Internationally qualified nurses' perspectives on transitioning specialty skills within Australia: A content analysis.

AIM: To explore internationally qualified nurses' perceptions regarding the facilitators and barriers to specialty skill transfer in Australia. DESIGN: The study utilised a descriptive research design with a cross-sectional survey. Data were collected from July to September 2022. METHODS: A self-designed survey was distributed through social media, snowballing and nursing professional organisations. The survey included six open-ended questions which were analysed using thematic content analysis. RESULTS: Sixty-three participants completed the open-ended questions in the survey. The findings identified a range of facilitators (support, previous experience, self-agency) and barriers (systems barriers, bias/discrimination, being undervalued, lack of trust) to skill transition. CONCLUSION: Recognising and addressing facilitators and barriers, coupled with creating customised pathways for specialty skill integration, are essential for optimising the utilisation of specialised skills in internationally qualified nurses. IMPACT: This study aims to explore the barriers and facilitators involved in maximising skill utilisation among internationally qualified nurses in Australia. Identifying these barriers and facilitators is essential for improving patient care, as it will guide the development of strategies for safe nursing service delivery and the optimisation of skill usage. These findings hold significant implications for policymakers, healthcare organisations and nurses, providing valuable insights into how to address these obstacles and capitalise on the factors that make skill transfer smoother and more effective. PATIENT OR PUBLIC CONTRIBUTION: Sixty-three internationally qualified nurses shared their experiences and opinions.

Exploring career choices of specialist nurse students: Their decision-making motives. A qualitative study.

AIMS: To explore Registered Nurses' motives to undergo specialist training and to choose a particular speciality. DESIGN: A descriptive qualitative interview study. METHODS: Semi-structured interviews were conducted during 2021 with 20 Swedish specialist nurse students from different specialisation areas. Qualitative content analysis was used. The COREQ checklist was used to report the study. RESULTS: Specialist nurse students' motivations for further training were divided into three main categories with two sub-categories each. The main categories were 'toward new challenges and conditions in work life', 'contributions to the development and higher competencies in health care' and 'personal work and life experiences as ground for choice'. CONCLUSION: Our study demonstrates the importance of motivating factors in the career choices of Specialist nurse students, such as personal challenges, desirable working conditions, career growth opportunities and personal experiences in the career choices. Creating a supportive work environment that helps to prioritise work-life balance and offers the development of new skills might help retain nurses. NO PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was used. However, if more nurses would choose to undergo specialist training, especially in areas facing significant shortages, it would most likely lead to improved health-related outcomes for patients or populations.

Factors associated with medical students' career choice in different specialties: a multiple cross-sectional questionnaire study at a German medical school.

BACKGROUND: Given the shortage and unequal distribution of physicians across specialties, we aimed to evaluate factors associated with medical students' career choices, including background, personality traits, educational experience, personal interests, lifestyle considerations, and the awareness of work requirements. METHODS: We conducted multiple cross-sectional surveys of students; a 159-item online questionnaire was designed and students from three different stages of the six-year medical degree course (outset, clinical phase, and on graduation) were invited to complete the survey. Data were collected between May 2021 and April 2023. RESULTS: The questionnaire was sent to 1406 students, of whom 683 replied (49%); 481 respondents were female (70%). The top specialty choices across the respondents were internal medicine, surgery, and general practice, with anaesthesiology, paediatric and adolescent medicine (ranging 11-15%), and obstetrics and gynaecology also receiving interest, with 6% undecided. In particular, female students lost interest in surgery during the course of study in favour of the other options. The choice of general practice was associated with more vocational training, prior positive experiences with the specialty, and lower grades in the university entry examination. Clinical clerkships in a specific (freely chosen) specialty aligned with career choice, while the final practical year did not have an impact on career decision-making. All students highly desired regulated working hours and work-life-balance; however, students choosing surgery rated these items as less important. Willingness to work in a hospital environment was highly associated with choosing anaesthesiology and surgery, whereas rural areas and practices were associated with general practice. Higher scores at agreeableness were associated with choosing paediatric and adolescent medicine by more female students, whereas lower neuroticism values were associated with the choice of anaesthesiology. CONCLUSIONS: The results highlight the intricate nature of decision-making and shed light on various aspects that contribute to the process of selecting a specialty. By identifying and addressing influencing factors, we can develop targeted interventions and policies to enhance diversity and distribution across medical specialisations and to aim for high-quality and equitable healthcare that matches the specific needs of both individuals and the population as a whole.

