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Background: Neuroscience patients can present with agitation due to a number of factors such as the presence of cerebral abnormalities, tumours, trauma, or medications. Agitation among neuroscience patients that escalates to violence and aggression appears to be increasing and highly challenging for neuroscience nursing practice across Australasia. Neuroscience wards or units endeavour to effectively manage patients who are affected by agitation and provide appropriate training for clinical and non-clinical staff. Following a workshop through Australasian Neuroscience Nurses' Association (ANNA), a group of neuroscience nurses, passionate about improving the care of neuroscience patients presenting with agitation and the safety of the staff; collaborated and researched the most effective prevention and management strategies that can be used to ensure that care delivery for these patients is therapeutic and effective. Purpose: The purpose of this paper is to share recommendations that can guide the prevention and management of agitation among neuroscience patients from the perspective of neuroscience nurses in Australasia. Discussion: These recommendations have been discussed from hospitals across Australasia including Perth, Brisbane, Sydney, Canberra, Melbourne, and Wellington in the hope that other cities can make changes in their own hospitals to inform neuroscience nurses and allied clinicians, improve guidelines and provide effective education for staff members that interact with neuroscience patients. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper aims to investigate the transition experiences of students with previous nursing qualifications (nondegree qualifications) entering a nursing degree program. Background Nurses with professional nursing qualifications (nondegree) are an important pool of professionals to draw on to help address nursing shortages through providing alternative pathways to becoming registered nurses. However, research suggests this cohort need higher levels of support and intervention to be successful. Design An integrative review was conducted, guided by Whittemore and Knafl's framework. A comprehensive search was conducted and 14 studies were included in the review. Methods A five-stage approach was used to conduct the review: problem identification, literature search, data evaluation, data analysis and presentation of results. Constant comparative analysis was used to identify commonalities, differences and themes in the relevant literature. Results Themes emerged that suggested students struggled with academic and institutional challenges, becoming learners, managing conflicting demands of outside life, developing a student identity and experienced threat to their sense of professional identity. Additionally, the cohort did not view themselves as 'the same' as traditional students. Holland's framework provides a useful framework from which to conceptualise these students' experiences. Conclusion There are challenges for this cohort of students as they transition into degree level study. Supportive activities that extend and further develop students' personality orientations may be a useful starting point in addressing some of the challenges and providing a more positive transition to university. Relevance to clinical practice The demand for health care is growing and there remains a shortfall of registered nurses. Nurses with professional qualifications (nondegree) are an important pool of professionals from which to increase registered nurse numbers and address workforce sustainability issues. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to establish current management practice for patent ductus arteriosus (PDA) among individual consultant neonatologists in Australia and New Zealand, to examine the influences that drives practice and highlight the importance of future randomised controlled trials in the region. Methods: Eligible subjects were identified from the Directory of Neonatal Intensive Care Units in Australia and New Zealand, 2007. A questionnaire was sent online to each consultant and was followed up with a letter and telephone call. Seven questions addressed management approach, the drug used and the treatment regimen, threshold for referral for surgical ligation and the literature influencing practice. Data were collected from 22 August 2007 to 22 November 2007. Results: The overall response rate was 95%. For infants ≤28 weeks or ≤1000 g, all consultants treat PDA by one of four distinct management approaches. Expectant management was favoured by 35%, echocardiographic targeted prophylaxis 32%, presymptomatic treatment 16% and prophylaxis by 17%. There were marked regional variations in practice. Within individual units, more than one approach is used in 14 out of 24 units. Long courses of indomethacin are used to treat PDA by 86%. For 22% of consultants, management is not influenced by published literature. Conclusions: Differences of opinion in the literature are reflected by the heterogeneity in clinical practice across regions and within units. Crucial questions undergoing evaluation are whether data extrapolated from a previous area are relevant to PDA in modern neonatology and whether targeting treatment early can translate to improved clinical outcome. [ABSTRACT FROM AUTHOR]

