The Effects of Conditioned Reinforcers on Extinction When Delivered on Schedules of Extinction

The purpose of the present research was to examine extinction of responding with regard to the rapidity and thoroughness of the process when conditioned reinforcement was available on one of five schedules during extinction. Forty-five mixed-breed pigeons served as subjects with 15 in each of three experiments. Reinforcement training schedules were as follows: Experiment 1, continuous; Experiment 2, fixed ratio 15; Experiment 3, variable-interval one-minute. After training, subjects experienced one of five extinction procedures (here called schedules of extinction) which were as follows: traditional schedule without keylight did not provide conditioned reinforcement; traditional with keylight had the keylight on continuously but withheld other conditioned reinforcement (no schedule, per se, was used); the remaining three schedules (i.e., continuous, fixed ratio 15, and variable-interval one-minute) provided the following four conditioned reinforcers: the sound of the food magazine, the hopper light, the sight of food, and the keylight. Predictions for responding were based on the discrimination hypothesis which states that the more alike training and extinction conditions are, the slower the process of extinction. In order to compare response rates among subjects, a percentage of baseline responding was computed. Four spontaneous recovery tests were conducted to measure the thoroughness of the extinction procedures. Results did not support predictions based on the discrimination hypothesis; that is, subject response rates did not appear to be affected by the similarity of the extinction condition to previous training history. The second finding was that the most rapid and thorough extinction was obtained when the extinction schedule was traditional without keylight. When conditioned reinforcement was available, the continuous extinction schedule produced the most rapid and thorough extinction. The third major finding was that the schedule of unconditioned reinforcement was more predictive of extinction responding than was the conditioned reinforcement schedule during extinction. The last finding was that a subject\u27s pattern of responding was typical of the schedule whether it was on an unconditioned or a conditioned reinforcement schedule. It is suggested that extinction-of-a-human-intervention strategies might be more effective if conditioned reinforcement was identified and controlled

Variables associated with successful vascular access cannulation in hemodialysis patients: A prospective cohort study

BACKGROUND: Successful vascular access (VA) cannulation is integral to the delivery of adequate dialysis, highlighting the importance of ensuring the viability of arteriovenous access in hemodialysis (HD) patients. Missed VA cannulation can lead to infection, infiltration, hematoma or aneurysm formation resulting in the need for access revision, central venous catheter (CVC) placement, or permanent loss of VA. Cannulation-related complications can also negatively impact on a patient\u27s dialysis experience and quality of life. This study aimed to identify patient, VA and nurse factors associated with unsuccessful VA cannulations. METHODS: A prospective cohort study was conducted in HD patients with a permanent VA from three HD units. Data on patient, VA and nurse characteristics, plus, cannulation technique were collected for each episode of cannulation. General Estimating Equation was used to fit a repeated measures logistic regression to determine the odds of cannulation success. RESULTS: We collected data on 1946 episodes of cannulation (83.9% fistula) in 149 patients by 63 nurses. Cannulation included use of tourniquet (62.9%), ultrasound (4.1%) and was by rope ladder (73.8%) or area (24.7%) technique. The miscannulation rate was 4.4% (n = 85) with a third of patients (n = 47) having at least one episode of miscannulation. Extravasation (n = 17, 0.9%) and use of an existing CVC (n = 6, 0.6%) were rare. Multivariable characteristics of successful cannulation included fistula compared with graft [OR 4.38; 95%CI, 1.89-10.1]; older access [OR 1.68; 95%CI, 1.32-2.14]; absence of stent [OR 3.37; 95%CI, 1.39-8.19]; no ultrasound [OR 13.7; 95%CI, 6.52-28.6]; no tourniquet [OR 2.32; 95%CI, 1.15-4.66]; and lack of post graduate certificate in renal nursing [OR 2.27; 95%CI, 1.31-3.93]. CONCLUSION: This study demonstrated a low rate of miscannulation. Further research is required on ultrasound-guided cannulation. Identifying variables associated with successful cannulation may be used to develop a VA cannulation complexity instrument that could be utilised to match to the cannulation skill of a competency-assessed nurse, thereby minimising the risk of missed cannulation and trauma