Prey specificity of predatory venoms.

Venom represents a key adaptation of many venomous predators, allowing them to immobilise prey quickly through chemical rather than physical warfare. Evolutionary arms races between prey and a predator are believed to be the main factor influencing the potency and composition of predatory venoms. Predators with narrowly restricted diets are expected to evolve specifically potent venom towards their focal prey, with lower efficacy on alternative prey. Here, we evaluate hypotheses on the evolution of prey-specific venom, focusing on the effect of restricted diet, prey defences, and prey resistance. Prey specificity as a potential evolutionary dead end is also discussed. We then provide an overview of the current knowledge on venom prey specificity, with emphasis on snakes, cone snails, and spiders. As the current evidence for venom prey specificity is still quite limited, we also overview the best approaches and methods for its investigation and provide a brief summary of potential model groups. Finally, possible applications of prey-specific toxins are discussed.

Professionalisation and specialisation in the practice of anaesthesia in the UK.

The year 2024 marks 70 years since graduation of the first candidates in revised examinations for Fellowship of the Faculty of Anaesthetists of the Royal College of Surgeons (FFARCS). Here we review the progress of specialisation and professionalisation of anaesthesia in the UK.

Building the workforce of tomorrow: The weighting of rural exposure in standardised curriculum vitae scoring criteria for entrance into Australian specialty training programs.

OBJECTIVE: To determine the weighting of rural exposure within publicly available standardised curriculum vitae (CV) scoring criteria for trainee medical officer's applying into medical and surgical specialty training programs in Australia and New Zealand. METHODS/DESIGN: An observational analysis of rural exposure point allocations within publicly available standardised CV scoring criteria for entrance into specialty training programs. SETTING: All Australian and New Zealand medical and surgical specialties training programs outlined by the Australian Health Practitioner Regulation Agency (AHPRA) who publish publicly available standardised CV scoring criteria for entrance into specialty training were included. RESULTS: Of the 14 specialty training programs that publish publicly available standardised CV scoring criteria, 8/14 allocate points towards rural exposure. While the allocation of points within this scoring domain varies between the eight training programs, the mean weighting of rural exposure is 13.7%. CONCLUSIONS: The relative weighting of rural exposure varies between the eight specialty training programs who include rural exposure as a CV scoring criteria. The deliberate and strategic construction of CV scoring criteria and inclusion of rural exposure points is important to continue developing the Australian rural specialist workforce. Future development of standardised CV scoring criteria should continue to consider point allocation towards rural exposure and related activities to ensure that the requirements of rural Australian healthcare needs are met across medical and surgical specialties.

Vertical stratification and defensive traits of caterpillars against parasitoids in a lowland tropical forest in Cameroon.

Insect herbivores and their parasitoids play a crucial role in terrestrial trophic interactions in tropical forests. These interactions occur across the entire vertical gradient of the forest. This study compares how caterpillar communities, and their parasitism rates, vary across vertical strata and between caterpillar defensive strategies in a semi deciduous tropical forest in Nditam, Cameroon. Within a 0.1 ha plot, all trees with a diameter at breast height (DBH) ≥ 5 cm were felled and systematically searched for caterpillars. We divided the entire vertical gradient of the forest into eight, five-metre strata. All caterpillars were assigned to a stratum based on their collection height, reared, identified, and classified into one of three defensive traits: aposematic, cryptic and shelter-building. Caterpillar species richness and diversity showed a midstory peak, whereas density followed the opposite pattern, decreasing in the midstory and then increasing towards the highest strata. This trend was driven by some highly dense shelter-building caterpillars in the upper canopy. Specialisation indices indicated decreasing levels of caterpillar generality with increasing height, a midstory peak in vulnerability, and increasing connectance towards the upper canopy, although the latter was likely driven by decreasing network size. Both aposematic and shelter-building caterpillars had significantly higher parasitism rates than cryptic caterpillars. Our results highlight nuanced changes in caterpillar communities across forest strata and provide evidence that defences strategies are important indicators of parasitism rates in caterpillars and that both aposematic and shelter-building caterpillars could be considered a "safe haven" for parasitoids.

