Ingrid Belan

E-learning & information communication technology (ICT) in nursing education: A review of the literature

OBJECTIVES To examine primary research articles published between January 2001 and December 2012 that focused on the issues for students and educators involved with E-learning in preregistration nursing programs. The literature was systematically reviewed, critically appraised and thematically analyzed. BACKGROUND E-learning is arguably the most significant change to occur in nursing education since the move from hospital training to the tertiary sector. Differences in computer and information literacy for both students and educators influence the success of implementation of E-learning into current curricula. DATA SOURCES Online databases including CINAHL, MEDLINE, OVID, the ProQuest Central, PubMed, ERIC and Science Direct were used. METHODS The criteria used for selecting studies reviewed were: primary focus on electronic learning and issues faced by nursing students and/or nurse educators from undergraduate preregistration nursing programs; all articles had to be primary research studies, published in English in peer reviewed journals between January 2001 and December 2012. RESULTS Analysis of the 28 reviewed studies revealed the following three themes: issues relating to E-learning for students; use of information technologies; educator (faculty) issues involving pedagogy, workload and staff development in E-learning and associated technology. CONCLUSION The review highlighted that commencing preregistration nursing students required ongoing education and support surrounding nursing informatics. This support would enable students to progress and be equipped with the life-long learning skills required to provide safe evidence based care. The review also identified the increased time and skill demands placed on nurse educators to adapt their current education methodologies and teaching strategies to incorporate E-learning.

Daily and seasonal rhythms in selected body temperatures in the Australian lizard Tiliqua rugosa (Scincidae): field and laboratory observations.

This study examined daily and seasonal activity and thermoregu‐latory behaviour of the sleepy lizard, Tiliqua rugosa, a large, diurnally active temperate‐dwelling Australian lizard, in the field and laboratory. Activity temperatures in the field were compared with those selected by lizards in laboratory thermal gradients in order to assess the extent to which endogenous versus exogenous factors contribute to seasonal variations in thermoregulatory behaviour. In the field, lizards are most active in late winter–spring (August –November), during which their activity varies from mostly unimodal on days of mild temperature to bimodal on hot days. In late spring–summer (November–January), activity is largely restricted to early morning, and at all other seasons sleepy lizards are rarely active. The winter–spring activity of sleepy lizards is constrained by low environmental temperatures, as lizards at these seasons have low body temperatures in the field but higher temperatures in laboratory thermal gradients. The lower temperatures selected in the laboratory in the summer–autumn months suggest the avoidance of high ambient temperatures and general inactivity in the field at these times. Thermal selection in the laboratory at the eight times of year tested showed that the phase of the minimum and maximum temperature selected and the amplitude of the rhythm of temperature selected varied continuously with the time of year. These daily and seasonal shifts in thermoregulatory behaviour may be regulated by endogenous physiological mechanisms coupled with seasonal ecological constraints such as food availability.

Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review

TITLE Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review. AIM This paper is a report of a literature review conducted to examine current research studies into attitudes of nursing students towards caring for people with HIV/AIDS and to identify factors that influenced those attitudes to inform current nursing practice and to develop nursing education regarding care provided to people with HIV/AIDS. BACKGROUND Attitudes of nurses towards people living with HIV/AIDS have long been scrutinized. Studies show that some nurses have negative attitudes and are reluctant to provide care to people with HIV/AIDS, resulting in poorer quality nursing support being provided. Attitudes of nursing students towards caring for people with HIV/AIDS is thus of vital importance since they become the future practising nurses. DATA SOURCES Eight electronic data bases were searched from 1996-2008. REVIEW METHODS Criteria used for study selection were: attitudes of nursing students towards caring for people with HIV/AIDS, primary research studies, published in English language in peer reviewed journals from 1996 to June 2008. Sixteen studies were identified for inclusion in this thematic review. RESULTS The following themes were identified: education and knowledge of HIV/AIDS; fear of contracting HIV/AIDS; reluctance to care for people with HIV/AIDS; homophobia; and stigma associated with HIV/AIDS. CONCLUSION There is reluctance on the part of some nursing students in specific regions of the world to provide care for people with HIV/AIDS. Educational programmes based on research evidence must play a leading role in developing strategies to help nursing students understand and overcome such attitudes.

