ORCID Profile
0000-0001-9174-3499
Current Organisations
Griffith University
,
University of South Australia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Wiley
Date: 10-11-2009
DOI: 10.1111/J.1755-6686.2009.00116.X
Abstract: Given increasing demand for renal replacement therapy, this study sought to identify of key workforce issues facing dialysis units, based on a "snapshot" of the current workforce. A web-based survey of all dialysis unit managers in Australia and New Zealand, in October 2008, about their workforce. A significant minority of dialysis staff in most regions were not registered nurses. Many renal registered nurses worked part-time. Staff atient ratios in dialysis units varied significantly by region, reflecting the relative prevalence of home therapies. Most dialysis units were generally adequately staffed. The proportion of registered nurses with specific renal qualifications varied significantly by region. The changing character of the workforce in the dialysis unit in the future will require clarification of the relationships between different categories of dialysis staff. Specialty education for nurses needs to be oriented to equipping staff to be effective in their changing work environment.
Publisher: Oxford University Press (OUP)
Date: 28-12-2016
DOI: 10.1093/NDT/GFV416
Abstract: Intradialytic exercise programmes are important because of the deterioration in physical function that occurs in people receiving haemodialysis. Unfortunately, exercise programmes are rarely sustained in haemodialysis clinics. The aim of this study was to determine the efficacy of a sustainable resistance exercise programme on the physical function of people receiving haemodialysis. A total of 171 participants from 15 community satellite haemodialysis clinics performed progressive resistance training using resistance elastic bands in a seated position during the first hour of haemodialysis treatment. We used a stepped-wedge design of three groups, each containing five randomly allocated cluster units allocated to an intervention of 12, 24 or 36 weeks. The primary outcome measure was objective physical function measured by the 30-s sit-to-stand (STS) test, the 8-foot timed up and go (TUG) test and the four-square step test. Secondary outcome measures included quality of life, involvement in community activity, blood pressure and self-reported falls. Exercise training led to significant improvements in physical function as measured by STS and TUG. There was a significant average downward change (β = -1.59, P < 0.01) before the intervention and a significant upward change after the intervention (β = 0.38, P < 0.01) for the 30-s STS with a similar pattern noted for the TUG. Intradialytic resistance training can improve the physical function of people receiving dialysis.
Publisher: Human Kinetics
Date: 02-2021
Abstract: Context : Abdominal musculature underpins core stability, which can allow for optimal performance in many activities of daily living (eg, walking and rising from a chair). Therefore, assessment of the abdominal muscles poses as an important consideration for clinicians in order to identify people at risk of injury or functional decline. Objective : This study aimed to build on the limited amount of knowledge surrounding abdominal muscle strength assessments by investigating the validity and reliability of hand-held dynamometry (HHD) for the assessment of isometric abdominal flexion strength. Study Design and Participants : Comparative analysis for validity and test–retest reliability was employed on a cohort of apparently healthy in iduals. HHD was compared with the criterion, isokinetic dynamometry, through an isometric contraction of trunk flexion on both instruments. Hand-held dynamometry assessments only were performed on a subsequent day for reliability analysis. The peak values for all assessments were recorded. Results : A total of 35 participants were recruited from the University of South Australia and the general public. Comparative analysis between the HHD and isokinetic dynamometer showed good agreement (intraclass correlation coefficients = .82), with the Bland–Altman plots confirming no proportional bias. Reliability analysis for the HHD reported good consistency (intraclass correlation coefficients = .87). Conclusion : HHD together with the participant setup (supine, trunk flexed, and supported at 25° with the legs horizontal and remaining unfixed) is a valid and reliable tool to assess isometric abdominal flexion strength.
Publisher: Wiley
Date: 02-05-2018
DOI: 10.1111/SDI.12703
Abstract: Greater focus on patient-reported outcome measures for dialysis patients and an increased patient engagement focus has highlighted a lack of formal patient-generated strategies. Patient-to-patient peer mentoring is one approach that may improve the outcomes for people receiving dialysis. This review aims to synthesize quantitative and qualitative studies investigating dialysis-associated patient-to-patient peer mentor support among adults with chronic kidney disease and end stage kidney disease. Research studies describe the benefits of peer mentor programs in dialysis to include: improved goal setting, decision-making and increased self-management. While a variety of program formats exist, a combination of face-to-face and telephone peer support models are recommended and formal training of mentors is required. In addition, the formal support of dialysis clinicians, nephrologists and administrators is vital for the success of a dialysis patient-to-patient peer mentor program.
Publisher: Cambridge Media
Date: 08-11-2019
Publisher: Wiley
Date: 31-07-2013
DOI: 10.1111/J.1755-6686.2013.12024.X
Abstract: Rapid intradialytic potassium shifts during haemodialysis have been associated with increased mortality and morbidity. Standardising dialysate potassium to 2 mmol/l may decrease the potassium shift. To examine the effect of standardising dialysate potassium to 2 mmol/l for all chronic dialysis treatments. Pre- and post-intervention comparison of monthly serum potassium. Ninety-seven in iduals, of whom 56 patients could be matched across both data collection periods. Serum potassium data were categorised based on a target range 3.5-6.0 mmol/l. Overall pre- and post-intervention mean scores were compared using a paired s les t-test. Data for patients routinely prescribed dialysate potassium 1 mmol/l pre-intervention (n = 6) underwent paired s les t-test to compare their mean serum potassium pre- and post-intervention. There was no statistically significant change in serum potassium post-intervention. The majority of patients remained within the target range, including the subset of patients who had a history of high serum potassium during the pre-intervention period. A standard potassium dialysate of 2 mmol/l may reduce intradialytic serum potassium shifts and may assist in standardising safer work practices.
Publisher: Wiley
Date: 16-01-2017
DOI: 10.1111/NHS.12322
Abstract: E-learning involves the transfer of skills and knowledge via technology so that learners can access meaningful and authentic educational materials. While learner engagement is important, in the context of healthcare education, pedagogy must not be sacrificed for edu-tainment style instructional design. Consequently, health professional educators need to be competent in the use of current web-based educational technologies so that learners are able to access relevant and engaging e-learning materials without restriction. The increasing popularity of asynchronous e-learning programs developed for use outside of formal education institutions has made this need more relevant. In these contexts, educators must balance design and functionality to deliver relevant, cost-effective, sustainable, and accessible programs that overcome scheduling and geographic barriers for learners. This paper presents 10 guiding design principles and their application in the development of an e-learning program for general practice nurses focused on behavior change. Consideration of these principles will assist educators to develop high quality, pedagogically sound, engaging, and interactive e-learning resources.
Publisher: Wiley
Date: 03-09-2023
DOI: 10.1111/JOCN.16877
Publisher: SAGE Publications
Date: 05-11-2020
Abstract: People with chronic kidney disease (CKD) are at increased risk for falls and fall-related injuries. Depressive disorders (DEP) are common in in iduals with CKD and may increase the risk of falls and fall-related injuries. However, not much is known about the relationship between DEP and falls in people with CKD. The purpose of this study was to determine the influence of DEP on the relationship between CKD, falls, and fall-related injuries. Using the Behavioral Risk Factor Surveillance System, we identified 16,574 adults with CKD. Patients with CKD were stratified by history of self-reported DEP (SRDEP), and multivariate logistic regression was conducted to determine the odds for falls and fall-related injuries among those with and without SRDEP. In unadjusted regression analysis, falls (OR = 2.40, 95% CI = 2.08-2.76) and fall-related injuries (OR = 2.12, 95% CI = 1.72-2.59) were higher in in iduals with CKD and history of SRDEP compared to those with CKD and no history of SRDEP. Adjustment for confounders had little effect on the relationship between a history of SRDEP and either falls (AOR = 1.87, 95% CI = 1.60-2.19) or fall-related injuries (AOR = 1.58, 95% CI = 1.26-1.97). People with CKD and DEP are at increased odds for falls and fall-related injuries even after adjustment for sociodemographic, lifestyle factors, and comorbidities. Prospective studies are warranted to further understand this relationship, but it may be prudent for clinicians, in particular nurses, to consider fall risk when treating DEP in patients with CKD.
Publisher: Elsevier BV
Date: 11-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-07-2020
Publisher: American Physiological Society
Date: 05-2019
DOI: 10.1152/AJPRENAL.00317.2018
Abstract: Patients with end-stage kidney disease on dialysis have increased mortality and reduced physical activity, contributing to impaired physical function. Although exercise programs have demonstrated a positive effect on physiological outcomes such as cardiovascular function and strength, there is a reduced focus on physical function. The aim of this review was to determine whether exercise programs improve objective measures of physical function indicative of activities of daily living for patients with end-stage kidney disease on dialysis. A systematic search of Medline, Embase, the Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature identified 27 randomized control trials. Only randomized control trials using an exercise intervention or significant muscular activation in the intervention, a usual care, nonexercising control group, and at least one objective measure of physical function were included. Participants were ≥18 yr of age, with end-stage kidney disease, undergoing hemo- or peritoneal dialysis. Systematic review of the literature and quality assessment of the included studies used the Cochrane Collaboration’s tool for assessing risk bias. A meta-analysis was completed for the 6-min walk test. Data from 27 studies with 1,156 participants showed that exercise, regardless of modality, generally increased 6-min walk test distance, sit-to-stand time or repetitions, and grip strength as well as step and stair climb times or repetitions, dynamic mobility, and short physical performance battery scores. From the evidence available, exercise, regardless of modality, improved objective measures of physical function for end-stage kidney disease patients undergoing dialysis. It is acknowledged that further well-designed randomized control trials are required.
Publisher: Wiley
Date: 23-10-2022
DOI: 10.1111/JORC.12445
Abstract: Implementation of exercise training in people with kidney failure may be affected by clinicians' attitudes. To investigate Danish nephrology nurses' and medical doctors' attitudes towards: exercise for people undergoing dialysis use of physical activity interventions in chronic kidney disease and to compare Danish and previously reported Australian nurse attitudes. Cross‐sectional survey. Nurses and medical doctors from the nephrology field in Denmark. The questionnaire attitudes towards exercise in dialysis, and questions about exercise advice, counselling and interventions. Nephrology nurses ( n = 167) and 17 medical doctors (women 92%, age 47 ± 11 years) from 19 dialysis units participated. There were no differences between nurses' and medical doctors attitudes about training. Ninety‐five % and 88% of nurses and medical doctors, respectively, agreed that most people undergoing dialysis could benefit from exercise. Exercise training was offered to people undergoing haemodialyses in 88% of 17 departments. Danish nurses reported more positive attitudes than Australian towards exercise ( p 0.05). Ninety‐five % and 86% of the Danish and Australian nurses, respectively, agreed/strongly agreed that most people undergoing dialysis could benefit from exercise. Six % and 35% of the Danish and Australian nurses, respectively, agreed/strongly agreed that most people with dialysis were too sick to exercise. Danish nephrology nurses and medical doctors had mostly positive attitudes to exercise training to people undergoing dialysis, and exercise to people with dialysis was offered frequently. Danish and Australian nurses had positive attitudes to exercise to people undergoing dialysis, it was however more positive in Danish nurses.
Publisher: Elsevier BV
Date: 07-2021
DOI: 10.1053/J.JRN.2020.11.010
Abstract: Patients with end-stage kidney disease requiring hemodialysis suffer frailty and poor physical function. Exercise can improve physical function however, barriers exist to intradialytic exercise programs. The objective of this study was to explore patients' reasons for not exercising in an extant intradialytic exercise program. We conducted a retrospective analysis reporting the reasons for not exercising in an intradialytic exercise program in two hemodialysis centers over a 4-week period. We explored whether patient characteristics and the presence of an exercise professional were associated with missed exercise sessions. Seventy-five patients participating in the intradialytic exercise program completed 57% of prescribed intradialytic exercise sessions. The three most frequently reported reasons from patients not exercising were refusal (24%), followed by fatigue (19%) and symptoms (14%). Patients were more than twice as likely to exercise if a kinesiologist was present (odds ratio [OR]: 2.26, confidence interval [CI]: 1.5, 3.4 P = .03). They were less likely to exercise if they were women (OR: 0.66, CI: 0.45, 0.95 P = .002), had been on dialysis greater than 60 months (OR: 0.55, CI: 0.37, 0.80 P < .002), or had more than two comorbid conditions (OR: 0.63, CI: 0.43, 0.90, P = .01). Patient adherence to intradialytic exercise programs is strongly associated with the presence of exercise professionals.
