The relationship between nurses' clinical competency and job stress in Ahvaz university hospital, 2013

زمینه و هدف: صلاحیت بالینی پرستاری، شایستگی کاربرد همزمان دانش، مهارت، نگرش ها و ارزش ها در مراقبت از بیمار است که به دلیل اهمیت آن اخیراً مورد توجه بیشتری قرار گرفته است. با توجه به اهمیت روز افزون موضوع صلاحیت پرستاری، شناخت عوامل مرتبط با آن و از جمله استرس شغلی ضروری به نظر می رسد؛ لذا مطالعه حاضر با هدف تعیین رابطه صلاحیت بالینی و استرس شغلی پرستاران شاغل در بیمارستان های دانشگاهی شهر اهواز در سال1392 انجام شد. روش بررسی: در این پژوهش توصیفی- تحلیلی که به صورت مقطعی در طی سال 1392 انجام شد، 80 نفر پرستار شاغل در بیمارستان های آموزشی شهر اهواز از طریق نمونه گیری تصادفی انتخاب و وارد مظالعه شدند. ابزار گردآوری داده ها شامل پرسشنامه های استرس شغلی Osipow و پرسشنامه صلاحیت بالینی Benner بود که به صورت خود ایفاء تکمیل گردیدند. میزان صلاحیت بالینی پرستاران ارزیابی و ارتباط آن با استرس شغلی تعیین شد. یافته ها: بیشتر پرستاران (3/81 درصد) دارای استرس شغلی متوسط بودند. میانگین نمره کل صلاحیت بالینی پرستاران 48/18± 15/61 بود. آزمون همبستگی پیرسون نشان داد که بین استرس شغلی و صلاحیت بالینی پرستاران در تمام حیطه های آن همبستگی منفی و معنی داری وجود دارد (01/0>P). همچنین بین میزان استرس شغلی و بکارگیری صلاحیت بالینی کل ارتباط معنی داری وجود داشت (001/0>P). نتیجه گیری: بر اساس نتایج مطالعه حاضر، افزایش استرس شغلی پرستاران با کاهش صلاحیت های بالینی آنها رابطه دارد که بایستی مورد توجه مدیران پرستاری قرار گیرد

The Casimir force at high temperature

The standard expression of the high-temperature Casimir force between perfect conductors is obtained by imposing macroscopic boundary conditions on the electromagnetic field at metallic interfaces. This force is twice larger than that computed in microscopic classical models allowing for charge fluctuations inside the conductors. We present a direct computation of the force between two quantum plasma slabs in the framework of non relativistic quantum electrodynamics including quantum and thermal fluctuations of both matter and field. In the semi-classical regime, the asymptotic force at large slab separation is identical to that found in the above purely classical models, which is therefore the right result. We conclude that when calculating the Casimir force at non-zero temperature, fluctuations inside the conductors can not be ignored.Comment: 7 pages, 0 figure

Effects of music intervention on inflammatory markers in critically ill and post-operative patients: A systematic review of the literature

BACKGROUND: Music listening has been shown to reduce anxiety, stress, and patient tolerance of procedures. Music may also have beneficial effects on inflammatory biomarkers in intensive care and post-operative patients, but the quality of evidence is not clear. OBJECTIVES: We conducted a systematic review to evaluate the effects of music on inflammatory biomarkers in intensive care, and post-operative patients. METHODS: A comprehensive search of the literature was performed. After screening 1570 references, full text review of 26 studies was performed. Fourteen studies were selected for inclusion. RESULTS: Seven studies showed a significant decrease in cortisol levels, but the level of evidence was low. Three studies had low risk of methodological bias, while 11 studies had high risk of bias. CONCLUSIONS: Music intervention may decrease cortisol levels, but other biomarkers remain unchanged. Given the low level of evidence, further research on music effects on inflammatory biomarkers is needed

