Aesthetic Medicine Nurses and Qualified Nonmedical Practitioners: Our Role and Requirements as Aesthetic Medicine Adapts to Worldwide Changes and Needs.

Aesthetic medicine nursing is a highly skilled specialty, which continues to evolve. A survey of 197 experienced aesthetic medicine nurses practicing in eight countries revealed shortcomings in the current approach to their education, training, and registration. Education and training are currently self-identified and self-funded and are often provided by the companies that manufacture or distribute the products used in aesthetic medicine treatments. Accreditation and registration schemes are not mandatory, and an international professional governing body is lacking to facilitate international cooperation and sharing of best practice. There is a need for an academic, coherent, and comprehensive approach to the training and education of aesthetic medicine nurses that will equip them with the knowledge and experience to not only administer treatments and attain natural looking results but also prevent, recognize, and manage any potential complications associated with such treatments.

An evaluation of portable sleeping spaces for babies following the Christchurch earthquake of February 2011.

AIM: To describe how recipients of portable sleeping spaces (PSSs) for babies received and used these devices, offered as emergency baby beds in earthquake-ravaged Christchurch, New Zealand, 2011. METHOD: The PSS package responded to increased risk to babies from disrupted living and sleeping conditions in families. 'Door-to-door' distribution offered easy access to those in need. A subgroup of recipients gave feedback via a survey. RESULTS: From 642 families who received PSSs between March and August, 139 were invited to complete a survey on usage and 100 (72%) responded. Risks identified were 'earthquake related' (82%), bed-sharing (41%), smoking in pregnancy (26%) and prematurity or low birthweight (11%). PSSs were used for same-bed co-sleeping by 87%. They were used even though most families (96%) also had a cot or bassinet. Features most appreciated were 'having baby close' (90%), 'peace of mind' (88%) and portability (74%). CONCLUSION: PSSs were acceptable to parents and used as instructed. Enabling physical protection of babies when same-bed co-sleeping, they gave peace of mind to parents. PSSs could be considered in ordinary times for protecting babies from sudden infant death.

Usage and impact of an online education tool for preventing sudden unexpected death in infancy.

AIM: This paper describes the usage, impact and reach of an online education tool for preventing sudden infant death. METHODS: A 24-slide presentation was formatted for online access. Content was designed for mainstream audiences to align current knowledge, attitudes and actions for a blitz approach to preventing sudden infant death in New Zealand (NZ). The tool was promoted through a network of 'safe sleep' champions across the country and collected basic information on usage, reach and impact. RESULTS: From 3286 completed online sessions between 18 November 2009 and 31 December 2011, there were 2683 (81.7%) with complete data. Average usage was 24.4 completed sessions/week, over a 2-year period, at a cost of NZD1.11 per completed session. Usage reached across regions, ethnic groups and roles. On completion of the course, most rated highly (7-9/9) (68.8%) their 'increased confidence' to discuss infant sleep safety with others. A high increased confidence rating was significantly influenced by spending more time per slide (P < 0.05) and being Maori, Pacific, Asian or 'other' compared with NZ European (P < 0.05). CONCLUSIONS: This simple online education tool achieved its aims of high usage, broad participation and cost-effective impact on increasing confidence to discuss infant sleep safety with others. e-Learning modes should be considered where there is a need to align large numbers of people in a short time with understandings and actions for addressing a specific health issue.

Evidence-based smoking cessation interventions for patients with acute respiratory disorders.

Worldwide, tobacco use continues to be the most significant preventable cause of death and hospital admissions, particularly related to respiratory diseases. Acute respiratory illnesses requiring hospitalization provide an opportunity for nurses to intervene and help smokers quit. Of the three top hospital admissions related to respiratory diseases, chronic obstructive pulmonary disease (COPD) is the one that continues to have increased mortality whereas community acquired pneumonia and asthma have decreased over the past 5 years. The course of all three can be caused or exacerbated by continued smoking. This review describes the state of the science of nursing research focused on tobacco cessation interventions for hospitalized patients with COPD, asthma, or community acquired pneumonia. Additionally, we describe two evidence-based, nurse-driven, hospital protocols to treat tobacco dependence that can serve as models of care. Recommendations are made as to how to effectively promote nursing interventions for tobacco cessation in the acute care setting.

What makes a good family-centered partnership between women and their practitioners? A qualitative study.

