Verbal Abuse of Pediatric Nurses by Patients and Families

Objective: The purpose of this study was to determine the extent to which nurses practicing in a pediatric hospital encounter verbal abuse by patients and families and their reactions to this abuse. Background: Verbal abuse, the most common type of workplace violence against nurses results in declining morale and job satisfaction, and can negatively impact nurse turnover and quality of patient care. Methods: The study employed a concurrent triangulation strategy using mixed methods. The 162 nurses who volunteered completed a 3-part questionnaire, and a subgroup participated in one of three focus groups. Results: Eighty-two percent of subjects reported verbal abuse an average of 4 times per month. The majority of these continued to think about the incident for a few hours (25%), a few days (36%), or a week or more (12%). Nearly half reported feeling angry or powerless and 14% said they thought of leaving their position. Conclusions: The findings of this study described the nature and scope of the problem, and prompted improvement in processes and education to support nurses. This study was motivated by nurses employed at an urban children\u27s hospital reporting increased incidences of verbal abuse by patients and families. These nurses told of negative encounters which produced feelings of frustration. They perceived that the hospital\u27s increased emphasis on patient and family satisfaction prevented them from setting limits on verbal abuse perpetrated by patients and families. Nursing administration, concerned about staff morale, proposed a study that would describe the extent to which nurses practicing in a pédiatrie hospital encounter verbal abuse by patients and families and their reactions to this abuse

Dynamical Multiferroicity

An appealing mechanism for inducing multiferroicity in materials is the generation of electric polarization by a spatially varying magnetization that is coupled to the lattice through the spin-orbit interaction. Here we describe the reciprocal effect, in which a time-dependent electric polarization induces magnetization even in materials with no existing spin structure. We develop a formalism for this dynamical multiferroic effect in the case for which the polarization derives from optical phonons, and compute the strength of the phonon Zeeman effect, which is the solid-state equivalent of the well-established vibrational Zeeman effect in molecules, using density functional theory. We further show that a recently observed behavior -- the resonant excitation of a magnon by optically driven phonons -- is described by the formalism. Finally, we discuss examples of scenarios that are not driven by lattice dynamics and interpret the excitation of Dzyaloshinskii-Moriya-type electromagnons and the inverse Faraday effect from the viewpoint of dynamical multiferroicity

Heating and Cooling of Hot Accretion Flows by Non Local Radiation

We consider non-local effects which arise when radiation emitted at one radius of an accretion disk either heats or cools gas at other radii through Compton scattering. We discuss three situations: 1. Radiation from the inner regions of an advection-dominated flow Compton cooling gas at intermediate radii and Compton heating gas at large radii. 2. Soft radiation from an outer thin accretion disk Compton cooling a hot one- or two-temperature flow on the inside. 3. Soft radiation from an inner thin accretion disk Compton cooling hot gas in a surrounding one-temperature flow. We describe how previous results are modified by these non-local interactions. We find that Compton heating or cooling of the gas by the radiation emitted in the inner regions of a hot flow is not important. Likewise, Compton cooling by the soft photons from an outer thin disk is negligible when the transition from a cold to a hot flow occurs at a radius greater than some minimum $R_{tr,min}$. However, if the hot flow terminates at $R < R_{tr,min}$, non-local cooling is so strong that the hot gas is cooled to a thin disk configuration in a runaway process. In the case of a thin disk surrounded by a hot one-temperature flow, we find that Compton cooling by soft radiation dominates over local cooling in the hot gas for \dot{M} \gsim 10^{-3} \alpha \dot{M}_{Edd}, and R \lsim 10^4 R_{Schw}. As a result, the maximum accretion rate for which an advection-dominated one-temperature solution exists, decreases by a factor of $\sim 10$, compared to the value computed under an assumption of local energy balance.Comment: LaTeX aaspp.sty, 25 pages, and 6 figures; to appear in Ap

The hunt for protective correlates of immunity to Plasmodium falciparum malaria

Determining an immunologic correlate of protection against Plasmodium falciparum malaria has been the holy grail of natural infection studies, and sought after as an endpoint for malaria vaccine trials. An in vitro assay that provides an accurate and precise assessment of protective immunity to malaria would make smaller, short-duration studies feasible, rather than the currently powered study designs that use morbidity or mortality as outcomes. Such a biomarker would be especially desirable in situations where malaria control measures that result in decreases in clinical endpoints and putatively waning protective immunity have been implemented. In an article published in BMC Medicine, Osier and colleagues addressed this problem, and demonstrated that antibodies promoting opsonic phagocytosis of merozoites provide a functional link between antigen-specific responses and protection. Understanding the mechanisms conferring protection against malaria not only improves our knowledge of basic human immunology, but promises to help in the design of an effective malaria vaccine

Domestic Violence: A Non-random Affair

In this paper, we develop and estimate a model of violence between romantically linked men and women. Physical violence is viewed as both a source of direct gratification and as an instrument for controlling the victim's behavior. Our model is a Stackleberg type model in which the assailant maximizes expected utility subject to the stochastic reaction function of the victim. Our model is estimated by a bounded-?influence regression technique because the process generating violence appears to lead to a heavy-tailed error distribution. Our empirical results suggest that increases in the assailants(i.e. the male's) income serve to increase violence, while increases in the proportion of the year that he is employed serve to decrease violence. Further, the employment effect is larger than the income effect. By way of contrast, our results suggest that the effect of a change in the female's employment or income depends heavily onher economic status relative to the male's. Finally, we find that improvements in the female's opportunites outside the relationship significantly reduce the level of violence.