Publisher: Public Library of Science (PLoS)
Date: 28-04-2022
DOI: 10.1371/JOURNAL.PONE.0267290
Abstract: Remaining physically active is important to patients undertaking dialysis, however, clinical recommendations regarding exercise type, timing, intensity, and safety precautions vary. The purpose of this scoping review was to analyse and summarise recommendations for physical activity and exercise for people undertaking dialysis and identify areas that require further research or clarification. A scoping review of literature from five bibliographic databases (Medline, Scopus, Web of Science, CINAHL, and SPORTDiscus) was conducted. Eligible articles included consensus guidelines, position statements, reviews, or clinical practice guidelines that included specific physical activity and exercise recommendations for people undertaking dialysis. Key search terms included "kidney disease" OR "kidney failure" OR "chronic kidney disease" OR "end stage kidney disease" AND guideline* OR consensus OR "position statement" OR prescription OR statement AND exercise OR "physical activity". Hand searching for relevant articles in all first twenty quartile 1 journals listed on SCImago under ‘medicine—nephrology’ and ‘physical therapy, sports therapy and rehabilitation’ using the terms ‘exercise and dialysis’ was undertaken. Finally, home pages of key societies and professional organisations in the field of sports medicine and nephrology were searched. The systematic search strategy identified 19 articles met the inclusion criteria. Two were specific to pediatric dialysis and three to peritoneal dialysis. Whilst many publications provided recommendations on aerobic exercise, progressive resistance training and flexibility, few provided explicit guidance. Recommendations for the intensity, duration and frequency of aerobic and resistance training varied. Discrepancies or gaps in guidance about precautions, contraindications, termination criteria, progression, and access site precautions were also apparent. Future guidelines should include specific guidance regarding physical activity, safety precautions, and timing and intensity of exercise for in iduals who undertake dialysis. Collaborative multidisciplinary guideline development and appropriate exercise counselling may lead to increased participation in physical activity and exercise and facilitate better patient outcomes.
Publisher: Human Kinetics
Date: 04-2020
Abstract: Background : Patients receiving dialysis have reduced physical function, which is associated with unfavorable clinical outcomes and decreased quality of life. The authors aimed to identify and explore modifiable physical factors associated with physical function for patients receiving dialysis. Methods : Searches were performed in MEDLINE, Embase, Ovid Emcare, and The Cochrane Library in October 2018. Etiological studies involving dialysis populations that report association or predictive statistics between a modifiable physical factor and physical function were eligible for inclusion. Predictor variables were (1) modifiable via exercise and (2) considered an impairment in the International Classification of Functioning, Disability and Health. Results : Of 5384 titles screened, 23 studies were included. Thirteen studies focused on physical activity levels and muscle strength and the relationship with physical function while 2 studies investigated sedentary behavior. Twenty-one studies focused on hemodialysis populations. Studies related to physical activity levels displayed a moderately strong relationship with physical function, whereas muscle strength displayed a predominantly weak to moderate relationship. Conclusions : Physical activity levels, sedentary behavior levels, and muscle strength are related to physical function status for patients receiving dialysis. There is a need for robust longitudinal data to confirm the results of this investigation and for more focus on populations receiving peritoneal dialysis.
Publisher: Wiley
Date: 12-02-2009
DOI: 10.1111/J.1466-7657.2008.00667.X
Abstract: People living with chronic kidney disease will require renal dialysis or a kidney transplant to maintain life. Although Indonesia has a developing healthcare industry, Indonesia's kidney transplant rates are lower than comparable nations. To explore the healthcare literature to identify barriers to kidney transplants in particular in relation to Indonesia. Healthcare databases were searched (CINAHL, Medline, EBSCOhostEJS, Blackwell Synergy, Web of Science, PubMed, Google Scholar and Proquest 5000) using the search terms: transplant, kidney disease, renal, dialysis, haemodialysis, Indonesia and nursing. The search was limited to English and Indonesian language data sources from 1997 to 2007. Reference lists of salient academic articles were hand searched. The results of our search identified six articles that met our criteria. Costs are the major barrier to kidney transplant in Indonesia, followed by cultural beliefs, perception of the law, lack of information and lack of infrastructure. In addition, kidney disease prevention strategies are required. There are many complex socio-economic, geographical, legal, cultural and religious factors that contribute to low kidney transplant rates in Indonesia. Although an increase in transplantation rates will require strategies from various agencies, healthcare professionals, including nurses, can play a role in overcoming some barriers. Community education programmes, improving their own education levels and by increasing empowerment in nursing we may contribute to improved kidney transplant rates in Indonesia.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1053/J.JRN.2021.06.007
Abstract: Impairment in physical function and physical performance leads to decreased independence and health-related quality of life in people living with chronic kidney disease and end-stage kidney disease. Physical activity and exercise in kidney care are not priorities in policy development. We aimed to identify global policy-related enablers, barriers, and strategies to increase exercise participation and physical activity behavior for people living with kidney disease. Guided by the Behavior Change Wheel theoretical framework, 50 global renal exercise experts developed policy barriers and enablers to exercise program implementation and physical activity promotion in kidney care. The consensus process consisted of developing themes from renal experts from North America, South America, Continental Europe, United Kingdom, Asia, and Oceania. Strategies to address enablers and barriers were identified by the group, and consensus was achieved. We found that policies addressing funding, service provision, legislation, regulations, guidelines, the environment, communication, and marketing are required to support people with kidney disease to be physically active, participate in exercise, and improve health-related quality of life. We provide a global perspective and highlight Japanese, Canadian, and other regional ex les where policies have been developed to increase renal physical activity and rehabilitation. We present recommendations targeting multiple stakeholders including nephrologists, nurses, allied health clinicians, organizations providing renal care and education, and renal program funders. We strongly recommend the nephrology community and people living with kidney disease take action to change policy now, rather than idly waiting for indisputable clinical trial evidence that increasing physical activity, strength, fitness, and function improves the lives of people living with kidney disease.
Publisher: Elsevier BV
Date: 02-2015
Publisher: Wiley
Date: 23-08-2022
Abstract: To mitigate flooding associated with the gas diffusion layer (GDL) during electroreduction of CO 2 , we report a hydrophobicity‐graded hydrophobic GDL (HGGDL). Coating uniformly dispersed polytetrafluoroethylene (PTFE) binders on the carbon fiber skeleton of a hydrophilic GDL uniformizes the hydrophobicity of the GDL and also alleviates the gas blockage of pore channels. Further adherence of the PTFE macroporous layer (PMPL) to one side of the hydrophobic carbon fiber skeleton was aided by sintering. The introduced PMPL shows an appropriate pore size and enhanced hydrophobicity. As a result, the HGGDL offers spatial control of the hydrophobicity and hence water and gas transport over the GDL. Using a nickel‐single‐atom catalyst, the resulting HGGDL electrode provided a CO faradaic efficiency of over 83 % at a constant current density of 75 mA cm −2 for 103 h operation in a membrane electrode assembly, which is more than 16 times that achieved with a commercial GDL.
Publisher: American Physiological Society
Date: 03-2020
DOI: 10.1152/AJPRENAL.00576.2019
Abstract: End-stage kidney disease is associated with reduced exercise capacity, muscle atrophy, and impaired muscle function. While these may be improved with exercise, single modalities of exercise do not traditionally elicit improvements across all required physiological domains. Blood flow-restricted exercise may improve all of these physiological domains with low intensities traditionally considered insufficient for these adaptions. Investigation of this technique appeals, but is yet to be evaluated, in patients undergoing dialysis. With the use of a progressive crossover design, 10 satellite patients undergoing hemodialysis underwent three exercise conditions over 2 wk: two bouts (10 min) of unrestricted cycling during two consecutive hemodialysis sessions ( condition 1), two bouts of cycling with blood flow restriction while off hemodialysis on 2 separate days ( condition 2), and two bouts of cycling with blood flow restriction during two hemodialysis sessions ( condition 3). Outcomes included hemodynamic responses (heart rate and blood pressure) throughout all sessions, participant-perceived exertion and discomfort on a Borg scale, and evaluation of ultrafiltration rates and dialysis adequacy (Kt/V) obtained post hoc. Hemodynamic responses were consistent regardless of condition. Significant increases in heart rate, systolic blood pressure, and mean arterial blood pressure ( P 0.05) were observed postexercise followed by a reduction in blood pressures during the 60-min recovery (12, 5, and 11 mmHg for systolic, diastolic, and mean arterial pressures, respectively). Blood pressures returned to predialysis ranges following the recovery period. Blood flow restriction did not affect ultrafiltration achieved or Kt/V. Hemodynamic safety and tolerability of blood flow restriction during aerobic exercise on hemodialysis is comparable to standard aerobic exercise.
Publisher: Elsevier BV
Date: 09-2021
Publisher: SAGE Publications
Date: 23-09-2021
Publisher: Wiley
Date: 25-02-2013
DOI: 10.1111/J.1755-6686.2013.00343.X
Abstract: Phosphate binder medication adherence is required to maintain optimal phosphate levels and minimise bone disease in people with end stage kidney disease. To examine the impact of a nurse-led education intervention on bone disorder markers, adherence to phosphate binder medication and medication knowledge. Descriptive study with a paired pre-post intervention survey. Adults receiving haemodialysis. Twelve-week intervention where patients self-administered their phosphate binder medication at each dialysis treatment. Nurses provided in idualised education. Patients completed a pre- and post-intervention survey designed to explore their knowledge of phosphate binders. There were no statistically significant changes in clinical markers but a significant improvement in the proportion of patients who took their phosphate binder correctly, increasing from 44 to 72% (p = 0.016). There were moderate to large effect size changes for improved knowledge. A nurse-led intervention education programme can increase patients' phosphate binder adherence. However, this does not necessarily manifest into improved serum phosphate levels.
Publisher: Oncology Nursing Society (ONS)
Date: 06-2015
Publisher: Springer Science and Business Media LLC
Date: 09-06-2015
Publisher: Cambridge Media
Date: 10-03-2020
Publisher: Elsevier BV
Date: 2022
DOI: 10.1053/J.AJKD.2021.07.015
Abstract: Patient activation, the measure of patients' readiness and willingness to manage their own health care, is low among people receiving in-center hemodialysis, which is exacerbated because such centers are commonly set up for patients to passively receive care. In our pursuit of person-centered care and value-based medicine, enabling patients to take a more active role in their care can lead to healthy behaviors, with subsequent reductions in in idual burden and costs to the health care system. To improve patient activation, we need to embrace a patient-first approach and combine it with ways to equip patients to thrive with self-management. This requires changes in the training of the health care team as well as changes in care delivery models, promoting interventions such as health coaching and peer mentoring, while leveraging technology to enable self-access to records, self-monitoring, and communication with providers. We also need health care policies that encourage a focus on patient-identified goals, including more attention to patient-reported outcomes. In this article, we review the current status of patient activation in dialysis patients, outline some of the available interventions, and propose steps to change the dynamics of the current system to move toward a more active role for patients in their care.
