Exploring environmental factors in nursing workplaces that promote psychological resilience: Constructing a unified theoretical model

Building nurses' resilience to complex and stressful practice environments is necessary to keep skilled nurses in the workplace and ensuring safe patient care. A unified theoretical framework titled Health Services Workplace Environmental Resilience Model (HSWERM), is presented to explain the environmental factors in the workplace that promote nurses' resilience. The framework builds on a previously-published theoretical model of individual resilience, which identified the key constructs of psychological resilience as self-efficacy, coping and mindfulness, but did not examine environmental factors in the workplace that promote nurses' resilience. This unified theoretical framework was developed using a literary synthesis drawing on data from international studies and literature reviews on the nursing workforce in hospitals. The most frequent workplace environmental factors were identified, extracted and clustered in alignment with key constructs for psychological resilience. Six major organizational concepts emerged that related to a positive resilience-building workplace and formed the foundation of the theoretical model. Three concepts related to nursing staff support (professional, practice, personal) and three related to nursing staff development (professional, practice, personal) within the workplace environment. The unified theoretical model incorporates these concepts within the workplace context, linking to the nurse, and then impacting on personal resilience and workplace outcomes, and its use has the potential to increase staff retention and quality of patient care

Experiences of living with dementia: qualitative content analysis of semi-structured interviews

Aim and objective: To describe people’s experiences of living with dementia in Iran. Background: A knowledge gap exists regarding the experiences of living with dementia in non-Western contexts. This gap may be especially apparent within the Iranian context, where dementia research is relatively new. Deeper understanding about context related experiences of dementia is a prerequisite for nurses’ ability to provide adequate and meaningful care. Design: Qualitative, cross-sectional design. Methods: Qualitative content analysis of semi-structured interviews with people living with dementia in urban Iran (six women and nine men; 60 to 87 years old). Findings: The participants experienced their condition as a state of forgetfulness that was accompanied by losses and dependency on others. They wanted to feel good about themselves and feel important, but they continually struggled with matters such as a loss of accountability, feelings of futility, and the frustration of others. Economic dependency and a lack of economic resources were sources of feelings of futility. Conclusion: Experiences of living with dementia in Iran included a substantial struggle to stay connected to the social world and to deal with dramatic life changes, aspects of living with dementia that seem to be universal. However, the feelings of financial burden and the experience of being nagged for their shortfalls by family members have seldom been described in other studies and seem to represent a cultural aspect of their experience. Relevance to clinical practice: The results of the study call for further nursing efforts in supporting people living with dementia in their struggle with their altered lives and in retaining their connections to everyday life. Furthermore, their family members might benefit of specific nursing interventions including information about dementia and advice on how to help the family members with dementia to interact with others while exercising their individual strengths

Exploring environmental factors in nursing workplaces that promote psychological resilience : constructing a unified theoretical model

Building nurses’ resilience to complex and stressful practice environments is necessary to keep skilled nurses in the workplace and ensuring safe patient care. A unified theoretical framework titled Health Services Workplace Environmental Resilience Model (HSWERM), is presented to explain the environmental factors in the workplace that promote nurses’ resilience. The framework builds on a previously-published theoretical model of individual resilience, which identified the key constructs of psychological resilience as self-efficacy, coping and mindfulness, but did not examine environmental factors in the workplace that promote nurses’ resilience. This unified theoretical framework was developed using a literary synthesis drawing on data from international studies and literature reviews on the nursing workforce in hospitals. The most frequent workplace environmental factors were identified, extracted and clustered in alignment with key constructs for psychological resilience. Six major organizational concepts emerged that related to a positive resilience-building workplace and formed the foundation of the theoretical model. Three concepts related to nursing staff support (professional, practice, personal) and three related to nursing staff development (professional, practice, personal) within the workplace environment. The unified theoretical model incorporates these concepts within the workplace context, linking to the nurse, and then impacting on personal resilience and workplace outcomes, and its use has the potential to increase staff retention and quality of patient care

Depressed patients’ experiences with and perspectives on treatment provided by homeopaths. A qualitative interview study embedded in a trial

Introduction Depression is one of the clinical conditions patients most commonly consult homeopaths. This study therefore aimed to learn about patients’ experiences having this intervention. Methods A semi-structured qualitative interview study was nested within a randomised controlled trial to learn about depressed patients’ experiences with treatment provided by homeopaths. A purposive selection of adults with moderate to severe self-reported depression were included. Interviews were conducted post initial consultation and six months post-randomisation. Thematic analysis was used to develop themes describing participants’ experiences, thoughts and understandings. Results Forty-six interviews were carried out with 33 adults. Sixteen themes were developed and have been categorised under three main headings: 1) changed understanding of the intervention, with themes such as understanding the intervention as being adapted; 2) experiences with the consultation and the medication, such as caring support, trust and optimism arising from consultations with homeopaths; and 3) changes in state of health, such as improvement in mood, wellbeing and ability to cope, or little or no change, or transient adverse events. Conclusion This is the first qualitative study of depressed patients’ experiences with treatment provided by homeopaths. Results provide an insight into their experiences with consultations and homeopathic and antidepressant medication, their understanding of the intervention, and the changes in their state of health over time

