Educating student nurses about chronic pain

University of Technology, Sydney. Faculty of Education.This thesis explores the issue of educating student nurses about chronic pain. Chronic illness is a substantial health and disability issue across the globe. Chronic pain is a particularly prevalent chronic health experience, with estimates that between a quarter and a half of the world’s population, experience some degree of chronic pain. A good deal of knowledge about the causes and treatment of various types of pain have developed in recent years. However, patients believe that their pain is not adequately treated by health professionals. The prevalence of chronic pain, concerns about the inadequate management of it, and the leading role that nurses play in assessing patients and providing treatment, make it timely to explore chronic pain in relation to nursing education. This study focussed on exploring how student nurses think about and may respond to patients experiencing chronic pain. A number of misconceptions had previously been identified as being held by health professionals, and having the potential to detrimentally impact on their response to patients (McCaffery & Pasero, 1999). This research was designed to explore the extent to which those misconceptions about patients with chronic pain were held by student nurses during their pre-registration education. This phenomenon had not previously been researched. The findings of the study suggest that attitudes and knowledge of student nurses about patients with chronic pain are inadequate. Further exploration of the findings suggests that the views held by student nurses are not positively addressed to any significant extent during the course of their undergraduate education. It is argued that ensuring appropriate knowledge is taught to students and linked to practice may play a substantial role in improving the practise of nurses and the experience of patients with chronic illness

Efektifitas Implementasi Smm Iso 9001:2008 Pada Smk Negeri Di Kota Singaraja

Penelitian ini bertujuan untuk memberikan gambaran tentang : 1) efektivitas penerapan Sistem Manajemen Mutu (SMM) ISO 9001:2008 pada SMK Negeri di kota Singaraja dilihat dari konteks, masukan, proses, dan hasil penerapan; 2) kendala-kendala yang dihadapai dalam melaksanakan SMM ISO 9001:2008 pada SMK Negeri dikota Singaraja serta alternatif pemecahannya. Penelitian ini dilaksanakan pada SMK Negeri dikota Singaraja pada tahun pelajaran 2013/2014, dengan menggunakan model evaluasi CIPP dari Stufflebeam yang melibatkan 354 responden. Variabel konteks yang terdiri dari sub variabel SMM sekolah dan keterlibatan komite sekolah. Variabel masukan terdiri dari sub variabel manajemen sekolah dan keterlibatan dunia USAha/dunia industri (DU/DI). Variabel proses yang terdiri dari sub variabel pemeliharaan dan pengadaan sarana pendidikan, kegiatan belajar mengajar oleh guru, dan kegiatan belajar mengajar siswa. Variabel produk dengan sub variabel nilai ujian tahun pemelajaran 2013/2014 (UN, US dan UK). Metode kuesioner digunakan untuk menjaring data SMM sekolah, manajemen sekolah dengan responden semua staff manajemen, keterlibatan dunia USAha/dunia industri (DU/DI), dan proses pembelajaran siswa. Metode wawancara untuk menjaring data keterlibatan komite sekolah. Metode observasi untuk menjaring data kegiatan belajar mengajar oleh guru. Metode studi dokumen untuk menjaring data SMM sekolah, pengadaan dan pemeliharaan sarana pendidikan, dan nilai ujian. Hasil penelitian menunjukkan bahwa : 1) efektif dilihat dari variabel konteks dengan frekuensi kategori positif 54.286% untuk SMM dan frekuensi kategori positif 75% untuk keterlibatan komite; 2) efektif dilihat dari variabel masukan dengan frekuensi kategori positif 57.6271% untuk manajmen sekolah dan frekuensi kategori positif 52.041% untuk keterlibatan DU/DI; 3) kurang efektif dilihat dari variabel proses dengan frekuensi kategori negatif 63.1578% untuk pemeliharaan dan pengadaan saran pendidikan, dan frekuensi kategori positif 57.4713% untuk kegiatan belajar mengajar oleh guru, dan frekuensi kategori positif 52.308% untuk kegiatan belajar mengajar siswa; 4) efektif dilihat dari variabel produk dengan frekuensi kategori positif 52.055.00% untuk nilai ujian. Bertolak dari hasil penelitian tersebut dapat direkomendasikan: 1) meningkatkan koordinasi setiap kebijakan baru; 2) penerapan SMM perlu disosialisasikan secara terus menerus pada setiap kesempatan; 3) meningkatkan komitmen warga sekolah untuk menerapakan SMM; 4) meningkatkan koordinasi dengan industri menuju Manajemen Partisipatif; 5) memberikan tugas dan tanggungjawab yang jelas kepada kepala program