Publisher: Elsevier BV
Date: 2006
DOI: 10.1053/J.JRN.2005.10.013
Abstract: To assess the reliability of a nurse-performed nutrition screening tool (NST) for hemodialysis (HD) patients to identify nutritionally at-risk patients. Tool reliability assessment. The setting was nine non-hospital private (n = 3) and public (n = 6) HD units in Australia (two rural and seven metropolitan). Participants were 112 HD patients. A total of 112 HD patients (male = 65, female = 47) from 9 non-hospital HD units in Australia (seven metropolitan and two rural) were screened with the NST and the outcome of dietitian referral compared with Standard Dietitians Assessment. The mean age of patients was 57.6 years. Overall, the NST showed a sensitivity of 0.84 (range, 0.71 to 0.94 P < .05) and a specificity of 0.9 (range, 0.82 to 0.98 P < .05). The NST was more sensitive (sensitivity, 0.93 [range, 0.87 to 0.99 P < .05]) and was more specific for men (specificity, 0.92 [range, 0.85 to 0.99 P < .05]). Specificity was very strong in metropolitan patients (specificity, 0.94 [range, 0.87 to 1.01 P < .05]). The tool was more sensitive and specific than the NST previously reported by the same investigators. The tool is particularly specific in that it screens those patients not requiring dietitian intervention. The use of this tool may benefit HD units that do not have on-site or regular dietetic support to prioritize patients needing dietitian intervention.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2022
DOI: 10.2215/CJN.00940122
Publisher: Wiley
Date: 19-04-2022
DOI: 10.1111/HDI.13013
Abstract: Increased patient activation is associated with improved health outcomes however, little is known about patient activation in people with end‐stage kidney disease at the start of their dialysis journey. This study aimed to measure activation status changes over the first 4 months of dialysis. Prospective, longitudinal, and observational study. Incident patients initiating dialysis at 25 in‐center hemodialysis and 17 home dialysis programs across three US states managed by the same dialysis provider completed the 13‐item Patient Activation Measure (PAM‐13) survey at baseline (month 1 after commencement of dialysis) and follow‐up (month 4). The survey yields a score (0–100) that corresponds to four levels (1–4), with higher scores or levels indicating higher activation. One hundred eighty‐two participants (139 center, 43 home) completed both baseline and follow‐up surveys. Mean age was 60 ± 15 years, 40% female. Mean PAM‐13 scores were 65.1 ± 16.8 and 64.8 ± 17.8 at baseline and follow‐up, respectively mean intrain idual change: −0.3 ± 17.3. The proportions of patients at levels 1–4 at baseline were 11%, 23%, 35%, and 31% respectively. At follow‐up, 50%, 64%, 52%, and 37% of participants at levels 1–4, respectively, changed to a different PAM level (Spearman correlation = 0.47 p 0.001). Home dialysis was associated with higher PAM scores when compared to in‐center hemodialysis in multivariable analyses, adjusted for sociodemographic variables, comorbidities, and predialysis nephrology care ( β = 5.74, 95% confidence intervals [CI]: 0.11–11.37 and 9.02, 95% CI: 3.03–15.02, at baseline and follow–up, respectively). Although aggregated group scores and levels remained stable, intra‐in idual patient activation changed significantly during the first 4 months of dialysis. This novel finding is foundational to future projects aiming to design interventions to improve patient activation.
Publisher: Wiley
Date: 18-01-2023
Abstract: Herein, we report highly efficient carbon supported Ni−MoO 2 heterostructured catalysts for the electrochemical hydrogenation (ECH) of phenol in 0.10 M aqueous sulfuric acid (pH 0.7) at 60 °C. Highest yields for cyclohexanol and cyclohexanone of 95 % and 86 % with faradaic efficiencies of ∼50 % are obtained with catalysts bearing high and low densities of oxygen vacancy (O v ) sites, respectively. In situ diffuse reflectance infrared spectroscopy and density functional theory calculations reveal that the enhanced phenol adsorption strength is responsible for the superior catalytic efficiency. Furthermore, 1‐cyclohexene‐1‐ol is an important intermediate. Its hydrogenation route and hence the final product are affected by the O v density. This work opens a promising avenue to the rational design of advanced electrocatalysts for the upgrading of phenolic compounds.
Publisher: Wiley
Date: 14-03-2014
DOI: 10.1111/JORC.12058
Abstract: Chronic kidney disease (CKD) is a complex health problem, which requires in iduals to invest considerable time and energy in managing their health and adhering to multifaceted treatment regimens. To review studies delivering self-management interventions to people with CKD (Stages 1-4) and assess whether these interventions improve patient outcomes. Systematic review. Nine electronic databases (MedLine, CINAHL, EMBASE, ProQuest Health & Medical Complete, ProQuest Nursing & Allied Health, The Cochrane Library, The Joanna Briggs Institute EBP Database, Web of Science and PsycINFO) were searched using relevant terms for papers published between January 2003 and February 2013. The search strategy identified 2,051 papers, of which 34 were retrieved in full with only 5 studies involving 274 patients meeting the inclusion criteria. Three studies were randomised controlled trials, a variety of methods were used to measure outcomes, and four studies included a nurse on the self-management intervention team. There was little consistency in the delivery, intensity, duration and format of the self-management programmes. There is some evidence that knowledge- and health-related quality of life improved. Generally, small effects were observed for levels of adherence and progression of CKD according to physiologic measures. The effectiveness of self-management programmes in CKD (Stages 1-4) cannot be conclusively ascertained, and further research is required. It is desirable that in iduals with CKD are supported to effectively self-manage day-to-day aspects of their health.
Publisher: Elsevier BV
Date: 05-2020
Publisher: Elsevier BV
Date: 02-2008
DOI: 10.1016/J.NEDT.2007.04.005
Abstract: Video streaming technology enables video content, held on the web sites, to be streamed via the web. We report the implementation and evaluation of video streaming in an undergraduate nursing program in a metropolitan university in Australia. Students (n=703) were emailed a survey with a 15% response rate. We found that 91% (n=74) of respondents stated that video streaming assisted their learning. Forty-six percent(n=50) of students had difficulty accessing video streaming (particularly at the beginning of the study period). Over a 97-day period there were 8440 "hits" to the site from 1039 different internet protocol (IP) addresses. There were 4475 video streaming sessions undertaken by users. Video streaming was used for reviewing previously attended lectures (52%, n=56), examination preparation (34%, n=37), viewing missed lectures (27%, n=29) and class preparation (9%, n=10). Our experience with the introduction of video streaming has met with general enthusiasm from both students and teaching staff. Video streaming has particular relevance for rural students.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2014
Publisher: Elsevier BV
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 11-09-2017
Publisher: Mark Allen Group
Date: 03-2010
DOI: 10.12968/JORN.2010.2.2.47253
Abstract: It is widely known that patients on dialysis benefit from exercise. Here, Paul Bennett points out that patients can increase the amount and the quality of exercise if the dialysis centre they are attending has a culture of exercise. He describes the elements required to maintain such a culture.
Publisher: Informa UK Limited
Date: 12-2012
DOI: 10.5172/CONU.2012.43.1.99
Abstract: Professional nursing governance refers to the processes and structures that influence nursing practice within an organisation. This study measured the effect of structured meeting communication processes on nurses' perceptions of professional governance. The intervention was implemented in eight hospital wards. After 3 months, nurses on the intervention wards and eight matched-control wards completed the Index of Professional Nursing Governance (N = 225). Data were compared with a s le of Magnet(®) (N = 3) and non-Magnet (N = 46) hospitals. There was substantial variation in nurses' perceptions of governance across the 16 wards, irrespective of the intervention. Compared to non-Magnet hospitals, the overall score and three of the six subscales scores were higher in this study. Magnet hospitals scores, however, were typically higher suggesting greater progress towards shared governance. Professional nursing governance can be highly variable across in idual wards and tailored interventions should be considered.
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.NEDT.2010.09.008
Abstract: Nurses and other health professionals are required to demonstrate broad levels of expertise and service to ensure quality patient-centred health care. Interprofessional practice aligned with interprofessional education (IPE) has been promoted as a vehicle to promote broad levels of expertise. However, challenges remain for universities and other higher education institutions to successfully provide IPE opportunities for students. This paper presents perceptions of academic staff towards IPE from one Australian multi-c us health faculty. Perceptions were collected using interviews and two workshops. Findings are themed under the categories of faculty barriers, industry challenges and future opportunities. The perceptions of one health faculty regarding the fundamental factors required for IPE success were executive leadership of IPE, a supportive funding framework and an IPE based curricula. Nursing education can play a key role in embracing and leading future IPE approaches given that nurses are the numerically dominant health professional group and work collaboratively with other professionals to deliver patient-centred care.
Publisher: Wiley
Date: 26-03-2014
DOI: 10.1111/JORC.12066
Abstract: Mothers requiring dialysis to treat end-stage kidney disease face the challenging demands of the disease and dialysis treatment in addition to their role as a parent. To describe the experience of mothers who require haemodialysis. Four mothers receiving haemodialysis treatment for end-stage kidney disease in regional Australia were interviewed to explore the mothers' experiences, attitudes, beliefs and values of their dual role as mothers and haemodialysis recipients. The overarching theme emerging from the data was the competing roles of motherhood and dialysis. Four key sub-themes emerged: fitting everything in, internal family challenges, lost connections and striving for normality. Being a mother adds a range of complexities to being on dialysis. While managing dialysis, mothers struggle to care for their children and stay connected with family life. Nephrology health professionals are uniquely placed to support mothers and need to develop strategies to ease their burdens of care.
Publisher: Elsevier BV
Date: 11-2019
Publisher: Wiley
Date: 08-01-2017
DOI: 10.1111/NEP.12811
Abstract: People with end-stage kidney disease receiving haemodialysis are restricted to holidays where dialysis services are readily available. Holiday dialysis in regional, rural and remote areas is particularly challenging. The aims of this study were to evaluate the wellbeing of those who received dialysis in a holiday haemodialysis bus and to measure patient well-being with that of a comparable cohort of haemodialysis patients. A three machine haemodialysis bus, the Big Red Kidney Bus, was built to enable people, their families and carers to take holidays across a range of tourist destinations in Victoria, Australia. Measures included pre-post subjective well-being, dialysis symptoms and mood questionnaires complemented by post semi-structured telephone interviews. Participating holidaymakers were positive about the haemodialysis bus service and the standard of care experienced. They reported decreased dialysis side effects of fatigue, muscle cr and dry skin. The overall number of reported symptoms decreased, and the perceived level of bother associated with symptoms also decreased. No changes in subjective well-being and mood were detected. Mean Personal Wellbeing Index scores were significantly higher than in a comparative haemodialysis s le. The Big Red Kidney Bus provided a safe and feasible holiday dialysis service. Holidaymakers' well-being was reflected by the decreased dialysis patient side effects.
Publisher: Wiley
Date: 11-03-2021
DOI: 10.1111/NEP.13867
Abstract: Home dialysis therapies are flexible kidney replacement strategies with documented clinical benefits. While the incidence of end‐stage kidney disease continues to increase globally, the use of home dialysis remains low in most developed countries. Multiple barriers to providing home dialysis have been noted in the published literature. Among known challenges, gaps in clinician knowledge are potentially addressable with a focused education strategy. Recent national surveys in the United States and Australia have highlighted the need for enhanced home dialysis knowledge especially among nephrologists who have recently completed training. Traditional in‐person continuing professional educational programmes have had modest success in promoting home dialysis and are limited by scale and the present global COVID‐19 pandemic. We hypothesize that the use of a ‘Hub and Spoke’ model of virtual home dialysis mentorship for nephrologists based on project ECHO would support home dialysis growth. We review the home dialysis literature, known educational gaps and plausible educational interventions to address current limitations in physician education.
Publisher: Wiley
Date: 24-04-2017
DOI: 10.1111/WVN.12201
Abstract: The policy of single over double checking of medications has been adopted by many health services however, nurses' attitudes toward single-checking medications remains unclear. The aim of this study was to explore the attitudes of nurses who single check and administer medications in a setting where single checking has been in place for over a decade. A cross-sectional survey design using the validated Single Checking Administration Medication Scale-II to registered nurses (n = 299) working in one metropolitan teaching hospital in Victoria, Australia. Descriptive analyses for participants' demographics were examined and confirmatory factor analysis (CFA) was performed on the survey items to represent the main themes of nurses' attitudes toward single checking. Nurses reported single checking allowed a greater accountability as a professional nurse and more control over drug administration. The efficiency of single checking was welcomed by nurses through reductions in administration time and workplace interruptions. Nurses were more likely to adhere to drug administration procedures when single checking and this process facilitated drug knowledge updates. There was significant variance in attitudes amongst nurses based upon current appointment and years of clinical experience. Free text responses indicated nurses' attitudes were situated in the context of the traditional double-checking system. Understanding nurses' attitudes toward single checking may assist health care services to positively address medication safety. Accountability, efficiency and knowledge are important for nurses when administering medications. Nurses' attitudes are varied when correlated with demographic characteristics.
