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Biomedical subjects

Sharon Kendall

Publications and source records attributed to Sharon Kendall.

8 recordsLinked to original sources
PubMed2007

Review of effective advanced cardiac life support training using experiential learning.

AIMS AND OBJECTIVES: This paper examines issues of contention regarding current practices and suggests the application of the experiential theory of learning (incorporating reflective practice) to advanced cardiac life support (ACLS) training. BACKGROUND: The need for formalized training in cardiopulmonary resuscitation (CPR) and ACLS is well documented. However, the effectiveness of traditional training programmes has not been firmly established. The question still remains - how to best ensure transfer of learning enabling learners to apply classroom knowledge successfully in the clinical setting. It is argued that educators can no longer rely on traditional teaching methods and more effective learner-centred education techniques are required. METHOD: A review of available literature regarding ACLS training has been conducted for this discussion. DATA SOURCES AND SELECTION: MEDLINE, CINAHL, OVID, Expanded Academic and Proquest were searched using textwords. English-language articles related to CPR and ACLS practices and also experiential learning were reviewed. Additional references were also reviewed from the bibliographies and from citation searches on key articles. Articles related to CPR/ACLS and experiential learning practices published within the last 10 years were reviewed. RESULTS: There is evidence that past ACLS training programmes have proven inconsistent and inadequate, with numerous studies reporting trainees have poor retention; and, therefore, ineffective ACLS skills as a result. CONCLUSIONS: The reviewed literature demonstrates that the need for effective ACLS training is clear. Increasing numbers of critically ill patients in hospitals means that it has never been more important to ensure the competence of healthcare professionals. Training must give learners a chance to pull together all aspects of ACLS and the use of experiential learning has the potential to achieve this aim. RELEVANCE TO CLINICAL PRACTICE: It is argued that providing training designed and implemented using experimental learning enhances learning through critical thinking and reflection, and subsequently should improve ACLS outcomes.

Advanced Cardiac Life Support↗
PubMed2006

Admiring courage: Nurses' perceptions of caring for patients with cancer.

This paper details one of the findings of a large phenomenological study into the effects of nurse-patient encounters on clinical learning and practice. Every nurse faces the challenge of caring for a patient with cancer at some point in his or her nursing career. The participants, 392 nurses, were asked to provide an account of a care episode from their practice. These narrative/clinical exemplars were for a patient with a diagnosis of cancer and participants were asked to discuss the impact this encounter had on clinical learning and clinical practice. Each day nurses work through the daily grind of the job and occasionally encounter a person, who inspires them, someone they admire because of their courage. Responses from the participants identified a number of such people. Nurses used powerful language, brave, strong, courageous, to describe these patients. The diagnosis of cancer is a daunting prospect and is seen as a challenge physically and emotionally. Participants spoke of their admiration, affection and their sadness when describing the nurse-patient encounters. The life-threatening potential of cancer for the patient and the perception of potential and actual suffering does impact on nurses, their learning and their clinical practice. The struggle against such a daunting adversary places patients diagnosed with cancer in a position to be seen by nurses as people with immense courage. Participants clearly felt the influence of patients' courage, personally and professionally. Many spoke of the inspirational qualities of their patients. Participants detailed learning from the encounters and reflected with great insight on themselves and their practice. The identified nurse-patient encounters were seen to have changed their clinical practice forever.

Humans↗
PubMed2006

Being asked not to tell: nurses' experiences of caring for cancer patients not told their diagnosis.

AIMS AND OBJECTIVES: The aim of the primary research was to investigate the impact of the nurse-patient relationship on clinical learning and subsequently clinical practice. Coincidently, 32 participants, all Registered Nurses in Hong Kong, provided details of nurse-patient encounters involving withholding of a cancer diagnosis. BACKGROUND: The changing face of clinical practice and cancer care has fuelled discussion and debate around disclosure or non-disclosure of the diagnosis of cancer, global consensus on this issue still does not exist. In different countries there is marked variation in how and what a patient may be told about their diagnosis and prognosis. There is considerable variability in the reported rate of cancer diagnosis disclosure across studies and countries. Being asked not to tell a patient their diagnosis of cancer presents many problems for nurses caring for those patients. The issue of non-disclosure directly affects nurses and their clinical practice. METHODS: This paper reports one of the findings of a large international qualitative study informed by phenomenology into the perceptions of nurses about caring for a patient with a diagnosis of cancer. RESULTS: Responses from participants revealed considerable difficulties for nurses when caring for patients who were not informed of their diagnosis. They recounted having learned from the encounters but remarked on the negativity of the experience. They discussed their inability to act decisively in the past situations but expressed hope that they had found a resolve to act in future. RELEVANCE TO CLINICAL PRACTICE: Although, overwhelmingly, participants doubted they would actually be able to change the reality of practice. The identified care episode and the nurse-patient relationship, according to participants, did change their clinical practice but often not for the better.

