The art of Clinical Supervision Program for registered nurses

Nursing students’ clinical placements should provide an environment in which they can apply their nursing education in the fast-paced world of health care and develop a framework for practice. Students rely on effective teaching and supportive clinical supervisors to provide a placement in which they are not only encouraged to practice, but also to learn from this practice. This is achieved through welcoming students into the health care team by valuing their input and contributions, and consolidating their clinical practice through activities such as critical thinking and reflection. The role of the clinical supervisor is therefore complex and often constrained by time because of the need to prioritise patient care. The role is also distant to that of providing clinical care; therefore, staff require specific education and guidance to understand and implement the role’s requirements. This research aimed to develop, implement and evaluate a new education program for nursing staff. This process was guided by the current literature in relation to the role of the clinical supervisor, the theories and principles of adult learning, and the theories of attitude and attitude change. The effect of the program was determined using a descriptive methodology involving the collection and analysis of quantitative and qualitative data using a triangulation approach. This involved the use of pre- and post-program attendance (on the day and after eight weeks) knowledge and attitude surveys, online reflective statements for up to eight weeks after attending the program, and individual interviews. Analysis of the data determined that participants improved both their knowledge and attitude towards students and clinical supervision. Participants viewed the program as a positive strategy for improving their attitude towards students and student clinical supervision, while also being supported with realistic strategies for promoting a welcoming environment conducive to student learning. Participants also articulated their concerns related to perceived organisational barriers to providing effective clinical supervision. There are multiple implications of this research. The Clinical Supervision Program (CSP) for Registered Nurses is confirmed as a strategy for providing effective education for nurses involved in the role of clinical supervision. The study also articulates the importance of health care facilities and education providers in ensuring ongoing support and recognition of the role, as well as facilitating a workplace that is supportive of student placements

The art of clinical supervision: Strategies to assist with the delivery of student feedback

Objective: The Art of Clinical Supervision (ACS) seminar was developed to provide health professionals with the essential knowledge, skill and attitude to support student clinical learning. This paper provides an outline of the strategies provided to participants to support the delivery of feedback to students on clinical placement. Setting: Western Australian health services Primary argument: The provision of timely and descriptive feedback to students on clinical placement is essential for learning and achievement of competence. Health professionals working with students in the delivery of patient care, termed clinical supervisors, require effective strategies to support this communication technique. Conclusion: ACS participant feedback supports the use of both strategies to formulate the delivery of feedback. This ensures that the student and supervising health professional have discussed the required learning needs, strategies for learning and evaluation

The essence of helping: Significant others and nurses in action draw men into nursing

Background: Nurses are ageing placing nursing workforce sustainability under threat. An untapped potential resource of men in nursing exists within Australia. Objective: The aim of the first phase of this longitudinal study was to investigate why men choose nursing. Design: Qualitative methodological approach used interpretative phenomenological analysis (IPA). Research question: “What are the experiences of male graduate nurses regarding their career choice?” Method: The IPA method focused on personal subjective experience where the participants’ own sense-making is important. Discussions were audio-recorded, transcribed verbatim and analysed using a format relevant to IPA. Participants: Purposeful snowball sampling recruited nine nurses. Findings: The “essence of helping” permeated the key theme through significant others and career choice triggers impacting on their decision to enter nursing. Conclusion: Exposure to nurses in action is purported to enhance the awareness of nursing as a career option for men that may contribute to increased recruitment of men into nursing

Using a clinical deterioration scenario (video) as an approach for interprofessional learning

For effective management of clinical deterioration, health professionals must work together to recognise and respond to the patients changing health status. This paper provides an overview of the clinical deterioration video, used as a learning tool to engage medical, nursing and physiotherapy students and junior clinicians for the purpose of identifying the deteriorating patient and to support the development of interprofessional teamwork skills. This paper describes the perspectives of educators who have used this resource, a description of the resource, its evaluation, and access to the resource. The educators felt that the clinical deterioration video provides a learning environment in which learners develop an insight into the essential knowledge and skills required to support interprofessional practice and good patient outcomes

Diet quality and telomere length in older Australian men and women

PurposeTelomere length is a biomarker of cellular ageing, with longer telomeres associated with longevity and reduced risk of chronic disease in older age. Consumption of a healthy diet may contribute to longevity via its impact on cellular ageing, but studies on diet and telomere length to date have been limited and their findings equivocal. The aim of this study was to examine associations between three indices of diet quality and telomere length in older men and women.MethodsAdults aged 57–68 years participating in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 679), completed a postal survey including an 111-item food frequency questionnaire in 2012. Diet quality was assessed via three indices: the Dietary Guideline Index, the Recommended Food Score, and the Mediterranean Diet Score. Relative telomere length was measured by quantitative polymerase chain reaction. Associations between diet quality and telomere length were assessed using linear regression adjusted for covariates.ResultsAfter adjustment for age, sex, education, smoking, physical activity, and body mass index (BMI), there were no significant associations between diet quality and relative telomere length.ConclusionsIn a sample of older adults residing in Victoria, Australia, men and women aged 57–68 years with better-quality diets did not have longer telomeres. Further investigation in longitudinal studies will determine whether diet can influence telomere length over time in an ageing population

Real-time qPCR improves meningitis pathogen detection in invasive bacterial-vaccine preventable disease surveillance in Fiji.

As part of the World Health Organization Invasive Bacterial-Vaccine Preventable Diseases (IB-VPD) surveillance in Suva, Fiji, cerebrospinal fluid (CSF) samples from suspected meningitis patients of all ages were examined by traditional methods (culture, Gram stain, and latex agglutination for bacterial antigen) and qPCR for Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Of 266 samples tested, pathogens were identified in 47 (17.7%). S. pneumoniae was the most common pathogen detected (n = 17) followed by N. meningitidis (n = 13). The use of qPCR significantly increased detection of IB-VPD pathogens (P = 0.0001): of 35 samples that were qPCR positive for S. pneumoniae, N. meningitidis, and H. influenzae, only 10 were culture positive. This was particularly relevant for N. meningitidis, as only 1/13 cases was culture positive. Molecular serotyping by microarray was used to determine pneumococcal serotypes from 9 of 16 (56%) of samples using DNA directly extracted from CSF specimens. Results indicate that qPCR significantly increases detection of S. pneumoniae, N. meningitidis, and H. influenzae in CSF, and that application of molecular diagnostics is a feasible way to enhance local and global surveillance for IB-VPD

Questioning the rise of gelatinous zooplankton in the World's oceans

During the past several decades, high numbers of gelatinous zooplankton species have been reported in many estuarine and coastal ecosystems. Coupled with media-driven public perception, a paradigm has evolved in which the global ocean ecosystems are thought to be heading toward being dominated by “nuisance” jellyfish. We question this current paradigm by presenting a broad overview of gelatinous zooplankton in a historicalcontext to develop the hypothesis that population changes reflect the human-mediated alteration of global ocean ecosystems. To this end, we synthesize information related to the evolutionary context of contemporary gelatinous zooplankton blooms, the human frame of reference forchanges in gelatinous zooplankton populations, and whether sufficient data are available to have established the paradigm. We conclude that the current paradigm in which it is believed that there has been a global increase in gelatinous zooplankton is unsubstantiated, and we develop a strategy for addressing the critical questions about long-term, human-related changes in the sea as they relate to gelatinous zooplankton blooms

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Genomic investigations of unexplained acute hepatitis in children

Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children