bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of Sulfate Removal in Low Concentration Brine Solutions
Authors: Paulo Guilherme Freitas Melo  , Kátia Cecília de Souza Figueiredo
Published: June 2024

Sulfate is a common ion present in natural water bodies at low concentrations and as effluent in different metallurgical processes. The discharge of sulfate in rivers and waterbodies can cause direct and indirect damage to the environment. Regulatory agencies have been increasing the constraints in sulfate content limit for discharge focused on human equity and environmental protection. A common practice is the precipitation of sulfate with lime, but the remaining solution still has ca. 1,500 mg L-1 of sulfate, which is not acceptable for disposal or reuse. This work describes the main routes for sulfate removal such as chemical precipitation, biological degradation, ion exchange, and separation through membranes and discusses the main advantages and issues of each approach. One of the main challenges is to scale up the tests and show the performances at the industrial level. The subject must be the focus of constant study to obtain relevant results so that usual technologies are replaced by more innovative, cheap and efficient methods.
Comparison of the Incidence of Dumping Syndrome in Post-Bariatric Surgery Patients with Roux-en-Y Gastric Bypass (RYGB) Techniques and Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S)
Authors: Gracienne  , Limas Peter Ian
Published: June 2024

Introduction: Dumping syndrome (DS) is a common post-bariatric surgery complication. This study aims to compare the incidence of DS between Roux-en-Y gastric bypass (RYGB) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) at Sumber Waras Hospital, Jakarta, Indonesia.
Methods: This single-center retrospective observational study included 187 patients who underwent RYGB or SADI-S between January 2018 and December 2023. Demographic, clinical, and DS-related data were collected from patients' medical records. Statistical analysis was carried out using SPSS version 25.
Results: The overall incidence of DS was 21.4%, with 23.2% in the RYGB group (n=95) and 19.6% in the SADI-S group (n=92). There was no significant difference in the incidence of DS between the two groups (p = 0.56). Young age (OR 2.18; 95% CI 1.05-4.53; p = 0.04) and history of type 2 diabetes mellitus (OR 3.05; 95% CI 1.21-7.70; p = 0.02) is an independent risk factor for DS.
Conclusion: There was no significant difference in the incidence of DS between RYGB and SADI-S. Young age and a history of type 2 diabetes mellitus are independent risk factors for DS.
Tracing participants for longitudinal environmental health research using social networking sites: a pilot study
Authors: Andrawes Rogih Riad , Yousufzai Susan Jamuria , Mattin Susan Sahar , Elliott Susan , Barakat Caroline
Published: June 2024

Aim: Longitudinal cohort study designs are considered the gold standard for investigating associations between environmental exposures and human health yet they are characterized by limitations including participant attrition, and the resource implications associated with cohort recruitment and follow-up. Attrition compromises the integrity of research by threatening both the internal and external validity of empirical results, weakening the accuracy of statistical inferences and the generalizability of findings. This pilot study aimed to trace participants from a historical cohort study, the Hamilton Child Cohort Study (HCC) (n = 3,202), (1976–1986, 2003–2008) which was originally designed to examine the relative contribution of indoor and outdoor exposure to air pollution on respiratory health.
Methods: Original participants were traced through social networking sites (SNS) by leveraging personal identifying data (name, age, sex, educational affiliation, and geographical locations) from the HCC entered into SNS search engines.
Results: Of the original cohort (n = 3,166), 21% (n = 665) were identified as having social media presence (SMP) on a single social media platform, with 15% (n = 479) found on Facebook, 6% (n = 185) on LinkedIn, < 1% (n = 9) on Instagram, and n = 1 participant on Twitter. However, 68% (n = 2,168) of the cohort were associated with multiple SNS with the same features (matching names, ages, and locations), making conclusive identification challenging. The remaining 11% (n = 334) of the cohort had no SMP (NSMP). Statistical differences in sample characteristics of each cohort were analyzed using the Pearson chi-square test. Significant differences between the SMP and NSMP cohorts were found in relation to sex (p < 0.001), and childhood neighborhood of residence (p < 0.05).
Conclusions: This study underscores social media’s potential for tracing participants in longitudinal studies while advising a multi-faceted approach to overcome inherent limitations and biases. A full-scale study is necessary to determine whether utilizing SNS to trace participants for longitudinal research is an effective tool for re-engaging research participants lost to attrition.
Automated Diagnosis of Covid-19 and Pneumonia Using Transfer Learning and Custom Segmentation on Chest X-Ray Images
Authors: Asok Advait K , Thampi Lidiya Lilly
Published: June 2024