SOWFIA Project - Work Package 3 Interim Report

The Streamlining of Ocean Wave Farms Impact Assessment (SOWFIA) Project (IEE/09/809/ SI2.558291) is an EU Intelligent Energy Europe (IEE) funded project that draws together ten partners, across eight European countries, who are actively involved with planned wave farm test centres. The SOWFIA project aims to achieve the sharing and consolidation of pan-European experience of consenting processes and environmental and socio-economic impact assessment (IA) best practices for offshore wave energy conversion developments. Studies of wave farm demonstration projects in each of the collaborating EU nations are contributing to the findings. The study sites comprise a wide range of device technologies, environmental settings and stakeholder interests. Through project workshops, meetings, on-going communication and networking amongst project partners, ideas and experiences relating to IA and policy are being shared, and co-ordinated studies addressing key questions for wave energy development are being carried out. The overall goal of the SOWFIA project is to provide recommendations for approval process streamlining and European-wide streamlining of IA processes, thereby helping to remove legal, environmental and socio-economic barriers to the development of offshore power generation from waves. By utilising the findings from technology-specific monitoring at multiple sites, SOWFIA will accelerate knowledge transfer and promote European-wide expertise on environmental and socio-economic impact assessments of wave energy projects. In this way, the development of the future, commercial phase of offshore wave energy installations will benefit from the lessons learned from existing smaller-scale developments

What works for whom in the management of diabetes in people living with dementia: a realist review

Background Dementia and diabetes mellitus are common long-term conditions and co-exist in a large number of older people. People living with dementia (PLWD) may be less able to manage their diabetes, putting them at increased risk of complications such as hypoglycaemia. The aim of this review was to identify key mechanisms within different interventions that are likely to improve diabetes outcomes in PLWD. Methods This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories and their validation with a purposive sample of stakeholders. Twenty-six stakeholders — user/patient representatives, dementia care providers, clinicians specialising in diabetes or dementia and researchers — took part in interviews, and 24 participated in a consensus conference. Results We included 89 papers. Ten focused on PLWD and diabetes, and the remainder related to people with either dementia, diabetes or other long-term conditions. We identified six context-mechanism-outcome configurations which provide an explanatory account of how interventions might work to improve the management of diabetes in PLWD. This includes embedding positive attitudes towards PLWD, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. An overarching contingency emerged concerning the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. Conclusions Evidence highlighted the need for personalised care, continuity and family-centred approaches, although there was limited evidence that this happens routinely. This review suggests there is a need for a flexible service model that prioritises quality of life, independence and patient and carer priorities. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to their needs. Trial registration PROSPERO, CRD42015020625. Registered on 18 May 2015

Identifying Canadian Freshwater Fishes through DNA Barcodes

BACKGROUND: DNA barcoding aims to provide an efficient method for species-level identifications using an array of species specific molecular tags derived from the 5' region of the mitochondrial cytochrome c oxidase I (COI) gene. The efficiency of the method hinges on the degree of sequence divergence among species and species-level identifications are relatively straightforward when the average genetic distance among individuals within a species does not exceed the average genetic distance between sister species. Fishes constitute a highly diverse group of vertebrates that exhibit deep phenotypic changes during development. In this context, the identification of fish species is challenging and DNA barcoding provide new perspectives in ecology and systematics of fishes. Here we examined the degree to which DNA barcoding discriminate freshwater fish species from the well-known Canadian fauna, which currently encompasses nearly 200 species, some which are of high economic value like salmons and sturgeons. METHODOLOGY/PRINCIPAL FINDINGS: We bi-directionally sequenced the standard 652 bp "barcode" region of COI for 1360 individuals belonging to 190 of the 203 Canadian freshwater fish species (95%). Most species were represented by multiple individuals (7.6 on average), the majority of which were retained as voucher specimens. The average genetic distance was 27 fold higher between species than within species, as K2P distance estimates averaged 8.3% among congeners and only 0.3% among concpecifics. However, shared polymorphism between sister-species was detected in 15 species (8% of the cases). The distribution of K2P distance between individuals and species overlapped and identifications were only possible to species group using DNA barcodes in these cases. Conversely, deep hidden genetic divergence was revealed within two species, suggesting the presence of cryptic species. CONCLUSIONS/SIGNIFICANCE: The present study evidenced that freshwater fish species can be efficiently identified through the use of DNA barcoding, especially the species complex of small-sized species, and that the present COI library can be used for subsequent applications in ecology and systematics

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead