effect of an ecosystem engineer by comparing active beaver ponds (BP) in southern Sweden with coexisting other wetlands (OW), using sedentary (plants) and mobile (water beetles) organisms as indicators. BP differed predictably from OW in environmental characteristics and were more heterogeneous. BP supported more plant species at plot (+15%) and site (+33%) scales, and plant beta diversity, based on turnover between plots, was 17% higher than in other wetlands (OW), contributing to a significantly larger species pool in BP (+17%). Beetles were not differentiated between BP and OW based on diversity measures but were 26% more abundant in BP. Independent of habitat creation beaver are thus significant agents of within-habitat heterogeneity that differentiates beaver ponds from other standing water habitat; as an integral component of the rewilding of wetlands re-establishing beaver should benefit aquatic biodiversity across multiple scales

Underground mining of aggregates. Main report

This report examines the economic feasibility of underground mining for crushed rock aggregates in the UK, but particularly in the London, South East and East of England regions (the South East area of England). These regions import substantial volumes of crushed rock, primarily from the East Midlands and South West regions, requiring relatively long transport distances to market for this bulk commodity. A key part of the research was to determine whether or not aggregate could be produced and delivered to a local market from an underground aggregates operation at a cost comparable with that for production and transport of the commodity from traditional surface quarries located further afield. In essence the investigation asked – could the reduced transport costs compensate for the higher production costs underground so that underground crushed rock aggregates producers can compete with the established Leicestershire and Somerset surface quarries exporting to the South East? Work Programme The research effort involved establishing and verifying cost models for aggregates production, stone processing (sizing and sorting), haulage of product to market, environmental impact mitigation, health and safety, decommissioning and restoration. Another major element of the work was the re-examination of the BGS exploratory borehole and geophysical databases to identify potential areas of crushed rock aggregates resource at depth in the South East area of England. Land use pressure is typically higher in this area of England than elsewhere so another major part of the research was the identification of potential concurrent uses of land around the surface facilities of underground aggregates mines. The value, development costs for specific developments and determination of yields expected, from these uses were estimated. These were also used to investigate potential economic benefits associated with after uses of remediated surface land above potential underground aggregates mines and also for the new underground space that would be created. Key technical issues such as subsidence within relatively heavily populated areas of the South East area of England were also addressed. Economic Results The discounted cost of aggregate delivered at a discount rate of 10% was the metric used to appraise the options. This is the price of aggregate that leads to a zero net present value of project cash flows realised over the aggregates project life. The results show that the discounted costs of aggregate delivered to a local South East area of England market from an underground mine producing 3.5 million tonnes per annum (MTPA) of crushed rock aggregates, are in the range of £13.03 per tonne to £13.93 per tonne for the top six prospect locations. These are greater than the corresponding cost for a “reference” quarry in Leicestershire producing 3.5 MTPA (£10.95 per tonne), but lower than a “reference” quarry in Leicestershire producing 1.25 MTPA (£16.48 per tonne). These figures indicate that underground crushed rock aggregate mines located within the South East area of England may be able to compete for a share in the overall market by replacing / displacing aggregate imported from the quarries in Leicestershire and Somerset producing around or less than 1.25 MTPA. The surprise in these figures is not really that the more remote surface quarry has a lower discounted cost of aggregate delivered, but that the values for the quarry and underground mine are so close. The capital intensity for the development of underground aggregates mines was found to be higher than that required for surface quarries of comparable scale, by a factor ranging from 1.33 to 1.65 and thus may represent a disincentive for aggregates operators. Carbon Emissions The total carbon emissions of the ‘reference’ 3.5 MTPA quarry in Leicestershire were estimated at 9.28 kg CO2/tonne aggregate delivered and this is to be compared with carbon emissions for the 150 metre deep underground mines serving the local market which were estimated at 9.31 kg CO2/tonne delivered for a Bletchley prospect using an adit to access the sub-surface and 14.25 kg CO2/tonne delivered for a prospect based on the Chitty bore hole using a shaft. Depth of the mine is a key factor in determination of the relative carbon emissions from each of the underground mining operations considered as electricity consumption for ventilation, pumping and winding is proportional to depth. Recommendations The current research generated seven principal recommendations which are discussed in detail in the concluding section of the report. These are: Appraise policy incentives for underground aggregates mining. Conduct an industry-wide consultation on findings from the current research. Obtain public and stakeholder opinion on new uses for underground space. Conduct research to reducing the energy intensity of mine services. Develop a deep level aggregates-specific drilling campaign. Investigate underground aggregates mines developed from existing surface quarries. Investigate underground aggregates as co-products of industrial minerals mining

Well-being, turnover intention, and stigma attitudes of mental health transition-to-practice nurses : A cross-sectional study

There is global recognition that mental health nursing can be stressful and have detrimental effects on nurses' well-being and retention. With substantial nursing shortages, there is an urgent need to attract and retain nurses to sustain this workforce and provide effective mental healthcare. Mental health transition programs provide vital recruitment pathways and support novice registered nurses, enrolled nurses and experienced registered generalist nurses moving into this field. There is little evidence, however, on the well-being, resilience, and retention of nurses transitioning into mental health. The primary aims for this cross-sectional study were to describe demographic characteristics, perceived stress, well-being, resilience, mental illness stigma attitudes, work satisfaction, and turnover intention of four nurse cohorts entering mental health transition programs: generalist registered nurses, graduate and post-graduate registered nurses, and enrolled nurses; to explore relationships between these variables; and explore differences between these four nurse cohorts. Findings (n = 87) included overall moderate perceived stress, moderate well-being and resilience, high work satisfaction, low stigma, and low turnover intention. Higher turnover intention was associated with lower age and work satisfaction, and higher perceived stress. Generalist RNs had significantly higher stress and stigmatizing attitudes than Enrolled Nurses. Secondary analysis of well-being scores identified 14 nurses with scores indicating depression, with significantly lower resilience and work satisfaction, and significantly higher stress than the rest of the sample. To help prevent attrition, it is vital that mental health services provide tailored well-being initiatives during transition and intervene early to provide support for nurses with mental distress