The key goals of this study are to discover, demonstrate, and quantify advancements in deep learning approaches for classifying healthy, pneumonia of the community-acquired and viral types, and COVID-infected lungs from X-ray images and to learn how the pre-trained models react to the training with custom segmented images. The proposed model uses the dataset pre-processed to generate unique masks and segment the lung region to train a convolutional neural network with a transfer learning model using VGG16 and VGG19 architecture. The accuracy and F1 score results for 3-way classification with custom processing are high for VGG19 with custom segmentation. In contrast, the results for the 4-way classification were stable with and without custom processing for both VGG16 and VGG19 models.
HEALTH CARE WORKERS’ KNOWLEDGE OF HEPATITIS C AND ATTITUDES TOWARDS PATIENTS WITH HEPATITIS C: A PILOT STUDY
Authors: Van de Mortel Thea
Published: June 2024

A questionnaire was developed to determine health care workers’ (HCWs) knowledge of, and attitudes towards, hepatitis C in order to inform an education strategy to prevent discrimination towards hepatitis Cpositive patients. The study’s aim was to determine the questionnaire’s reliability and validity. Fifty-eight of 100 questionnaires distributed to HCWs were returned. The internal consistency of the scale was 0.7 following the removal of one item. The face validity of the instrument was high. It was found that a number of demographic variables impacted on HCWs’ level of knowledge regarding hepatitis C and their willingness to care for patients with hepatitis C. Further research with a larger sample size is needed to clarify these issues.
NURSING AND HEALTH CARE IN SWEDEN
Authors: Shields Linda , Kristensson-Hallström Inger , Andershed Birgitta , Jackson Karin , Eriksson Mats
Published: June 2024

Sweden, one of the Nordic countries, has a long history of social justice and equality of access to health care. Nursing plays an important role in this and nursing education is of a high standard. The aim of this paper is to describe Sweden’s health system and nursing within it, thereby giving Australian nurses information which may generate an interest in, and provide background for, collaborative work. It is part of a series initiated by the first author who visited Sweden, Iceland and England in 2000 under the auspices of a Churchill Fellowship, and who has returned to Sweden and England to continue work begun during the Fellowship.
Sweden’s health service is characterised by an ethic of egalitarianism and high standards; primary health care plays a large role and tertiary health care is easily accessible. Nursing in Sweden is of a high standard, with devolvement of responsibility and decisionmaking to those working in the wards and units. Nursing education has been influenced by the historical development of nursing in Europe and today, Swedish nurses enjoy a high standard of university education with government support readily available to make specialist education accessible. Because of the similarities in both the cultures, and nursing, in Australia and Sweden, Australian nurses would find Sweden a wonderful country in which to implement cross-cultural, collaborative work. This paper provides background knowledge for such collaboration.
MENTORING: IMPROVING TRANSITION TO PRACTICE
Authors: Theobald Karen , Mitchell Marion
Published: June 2024

Nurse graduates indicate the transition from student of nursing to registered nurse (RN) is a difficult conversion. This impending change of role and accompanying higher expectations placed upon newly graduating RNs causes concern for students as their Bachelor of Nursing program nears completion. A career mentor scheme is suggested as a way to better prepare final year students for this transition. Evaluations indicate the positive impact the scheme has made on both mentors and mentees as it has enhanced their career development.
ADVANCED PRACTICE NURSES IN MELBOURNE’S HOSPITALS: CLINICAL COORDINATORS IN A RAPID ASSESSMENT MEDICAL UNIT
Authors: Sinclair Cameron , Boyd Kerri , Sinnott Helen
Published: June 2024

Maintaining optimum health and functioning of ageing populations is an ongoing challenge for acute care facilities worldwide. As populations age, the risk of illness and potential debility increases with the increased rate of comorbidity, multipharmacy and sensory and muscle bulk loss that accompany old age.
With these factors comes the potential for increased hospital admission rate, prolonged immobility, reduced function and increasing length of stay (NHMRC 2000). To address these issues, a hospital in Melbourne has developed a Rapid Assessment Medical Unit (RAMU) which provides comprehensive multidisciplinary assessment and commences discharge planning for all medical patients within 48 hours of admission. Coordinating this function is a Clinical Coordinator (CC), who is an advanced practice nurse (APN): a particular feature of the model. Parsons and McMurty (1997) argue that APNs in this role significantly enhance effective utilisation of health services through comprehensive assessment and contextualisation of patient health issues. The result is a streamlining of care, effective and efficient use of resources with an emphasis on discharge planning and community support.
DETERMINANTS OF JOB SATISFACTION AMONG NURSES IN KUWAIT
Authors: Shah Makhdoom , Al-Enezi Naser , Chowdhury Rafiq , Al Otabi Mohammed
Published: June 2024