Thermocyclic entrainment of lizard blood plasma melatonin rhythms in constant and cyclic photic environments

We assessed how chronic exposure to 6-h cryophase temperatures of 15 degrees C in an otherwise 33 degrees C environment entrains the rhythm of blood plasma melatonin rhythms in lizards (Tiliqua rugosa) subjected to constant dark (DD), constant light (LL), and to 12:12-h light-dark cycles (12L:12D). The peak of the melatonin rhythm was entrained by the cryophase temperature of the thermocycle in DD and LL, irrespective of the time at which the cryophase temperature was applied. Comparable thermocycles of 6 h at 15 degrees C imposed on a 12L:12D photocycle, however, affected the amplitude and phase of the melatonin rhythm, depending on the phase relationship between light and temperature. Cold pulses in the early light period and at midday resulted, respectively, either in low amplitude or nonexistent melatonin rhythms, whereas those centered in or around the dark phase elicited rhythms of high amplitude. Supplementary experiments in 12L:12D using two intermittent 6-h 15 degrees C cryophases, one delivered in the midscotophase and another in the midphotophase, elicited melatonin rhythms comparable to those in lizards subjected to constant 33 degrees C and 12L:12D. In contrast, lizards subjected to 12L:12D and a 33 degrees C:15 degrees C thermocycle, whose thermophase was aligned with the photophase, produced a threefold increase in the amplitude of the melatonin rhythm. Taken together, these results support the notion that there is an interaction between the external light and temperature cycle and a circadian clock in determining melatonin rhythms in Tiliqua rugosa.We assessed how chronic exposure to 6-h cryophase temperatures of 15°C in an otherwise 33°C environment entrains the rhythm of blood plasma melatonin rhythms in lizards ( Tiliqua rugosa) subjected to constant dark (DD), constant light (LL), and to 12:12-h light-dark cycles (12L:12D). The peak of the melatonin rhythm was entrained by the cryophase temperature of the thermocycle in DD and LL, irrespective of the time at which the cryophase temperature was applied. Comparable thermocycles of 6 h at 15°C imposed on a 12L:12D photocycle, however, affected the amplitude and phase of the melatonin rhythm, depending on the phase relationship between light and temperature. Cold pulses in the early light period and at midday resulted, respectively, either in low amplitude or nonexistent melatonin rhythms, whereas those centered in or around the dark phase elicited rhythms of high amplitude. Supplementary experiments in 12L:12D using two intermittent 6-h 15°C cryophases, one delivered in the midscotophase and another in the midphotophase, elicited melatonin rhythms comparable to those in lizards subjected to constant 33°C and 12L:12D. In contrast, lizards subjected to 12L:12D and a 33°C:15°C thermocycle, whose thermophase was aligned with the photophase, produced a threefold increase in the amplitude of the melatonin rhythm. Taken together, these results support the notion that there is an interaction between the external light and temperature cycle and a circadian clock in determining melatonin rhythms in Tiliqua rugosa.

CIRCADIAN RHYTHM OF BEHAVIORAL THERMOREGULATION IN THE SLEEPY LIZARD (TILIQUA RUGOSA)

The daily rhythm of behavioral thermoregulation in sleepy lizards (Tiliqua rugosa) was studied in laboratory thermal gradients under a 12L∶12D photoperiod in autumn and spring. In both seasons, lizards showed distinctive daily rhythms of behavioral thermoregulation, selecting their highest body temperatures during the late photophase and lowest ones during the late scotophase or early photophase. When lizards were subjected to a period of constant darkness at both seasons, this rhythm persisted and free-ran with a period of 24.7 h, indicating that it is an endogenous circadian rhythm. Furthermore, the expression of this circadian rhythm varies seasonally in the amplitude of its free-running rhythm and in the phase at which the minimum Tb is selected during 12L∶12D. The seasonal variation in the expression of the circadian rhythm of behavioural thermoregulation in Tiliqua rugosa lizards is likely to reflect seasonal changes in the neural regulation of this rhythm.

Interseasonal variation in the circadian rhythms of locomotor activity and temperature selection in sleepy lizards, Tiliqua rugosa.

Few studies in non-mammalian vertebrates have examined how various effectors of the circadian system interact. To determine if the daily locomotor and behavioural thermoregulatory rhythms of Tiliqua rugosa are both controlled by the circadian system in different seasons, lizards were tested in laboratory thermal gradients in four seasons and in constant darkness. Circadian rhythmicity for both rhythms was present in each season, being most pronounced in spring and summer and least evident in autumn. Most lizards displayed a unimodal locomotor activity pattern across all seasons. However, some individuals presented a bimodal locomotor activity pattern in spring and summer. Seasonal variations in the phase relationships of both rhythms to the light:dark (LD) cycle were demonstrated. No seasonal differences in the free-running period lengths of either rhythm were detected, raising the possibility that a single circadian pacemaker drives both rhythms in this species. Our present results demonstrate that both rhythms are similarly controlled by the circadian system in each season. Although seasonal variations in the thermal preferences of reptiles both in the field and laboratory have previously been well documented, this study is the first to demonstrate circadian rhythms of temperature selection in a reptile species in each season.

A comparison of fentanyl with pethidine for pain relief during childbirth: a randomised controlled trial

To compare the efficacy of fentanyl administered via the subcutaneous (s.c.) or intranasal (i.n.) route with intramuscular (i.m.) pethidine in labouring women requesting analgesia.