Analysis of leukocyte membrane protein interactions using protein microarrays

BACKGROUND: Protein microarrays represent an emerging class of proteomic tools to investigate multiple protein-protein interactions in parallel. A sufficient proportion of immobilized proteins must maintain an active conformation and an orientation that allows for the sensitive and specific detection of antibody and ligand binding. In order to establish protein array technology for the characterization of the weak interactions between leukocyte membrane proteins, we selected the human leukocyte membrane protein CD200 (OX2) and its cell surface receptor (hCD200R) as a model system. As antibody-antigen reactions are generally of higher affinity than receptor-ligand binding, we first analyzed the reactivity of monoclonal antibodies (mAb) to normal and mutant forms of immobilized CD200R. RESULTS: Fluorescently labelled mAb DX147, DX136 and OX108 were specifically reactive with immobilized recombinant hCD200R extracellular region, over a range of 0.1–40 μg ml(-1 )corresponding to a limit of sensitivity of 0.01–0.05 femtomol per spot. Orientating hCD200R using capture antibodies, showed that DX147 reacts with an epitope spatially distinct from the more closely related DX136 and OX108 epitopes. A panel of soluble recombinant proteins with mutations in hCD200R domain 1 produced by transiently transfected cells, was arrayed directly without purification and screened for binding to the three mAb. Several showed decreased binding to the blocking mAb DX136 and OX108, suggesting close proximity of these epitopes to the CD200 binding site. Binding of hCD200 to directly immobilized rat, mouse, and hCD200R was achieved with multimeric ligands, in the form of biotinylated-hCD200 coupled to FITC-labelled avidin coated beads. CONCLUSION: We have achieved sensitive, specific and reproducible detection of immobilized CD200R with different antibodies and mapped antigenic epitopes for two mAb in the vicinity of the ligand binding site using protein microarrays. We also detected CD200 binding to its receptor, a low affinity interaction, using beads presenting multivalent ligands. Our results demonstrate the quantitative aspects of protein arrays and their potential use in detecting simultaneously multiple protein-protein interactions and in particular the weak interactions found between leukocyte membrane proteins

Behavioural physical activity interventions in participants with lower-limb osteoarthritis: a systematic review with meta-analysis

Objective: To assess effectiveness of osteoarthritis interventions to promote long-term physical activity behaviour change.Design: A systematic review and meta-analysis. Protocol registration PROSPERO CRD4201300444 5 (http://www.crd.york.ac.uk/prospero/).Study selection: Randomised controlled trials (RCTs) comparing physical activity interventions with placebo, no/or minimal intervention in community-dwelling adults with symptomatic knee or hip osteoarthritis. Primary outcomes were change in physical activity or cardiopulmonary fitness after a minimum follow-up of 6 months.Data extraction: Outcomes were measures of physical activity (self-reported and objectively measured) and cardiovascular fitness. Standard mean differences between postintervention values were used to describe the effect sizes.Results: 27 984 titles were screened and 180 papers reviewed in full. Eleven RCTs satisfied inclusion criteria, total study population of 2741 participants, mean age 62.2. The commonest reasons for study exclusion were follow-up less than 6 months and no physical activity measures. The majority of included interventions implement an arthritis self-management programme targeting coping skills and self-efficacy. Seven studies used self-report measures, the pooled effect of these studies was small with significant heterogeneity between studies (SMD 0.22 with 95% CI −0.11 to 0.56, z=1.30 (p=0.19) I2 statistic of 85%). Subgroup analysis of 6–12 month outcome reduced heterogeneity and increased intervention effect compared to control (SMD 0.53, 95% CI 0.41 to 0.65, z=8.84 (

Operationalising generalism in medical education: a narrative review of international policy and mission documents

Introduction Despite moves across medical education to increase learning of generalist principles, a lack of clarity about what generalism means and how we should train doctors as ‘generalists’, has remained. This study explores how international, undergraduate and postgraduate, policy and educational mission documents characterise the practice and learning of generalism and how this can inform physician training. Methods A narrative literature review was conducted based on policy and mission documents identified through grey literature searches and a wider systematic review looking at empirical texts. Texts published between 1999 and present and related to ‘generalism’ were eligible for inclusion. Texts were coded and codes were reviewed and grouped into key themes. Results Thirty-four documents were included. Definitions vary: some described generalism as a basic skill, whilst others emphasised expertise. Factors which support learning generalism include: favourable financial outcomes; ageing populations; coordination of multidisciplinary care; demand for doctors with transferable skills; and patient expectations. Barriers to learning about generalism include: preference for specialisation; structure of undergraduate teaching and assessment; and the hidden curriculum. Solutions may include re-imagining generalists and specialists as being on a continuum as well as increasing exposure throughout medical education. Discussion Whilst generalism is consistently positioned as valuable, less clarity exists about how best to operationalise this in medical education. Fundamental ideological and structural changes within teaching curricula and assessment, are necessary to improve generalist learning and to promote sustainable practice. Medical education needs careful, considered planning to ensure workforce expertise is meeting population needs