Objective: Job satisfaction among nurses working in five general hospitals in Kuwait was analysed using a global scale based on the McClosky Mueller Satisfaction Scale (MMSS) in relation to selected background characteristics (eg age, gender, nationality, educational qualification, monthly salary and the departments in which they worked.
Design: The questionnaire was distributed to 500 nurses using a stratified random sample. The response rate was 87.2%.
Results: Age, nationality and the department worked in had a positive significant relationship with job satisfaction. However, a higher level of educational qualification and previous work experience in other countries showed an inverse relationship with job satisfaction.
Conclusion: Based on our findings, we recommend that expatriate staff should be provided with an understanding of cultural differences and how to cope with them. Special attention should be paid to the norms regarding interaction among males and females and social interaction among professionals from the opposite gender. Intensive courses in the languages to be used in the care provision process should be provided to impart requisite language competency.
PERSPECTIVES OF CORONARY BYPASS SURGERY IN TERMS OF GENDER, AGE, PREVIOUS MYOCARDIAL INFARCTION AND SPIRITUALITY
Authors: Råholm Maj-Britt , Eriksson Katie , Lindholm Lisbet , Santavirta Nina
Published: June 2024

Aim: To explore the relationship between the spiritual experience and the physical well-being of patients following coronary bypass surgery.
Method: The design of the study was cross-sectional. The dependent variables were the patients’ spiritual experiences and their physical well-being. The independent variables were gender, age and previous myocardial infarction.
Results: A significant gender difference was found both for physical well-being and for spiritual experience.
Conclusion: The results of this study demonstrate an interrelationship between spiritual and physical dimensions of illness and gender.
THE CONTEXTUAL ISSUES ASSOCIATED WITH SEXUAL HARASSMENT EXPERIENCES REPORTED BY REGISTERED NURSES
Authors: Madison Jeanne , Minichiello Victor
Published: June 2024

Objective: The study aimed to explore contextual conditions in Australian health care workplaces that make sexbased and sexual harassment (SB&SH) a relatively common experience for registered nurses (RNs).
Design: Unstructured, in-depth interviews with a convenience sample of Australian RNs.
Participants: The informants were 16 RNs (15 female and one male), working in health care, who were students enrolled in advanced tertiary preparation in nursing, counselling, and health care management at an Australian university.
Main outcome measure(s): Experiences described by the interview informants identified four conditions present in their workplace when they experienced SB&SH.
Results: Informants noted: 1) the silence that surrounds harassment; 2) that they could not expect support from their peers and professional colleagues; 3) that education did not exist in their workplaces regarding (SB&SH); and, 4) that traditional stereotypes associated with RNs were closely linked to the experience of harassment in the workplace.
Conclusions: Inadequate coverage of workplace issues related to (SB&SH) in undergraduate or postgraduate educational programs were identified.
RE-WRITING MOTHERHOOD: RESEARCHING WOMEN’S EXPERIENCES OF LEARNING TO MOTHER FOR THE FIRST TIME
Authors: Fowler Cathrine , Lee Alison
Published: June 2024

Objective: The aim of this paper was to examine one woman’s experience and memory of learning to mother during pregnancy and the first postnatal year.
Design: Narratives of experience and memory were elicited through three in-depth interviews: during the third trimester of pregnancy; at four to six weeks postpartum; and, when the infant was nine months old. Feminist poststructural approaches informed the interview process. Through discourse analysis the detail of this woman’s experiences was read closely in terms of the constructions, tensions, gaps, absences and contradictions as she reflected on what and how she learned to mother.
Setting: The woman was interviewed in her home.
Participants: The larger research study from which the data in this article are drawn was an extended interview study of 15 women over a 12-month period.
Results: The close analysis of the data exemplifies the outcomes of the larger study from which it was drawn, in its demonstration of the complex and often contradictory processes of maternal learning. An understanding of this complexity is argued to be an essential condition for effective and inclusive nursing and midwifery intervention.
Conclusions: Norms of ‘good’ mothering have been traditionally narrow within nursing literature. Although this is changing, these norms still serve to shape and also restrict possible positions women can take up to make sense of their experience. They provide background to the complex, and sometimes contradictory, processes of learning that take place during the perinatal period.
DOCUMENTATION AND THE TRANSFER OF CLINICAL INFORMATION IN TWO AGED CARE SETTINGS
Authors: Pelletier Dianne , Duffield Christine , Donoghue Judith
Published: June 2024

BACKGROUND: Increasingly, documentation, both formal and informal, is being undertaken by nurses using a range of modalities. In Australia there is a sense that the demand for this in the aged care sector is increasing in line with requirements of funding agencies. However, the scope of this activity and its impact on nursing workload in aged care facilities has not been rigorously investigated. Funding of aged care facilities in the public hospital system in Australia is dependent on documentation of care.
Objective: The purpose of this study was to determine the frequency and time of day that documentation and transfer of clinical information activities occurred for nurses of all skill levels in two aged care facilities in New South Wales, Australia.
Design: Work sampling of direct care, indirect care, unitrelated activities and personal time.
Setting: Two hospitals with aged care facilities near Sydney, Australia. 
Subjects: One hundred and six nurses.
Results: 16,395 observations of nursing activities were recorded. The transfer of clinical information between health care professionals comprises a large part of the nurse’s working day. It comprised between 37 and 38% in this study, but the time of day in which it took place differed between the two hospitals.
Conclusion: Documentation needs to be seen as an integral part of care by managers and clinicians. Both would wish to ensure that it is undertaken in the most efficient and effective manner to allow the necessary time for direct care. More detailed understanding may allow clinical unit managers to re-structure the workday in terms of documentation to achieve greater efficiencies or effective use of nursing time.
PREDICTORS OF DIETARY AND HEALTH SUPPLEMENT USE IN OLDER AUSTRALIANS
Authors: Brownie Sonya
Published: June 2024

