Validity and reliability of the client perception of value questionnaire.

OBJECTIVES: To describe the processes involved in and the results from psychometric testing of the client perception of value (CPV) questionnaire. METHOD: The CPV was developed through literature review, review of consumer participation models, consultation with industry experts and focus groups with aged care residents and their relatives. CPV data from 391 residents residing in 21 residential aged care facilities and 671 relatives of residents were collected from June-September 2008. Multi-trait analysis, Cronbach's alpha and exploratory factor analysis were used to determine the psychometric properties of the two versions of the CPV instrument. Means, standard deviations, 95% confidence intervals, medians and IQRs were calculated for each of the nine service areas within the two versions. RESULTS: Both resident and relative versions demonstrated adequate internal consistency reliability. Exploratory factor analysis replicated the service areas as initially conceived. In general, residents reported higher scores than relatives on the service areas. CONCLUSION: The CPV is a valid and reliable tool that can be used for assessing residents' and relatives' level of satisfaction and perceptions of the quality of aged care service.

Results of the 2023 AORN Salary and Compensation Survey.

AORN conducted its 21st annual compensation survey for perioperative nurses in May and June of 2023. A multiple regression model was used to examine how several variables, including job title, education level, certification, experience, and geographic region, affect perioperative nurse compensation. Comparisons between the 2023 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on total compensation are also examined. Additional analyses explore the current state of the nursing shortage and the sources of job satisfaction and dissatisfaction.

Results of the 2022 AORN Salary and Compensation Survey.

AORN conducted its 20th annual compensation survey for perioperative nurses in June of 2022. A multiple regression model was used to examine how several variables, including job title, education level, certification, experience, and geographic region, affect perioperative nurse compensation. Comparisons between the 2022 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on total compensation are also examined. Additional analyses explore the current state of the nursing shortage and the sources of job satisfaction and dissatisfaction.

Results of the 2021 AORN Salary and Compensation Survey.

AORN conducted its 19th annual compensation survey for perioperative nurses in June and July of 2021. A multiple regression model was used to examine how several variables, including job title, education level, certification, experience, and geographic region, affect perioperative nurse compensation. Comparisons between the 2021 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on total compensation are also examined. Additional analyses explore the current state of the nursing shortage and the sources of job satisfaction and dissatisfaction.

Results of the 2020 AORN Salary and Compensation Survey.

AORN conducted its 18th annual compensation survey for perioperative nurses in June 2020. A multiple regression model was used to examine how several variables, including job title, education level, certification, experience, and geographic region, affect perioperative nurse compensation. Comparisons between the 2020 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on total compensation are also examined. Additional analyses explore the current state of the nursing shortage, sources of job satisfaction and dissatisfaction, and the effects of the Coronavirus Disease 2019 pandemic.

Results of the 2019 AORN Salary and Compensation Survey.

AORN conducted its 17th annual compensation survey for perioperative nurses in June 2019. A multiple regression model was used to examine how several variables, including job title, education level, certification, experience, and geographic region, affect perioperative nurse compensation. Comparisons between the 2019 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on total compensation also are examined. Additional analyses explore the current state of the nursing shortage and the sources of job satisfaction and dissatisfaction.

Movement-dependent stroke recovery: a systematic review and meta-analysis of TMS and fMRI evidence.

Evidence indicates that experience-dependent cortical plasticity underlies post-stroke motor recovery of the impaired upper extremity. Motor skill learning in neurologically intact individuals is thought to involve the primary motor cortex, and the majority of studies in the animal literature have studied changes in the primary sensorimotor cortex with motor rehabilitation. Whether changes in engagement in the sensorimotor cortex occur in humans after stroke currently is an area of much interest. The present study conducted a meta-analysis on stroke studies examining changes in neural representations following therapy specifically targeting the upper extremity to determine if rehabilitation-related motor recovery is associated with neural plasticity in the sensorimotor cortex of the lesioned hemisphere. Twenty-eight studies investigating upper extremity neural representations (e.g., TMS, fMRI, PET, or SPECT) were identified, and 13 met inclusion criteria as upper extremity intervention training studies. Common outcome variables representing changes in the primary motor and sensorimotor cortices were used in calculating standardized effect sizes for each study. The primary fixed effects model meta-analysis revealed a large overall effect size (ES=0.84, S.D.=0.15, 95% CI=0.76-0.93). Moreover, a fail-safe analysis indicated that 42 null effect studies would be necessary to lower the overall effect size to an insignificant level. These results indicate that neural changes in the sensorimotor cortex of the lesioned hemisphere accompany functional paretic upper extremity motor gains achieved with targeted rehabilitation interventions.

