Density Functional Theory - Machine Learning Approach to Analyze the Bandgap of Elemental Halide Perovskites and Ruddlesden-Popper Phases.

In this study, we have developed a protocol for exploring the vast chemical space of possible perovskites and screening promising candidates. Furthermore, we examined the factors that affect the band gap energies of perovskites. The Goldschmidt tolerance factor and octahedral factor, which range from 0.98 to 1 and from 0.45 to 0.7, respectively, are used to filter only highly cubic perovskites that are stable at room temperature. After removing rare or radioactively unstable elements, quantum mechanical density functional theory calculations are performed on the remaining perovskites to assess whether their electronic properties such as band structure are suitable for solar cell applications. Similar calculations are performed on the Ruddlesden-Popper phase. Furthermore, machine learning was utilized to assess the significance of input parameters affecting the band gap of the perovskites.

Practice nurses and cervical screening: a two-country review.

The aim of this review is to explore the literature relating to the delivery of cervical screening by practice nurses (PNs) in the United Kingdom and Australia. Research relating to PNs began in earnest approximately 15 years ago in the UK context, and more recently, c.2005, in Australia. Although there is scant literature devoted specifically to the role of PNs in cervical screening, literature relating to the role of PNs provides evidence of the extent to which PNs in the United Kingdom and Australia are involved in the provision of cervical screening services. Findings from this review indicate that the role of PNs in the provision of cervical screening differs substantially between the United Kingdom and Australia. PNs in the United Kingdom provide a high percentage of cervical screening services, whereas in Australia general practitioners provide around 80% of all cervical smears, which account for only 0.6% of all procedures undertaken by PNs. Employment and funding models and inadequate multidisciplinary collaboration are contributing to the underutilization of PNs in Australia.

Newton's cradle: a metaphor to consider the flexibility, resistance and direction of nursing's future.

Nursing faces an uncertain future as technological developments, structural changes within health systems and rapidly evolving health needs create new and challenging possibilities. This article draws on the results of a qualitative study undertaken with a range of Queensland nurse leaders to explore their perceptions of these changes. The study re-surfaced, and allows for a re-examination of, four issues that have long created tension within nursing and which continue to have a negative impact on the profession as a whole. These are as follows: professionalisation; preparation of graduates; myths and narratives of nursing; and leadership. We provide a metaphor that imagines all of these tensions operating in dynamic interplay. The image is that of a Newton's Cradle - a model for energy and momentum. The metaphor allows one to see the wide context of changes affecting nursing and the significance of the interconnections. If tensions within nursing maintain their own integrity through containment, understanding and development, they remain in alignment, and energy is conserved rather than wasted or misdirected. It suggests that with increased awareness and attention paid to internal challenges, and by taking a broad-based approach to systemic improvements, nursing could become more effective, progressive and proactive in shaping its own future.

Cluster randomised controlled trial: educational self-care intervention with older Taiwanese patients with type 2 diabetes mellitus--impact on blood glucose levels and diabetic complications.

AIMS: To investigate whether self care behaviours, medical outcomes and quality of life of Taiwanese elderly with Type 2 diabetes mellitus (DM) can be improved by delivery of an educational health care package. BACKGROUND: DM is a major health problem in developed and developing countries, with older adults constituting about half of the diabetic population. Type 2 DM is the most rapidly increasing chronic disease in Taiwan. METHODS: During 2005 and 2006, Taiwanese elderly with Type 2 DM (n = 500) were randomly allocated to either an intervention or control group. Data collection using validated instruments occurred at baseline and 6 months follow-up. Main outcome measures were blood glucose levels and diabetic complications. RESULTS: At baseline, 88.4% participants in the control and 78.8% in the experimental group had a blood glucose level above normal range (p = 0.076); respective results at 6 months were 92.4% for the control group and 60.4% for the experimental group (p < 0.001). The multivariate adjusted result showed that the intervention group was 11.1 times less likely to have blood glucose levels above normal (p = 0.002) at 6 months follow-up compared to the control group. Occurrence of complications was significantly fewer in the intervention group at baseline and at 6 month follow-up compared to the control group (baseline: 42.0% versus 82.1%, p = 0.003; 6 month follow-up: 48.4% versus 87.0%; p = 0.006). CONCLUSION: Although overall occurrence of complications remained unchanged, the educational health care package specifically developed for Taiwanese elderly with Type 2 DM improved blood glucose levels.