Objective: This study aimed to identify the health conditions and symptoms that predicted dietary and health supplement use in older Australians.
Design: Almost 2,500 Australians aged 65 years and over were randomly selected from the 2000 Australian Electoral Commission roll. All states and territories were proportionally represented in the sample. Data were obtained using a self-administered postal survey.
Subjects: Approximately 1,200 individuals (51% males and 49% females) aged between 65-98 years completed the survey.
Results: At the time of survey, 43% (n=548) reported using some form of supplement. Supplement use was significantly associated with gender (female) and chronic musculoskeletal ailments such as arthritis, osteoporosis and generalised back or neck problems. A diagnosis of hypertension or a heart condition were significant barriers to supplement use in this sample. The most common potential drug-supplement interaction was between calcium supplements and antihypertensives.
Conclusion: Older supplement users may be of the opinion that supplements offer relief from the pain and suffering associated with their medical problems. If so, current supplement patterns would indicate that they are misguided. Nurses have an important role to play in encouraging older individuals to disclose their use of supplements to all health professionals involved in their continuing care.
Returning to nursing after a career break: elements of successful re-entry
Authors: Long Janet , West Sandra
Published: June 2024

Background: The well reported shortage of registered nurses (RNs) means recruitment of RNs not currently in the nursing workforce is an option. Nurses re‑entering the nursing workforce are widely considered to be valuable staff members across many health care settings, bringing maturity, life experience and enthusiasm to their work.
Objective: To survey the literature to identify the special needs of the re‑entry RN and suggest elements of a successful re‑entry recruitment, training and retention policy.
Conclusions: The typical re‑entry RN is a 40-year-old female with school‑aged children. She may be unaware of re‑entry opportunities in her area. She wants family friendly shifts and an acknowledgment of family responsibilities; a paid, on‑the‑job refresher course that is relevant and that guarantees future employment; as well as ongoing support to help overcome anxiety and loss of confidence. Positive support from existing staff is crucial.
Homophobia and heterosexism: implications for nursing and nursing practice
Authors: Irwin Lyn
Published: June 2024

Discrimination against lesbian, gay, bisexual and transgender people (LGBT) continues to exist in contemporary society and in institutions such as health care systems despite increasing social tolerance over the past three decades. This article explores the existence of discrimination against LGBT people among nurses and the implications this has for nursing and the quality of care delivered. The evidence suggests that LGBT patients and clients experience discrimination because of the homophobic and heterosexist attitudes of some nurses and other health professionals. Furthermore, some gay and lesbian health care workers also experience prejudice, discrimination and rejection from their colleagues. These experiences have detrimental effects for LGBT patients and staff. Strategies that may enhance the wellbeing of LGBT patients and staff are suggested.
The future nursing workforce in Australia: baseline data for a prospective study of the profile, attrition rates and graduate outcomes in a contemporary cohort of undergraduates
Authors: Gaynor Lynda , Gallasch Tamara , Yorkston Emily , Stewart Simon , Bogossian Fiona , Fairweather Carrie , Foley David , Nutter Helen , Thompson Jan , Stewart Lee , Anastasi Jenny , Kelly Jenny , Barnes Lynne , Glover Pauline , Turner Catherine
Published: June 2024

Objective: To gather data from ten universities across two Australian states in order to: provide a descriptive demographic profile of undergraduate Australian nursing students; provide baseline data for a prospective analysis of attrition within undergraduate nursing programs; and to facilitate student recruitment into a prospective cohort study to examine graduate outcomes.
Methods: Approval was sought from each Head of School to enable recruitment of undergraduate nursing students as a sub‑sample of an ongoing large scale longitudinal e‑cohort study involving Australian, New Zealand and United Kingdom nurses and midwives(http://www.e‑cohort.net). Each nursing school nominated a contact person to become part of the research team; provide aggregate data on the quantity and demographic profile of currently enrolled undergraduate nursing students; and to facilitate recruitment of students into the cohort study.
Results: Two of the ten universities could not supply any demographics of their undergraduate nursing student body and one university could not provide data on year levels. The remaining data revealed an interesting demographic profile in the following areas: the age range of students across both states was 17 to 68 years, with just under half the population of students aged over 25 years. Some universities had a younger cohort of students in comparison to others and this was potentially associated with universities which only offered their program in full‑time mode. The high proportion of students choosing to enrol in their undergraduate program part‑time in South Australia (22.5%) as well as the large number of international students at one Queensland university (28% in year one) may impact on the future graduate nursing workforce supply. Retrospective analysis of the average attrition rate in Queensland
Conclusion: Whilst this preliminary data reveals some interesting issues, in general, there is a paucity of evidence about the demographics of the future Australian nursing workforce, attrition within undergraduate nursing programs and graduate outcomes. Clearly there is a need to systematically track undergraduates and new graduates to quantify student attrition, graduate retention and career plans and begin to build this evidence‑base. A minimum demographic dataset of all undergraduate nursing students in Australia should be established to track trends over time that will inform future workforce planning.
Working in an overcrowded accident and emergency department: nurses' narratives
Authors: Kilcoyne Mary , Dowling Maura
Published: June 2024

