Aged care nurse practitioners in Australia: evidence for the development of their role

2013 ◽  
Vol 37 (5) ◽  
pp. 594 ◽  
Author(s):  
Shannon Clark ◽  
Rhian Parker ◽  
Brenton Prosser ◽  
Rachel Davey

Aim To consider evidence surrounding the emerging role of nurse practitioners in Australia with a particular focus on the provision of healthcare to older people. Methods Methods used included keyword, electronic database and bibliographic searches of international literature, as well as review of prominent policy reports in relation to aged care and advanced nursing roles. Results This paper reports on evidence from systematic reviews and international studies that show that nurse practitioners improve healthcare outcomes, particularly for hard to service populations. It also maps out the limited Australian evidence on the impact of nurse practitioners’ care in aged care settings. Conclusions If Australia is to meet the health needs of its ageing population, more evidence on the effectiveness, economic viability and sustainability of models of care, including those utilising nurse practitioners, is required. What is known about the topic? Australia, like many industrialised countries, faces unprecedented challenges in the provision of health services to an ageing population. Attempts to respond to these challenges have resulted in changing models of healthcare and shifting professional boundaries, including the development of advance practice roles for nurses. One such role is that of the nurse practitioner. There is international evidence that nurse practitioners provide high-quality healthcare. Despite being established in the United States for nearly 50 years, nurse practitioners are a relatively recent addition to the Australian health workforce. What does this paper add? This paper positions a current Australian evaluation of nurse practitioners in aged care against the background of the development of the role of nurse practitioners internationally, evidence for the effectiveness of the role, and evidence for nurse practitioners in aged care. Recent legislative changes in Australia now mean that private nurse practitioner roles can be fully implemented and hence evaluated. In the face of the increasing demands of an ageing population, the paper highlights limitations in current Australian evidence for nurse practitioners in aged care and identifies the importance of a national evaluation to begin to address these limitations. What are the implications for practitioners? The success of future healthcare planning and policy depends on implementing effective initiatives to address the needs of older Australians. Mapping the terrain of contemporary evidence for nurse practitioners highlights the need for more research into nurse practitioner roles and their effectiveness across Australia. Understanding the boundaries and limitations to current evidence is relevant for all involved with health service planning and delivery.

2020 ◽  
Author(s):  
Francesco Rigoli

Research has shown that stress impacts on people’s religious beliefs. However, several aspects of this effect remain poorly understood, for example regarding the role of prior religiosity and stress-induced anxiety. This paper explores these aspects in the context of the recent coronavirus emergency. The latter has impacted dramatically on many people’s well-being; hence it can be considered a highly stressful event. Through online questionnaires administered to UK and USA citizens professing either Christian faith or no religion, this paper examines the impact of the coronavirus crisis upon common people’s religious beliefs. We found that, following the coronavirus emergency, strong believers reported higher confidence in their religious beliefs while non-believers reported increased scepticism towards religion. Moreover, for strong believers, higher anxiety elicited by the coronavirus threat was associated with increased strengthening of religious beliefs. Conversely, for non-believers, higher anxiety elicited by the coronavirus thereat was associated with increased scepticism towards religious beliefs. These observations are consistent with the notion that stress-induced anxiety enhances support for the ideology already embraced before a stressful event occurs. This study sheds light on the psychological and cultural implications of the coronavirus crisis, which represents one of the most serious health emergencies in recent times.


Author(s):  
Anne Nassauer

This book provides an account of how and why routine interactions break down and how such situational breakdowns lead to protest violence and other types of surprising social outcomes. It takes a close-up look at the dynamic processes of how situations unfold and compares their role to that of motivations, strategies, and other contextual factors. The book discusses factors that can draw us into violent situations and describes how and why we make uncommon individual and collective decisions. Covering different types of surprise outcomes from protest marches and uprisings turning violent to robbers failing to rob a store at gunpoint, it shows how unfolding situations can override our motivations and strategies and how emotions and culture, as well as rational thinking, still play a part in these events. The first chapters study protest violence in Germany and the United States from 1960 until 2010, taking a detailed look at what happens between the start of a protest and the eruption of violence or its peaceful conclusion. They compare the impact of such dynamics to the role of police strategies and culture, protesters’ claims and violent motivations, the black bloc and agents provocateurs. The analysis shows how violence is triggered, what determines its intensity, and which measures can avoid its outbreak. The book explores whether we find similar situational patterns leading to surprising outcomes in other types of small- and large-scale events: uprisings turning violent, such as Ferguson in 2014 and Baltimore in 2015, and failed armed store robberies.


Author(s):  
Abigail A. Fagan ◽  
Kristen M. Benedini

This chapter reviews the degree to which empirical evidence demonstrates that families influence youth delinquency. Because they are most likely to be emphasized in life-course theories, this chapter focuses on parenting practices such as parental warmth and involvement, supervision and discipline of children, and child maltreatment. It also summarizes literature examining the role of children's exposure to parental violence, family criminality, and young (teenage) parents in affecting delinquency. Because life-course theories are ideally tested using longitudinal data, which allow examination of, in this case, the impact of parenting practices on children's subsequent behaviors, this chapter focuses on evidence generated from prospective studies conducted in the United States and other countries. It also discusses findings from experimental studies designed to reduce youth substance use and delinquency by improving the family environment.