Publisher: Wiley
Date: 05-06-2017
DOI: 10.1111/SDI.12610
Abstract: The progressive physical deterioration of dialysis patients is apparent to all who are involved in their care. Exercise can help stem this decline, yet exercise uptake in chronic and end-stage kidney disease is low. The involvement of exercise professionals has been shown to significantly increase patients' physical function and improve their quality of life. However, exercise professionals are scarce in renal programs, far less than dietetic and social work services. A review of 10 years of renal exercise publications in the physical therapy and rehabilitation literature found that only 0.4% (7 out of a total of 1763) of all published articles were focused on people with kidney disease. This compared with stroke (44%, n=883), arthritis/bone (29%, n=458), cancer (9%, n=168), respiratory (8%, n=106), cardiac (5%, n=82), and diabetes (3%, n=45). These results reflect the low emphasis placed on renal rehabilitation by the physical therapy professions and the low renal content in physical therapy tertiary education programs. This is likely to have an impact on the level of involvement of physical therapists in renal programs leading to lower physical function and poorer quality of life for renal patients.
Publisher: Wiley
Date: 03-02-2022
Abstract: Herein, we report a series of CuPd catalysts for electrochemical hydrogenation (ECH) of furfural to 2‐methylfuran (MF or FurCH 3 where Fur=furyl) in aqueous 0.1 M acetic acid (pH 2.9). The highest faradaic efficiency (FE) for MF reached 75 % at −0.58 V vs. reversible hydrogen electrode with an average partial current density of 4.5 mA cm −2 . In situ surface‐enhanced Raman spectroscopic and kinetic isotopic experiments suggested that electrogenerated adsorbed hydrogen (H ads ) was involved in the reaction and incorporation of Pd enhanced the surface coverage of H ads and optimized the adsorption pattern of furfural, leading to a higher FE for MF. Density functional theory calculations revealed that Pd incorporation reduced the energy barrier for the hydrogenation of FurCH 2 * to FurCH 3 *. Our study demonstrates that catalyst surface structure/composition plays a crucial role in determining the selectivity in ECH and provides a new strategy for designing advanced catalysts for ECH of bio‐derived oxygenates.
Publisher: Wiley
Date: 2010
Publisher: Elsevier BV
Date: 09-2022
Publisher: Wiley
Date: 05-05-2018
DOI: 10.1111/HDI.12570
Abstract: Physical function in people on hemodialysis deteriorates significantly, however quantification of the rate of deterioration has not been well established. The aim of this study was to examine the rate of deterioration in objective physical function among end-stage kidney disease patients receiving hemodialysis. One hundred and ninety-three participants (mean age 67.5 ±13.2 years, 60.6% males) receiving hemodialysis in Australia. Objective physical function was assessed via the 30-second sit-to-stand and eight-foot timed up-and-go at baseline, 12 and 24 weeks. We found a decrease in the mean number 30-second sit-to-stands performed from 10.0 (IQR, 4.0 to 13.0) 95% CI (8.0, 11.0) to 8.0 (IQR, 0.0 to 11.0) 95% CI (5.5, 9.0) at 12 weeks to 7.0 (IQR, 0.0 to 11.0) 95% CI (5.5, 9.0) at 24 weeks and a significant overall decreased rate (RR = 0.82 95% CI, 0.80 to 0.85 P < 0.001). There was a decreased performance in the eight-foot timed up-and-go time from 8.9 seconds (95% CI: 8.1 to 9.7) to 9.0 (95% CI: 8.1 to 9.7) after 12 weeks and further increasing to 9.7 (95% CI: 8.7 to 9.6) seconds after 24 weeks, and overall decreased rate (HR = 0.56 95% CI, 0.39 to 0.80 P = 0.001) between baseline and week 24. Physical function significantly decreases on hemodialysis. Exercise programs to address this physical function decline should be included in hemodialysis treatment regimens.
Publisher: Royal Society of Chemistry (RSC)
Date: 2021
DOI: 10.1039/D1FD00050K
Abstract: Deep neural networks applied to three cycle voltammograms showed significant advantages in classifying difficult simulated E, EC 1 st and EC 2 nd processes.
Publisher: Wiley
Date: 10-2012
DOI: 10.1111/J.1542-4758.2012.00747.X
Abstract: The increasing prevalence of obesity in developed countries is reflected in the chronic kidney disease, dialysis, and transplant populations. The added risk factor of obesity increases the risk of vascular events, inflammation, insulin resistance, blood pressure, dyslipidemia, and mortality risk. Nephrology center policies may exclude obese people from transplantation programs resulting in many years of dialysis. The case of a 215-kg Australian male who has successfully dialyzed at home for more than 8 years will be used to illustrate the important considerations and clinical support that these people require for successful home dialysis treatment. The aim of this paper is to report on a program that has successfully trained 23 obese (body mass index >30) people who commenced on home hemodialysis between 2001 and 2009. Body weight ranged between 94.0 and 215 kg (mean 126, SD 26.19) and body mass index ranged between 34.9 and 71 (mean 43.38, SD 9.99) at the start of home training. During the 8.5 years of follow-up, average time on home dialysis was 43.7 months. Home hemodialysis is a feasible treatment for obese people to facilitate longer and more frequent dialysis, resulting in improved hemodynamic stability and improved quality of life. For obese people with end-stage kidney disease, home hemodialysis has shown to be cost-effective and can result in greater treatment efficacy than in-center hospital dialysis.
Publisher: Elsevier BV
Date: 08-2021
Publisher: SAGE Publications
Date: 11-02-2021
Abstract: Fatigue is a frequent and debilitating symptom for people with end-stage kidney disease (ESKD) receiving dialysis. Ecological momentary assessment (EMA) allows real-time data capture of day-to-day and diurnal variations. EMA has been used to study haemodialysis-related fatigue but not in people receiving peritoneal dialysis who are unique in their physical, environmental and logistical characteristics. The aim of this study is to explore the real-time associations between fatigue and mood (EMA mobile application) and objective physical activity levels (accelerometry) in people with EKSD receiving peritoneal dialysis. A 7-day intensive longitudinal study will be conducted. People receiving peritoneal dialysis within South Australia will be invited to participate. Five times throughout the day, participants will be prompted to answer 18 questions relating to fatigue (Visual Analogue Scale to Evaluate Fatigue Severity) and a single question for mood (Visual Analogue Mood Scale). Participants will continuously wear a GENEActiv accelerometer to capture physical activity levels during the 7-day period. At the completion of the data collection, participants will answer questions to evaluate the feasibility and acceptability of using EMA. This study will be the first to explore the real-time relationships between fatigue, mood and physical activity in people with ESKD receiving peritoneal dialysis. Understanding the fluctuations people experience and the relationships between mood and physical activity and fatigue will inform clinical management and well-being intervention development.
Publisher: MDPI AG
Date: 03-03-2022
DOI: 10.3390/KIDNEYDIAL2010012
Abstract: The importance of patient activation (i.e., the knowledge, skills, and confidence one has in managing one’s own healthcare) in people with long-term conditions, including kidney disease, is growing. Enabling and empowering patients to take a more active role in their health and healthcare is the focus of person-centred care. Patient activation is recognised as a key construct of self-management, as to effectively self-manage a long-term condition, it is required to enable in iduals to actively participate in treatment decisions, prevent complications, and manage risk factors. Identifying an in idual’s level of activation can help guide and tailor care, and interventions aimed at increasing patient activation may improve patient engagement and health outcomes. In this review, we explore the concepts of patient activation and self-management, the relationship between patient activation and self-management, interventions aimed at improving these, and what these mean to people living with kidney disease.
Publisher: Public Library of Science (PLoS)
Date: 10-06-2021
DOI: 10.1371/JOURNAL.PONE.0253048
Abstract: Little is known about the prevalence and best management of needle fear in adults with chronic disease, who may experience frequent and long-term exposure to needles for lifesaving therapies such as renal dialysis and cancer treatment. Identifying interventions that assist in management of needle fear and associated distress is essential to support these patients with repeated needle and cannula exposure. We followed the PRISMA methodology for scoping reviews and systematically searched PsychINFO, PubMed (MEDLINE), ProQuest, Embase and grey literature and reference lists between 1989 and October 2020 for articles related to needle discomfort, distress, anxiety, fear or phobia. The following chronic diseases were included: arthritis, asthma, chronic back pain, cancer, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and mental illness, or kidney failure. Literature concerning dentistry, vaccination, intravenous drug users and paediatric populations were excluded. We identified 32 papers reporting prevalence (n = 24), management (n = 5) or both (n = 3). Needle fear prevalence varied in disease cohorts: 17–52% (cancer), 25–47% (chronic kidney disease) and 0.2–80% (diabetes). Assessment methods varied across studies. Management strategies had poor evidence-base, but included needle-specific education, decorated devices, cognitive-behavioural stress management techniques, distraction, and changing the therapy environment or modality. Although needle fear is common there is a paucity of evidence regarding interventions to address it among adults living with chronic disease. This scoping review has highlighted the need for improved identification of needle fear in adults and development of interventions are required for these cohorts.
Publisher: Wiley
Date: 06-07-2011
DOI: 10.1111/J.2044-8287.2011.02040.X
Abstract: To identify an evidence-based intervention to promote changes in diet and physical activity and adapt it for a UK primary care setting for people with high cardiovascular risk. A three-stage mixed-methods design was used to facilitate a strategic approach to programme selection and adaptation. Stage 1: Criteria for scientific quality and local appropriateness were developed for the selection/adaptation of an intervention to promote lifestyle change in people of high cardiovascular risk through (1) patient interviews, (2) a literature search to extract evidence-based criteria for behavioural interventions, and (3) stakeholder consultation. Stage 2: Potential interventions for adaptation were identified and ranked according to their performance against the criteria developed in Stage 1. Stage 3: Intervention mapping (IM) techniques were used to (1) specify the behavioural objectives that participants would need to reach in order to attain programme outcomes, and (2) adapt the selected intervention to ensure that evidence-based strategies to target all identified behavioural objectives were included. Four of 23 potential interventions identified met the 11 essential criteria agreed by a multi-disciplinary stakeholder committee. Of these, the Greater Green Triangle programme (Laatikainen et al., 2007) was ranked highest and selected for adaptation. The IM process identified 13 additional behaviour change strategies that were used to adapt the intervention for the local context. IM provided a useful set of techniques for the systematic adaptation of an existing lifestyle intervention to a new population and context, and facilitated transparent working processes for a multi-disciplinary team.
Publisher: Elsevier BV
Date: 10-2022
Publisher: Wiley
Date: 26-03-2015
DOI: 10.1111/JORC.12116
Abstract: Happiness is a construct that has been gaining more prominence in both social and health research. The measure of happiness, subjective well-being, has not been rigorously explored in the end-stage kidney disease (ESKD) population. To measure the subjective well-being of people with ESKD on haemodialysis and to compare their subjective well-being with a general population cohort. A cross-sectional design measuring the subjective well-being of an Australian haemodialysis cohort compared with a non-dialysis age-matched cohort. The haemodialysis cohort (N = 172), recruited from eight dialysis centres, had a mean age of 64.04 years (SD = 14.82) and included 104 males (60.5%) and 66 (38.4%) females. The non-dialysis cohort (N = 200), randomly extracted from the 2012 Australian Unity Wellbeing Index, had a mean age of 63.97 (SD = 14.68) and included 101 males (50.5%) and 99 females (49.5%). Subjective well-being was measured using the Personal Wellbeing Index. This seven-item measure rates satisfaction with life in seven domains: standard of living, health, achievements in life, relationships, safety, community and future security. The haemodialysis cohort reported lower general life satisfaction, life achievements, relationship and personal safety compared to the general population. There were no differences between the two groups for health, community and future security. Standard of living and satisfaction with life achievements carried higher importance in subjective well-being compared with health satisfaction Subjective well-being can be an important indicator of people's life quality to be considered by clinicians and nephrology researchers in future studies.