Accelerated decline in motor suppression in patients with cerebrovascular disorders: A kinetic analysis using the square-tracing task.

BACKGROUND: Patients with cerebrovascular disorders (CVDs) tend to exhibit impulsive behaviour without controlling their movements, leading to difficulty in performing activities of daily living and an increased risk of accidents. This hastiness, termed 'pacing impairment', has been studied but is not fully understood. OBJECTIVE: To experimentally examine the kinetic features of pacing impairment by focusing on changes in speed and investigating neuropsychological substrates. METHODS: We instructed 53 inpatients with CVDs, 20 orthopaedic inpatients, and 20 healthy participants to trace a 200 mm-sided square as slowly as possible for 120 seconds. We measured the tracing length and mean acceleration and examined the relationship between these measurements, neuropsychological symptoms, and lesion sites. RESULTS: Gradual acceleration in drawing, i.e., decline in motor suppression, was observed more frequently in the CVD group than in the control groups. Excessive acceleration was associated with unilateral spatial neglect, frontal lobe signs, and attention disorders but not with motor impersistence. Additionally, the incidence of excessive acceleration did not differ between left and right hemisphere lesion subgroups and was not associated with any specific lesion site. CONCLUSION: Pacing impairment can manifest as general or holistic deficits in attentional function widely distributed throughout the cerebral hemispheres.

Exploring the evolutionary dynamics of myrmecophytism: Perspectives from the Southeast Asian Macaranga ant-plant symbiosis.

Myrmecophytic plants utilise defensive services offered by obligate ant partners nesting in their domatia in a novel means of survival in tropical habitats. Although much is known about the ecology of myrmecophytism, there aren't enough empirical examples to demonstrate whether it substantially influences evolutionary patterns in host plant lineages. In this study, we make use of the species-rich Macaranga (Euphorbiaceae) ant-plant symbiosis distributed in the Southeast Asian Sundaland to delve into the evolutionary dynamics of myrmecophytism in host plants. We generated the most comprehensive dated phylogeny of myrmecophytic Macaranga till date using genotyping-by-sequencing (GBS). With this in hand, we traced the evolutionary history of myrmecophytism in Macaranga using parametric biogeography and ancestral state reconstruction. Diversification rate analysis methods were employed to determine if myrmecophytism enhanced diversification rates in the genus. Our results demonstrate that myrmecophytism is labile and easily lost. Ancestral state reconstruction supported a single origin of myrmecophytism in Macaranga âˆ¼18 mya on Borneo followed by multiple losses. Diversification rate analysis methods did not yield sufficient evidence to support the hypothesis that myrmecophytism enhanced diversification rates in Macaranga; we found that topographical features on Borneo may have played a more direct role in the divergence of clades instead. Our study provides evidence that while the acquisition of domatia clearly functions as a key innovation that has enabled host plants to exploit the environment in novel ways, it may not necessarily enhance diversification rates. In fact, we hypothesise that overly specialised cases of myrmecophytism may even be an evolutionary dead end.

Evolution of larval gregariousness is associated with host plant specialisation, but not host morphology, in Heliconiini butterflies.