Adaptation, Psychological↗
PubMed2006

Advocating for a harm-minimization approach to drug education in Australian schools.

The concept of using a harm-minimization approach to drug education in Australian schools has existed in both national and state government policy documents for over two decades. However, this approach appears to be ineffectively and inconsistently incorporated within the curriculum. Harm minimization emphasizes strategies that reduce the harms associated with drug use and prevent related health and social problems. Traditional drug education programs that promote abstinence as the only option may not be realistic and appear to have had limited success. School nurses in the state of Victoria have a significant role in improving both the understanding and adoption of this approach through advocacy, education, and their understanding of evidence-based practice.

Adolescent↗
PubMed2004

The Mycobacterium tuberculosis sigJ gene controls sensitivity of the bacterium to hydrogen peroxide.

Sigma factors are important global regulators which control bacterial gene expression during growth and in response to stress. Previous work showed that mRNA of the sigJ gene was up-regulated in late stationary-phase and after rifampicin treatment. In order to verify the function of SigJ, we constructed a Mycobacterium tuberculosis mutant lacking the sigJ gene. In a microaerophilic stationary-phase model, the sigJ mutant showed the same growth pattern as the wild-type strain. In an immune stasis murine model in which the bacterial number plateaued between the second and the 15th week, the mutant showed a similar growth curve to the wild-type strain. However, the sigJ mutant was more susceptible to killing by H2O2 than its parental strain. The parental level of sensitivity to H2O2 was recovered in the sigJ complemented strain. These data suggest that the SigJ protein is not essential for survival in long-term stationary phase or in bacterial stasis in mice. However, the sigJ gene may control an alternative H2O2 resistance pathway.

Animals↗
PubMed2003

Deletion of two-component regulatory systems increases the virulence of Mycobacterium tuberculosis.

Two-component regulatory signal transduction systems are widely distributed among bacteria and enable the organisms to make coordinated changes in gene expression in response to a variety of environmental stimuli. The genome sequence of Mycobacterium tuberculosis contains 11 complete two-component systems, four isolated homologous regulators, and three isolated homologous sensors. We have constructed defined mutations in six of these genes and measured virulence in a SCID mouse model. Mice infected with four of the mutants (deletions of devR, tcrXY, trcS, and kdpDE) died more rapidly than those infected with wild-type bacteria. The other two mutants (narL and Rv3220c) showed no change compared to the wild-type H37Rv strain. The most hypervirulent mutant (devRdelta) also grew more rapidly in the acute stage of infection in immunocompetent mice and in gamma interferon-activated macrophages. These results define a novel class of genes in this pathogen whose presence slows down its multiplication in vivo or increases its susceptibility to host killing mechanisms. Thus, M. tuberculosis actively maintains a balance between its own survival and that of the host.

Animals↗
PubMed2002

Consequences of livestock grazing on water quality and Benthic algal biomass in a Canadian natural grassland plateau.

The effects of livestock grazing on selected riparian and stream attributes, water chemistry, and algal biomass were investigated over a two-year period using livestock enclosures and by completing stream surveys in the Cypress Hills grassland plateau, Alberta, Canada. Livestock enclosure experiments, partially replicated in three streams, comprised four treatments: (1) early season livestock grazing (June-August), (2) late season livestock grazing (August-September), (3) all season grazing (June-September), and (4) livestock absent controls. Livestock grazing significantly decreased streambank stability, biomass of riparian vegetation, and the extent to which aquatic vegetation covered the stream channels compared with livestock-absent controls. Water quality comparisons indicated significant differences among the four livestock grazing treatments in Battle and Graburn creeks but not in Nine Mile Creek. In Graburn Creek, the concentration of total phosphorus in the all-season livestock grazing treatment was significantly higher than that in the livestock-absent control, and the early season and late season grazing treatments. Concentrations of soluble reactive phosphorus in the all-season livestock grazing treatment also exceeded that in livestock-absent control. In contrast, differences in water quality variables in the remaining 22 comparisons (i.e., 22 of the total 24 comparisons) were minor even when differences were statistically significant. Effects of livestock grazing on algal biomass were variable, and there was no consistent pattern among creeks. At the watershed scale, spatial variation in algal biomass was related (P < 0.05) with concentrations of NO(2)(-) + NO(3) (-) and soluble reactive phosphorus in two of the four study creeks. Nutrient diffusing substrata experiments showed that algal communities were either nitrogen-limited or not limited by nutrients, depending on stream and season.

Alberta↗