Publisher: Wiley
Date: 03-02-2022
Abstract: Herein, we report a series of CuPd catalysts for electrochemical hydrogenation (ECH) of furfural to 2‐methylfuran (MF or FurCH 3 where Fur=furyl) in aqueous 0.1 M acetic acid (pH 2.9). The highest faradaic efficiency (FE) for MF reached 75 % at −0.58 V vs. reversible hydrogen electrode with an average partial current density of 4.5 mA cm −2 . In situ surface‐enhanced Raman spectroscopic and kinetic isotopic experiments suggested that electrogenerated adsorbed hydrogen (H ads ) was involved in the reaction and incorporation of Pd enhanced the surface coverage of H ads and optimized the adsorption pattern of furfural, leading to a higher FE for MF. Density functional theory calculations revealed that Pd incorporation reduced the energy barrier for the hydrogenation of FurCH 2 * to FurCH 3 *. Our study demonstrates that catalyst surface structure/composition plays a crucial role in determining the selectivity in ECH and provides a new strategy for designing advanced catalysts for ECH of bio‐derived oxygenates.
Publisher: Elsevier BV
Date: 2013
Publisher: American Chemical Society (ACS)
Date: 08-01-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 22-12-2021
DOI: 10.2215/CJN.11690720
Abstract: Mobile health is the health care use of mobile devices, such as smartphones. Mobile health readiness is a prerequisite to successful implementation of mobile health programs. The aim of this study was to examine the status and correlates of mobile health readiness among in iduals on dialysis. A cross-sectional 30-item questionnaire guided by the Khatun mobile health readiness conceptual model was distributed to in iduals on dialysis from 21 in-center hemodialysis facilities and 14 home dialysis centers. The survey assessed the availability of devices and the internet, proficiency, and interest in using mobile health. In total, 949 patients (632 hemodialysis and 317 home dialysis) completed the survey. Of those, 81% owned smartphones or other internet-capable devices, and 72% reported using the internet. The majority (70%) reported intermediate or advanced mobile health proficiency. The main reasons for using mobile health were appointments (56%), communication with health care personnel (56%), and laboratory results (55%). The main reported concerns with mobile health were privacy and security (18%). Mobile health proficiency was lower in older patients: compared with the 45- to 60-years group, respondents in age groups , 61–70, and years had adjusted odds ratios of 5.04 (95% confidence interval, 2.23 to 11.38), 0.39 (95% confidence interval, 0.24 to 0.62), and 0.22 (95% confidence interval, 0.14 to 0.35), respectively. Proficiency was lower in participants with Hispanic/Latinx ethnicity (adjusted odds ratio, 0.49 95% confidence interval, 0.31 to 0.75) and with less than college education (adjusted odds ratio for “below high school,” 0.09 95% confidence interval, 0.05 to 0.16 and adjusted odds ratio for “high school only,” 0.26 95% confidence interval, 0.18 to 0.39). Employment was associated with higher proficiency (adjusted odds ratio, 2.26 95% confidence interval, 1.18 to 4.32). Although home dialysis was associated with higher proficiency in the unadjusted analyses, we did not observe this association after adjustment for other factors. The majority of patients on dialysis surveyed were ready for, and proficient in, mobile health. NCT04177277
Publisher: Royal Society of Chemistry (RSC)
Date: 2022
DOI: 10.1039/D2NJ00045H
Abstract: Titania nanocrystal rods grown hydrothermally onto titanium microwire are mechanically robust and photoelectrochemically active.
Publisher: Wiley
Date: 12-03-2019
DOI: 10.1111/HDI.12752
Publisher: Springer Science and Business Media LLC
Date: 31-03-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2017
DOI: 10.1097/SGA.0000000000000264
Abstract: In Australia, nurses performing endoscopic procedures is a recent phenomenon and is uncommon. Challenges include gastroenterologist and patient acceptance of the nurse endoscopist role. This article aims to explore Monash Health's experience with the introduction of a nurse endoscopist. A nurse endoscopist trainee undertook a comprehensive training program under the supervision of a gastroenterologist. All procedural data were collected, organizational policy and procedures were developed, and patients ( n = 40) completed a telephone interview postprocedure. The nurse endoscopist trainee completed all training requirements during the 12-month program and was deemed competent for independent practice. The trainee performed 255 colonoscopies, with no complications reported. The organization successfully implemented the expanded scope of practice, established a new model of care for patients, and initiated a governance framework for this advanced practice role. Eighty percent of patients ( n = 32) reported that overall, they had a very good experience with the nurse endoscopist trainee. A nurse endoscopist initiative can facilitate the expansion of endoscopy services to meet the growing need for gastroenterological procedures within the community. This pilot program has demonstrated that it is possible to integrate an advanced practice nurse role into an established endoscopy unit.
Publisher: Wiley
Date: 18-10-2010
DOI: 10.1111/J.1365-2648.2010.05474.X
Abstract: This paper is a report of an exploration of nurses' perceptions of the quality of satellite dialysis care and how aspects of power that influenced quality nursing care. In Australia, the majority of people living with established kidney failure undertake haemodialysis in nurse-run satellite dialysis units. Haemodialysis nurses provide the majority of care, and their perceptions of what constitutes quality nursing care may influence their care of the person receiving haemodialysis. A critical ethnographic study was conducted where data were collected from one metropolitan satellite dialysis unit in Australia over a 12-month period throughout 2005. The methods included non-participant observation, interviews, document analysis, reflective field notes and participant feedback. Three theoretical constructs were identified: 'What is quality?', 'What is not quality?' and What influences quality?' Nurses considered technical knowledge, technical skills and personal respect as characteristics of quality. Long-term blood pressure management and arranging transport for people receiving dialysis treatment were not seen to be priorities for quality care. The person receiving dialysis treatment, management, nurse and environment were considered major factors determining quality dialysis nursing care. Aspects of power and oppression operated for nurses and people receiving dialysis treatment within the satellite dialysis context, and this environment was perceived by the nurses as very different from hospital dialysis units.
Publisher: Wiley
Date: 14-06-2021
Abstract: Use of carefully designed computer supported parameterisation methods in voltammetric studies can provide highly robust and accurate methods for simultaneously quantifying the large number of parameters present in complex electrochemical reactions. In this study, a computer program has been developed to parameterise large litude AC voltammetric data using mathematical optimisation in combination with Bayesian inference algorithms for calculating posterior distributions of parameters and hence uncertainties in parameter values. The computer program has been applied to objective functions, relevant to total AC current, frequency domain data in the form of the power spectrum derived from Fourier transformation and multivariate based methods using the resolved harmonic data. The robustness of the objective functions have been confirmed and Bayesian inference methods have been validated using “noisy” synthetic and experimental data for the [Fe(CN) 6 ] 3−/4− reduction process in aqueous 3.0 M KCl electrolyte at a gold electrode. It was found that the harmonic based Bayesian inference methods outperformed other methods in parameterisation of the thermodynamics and electrode kinetics of the close to reversible [Fe(CN) 6 ] 3−/4− process due to their ability to compensate for non‐ideality in the modelling and the superior parameter sensitivities available in the higher harmonics. The computer supported and heuristic methods were compared. Their advantages and limitations are discussed.
Publisher: SAGE Publications
Date: 07-11-2021
DOI: 10.1177/08968608211055290
Abstract: Life participation requiring physical activity and physical function is a key patient-reported outcome for people receiving peritoneal dialysis (PD). Clinician guidance is required from multidisciplinary sources regarding exercise and activity advice to address the specific needs of this group. From August 2020 through to June 2021, the Global Renal Exercise Network and the International Society for Peritoneal Dialysis reviewed the published literature and international clinical experience to develop a set of clinical practice points. A set of questions relevant to physical activity and exercise were developed from the perspective of a person receiving PD and were the basis for the practice point development. The GRADE framework was used to evaluate the quality of evidence and to guide clinical practice points. The review of the literature found sparse quality evidence, and thus the clinical practice points are generally based on the expert consensus of people receiving PD, PD exercise expert clinicians and experienced PD exercise researchers. Clinical practice points address timing of exercise and activity (post-catheter insertion, peritoneal space empty or full), the uptake of specific activities (work, sex, swimming, core exercise), potential adverse outcomes related to activity and exercise (exit site care, perspiration, cardiovascular compromise, fatigue, intra-abdominal pressure), the effect of exercise and activity on conditions of interest (mental health, obesity, frailty, low fitness) and exercise nutrition.
Publisher: Springer Science and Business Media LLC
Date: 19-05-2022
DOI: 10.1186/S13063-022-06355-0
Abstract: Kidney failure prevalence is increasing worldwide. Haemodialysis, peritoneal dialysis or kidney transplantation are undertaken to extend life with kidney failure. People receiving haemodialysis commonly experience fatigue, pain, nausea, cr ing, itching, sleeping difficulties, anxiety and depression. This symptom burden contributes to poor health-related quality of life (QOL) and is a major reason for treatment withdrawal and death. The Symptom monitoring WIth Feedback Trial (SWIFT) will test the hypothesis that regular symptom monitoring with feedback to people receiving haemodialysis and their treating clinical team can improve QOL. We are conducting an Australia and New Zealand Dialysis and Transplant (ANZDATA) registry-based cluster randomised controlled trial to determine the clinical- and cost-effectiveness at 12 months, of 3-monthly symptom monitoring using the Integrated Palliative Outcome Scale-Renal (IPOS-Renal) survey with clinician feedback, compared with usual care among adults treated with haemodialysis. Participants complete symptom scoring using a tablet, which are provided to participants and to clinicians. The trial aims to recruit 143 satellite haemodialysis centres, (up to 2400 participants). The primary outcome is change in health-related QOL, as measured by EuroQol 5-Dimension, 5-Level (EQ-5D-5L) instrument. Secondary outcomes include overall survival, symptom severity (including haemodialysis-associated fatigue), healthcare utilisation and cost-effectiveness. SWIFT is the first registry-based trial in the Australian haemodialysis population to investigate whether regular symptom monitoring with feedback to participants and clinicians improves QOL. SWIFT is embedded in the ANZDATA Registry facilitating pragmatic recruitment from public and private dialysis clinics, throughout Australia. SWIFT will inform future collection, storage and reporting of patient-reported outcome measures (PROMs) within a clinical quality registry. As the first trial to rigorously estimate the efficacy and cost-effectiveness of routine PROMs collection and reporting in haemodialysis units, SWIFT will provide invaluable information to health services, clinicians and researchers working to improve the lives of those with kidney failure. Australian New Zealand Clinical Trials Registry ACTRN12620001061921 . Registered on 16 October 2020
Publisher: Royal Society of Chemistry (RSC)
Date: 2021
DOI: 10.1039/D1DT02219A
Abstract: The distribution of redox species in single crystals of [FeFe]-hydrogenase can be tuned electrochemically. All catalytic intermediates are observed by simultaneous infrared microspectroscopy, providing a roadmap for enriching specific redox states.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.AENJ.2017.08.001
Abstract: Older adults are high users of emergency department services and their care requirements can present challenges for emergency nurses. Although clinical outcomes for older patients improve when they are cared for by nurses with specialist training, emergency nurses' knowledge and self-assessment of care for older patients is poorly understood. To assess emergency nurses' knowledge and self-rating of practice when caring for older patients. A cross-sectional self-report survey of emergency nurses (n=101) in Melbourne, Australia. Mean scores were 12.7 (SD 2.66) for the 25-item knowledge of older persons questionnaire, and 9.04 (SD 1.80) for the 15-item gerontic health related questions. Scores were unaffected by years of experience as a registered nurse or emergency nurse. More than 80% of nurses rated themselves as 'very good' or 'good' in assessing pain (94.9%), identifying delirium (87.8%), and identifying dementia (82.8%). Areas with a 'poor' ratings were identifying depression (46.5%), assessing polypharmacy (46.5%) and assessing nutrition (37.8%). There was variation in knowledge and self-rating of practice related to care of older patients. The relationship between knowledge and self-ratings of practice in relation to actual emergency nursing care of older people and patient outcomes warrants further exploration.
Publisher: Wiley
Date: 03-08-2202
DOI: 10.1111/SDI.12909
Publisher: Wiley
Date: 28-01-2014
DOI: 10.1111/SDI.12194
Abstract: Laughter and humor therapy have been used in health care to achieve physiological and psychological health-related benefits. The application of these therapies to the dialysis context remains unclear. This paper reviews the evidence related to laughter and humor therapy as a medical therapy relevant to the dialysis patient population. Studies from other groups such as children, the elderly, and persons with mental health, cancer, and other chronic conditions are included to inform potential applications of laughter therapy to the dialysis population. Therapeutic interventions could range from humorous videos, stories, laughter clowns through to raucous simulated laughter and Laughter Yoga. The effect of laughter and humor on depression, anxiety, pain, immunity, fatigue, sleep quality, respiratory function and blood glucose may have applications to the dialysis context and require further research.