Insect herbivores, such as lepidopteran larvae, often have close evolutionary relationships with their host plants, with which they may be locked in an evolutionary arms race. Larval grouping behaviour may be one behavioural adaptation that improves host plant feeding, but aggregation also comes with costs, such as higher competition and limited resource access. Here, we use the Heliconiini butterfly tribe to explore the impact of host plant traits on the evolution of larval gregariousness. Heliconiini almost exclusively utilise species from the Passifloraceae as larval host plants. Passifloraceae display incredible diversity in leaf shape and a range of anti-herbivore defences, suggesting they are responding to, and influencing, the evolution of Heliconiini larvae. By analysing larval social behaviour as both a binary (solitary or gregarious) and categorical (increasing larval group size) trait, we revisit the multiple origins of larval gregariousness across Heliconiini. We investigate whether host habitat, leaf defences and leaf size are important drivers of, or constraints on, larval gregariousness. Whereas our data do not reveal links between larval gregariousness and the host plant traits included in this study, we do find an interaction between host plant specialisation and larval behaviour, revealing gregarious larvae to be more likely to feed on a narrower range of host plant species than solitary larvae. We also find evidence that this increased specialisation typically precedes the evolutionary transition to gregarious behaviour. The comparatively greater host specialisation of gregarious larvae suggests that there are specific morphological and/or ecological features of their host plants that favour this behaviour.

Optimum ratio of dietary protein and carbohydrate that maximises lifespan is shared among related insect species.

Animals often regulate the intake and quantity of nutrients to maximise fitness through life-history traits such as lifespan, but we still lack a proper understanding of how specific nutrients influence these traits. Here, I developed an algorithm which allowed me to create a nutrient-specific database from literature data, and investigated how the requirements of protein (P) and carbohydrate (C) needed to maximise lifespan evolved across nine insect species. I found moderate evidence of a phylogenetic signal on the optimal ratio of protein to carbohydrate ratio (PC ratio) that maximised lifespan, suggesting that optimal PC ratio for lifespan could have evolved non-independently among related species. I also found evidence for weak-to-strong sex-specific optimal PC ratios for lifespan, suggesting that sex-specific nutritional needs to maximise lifespan can emerge and persist in some species. Although limited in the number of species, the approach adopted here is portable to experiments with n number of nutrients and, thus, can be used in complex comparative precision nutrition studies for insights into the evolution of animal nutrition.

De normalistas a naturalistas: la especialización de las mujeres en salud pública en Brasil (1920-1960) / From normalists to naturalists: The specialization of women in public health in Brazil (1920-1960)

El artículo tiene como objetivo demostrar como la institucionalización de la especialización en salud pública en Brasil abrió oportunidades para la capacitación y la profesionalización de mujeres a partir de los años 1920. El análisis busca avanzar en la historiografía en lo que toca al desempeño y especialización de las mujeres en el campo de la salud pública en un periodo, hasta entonces, poco estudiado, sobrepasando la Primera República brasileña (1889-1930), hasta 1960. La delimitación del marco temporal se realizó en función de las fuentes, es decir, la documentación de los cursos del Instituto Oswaldo Cruz y los formularios de registro e inscripción de las alumnas, que se encuentran bajo la tutela de la Casa de Oswaldo Cruz, Fundación Oswaldo Cruz.(AU)

The article aims at demonstrating how the institutionalisation of specialisation in public health in Brazil opened up opportunities for the training and professionalisation of women from the 1920s onwards. The analysis seeks to advance the historiography regarding the performance and specialisation of women in the field of public health during a period until then little studied, extending beyond the First Brazilian Republic (1889-1930), until 1960. The delimitation of the time frame was based on the arquives, i.e. the documentation of the courses of the Oswaldo Cruz Institute and the registration and enrolment forms of the students, which are under the care of the House of Oswaldo Cruz, Oswaldo Cruz Foundation.(AU)

The road to excellence in women's football: a retrospective cohort study over the last 30 years with Swiss national players.