1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 370
Author(s):  
Umair Iqbal ◽  
Ravirajsinh N. Jadeja ◽  
Harshit S. Khara ◽  
Sandeep Khurana

Hepatic encephalopathy (HE) is a common neurological consequence in patients with cirrhosis and has a healthcare burden of USD 5370 to 50,120 per patient annually. HE significantly hampers the quality of life and is a major cause of morbidity and mortality. Patients with cirrhosis are at a high risk for protein-calorie malnutrition due to altered metabolism. Current evidence has changed the old belief of protein restriction in patients with cirrhosis and now 1.2 to 1.5 g/kg/day protein intake is recommended. Case series and studies with small numbers of participants showed that a vegetarian protein diet decreases the symptoms of HE when compared to a meat-based diet, but the evidence is limited and requires further larger randomized controlled trials. However, vegetable or milk-based protein diets are good substitutes for patients averse to meat intake. Branch chain amino acids (BCAA) (leucine, isoleucine and valine) have also been shown to be effective in alleviating symptoms of HE and are recommended as an alternative therapy in patients with cirrhosis for the treatment of HE. In this review, we provide an overview of current literature evaluating the role of protein intake in the management of HE in cirrhosis.


PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 850-851
Author(s):  
Howard A. Pearson

Dr Elsa Stone, in her usual organized and lucid fashion, has presented the case for inclusion of pediatric nurse practitioners (PNPs) in private pediatric practices. She bases her conclusions on her nearly 10 years of positive experience with a PNP in her own practice in Connecticut. Dr Stone describes the PNP population and demography, describes the training curriculum of PNPs, and discusses the scope of work of these individuals. She concludes that "there is substantial evidence that PNPs provide quality health care and that collaborative teams of pediatricians and PNPs can provide high-quality, cost-effective care to a broader spectrum of children than can be served by either profession alone." The American Academy of Pediatrics (AAP) has insisted for several years that there is a shortage of pediatricians to meet the expanding needs of the children of the United States. Furthermore, pediatricians—because of system changes—will be expected increasingly to provide a variety of time-intensive services. Dr Stone believes that many of these services can be well provided by PNPs. Within the AAP, there have been some concerns about the role of PNPs. Of particular worry seems to be the possibility that PNPs might decide to practice independently, leading to a lower quality of care for their patients. Less often stated, but clearly an issue, is that PNPs are viewed by some pediatricians as potential competitors. Dr Stone's demographic analysis of what PNPs are currently doing is relevant to these concerns. One third of PNPs work in private pediatric practices or health maintenance organizations.


Elements ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 39-52
Author(s):  
Charlie Power

The debate over the future direction of elementary and secondary education in the United States is fractious and contentious. Many of these are rooted in concerns over disparities in financial circumstances and race. While the full extent of the gaps, in addition to the United States' mediocre education system relative to other industrialized nations, has been a subject of frequent research and heated debate, one crucial component of this divide has yet to be analyzed: summer learning loss. This paper will closely analyze published literature in order to analyze the impact of summer education loss. Additionally, this paper will argue that summer learning varies by socioeconomic status (SES), with low-income populations gradually regressing over the years. This phenomenon has ramifications on students' achievement and explains the disparities that accumulate over a student's educational career. Finally, based on current evidence, this paper will make policy recommendations on how to change the current education system to better address summer's inherent inequities. 


2021 ◽  
Vol 10 (19) ◽  
pp. 4462
Author(s):  
Konstantinos G. Kyriakoulis ◽  
Anastasios Kollias ◽  
Garyphallia Poulakou ◽  
Ioannis G. Kyriakoulis ◽  
Ioannis P. Trontzas ◽  
...  

The role of immunomodulatory agents in the treatment of hospitalized patients with COVID-19 has been of increasing interest. Anakinra, an interleukin-1 inhibitor, has been shown to offer significant clinical benefits in patients with COVID-19 and hyperinflammation. An updated systematic review and meta-analysis regarding the impact of anakinra on the outcomes of hospitalized patients with COVID-19 was conducted. Studies, randomized or non-randomized with adjustment for confounders, reporting on the adjusted risk of death in patients treated with anakinra versus those not treated with anakinra were deemed eligible. A search was performed in PubMed/EMBASE databases, as well as in relevant websites, until 1 August 2021. The meta-analysis of six studies that fulfilled the inclusion criteria (n = 1553 patients with moderate to severe pneumonia, weighted age 64 years, men 66%, treated with anakinra 50%, intubated 3%) showed a pooled hazard ratio for death in patients treated with anakinra at 0.47 (95% confidence intervals 0.34, 0.65). A meta-regression analysis did not reveal any significant associations between the mean age, percentage of males, mean baseline C-reactive protein levels, mean time of administration since symptoms onset among the included studies and the hazard ratios for death. All studies were considered as low risk of bias. The current evidence, although derived mainly from observational studies, supports a beneficial role of anakinra in the treatment of selected patients with COVID-19.


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