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Alcohol and other drugs (AOD) use is a significant public health issue and is associated with high mortality and morbidity rates. Despite this, people who use drugs are often reluctant to seek care due to the lack of trauma-informed treatment and harm reduction treatment options, as well as experiences of stigma and discrimination in health services. Arguably, AOD education that is co-produced with people who use alcohol and drugs can enhance future health professionals' ability to practice in ways that support the needs of this population. This paper reports on a qualitative co-evaluation of a co-produced undergraduate nursing AOD subject. The AOD subject was co-planned, co-designed, co-delivered, and co-evaluated with experts by experience, who have a lived experience of substance dependence and work as advocates and peer workers. Following the delivery of the subject in 2021 and 2022, focus groups were undertaken with 12 nursing students. Focus group data indicate that the co-produced subject supported participants to understand and appreciate how stigma impacts on nursing care and how to recognize and undertake 'good' nursing care that was oriented to the needs of service users. Student participants noted that being co-taught by people who use drugs was particularly powerful for shifting their nursing perspectives on AOD use and nursing care and took learning beyond what could be understood from a book. Findings indicate that co-produced AOD education can shift nursing students' perceptions of AOD use by providing access to tacit knowledge and embodied equitable and collaborative relationships with people who use drugs.

BACKGROUND: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. RESEARCH QUESTION: This article reports on one component and dataset from a larger study - 'the positives, perils and pitfalls of Facebook for nurses'. It explores the specific issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. PARTICIPANTS: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and 'snowballed' through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. ETHICAL CONSIDERATIONS: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. FINDINGS/RESULTS: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme 'blurred boundaries' was generated, which comprised three sub-themes: 'follow the science, 'abuse of power and erosion of trust' and 'the moral and ethical responsibility to safeguard public health'. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to

Aims: Translation of evidence-based psycho-oncology interventions into routine care can significantly improve patient outcomes, yet effective implementation remains challenging due to numerous real-world barriers. A key factor that may influence implementation is organisational readiness for change. This mixed method study sought to identify factors associated with organisational readiness for implementing the Australian clinical pathway for the screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP). Methods: We collected data from multidisciplinary staff across six Australian cancer services who were preparing to implement the ADAPT CP. Services were categorised as having ‘high’ versus ‘mid-range’ organisational readiness based on a median split on the Organizational Readiness for Implementing Change (ORIC) questionnaire (score range = 12–60). Qualitative data from the semi-structured interviews based on the Promoting Action Research in Health Services (PARiHS) framework were analysed thematically and compared for services with high- versus mid-range organisational readiness. Results: Three services with high- (mean ORIC range, 52.25–56.88), and three with mid-range (range, 38.75–46.39) organisational readiness scores were identified. Staff at services reporting higher readiness described a more collaborative and proactive service culture, strong communication processes and greater role flexibility. They also reported greater confidence in overcoming anticipated barriers and clearer strategies for addressing issues. Conclusions: Levels of organisational readiness were related to distinct qualitative themes. Targeting these issues in services where readiness is mid-range or low prior to full-scale roll-out may improve staff levels of confidence and efficacy in implementing psycho-oncology-focused interventions.

Aim. To review and discuss recent literature on the specific nature of COVID-19 in children and adolescents compared to the adult population. Background. The COVID-19 pandemic is a threat to the health and well-being of all people around the world. A significant proportion of adults require hospitalization, some developing severe life-threatening complications. However, although children can carry and transmit the virus, they typically do not develop severe disease, and the incidence is lower compared to adults. Design. An integrative literature review, prepared using the PRISMA-ScR reporting checklist. Methods. Using Arksey and O'Malley's framework, relevant databases were searched for articles published in English since the pandemic onset in March 2020 through August 2020. Inclusion and exclusion criteria were applied, and selected articles were thematically analyzed. Results. Four themes were identified and discussed relating to the potential care implications for children and adolescents: 1) the differing immune system in children, 2) the presentation of COVID-19 in children and adolescents, 3) vascular disease as a response to COVID-19, and 4) global policy changes relevant to COVID-19 in children and adolescents. Conclusion. The incidence, severity, and presentation of COVID-19 in young children differs to that of adults. Less is known about the disease pattern in adolescence. A new condition named as multisystem inflammatory syndrome in children (MIS-C) has emerged, about which we are still learning globally. Although perhaps not affected severely, children may still be vulnerable to the secondary consequences of policy changes (e.g., school closures, social distancing). Relevance to clinical practice. It is vital to address the significant global issues and contribute a pediatric and adolescent nursing perspective to the rapidly emerging body of evidence during the COVID-19 pandemic. Knowledge and understanding of the disease impact in children and adolescen

Ensuring students develop person-centred practice for diverse groups of people across health care settings is an important outcome of undergraduate nursing education. This paper presents the development and evaluation of a learning innovation, an integrated virtual patient case study and complementary online resources for person-centred nursing practice. The virtual patient case study of an Australian Aboriginal woman diagnosed with breast cancer was integrated within four core subjects of a Bachelor of Nursing program, for a total of 600 second-year students. The evaluation of this learning strategy was encouraging. Students reported that the online learning activities were engaging, particularly due to the level of realism, their understanding of Aboriginal Peoples’ healthcare needs increased, and they developed therapeutic communication skills, applicable in a variety of healthcare contexts. Staff concerns about student wellbeing when learning sensitive content online were unfounded. When carefully planned, a virtual patient case study and online learning resources can support students to enhance their person-centred nursing practice. Further evaluation, including student outcomes through assessment, is an important next step.