OBJECTIVES: This study examines the training (age at club entry, hours in club practice, free play, other sports) and environmental characteristics (popularity, media coverage, school and parental support) influencing the development of female Swiss national team players in elite football over a three-decade period. METHODS: A retrospective questionnaire was completed by 84 participants, who were divided into three cohorts based on their first game with the Swiss national team (C1 = until 2000, n = 24; C2 = 2001-2010, n = 29; C3 = 2011-2022, n = 31). ANOVAs were employed to compare the cohorts regarding training and environmental variables. RESULTS: The findings demonstrate better perceived environmental conditions, stagnating volume of free play and other sports in childhood, decreasing age at club entry, and increasing club practice and total training volume across cohorts. CONCLUSION: Practical implications highlight talent development avenues in unstructured settings during free time and in the micro-structure of club practice.

Evaluation of the Role of Veterinarians for Outcomes Related to the Health and Production of Dairy Small Ruminants in Greece.

The objective of the present study was to evaluate the potential benefits of veterinarians in improving the health and welfare of dairy sheep and goats by studying the associations of management practices employed in the farms with production- or health-related outcomes in sheep and goat farms in Greece. This work explored associations with 'professional relationship with a veterinarian' at 444 small ruminant dairy farms in an investigation performed around Greece, where 106 variables, related to infrastructure, animals, production outcomes, health management, health problems and human resources, were assessed. In 384 (86.5%) farms, a professional relationship with a veterinarian was maintained. The median value of visits made annually by veterinarians to these farms was five. In farms with a professional relationship with a veterinarian, significant differences were found in 24 variables (35.8%) related to management practices and 6 (30.0%) production- or health-related outcomes. In multivariable analysis, the following emerged with a significant association: epg counts in faecal samples (p = 0.014), average annual milk production per ewe/doe (p = 0.015), somatic cell counts in bulk-tank milk (p = 0.037), and annual incidence of clinical mastitis (p = 0.044). Moreover, associations of the characteristics of veterinarians emerged with somatic cell counts in bulk-tank milk: the gender (p < 0.0001) and the age (p = 0.004) of the veterinarians. The results attest that the application of veterinary advice and clinical services in sheep and goat dairy farms contributes to the improved health, production and welfare of animals.

Individual consistency in the localised foraging behaviour of shy albatross (Thalassarche cauta).

Quantifying the intra- and interindividual variation that exists within a population can provide meaningful insights into a population's vulnerability and response to rapid environmental change. We characterise the foraging behaviour of 308 trips taken by 96 shy albatross (Thalassarche cauta) from Albatross Island across seven consecutive years. At a population level, incubating shy albatross exploited a consistent area within ca. 500 km radius of their breeding colony. During half of the trips, individuals utilised the closest shelf break to the west of the colony, where upwelling events have been reported. The other half of the trips were exclusively within the neritic zone, utilising a variety of locations within the Bass Strait. Furthermore, we found evidence of individual consistency to geographic locations, with subsequent trips by an individual more similar than random trips from all individuals in our data, both within and between years (G-test, p < .05). Between-individual variation in foraging behaviour was not meaningfully explained by age (linear regression, p > .05) or sex (t-test, p > .05) for any metric, suggesting that other intrinsic individual factors are accounting for between-individual variation in foraging trips. A localised foraging distribution is unusual for albatross, which, combined with high variation in space use between individuals demonstrated here, suggests that this species is accessing adequate resources near the colony. Overall, these findings suggest that incubating shy albatross from Albatross Island exhibit tendencies of a generalist population comprised of uniquely specialised individuals. These results suggest that this species is operating below its biological capacity in this fast-warming area and provide a baseline from which to assess future change.

Lack of host specialization despite selective host use in brood parasitic cuckoo catfish.

