Understanding nurses' dual practice: A scoping review of what we know and what we still need to ask on nurses holding multiple jobs

© 2018 The Author(s). Background: Mounting evidence suggests that holding multiple concurrent jobs in public and private (dual practice) is common among health workers in low- as well as high-income countries. Nurses are world's largest health professional workforce and a critical resource for achieving Universal Health Coverage. Nonetheless, little is known about nurses' engagement with dual practice. Methods: We conducted a scoping review of the literature on nurses' dual practice with the objective of generating hypotheses on its nature and consequences, and define a research agenda on the phenomenon. The Arksey and O'Malley's methodological steps were followed to develop the research questions, identify relevant studies, include/exclude studies, extract the data, and report the findings. PRISMA guidelines were additionally used to conduct the review and report on results. Results: Of the initial 194 records identified, a total of 35 met the inclusion criteria for nurses' dual practice; the vast majority (65%) were peer-reviewed publications, followed by nursing magazine publications (19%), reports, and doctoral dissertations. Twenty publications focused on high-income countries, 16 on low- or middle-income ones, and two had a multi country perspective. Although holding multiple jobs not always amounted to dual practice, several ways were found for public-sector nurses to engage concomitantly in public and private employments, in regulated as well as in informal, casual fashions. Some of these forms were reported as particularly prevalent, from over 50% in Australia, Canada, and the UK, to 28% in South Africa. The opportunity to increase a meagre salary, but also a dissatisfaction with the main job and the flexibility offered by multiple job-holding arrangements, were among the reported reasons for engaging in these practices. Discussion and conclusions: Limited and mostly circumstantial evidence exists on nurses' dual practice, with the few existing studies suggesting that the phenomenon is likely to be very common and carry implications for health systems and nurses' welfare worldwide. We offer an agenda for future research to consolidate the existing evidence and to further explore nurses' motivation; without a better understanding of nurse dual practice, thiswill continue to be a largely 'hidden' element in nursing workforce policy and practice, with an unclear impact on the delivery of care

Partial discharge measurements in high voltage motors.

The work presented in this thesis is concerned with the development of an on-line technique for detecting and locating partial discharges in the stator winding of a high voltage electrical machine. This technique forms part of an on-line health monitoring strategy for the insulation of high voltage machines. Existing diagnostic techniques and partial discharge measurement systems are reviewed. The requirement for an on-line partial discharge location technique is discussed. An experimental investigation was carried out into the propagation characteristics of partial discharge pulses within a model stator winding. This allowed identification of the main propagation characteristics which were used as the basis for the development of a partial discharge location technique. In the development of a location technique, a means of on-line detection of discharge signals at the motor terminals is required. A study was therefore made on the use of the Rogowski coil for the non-invasive measurement of partial discharges. A partial discharge location system was developed based on the correlation of partial discharge pulses detected at the two ends of a motor phase winding. The performance of the location system was investigated by injecting artificially generated discharge pulses into the model stator winding. Further verification of the ability of the technique to locate the position of discharges was done by injecting high voltage discharges. The final part of the research work was to develop a theoretical model to predict the propagation behaviour of partial discharge pulses in the stator winding of an electrical machine . The effect of electromagnetic propagation through the endwinding region is incorporated in the model of two adjacent coils in a winding

Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting

Background: An elevated preoperative white blood cell count has been associated with a worse outcome after coronary artery bypass grafting (CABG). Leukocyte subtypes, and particularly the neutrophil-lymphocyte (N/L) ratio, may however, convey superior prognostic information. We hypothesized that the N/L ratio would predict the outcome of patients undergoing surgical revascularization. Methods: Baseline clinical details were obtained prospectively in 1938 patients undergoing CABG. The differential leukocyte was measured before surgery, and patients were followed-up 3.6 years later. The primary end point was all-cause mortality. Results: The preoperative N/L ratio was a powerful univariable predictor of mortality (hazard ratio [HR] 1.13 per unit, P 3.36). Conclusion: An elevated N/L ratio is associated with a poorer survival after CABG. This prognostic utility is independent of other recognized risk factors.Peer reviewedAuthor versio

Polygenic threshold model with sex dimorphism in adolescent idiopathic scoliosis: The Carter effect

Background: Idiopathic clubfoot is approximately twice as common in males than in females. The reason for this discrepancy is unclear butmay represent an inherent difference in the susceptibility to thedeformity. If this difference is due to genetic factors it is predicted that in order to inherit clubfoot, females need to have a greater number of susceptibility genes than males. Females would also be more likely to transmit the disease to their children and have siblings with clubfoot. This phenomenon is known as the Carter effect, and the presence of such an effect supports a multifactorial threshold model of inheritance. Methods: Ninety-seven multiplex families with more than one individual with idiopathic clubfoot were studied. The study included1093 individuals: 291with clubfoot and802unaffected relatives. Ratesof transmissionby the thirty-seven affected fathers and twenty-six affected mothers were calculated, and the prevalence among siblings was determined in the nuclear families of affected persons

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project: Current and advanced act control system definition study. Volume 2: Appendices

The current status of the Active Controls Technology (ACT) for the advanced subsonic transport project is investigated through analysis of the systems technical data. Control systems technologies under examination include computerized reliability analysis, pitch axis fly by wire actuator, flaperon actuation system design trade study, control law synthesis and analysis, flutter mode control and gust load alleviation analysis, and implementation of alternative ACT systems. Extensive analysis of the computer techniques involved in each system is included