Distribution of motor impairment influences quality of life in Parkinson's disease.

We evaluated the relationship between upper extremity (UE) and lower extremity (LE) motor impairments in Parkinson's disease (PD) to overall disability and quality of life (QoL) measures. A total of 639 patients who were diagnosed with idiopathic PD were administered the Unified Parkinson's Disease Rating Scale (UPDRS), QoL, activities of daily living (ADL), and behavioral scales. Composite UE and LE scores from the motor section of the UPDRS were correlated with ADL, QoL, and behavioral measurement scores while controlling for disease duration. Patients with greater UE and LE motor impairments had lower QoL scores. However, LE impairments had a greater influence than UE impairments across all QoL measures.

Results of the 2018 AORN Salary and Compensation Survey.

AORN conducted its 16th annual compensation survey for perioperative nurses in June 2018. A multiple regression model was used to examine how several variables, including job title, education level, certification, experience, and geographic region, affect perioperative nurse compensation. Comparisons between the 2018 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on total compensation also are examined. Additional analyses explore the current state of the nursing shortage and the sources of job satisfaction and dissatisfaction.

Modelling the hepatitis C virus epidemic in Australia.

BACKGROUND: Hepatitis C virus (HCV) infection in Australia is predominantly transmitted through injecting drug use. A reduction in the heroin supply in Australia in late 2000 and early 2001 may have impacted the number of injecting drug users (IDUs) and consequently the number of new hepatitis C infections in Australia. This paper updates estimates of HCV incidence and prevalence between 1960 and 2005. METHODS: Simple mathematical models were used to estimate HCV incidence among IDUs, migrants to Australia from high HCV-prevalence countries, and other HCV exposure groups. Recent trends in numbers of IDUs were based on indicators of injecting drug use. A natural history of HCV model was applied to estimate the prevalence of HCV in the population. RESULTS: The modelled best estimate of past HCV incidence showed a consistent increasing rate of HCV infections to a peak of 14,000 new seroconversions in 1999, followed by a decline in 2001-2002 coincident with the decline in heroin availability. HCV incidence was estimated to be 9700 (lower and upper limits of 6600 and 13,200) in 2005. Of these, 88.7% were estimated to be through injecting drug use, 7.2% among migrants and 4.1% through other transmission routes. An estimated 264,000 (lower and upper limits of 206,000 and 318,000) people were HCV antibody positive in 2005. CONCLUSIONS: Mathematical models suggest that HCV incidence in Australia decreased from a peak of 14,000 new infections in 1999 to 9700 new infections in 2005, largely attributable to a reduction in injecting drug use. The numbers of people living with HCV in Australia is, however, estimated to continue to increase.

Results of the 2017 AORN Salary and Compensation Survey.

AORN conducted its 15th annual compensation survey for perioperative nurses in June 2017. A multiple regression model was used to examine how several variables, including job title, educational level, certification, experience, and geographic region, affect nurse compensation. Comparisons between the 2017 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on base compensation rates are examined. Additional analyses explore the current state of the nursing shortage and the sources of job satisfaction and dissatisfaction.

Low-level maternal exposure to nicotine associates with significant metabolic perturbations in second-trimester amniotic fluid.

Decades of public health research have documented that smoking in pregnancy poses significant health risks to both mother and child. More recent studies have shown that even passive maternal exposure to secondhand smoke associates with negative birth outcomes. However, the mechanisms linking exposure to outcomes have remained obscure. As a first step toward defining the metabolic consequence of low-level nicotine exposure on fetal development, we conducted an untargeted metabolomic analysis of 81 paired samples of maternal serum and amniotic fluid collected from karyotypically normal pregnancies in the second trimester. By comparing the m/z and retention times of our mass spectral features with confirmed standards, we identified cotinine, a nicotine derivative, and used the calculated cotinine concentrations to classify our maternal serum samples into exposure groups using previously defined cut-offs. We found that cotinine levels consistent with low-level maternal exposure to nicotine associated with distinct metabolic perturbations, particularly in amniotic fluid. In fact, the metabolic effects in amniotic fluid of ostensibly low-level exposed mothers showed greater overlap with perturbations previously observed in the sera of adult smokers than did the perturbations observed in the corresponding maternal sera. Dysregulated fetal pathways included aspartate and asparagine metabolism, pyrimidine metabolism, and metabolism of other amino acids. We also observed a strong negative association between level of maternal serum cotinine and acetylated polyamines in the amniotic fluid. Combined, these results confirm that low-level maternal nicotine exposure, indicated by a maternal serum cotinine level of 2-10ng/mL, is associated with striking metabolic consequences in the fetal compartment, and that the affected pathways overlap those perturbed in the sera of adult smokers.