Host-parasite dynamics involve coevolutionary arms races, which may lead to host specialization and ensuing diversification. Our general understanding of the evolution of host specialization in brood parasites is compromised by a restricted focus on bird and insect lineages. The cuckoo catfish (Synodontis multipunctatus) is an obligate parasite of parental care of mouthbrooding cichlids in Lake Tanganyika. Given the ecological and taxonomic diversity of mouthbrooding cichlids in the lake, we hypothesized the existence of sympatric host-specific lineages in the cuckoo catfish. In a sample of 779 broods from 20 cichlid species, we found four species parasitized by cuckoo catfish (with prevalence of parasitism of 2%-18%). All parasitized cichlids were from the tribe Tropheini, maternal mouthbrooders that spawn over a substrate (rather than in open water). Phylogenetic analysis based on genomic (ddRAD sequencing) and mitochondrial (Dloop) data from cuckoo catfish embryos showed an absence of host-specific lineages. This was corroborated by analyses of genetic structure and co-ancestry matrix. Within host species, parasitism was not associated with any individual characteristic we recorded (parent size, water depth), but was costly as parasitized parents carried smaller clutches of their own offspring. We conclude that the cuckoo catfish is an intermediate generalist and discuss costs, benefits and constraints of host specialization in this species and brood parasites in general.

Examining the adequacy of preoperative informed consent in a developing country: Challenges in the era of surgical specialisation.

Preoperative informed consent is a legal and ethical requirement that ensures patients understand a procedure, its associated risks and benefits, alternative treatment options, and potential complications to make an informed decision about their care. This cross-sectional study evaluated the informed consent process for major orthopaedic surgeries at a tertiary hospital in Nigeria. A self-administered questionnaire was used to collect data from 120 adult participants. Results showed that many patients do not read the consent form before signing it, and surgeons do not adequately explain the alternatives to surgery, potential risks, and available anaesthetic options. Higher-educated patients are more likely to read the consent form. Surgeons performed well in explaining the nature of the condition and prognosis, the procedure's potential benefits, and answering patients' questions. The study emphasises the need to improve the informed consent process to ensure patients understand and can make rational decisions about their healthcare.

Is separating obstetrics from gynaecology the way forward? A UK perspective.

A recent editorial in this Journal argued that increasing surgical complexity coupled with more limited training calls for separating obstetrics from gynaecology. The speciality suffers manpower challenges and high attrition rates. There is an apparent gulf in approach between researchers focussing on the views of UK graduates or trainees and workforce planners who address the problem through overseas recruitment. Whilst available literature provides scant, if any, indication as to how to address current challenges, it is important that advocates for women's health assess and mitigate potential drawbacks when exploring the way forward.

Plant phylogeny determines host selection and acceptance of the oligophagous leaf beetle Cassida rubiginosa.

BACKGROUND: Predicting the host range of biocontrol agents is important for the safe and effective implementation of biocontrol of weeds. In this study, we examined the phylogenetic pattern of host selection and acceptance by the biocontrol beetle, Cassida rubiginosa. The beetle was released in New Zealand for control of Cirsium arvense, its primary host plant, but has potential to attack many Cardueae (thistles and knapweeds) species. We conducted a series of no-choice and choice experiments and modelled the responses of Cassida rubiginosa in relation to phylogenetic distance from Cirsium arvense. RESULTS: The olfactory recognition (single odour) and preference (two odours) of the beetle showed a significant phylogenetic relationship. These relationships showed a high degree of correlation with 66.9% of the variation in olfactory recognition and 82.8% of the variation in olfactory preference explained by phylogeny. Where the beetle could contact plants, under no-choice conditions there was no phylogenetic pattern to host plant acceptance. However, under choice conditions, phylogenetic distance was a strong predictor of feeding and oviposition preference. These relationships showed a high degree of correlation, with 63.4% of the variation in feeding preference, and 89.0% of the variation in oviposition preference, explained by phylogeny. CONCLUSIONS: As far as we are aware, this is the first demonstration of an herbivorous insect that exhibits a phylogenetic pattern to olfactory host plant selection. Host plant utilisation by Cassida rubiginosa in New Zealand will be mostly restricted to Cirsium and Carduus species, with minimal potential for impact on other Cardueae weeds. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.