Exploring the role of music therapy in cardiac rehabilitation after cardiothoracic surgery: a qualitative study using the Bonny method of guided imagery and music.

BACKGROUND: Cardiac rehabilitation integrates physical, psychological, and vocational strategies to restore and sustain optimal health. OBJECTIVE: An innovative study using music therapy (Bonny Method of Guided Imagery and Music [BMGIM]) explored the experiences of cardiac rehabilitation participants in an outpatient setting at 2 major metropolitan teaching hospitals. METHODS: Commencing 6 to 15 weeks after cardiothoracic surgery, 6 study participants were recruited for 6 weekly music therapy (BMGIM) sessions. Qualitative analysis of the patient narrative within a semiotic framework demonstrated that patients used music therapy to spontaneously explore their recovery process. RESULTS: Five grand themes emerged: (1) looking through the frame, (2) feeling the impact, (3) spiralling into the unexpected, (4) sublime plateau, and (5) rehearsing new steps. The themes related to physical changes, adjustment after surgery, and anticipated lifestyle. CONCLUSIONS: This study demonstrates that music therapy (BMGIM) may be used to access and understand the internal recovery process of postcardiothoracic surgical patients, providing an additional clinical tool to augment the external rehabilitation process.

The wartime experience of civilian nurses in Iran-Iraq war, 1980-1988: an historical research.

BACKGROUND: During the 8 years of Iran-Iraq war, the work of Iranian nurses was essential and efficiently performed, and played a very important role in maintaining the wellbeing of the forces. A review of nurses' activities reveals their experiences and the nature of their activities, an area of study that has not been given due consideration. METHOD: By adopting the oral history method and in-depth interviews with the participating nurses it was possible to demonstrate the significance and humanistic nature of their work. FINDINGS: The majority of the health care assistants and nurses who joined the armed forces, despite not having prior training in this area of nursing, were able to adapt themselves to the situation very quickly and perform their task successfully. CONCLUSION: Nurses' efforts and experiences and their outstanding achievement, contributes to our understanding of wartime nursing.

Nominal group technique: an effective method for obtaining group consensus.

This paper aims to demonstrate the versatility and application of nominal group technique as a method for generating priority information. Nominal group technique was used in the context of four focus groups involving clinical experts from the emergency department (ED) and obstetric and midwifery areas of a busy regional hospital to assess the triage and management of pregnant women in the ED. The data generated were used to create a priority list of discussion triggers for the subsequent Participatory Action Research Group. This technique proved to be a productive and efficient data collection method which produced information in a hierarchy of perceived importance and identified real world problems. This information was vital in initiating the participatory action research project and is recommended as an effective and reliable data collection method, especially when undertaking research with clinical experts.

Reclaiming caring in nursing leadership: a deconstruction of leadership using a Habermasian lens.

Nursing leaders function in an environment of increasing demands coupled with decreasing resources. This paper explores the landscape of nursing leadership from a critical theory perspective, particularly Habermas's theory of communicative action. We not only deconstruct contemporary nursing leadership, discussing the potential negative consequences for those who fulfil roles of both 'nurse' and 'leader', but also offer possibilities for a more positive future.

Clinical decision-making for 'as needed' medications in mental health care.

AIM: This paper is a report of a study exploring the medical and nursing decision-making process associated with the prescription and administration of 'as needed' psychotropic medication. BACKGROUND: The administration of 'as needed' psychotropic medications is a relatively autonomous component of a nurse's role, allowing for the capacity to administer psychotropic medications rapidly in acute situations or at the request of a patient. From the research evidence available to date, it is very difficult to determine how doctors and nurses make decisions about the prescription and administration of 'as needed' psychotropic medications. METHOD: A qualitative exploratory-descriptive study was undertaken to explore nurses and doctors decision-making surrounding the administration of pro re nata or 'as needed' psychotropic medications. Nineteen medical and nursing staff from three mental healthcare sites (acute, secure and rehabilitation) in Australia participated in semi-structured interviews in 2006. Thematic content analysis of the transcripts was conducted independently by two members of the research team and then merged to form the final themes. RESULTS: Four themes were identified in the data: decision-making processes; factors which influenced the administration and prescription of 'as needed' medication; individual protocols and improving practice. CONCLUSION: In-service education should be developed for mental health nurses on psychotropic medications and 'as needed' medications, and on the appropriate use of 'as needed' medications as a behaviour management strategy. Further, an extensive review of 'as needed' medication prescription and administration compared to best practice guidelines is needed.

