A History of Nursing

Gutsy life experience poems from a nurse-poet who knows the forces that bend people like trees under a wet spring snow. Read these poems again and again to get the truth -- the whole truth of how her life was and how her life remains. Here in strong poems, is a complex life fully exposed. The poems in A History of Nursing combine the professional life of a woman in the healing arts with the other aspects of her life. Just as she can never stop being the child of her parents, and adult woman, or a mother, a life in nursing colors everything she does and feels. When the nurse becomes a critically ill patient, all of those elements fuse, making her understand the impact she, as a nurse, has had on others. About the Author Anne Webster spent her twenty-five-year nursing career in hospital positions, ranging from float nurse in critical care and emergency departments to nursing administration for those areas. During those years, her poetry appeared in many literary journals and anthologies, including Intensive Care and The Poetry of Nursing. Webster has also taught business writing, consulted to communications firms on writing projects, and edited manuscripts. She conducts creative writing workshops in memoir and poetry and is currently completing a memoir and a novel. Webster lives in Atlanta with her husband.https://digitalcommons.kennesaw.edu/ksupresslegacy/1000/thumbnail.jp

Sleep disturbances in people with dementia living in care homes: measurement, prevalence, manifestation, causes, impact, and persistence

Background :Sleep disturbances are common in people living with dementia and maybe the reason they move into a care home. A third of people with dementia in the UK live in care homes. However, there is little research into the prevalence, causes and impacts of sleep disturbances in this population, and this has practical implications on if and how these disturbances should be treated. / Aim: I aimed to investigate measurement, prevalence, manifestation, causes, impact, and persistence of sleep disturbances in people with dementia living in care homes. / Methods: I conducted a meta-analysis on the measurement and prevalence of sleep disturbances and qualitatively interviewed care home staff about their experiences of sleep disturbances in residents with dementia. Lastly, I investigated the manifestation, persistence and impact of sleep disturbances using the MARQUE (Managing Agitation and Raising QUality of lifE) cohort study; data collected from 1483 residents with dementia for 16 months. / Results: In my meta-analyses, the prevalence of sleep disturbances on validated questionnaires was 38% for symptoms and 20% for clinically significant cases. On actigraphy, 70% had sleep disturbance and staff described how sleep disturbances negatively impacted residents with dementia, staff and other residents. In MARQUE, half of the residents had symptoms of sleep disturbance at one-time point of the study, often getting up at night-time and daytime sleepiness. Of those who had symptoms of sleep disturbance at baseline, the disturbance mostly fluctuated (47%) or persisted (25%) across the study. Having sleep disturbances longitudinally negatively impacted residents’ quality of life (regression coefficient -3.94, 95% confident intervals -4.82 to -3.06), and those with clinically significant cases were more likely to have hospital admissions. There was no correlation between sleep disturbances and mortality. / Conclusion: Sleep disturbances in residents with dementia are common, often fluctuate or persist, and negatively impact their quality of life and are therefore a priority for treatment