Bilateral movement training and stroke rehabilitation: a systematic review and meta-analysis.

OBJECTIVE AND DESIGN: Bilateral movement training is being increasingly used as a post-stroke motor rehabilitation protocol. The contemporary emphasis on evidence-based medicine warrants a prospective meta-analysis to determine the overall effectiveness of rehabilitating with bilateral movements. METHODS: After searching reference lists of bilateral motor recovery articles as well as PubMed and Cochrane databases, 11 stroke rehabilitation studies qualified for this systematic review. An essential requirement for inclusion was that the bilateral training protocols involved either functional tasks or repetitive arm movements. Each study had one of three common arm and hand functional outcome measures: Fugl-Meyer, Box and Block, and kinematic performance. RESULTS: The fixed effects model primary meta-analysis revealed an overall effect size (ES=0.732, S.D.=0.13). These findings indicate that bilateral movement training was beneficial for improving motor recovery post-stroke. Moreover, a fail-safe analysis indicated that 48 null effects would be necessary to lower the mean effect size to an insignificant level. CONCLUSION: These meta-analysis findings indicate that bilateral movements alone or in combination with auxiliary sensory feedback are effective stroke rehabilitation protocols during the sub-acute and chronic phases of recovery.

Results of the 2016 AORN Salary and Compensation Survey.

AORN conducted its 14th annual compensation survey for perioperative nurses in June 2016. A multiple regression model was used to examine how several variables, including job title, education level, certification, experience, and geographic region, affect nurse compensation. Comparisons between the 2016 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on base compensation rates also are examined. Additional analyses explore the effect of the economic downturn on the perioperative work environment.

Results of the 2015 AORN Salary and Compensation Survey.

AORN conducted its 13th annual compensation survey for perioperative nurses in June and July 2015. A multiple regression model was used to examine how a number of variables, including job title, education level, certification, experience, and geographic region, affect nurse compensation. Comparisons between the 2015 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on base compensation rates also are examined. Additional analyses explore the effect of the economic downturn on the perioperative work environment.

Do we practice what we preach? Health care worker screening and vaccination.

OBJECTIVE: To describe the current screening and immunization practices in New South Wales (NSW) hospitals and the experience of NSW nurses in relation to screening and immunization and to identify areas that can be targeted for improvement. DESIGN: This was a cross-sectional survey. SETTING: The study was performed in NSW, Australia. METHODS: We used a written questionnaire to survey the infection control/occupational health coordinators of all of the 85 private hospitals and 204 eligible public hospitals in NSW and 800 randomly sampled registered nurses. RESULTS: Response rates were high (hospitals [90%], nurses [70%]). Hospitals almost universally offered hepatitis B vaccination to nurses (251/261, 96%), but more than one quarter (132/473, 28%) of nurses reported incomplete vaccination. Provision to physicians was relatively poor (142/261, 54%). The majority of nurses (> 80%) had been vaccinated with bacille Calmette-Guérin vaccine, but hospitals reported variable tuberculosis screening practices. Both hospitals and nurses reported low rates (< 30%) of screening and vaccination provision for varicella and measles-mumps-rubella. Two thirds of NSW hospitals (174/261, 67%) provided annual influenza vaccination. CONCLUSIONS: Even though hepatitis B immunization programs were widespread, their effectiveness could be improved by ensuring that vaccination schedules are completed and by targeting physicians. Varicella and measles-mumps-rubella screening and immunization programs are currently lacking. Better strategies are needed to improve the implementation of health care worker protection guidelines in hospitals.

Results of the 2014 AORN Salary and Compensation Survey.

AORN conducted its 12th annual compensation survey for perioperative nurses in June and July 2014. A multiple regression model was used to examine how a number of variables, including job title, education level, certification, experience, and geographic region, affect nurse compensation. Comparisons between the data from 2014 and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials) on base compensation rates also are examined. Additional analyses explore the effect of the economic downturn on the perioperative work environment.

Results of the 2013 AORN Salary and Compensation Survey.

AORN conducted its 11th annual compensation survey for perioperative nurses in June 2013. A multiple regression model was used to examine how a number of variables, including job title, education level, certification, experience, and geographic region affect nurse compensation. Comparisons among the 2013 data and previous years' data are presented. The effects of other forms of compensation, such as on-call compensation, overtime, bonuses, and shift differentials on base compensation rates are also examined. Additional analyses explore the effect of the current economic downturn on the perioperative work environment.