Aim: The aim of this study was to highlight nursing issues associated with overcrowding (or access block) in the Accident and Emergency (A&E) department.
Design: An interpretive phenomenological approach was adopted, with the utilisation of unstructured interviews.
Setting: The A&E department of a general hospital situated in the West of Ireland.
Participants: Eleven nurses working in the A&E department volunteered to be interviewed.
Findings: Three central themes, with inter‑related sub‑themes, emerged from the data. The central themes identified were: lack of space, elusive care, and powerlessness, with sub‑themes being health and safety issues, infection control issues, poor service delivery, lack of respect/dignity, nurses hovering, unmet basic human needs, not feeling valued, moral distress, and stress/burnout.
Conclusions: The nurses in this study provide a distressing picture of nursing in an A&E department, as they pursue the provision of effective, holistic care of patients in overcrowded conditions.
Income inequality and health status: a nursing issue
Authors: Massey Peter , Durrheim David
Published: June 2024

Objective: To review the association between income inequality and health status, and consider an appropriate nursing response.
Primary Argument: Nursing has a rich heritage of advocating for a healthy society established on a foundation of social justice. The future legitimacy and success of public health nursing depends on recognising and appropriately addressing the social, economic and political determinants of health in the populations served. There is an incontrovertible association between population health status, absolute income levels and income inequality. Thus, along with other social determinants of health, income differentials within populations must be a fundamental consideration when planning and delivering nursing services. Ensuring that federal and state health policy explicitly addresses this key issue remains an important challenge for the nursing profession, the public health system and the Australian community.
Conclusions: Higher mortality and worse health status occur in societies with higher income inequality. The relationship between income inequality and health appears to be determined both by relative access to resources for health gain and relative social position. The association between greater income equality and improved health may be explained by improved social cohesion. As social factors are at the root of much of health inequality, this knowledge needs to invoke political action and advocacy from the nursing profession to promote the development of healthy public policy.Including indicators of income inequality when planning and monitoring nursing services will enable services to measure to what extent they are based on the principle of social justice.
Legality, morality and reality ‑ the role of the nurse in maintaining standards of care
Authors: Chiarella Mary , McInnes Elizabeth
Published: June 2024

Objective: This paper explores the legal and ethical frameworks that inform nursing practice and health care cultures. Using methodologies informed by critical race and feminist jurisprudence (also called ‘outsider scholarship’), images of nursing and the positive and negative effects of these images and their legal, moral and ethical impact on nursing practice, are explored. This exploration assists in exposing some of the power structures and assumptions which govern contemporary nursing practice and standards of care and which impact on factors such as workforce retention. Legality, morality and reality ‑ the role of the nurse in maintaining standards of care.
Setting: Applies to all settings in which nurses’ practise.
Subjects: Nurses, other health care professionals and patients.
Primary argument: Examples from case law are used to illustrate the relationship between image and power and how these affect legal and moral frameworks and the realities of the workplace for nurses. This is done by examining the law, as a form of insider (whereby the world is described in terms of pre‑existing power structures) and outsider story‑telling (whereby stories are challenged to reflect experiences). Five dominant and recurrent images of nursing emerge from case law analysis. These have implications for: the way in which nurses respond to critical situations which involve the adoption of a moral stance; nurses’ legal and ethical status, and; the environment in which nurses’ practise.
Conclusion: Each of the images of nurses described in this paper is still present in both recent case law and workplace practice. These images have deleterious effects, most particularly contributing to feelings of powerlessness in the workplace and affecting nurses’ ability to be ‘heard’ when patient safety is at stake. While some images give the nurse a degree of moral (and clinical) responsibility, there is no promise of power. Both the inability to influence patient care and an unmet need to feel valued and appreciated contribute to nursing workforce attrition. A complex mix of solutions needs to be implemented to achieve improved workplaces, patient outcomes and retention rates. The promotion of a safety and quality agenda; promoting strategies for self care; well developed clinical career paths; implementing clinical supervision, and introducing Magnet organisation reform, are among the important solutions for addressing these issues.
Mature learners becoming registered nurses: a grounded theory model
Authors: Drury Vicki , Francis Karen , Chapman Ysanne
Published: June 2024