Background: Canada, the United States, Australia, and New Zealand consistently place near the top of the United Nations Development Programme's Human Development Index (HDI) rankings, yet all have minority Indigenous populations with much poorer health and social conditions than non-Indigenous peoples. It is unclear just how the socioeconomic and health status of Indigenous peoples in these countries has changed in recent decades, and it remains generally unknown whether the overall conditions of Indigenous peoples are improving and whether the gaps between Indigenous peoples and other citizens have indeed narrowed. There is unsettling evidence that they may not have. It was the purpose of this study to determine how these gaps have narrowed or widened during the decade 1990 to 2000. Methods: Census data and life expectancy estimates from government sources were used to adapt the Human Development Index (HDI) to examine how the broad social, economic, and health status of Indigenous populations in these countries have changed since 1990. Three indices -- life expectancy, educational attainment, and income -- were combined into a single HDI measure. Results: Between 1990 and 2000, the HDI scores of Indigenous peoples in North America and New Zealand improved at a faster rate than the general populations, closing the gap in human development. In Australia, the HDI scores of Indigenous peoples decreased while the general populations improved, widening the gap in human development. While these countries are considered to have high human development according to the UNDP, the Indigenous populations that reside within them have only medium levels of human development. Conclusion: The inconsistent progress in the health and well-being of Indigenous populations over time, and relative to non-Indigenous populations, points to the need for further efforts to improve the social, economic, and physical health of Indigenous peoples. [ABSTRACT FROM AUTHOR]

Funds to combat biodiversity loss are insufficient, requiring conservation managers to make trade-offs between costs for actions to avoid further loss and costs for research and monitoring to guide effective actions. Using species' management plans for 2328 listed species from three countries we show that 50% of species' proposed recovery plan budgets are allocated to research and monitoring. The proportion of budgets allocated to research and monitoring vary among jurisdictions and taxa, but overall, species with higher proportions of budgets allocated to research and monitoring have poorer recovery outcomes. The proportion allocated to research and monitoring is lower for more recent recovery plans, but for some species, plans have allocated the majority of funds to information gathering for decades. We provide recommendations for careful examination of the value of collecting new information in recovery planning to ensure that conservation programs emphasize action or research and monitoring that directly informs action. How to best allocate limited resources for conserving imperilled species is a difficult challenge. Here the authors analyse data on over 2000 threatened species from USA, Australia, and New Zealand, finding that on average half of the budget is allocated to research and monitoring. Species with higher budget allocation to research and monitoring tend to have poorer recovery outcomes. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) remains the largest cause of death in breast cancer survivors. The aim of this study was to explore the impact of exercise intensity on aerobic fitness and autonomic cardiac regulation (heart rate variability (HRV)) and salivary biomarkers of the stress systems (HPA-axis, cortisol; sympathetic nervous system, α-amylase) and mucosal immunity (secretory(s)-IgA), markers of increased risk of CVD in breast cancer survivors.Methods: Participants were randomly assigned to; 1) high intensity interval training (HIIT); 2) moderate-intensity, continuous aerobic training (CMIT); or 3) a wait-list control (CON) for a 12-week (36 session) stationary cycling intervention. Cardiorespiratory fitness (VO2peak), resting HRV and salivary biomarkers were measured at baseline 2-4 d pre-intervention and 2-4 d post the last exercise session.Results: Seventeen participants were included in this study (62 ± 8 years, HIIT; n = 6, CMIT; n = 5, CON; n = 6). A significant improvement (p ≤ 0.05) was observed for VO2peak in the HIIT group; 19.3% (B = 3.98, 95%CI = [1.89; 4.02]) and a non-significant increase in the CMIT group; 5.6% (B = 1.96, 95%CI = [- 0.11; 4.03]), compared with a 2.6% (B = - 0.64, 95%CI = [- 2.10; 0.82]) decrease in the CON group. Post intervention improvements in HRV markers of vagal activity (log (ln)LF/HF, LnRMSSD) and sympathetic nervous system (α-amylase waking response) occurred for individuals exhibiting outlying (> 95% CI) levels at baseline compared to general population.Conclusion: High intensity interval training improved cardiovascular fitness in breast cancer survivors and improved cardiac regulation, and sympathetic nervous system (stress) responses in some individuals. High-intensity interval training was safe and effective for breast cancer survivors to participate in with promising results as a time efficient intensity to improve physical health and stress, reducing CVD risk.Trial Registration: This pilot study was retrospectively registered through the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620000684921 . [ABSTRACT FROM AUTHOR]