The Australian and New Zealand dialysis workforce

Aim: To capture a &quot;snapshot&quot; of the current Australian and New Zealand dialysis workforce in order to contribute to the future renal workforce challenges. Methods: A web-based survey of dialysis managers (n=221) were asked fifteen questions relating to demographics, age, full-time equivalent information, workforce designation, post-registration qualifications, subjective perceptions of staffing levels, staffing strategies and future dialysis research recommendations Results: In Australia in 2008 there were 2433 registered nurses, 188 enrolled nurses and 295 dialysis professionals (technicians) and 327 registered nurses (RNs), 8 enrolled nurses (ENs) and 64 dialysis professionals in New Zealand. There were significant variations in staff/patient ratios, workforce profiles and post-registration qualifications. There is a significant association between staff/ patient and home dialysis ratios. A high proportion of renal staff worked part-time, particularly in Australia. The dialysis workforce reflects the aging nature of the general nursing population in Australia and New Zealand. The majority of dialysis nurse managers perceived they had sufficient staff. Conclusion: Workforce variations found in this study may be useful to identify future workforce challenges and strategies. <br /

Beaver and Aspen: Synergy Among Keystone Species

In the West, climate change is likely to increase the frequency, intensity, and duration of drought. Restoration of soils and water storage capacity can help create resilient uplands and riverscapes (i.e., streams and the valley bottoms). Over the past two centuries, common land uses, the removal of beaver and wood, straightening of streams, and damage to riparian areas have created simplified, structurally starved, riverscapes. Degraded streams are very efficient at transporting water, sediment, and nutrients downstream. Aspen forests are also biological hotspots that have been degraded by past land uses such as overbrowsing ungulates, land clearing, fire suppression, and outright removal in favor of timber species. Loss of riverscape and aspen habitats has a disproportionate impact on biodiversity and landscape resilience. When aspen occur in or near riverscapes they are a preferred food and building material for beavers. Beaver, in-turn, can stimulate aspen regeneration, both through cutting and restoring hydrologic function in riparian areas. Adding beavers can reinstate riparian processes, increase aspen growth and diversity that extends to uplands, and buffer ecosystem sensitivity to extended drought

Book Recommending Using Text Categorization with Extracted Information

Content-based recommender systems suggest documents, items, and services to users based on learning a profile of the user from rated examples containing information about the given items. Text categorization methods are very useful for this task but generally rely on unstructured text. We have developed a bookrecommending system that utilizes semi-structured information about items gathered from the web using simple information extraction techniques. Initial experimental results demonstrate that this approach can produce fairly accurate recommendations. Introduction There is a growing interest in recommender systems that suggest music, films, and other items and services to users (e.g. www.bignote.com, www.filmfinder.com) (Maes 1994; Resnik &amp; Varian 1997). These systems generally make recommendations using a form of computerized matchmaking called collaborative filtering. The system maintains a database of the preferences of individual users, finds other users whose known preferenc..

A simple nutrition screening tool for hemodialysis nurses

Objective : To assess the reliability of a nurse-performed nutrition screening tool (NST) for hemodialysis (HD) patients to identify nutritionally at-risk patients.Design : Tool reliability assessment.Setting and Participants : The setting was nine non-hospital private (n = 3) and public (n = 6) HD units in Australia (two rural and seven metropolitan). Participants were 112 HD patients.Results : A total of 112 HD patients (male = 65, female = 47) from 9 non-hospital HD units in Australia (seven metropolitan and two rural) were screened with the NST and the outcome of dietitian referral compared with Standard Dietitians Assessment. The mean age of patients was 57.6 years. Overall, the NST showed a sensitivity of 0.84 (range, 0.71 to 0.94; P &lt; .05) and a specificity of 0.9 (range, 0.82 to 0.98; P &lt; .05). The NST was more sensitive (sensitivity, 0.93 [range, 0.87 to 0.99; P &lt; .05]) and was more specific for men (specificity, 0.92 [range, 0.85 to 0.99; P &lt; .05]). Specificity was very strong in metropolitan patients (specificity, 0.94 [range, 0.87 to 1.01; P &lt; .05]).Conclusions : The tool was more sensitive and specific than the NST previously reported by the same investigators. The tool is particularly specific in that it screens those patients not requiring dietitian intervention. The use of this tool may benefit HD units that do not have on-site or regular dietetic support to prioritize patients needing dietitian intervention.<br /

A nurse managed kidney disease program in regional and remote Australia

Health services that aim to prevent and manage chronic kidney disease (CKD) in rural and remote Aboriginal communities in Australia, including the Goldfields region of Western Australia (WA), require innovative approaches. Nursing roles can significantly improve access to renal services in rural and remote areas as they are able to address a range of renal health promotion and prevention activities, and provide renal clinical education and support to Aboriginal people. The Goldfields Kidney Disease Nursing Management Program (GKDNMP), funded through the Council of Australian Governments (COAG) National Partnership Agreements, was developed to provide a comprehensive approach to primary health care that incorporates a range of health promotion and disease management activities. In the first year, the program increased home dialysis rates and decreased patient travel due to expanded access to renal care within the region. Context-specific health programs generated in response to local needs can be successful in addressing specific health care challenges in rural and remote health.<br /

A combined strength and balance exercise program to decrease falls risk in dialysis patients : a feasibility study

People suffering end-stage kidney disease receiving hemodialysis have a greater risk of falling and suffering debilitating injuries. The purpose of this study was to examine the feasibility and impact of a combined strength and balance exercise intervention on falls risk in hemodialysis patients. Twenty-four adults (mean age = 67.8 yrs) from two Australian outpatient hemodialysis clinics completed the intervention. Falls risk was measured using the Physiological Profile Assessment (PPA). There was a significant reduction in the median overall falls risk z-score from 1.67 to .52 (z = -3.11, P&lt;.008; r = .45). Median reaction time improved from .30 to .26 sec (z = -2.86, P&lt;.008; r = .41). A strength and balance intervention to reduce the falls risk for dialysis patients is feasible and may reduce falls risk for at risk patients