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Background: In 2017 the Nursing Council of NZ (NCNZ) broadened Nurse Practitioner (NP) scope of practice to ensure the role remained safe, flexible and appropriate to meet health needs. It also removed the requirement to restrict practice to a specific area. This facilitated nurse practitioner roles to meet population needs. Historically, within renal services NP training was led by nephrologists -- however transitioning to national training programmes required modification to ensure NCNZ competence. Large metro health providers service a diverse population with significant socioeconomic disparities. This is further observed in the renal population with considerable barriers to care outwith secondary care. Broadening the NP scope provided opportunity for our patient population to receive improved access to healthcare beyond renal specific problems and a collaborative approach to integrated care with primary care providers. Aim: To develop an integrative training programme with NP's a key workforce partner, improving healthcare outcomes. Methods: Workforce development to ensure adequate lead time in aligning of academic prerequisites alongside clinical skill. This required interface across multiple key stakeholders and nursing leaders to ensure the clinical impact of a broadened scope was understood. Support and models of care developed to allow existing qualified NP's to be responsible as key partners in further NP's training. Conclusion: Change in advanced nursing development has resulted in a departmental cultural shift with NP's driving comprehensive care beyond 'renal' specific health conditions. Consequently, becoming integral in CQI and service provision of Renal service planning. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To validate our previously developed 16 plasma-protein biomarker panel to differentiate between transient ischaemic attack (TIA) and non-cerebrovascular emergency department (ED) patients. METHOD: Two consecutive cohorts of ED patients prospectively enrolled at two urban medical centers into the second phase of SpecTRA study (training, cohort 2A, n = 575; test, cohort 2B, n = 528). Plasma samples were analyzed using liquid chromatography/multiple reaction monitoring-mass spectrometry. Logistic regression models which fit cohort 2A were validated on cohort 2B. RESULTS: Three of the panel proteins failed quality control and were removed from the panel. During validation, panel models did not outperform a simple motor/speech (M/S) deficit variable. Post-hoc analyses suggested the measured behaviour of L-selectin and coagulation factor V contributed to poor model performance. Removal of these proteins increased the external performance of a model containing the panel and the M/S variable. CONCLUSIONS: Univariate analyses suggest insulin-like growth factor-binding protein 3 and serum paraoxonase/lactonase 3 are reliable and reproducible biomarkers for TIA status. Logistic regression models indicated L-selectin, apolipoprotein B-100, coagulation factor IX, and thrombospondin-1 to be significant multivariate predictors of TIA. We discuss multivariate feature subset analyses as an exploratory technique to better understand a panel’s full predictive potential. [ABSTRACT FROM AUTHOR]

We describe a new strategy for interpreting frequency responses of thickness shear mode resonators loaded with spatially uniform viscoelastic films. This procedure leads to unambiguous extraction of the four parameters that characterize such a film: its thickness, density and shear modulus components (storage and loss moduli). The interpretational difficulty is that the experimental frequency response (impedance spectrum) can only provide two parameters; thus, the problem is underdetermined. Previous interpretations employed various approximations and assumptions for two (or more) film parameters to effectively reduce the problem to a two-parameter fit. Such approaches are clearly imperfect. Our new strategy splits the problem into two separate two-parameter sub-problems, each of which is solved by the measurement of two different experimental responses. The result is a unique fit to the data without the need to make approximations or assumptions for film parameters. First, in the acoustically thin regime, measured frequency shift and film charge are combined to provide a unique solution for film thickness and density; shear moduli components do not affect the response in this regime. Second, film density is carried forward directly, and the film thickness-charge relationship is extrapolated into the acoustically thick regime. Third, with film density and thickness held fixed, crystal impedance data in the acoustically thick regime provide unambiguous shear modulus components. The method is generalized to any other (nonelectrochemical) probe that provides film thickness data and validated using crystal impedance data for poly(3-methylthiophene) films exposed to propylene carbonate.