Development of the quality of Australian nursing documentation in aged care (QANDAC) instrument to measure paper-based and electronic resident records

Aim: To develop an Australian nursing documentation in aged care (Quality of Australian Nursing Documentation in Aged Care (QANDAC)) instrument to measure the quality of paper-based and electronic resident records. Methods: The instrument was based on the nursing process model and on three attributes of documentation quality identified in a systematic review. The development process involved five phases following approaches to designing criterion-referenced measures. The face and content validities and the inter-rater reliability of the instrument were estimated using a focus group approach and consensus model. Results: The instrument contains 34 questions in three sections: completion of nursing history and assessment, description of care process and meeting the requirements of data entry. Estimates of the validity and inter-rater reliability of the instrument gave satisfactory results. Conclusion: The QANDAC instrument has a potential as a useful audit tool for the purposes of quality improvement and research in aged care documentation

The shear characteristic and failure mechanism study of infilled rock joints with constant normal load

In order to evaluate the shear deformation characteristics, the direct shear tests for the rock-like specimens with regular sawtooth were carried out in the laboratory. The different asperity angles and different normal stress conditions were considered and the dilatancy characteristics and the corresponding failure modes were analyzed accordingly. The uncommon asperity angle of 25°, 40° and 55° have been selected to compare with the common angles, which can study the differences in detail. Studies show that when the normal stress keeps constant, the peak shear strength increases first and decreases with the increasing asperity angle afterwards. It is because the force causing sawtooth damage under tensile failure is less than the force under shear failure. When the asperity angle keeps constant, the greater the normal stress, the greater the peak shear strength. The larger the normal displacement of dilatancy angle and dilatancy are caused by larger asperity angle. According to the verification, the test results are in good agreement with the analytical results. It should be noted that the analytical results presented locate below the test result curves, which is due to the small values of c and m in the formula. The sliding failure is usually induced when the asperity angle or the normal stress is small. On the contrary, the tensile damage normally occurs while the asperity angle is large enough

Factors influencing nursing time spent on administration of medication in an Australian residential aged care home

Aims: To examine nursing time spent on administration of medications in a residential aged care (RAC) home, and to determine factors that influence the time to medicate a resident. Background: Information on nursing time spent on medication administration is useful for planning and implementation of nursing resources. Methods: Nurses were observed over 12 morning medication rounds using a time-motion observational method and field notes, at two high-care units in an Australian RAC home. Results: Nurses spent between 2.5 and 4.5 hours in a medication round. Administration of medication averaged 200 seconds per resident. Four factors had significant impact on medication time: number of types of medication, number of tablets taken by a resident, methods used by a nurse to prepare tablets and methods to provide tablets. Conclusion: Administration of medication consumed a substantial, though variable amount of time in the RAC home. Nursing managers need to consider the factors that influenced the nursing time required for the administration of medication in their estimation of nursing workload and required resources. Implications for nursing management: To ensure safe medication administration for older people, managers should regularly assess the changes in the factors influencing nursing time on the administration of medication when estimating nursing workload and required resources

Prevalence of insomnia symptoms and their associated factors in patients treated in outpatient clinics of four general hospitals in Guangzhou, China

Background: Data on the prevalence of insomnia symptoms in medical outpatient clinics in China are lacking. This study examined the prevalence of insomnia symptoms and their socio-demographic correlates in patients treated at medical outpatient clinics affiliated with four general hospitals in Guangzhou, a large metropolis in southern China. Method: A total of 4399 patients were consecutively invited to participate in the study. Data on insomnia and its socio-demographic correlates were collected with standardized questionnaires. Results: The prevalence of any type of insomnia symptoms was 22.1% (95% confidence interval (CI): 20.9–23.3%); the prevalence of difficulty initiating sleep was 14.3%, difficulty maintaining sleep was 16.2%, and early morning awakening was 12.4%. Only 17.5% of the patients suffering from insomnia received sleeping pills. Multiple logistic regression analysis revealed that male gender, education level, rural residence, and being unemployed or retired were negatively associated with insomnia symptoms, while lacking health insurance, older age and more severe depressive symptoms were positively associated with insomnia symptoms. Conclusions: Insomnia symptoms are common in patients attending medical outpatient clinics in Guangzhou. Increasing awareness of sleep hygiene measures, regular screening and psychosocial and pharmacological interventions for insomnia are needed in China. Trial registration: ChiCTR-INR-16008066. Registered 8 March 2016

A Lattice Study of (Dˉ1D∗)±(\bar{D}_1 D^{*})^\pm Near-threshold Scattering

In this exploratory lattice study, low-energy near threshold scattering of the $(\bar{D}_1 D^{*})^\pm$ meson system is analyzed using lattice QCD with $N_f=2$ twisted mass fermion configurations. Both s-wave ($J^P=0^-$) and p-wave ($J^P=1^+$) channels are investigated. It is found that the interaction between the two charmed mesons is attractive near the threshold in both channels. This calculation provides some hints in the searching of resonances or bound states around the threshold of $(\bar{D}_1 D^{*})^\pm$ system.Comment: 20 pages, 15 figures, matches the version on PR

Enhanced oxidation resistance of active nanostructures via dynamic size effect.

A major challenge limiting the practical applications of nanomaterials is that the activities of nanostructures (NSs) increase with reduced size, often sacrificing their stability in the chemical environment. Under oxidative conditions, NSs with smaller sizes and higher defect densities are commonly expected to oxidize more easily, since high-concentration defects can facilitate oxidation by enhancing the reactivity with O2 and providing a fast channel for oxygen incorporation. Here, using FeO NSs as an example, we show to the contrary, that reducing the size of active NSs can drastically increase their oxidation resistance. A maximum oxidation resistance is found for FeO NSs with dimensions below 3.2 nm. Rather than being determined by the structure or electronic properties of active sites, the enhanced oxidation resistance originates from the size-dependent structural dynamics of FeO NSs in O2. We find this dynamic size effect to govern the chemical properties of active NSs