Publisher: American Nephrology Nurses Association
Date: 2020
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.CLNU.2022.03.025
Abstract: Sarcopenia is a risk factor for adverse outcomes in older adults, but this has yet to be confirmed in chronic kidney disease (CKD). We conducted a systematic review to investigate the association between sarcopenia and its traits with mortality, hospitalization, and end-stage kidney disease (ESKD) progression in CKD patients. Five electronic databases were searched, including MEDLINE and Embase. Observational cohort studies with CKD patients were included. The sarcopenia traits assessed were low muscle strength, low muscle mass, and low physical performance, as well as diagnosed sarcopenia (combined low muscle mass and low strength erformance). Hazard ratios (HR), risk ratios (RR), odds ratios (OR), and 95% confidence intervals (CI) were pooled using random-effect meta-analyses. From a total of 4922 screened studies, 50 (72,347 patients) were included in the review and 38 (59,070 patients) in the meta-analyses. Most of the included studies were in dialysis patients (n = 36, 72%). Pooled analyses showed that low muscle strength (15 studies HR:1.99 95%CI:1.65 to 2.41 I Low muscle strength, low muscle mass, and low physical performance were associated with higher mortality in CKD patients. In dialysis patients, diagnosed sarcopenia also represented higher mortality risk. Evidence to conclude associations with hospitalization and ESKD progression is currently lacking. CRD42020192198.
Publisher: SAGE Publications
Date: 29-04-2022
DOI: 10.1177/08968608221094423
Abstract: People receiving peritoneal dialysis (PD) may benefit from participation in exercise or physical activity. However, exercise therapy for people receiving PD is not typically included in routine care, in part, due to ongoing uncertainties about risk. The aim of this review was to systematically collate and explore data on adverse events experienced by people receiving PD while undertaking an exercise or physical activity intervention. Searches yielded 25 exercise or physical activity intervention studies involving people receiving PD. Of these 25 studies, 17 studies provided adverse event data and were included in the final review. No serious adverse events (e.g. death, hospitalisation) were found attributable to the intervention. From 50 reported adverse events during the intervention period, 32 were attributable to the exercise or physical activity intervention with most being musculoskeletal (e.g. muscle/joint pain, etc.) followed by fatigue. Most events were mild to moderate in severity and resolved by exercise programme modification, education, rest or medication. The results from this review did not uncover signals of harm for people receiving PD who engage in exercise with risk of adverse events appearing to be low, however, improved adverse events reporting and further interventional studies are required before robust guidelines can be produced.
Publisher: Springer Science and Business Media LLC
Date: 27-09-2013
Publisher: Wiley
Date: 16-06-2021
Abstract: The development of Cu‐based catalysts for the electrochemical CO 2 reduction reaction (eCO 2 RR) is of major interest for generating commercially important C 2 liquid products such as ethanol. Cu is exclusive among the eCO 2 RR metallic catalysts in that it facilitates the formation of a range of highly reduced C 2 products, with a reasonable total faradaic efficiency but poor product selectivity. Here, a series of new sulfide‐derived copper‐cadmium catalysts (SD‐Cu x Cd y ) was developed. An excellent faradaic efficiency of around 32 % but with a relatively low current density of 0.6 mA cm −2 for ethanol was obtained using the SD‐CuCd 2 catalyst at the relatively low overpotential of 0.89 V in a CO 2 ‐saturated aqueous 0.10 m KHCO 3 solution with an H‐cell. The current density increased by an order of magnitude under similar conditions using a flow cell where the mass transport rate for CO 2 was greatly enhanced. Ex situ spectroscopic and microscopic, and voltammetric investigations pointed to the role of abundant phase boundaries between CdS and Cu + /Cu sites in the SD‐CuCd 2 catalyst in enhancing the selectivity and efficiency of ethanol formation at low potentials.
Publisher: Springer Science and Business Media LLC
Date: 15-06-2021
DOI: 10.1186/S41100-021-00355-7
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect the kidney and the presence of chronic kidney disease (CKD) constitutes a higher risk of negative prognosis. SARS-CoV-2 main sequelae in CKD patients are an incomplete recovery of kidney function, muscle weakness and atrophy, breathiness, tiredness, pulmonary fibrosis, and initiation of kidney replacement therapy. The overall aim of this review is to provide a theoretical basis for early improvements of physical function health to all CKD stages by rehabilitation therapies. Chronic kidney disease patients infected with SARS-CoV-2 should be monitored by rehabilitation professionals as the cardiopulmonary, musculoskeletal, and cognitive systems might be deteriorated. Long-term consequences of SARS-CoV-2 are unknown and preventive rehabilitation may attenuate them.
Publisher: Wiley
Date: 10-07-2011
DOI: 10.1111/J.1440-1800.2011.00537.X
Abstract: BENNETT PN. Nursing Inquiry 2011 18: 247-252 Technological intimacy in haemodialysis nursing Technology plays a major role in nursing care. Among the challenges for nurses is being able to maintain a patient focus while surrounded by highly complex technology. The provision of high quality nursing care in technologically complex environments is particularly challenging when nurses develop relationships with their patients over an extended period of time. In these environments the potential for intimate relationships can increase. This potential for intimacy is evident in the haemodialysis context where dialysis technology, nurses and patients interface. As nurses and patients can spend up to 20 hours per week together intimate relationships can develop. This paper identifies the challenges these dialysis nurses face and introduces the concept of technological intimacy. Technological intimacy can be defined as physical touching and self disclosure, associated with closeness and knowing, that is undertaken in the full view of others in a healthcare environment dominated by technology. In the haemodialysis context technological intimacy has been scarcely acknowledged and rarely researched. Further research will assist in guiding haemodialysis nursing practice.
Publisher: Elsevier BV
Date: 09-2017
Publisher: Wiley
Date: 25-08-2020
DOI: 10.1111/HDI.12870
Publisher: SAGE Publications
Date: 28-07-2020
Publisher: American Chemical Society (ACS)
Date: 12-01-2022
DOI: 10.1021/ACS.ACCOUNTS.1C00617
Abstract: ConspectusElectrochemical reduction of the greenhouse gas CO
Publisher: Springer Science and Business Media LLC
Date: 15-09-2015
Publisher: Elsevier BV
Date: 11-2021
Publisher: Elsevier BV
Date: 04-2023
Publisher: Informa UK Limited
Date: 03-2013
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1053/J.AJKD.2021.12.007
Abstract: Patients receiving hemodialysis experience high symptom burden and low quality of life (QOL). Electronic patient-reported outcome measures (e-PROMs) monitoring with feedback to clinicians may be an acceptable intervention to improve health-related QOL for patients receiving hemodialysis. This study explored patient and clinician perspectives on e-PROMs monitoring with feedback to clinicians. Qualitative study. 41 participants (12 patients, 13 nephrologists, 16 dialysis nurses) who participated in a 6-month feasibility pilot study of adults receiving facility-based hemodialysis across 4 Australian units. The intervention consisted of electronic symptom monitoring with feedback to clinicians, who also received evidence-based symptom management recommendations to improve health-related QOL. Semistructured interviews and focus group discussions explored the feasibility and acceptability of e-PROMs monitoring with feedback to clinicians. We conducted a thematic analysis of transcripts. We identified 4 themes: enabling efficient, systematic, and multidisciplinary patient-centered care experiencing limited data and options for symptom management requiring familiarity with technology and processes and identifying barriers and competing priorities. While insufficient patient engagement, logistic/technical challenges, and delayed symptom feedback emerged as barriers to implementation, active engagement by nurses in encouraging and supporting patients during survey completion and clinicians' prompt action after symptom feedback were considered to be facilitators to implementation. Limited generalizability due to inclusion of English-speaking participants only. Patients, nurses, and nephrologists considered e-PROMs monitoring with feedback to clinicians feasible for symptom management in hemodialysis. Clinician engagement, patient support, reliable technology, timely symptom feedback, and interventions to address symptom burden are likely to improve its implementation within research and clinical settings.
Publisher: Elsevier BV
Date: 02-2021
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15202
Abstract: Objectives The objective of this paper is to review and compare the content of medication management policies across seven Australian health services located in the state of Victoria. Methods The medication management policies for health professionals involved in administering medications were obtained from seven health services under one jurisdiction. Analysis focused on policy content, including the health service requirements and regulations governing practice. Results and Conclusions The policies of the seven health services contained standard information about staff authorisation, controlled medications and poisons, labelling injections and infusions, patient self-administration, documentation and managing medication errors. However, policy related to in idual health professional responsibilities, single- and double-checking medications, telephone orders and expected staff competencies varied across the seven health services. Some inconsistencies in health professionals’ responsibilities among medication management policies were identified. What is known about the topic? Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration. Medication management is a complex process involving several management and treatment decisions. Policies are developed to assist health professionals to safely manage medications and standardise practice however, co-occurring activities and interruptions increase the risk of medication errors. What does this paper add? In the present policy analysis, we identified some variation in the content of medication management policies across seven Victorian health services. Policies varied in relation to medications that require single- and double-checking, as well as by whom, nurse-initiated medications, administration rights, telephone orders and competencies required to check medications. What are the implications for practitioners? Variation in medication management policies across organisations is highlighted and raises concerns regarding consistency in governance and practice related to medication management. Lack of practice standardisation has previously been implicated in medication errors. Lack of intrajurisdictional concordance should be addressed to increase consistency. Inconsistency in expectations between healthcare services may lead to confusion about expectations among health professionals moving from one healthcare service to another, and possibly lead to increased risk of medication errors.
Publisher: Springer Science and Business Media LLC
Date: 06-09-2021
DOI: 10.1186/S12912-021-00680-6
Abstract: Nurse and Midwifery Unit Managers (NMUMs) play pivotal roles in quality patient care, nurse and midwife satisfaction and retention. NMUMs are expected to be both leaders and managers simultaneously, which may create role tension. This study aimed to explore the understanding and experience of NMUMs regarding their role to explore what barriers and facilitators NMUMs identified to achieving the goals of their clinical area and to explore NMUMs’ career plans. Set in Victoria, Australia, this study was guided by naturalistic inquiry using a qualitative descriptive approach. Thematic analysis was used to inductively develop core themes, which facilitated the motivations, experience and meanings underlying the data to be elaborated. In all, 39 interviews were conducted with NMUMs across four hospitals. Two overarching themes were identified from the data system challenges and influences on people and each theme had three sub-themes. In relation to system challenges, participants spoke about the structural challenges that they encountered such as financial stressors and physical infrastructure that made their work difficult. Participants felt they were unprepared for the NMUM role and had limited support in the preparation for the role. Participants also related their frustration of not being included in important decision-making processes within the hospital. Regarding their career plans, most did not envisage a career beyond that of a NMUM. This study of contemporary NMUMs uncovered a continued lack of investment in the orientation, professional development and support of this critical leadership and management role. There is an urgent need for targeted interventions to support and develop capabilities of NMUMs to meet the current and evolving demands of their role.