Changing patterns in women seeking terminations of pregnancy: A trend analysis of data from one service provider 1996–2006

Objectives: The purpose of this study was to assess emerging trends in five characteristics: age, first ever pregnancy, contraception at time of conception, contraception choices post‐operatively and referral source of women presenting for a termination of pregnancy (1996–2006) from a southern service in Adelaide, South Australia.

Persistence of a plasma melatonin rhythm in constant darkness and its inhibition by constant light in the sleepy lizard, Tiliqua rugosa

Abstract:  This study determined whether a blood plasma melatonin rhythm persists in constant photothermal environments in the sleepy lizard, Tiliqua rugosa. It builds upon an earlier investigation which provided equivocal results as to whether an in vivo melatonin rhythm persists in constant dark (DD) and light (LL) and temperature in this species. Using more frequent sampling points and new assay techniques, the present study showed that the melatonin rhythm persisted for at least 6 days at temperatures of 25 and 33°C in constant dark (DD). The melatonin rhythm, however, was largely eliminated in constant light (LL) at 33°C, thereby contradicting some previous findings in other species of reptiles where melatonin levels were apparently insensitive to an unexpected pulse of light at night. These results demonstrate that the sleepy lizard has a persistent, possibly circadian rhythm of melatonin in DD and constant temperature, and that the rhythm is inhibited by LL and constant temperature. Therefore, the sleepy lizard pineal gland may be an independent oscillator capable of driving the melatonin rhythm and be a transducer of the seasonally changing external photothermal environment.

Subcutaneous administration of fentanyl in childbirth: an observational study on the clinical effectiveness of fentanyl for mother and neonate.

OBJECTIVE to explore the maternal and neonatal effects of fentanyl administered subcutaneously to women during labour. DESIGN two methods were used: (1) A retrospective audit of the birth register and maternal and neonatal records for the period from January 2000 to December 2007. (2) A pilot study was also conducted on a convenience sample of women between July 2008 and October 2008. SETTING this study was conducted within a maternity unit at a rural South Australian hospital where approximately 350 babies are birthed each year. PARTICIPANTS audit participants included women who had uncomplicated pregnancies and birthed at term (37-42 weeks gestation). Women in the experimental group consisted of those who had utilised only subcutaneous fentanyl for pain relief (n=75), or nitrous oxide and oxygen prior to being administered subcutaneous fentanyl (n=196). Stratified random selection based on parity and age was used to determine the control group, which consisted of women who used no pharmacological pain relief (n=196). The pilot study involved a convenience sample of women (n=10) assessed to have an uncomplicated pregnancy and labour occurring at term (≥37 weeks gestation). MEASUREMENTS audit variables examined included the womens age, parity, labour duration, mode of birth (spontaneous or assisted), analgesia used, total dosage, time administered prior to birth, time of birth, neonatal Apgar scores, time to establish breathing, naloxone use, days spent in hospital post-birth and breast-feeding outcomes upon discharge. The pilot study explored maternal effects assessed pre- and 30 minutes post-administration of subcutaneously administered fentanyl by observing pain scores, vital signs, sedation levels, nausea/vomiting scores and anti-emetic use. To assess possible adverse effects in the neonate Apgar scores, time to establish respiration, naloxone use, transfer to neonatal nursery and breast-feeding outcomes upon discharge were recorded. FINDINGS women in the experimental groups were more likely to be induced, experienced a longer duration of labour and had an increased likelihood of an assisted vaginal birth. The average total dose of fentanyl administered was 250 μg. Neonatal outcomes were comparable between groups when examining Apgar scores <7 at 1 and 5 minutes and time to establish breathing. There was, however, a significant difference with naloxone administration between the groups. There was no significant difference between groups in hospital stay or breast-feeding on discharge. The pilot study identified a clinically significant reduction in pain scores for 78% of women following the administration of subcutaneous fentanyl, with the average pain score decreasing from 8.4 (±1.4) to 7.2 (±1.1) (paired t-test, p=0.017). Vital signs were not affected, no anti-emetics were required and all women remained alert with no sedation noted. KEY CONCLUSIONS the audit identified fentanyl use was associated with a longer length of labour, but this may be explained by more women in the experimental groups requiring induction of labour than those in the control group. However, length of hospital stay, breast-feeding rates and neonatal outcomes were comparable amongst the three groups. Results of the pilot study are consistent with those of the audit in relation to the effects on mother and neonate. In addition, the pilot study begins to provide evidence that fentanyl is efficacious in providing pain relief. IMPLICATIONS FOR PRACTICE results of this study are the first to explore the effects of fentanyl administered subcutaneously to women during labour. This method of analgesia offers women an additional choice of pain relief during childbirth and may be particularly beneficial in remote and rural settings where resources are often limited and access to specialist services difficult. Further research, however, is required to be able to generalise the outcomes and provide further data to support the clinical effectiveness of this route of administration of fentanyl.