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Biomedical subjects

J Clare

Publications and source records attributed to J Clare.

At least 19 recordsLinked to original sources
PubMed2002

Who would want to be a nurse? Violence in the workplace--a factor in recruitment and retention.

In a climate of a declining nursing workforce where violence and hostility is a part of the day-to-day lives of most nurses, it is timely to name violence as a major factor in the recruitment and retention of registered nurses in the health system. Workplace violence takes many forms such as aggression, harassment, bullying, intimidation and assault. Violent acts are perpetrated against nurses from various quarters including patients, relatives, other nurses and other professional groups. Research suggests that nurse managers are implicated in workplace violence and bullying. Furthermore, there may be a direct link between episodes of violence and aggression towards nurses and sick leave, burnout and poor recruitment and retention rates. This paper explores what is known about workplace violence as it affects nurses, and calls for managerial support and policy to act to improve work environments for all nurses.

Humans↗
PubMed2001

Peak flow technique and the 'windmill' trainer in older subjects admitted with acute airflow limitation.

METHODS: peak expiratory flow technique was assessed as being satisfactory or unsatisfactory in consecutive patients >60 years with an acute exacerbation of airflow obstruction, admitted to an integrated medical and elderly unit. RESULTS: at baseline assessment, 16 (25%) of 63 patients had satisfactory peak expiratory flow technique. After conventional teaching, this improved to 38 (60%) of 63 (P<0.0001). Further instruction using a 'windmill' device failed to improve the number with a satisfactory technique.

Acute Disease↗
PubMed1999

Localization of the type VI voltage-gated sodium channel protein in human CNS.

The cellular distribution of the type VI human voltage-gated sodium channel (Type VI) was examined in selected human brain regions. Antibodies designed to be specific to rat and human Type VI were raised against a synthetic peptide from the predicted NH2-terminal of the protein, and used for an immunohistochemical investigation. Immunoblot experiments showed that purified antibodies specifically detected the presence of Type VI in transfected cells and human brain membrane preparations. Immunohistochemistry on perfusion fixed human tissue revealed a predominantly somato-dendritic distribution of Type VI in major output neurons of the cerebellum, cerebral cortex and hippocampus. The observed localisation of this channel may reflect an important role in the integration of synaptic input in the human CNS.

Animals↗
PubMed1999

Evaluation of a model of collaboration: academic and clinician partnership in the development and implementation of undergraduate teaching.

The difficulty nursing students experience in making the transition from the university to clinical context is attributed to the gap between theory and practice, and education and service. Collaboration between academics and clinicians in the provision of undergraduate education is considered to be a strategy for overcoming these problems. A project team consisting of four academics and six clinicians collaboratively developed and implemented an acute care topic, in the third year of a pre-registration nursing course at the School of Nursing, Flinders University. A review of the literature did not provide examples of collaborative models relevant to undergraduate teaching. The subsequent model, devised by the project team, focused on technical, cultural and interpersonal aspects of collaborative teaching. The model was evaluated by illuminative research methods. Participants in the project included academics (n = 4), clinicians (n = 6) and students (n = 104). Student questionnaires and academic and clinician interviews were used to inform evaluation procedures. The qualitative data was coded and analysed based upon the definitions and characteristics of collaboration described by Henneman et al (1995). Study findings demonstrated that the model was effective in facilitating collaborative relationships necessary for the successful development and implementation of reality-based learning for students.

Cooperative Behavior↗
PubMed1999

Rhetoric to practice: the challenge of collaboration of academe and industry.

Community health nursing is a complex practice that encompasses nurses working in many diverse settings. This article discusses the development of a project which focused on better preparation of students for potential employment in community settings. The formation of the working team and the development of the curriculum is outlined. A focus is given to the linking of primary health care principles in the teaching and facilitation of students within hospital and community settings. Comprehensive conclusions cannot be made yet from the project's preliminary findings. However, the process of collaboration has demonstrated several issues. These will have an impact on everyone who has been part of this project, and the issues are discussed in this article. The article provides an overview of the first year of collaboration of a 4-year project.

Community Health Nursing↗
PubMed1999

The role of the hospital liaison nurse in effective discharge planning for older people: perspectives of discharge planners.

The study identified effective discharge planning for older people from the perspectives of older people, their carers and nursing and social work discharge planners at a city hospital. This article discusses findings from the discharge planners who argued discharge planning was dependent upon effective communication between hospital and community staff, older people and their carers. They felt frustrated in their attempts to facilitate continuity of care within a casemix environment, and identified the pivotal role of the hospital liaison nurse in effective discharge planning. In addition, they called for ongoing reviews of hospital and community discharge planning practice, secondment of nurses between sectors to increase knowledge of other health services, and collaborative research.