Publisher: American Chemical Society (ACS)
Date: 06-05-2021
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-039014
Abstract: People receiving haemodialysis experience a high symptom burden and impaired quality of life. The use of patient-reported outcome measures (PROMs) is increasing in nephrology care, however their acceptability, utility and impacts are not well understood. We describe a protocol for a qualitative study to evaluate the feasibility and acceptability of electronic-PROMs (e-PROMs) data capture and feedback in haemodialysis following the pilot S ymptom monitoring WI th F eedback T rial (SWIFT). SWIFT involves linkage of e-PROMs data, including symptoms and health-related quality of life, to the Australia and New Zealand Dialysis and Transplant Registry with feedback to patients’ treating nephrologists and nurse unit managers. Focus groups and semistructured interviews will be conducted with nephrologists (n=15), dialysis nurses (n=24) and patients receiving haemodialysis (n=24) from six dialysis units in Australia. Question topics will include the technical and clinical feasibility and acceptability of e-PROMs reporting and feedback (including the barriers and enablers to uptake) and perceived impact on patient care and outcomes. Transcripts will be analysed thematically and guided by Normalisation Process Theory. Ethics approval was obtained from the relevant hospital Human Research Ethics Committees (HREC/18/CALHN/481 HREC/MML/54599). The findings from the SWIFT pilot and qualitative evaluation will inform the implementation of the SWIFT main trial, and more broadly, the use of e-PROMs in clinical settings and registries. ANZCTRN12618001976279.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Wiley
Date: 04-02-2022
DOI: 10.1111/JORC.12411
Abstract: Haemodialysis plastic cannulae have been limited to incident arterio‐venous fistulae cannulation or in those who require a more flexible in situ access device. The feasibility of plastic cannulae in prevalent patients on haemodialysis has not been reported. To determine the feasibility of plastic cannulae in prevalent haemodialysis patients. Prospective feasibility crossover randomised control trial. Adults diagnosed with chronic kidney disease G5 requiring haemodialysis three or more times per week via a native arteriovenous fistula previously cannulated for at least 6 weeks. Cannulation success rate, cannulation manipulation type, arterial and venous needle pressure. Patient needle‐related anxiety as measured by the 4‐item Patient Health Questionnaire and Meditation in Dialysis Questionnaire and nurse satisfaction. Eight patients completed 12 weeks plastic canulae and metal needles. Plastic cannulae were less likely to be successful in cannulation compared to metal needles (odds ratio = 0.15 95% confidence interval [CI]: 0.05–0.48 p = 0.001). There was no effect of type of needle on the change in arterial needle pressure or change in venous needle pressure and no effect of plastic needle on repositioning (relative risk [RR] = 1.09 95% CI: 0.385, 3.089 p = .871) or gauze pillow application (RR = 0.936 95% CI: 0.467, 1.874 p = .851) than metal needles, relative to no manipulation. There were low rates of psychological distress or needle‐related anxiety towards plastic or metal needles. Plastic cannulae are feasible in prevalent haemodialysis patients, however, metal needles are still preferred in a haemodialysis center that has historically used metal needles.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Wiley
Date: 04-2015
DOI: 10.1111/HDI.12258
Abstract: Psychosocial aspects related to home hemodialysis (HD) play an important role in the success of home HD programs. Once patients commence HD at home, unique psychosocial issues related to patient and care partner burden can emerge. Proactive professional support, peer support, respite care, travel support, and financial support from the home HD health care team must be a priority for patient care. If the psychosocial aspects are not proactively addressed, patients receiving HD at home may return to in-center HD and the program may struggle as a result. This review provides a psychosocial guide for new start-up home HD programs.
Publisher: Wiley
Date: 23-08-2022
Abstract: To mitigate flooding associated with the gas diffusion layer (GDL) during electroreduction of CO 2 , we report a hydrophobicity‐graded hydrophobic GDL (HGGDL). Coating uniformly dispersed polytetrafluoroethylene (PTFE) binders on the carbon fiber skeleton of a hydrophilic GDL uniformizes the hydrophobicity of the GDL and also alleviates the gas blockage of pore channels. Further adherence of the PTFE macroporous layer (PMPL) to one side of the hydrophobic carbon fiber skeleton was aided by sintering. The introduced PMPL shows an appropriate pore size and enhanced hydrophobicity. As a result, the HGGDL offers spatial control of the hydrophobicity and hence water and gas transport over the GDL. Using a nickel‐single‐atom catalyst, the resulting HGGDL electrode provided a CO faradaic efficiency of over 83 % at a constant current density of 75 mA cm −2 for 103 h operation in a membrane electrode assembly, which is more than 16 times that achieved with a commercial GDL.
Publisher: Wiley
Date: 06-08-2009
DOI: 10.1111/J.1365-2702.2008.02765.X
Abstract: To review the literature and identify opportunities for nutritional practice improvement in the critically ill and opportunities to improve nurses' knowledge relating to enteral feeding. The literature reports varying nutritional practices in intensive care. Systematic review. A systematic search, selection, analysis and review of nursing, medical and dietetic primary research articles was undertaken. Fifteen studies met the selection criteria. Delivery of nutrition to the critically ill varied widely. Patients were frequently underfed and less frequently, overfed. Both under- and overfeeding have been linked with unacceptable consequences including infections, extended weaning from mechanical ventilation, increased length of stay and increased mortality. Underfeeding was related to slow initiation and advancement of nutrition support and avoidable feed interruptions. The most common reasons for interrupting feeds were gastrointestinal intolerance and fasting for procedures. Certain nursing practices contributed to underfeeding such as the management of gastric residual volumes. Consistent and reliable nutrition support in intensive care units is h ered by a lack of evidence leading to varying nutrition practices. Factors impeding delivery of enteral nutrition were considered avoidable. A new concept of a therapeutic range of energy delivery in the critically ill has emerged implying the need for re-evaluation of energy recommendations and improved delivery of enteral nutrition. This review supports the multi-disciplinary development and implementation of an evidence-based enteral feeding protocol in intensive care units as a strategy to improve adequacy of nutritional intake. Critical care nurses are well placed to improve this process.
Publisher: Royal Society of Chemistry (RSC)
Date: 2021
DOI: 10.1039/D0GC03999C
Abstract: Furfural can be electrochemically hydrogenated to 2-methylfuran in mild conditions with high selectivity using a catalyst containing single atom copper active sites and oxophilic phosphorus dopants.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-08-2021
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/23743735221112220
Abstract: Patient activation is the product of knowledge, skills, and confidence that enables a person to manage their own healthcare. It is associated with healthy behaviors and improved patient outcomes. We surveyed prevalent hemodialysis (HD) patients at 10 centers using the Patient Activation Measure 13-item instrument (PAM-13). Activation was reported as scores (0-100) and corresponding levels (1-4). Of 1149 eligible patients, surveys were completed by 925 patients (92% response rate). Mean age was 62 ± 14 years, 40% were female, median vintage was 41 (IQR 19-77) months, and 66% had diabetes. Mean PAM score was 56 ± 13, with 14%, 50%, 25%, and 10% in levels 1 to 4, respectively. In adjusted analysis, older age and having diabetes were associated with lower activation, whereas higher educational levels and female gender were associated with higher scores. Significant variation in activation was observed among participants from different centers even after adjustment for other variables. In conclusion, low activation is common among prevalent HD patients.
Publisher: Elsevier BV
Date: 2021
DOI: 10.2139/SSRN.3779558
Publisher: Wiley
Date: 08-10-2012
DOI: 10.1111/J.1365-2702.2012.04286.X
Abstract: To determine whether a nurse-completed dialysis nutritional screening tool improves referral rates for nutritional support and compare nutrition sensitive biochemical indices, mortality rates and patient-centred quality of life outcomes between referred and non-referred dialysis patients. People with chronic kidney disease requiring dialysis are nutritionally at risk. Nutrition screening has been shown to identify dialysis patients who are nutritionally at risk to refer to dietitian expertise. Prospective cluster-randomised control trial. Monthly nurse-completed nutrition screening was completed for six consecutive months using a validated four-item instrument measuring weight change, serum phosphate, serum potassium and appetite. Participants (n = 81) were haemodialysis patients from four satellite haemodialysis centres in one Australian metropolitan health service. Primary outcome measure was rate of referral to dietetic services for nutrition support for intervention vs. control groups at six months. Secondary outcome measures were blood pressure, biochemical indices and mortality for referred vs. non-referred patients at six and nine months, and generic and dialysis-specific quality of life for referred vs. non-referred at nine months was examined. There were three times as many dietetic referrals in the intervention group than in the control group (26·3 vs. 9·3%). Serum phosphate increased significantly more in the referred patients than the non-referred patients. There were no clinically significant changes between groups in quality of life, blood pressure, mortality rates or other biochemical indices at either six or nine months. Nurse-completed nutritional screening can lead to appropriate dietetic referrals for nutritional support by nutritional expert clinicians. This study is the first to demonstrate that monthly systematic nurse-completed nutritional screening can facilitate appropriate dietetic referrals that may lead to increased nutritional care for people in satellite dialysis centres.
Publisher: Wiley
Date: 28-10-2011
DOI: 10.1111/J.1755-6686.2011.00220.X
Abstract: This literature review explored the extant literature to further our understanding of the experience of being a parent on dialysis. Keywords used to search the literature were haemodialysis, hemodialysis, chronic kidney disease, end stage renal disease, parent and experience. Databases searched included CINAHL, Medline, Wiley/Blackwell, EBSCOHost, Web of Science, Pubmed and ProQuest. Years included were 1999-2009. Seventeen primary research articles (sixteen qualitative, one mixed methods) met the search criteria with only one on parents undergoing dialysis. The experience of the parent on dialysis has rarely been explored in the literature. Related research has indicated important themes including: restricted lives relationships adjustment consequences and future outlook. More should be known about challenges that face parents who receive dialysis. This review established an urgent need for further research to determine the experiences and needs of this population to provide empirical, person-centred nursing care.
Publisher: Springer Science and Business Media LLC
Date: 26-11-2015
DOI: 10.1038/NCOMMS9910
Abstract: Outlet glaciers grounded on a bed that deepens inland and extends below sea level are potentially vulnerable to ‘marine ice sheet instability’. This instability, which may lead to runaway ice loss, has been simulated in models, but its consequences have not been directly observed in geological records. Here we provide new surface-exposure ages from an outlet of the East Antarctic Ice Sheet that reveal rapid glacier thinning occurred approximately 7,000 years ago, in the absence of large environmental changes. Glacier thinning persisted for more than two and a half centuries, resulting in hundreds of metres of ice loss. Numerical simulations indicate that ice surface drawdown accelerated when the otherwise steadily retreating glacier encountered a bedrock trough. Together, the geological reconstruction and numerical simulations suggest that centennial-scale glacier thinning arose from unstable grounding line retreat. Capturing these instability processes in ice sheet models is important for predicting Antarctica’s future contribution to sea level change.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.OUTLOOK.2016.11.005
Abstract: The use of the term care partner has increased, particularly in the chronic disease literature however, the concept has not been well defined. The purpose of this concept analysis was to define and assist nurses to better understand the concept of care partner. The method by Walker and Avant was used for this literature-based concept analysis. Care partnering includes providing assistance to an in idual with a health condition to meet their self-care deficits, the commitment to a care partner relationship, and the recognition that people with self-care deficits are care partners contributing to their own care. Emphasizing the care partner dyad in nursing may contribute to improved patient care outcomes both in the acute and chronic settings. It is recommended that nurses view the person with the condition as a contributor and partner in their own care in the context of a larger care partnership.
Publisher: Royal Society of Chemistry (RSC)
Date: 2021
DOI: 10.1039/D0CC07549C
Abstract: Advanced data analysis tools such as mathematical optimisation, Bayesian inference and machine learning have the capability to revolutionise the field of quantitative voltammetry.
Publisher: SAGE Publications
Date: 27-01-2022
DOI: 10.1177/11297298211069821
Abstract: Standard cannulation practice for hemodialysis consists of inserting needles “blindly” through skin into an arteriovenous fistula (AVF), which is more likely to cause damage. Point-of-care ultrasound (POCUS) guided cannulation has potential for less damage however, efficacy of this technique has not been explored. Our purpose was to test the feasibility and effectiveness of POCUS guidance for cannulation of AVFs in hemodialysis patients. A random-order crossover research design was used patients and nurses acted as their own control. S le included 13 patients with functioning AVFs and 9 nurses, recruited from a single hemodialysis center. All nurses cannulated all patients using standard and POCUS-guided cannulation. Data were collected at each cannulation (time taken, nurse position, probe direction, pressures, patient satisfaction, pain scores). Ultrasound images of needle position were collected from which needle tip locations inside vessels were measured. Nurses were surveyed at three timepoints and were interviewed at conclusion of data collection. Analysis involved linear mixed-models for clinical data, descriptive statistics for binary and feasibility data, and content analysis for interview data. Eleven patients and seven nurses completed. Protocol adherence was 94.4%. Two miscannulations occurred, both during standard cannulation. Cannulation time using POCUS guidance was significantly higher than standard cannulation ( p = 0.008, 95% CI 39–166). All other variables showed no statistically significant difference. Content analysis of interview data showed cultural shift toward use of POCUS nurses gained confidence and become more proficient in their POCUS technique. Random-order crossover is a feasible design to measure differences in POCUS-guided and standard cannulation. It is also feasible to implement POCUS into hemodialysis centers and whilst POCUS guidance takes longer, nurses become more proficient, and confident with persistent use.
