Community- and hospital-based nurses’ implementation of evidence-based practice: are there any differences?

The aim of this paper is to discuss the effect of nurses’ beliefs, knowledge, and skills on the implementation of evidence-based practice (EBP) in hospital and community settings. EBP refers to the implementation of the most up-to-date robust research into clinical practice. Barriers have been well documented and traditionally include the negative beliefs of nurses as well as a lack of time, knowledge, and skills. However, with degree entry nursing and a focus on community health care provision, what has changed? A comprehensive search of contemporary literature (2010–2015) was completed. The findings of this review show that the traditionally acknowledged barriers of a lack of time, knowledge, and skills remained; however, nurses’ beliefs toward EBP were more positive, but positive beliefs did not affect the intentions to implement EBP or the knowledge and skills of EBP. Nurses in hospital and community settings reported similar barriers and facilitators. This document is the Accepted Manuscript version of a Published Work that appeared in final form in the British Journal of Community Nursing, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see https://www.magonlinelibrary.com/doi/abs/10.12968/bjcn.2016.21.3.148?af=R&mobileUi=

Promoting Physical Activity in Low Income African Americans: Project LAPS

Low income African Americans are at increased risk for physical inactivity and related chronic illnesses. Thus, effective interventions are needed to address these health disparities. The current study examined the efficacy of a home-based physical activity intervention among a low income African American sample with high rates of chronic illnesses (obesity, hypertension, diabetes, high cholesterol). Participants (n=214) were randomly assigned to either the home-based physical activity intervention (self-help print materials, five monthly newsletters, two telephone counseling sessions) or an attention control condition, which promoted healthy diet. Results indicated that the intervention did not produce significantly greater increases in physical activity from baseline to six months than the control group. Lessons learned from the current study include the importance of using proactive retention strategies with low income African American participants and taking into consideration the cultural relevance of the intervention

Odyssean malaria outbreaks in Gauteng Province, South Africa, 2007- 2013

KMBackground: Odyssean malaria refers to malaria transmitted by translocated mosquitoes and is a diagnosis of exclusion, as the probability of finding the responsible vector is miniscule. We believe that road traffic from endemic areas in and around South Africa is the source of most of the infected mosquitoes. Because of the unexpected nature of the disease, diagnosis is often delayed and severe and complicated malaria is common Objectives: To describe outbreaks of odyssean malaria during the period 2007 through 2013 in Gauteng Province, South Africa, and to educate healthcare workers about this form of malaria. Methods: Site visits, environmental hygiene inspections, patient interviews, and entomological investigations for adult mosquitoes and larvae in potential breeding sites were done in each identified outbreak. Results: Over the period, 14 laboratory-proven and 7 probable cases of odyssean malaria were investigated. There were 2 deaths (9.5% case fatality rate, approximately 10 times higher than the national fatality rate for malaria). We describe two recent clusters of cases in detail, and emphasise the importance of clinician awareness of this rare but frequently severe form of malaria. Conclusion. Odyssean malaria cases are inevitable in South Africa, given the volume of road, rail and air traffic from malaria risk areas into Gauteng and other non-endemic provinces. It is likely that many cases are missed, owing to the rare and sporadic nature of the condition. Malaria should always be kept in mind as a cause of unexplained fever and thrombocytopenia, even in the absence of a travel histor

Development of a radiographic technique for porcine head ballistic research

Introduction: The porcine model shows structural features comparable to that of humans and are routinely used within research, due to the ethical, legal, and practical use of post-mortem human samples. Methods for obtaining high quality and comparable reference data using standardised acquisition protocols are essential. Methods: The decapitated heads of three adult white sows were subjected to radiographic imaging before and after cranial trauma (9 mm, Heckler and Koch MP5). Digital radiographs were generated using a Siemens MULTIX TOP system with an Agfa digital detector, with foam blocks and sandbags as ancillary equipment. An iterative approach was adopted by the authors to generate reproducible radiographic views from two perpendicular angles. Specimens were kept at 5 °C and wrapped in polythene bags to reduce the impact of putrefaction. Results: Standardised head radiography technique was developed for superior-inferior and lateral views demonstrating porcine anatomy. Key parameters included: automatic exposure control for tube current (∼4 mAs), tube voltage of 73 kVp, 100 cm source to image receptor distance, and an anti-scatter grid. Slight variances in specimen morphology, developmental status, and soft tissue changes did not affect imaging outcomes. Conclusion: The technique and positioning proposed in this study allows for the acquisition of high quality and reproducible radiographic images for comparable ballistic research datasets. Specimen positioning and centring of the primary beam may be applied across porcine breeds, although individual radiographic parameters may differ according to equipment specifications and specimen size. Implications for practice: Development of a reproducible radiographic technique of porcine heads in forensic and veterinary research

Transverse instability for non-normal parameters

We consider the behaviour of attractors near invariant subspaces on varying a parameter that does not preserve the dynamics in the invariant subspace but is otherwise generic, in a smooth dynamical system. We refer to such a parameter as ``non-normal''. If there is chaos in the invariant subspace that is not structurally stable, this has the effect of ``blurring out'' blowout bifurcations over a range of parameter values that we show can have positive measure in parameter space. Associated with such blowout bifurcations are bifurcations to attractors displaying a new type of intermittency that is phenomenologically similar to on-off intermittency, but where the intersection of the attractor by the invariant subspace is larger than a minimal attractor. The presence of distinct repelling and attracting invariant sets leads us to refer to this as ``in-out'' intermittency. Such behaviour cannot appear in systems where the transverse dynamics is a skew product over the system on the invariant subspace. We characterise in-out intermittency in terms of its structure in phase space and in terms of invariants of the dynamics obtained from a Markov model of the attractor. This model predicts a scaling of the length of laminar phases that is similar to that for on-off intermittency but which has some differences.Comment: 15 figures, submitted to Nonlinearity, the full paper available at http://www.maths.qmw.ac.uk/~eo

Melting transition of an Ising glass driven by magnetic field

The quantum critical behavior of the Ising glass in a magnetic field is investigated. We focus on the spin glass to paramagnet transition of the transverse degrees of freedom in the presence of finite longitudinal field. We use two complementary techniques, the Landau theory close to the T=0 transition and the exact diagonalization method for finite systems. This allows us to estimate the size of the critical region and characterize various crossover regimes. An unexpectedly small energy scale on the disordered side of the critical line is found, and its possible relevance to experiments on metallic glasses is briefly discussed.Comment: 4 pages, 3 figure

Exact averages of central values of triple product L-functions

We obtain exact formulas for central values of triple product L-functions averaged over newforms of weight 2 and prime level. We apply these formulas to non-vanishing problems. This paper uses a period formula for the triple product L-function proved by Gross and Kudla