Aged↗
PubMed1998

Expression of tetanus toxin fragment C.

1. The yield of fragment C was only modestly affected by Mut phenotype, and the site and type of integration event. 2. Fragment C accumulation was closely correlated with gene dosage and maximal expression levels required high gene copy number. 3. Yields were greatly increased in controlled fermenters, compared to shake-flasks, owing to the high cell density achieved and to an increased efficiency of induction (2.5- to 10-fold). 4. In fermenter inductions of a 14-copy strain, fragment C accumulated to 27% of total protein, giving an estimated yield of 12 g/L. 5. Considerable clonal variation in the level of expression occurred with transplacement transformants, and this was owing to a diversity of different integration events and to differences in gene copy number. 6. These multicopy transplacement events occur by in vivo circularization of transforming DNA fragments followed by repeated single-crossover integration. This is presumably a general phenomenon, such that it should be possible to obtain multicopy integrants from all P. pastoris transplacement transformations.

Alcohol Oxidoreductases↗
PubMed1998

Expression of EGF and HIV envelope glycoprotein.

1. The S. cerevisiae alpha-factor prepro leader is functional and is correctly processed in P. pastoris. 2. P. pastoris has a high secretory capacity, but yields can be severely reduced by extracellular proteases. This problem can be reduced by altering the medium composition, e.g., adjusting the pH or by adding casamino acids. 3. A rapid DNA dot-blot technique can be used for mass screening of transformants to obtain high-copy-number, high-expressing strains. 4. For mEGF, which is an efficiently secreted protein, there was a good correlation between gene dosage and yield, and maximum levels were obtained at high copy number. 5. Vectors conferring resistance to G418 have been developed for the selection of high-copy-number transformants. These vectors can also be used to isolate a series of transformants with increasing copy number of optimizing the expression of genes where high copy number may be detrimental. 6. The HIV-1 ENV gene was not expressed in P. pastoris owing to fortuitous termination of transcription within AT-rich regions. This is a species-specific phenomenon, since full-length HIV-1 ENV transcripts are produced in S. cerevisiae. The problem was overcome by synthesizing the relevent portion of the gene with increased GC content. 7. ENV was hyperglycosylated and immunologically inactive when secreted by P. pastoris. The yield was reduced by extracellular proteases, but like mEGF, this could be significantly improved by altering the pH of the culture medium and by adding casamino acids. 8. In single-copy integrants, transcripts from the semisynthetic HIV-1 ENV gene were almost as abundant as endogenous AOX1. Transcript levels increased progressively with increasing copy number, showing that the AOX1 promoter is not greatly limited by the level of trans-activating factors.

Animals↗
PubMed1997

Planning aged care in Australia: a review and critique of the reforms 1975-96.

The residential aged-care reforms implemented a decade ago in Australia have seen the planning of nursing-home beds, hostel places and home/community care using a rigid, demographically-based formula. This planning had its roots in a number of commissioned reports and reviews, and the aim was control over the unsustainable growth of the nursing-home industry and a reversal of the trend toward institutionalisation of the elderly. The demographic profile of the Australian population is changing and the profile of nursing-home and hostel residents has also changed. Community services appear inadequate for a continuum of care and de-institutionalisation. Acute services have adopted a casemix-based system of funding, which has an effect on appropriate care of the elderly by moving more elderly patients out of the acute institutions into the community, hostels and nursing homes. Despite all these shifts, the planning ratio for nursing-home beds remains as set in 1986. This paper provides an overview of the federal government's planning of aged care in Australia from an historical perspective, one which identifies some of the influences that have had a bearing on the planning process. Further discussion centres around what is occurring in aged care, as related to the planning arrangements and with an emphasis on nursing-home-based care. The present planning ratio is restrictive and has not been researched for appropriateness or validity on a national basis, which brings into question its reliability in planning for the future health-care needs of the elderly population. The planning of aged care can only be accomplished with any reliability when the many variables impinging on aged care have been clearly defined.

Aged↗
PubMed1997

Curriculum collaboration and the Ottawa Charter: a nursing initiative.

The World Health Organization (WHO) and the International Council of Nurses (ICN) have been consistent in their call for nurses to be involved with Primary Health Care (PHC). This paper will demonstrate how an innovative partnership between the School of Nursing, Flinders University of South Australia (FUSA) and Noarlunga Health Services (NHS) has been instrumental in developing an undergraduate nursing curriculum which has the potential to guide future nursing practice. The Community Enrichment Project (CEP) has been an example of health promotion in practice and demonstrates how a PHC philosophy can permeate all levels of health care.