Objective: This study describes how mature aged people reconstruct themselves as nursing students.
Design: This is a constructivist grounded theory study that used grounded theory methods of concurrent data generation and analysis, coding, developing categories and memoing.
Setting: The study was undertaken at the rural campuses of two major Australian universities. The universities were in two different states of Australia.
Subjects: Data were gathered through semi‑structured interviews and focus groups over an eighteen month period between January 2006 and June 2007 with fourteen mature aged undergraduate nursing students. These students were in the second or third year of three year baccalaureate degrees that led to registration as registered nurses (titled Registered Nurse Division 1 in the state of Victoria, Australia). Participants’ backgrounds were all slightly different. Two participants were currently employed as enrolled nurses (titled Registered Nurse Division 2 in the state of Victoria, Australia). Three participants were married, two were supporting parents and one participant was in a committed defacto relationship. Only one participant had no children with other participants having between one and seven children aged between one week old and twenty years.
Results: This study found that mature aged students experienced three stages in their trajectory of Becoming a registered nurse. These phases were called: Taking the first step; Keeping going; and finally, Letting go and moving forward.
Conclusion: Mature aged undergraduate student have different needs to younger students including academic and pastoral support, on campus subsidised childcare and creative timetabling. During each phase of their university journey mature aged undergraduate nursing students developed different skills and knowledge and identified different needs that resulted in both professional and personal growth.
Effect of music on preoperative anxiety in men undergoing urogenital surgery
Authors: Arslan Sevban , Özer Nadiye , Özyurt Funda
Published: June 2024

Objective: The purpose of the current study was to investigate the effect of music therapy on preoperative anxiety levels in Turkish men undergoing urogenital surgery.
Design: The study employed a quasi‑experimental design. Patients were selected using randomized controlled sampling.
Setting: The study was conducted in a urology clinic in Aziziye Research Hospital, Süleyman Demirel Medical Centre, Atatürk University, Erzurum, a city in the east of Turkey.
Subjects: The study was conducted with a total of 64 patients; 32 in the experimental group; 32 in the control group; aged between 18 and 65; and able to speak, read and write Turkish.
Intervention: The control group received routine preoperative care while the experimental group listened to their choice of music for 30 minutes in their room while they awaited surgery.
Main outcome measures: Pre and post test anxiety was measured using the State Trait Anxiety Inventory (STAI) to assess anxiety before and after listening to the music preferred by the patient.
Results: Anxiety score averages between the groups following the music therapy were statistically significant (p<0.001); 33.68 (SD=8.03) for the experimental group and 44.43(SD=10.42) for the control group.
Conclusions: These findings support the use of music as an independent nursing intervention to manage preoperative anxiety in patients undergoing urogenital surgery. Listening to self‑selected music during the preoperative period can effectively reduce anxiety levels and should be a useful tool for preoperative nursing.
Finding a way: a grounded theory of young people’s experience of the pathway to mental health care
Authors: Webster Sue , Beck Lindsay
Published: June 2024

Objective: The purpose of this grounded theory study was to explore how young people experienced the onset of mental health problems and to investigate their initial interactions with the health system.
Design: Grounded theory was used to address the study objectives. Data were obtained through in‑depth semi‑structured interviews.
Setting: Participants were recruited through two community health centres in a Sydney metropolitan area health service.
Subjects: The purposive sample consisted of eight males and twelve females between the ages of eighteen and twenty-five (mean age was 21).
Main outcome measures: The research identified a basic social process, a core category or central phenomenon which had the characteristics of a maze through which the participants had to struggle to find a way. The process of ‘finding a way’ has four stages. These are (a) first sign in the early stages, often involving denial or fear, and self‑medication with alcohol or other drugs; (b) recognition of the symptoms as a sign of mental illness; (c) understanding, discovering information about the illness; and (d) resolution, when care is successfully accessed. At each stage, barriers and/or facilitating factors either delay or speed progress.
Conclusions: The study offers insights into the experiences of a small group of individuals and hence has limitations; however this theoretical approach provides an understanding of what ‘finding a way’ means to this group of participants and how it influences their lives. It offers a framework for understanding some of the cultural and contextual factors that affect young people’s pathways into mental health services and can inform interventions.
Palliative care in a multicultural society: a challenge for western ethics
Authors: Chater Keri , Chun‑Ting
Published: June 2024