Boron Fullerenes: A First-Principles Study

A family of unusually stable boron cages was identified and examined using first-principles local density functional method. The structure of the fullerenes is similar to that of the B12 icosahedron and consists of six crossing double-rings. The energetically most stable fullerene is made up of 180 boron atoms. A connection between the fullerene family and its precursors, boron sheets, is made. We show that the most stable boron sheets are not necessarily precursors of very stable boron cages. Our finding is a step forward in the understanding of the structure of the recently produced boron nanotubes.Comment: 10 pages, 4 figures, 1 tabl

The Voices and Choices of Women in the Academy

While it is clear that gender inequity still exists, this situation is compounded by race, ethnicity and sexism. The daily experiences of women confirm that racism and sexism is alive and well. This article presents and examines the experiences of Latino, Black, Arab, and Asian professional women and the consequences of their career decisions. Synthesized with literature, conceptual patterns of significance are noted for young girls and women of color aspiring and pursuing professional careers in education. The strategies utilized by these diverse professional women to cope with the trials and tribulations of contemporary educational and professional challenges are reviewed. It is necessary to continue to educate the public about the struggles and successes of women of diverse backgrounds to assist both high school and college age women as they prepare to contribute to the global economy of the 21st century.https://digitalcommons.georgiasouthern.edu/jiasgag/1004/thumbnail.jp

Finite-size and correlation-induced effects in Mean-field Dynamics

The brain's activity is characterized by the interaction of a very large number of neurons that are strongly affected by noise. However, signals often arise at macroscopic scales integrating the effect of many neurons into a reliable pattern of activity. In order to study such large neuronal assemblies, one is often led to derive mean-field limits summarizing the effect of the interaction of a large number of neurons into an effective signal. Classical mean-field approaches consider the evolution of a deterministic variable, the mean activity, thus neglecting the stochastic nature of neural behavior. In this article, we build upon two recent approaches that include correlations and higher order moments in mean-field equations, and study how these stochastic effects influence the solutions of the mean-field equations, both in the limit of an infinite number of neurons and for large yet finite networks. We introduce a new model, the infinite model, which arises from both equations by a rescaling of the variables and, which is invertible for finite-size networks, and hence, provides equivalent equations to those previously derived models. The study of this model allows us to understand qualitative behavior of such large-scale networks. We show that, though the solutions of the deterministic mean-field equation constitute uncorrelated solutions of the new mean-field equations, the stability properties of limit cycles are modified by the presence of correlations, and additional non-trivial behaviors including periodic orbits appear when there were none in the mean field. The origin of all these behaviors is then explored in finite-size networks where interesting mesoscopic scale effects appear. This study leads us to show that the infinite-size system appears as a singular limit of the network equations, and for any finite network, the system will differ from the infinite system

Decreasing delirium through music (DDM) in critically ill, mechanically ventilated patients in the intensive care unit: Protocol for a randomized controlled trial

Background Delirium is a highly prevalent and morbid syndrome in intensive care units (ICUs). Changing the stressful environment within the ICU via music may be an effective and a scalable way to reduce the burden of delirium. Methods/design The Decreasing Delirium through Music (DDM) study is a three-arm, single-blind, randomized controlled feasibility trial. Sixty patients admitted to the ICU with respiratory failure requiring mechanical ventilation will be randomized to one of three arms (20 participants per arm): (1) personalized music, (2) non-personalized relaxing music, or (3) attention-control. Music preferences will be obtained from all enrolled participants or their family caregivers. Participants will receive two 1-h audio sessions a day through noise-cancelling headphones and mp3 players. Our primary aim is to determine the feasibility of the trial design (recruitment, adherence, participant retention, design and delivery of the music intervention). Our secondary aim is to estimate the potential effect size of patient-preferred music listening in reducing delirium, as measured by the Confusion Assessment Method for the ICU (CAM-ICU). Participants will receive twice daily assessments for level of sedation and presence of delirium. Enrolled participants will be followed in the hospital until death, discharge, or up to 28 days, and seen in the Critical Care Recovery Clinic at 90 days. Discussion DDM is a feasibility trial to provide personalized and non-personalized music interventions for critically ill, mechanically ventilated patients. Our trial will also estimate the preliminary efficacy of music interventions on reducing delirium incidence and severity. Trial registration ClinicalTrials.gov, Identifier: NCT03095443. Registered on 23 March 2017