Recovery-focused educational programmes have been implemented in mental health services in an attempt to transform care from a purely biomedical orientation to a more recovery-oriented approach. Mental health nurses have identified the need for enhancing their abilities and confidence in translating recovery knowledge into mental health nursing practice. However, recovery-focused educational programmes have not fully address nurses' learning needs. Therefore, this review synthesized the evidence of the effectiveness of recovery-focused educational programmes for mental health nurses. A systematic search of electronic databases and hand-searched references was conducted. It identified 35 programmes and 55 educational materials within 39 studies. Synthesizing the literature revealed three themes and nine subthemes. The first theme, a framework for understanding and supporting consumers' recovery, had four subthemes: consumers' involvement, multidisciplinary approach, profession-specific training, and performance indicators. The second theme, contents of educational materials, included the subthemes: knowledge development and recovery-focused care planning. The final theme, nurses' learning experiences, included the subthemes: understanding recovery, the positive effects of recovery-focused educational programmes, and implementation of recovery-oriented practices. Based on these findings, a mental health nursing recovery-focused educational programme framework is proposed. Further research should investigate the effectiveness of the framework, especially in relation to recovery-focused care planning and consumer and carer involvement in the development, delivery, participation, and evaluation of these educational programmes.

Breastfeeding is the ideal infant feeding modality; however, the reality is some parents need or choose to use bottles to feed their infants. Parents who bottle-feed have been identified as not receiving adequate levels of bottle-feeding information and advice from health professionals. This study's aim was to explore nurses' knowledge of the components in the bottle-feeding act. Twenty-one nurses working in early parenting residential units participated in three focus groups. Three themes were identified relating to nurses' bottle-feeding knowledge: experience not evidence-based, it is hard to know what to advise, we will support whatever choice they make. The nurses identified a deficit in their knowledge, education and training related to the components of bottle-feeding. The nurses struggled with their interpretation of infant feeding policies and the provision of bottle-feeding information to parents. Nurses working in child and family health were motivated to inform, educate and enable parents to confidently make decisions concerning infant feeding. The healthcare system and the infant feeding policy drivers appear to have a mixed and at times negative impact on nurses' practice. Further research is required across a larger population of nurses.

Background: Effective translation of evidence-based research into clinical practice requires assessment of the many factors that can impact implementation success. Research methods that draw on recognised implementation frameworks, such as the Promoting Action Research in Health Services (PARiHS) framework, and that test feasibility to gain information prior to full-scale roll-out, can support a more structured approach to implementation. Objective: This paper presents qualitative findings from a feasibility study in one cancer service of an online portal to operationalise a clinical pathway for the screening, assessment and management of anxiety and depression in adult cancer patients. The aim of this study was to explore staff perspectives on the feasibility and acceptance of a range of strategies to support implementation in order to inform the full-scale roll-out. Methods: Semi-structured interviews were conducted with fifteen hospital staff holding a range of clinical, administrative and managerial roles, and with differing levels of exposure to the pathway. Qualitative data were analysed thematically, and themes were subsequently organised within the constructs of the PARiHS framework. Results: Barriers and facilitators that affected the feasibility of the online portal and implementation strategies were organised across eight key themes: staff perceptions, culture, external influences, attitudes to psychosocial care, intervention fit, familiarity, burden and engagement. These themes mapped to the PARiHS framework's three domains of evidence, context and facilitation. Conclusions: Implementation success may be threatened by a range of factors related to the real-world context, perceptions of the intervention (evidence) and the process by which it is introduced (facilitation). Feasibility testing of implementation strategies can provide unique insights into issues likely to influence full-scale implementation, allowing for early tailoring and more effective fac

© 2018 Australian College of Mental Health Nurses Inc. Mental health consumers who hear voices frequently experience distress and express a desire to discuss their voice-hearing experience. Nurses do not regularly demonstrate a willingness to engage in such discussions. With the introduction of educational strategies that develop empathy and an understanding of voice-hearing experiences, it is anticipated that early career nurses will be able to translate such understanding into their professional nursing practice. To explore early career nurses’ understanding of providing care to mental health consumers who hear voices, a qualitative exploratory descriptive study was conducted in which nine early career Registered Nurses were interviewed regarding their experiences of caring for people who hear voices. Thematic analysis was employed to analyse the data and generate themes. Participants reported difficulty in developing relationships with consumers who hear voices, due to a workplace culture that was focussed on risk and lacking professional support. Nurses need specific education to develop the skills necessary to respond to consumers who hear voices and engage in dialogue that assists consumers to relate to the voices in a meaningful way. However, for this to succeed in practice, changes need to be supported by addressing the cultural barriers, such as risk-focussed environments, that prevent nurses implementing best practice.