Objective: This paper examines the notion of truth telling and its place in palliative care nursing with a particular focus on nursing people from minority cultures.
Setting: The setting is palliative care nursing.
Subjects: The subjects are patients receiving palliative nursing care particularly those from minority cultures.
Primary argument: Australia is a multicultural society yet its dominant ethical paradigm is firmly placed in the western philosophical tradition. The fundamental concept that western ethics is based on is that of autonomy which implies that the individual is a free agent able to make their own decisions including accepting or rejecting medical treatments. These decisions are based on the individual’s right to be informed about all treatment options. From this position of the autonomous subject other ethical principles have their genesis. Nurses’ ethical behaviour is guided to some extent by ethical principals including beneficence, non‑maleficence and truth telling. The major contention, drawn from literature is that truth telling may be an inadequate ethical principle when working with people from minority cultures.
Conclusion: This paper argues that the western ethical concepts of autonomy and truth-telling in the practice domain of palliative care nursing may not be appropriate for different cultural groups and that this may become a source of ethical dilemmas and a challenge for western ethics. The paper concludes with an option for nurses working in multicultural societies that accommodates differing cultural perspectives while not compromising the ethical principle of truth-telling.
Development of a questionnaire to assess health care students’ hand hygiene knowledge, beliefs and practices
Authors: Van de Mortel Thea
Published: June 2024

Objective: To determine the reliability and validity of a hand hygiene questionnaire (HHQ) developed to examine health care students’ hand hygiene knowledge, beliefs and practices.
Design: Pilot testing of the HHQ.
Setting: Undergraduate students of nursing undergoing university education. 
Subjects: The HHQ was administered to 14 student nurse volunteers in the final year of their undergraduate degree and to another 45 volunteers following revision.
Main outcome measures: Main outcomes measures were test‑retest coefficients, Cronbach’s alpha values and mean inter‑item correlations of the scale items.
Results: The face validity of the HHQ was high. Cronbach’s alpha values of 0.80, 0.74 and 0.77 were obtained for the Hand Hygiene Beliefs scale (HBS), the Hand Hygiene Practices Inventory (HHPI), and the Hand Hygiene Importance Scale (HIS) following removalof items with low item‑to‑total correlations or zero variance. The mean item‑to‑total correlations of the HBS, HHPI and IS were 0.37, 0.33, and 0.61 respectively. The two‑week test‑retest coefficients for each scale were 0.85, 0.79 and 0.89 respectively. Socially desirable responding was identified in participants’ responses to the HBS using the 11‑item short form of the Marlowe‑Crowne Social  desirability scale.
Conclusions: The HHQ demonstrated adequate reliability and validity and should be further tested on a wider sample of health care students.
Nurse practitioners in drug and alcohol: where are they?
Authors: Ling Stephen
Published: June 2024

Objective: The role of nurse practitioner encompasses advanced levels of practice with the potential to prescribe a range of medications within a recognised area of practice along with the use of appropriate ordering of pathology tests and referral practices. This paper introduces the nurse practitioner in drug and alcohol.
Setting: The nurse practitioner in Drug and Alcohol has the potential to support and enhance existing medical models of patient care in a variety of settings.
Primary Argument: Employment of nurse practitioners may be a way of addressing workforce issues. The advanced level of practice and resultant responsibility also requires higher levels of remuneration, which need to be accepted within an advanced practice framework. In many cases this model of care may in fact be acknowledging existing practices in areas where nursing staff are forced to undertake more advanced roles due to the shortage of appropriately trained Medical staff. Collaborative care involving nurse practitioners can lead to increased access, reduced waiting times and longer consultation times.
Conclusion: Nurse practitioners in the alcohol and other drugs field have enormous potential to support other experts in collaborative care for patients with substance use disorders. This potential does not come without some additional financial costs but the potential benefits to a health service in employing a nurse practitioner skilled in the management of substance use disorders can be enormous. The full potential of nurse practitioners in drug and alcohol will not however be realised until financial arrangements for outpatient care become a reality.
E-portfolios: developing nurse practitioner competence and capability
Authors: Anderson Debra , Gardner Glenn , Ramsbotham Jo , Tones Megan
Published: June 2024

Objective: This paper aims to integrate nurse practitioner literature on competence and capability with post graduate and nursing literature on e‑portfolios in order to demonstrate the potential merits of e‑portfolios in nurse practitioner education for competence and capability development.
Primary Argument: In the Nurse Practitioner Standards Project, competence and capability were proposed as key criteria to assess candidates in nurse practitioner educational courses. Portfolios have traditionally been used to demonstrate competence in nursing and are integral to nursing education as well. An examination of the portfolio and electronic portfolio literature in postgraduate nursing education and professional practice indicates that these portfolios fall under two main structures, each with different purposes: 1) A spinal column structure, with evidence and reflective pieces aligned to competency standards or course objectives, for the purposes of meeting prescribed competencies, professional development planning and showcasing evidence for authorisation or potential employers; and 2) A cake mix structure, which consists of a reflective narrative tying evidence together, which enables a greater focus on personal learning journeys, reflection and the development of personal qualities. Finally, evidence from the general nursing literature suggests the complexity of e‑portfolios in assessment and evaluation can be overcome by using qualitative research methods.
Conclusion: To meet the competence and capability needs of nurse practitioners, portfolios could be used, for competence and showcasing and for learning and capability. Further research would be useful to refine and explore the use of e‑portfolios to meet the needs of NP candidates and their educators, clinical mentors, authorisation personal and employers. The current evidence on nurse practitioner education, competence, capability and e‑portfolios points to the integration of the use of an e‑portfolio into current nurse practitioner curriculum models to meet the unique needs of nurse practitioner candidates.
Effectiveness of an advanced practice emergency nurse role in a minor injuries unit
Authors: Wallis Marianne , Hooper Jeffrey , Kerr David , Lind James , Bost Nerolie
Published: June 2024