BACKGROUND: Family-centered maternity care is an approach based on mutually beneficial partnerships between health care providers and families. It offers new ways of thinking about the relationship among childbearing women, their families, and health caregivers. This study was designed to identify health care practices that promoted or limited a family-centered philosophy. METHODS: A qualitative design, using reflexive interviews and focus groups, investigated the perspectives of 34, primarily African American women who used maternity services at a large urban hospital; some women traveled from rural areas for delivery. Inductive data analysis was conducted on the transcribed audiotapes of the interviews and groups. RESULTS: Barriers to family-centered maternity care were categorized as issues in coordination of services among health caregivers, patient-health caregiver relationships and systems, and access to services. Facilitators of family-centered maternity care were identified as perceived response to high-risk patients, health-related support outside the hospital, and special resources. Narratives, or personal stories told by the women, were used to illustrate barriers and facilitators. CONCLUSIONS: Education about family-centered maternity care is vitally important for health caregivers. In clinical situations, each childbearing woman and her family should be treated as if they are extraordinary. In this way, practitioners can alter routines that cause the woman and her family to lose individualized care.

Beyond 'beer, fags, egg and chips'? Exploring lay understandings of social inequalities in health.

This paper seeks to contribute to the limited body of work that has directly explored lay understandings of the causes of health inequalities. Using both quantitative and qualitative methodology, the views of people living in contrasting socio-economic neighbourhoods are compared. The findings support previous research in suggesting that lay theories about causality in relation to health inequalities, like lay concepts of health and illness in general, are multi-factorial. The findings, however, also illustrate how the ways in which questions about health and illness are asked shape people's responses. In the survey reported on here people had no problem offering explanations for health inequalities and, in response to a question asking specifically about area differences in health experience, people living in disadvantaged areas 'constructed' explanations which included, but went beyond, individualistic factors to encompass structural explanations that gave prominence to aspects of 'place'. In contrast, within the context of in-depth interviews, people living in disadvantaged areas were reluctant to accept the existence of health inequalities highlighting the moral dilemmas such questions pose for people living in poor material circumstances. While resisting the notion of health inequalities, however, in in-depth interviews the same people provided vivid accounts of the way in which inequalities in material circumstances have an adverse impact upon health. The paper highlights ways in which different methodologies provide different and not necessarily complementary understandings of lay perspectives on the causes of inequalities in health.

Effects of knowledge, personal attribution and perception of ecosystem health on depreciative behaviors in the intertidal zone of Pacific Rim National Park and Reserve.

Human activities levy a biological cost on ecosystems as resources are accessed and utilized at rates which are often incompatible with inherent ecosystem processes and structures. The recreational impact of humans upon intertidal zones and particularly fucoid algal assemblages is one major threat facing coastal ecosystems. The effect of human values, knowledge and perception in effecting biologically costly behaviors has rarely been examined. We hypothesize that with respect to intertidal zones: (1) Personal attribution and perception of ecosystem resiliency are more important than knowledge in determining the extent of depreciative behaviors individuals engage in, and; (2) Individuals who are uncertain about ecosystem resiliency will behave in a manner consistent with the 'precautionary principle'. We measured the depreciative behavior, and the attitudes and perceptions to ecosystem resilience, of visitors to Wick Headland in Pacific Rim National Park, British Columbia. Attitudes, knowledge, perceptions, and personal attribution were measured using questionnaire survey and structured interviews undertaken in situ. Depreciative behaviors of visitors were discreetly observed and correlated to the questionnaire survey and interview responses. We show that visitors who recorded greater knowledge of intertidal ecology engaged in more depreciative behaviors than visitors recording less knowledge. Visitors who perceived high ecosystem resilience in the intertidal zone engaged in significantly more behaviors eliciting biological cost than those who perceived low ecosystem resilience. Visitors who recorded uncertainty regarding ecosystem resilience engaged in significantly more depreciative behaviors than those who perceived low ecosystem resilience but slightly fewer depreciative behaviors than those who perceived high ecosystem resilience. Personal attribution was inversely correlated to the mean number of depreciative behaviors. We discuss the relevance of these results to the management of intertidal zones and marine protected areas, to multiple use management, the management of visitor impact, and natural resource use.

A proper place to live: health inequalities, agency and the normative dimensions of space.

This paper explores the links between lay knowledge, place and health related social action (or agency) at the individual and collective level. It is based on an analysis of in-depth interviews and neighbourhood survey data across four localities in two cities in the North West of England.The qualitative analysis has identified 'guidelines' that we argue provide socially shared understandings of the normative contours of 'proper places' which shape the way people respond to the everyday lived reality of places. The quantitative findings suggest that a substantial minority of people, particularly in disadvantaged areas, are exposed to significant dissonance between the normative dimensions and lived experience of place. The analysis points to potential interactions between individual and collective action which may affect the health of individuals and populations and 'ontological fit'-people's ability to (re) construct a positive identity despite living in what they and others perceive to be an 'improper' place. This is linked to their biographical connections with particular places and the extent to which they can localise problems and people in places at a distance from themselves. The paper contributes to understanding about the processes that generate inequalities in the health experience of people living in sharply contrasting socio-economic circumstances as well as finer-grained health inequalities between the 'poor' and the 'poorest'.

Infection control.

This article emphasised that older people are at increased risk of infection when they have illnesses such as diabetes, are on medications like steroids and in settings where residents live closely together and infection can spread.