Lancaster County Dune Inventory

Lancaster County, Virginia is located at the confluence of the Rappahannock River and Chesapeake Bay (Figure 1). Most of the dunes are located along the Rappahannock River with the remainder along Chesapeake Bay. There are a total of 45 dune sites identified along the Lancaster County shoreline (Figure 2). It is the intent of this publication to provide the user with information on the status of dunes in Lancaster County. This information comes from research performed in 1999 and 2000 which was presented in a report entitled “Chesapeake Bay Dune Systems: Evolution and Status (Hardaway et al., 2001). Although somewhat dated, the information provides a short historical perspective of the state of each site at the time of the site visit. Since much of the data was collected several years ago and the beach and dune systems may have changed, this report is intended only as a resource for coastal zone managers and homeowners; it is not intended for use in determining legal jurisdictional limits

Northampton County Dune Inventory

Northampton County is located on the Eastern Shore of Virginia (Figure 1). Only dune sites on Chesapeake Bay were analyzed. A total of 30 dune sites were identified along Northampton’s shoreline (Figure 2). It is the intent of this publication to provide the user with information on the status of dunes in Northampton County. This information comes from research performed in 1999 and 2000 which was presented in a report entitled “Chesapeake Bay Dune Systems: Evolution and Status (Hardaway et al., 2001). Although somewhat dated, the information provides a short historical perspective of the state of each site at the time of the site visit. Since much of the data was collected several years ago and the beach and dune systems may have changed, this report is intended only as a resource for coastal zone managers and homeowners; it is not intended for use in determining legal jurisdictional limits

City of Norfolk Dune Inventory

City of Norfolk, Virginia is located on the southern shore of Chesapeake Bay (Figure 1). Thirteen dune sites were identified along it’s Chesapeake Bay shore from Little Creek Inlet to Willoughby Spit (Figure 2). It is the intent of this publication to provide the user with information on the status of dunes in City of Norfolk. This information comes from research performed in 1999 and 2000 which was presented in a report entitled “Chesapeake Bay Dune Systems: Evolution and Status (Hardaway et al., 2001). Although somewhat dated, the information provides a short historical perspective of the state of each site at the time of the site visit. Since much of the data was collected several years ago and the beach and dune systems may have changed, this report is intended only as a resource for coastal zone managers and homeowners; it is not intended for use in determining legal jurisdictional limits

Northumberland County Dune Inventory

Northumberland County, Virginia is located on the western shore of Chesapeake Bay. Primary tidal shorelines extend from Smith Point southward to Indian Creek along Chesapeake Bay and northwestward up the Potomac River to the Yeocomico River. Fifty-nine (59) dune sites were identified along the Northumberland County shoreline. Thirty seven (37) were located on Chesapeake Bay and the remainder along the Potomac River. It is the intent of this publication to provide the user with information on the status of dunes in Northumberland County. This information comes from research performed in 1999 and 2000 which was presented in a report entitled “Chesapeake Bay Dune Systems:Evolution and Status (Hardaway et al., 2001). Since much of the data was collected several years ago and the beach and dune systems may have changed, this report is intended only as a resource for coastal zone managers and homeowners; it is not intended for use in determining legal jurisdictional limits

City of Virginia Beach Dune Inventory

The City of Virginia Beach is located on the southern shore of Chesapeake Bay (Figure 1). Ocean coast dunes were not included in this assessment. Primary tidal shorelines extend from Cape Henry westward to Little Creek Inlet. Eight (8) dune sites were identified along the City of Virginia Beach shoreline on the southern shore of Chesapeake Bay (Figure 2). It is the intent of this publication to provide the user with information on the status of dunes in City of Virginia Beach. This information comes from research performed in 1999 and 2000 which was presented in a report entitled “Chesapeake Bay Dune Systems: Evolution and Status (Hardaway et al., 2001). Since much of the data was collected several years ago and the beach and dune systems may have changed, this report is intended only as a resource for coastal zone managers and homeowners; it is not intended for use in determining legal jurisdictional limits