Ixodes ricinus, the sheep tick: ecology and disease

Relevant literature was reviewed and the ecology of the sheep tick, Ixodes ricinus and associated disease problems studied in south west Scotland. The development and maintenance of a colony of I.ricinus in the laboratory to provide tick-borne fever (T.B.F.) infected and T.B.F. free ticks for electron microscopic and tick pyaemia transmission studies was described. Additionally development times for each instar were measured during routine colony maintenance. The activity and development of I.ricinus was measured over three years at two sites on Ayrshire sheep farms by blanket drags of pasture areas and tick counts on sheep. Engorged stages were placed in nylon mesh tubes under the vegetation mat, in order to monitor development to subsequent stages. In all instances development to the next instar occurred during the late summer or autumn. Activity patterns varied from year to year with a prolonged period of summer activity in 1984, a bimodal distribution in 1985 and a single spring peak in 1986. Meteorological data was recorded in an attempt, only partially successful, to apply the model devised by Gardiner and Gettinby (1983) to data from these studies. A postal questionnaire was circulated to 300 farmers in Ayrshire and Argyll concerned with seasonal and local distribution of ticks, disease problems and control measures. The replies indicated a high tick incidence in Argyll and marked disease problems in certain regions of Ayrshire where ticks were present. Several of the farms were investigated in more detail by farm visits and examination of blood samples. Experimental tick-borne fever (T.B.F.) infections induced in young lambs were monitored by measurement of rectal temperatures, haematology, assessment of parasitaemias and neutrophil function tests. The classical febrile response accompanied by acute parasitaemia, lymphocytopaenia and followed by neutropaenia was recorded. Additionally an impairment of neutrophil function was demonstrated prior to the neutropaenia using an in vitro assay of neutrophil function. A counter immunoelectrophoresis (CIE) test was developed to detect antibodies produced after T.B.F. infection. Sera from experimental infections in lambs and goats were used to determine the interval after primary infection before antibody could be detected, this was shown to be 9-11 days post intravenous inoculation of the organism and the period of persistence 6-10 weeks in lambs. Four hundred and thirteen ovine field sera obtained from sheep of all ages from predominantly tick infested regions of Scotland and the north of England were tested with a positive rate of 18.2%. When CIE serology was coupled with conventional examination of blood smears the detection rate for ovine T.B.F. was doubled. Additionally, antibodies were detected in a number of sera from cattle, goats and deer using CIE. An electron microscopic technique was developed to demonstrate C.phagocytophila in I.ricinus. This technique was subsequently applied to ticks collected from one sheep farm in an attempt to estimate the level of infection. C.phagocytophila infection was absent from larvae, while 44% of nymphae were infected and 32 % of adults. This result supports the previous finding that transovarial transmission does not occur. Recent publications have indicated that an important aspect of T.B.F. infection in lambs is the associated immunosuppression which allows invasion of secondary pathogens, notably Staphylococcus aureus the causal agent of tick pyaemia. Several experiments were therefore conducted in lambs and mice to examine this aspect. In mice B-lymphocytes were depressed using cyclophosphamide (CY) [ to mimic one aspect of T.B.F. infection] and the mice subsequently challenged with Staphylococcus aureus administered by various routes. Death rates , lesion formation and bacteriological isolations were greater in mice pre-treated with CY. The experiment was repeated in young lambs using T.B.F. rather than CY as a potential suppressive agent. Five days after T.B.F. infection, S.aureus contaminated ticks were allowed to attach and engorge upon the lambs. At necropsy, abscesses from which S.aureus was recovered, were present in the lungs and livers of lambs given T.B.F. and exposed to contaminated ticks, but not in controls which were only exposed to contaminated ticks. This is believed to be the first experimental production of tick pyaemia in lambs using the sheep tick I.ricinus as a mechanical vector of S.aureus.Control of I.ricinus is traditionally by whole body immersion in acaricidal preparations; however more recently synthetic pyrethroid pour-on formulations have been available. Field trials to assess the efficacy of two synthetic pyrethroid pour-on products are described. Tick counts were performed on treated and control lambs and hoggs, disease levels assessed and other effects of the treatment monitored. Results indicate a degree of tick control was achieved , but disease problems still occurred

The Lotic Intersite Nitrogen Experiments: an example of successful ecological research collaboration

Collaboration is an essential skill for modern ecologists because it brings together diverse expertise, viewpoints, and study systems. The Lotic Intersite Nitrogen eXperiments (LINX I and II), a 17-y research endeavor involving scores of early- to late-career stream ecologists, is an example of the benefits, challenges, and approaches of successful collaborative research in ecology. The scientific success of LINX reflected tangible attributes including clear scientific goals (hypothesis-driven research), coordinated research methods, a team of cooperative scientists, excellent leadership, extensive communication, and a philosophy of respect for input from all collaborators. Intangible aspects of the collaboration included camaraderie and strong team chemistry. LINX further benefited from being part of a discipline in which collaboration is a tradition, clear data-sharing and authorship guidelines, an approach that melded field experiments and modeling, and a shared collaborative goal in the form of a universal commitment to see the project and resulting data products through to completion

Physical enrichment research for captive fish : time to focus on the DETAILS

Funding: Fisheries Society of the British Isles (GB) (Grant Number(s): PhD Studentship).Growing research effort has shown that physical enrichment (PE) can improve fish welfare and research validity. However, the inclusion of PE does not always result in positive effects and conflicting findings have highlighted the many nuances involved. Effects are known to depend on species and life stage tested, but effects may also vary with differences in the specific items used as enrichment between and within studies. Reporting fine-scale characteristics of items used as enrichment in studies may help to reveal these factors. We conducted a survey of PE-focused studies published in the last 5 years to examine the current state of methodological reporting. The survey results suggest that some aspects of enrichment are not adequately detailed. For example, the amount and dimensions of objects used as enrichment were frequently omitted. Similarly, the ecological relevance, or other justification, for enrichment items was frequently not made explicit. Focusing on ecologically relevant aspects of PE and increasing the level of detail reported in studies may benefit future work and we propose a framework with the acronym DETAILS ( D imensions, E cological rationale, T iming of enrichment, A mount, I nputs, L ighting and S ocial environment). We outline the potential importance of each of the elements of this framework with the hope it may aid in the level of reporting and standardization across studies, ultimately aiding the search for more beneficial types of PE and the development of our understanding and ability to improve the welfare of captive fish and promote more biologically relevant behaviour.Publisher PDFPeer reviewe

Management of difficult cases in female urology and neurourology at the Reed M. Nesbit society meeting festschrift in honor of Edward J. McGuire, MD

This is a panel discussion of seven complex urologic cases in female urology and neurourology. Differences in diagnosis and management are discussed by this international panel of experts. Neurourol. Urodynam. 29:S2–S12, 2010. © 2010 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71363/1/20795_ftp.pd