Publisher: Wiley
Date: 03-2008
DOI: 10.1111/J.1755-6686.2008.00007.X
Abstract: To explore nurse stress in both in-centre hospital haemodialysis and satellite haemodialysis unit in an Australian city's health service. Focus groups from both in-centre and satellite dialysis units were undertaken followed by questionnaires generated by the focus group data. In-centre nursing staff rated the busyness of the unit as the maximum stress and stated that they felt this high level of stress on a daily basis. The most notable stressor for the staff at the satellite unit related to patient behaviour and the perceived unrealistic expectations of the patient followed by patients arriving unwell at the unit. Nurses suffer stress on a daily basis in both in-centre and satellite dialysis units. The major stressors differ from in-centre to satellite dialysis units.
Publisher: Wiley
Date: 03-02-2022
DOI: 10.1111/SDI.13060
Abstract: The benefits of exercise interventions in in iduals with chronic kidney disease have been widely reviewed however, exercise has not yet been incorporated into routine clinical practice. In athletic populations, the goals of exercise training are to improve a specific aspect of physical performance such as strength or endurance, to ultimately optimize physical performance. This contrasts with many chronic kidney disease exercise studies where the goals are more aligned to a minimal effect, such as prevention of decline in physical function, frailty or protein energy wasting (PEW), weight loss for cardiovascular disease risk reduction, and risk minimization for mortality. In athletic populations, there are common targeted nutrition strategies used to optimize physical performance. In this review, we consider the evidence for and potential benefits of targeted nutrition strategies to complement well‐designed exercise interventions to improve physical performance in people with chronic kidney disease and dialysis. Overall, we found a small number of studies using targeted protein supplementation in combination with a variety of exercise protocols however, results were mixed. Future studies in people with chronic kidney disease should optimize acute (pre, during, and postexercise) and chronic nutritional status, utilizing targeted nutrition interventions proven in athletes to have benefit.
Publisher: Wiley
Date: 20-05-2014
DOI: 10.1111/NEP.12231
Abstract: There has been a global decline in the uptake of home-based dialysis therapies in the past 20 years. The ability to provide appropriate information to potential patients in this area may be confounded by a lack of knowledge of home dialysis options. The aim of this study was to develop a web-based education package for health professionals to increase knowledge and positive perceptions of home-based dialysis options. A three-module e-learning package concerning home dialysis was developed under the auspices of the home dialysis first project. These modules were tested on 88 undergraduate health professionals. Changes in attitudes and knowledge of home dialysis were measured using custom designed surveys administered electronically to students who completed the modules. Matched pre and post responses to the survey items were compared using Wilcoxon signed rank tests. The pre survey indicated clear deficits in existing knowledge of home dialysis options. In particular, when asked if haemodialysis could be performed at home, 22% of participants responded 'definitely no' and a further 24% responded 'probably no'. Upon completion of the e-learning, post survey responses indicated statistically significant improvements (P < 0.001) in eight of the nine items. When asked if the e-learning had increased their knowledge about home dialysis, 99% of participants responded 'definitely yes'. A suite of web-based education modules can successfully deliver significant improvements in awareness and knowledge around home dialysis therapies.
Publisher: Wiley
Date: 07-2019
DOI: 10.1111/SDI.12816
Publisher: Wiley
Date: 02-11-2017
DOI: 10.1111/SDI.12656
Abstract: Coping with the stress and anxiety caused by end stage kidney disease (ESKD) symptoms, treatment, restrictions, and social, financial and family stressors, consumes many afflicted with kidney disease. Meditation has been shown to decrease anxiety and stress, and improve wellbeing and quality of life of people with chronic disease. However, the clinical uptake of meditation is low in the ESKD dialysis population. This review describes what meditation and mindful meditation are and how they have been used for people with ESKD. Further research, using active control conditions and larger s le size, is required to identify effective meditation interventions that can improve the wellbeing of our patients and their ability to cope with the demands of ESKD.
Publisher: Springer Science and Business Media LLC
Date: 26-11-2018
Publisher: Springer Science and Business Media LLC
Date: 03-02-2023
Publisher: Elsevier BV
Date: 2019
Publisher: Royal Society of Chemistry (RSC)
Date: 2022
DOI: 10.1039/D2NR03539A
Abstract: Alloying is efficient for tuning product selectivity of copper in electrochemical reduction of CO 2 . Different alloying strategies and their impacts on product formation paths, the key challenges and future directions of the field have been reviewed.
Publisher: Springer Science and Business Media LLC
Date: 13-02-2023
Publisher: Wiley
Date: 24-03-2019
DOI: 10.1111/SDI.12784
Abstract: People with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) are physically inactive leading to low physical function and poor health outcomes. Guidelines recommend that nephrologists encourage PD patients to increase their activity levels however, PD patients are often discouraged from participating in exercise programs because of perceived barriers and a lack of precision about the appropriate exercise regimen. This review suggests ways forward to assist nephrology professionals to encourage PD patients to exercise, instead of creating barriers. The paper draws on the literature in addition to the experience of programs in France, the United States, and Australia to demonstrate the possibilities when considering increasing physical activity in this group.
Publisher: Wiley
Date: 14-01-2020
DOI: 10.1111/JORC.12313
Abstract: In iduals receiving peritoneal dialysis (PD) report low levels of physical activity, which increases their risk of morbidity and mortality. Little is known about their perceptions towards barriers and benefits of exercise or physical activity. The aim of this study was to explore the perceptions of exercise among people receiving PD. Cross-sectional survey. Thirty-nine adults (12 female and 27 male) with a mean age of 65 years and a median of 8 months receiving PD from one Australian dialysis service. The 26-item Dialysis Patient-Perceived Exercise Benefits and Barriers Survey was adapted to PD in order to measure self-reported barriers and benefits of exercise for people being treated with PD. The majority of the respondents reported positive perceptions towards exercise with 84.6% of the participants agreeing that exercise prevents muscular wasting 71.8% agreed that exercise can postpone a decline in body function and 69.2% agreed that exercise improves general well-being. In terms of barriers, symptoms including tiredness (69.2%) and body pain (43.6%), worrying about a fall (33.3%) and lack of exercise-related information (25.6%) were the main perceived barriers to exercise. Only 10% agreed that exercise may affect their PD catheter with 23% agreeing that fluid in their peritoneum was a barrier to exercise. People on PD hold positive perceptions towards exercise but face a number of perceived barriers to physical activity. Clinicians can acknowledge these barriers and focus on helping people on PD to overcome their perceived barriers to encourage sustained exercise participation.
Publisher: Elsevier BV
Date: 12-2022
Publisher: Wiley
Date: 04-2019
DOI: 10.1111/SDI.12787
Abstract: Theory-driven interventions are required to increase the adoption and implementation of physical activity and exercise programs among patients with ESKD. The Behavior Change Wheel (BCW) represents a synthesis of behavior change theories and can be used to aid the systematic development of theory-driven interventions designed to change exercise behavior. The goal of this review was to synthesize barriers and facilitators to engagement and implementation of exercise and develop theory-based recommendations for exercise behavior change interventions in patients with ESKD. We applied the BCW in the current context of exercise for ESKD patients and conducted an analysis of patients' and health care professionals' (HCPs) capabilities, opportunities, and motivations to engage or promote exercise, respectively. Our analysis identified a number of salient barriers that could be targeted via intervention to increase levels of physical activity and exercise. Intervention functions identified as most likely to change patient behavior included training, enablement, education, restructuring environment, persuasion, modeling, incentivizing, and coercion. Similarly, intervention functions most likely to change HCPs behavior for exercise promotion included training, modeling, education, environmental restructuring, persuasion, and incentivizing. We also considered potential over-arching policy changes required to support these interventions. Our findings provide theory-based recommendations that can help inform future clinical and research decision-making for implementing exercise interventions in these patients. However, high-quality research in this area is desperately needed to ensure that interventions not only be theory-driven, but evidence-based.
Publisher: Wiley
Date: 12-03-2023
DOI: 10.1111/WVN.12634
Abstract: Chronic kidney disease (CKD) is a complex health condition that profoundly impacts an in idual's general health and well‐being throughout their entire lifetime. People with CKD require the knowledge, confidence, and skills to actively self‐manage their health. This is referred to as patient activation. The efficacy of interventions to increase patient activation in the CKD population is unclear. This study aimed to examine the effectiveness of patient activation interventions on behavioral health‐related outcomes among people with CKD stages 3–5. A systematic review and meta‐analysis of randomized controlled trials (RCTs) of patients with CKD stages 3–5 was performed. MEDLINE, EMCARE, EMBASE, and PsychINFO databases were searched between 2005 and February 2021. Risk of bias was assessed using the Joanna Bridge Institute critical appraisal tool. Nineteen RCTs that enrolled 4414 participants were included for synthesis. Only one RCT reported patient activation using the validated 13‐item patient activation measure (PAM–13). Four studies demonstrated strong evidence that the intervention group developed a higher level of self‐management compared to the control group (standardized mean differences [SMD] = 1.12, 95% CI [0.36, 1.87], p = .004). Eight RCTs led to a significant improvement in self‐efficacy (SMD = 0.73, 95% CI [0.39, 1.06], p .0001). There was weak to no evidence on the effect of the strategies shown on the physical component and mental components of health‐related quality of life, and medication adherence. This meta‐analysis highlights the importance of including tailored interventions using a cluster approach including patient education, goal setting with in idualized action plan, and problem‐solving to engage patients to be more actively involved in the self‐management of their CKD.
Publisher: MDPI AG
Date: 19-07-2022
DOI: 10.3390/NU14142946
Abstract: Background: Oral nutritional supplementation (ONS) with or without exercise (EX) could improve muscle mass (MM) in chronic kidney disease. Methods: Patients were randomized into two groups: (1) ONS and (2) ONS + EX. Thigh muscle area (cm2) and intramuscular lipid content via attenuation were evaluated at baseline and 6 months with computed tomography (CT) to measure MM quantity and quality. Physical function was measured by six-minute walk test (6 MWT), gait speed, handgrip strength (HGS), and Time Up and Go test (TUG) at baseline and 3 and 6 months. Results: The ONS group (n= 14) showed statistically significant improvement in gait speed and HGS ONS + EX group (n = 10) showed differences in gait speed, in 6 MWT, and HGS. In the ANOVA (3 times × 2 groups), no differences were observed between groups. Greater effect sizes in favor to ONS + EX group were observed in the 6 MWT (d = 1.02) and TUG test (d = 0.63). Muscle quality at six months revealed a significant trend in favor of the EX-group (p = 0.054). Conclusions: Both groups had improved physical function, and greater effect sizes were seen in the ONS + EX group for the 6 MWT and TUG test. Neither MM quantity or quality was improved in either group.
Publisher: Elsevier BV
Date: 05-2014
Publisher: Wiley
Date: 13-10-2015
DOI: 10.1111/WVN.12115
Abstract: Single checking medications has been increasingly adopted over the past decade by nurses in Australian healthcare services. However, attitudes toward the practice of only one nurse checking medications remain unclear. The aim of this article is to report on the development, reliability, and validity of a tool to measure nurses' attitudes to single checking medications in a health service in which single checking has been in place for over a decade. In a cross-sectional survey design, the Single Checking and Administration of Medications Scale (SCAMS-II) was used to measure the attitudes of 299 registered nurses (RNs) who were single checking medications in one metropolitan teaching hospital in Australia. Exploratory factor analysis was used to explore the dimensions that best represented the SCAMS-II. Cronbach's α was used to assess internal consistency of the identified subscales. To test the construct validity of the emergent questionnaire, Confirmatory Factor Analysis and Rasch analyses were performed. The psychometric properties of the SCAMS-II revealed 12 items with three reliable subscales: a five-item accountability model a four-item efficiency model and a three-item knowledge model. In settings where single checking is current practice, the SCAMS-II is recommended as a reliable tool to measure nurses' attitudes toward the single checking of medications. The findings from this study may assist healthcare organizations in the development of policy and procedure guidelines for the safe administration of medications.
No related grants have been discovered for Paul N Bennett.