High prevalence of malignancy in HIV-positive patients with mediastinal lymphadenopathy: A study in the era of antiretroviral therapy.

Mediastinal lymphadenopathy (MLN) in human immunodeficiency virus (HIV) infection has a wide spectrum of aetiologies with different prognoses and treatments. The decision to pursue a histopathological diagnosis represents a clinical challenge as patients present with non-specific symptoms. This study aimed to determine the aetiology and predictive factors of MLN in a cohort of HIV-infected patients in the combination antiretroviral therapy (cART) era

The secret world of shrimps: polarisation vision at its best

Animal vision spans a great range of complexity, with systems evolving to detect variations in optical intensity, distribution, colour, and polarisation. Polarisation vision systems studied to date detect one to four channels of linear polarisation, combining them in opponent pairs to provide intensity-independent operation. Circular polarisation vision has never been seen, and is widely believed to play no part in animal vision. Polarisation is fully measured via Stokes' parameters--obtained by combined linear and circular polarisation measurements. Optimal polarisation vision is the ability to see Stokes' parameters: here we show that the crustacean \emph{Gonodactylus smithii} measures the exact components required. This vision provides optimal contrast-enhancement, and precise determination of polarisation with no confusion-states or neutral-points--significant advantages. We emphasise that linear and circular polarisation vision are not different modalities--both are necessary for optimal polarisation vision, regardless of the presence of strongly linear or circularly polarised features in the animal's environment.Comment: 10 pages, 6 figures, 2 table

Ethnic differences in Glycaemic control in people with type 2 diabetes mellitus living in Scotland

Background and Aims: Previous studies have investigated the association between ethnicity and processes of care and intermediate outcomes of diabetes, but there are limited population-based studies available. The aim of this study was to use population-based data to investigate the relationships between ethnicity and glycaemic control in men and women with diabetes mellitus living in Scotland.<p></p> Methods: We used a 2008 extract from the population-based national electronic diabetes database of Scotland. The association between ethnicity with mean glycaemic control in type 2 diabetes mellitus was examined in a retrospective cohort study, including adjustment for a number of variables including age, sex, socioeconomic status, body mass index (BMI), prescribed treatment and duration of diabetes.<p></p> Results: Complete data for analyses were available for 56,333 White Scottish adults, 2,535 Pakistanis, 857 Indians, 427 Chinese and 223 African-Caribbeans. All other ethnic groups had significantly (p<0.05) greater proportions of people with suboptimal glycaemic control (HbA1c >58 mmol/mol, 7.5%) compared to the White Scottish group, despite generally younger mean age and lower BMI. Fully adjusted odds ratios for suboptimal glycaemic control were significantly higher among Pakistanis and Indians (1.85, 95% CI: 1.68–2.04, and 1.62,95% CI: 1.38–1.89) respectively.<p></p> Conclusions: Pakistanis and Indians with type 2 diabetes mellitus were more likely to have suboptimal glycaemic control than the white Scottish population. Further research on health services and self-management are needed to understand the association between ethnicity and glycaemic control to address ethnic disparities in glycaemic control.<p></p&gt

WNT signaling regulates self-renewal and differentiation of prostate cancer cells with stem cell characteristics

Prostate cancer cells with stem cell characteristics were identified in human prostate cancer cell lines by their ability to form from single cells self-renewing prostaspheres in non-adherent cultures. Prostaspheres exhibited heterogeneous expression of proliferation, differentiation and stem cell-associated makers CD44, ABCG2 and CD133. Treatment with WNT inhibitors reduced both prostasphere size and self-renewal. In contrast, addition of Wnt3a caused increased prostasphere size and self-renewal, which was associated with a significant increase in nuclear Β-catenin, keratin 18, CD133 and CD44 expression. As a high proportion of LNCaP and C4-2B cancer cells express androgen receptor we determined the effect of the androgen receptor antagonist bicalutamide. Androgen receptor inhibition reduced prostasphere size and expression of PSA, but did not inhibit prostasphere formation. These effects are consistent with the androgen-independent self-renewal of cells with stem cell characteristics and the androgen-dependent proliferation of transit amplifying cells. As the canonical WNT signaling effector Β-catenin can also associate with the androgen receptor, we propose a model for tumour propagation involving a balance between WNT and androgen receptor activity. That would affect the self-renewal of a cancer cell with stem cell characteristics and drive transit amplifying cell proliferation and differentiation. In conclusion, we provide evidence that WNT activity regulates the self-renewal of prostate cancer cells with stem cell characteristics independently of androgen receptor activity. Inhibition of WNT signaling therefore has the potential to reduce the self-renewal of prostate cancer cells with stem cell characteristics and improve the therapeutic outcome.Peer reviewe

Gac two-component system in Pseudomonas syringae pv. tabaci is required for virulence but not for hypersensitive reaction

Pseudomonas syringae pv. tabaci 6605 causes wildfire disease on host tobacco plants. To investigate the regulatory mechanism of the expression of virulence, Gac two-Component system-defective mutants, Delta gacA and Delta gacS, and a double mutant, Delta gacA Delta gacS, were generated. These mutants produced smaller amounts of N-acyl homoserine lactones required for quorum sensing, had lost swarming motility, and had reduced expression of virulence-related hrp genes and the algT gene required for exopolysaccharide production. The ability of the mutants to cause disease symptoms in their host tobacco plant was remarkably reduced, while they retained the ability to induce hypersensitive reaction (HR) in the nonhost plants. These results indicated that the Gac two-component system of P. syringae pv. tabaci 6605 is indispensable for virulence on the host plant, but not for HR induction in the nonhost plants.</p

Protecting eyewitness evidence: Examining the efficacy of a self-administered interview tool

Given the crucial role of eyewitness evidence, statements should be obtained as soon as possible after an incident. This is not always achieved due to demands on police resources. Two studies trace the development of a new tool, the Self-Administered Interview (SAI), designed to elicit a comprehensive initial statement. In Study 1, SAI participants reported more correct details than participants who provided a free recall account, and performed at the same level as participants given a Cognitive Interview. In Study 2, participants viewed a simulated crime and half recorded their statement using the SAI. After a delay of 1 week, all participants completed a free recall test. SAI participants recalled more correct details in the delayed recall task than control participants

Dark spinor models in gravitation and cosmology

We introduce and carefully define an entire class of field theories based on non-standard spinors. Their dominant interaction is via the gravitational field which makes them naturally dark; we refer to them as Dark Spinors. We provide a critical analysis of previous proposals for dark spinors noting that they violate Lorentz invariance. As a working assumption we restrict our analysis to non-standard spinors which preserve Lorentz invariance, whilst being non-local and explicitly construct such a theory. We construct the complete energy-momentum tensor and derive its components explicitly by assuming a specific projection operator. It is natural to next consider dark spinors in a cosmological setting. We find various interesting solutions where the spinor field leads to slow roll and fast roll de Sitter solutions. We also analyse models where the spinor is coupled conformally to gravity, and consider the perturbations and stability of the spinor.Comment: 43 pages. Several new sections and details added. JHEP in prin