The accessibility of research-based knowledge for nurses in United Kingdom acute care settings

Background. The successful dissemination of the results of the National Health Service (NHS) research and development strategy and the development of evidence based approaches to health care rely on clinicians having access to the best available evidence; evidence fit for the purpose of reducing the uncertainties associated with clinical decisions. Aim. To reveal the accessibility of those sources of information actually used by nurses, as well as those which they say they use. Design. Mixed method case site, using interview, observational, Q sort and documentary audit data in medical, surgical and coronary care units (CCUs) in three acute hospitals. Results. Three perspectives on accessibility were identified: (a) the humanist-in which human sources of information were the most accessible; (b) local information for local needs-in which locally produced resources were seen as the most accessible and (c) moving towards technology-in which information technology begins to be seen as accessible. Nurses' experience in a clinical specialty is positively associated with a perception that human sources such clinical nurse specialists, link nurses, doctors and experienced clinical colleagues are more accessible than text based sources. Clinical specialization is associated with different approaches to accessing research knowledge. Coronary care unit nurses were more likely perceive local guidelines, protocols and on-line databases as more accessible than their counterparts in general medical and surgical wards. Only a third of text-based resources available to nurses oil the wards had any explicit research base. These, and the remainder were Out of date (mean age of textbooks 11 years), and authorship hard to ascertain. Conclusion. A strategy to increase the use of research evidence by nurses should harness the influence of clinical nurse specialists, link nurses and those engaged in practice development. These roles Could act as 'conduits' through which research-based messages for practice, and information for clinical decision making, could flow. This role should be explored and enhanced

Acute care nurses' perceptions of barriers to using research information in clinical decision-making

Aim. To examine the barriers that nurses feel prevent them from using research in the decisions they make. Background. A sizeable research literature focusing on research utilization in nursing has developed over the past 20 years. However, this literature is characterized by a number of weaknesses: self-reported utilization behaviour; poor response rates and small, nonrandom sampling strategies. Design. Cross-case analysis involving anonymised qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 h, and 122 nurses were involved in the Q modelling exercise (response rate of 64%). Results. Four perspectives were isolated that encompassed the characteristics associated with barriers to research use. These related to the individual, organization, nature of research information itself and environment. Nurses clustered around four main perspectives on the barriers to research use: (1) Problems in interpreting and using research products, which were seen as too complex, 'academic' and overly statistical; (2) Nurses who felt confident with research-based information perceived a lack of organizational support as a significant block; (3) Many nurses felt that researchers and research products lack clinical credibility and that they fail to offer the desired level of clinical direction; (4) Some nurses lacked the skills and, to a lesser degree, the motivation to use research themselves. These individuals liked research messages passed on to them by a third party and sought to foster others' involvement in research-based practice, rather than becoming directly involved themselves. Conclusions. Rejection of research knowledge is not a barrier to its application. Rather, the presentation and management of research knowledge in the workplace represent significant challenges for clinicians, policy-makers and the research community

Recruiting and retaining children and families' social workers. The potential of work discussion groups

Current difficulties with the recruitment and retention of children and families' social workers have been formally acknowledged. However, although initiatives which focus on remuneration and career progression are clearly welcome, research and evidence from practice highlights how social workers themselves place high value on the availability of good quality supervision. Yet, questions remain about whether first-line managers have the time or are even in the best position to offer this support. This article draws on the experience and evaluation of one particular model of supervision — 'work discussion groups' —and explores its impact with residential social work staff and teachers as well as the potential for further developments of this kind

Technological change and productivity growth in the air transport industry

The progress of the civil air transport industry in the United States was examined in the light of a proposal of Enos who, after examining the growth of the petroleum industry, divided that phenomenon into two phases, the alpha and the beta; that is, the invention, first development and production, and the improvement phase. The civil air transport industry developed along similar lines with the technological progress coming in waves; each wave encompassing several new technological advances while retaining the best of the old ones. At the same time the productivity of the transport aircraft as expressed by the product of the aircraft velocity and the passenger capacity increased sufficiently to allow the direct operating cost in cents per passenger mile to continually decrease with each successive aircraft development

Are Mock Jurors Influenced by the Defendants Gender, Socio-Economic Status and Emotional State in Forensic Medicine?