© 2017 Elsevier Ltd An innovative blended learning resource for undergraduate nursing and midwifery students was developed in a large urban Australian university, following a number of concerning reports by students on their experiences of bullying and aggression in clinical settings. The blended learning resource included interactive online learning modules, comprising film clips of realistic clinical scenarios, related readings, and reflective questions, followed by in-class role-play practice of effective responses to bullying and aggression. On completion of the blended learning resource 210 participants completed an anonymous survey (65.2% response rate). Qualitative data was collected and a thematic analysis of the participants' responses revealed the following themes: ‘Engaging with the blended learning resource’; ‘Responding to bullying’ and ‘Responding to aggression’. We assert that developing nursing and midwifery students' capacity to effectively respond to aggression and bullying, using a self-paced blended learning resource, provides a solution to managing some of the demands of the clinical setting. The blended learning resource, whereby nursing and midwifery students were introduced to realistic portrayals of bullying and aggression in clinical settings, developed their repertoire of effective responding and coping skills for use in their professional practice.

© 2016 Sigma Theta Tau International. Purpose: This article provides insights and perspectives from four experienced educators about their approaches to developing, delivering, and evaluating impactful simulation learning experiences for undergraduate nurses. A case study format has been used to illustrate the commonalities and differences of where simulation has been positioned within curricula, with examples of specialized clinical domains and others with a more generic focus. The importance of pedagogy in developing and delivering simulations is highlighted in each case study. A range of learning theories appropriate for healthcare simulations are a reminder of the commonalities across theories and that no one theory can account for the engaging and impactful learning that simulation elicits. Clinical Relevance: Creating meaningful and robust learning experiences through simulation can benefit students' performance in subsequent clinical practice. The ability to rehearse particular clinical scenarios, which may be difficult to otherwise achieve, assists students in anticipating likely patient trajectories and understanding how to respond to patients, relatives, and others in the healthcare team.

Purpose: This article provides insights and perspectives from four experienced educators about their approaches to developing, delivering, and evaluating impactful simulation learning experiences for undergraduate nurses. A case study format has been used to illustrate the commonalities and differences of where simulation has been positioned within curricula, with examples of specialized clinical domains and others with a more generic focus. The importance of pedagogy in developing and delivering simulations is highlighted in each case study. A range of learning theories appropriate for healthcare simulations are a reminder of the commonalities across theories and that no one theory can account for the engaging and impactful learning that simulation elicits. Clinical Relevance: Creating meaningful and robust learning experiences through simulation can benefit students' performance in subsequent clinical practice. The ability to rehearse particular clinical scenarios, which may be difficult to otherwise achieve, assists students in anticipating likely patient trajectories and understanding how to respond to patients, relatives, and others in the healthcare team. © 2016 Sigma Theta Tau International.

Role-play scenarios are frequently used with undergraduate nursing students enrolled in mental health nursing subjects to simulate the experience of voice-hearing. However, role-play has limitations and typically does not involve those who hear voices. This collaborative project between mental health consumers who hear voices and nursing academics aimed to develop and assess simulated voice-hearing as an alternative learning tool that could provide a deeper understanding of the impact of voice-hearing, whilst enabling students to consider the communication skills required when interacting with voice-hearers. Simulated sounds and voices recorded by consumers on mp3 players were given to eighty final year nursing students undertaking a mental health elective. Students participated in various activities whilst listening to the simulations. Seventy-six (95%) students completed a written evaluation following the simulation, which assessed the benefits of the simulation and its implications for clinical practice. An analysis of the students' responses by an external evaluator indicated that there were three major learning outcomes: developing an understanding of voice-hearing, increasing students' awareness of its impact on functioning, and consideration of the communication skills necessary to engage with consumers who hear voices. © 2013 Elsevier Ltd.

This paper presents the first instance of a double contact discontinuity in analytical solutions for multicomponent, two-phase flow in porous media. We use a three-component system with constant equilibrium ratios and fixed injection and initial conditions, to demonstrate this structure. This wave structure occurs for two-phase injection compositions. Such conditions were not considered previously in the development of analytical solutions for compositional flows. We demonstrate the stability of the double contact discontinuity in terms of the Liu entropy condition and also show that the resulting solution is continuously dependent on initial data. Extensions to four-component and systems with adsorption are presented, demonstrating the more widespread occurrence of this wave structure in multicomponent, two-phase flow systems. The developments in this paper provide the building blocks for the development of a complete Riemann solver for general initial and injection conditions.

_Science_ has published an article, Direct Experiments on the Ocean Disposal of Fossil Fuel CO2, discussing a recent experiment conducted by scientists at the Monterey Bay Aquarium Research Institute and Stanford University. The goal of this radical and ambitious experiment was to directly dispose carbon dioxide (produced due to burning fossil fuels) in the cold and high-pressure environment of the deep sea to prevent it from adding to the greenhouse effect. However, due to unexpected results, this idea seems to be more difficult to implement than imagined. In addition, the effects of deploying liquid carbon dioxide on deep-sea organisms still need to be investigated. The site is for the above-mentioned article that appears in the May 7, 1999 issue of Science; and will be accessible online for a limited time period.