Simulation of networks of spiking neurons: A review of tools and strategies

We review different aspects of the simulation of spiking neural networks. We start by reviewing the different types of simulation strategies and algorithms that are currently implemented. We next review the precision of those simulation strategies, in particular in cases where plasticity depends on the exact timing of the spikes. We overview different simulators and simulation environments presently available (restricted to those freely available, open source and documented). For each simulation tool, its advantages and pitfalls are reviewed, with an aim to allow the reader to identify which simulator is appropriate for a given task. Finally, we provide a series of benchmark simulations of different types of networks of spiking neurons, including Hodgkin-Huxley type, integrate-and-fire models, interacting with current-based or conductance-based synapses, using clock-driven or event-driven integration strategies. The same set of models are implemented on the different simulators, and the codes are made available. The ultimate goal of this review is to provide a resource to facilitate identifying the appropriate integration strategy and simulation tool to use for a given modeling problem related to spiking neural networks.Comment: 49 pages, 24 figures, 1 table; review article, Journal of Computational Neuroscience, in press (2007

Psychiatric symptoms and their association with sleep disturbances in intensive care unit survivors

Background: Sleep disturbances in critically ill patients are associated with poorer long-term clinical outcomes and quality of life. Studies are needed to better characterize associations and risk factors for persistent sleep disturbances after intensive care unit (ICU) discharge. Psychiatric disorders are frequently associated with sleep disturbances, but the role of psychiatric symptoms in sleep disturbances in ICU survivors has not been well-studied. Objective: To examine the association between psychiatric symptoms and sleep disturbances in ICU survivors. Methods: 112 adult ICU survivors seen from July 2011 to August 2016 in the Critical Care Recovery Center, an ICU survivor clinic at the Eskenazi Hospital in Indianapolis, IN, USA, were assessed for sleep disturbances (insomnia, hypersomnia, difficulty with sleep onset, difficulty with sleep maintenance, and excessive daytime sleepiness) and psychiatric symptoms (trauma-related symptoms and moderate to severe depressive symptoms) 3 months after ICU discharge. A multivariate logistic regression model was performed to examine the association between psychiatric symptoms and sleep disturbances. Analyses were controlled for age, hypertension, history of depression, and respiratory failure. Results: ICU survivors with both trauma-related and depression symptoms (OR 16.66, 95% CI 2.89-96.00) and trauma-related symptoms alone (OR 4.59, 95% CI 1.11-18.88) had a higher likelihood of sleep disturbances. Depression symptoms alone were no longer significantly associated with sleep disturbances when analysis was controlled for trauma-related symptoms. Conclusion: Trauma-related symptoms and trauma-related plus moderate to severe depressive symptoms were associated with a higher likelihood of sleep disturbances. Future studies are needed to determine whether psychiatric symptoms are associated with objective changes on polysomnography and actigraphy and whether adequate treatment of psychiatric symptoms can improve sleep disturbances

Response to depression treatment in the Aging Brain Care Medical Home model

OBJECTIVE: To evaluate the effect of the Aging Brain Care (ABC) Medical Home program's depression module on patients' depression severity measurement over time. DESIGN: Retrospective chart review. SETTING: Public hospital system. PARTICIPANTS: Patients enrolled in the ABC Medical Home program between October 1, 2012 and March 31, 2014. METHODS: The response of 773 enrolled patients who had multiple patient health questionnaire-9 (PHQ-9) scores recorded in the ABC Medical Home program's depression care protocol was evaluated. Repeatedly measured PHQ-9 change scores were the dependent variables in the mixed effects models, and demographic and comorbid medical conditions were tested as potential independent variables while including random effects for time and intercept. RESULTS: Among those patients with baseline PHQ-9 scores >10, there was a significant decrease in PHQ-9 scores over time (P50% decline from baseline) on the PHQ-9 at 6 months. CONCLUSION: These analyses demonstrate evidence for the sustained effectiveness of the ABC Medical Home program at inducing depression remission outcomes while employing clinical staff who required less formal training than earlier clinical trials