The 'order of things': tracing a history of the present through a re-reading of the past in nursing education.

For the best part of modern history, nursing's education system has tended to fore-ground the pragmatic over the esoteric, the practical over the theoretical and the primacy of character over intellect. As a consequence of this binary logic at work, nursing education inoculated its neophytes with a set of troublesome values about the importance of nursing education vis-à-vis nursing practice and, as a result, created a powerful cultural climate which both wittingly and unwittingly perpetuated the subjugation of nurses to other health professionals rather than the obverse. In this paper, a number of historical educational texts are read from a 'presentist' perspective to illustrate how a certain 'order of things' inscribed itself on the body/subjects of generations of nurses. This history has left an unfortunate legacy that ensures nurses' political voice continues to remain muted and their contribution to healthcare under-recognised and under-valued.

A nurse working for the Third Reich: Eva Justin, RN, PhD.

Eugenics underpinned the Nazi race theories which saw the murder of over 10 million people from "undesirable" groups, including Sinti (referred to in Nazi times as "Gypsies"), during the Holocaust. Eva Justin, from Dresden, completed a doctoral dissertation which examined a group of Sinti children of St Josef's Home in Mulfingen, Germany. She aimed to prove the racial inferiority of these children; her work was done with no informed consent, and the children were sent to Auschwitz after her experiments. The study was supported by senior Nazis, supervised by Nazi "scientists" and examined by committed Nazis. We argue that her work was biased, poorly designed, and ultimately unethical, but was in keeping with methods of the emerging disciplines of anthropology and racial hygiene, in Germany and other countries, at the time. It is not possible to say that her work caused the children to meet their deaths (of the 39 children she included, only four survived); however, she did reinforce the Nazi racial theories. It is unfortunate that one of the first nurses in the world to receive a PhD did so through research attempting to prove that a group of children were "racially inferior" in support of National Socialism.

Carspecken's five-stage critical qualitative research method: an application to nursing research.

In this article, the authors provide an account of Carspecken's (1996) five-stage approach to "doing" critical ethnography, or what he has termed critical qualitative research (CQR). They provide the reader with an overview of the concepts presented in Carspecken's book Critical Ethnography in Educational Research and describe how they applied several of his ideas within a research project that explored renal nurses' decision making using a critical ethnographic approach. They briefly describe the five stages of CQR and incorporate within the article an example of how they applied the stages. They propose this approach as a useful method for nursing and other health-related research.

Violence, zero tolerance and the subversion of professional practice.

Assaults on health care staff have been a fact of life since the earliest years of organised health services, but it is only in recent years that governments have begun to acknowledge the problem. Assaults not only inflict physical and emotional injury, but undermine morale, create a climate of fear, and subvert the quality of care. They are also costly in terms of lost labour, compensation, and legal and procedural expenses. The response to violence in health care settings has thus far ranged from what might be called the 'Ostrich position', in which it is simply ignored, to training in self-defence, the deployment of security staff in clinical areas, conflict resolution training and, more recently, the policy of 'zero tolerance'. This paper examines the rationale for zero tolerance policies, drawing on their origins and applications in the United States and Britain. It suggests that zero tolerance is an ineffective response to violence in health care settings, and its adoption by authorities in Australia should be rejected. It is further argued, that resource allocation and marginalisation are identifiable and modifiable factors contributing to violence in our health care systems.

Nurses Writing about Psychiatric Nurses' Involvement in Killings during the Nazi Era: A Preliminary Discourse Analysis.