Accomack County Dune Inventory

Accomack County is located on the Eastern Shore of Virginia (Figure 1). Only dune sites on Chesapeake Bay were analyzed. A total of 33 dune sites were identified along Accomack’s shoreline (Figure 2). It is the intent of this publication to provide the user with information on the status of dunes in Accomack County. This information comes from research performed in 1999 and 2000 which was presented in a report entitled “Chesapeake Bay Dune Systems: Evolution and Status (Hardaway et al., 2001). Although somewhat dated, the information provides a short historical perspective of the state of each site at the time of the site visit. Since much of the data was collected several years ago and the beach and dune systems may have changed, this report is intended only as a resource for coastal zone managers and homeowners; it is not intended for use in determining legal jurisdictional limits

Clinical deterioration as a nurse sensitive indicator in the out-of-hospital context: A scoping review

Aims: To explore and summarise the literature on the concept of ‘clinical deterioration’ as a nurse-sensitive indicator of quality of care in the out-of-hospital context. Design: The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews. Methods: Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out-of-hospital context were included regardless of methodology. Text and opinion papers were also considered. Study protocols were excluded. Data Sources: Data bases were searched from inception to June 2022 and included CINAHL, PsychINFO, MEDLINE, The Allied and Complementary Medicine Database, EmCare, Maternity and Infant Care Database, Australian Indigenous HealthInfoNet, Informit Health and Society Database, JSTOR, Nursing and Allied Health Database, RURAL, Cochrane Library and Joanna Briggs Institute. Results: Thirty-four studies were included. Workloads, education and training opportunities, access to technology, home visits, clinical assessments and use of screening tools or guidelines impacted the ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting. Conclusions: Little is known about the work of nurses or midwives in out-of-hospital settings and their recognition, reaction to and relay of information about patient deterioration. The complex and subtle nature of non-acute deterioration creates challenges in defining and subsequently evaluating the role and impact of nurses in these settings. Implications for the profession and/or patient care: Further research is needed to clarify outcome measures and nurse contribution to the care of the deteriorating patient in the out-of-hospital setting to reduce the rate of avoidable hospitalisation and articulate the contribution of nurses and midwives to patient care. Impact: What Problem Did the Study Address? Factors that impact a nurse\u27s ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting are not examined to date. What Were the Main Findings? A range of factors were identified that impacted a nurse\u27s ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting including workloads, education and training opportunities, access to technology, home visits, clinical assessments, use of screening tools or guidelines, and avoidable hospitalisation.Where and on whom will the research have an impact?Nurses and nursing management will benefit from understanding the factors that act as barriers and facilitators for effective recognition of, and responding to, a deteriorating patient in the out-of-hospital setting. This in turn will impact patient survival and satisfaction. Reporting Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines guided this review. The PRISMA-Scr Checklist (Tricco et al., 2018) is included as (supplementary file 1).Data sharing is not applicable to this article as no new data were created or analysed in this study.”. No Patient or Public Contribution: Not required as the Scoping Review used publicly available information

Fanny Copeland and the geographical imagination

Raised in Scotland, married and divorced in the English south, an adopted Slovene, Fanny Copeland (1872 – 1970) occupied the intersection of a number of complex spatial and temporal conjunctures. A Slavophile, she played a part in the formation of what subsequently became the Kingdom of Yugoslavia that emerged from the First World War. Living in Ljubljana, she facilitated the first ‘foreign visit’ (in 1932) of the newly formed Le Play Society (a precursor of the Institute of British Geographers) and guided its studies of Solčava (a then ‘remote’ Alpine valley system) which, led by Dudley Stamp and commended by Halford Mackinder, were subsequently hailed as a model for regional studies elsewhere. Arrested by the Gestapo and interned in Italy during the Second World War, she eventually returned to a socialist Yugoslavia, a celebrated figure. An accomplished musician, linguist, and mountaineer, she became an authority on (and populist for) the Julian Alps and was instrumental in the establishment of the Triglav National Park. Copeland’s role as participant observer (and protagonist) enriches our understanding of the particularities of her time and place and illuminates some inter-war relationships within G/geography, inside and outside the academy, suggesting their relative autonomy in the production of geographical knowledge