Research papers

Achieving knowledge translation in nursing care: the need for greater rigor in applying evidence to practice.

Mei Ling Yeh

Entry to nursing practice preceptor education and support: could we do it better?

Carmel Haggerty, Kathy Holloway, Debra Rose Wilson

High quality preceptorship during their first year of practice is seen as critical for new graduate nurses' development of competence and confidence. Quality preceptorship is dependent upon skilled and knowledgeable preceptors who are committed to this role. A recent longitudinal evaluation of 21 Nursing Entry to Practice (NETP) programmes in New Zealand identified that preceptorship selection, education and support do not always receive the attention they warrant. Failure to plan preceptor selection leads to ad hoc selection and consequent allocations of many preceptors who may not have attended appropriate education, or have a desire to undertake this role. Such a situation is detrimental to the job satisfaction of both preceptors and new graduate nurses. High workloads, rostering difficulties and increased acuity in many clinical areas often prevent preceptors from attending appropriate education and that, in turn, impacts negatively on the preceptor's expectations and clarity with respect to the role. To offset this effect the authors recommend development of a clearly defined preceptor selection process, along with flexible preceptor education programmes that provide a good foundation for support of new graduates in their first year of practice; but do not increase preceptor workloads.

Regularization Paths for Generalized Linear Models via Coordinate Descent.

Jerome H. Friedman, Trevor Hastie, Rob Tibshirani

We develop fast algorithms for estimation of generalized linear models with convex penalties. The models include linear regression, two-class logistic regression, and multinomial regression problems while the penalties include ℓ(1) (the lasso), ℓ(2) (ridge regression) and mixtures of the two (the elastic net). The algorithms use cyclical coordinate descent, computed along a regularization path. The methods can handle large problems and can also deal efficiently with sparse features. In comparative timings we find that the new algorithms are considerably faster than competing methods.

Measles antibodies in the breast milk of nursing mothers.

Adu Fd, Adeniji Ja

A total of 216 breast milk samples collected from nursing mothers and corresponding numbers of finger prick sera from their suckling babies were tested for measles antibodies. Fifty (22.1%) of the nursing mothers had antibody while 38 (16.8%) of the sera were positive for measles haemagglutinating (HI) antibodies. Forty-one (18.9%) breast milk samples were found to contain measles complement fixing (CF) antibody while none of the serum samples from the suckling babies had CF antibody. Only 12 of the positive sera were from HI positive mothers. Our result suggests that very little level of measles antibody is passed through the breast milk.

The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.

John E. Ware, Cathy D. Sherbourne

A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.