Nurses actively killed people in Nazi Europe between 1939 and 1945. The so-called 'science of eugenics' underpinned Nazi ideology, used to further the Nazi racist agenda. Edicts sanctioned selection and medically supervised killing of people, and nurses, principally in mental hospitals, participated in the killing of between 100­300 thousand patients. Erroneously termed 'euthanasia', there were three phases: the initial programme involving children, the T4 adult programme, and 'wild euthanasia'. Unofficial killings also took place before 1939. This paper uses discourse analysis to map and analyse published texts which explore the role of nurses in Nazi Germany. The aim is to identify its characteristics as a body of literature, to note strengths and weaknesses, emphases and silences, and to note aspects that need further exploration. It acknowledges that how these events are to be understood and represented in contemporary discourse constitutes a significant problem for historians of nursing.

Self-reported long-term conditions of nurses and midwives across a northern Australian health service: A survey.

BACKGROUND: Although nurses generally constitute the largest component of the health workforce there is no systematic collection of data about their health status. Similarly, little is known about how nurses manage any long-term condition they may have, which could contribute to their reducing hours of employment or leaving the workforce completely. Such information will become more important against the backdrop of a global shortage of nurses, and ageing of the nursing population. OBJECTIVES: This study aimed to identify the types and impacts of reported long-term conditions, and strategies employed by nurses to manage their conditions. DESIGN: A cross-sectional survey design was used. SETTINGS: The setting was a large regional health service in North Queensland, Australia, comprising a tertiary referral hospital, two residential aged care facilities and several rural and remote hospitals and community health services. PARTICIPANTS: All full-time, part-time and casual nurses and midwives employed within the health service were invited to participate; 665 (30.9%) completed surveys were returned. METHODS: A paper-based questionnaire, comprising six sections, was individually addressed to all potential participants, together with reply-paid envelopes for returning completed questionnaires. The anonymous questionnaire took approximately 15 to 25min to complete, less time if the nurse reported no long-term conditions. RESULTS: Three-fifths of respondents had at least one long-term condition. Respondents older than 50 years were statistically more likely to report having at least one long-term condition (χ(2)=5.64, p=0.018). Back pain, migraine and asthma were the most frequently reported individual conditions; more than one-quarter of respondents reported a condition relating to mental health and wellbeing. Respondents who reported more than one long-term condition compared to a single long-term condition were statistically more likely to have had more years of nursing experience (t=02.2, p=0.03). Nurses used a combination of varied personal and workplace strategies for many conditions; however personal strategies were most frequently used for all conditions. CONCLUSIONS: This survey elicited information about reported long-term conditions, and strategies that nurses used to manage the condition they considered most important to them. We recommend that further investigation into how the full range of workplace strategies could be implemented to assist nurses to manage long-term conditions.

Using Carspecken's critical ethnography in nursing research.

Critical ethnography is an increasingly popular methodology for nursing research, but little advice is available as to what forms it may take, their applicability and their relative strengths and weaknesses. This paper introduces and assesses the method developed and described by Phil Carspecken for use in educational research, presented in his book Critical Ethnography in Educational Research (1996). It outlines some of the philosophical and social theories which drive the methodology, and describes the steps in the research method with reference to nursing situations. Strengths and weaknesses are noted, and it is concluded that Carspecken's approach is useful for researching issues of interest to nurses who locate themselves in the critical theoretical tradition.

Improving the early detection of children with subtle developmental problems.

This article briefly reviews the recent literature identifying the possible reasons why children with subtle developmental problems are passing through health care systems undetected. It offers some explanations as to why consequently, in many Western societies, a large number of these children are not identified by health professionals until they reach school age. Early identification is one of the challenges facing health visitors or child health nurses, and it is suggested that if they can utilize the knowledge and experience of parents, the opportunities for early identification and intervention would be dramatically improved.

Through the eye of the beholder: to seclude or not to seclude.

The objective of this study is to provide new knowledge and understanding of the decision making used throughout the seclusion process. Seven mental health nurses and one doctor were each interviewed within 48 hours of making the decision to seclude a patient. The interviews were analysed using content analysis. This study provides valuable information regarding factors that are central to, and/or influence, the decision-making process surrounding seclusion. More importantly, the results demonstrate that seclusion is initiated only when all other less restrictive patient management strategies have proven to be unsuccessful with the patient.