Community Health Nursing↗
PubMed1996

From university student to registered nurse: the perennial enigma.

Crucial issues related to the transition from university student to registered nurse are addressed, through a review of the literature. The considerable literature in this area indicates three distinct approaches in examining this question: there are personal and professional deficits which the new graduate must make up, the formal content of the university curriculum is deficient and must be replaced, the socio-political and professional contexts of practice constrains beginning practice. Each of these approaches is examined here in the expectation that uncovering these issues will encourage employers and educators to work together to resolve some of the current conflicts and difficulties inherent in the transition from university student to registered nurse. Various models of transition in current use are then explored, since support for the graduate is paramount for provision of a cost effective and efficient nursing service in a rapidly changing health service environment.

Adaptation, Psychological↗
PubMed1993

Cloning and expression of a rat neuronal nitric oxide synthase coding sequence in a baculovirus/insect cell system.

A DNA sequence encoding rat neuronal NO synthase (nNOS) was isolated and cloned into the baculovirus expression vector pVL1393 to generate pVLRBNOS. Transfection of Spodoptera frugiperda Sf-21 cells with the construct pVLRBNOS resulted in the synthesis of high levels of neuronal NO synthase. Analysis of the expression pattern revealed soluble, enzymatically active NO synthase in the cytoplasm of cell extracts. Active enzyme could also be purified from culture supernatants using 2'-5' ADP sepharose affinity chromatography. This enzyme was recognised by antibodies to the native nNOS and showed a similar degree of inhibition by arginine analogs as the native nNOS. The majority of the NOS synthesised had accumulated as insoluble "inclusion-body" material. The purification of recombinant nNOS from insect cells should facilitate characterisation of neuronal NO synthase.

Amino Acid Oxidoreductases↗
PubMed1993

Change the curriculum--or transform the conditions of practice?

This paper explores the notion that contemporary teaching practices reinforce and maintain the legitimacy of traditional relations of power between teachers and students of nursing. Nurse teachers and clinicians have socially constructed and legitimated power over students which acts to constrain the development of critical consciousness. Student-centred learning packages and strategies such as problem-solving, questioning and dialogue may give the impression of student empowerment while leaving the authoritarian nature of teacher-student relationships intact. Furthermore nursing education is premised on the belief that 'real' learning takes place in the classroom (where teaching occurs) and is consolidated by practice (where nursing occurs). This situation creates a major dilemma for all teachers since the contradictions between classroom knowledge and experiential clinical knowledge are seldom officially recognised. The rhetoric of critical social science however, suggests that emancipation and empowerment of teachers and students would follow their enlightenment as to the nature of these contradictions. This assumption discounts the ways in which hegemonic ideology shapes the consciousness of nurses to accept dominant views of what constitutes professional practice or legitimate knowledge and how that may be obtained.

Authoritarianism↗
PubMed1993

A challenge to the rhetoric of emancipation: recreating a professional culture.

This paper explores the notion that nursing education is a political process which reproduces traditional practices. There is evidence to suggest that dominant ideologies, embedded in the social processes of education and health care, shape the consciousness of nurse teachers and students towards conformity and compliance with established practices in hegemonic institutions. Traditional practices or 'common sense' reinforces the structural arrangements which contribute to the contradictions that students experience between knowledge they are 'given' in the classroom and knowledge they derive from their clinical learning experiences. It is clinical placements which bring students face to face with their position in the established hierarchy of knowledge, professional relationships and routinized practices. In this sense students may experience their classroom education as a denial of their lived experience in clinical settings. They may learn to negotiate among the different meanings and explanations they encounter and learn to act in ways that are personally and professionally 'safe', thereby reproducing traditional nursing culture. Project 2000 in Great Britain and the calls for a 'curriculum revolution' from North America promise transformation of traditional practice. But it is the political processes of teaching and learning and their practical effects which must be revealed for critique and transformation if professional ideals of reflective practice, emancipatory knowledge and professional autonomy are to play an integral part in transforming professional nursing practice within hegemonic institutions.

Attitude↗
PubMed1991

Transforming health care: does nursing theory have anything to offer?

The notions of power, empowerment and autonomy have received little attention in modern nursing theory yet they lie at the very heart of primary health care. This paper explores the ways in which critical social theory, and in particular Habermas's knowledge-constitutive interests, might inform nursing theory. It then goes on to argue that incorporating the principles of primary health care in nursing theory requires a radical reconceptualisation of key concepts.

Freedom↗