Objective: To evaluate the effect of an emergency department discharge initiative (EDDI) nurse on discharge processes and patient transition outcomes.
Design: Prospective comparative study of two groups of patients, aged 18‑70 years discharged from a minor injuries unit.
Setting: Emergency Department Minor Injuries Unit at a large tertiary hospital in South East Queensland, Australia.
Subjects: In total 337 patients were eligible and 231 were included in the study. Participants were recruited into two groups one before the introduction of the intervention (n= 103) and one after the introduction of the intervention (n=128).
Intervention: Introduction of an EDDI nurse (an advanced practice role) focusing on improving patient pre‑discharge care and transition home.
Main outcome measures: Data were collected pre‑discharge and one week post discharge, using self reports of discharge planning processes and the Care Transitions Measure (CTM) Questionnaire.
Results: Patients seen by the EDDI nurse were significantly more likely to receive written discharge information, a discharge letter, information on equipment, information on medication side effects and have follow‑up arranged, than those not seen. The intervention group also had a better understanding of post discharge healthcare management with a mean CTM score of 83.3 out of a possible 100 compared with the pre‑intervention mean of 64.4. (p<0.001).
Conclusions: The introduction of an EDDI nurse in the minor injuries unit improves discharge information provision and follow‑up and leads to an improvement in post‑hospital care transition from the patient’s perspective.
The breast or bottle? Women’s infant feedings choices in a subsequent birth after a previous Caesarean Section
Authors: McGrath Pam , Phillips Emma
Published: June 2024

Objective: The objective of the study was to explore, from mothers’ perspectives, the experiences and decision‑making associated with a subsequent birth following a Caesarean Section (CS) of which feeding their newborns was a specific focus. This article presents the sub‑set of findings on infant feeding choices. 
Design: A qualitative methodological framework, utilizing descriptive phenomenology.
Setting: A maternity hospital in Brisbane, Australia.
Participants: Twenty women who had given birth at Redland Hospital after experiencing a previous CS were invited to participate.
Data Collection Techniques: Tape recorded interviews were conducted six weeks postpartum.
Results: The findings identify that mothers fell into three different attitudinal groups regarding their decision‑making with respect to feeding their newborn. The first perspective was based on a strong commitment to breastfeeding, which was often maintained in the face of quite significant difficulties. The second perspective was a complete refusal to breastfeed and a clear decision to bottle feed made prior to the birth and adhered to irrespective of alternative advice or persuasion. The third perspective was an initial desire to breastfeed that was easily thwarted by difficulties. The findings emphasise the importance of facilitating for CS births an environment that promotes bonding and breastfeeding by ensuring, where possible, that there is no separation of mother and baby after the birth, maximum opportunity for skin‑to‑skin contact, time for the mother to breastfeed the baby in the period immediately after the birth and no supplementation of breastfeeding with formula.
Conclusions: The success of the midwife or maternity nurse in relation to supporting breastfeeding was, in part, impacted on by the mother’s pre‑determined approach to feeding the newborn. Breastfeeding support for attitudinal groups one and three were most likely to be successful, while the second group was refractory to nursing breastfeeding assistance.
Farewell to the handmaiden? Profile of nurses in Australian general practice in 2007
Authors: Joyce Catherine , Piterman Leon
Published: June 2024

Objective: To describe the characteristics of nurses working in Australian general practice, including their backgrounds, working environments, tasks and duties.
Design: National cross‑sectional survey.
Setting: General practices in all regions of Australia.
Subjects: 104 registered and enrolled nurses working as practice nurses (PNs).
Results: Participants were predominantly registered nurses (93%); all female; and had been in general practice for an average of 6.2 years. They were generally working part time (average 26.2 hours per week), with pay ranging from $18 to $45 per hour. Registered nurses had higher rates of pay but there was no clear relationship between rate of pay and years in general practice. The majority (86%) had completed one or more short courses, and one in six (16%) held or were undertaking postgraduate studies in practice nursing. PNs in the sample worked in practices where there was an average of one PN for every 2.43 GPs. Almost half (47%) worked in practices which employed allied health professionals, and 90% employed practice managers. All undertook duties relating to direct patient care, coordination of care, and management of the clinical environment. 90% undertook practice management and administration tasks, including 57% who provided some reception or secretarial support.
Conclusions: Although some differentiation of roles within the PN workforce was apparent, there were few discernable differences in nurse or practice characteristics associated with these different profiles, and they were unrelated to experience and remuneration. Findings highlight the need for development of career pathways and better monitoring of the PN workforce.