Tax Compliance: An Investigation Using Individual TCMP Data

In this paper, we analyze the tax compliance behavior of US taxpayers by using a 1979 data set that combines information from a random sample of individual tax returns each of which has been thoroughly audited, IRS administrative records, and sociodemographic data from the Census. We find evidence that both audits and tax code provisions affect compliance. However, the effects are significant for only the low and high income groups. Interestingly, previous research has shown that these groups also participate most actively in underground economic activities, the income from which is not reported on any tax returns. Our results for audits suggest that the "ripple" or general deterrent effect of audits may be many times larger than the direct revenue yield of audits for high income taxpayers. Our results for allowable subtractions from income imply that the 1986 Tax Reform Act changes to lower allowable subtractions may have procompliance effects.

A Structural Equation Model for Tax Compliance and Auditing

In this paper. we estimate a three equation model for taxpayers' reported income and tax liability and for the probability of an audit. Our work differs from previous studies in that our dependent variables in the compliance equations are taxpayer reports rather than a variable related to auditor estimates of noncompliance and in that we estimate a structural equation for audits. We find that audits stimulate compliance although the effect is not large and is not statistically significant for all groups. Audits are more effective at inducing accurate reporting of subtractions from income than of income. Reduced-form results suggest that IRS activities other than audits have significant compliance effects. Results for the sociodemographic variables are interesting and help to explain some seemingly incongruous findings in the literature. We find compliance to be higher, if anything. in areas with less educated and older taxpayers, a large proportion of households headed by females. and a mostly native born population.

Exact ground states and correlation functions of chain and ladder models of interacting hardcore bosons or spinless fermions

By removing one empty site between two occupied sites, we map the ground states of chains of hardcore bosons and spinless fermions with infinite nearest-neighbor repulsion to ground states of chains of hardcore bosons and spinless fermions without nearest-neighbor repulsion respectively, and ultimately in terms of the one-dimensional Fermi sea. We then introduce the intervening-particle expansion, where we write correlation functions in such ground states as a systematic sum over conditional expectations, each of which can be ultimately mapped to a one-dimensional Fermi-sea expectation. Various ground-state correlation functions are calculated for the bosonic and fermionic chains with infinite nearest-neighbor repulsion, as well as for a ladder model of spinless fermions with infinite nearest-neighbor repulsion and correlated hopping in three limiting cases. We find that the decay of these correlation functions are governed by surprising power-law exponents.Comment: 20 pages, 18 figures, RevTeX4 clas

Retention of Low Income Children in Three Dental Studies Investigating Early Childhood Caries

Background: To our knowledge no dental studies have looked closely at subject retention, which is crucial to better understand oral health disparities. In this paper, we report retention rates and review and attempt to assess which retention strategies utilized in 3 dental research studies investigating ECC were effective for retaining WIC-enrolled children. The purpose of this paper is to discuss challenges that were encountered when working with these populations, describe characteristics of those not retained, and summarize some recommendations for future dental studies working at WIC sites. Methods: Three dental studies were conducted at WIC clinics in Iowa. Retention strategies focused on maintenance of contact over time, persistence in rescheduling appointments, utilization of incentives, high recruitment, and frequent communication with parents and program staff. Results: Retention rates in the studies ranged from 60 to 75 percent at the final research interventions. Studies were challenged by frequent moves of subjects, missed appointments, disconnected phones, busy schedules of parents, transportation problems, loss of child custody, family illness, and lack of interest. Those not retained in the studies were more likely to be younger, single, and less educated, with a lower household income and a non-Caucasian child. Lower retention was also associated with the presence of carious lesions. Conclusions: Despite many challenges, studies had good retention rates and benefited from the retention strategies. Future dental studies at WIC clinics may also benefit from arranging transportation, obtaining a free, 800 callback number, and offering after-hours appointments for working parents

Autonomous control procedures for shuttle rendezvous proximity operations

The results are presented of a study which uses fuzzy sets to model a Space Shuttle pilot's reasoning and actions while performing rendezvous proximity operation maneuvers. In this model fuzzy sets are used to simulate smooth and continuous actions as would be expected from an experienced pilot and to simulate common sense reasoning in the decision process. The present model assumes visual information available to the Shuttle pilot from the Shuttle Crew Optical Alignment Sighting (COAS) device and the overhead window and rendezvous radar sensor information available to him from an onboard display. This model will be used in a flight analysis simulator to perform studies requiring a large number of runs, each of which currently needs an engineer in the loop to supply the piloting decisions. This work has much broader implications in control of robots such as the Flight Telerobotic Servicer, in automated pilot control and attitude control, and in advisory and evaluation functions that could be used for flight data monitoring or for testing of various rule sets in flight preparation