The aim of this study was to investigate whether mock jurors’ decisions were affected by the defendant’s gender, socio-economic status and emotional state in mock cases. The implications are far reaching, especially in trials that involve forensic medicine. An experimental design was used where a total of 24 participants from Bournemouth University took part, and were assigned to one of four groups. In these groups, the three independent variables were manipulated. Participants were presented with two murder/manslaughter cases. The results suggest male defendants received harsher judgements than female defendants. More female defendants were found not guilty than male defendants. Male defendants from a high socio-economic background received harsher judgements than male defendants from a low socio-economic background. Female defendants from a low socio-economic background received harsher judgements than female defendants from a high socio-economic background. Female defendants were found to be more trustworthy than male defendants. These findings are discussed are discussed in the context of the jury’s verdict, sentence length and personal opinion of the defendant

On the nature of QPO in the tail of SGR giant flares

A model is presented for the quasiperiodic component of magnetar emission during the tail phase of giant flares. The model invokes modulation of the particle number density in the magnetosphere. The magnetospheric currents are modulated by torsional motion of the surface and we calculate that the amplitude of neutron star surface oscillation should be ~1% of the NS radius in order to produce the observed features in the power spectrum. Using an axisymmetric analytical model for structure of the magnetosphere of an oscillating NS, we calculate the angular distribution of the optical depth to the resonant Compton scattering. The anisotropy of the optical depth may be why QPO are observed only at particular rotational phases.Comment: 7 pages, 4 figures, emulateapj styl

Transform-limited X-ray pulse generation from a high-brightness self-amplified spontaneous-emission free-electron laser

A method to achieve high-brightness self-amplified spontaneous emission (HB-SASE) in the free-electron laser (FEL) is described. The method uses repeated nonequal electron beam delays to delocalize the collective FEL interaction and break the radiation coherence length dependence on the FEL cooperation length. The method requires no external seeding or photon optics and so is applicable at any wavelength or repetition rate. It is demonstrated, using linear theory and numerical simulations, that the radiation coherence length can be increased by approximately 2 orders of magnitude over SASE with a corresponding increase in spectral brightness. Examples are shown of HB-SASE generating transform-limited FEL pulses in the soft x-ray and near transform-limited pulses in the hard x-ray. Such pulses may greatly benefit existing applications and may also open up new areas of scientific research

A review of reaction rates and thermodynamic and transport properties for the 11-species air model for chemical and thermal nonequilibrium calculations to 30000 K

Reaction rate coefficients and thermodynamic and transport properties are provided for the 11-species air model which can be used for analyzing flows in chemical and thermal nonequilibrium. Such flows will likely occur around currently planned and future hypersonic vehicles. Guidelines for determining the state of the surrounding environment are provided. Approximate and more exact formulas are provided for computing the properties of partially ionized air mixtures in such environments

An Update on the 0Z Project

We give an update on our 0Z Survey to find more extremely metal poor (EMP) stars with [Fe/H] < -3 dex through mining the database of the Hamburg/ESO Survey. We present the most extreme such stars we have found from ~1550 moderate resolution follow up spectra. One of these, HE1424-0241, has highly anomalous abundance ratios not seen in any previously known halo giant, with very deficient Si, moderately deficient Ca and Ti, highly enhanced Mn and Co, and low C, all with respect to Fe. We suggest a SNII where the nucleosynthetic yield for explosive alpha-burning nuclei was very low compared to that for the hydrostatic alpha-burning element Mg, which is normal in this star relative to Fe. A second, less extreme, outlier star with high [Sc/Fe] has also been found. We examine the extremely metal-poor tail of the HES metallicity distribution function (MDF). We suggest on the basis of comparison of our high resolution detailed abundance analyses with [Fe/H](HES) for stars in our sample that the MDF inferred from follow up spectra of the HES sample of candidate EMP stars is heavily contaminated for [Fe/H](HES) < -3 dex; many of the supposed EMP stars below that metallicity are of substantially higher Fe-metallicity, including most of the very C-rich stars, or are spurious objects.Comment: to appear in conference proceedings "First Stars III", ed. B. O'Shea, A. Heger & T.Abel, 4 pages, 2 figure

Computer codes for the evaluation of thermodynamic and transport properties for equilibrium air to 30000 K

The computer codes developed here provide self-consistent thermodynamic and transport properties for equilibrium air for temperatures from 500 to 30000 K over a temperature range of 10 (exp -4) to 10 (exp -2) atm. These properties are computed through the use of temperature dependent curve fits for discrete values of pressure. Interpolation is employed for intermediate values of pressure. The curve fits are based on mixture values calculated from an 11-species air model. Individual species properties used in the mixture relations are obtained from a recent study by the present authors. A review and discussion of the sources and accuracy of the curve fitted data used herein are given in NASA RP 1260