Bachelor of Nursing Honours Programs in Australia: current trends and key challenges

Background: To prepare nurses for a role in knowledge generation they need to engage in research training. Bachelor of Nursing (Honours) programs are a first step in this training. Developing a better understanding of current programs, their challenges and outcomes will provide an evidence base to inform curriculum development and policy making. Aim: The aim of this study was to explore current Australian Bachelor of Nursing (Honours) programs in terms of their composition, delivery and number of enrolments/graduates. Methods: Bachelor of Nursing Honours Coordinators or Heads of Schools of Nursing and Midwifery at Australian Universities were emailed an invitation to participate in an online survey. Findings: Of the 19 academics who responded to the survey, 15 (78.9%) reported currently offering a Bachelor of Nursing (Honours) program in their institution. A steady decline in mean enrolments was evident over recent years. There were clear differences in course delivery and assessment tasks between courses. Conclusion: This paper highlights the need to further explore Bachelor of Nursing (Honours) programs across Australia to ensure consistency in outcomes and to explore innovations in course delivery and project development. Such changes should incorporate feedback from students, supervisors, curriculum developers and professional stakeholders to ensure that programs address their various needs

Registered nurses' perceptions and experiences of autonomy: a descriptive phenomenological study

Background Professional autonomy is a key concept in understanding nurses’ roles in delivering patient care. Recent research exploring the role of autonomy in the nursing work environment indicated that English and American nurses had differing perceptions of autonomy. This qualitative study aimed to explore the understanding and experiences of autonomy of nurses working in England. Methods A descriptive phenomenological analysis of data from 48 semi-structured interviews with registered nurses from two National Health Service (NHS) hospitals (purposive sample) was used to explore the concept of autonomy. Results Six themes were identified: working independently; working in a team; having professional skills and knowledge; involvement in autonomy; boundaries around autonomy; and developing autonomy requires support. A key finding was that nurses related autonomy to their clinical work and to the immediate work environment of their ward, rather than to a wider professional context. Nurses also perceived that autonomy could be turned off and on rather than comprising an integrated aspect of nursing. Conclusions Findings suggest that nurses in England, as framed by the sample, had a local ward-focused view of autonomy in comparison to nurses in America, who were reported to relate autonomy to a wider involvement in hospital level committees. Findings further indicate that autonomy was practiced occasionally, rather than incorporated into practice. Findings highlight the need for nurses in England to adopt a broader perspective and actively contribute to writing hospital guidelines and policies that recognise the importance of autonomy to nurse training and practice

Genome-wide Analyses Identify KIF5A as a Novel ALS Gene

To identify novel genes associated with ALS, we undertook two lines of investigation. We carried out a genome-wide association study comparing 20,806 ALS cases and 59,804 controls. Independently, we performed a rare variant burden analysis comparing 1,138 index familial ALS cases and 19,494 controls. Through both approaches, we identified kinesin family member 5A (KIF5A) as a novel gene associated with ALS. Interestingly, mutations predominantly in the N-terminal motor domain of KIF5A are causative for two neurodegenerative diseases: hereditary spastic paraplegia (SPG10) and Charcot-Marie-Tooth type 2 (CMT2). In contrast, ALS-associated mutations are primarily located at the C-terminal cargo-binding tail domain and patients harboring loss-of-function mutations displayed an extended survival relative to typical ALS cases. Taken together, these results broaden the phenotype spectrum resulting from mutations in KIF5A and strengthen the role of cytoskeletal defects in the pathogenesis of ALS.Peer reviewe

The transcriptional landscape of age in human peripheral blood

Disease incidences increase with age, but the molecular characteristics of ageing that lead to increased disease susceptibility remain inadequately understood. Here we perform a whole-blood gene expression meta-analysis in 14,983 individuals of European ancestry (including replication) and identify 1,497 genes that are differentially expressed with chronological age. The age-associated genes do not harbor more age-associated CpG-methylation sites than other genes, but are instead enriched for the presence of potentially functional CpG-methylation sites in enhancer and insulator regions that associate with both chronological age and gene expression levels. We further used the gene expression profiles to calculate the 'transcriptomic age' of an individual, and show that differences between transcriptomic age and chronological age are associated with biological features linked to ageing, such as blood pressure, cholesterol levels, fasting glucose, and body mass index. The transcriptomic prediction model adds biological relevance and complements existing epigenetic prediction models, and can be used by others to calculate transcriptomic age in external cohorts.Peer reviewe

Do Barriers Exist to the Transfer of Tacit Knowledge? An Exploration into the area of Knowledge Transfer

Nature of the study: This study is an exploration into the area of knowledge transfer. It primarily seeks to investigate whether barriers to tacit knowledge transfer within organisations. This study also examines the importance and relevance of knowledge transfer, the differences between tacit and explicit knowledge, and whether changing tacit knowledge into explicit knowledge can be of benefit to an organisation. Methodology: A qualitative approach was adopted for this research through the use of a semi structured interview process and a sample size of eleven participants. Principle findings: The primary barriers to tacit knowledge have been identified by the participants of this study as time, language, perception and trust. As well as this it is noted that individuals are aware of the importance and relevance of tacit knowledge, and the differences between tacit knowledge and explicit knowledge have been explored. Finally it has been found that while participants feel as though tacit knowledge is important to the organisation, they do not see the need to write this information down in order to turn it into explicit knowledge

Examining how advance care directives are used for individuals with dementia living in residential accommodation: a literature review

A poster presentation

Nitrous oxide abuse presenting as functional vitamin B12 deficiency

Introduction: Nitrous oxide is used in anesthesia, dental and obstetrical practices. The gas is also inhaled recreationally because of its ability to induce euphoria and reduce anxiety. There have been several reports of disabling neurological consequences due to prolonged nitrous oxide use, resulting in functional inactivation of vitamin B12. Common neurological presentations of nitrous oxide toxicity include paresthesias and gait disturbance. Case Description: A 24-year-old female presented with 4 days of ascending lower extremity weakness and paresthesias in a stocking-glove distribution. Symptoms began in bilateral feet and progressed to the trunk, and she sustained a fall at home secondary to gait instability as well as leg weakness. Patient reported huffing nitrous oxide from “whippet” canisters every other weekend during the previous 9 months. On physical exam she was noted to have instability in gait, symmetrical loss of flexor and extensor strength in lower extremities, absent ankle reflexes and absent proprioception in the toes. CT head was negative and labs were mostly unremarkable except for WBC count 11.9 K/mcL (4.2-11) and magnesium level 1.6 md/dL (1.7-2.4). Neurology recommended high dose methylprednisolone for suspicion of transverse myelitis. MRI of brain and cervical/thoracic spine showed no abnormalities and patient underwent lumbar puncture with negative CSF culture, cell count, MS panel, and meningitis/encephalitis panel. Subsequent lab studies were notable for negative ANA, serum vitamin D 21.2 ng/mL (30-100), vitamin B12 242 pg/mL (211-911), and methylmalonic acid 25,626 nmol/L (79-376). Treatment with high dose intramuscular cyanocobalamin injections was initiated, and her ambulation gradually improved over the next several days. Discussion: Patients with nitrous oxide-induced neurological dysfunction may have normal vitamin B12 levels. In these situations, a functional deficiency can be diagnosed by measuring methlymalonic acid and homocysteine (substrates of reactions catalyzed by vitamin B12). Nitrous oxide is believed to inactivate and deplete vitamin B12, and high dose replacement has been shown to improve neurological symptoms