The effectiveness of education in the recognition and management of deteriorating patients: A systematic review

publisher: Elsevier articletitle: The effectiveness of education in the recognition and management of deteriorating patients: A systematic review journaltitle: Nurse Education Today articlelink: http://dx.doi.org/10.1016/j.nedt.2016.06.001 content_type: article copyright: © 2016 Elsevier Ltd. All rights reserved

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Trophic rewilding presents regionally specific opportunities for mitigating climate change

Large-bodied mammalian herbivores can influence processes that exacerbate or mitigate climate change. Herbivore impacts are, in turn, influenced by predators that place top-down forcing on prey species within a given body size range. Here, we explore how the functional composition of terrestrial large herbivore and carnivore guilds vary between three mammal distribution scenarios: Present-Natural, Current-Day, and Extant-Native Trophic (ENT) Rewilding. Considering the effects of herbivore species weakly influenced by top-down forcing, we quantify the relative influence keystone large herbivore guilds have on methane emissions, woody vegetation expansion, fire dynamics, large-seed dispersal, and nitrogen and phosphorous transport potential. We find strong regional differences in the number of herbivores under weak top-down regulation between our three scenarios with important implications for how they will influence climate change relevant processes. Under the Present-Natural non-ruminant, megaherbivore, browsers were a particularly important guild across much of the world. Megaherbivore extinction and range contraction and the arrival of livestock means large, ruminant, grazers have become more dominant. ENT Rewilding can restore the Afrotropics and Indo-Malay to the Present-Natural benchmark, but causes top-down forcing of the largest herbivores to become common place elsewhere. ENT Rewilding will reduce methane emissions, but does not maximise Natural Climate Solution potential

Living biointerfaces based on non-pathogenic bacteria to direct cell differentiation

Genetically modified Lactococcus lactis, non-pathogenic bacteria expressing the FNIII7-10 fibronectin fragment as a protein membrane have been used to create a living biointerface between synthetic materials and mammalian cells. This FNIII7-10 fragment comprises the RGD and PHSRN sequences of fibronectin to bind α5β1 integrins and triggers signalling for cell adhesion, spreading and differentiation. We used L. lactis strain to colonize material surfaces and produce stable biofilms presenting the FNIII7-10 fragment readily available to cells. Biofilm density is easily tunable and remains stable for several days. Murine C2C12 myoblasts seeded over mature biofilms undergo bipolar alignment and form differentiated myotubes, a process triggered by the FNIII7-10 fragment. This biointerface based on living bacteria can be further modified to express any desired biochemical signal, establishing a new paradigm in biomaterial surface functionalisation for biomedical applications

What is food without love? The micro-politics of food practices in South Asians in Britain, India and Pakistan

This article draws on Morgan’s theorisation of family life as consisting of political, moral, and emotional economies to examine the interplay of women’s control over resources, gender norms, and expectations of intimacy in the context of household food consumption. The research that informs the article focuses on findings from 84 interviews with two South Asian groups: Pakistani Muslim and Gujarati Hindu women with at least one dependent child and from a variety of occupations and household compositions. In examining everyday food consumption, the research demonstrates how gender hierarchies are reproduced by parallel, mutually reinforcing, political, moral, and emotional economies. The women in the study sometimes struggled to subvert gender oppression and negotiate more powerful positions within the household through food management and/or employing manipulative and deceptive tactics. The article argues that, while access to economic resources is important if women are to achieve desirable food and nutritional outcomes, it is not in itself sufficient to meet this aim. Instead, the interplay of resources, gender norms, and conjugal relations are central to household food consumption

Practice priorities for acute care nursing: A Delphi study

Aims and objectives: To describe the risk and frequency of challenges in acute care nursing, and the practice priorities in Australian hospital wards based upon expert consensus. Background: Health care is facing increasing demands that are negatively impacting upon the safety and quality of nursing care. Design: Delphi Method. Method: A three-round electronic Delphi method was used to collect and synthesise expert consensus opinion of 30 participants in Rounds One and Two of the survey, and 12 participants in Round Three. The study was carried out from July to December 2016. This study complied with the STROBE checklist. Results: High patient acuity or complexity, as well as inadequate bed space on wards, are “very high” risks that occur “often” and “very often,” respectively. The pressure to admit patients, delayed medical review and patient boarding are all “high” risks that occur “often.” Though only occurring “sometimes,” inadequate numbers and skill mix of staff, suboptimal communication and early or inappropriate discharge all pose a “very high” risk to patient care. Conclusion: The key practice priorities for nurse managers should include the design, implementation and evaluation of sustainable system-wide frameworks, processes and models of care that address patient boarding, communication and discharge processes, job satisfaction, staffing numbers and expertise. Relevance to clinical practice: This study provides a description of the challenges that face acute care nursing in the provision of safe and high-quality care. © 2020 John Wiley & Sons Lt

Games People Play: The Collapse of “Masculinities” and the Rise of Masculinity as Spectacle

Perspective is important. When Andy Warhol produced an art piece of 13 police mugshots of “Thirteen Most Wanted Men” for the New York World’s Fair in 1964, the work was hurriedly painted over by concerned authorities before the public could view it. It was only years later that the Warhol’s subversive (homoerotic) gaze on the FBI list was more widely appreciated (Crimp in Social Text 59: 49–66, 1999; Siegel in Art Journal 62(1): 7–13, 2003). I begin with this story because it points to key issues I want to take up in this chapter, in particular, the importance of “audience” and different readings when it comes to masculinity. While current theory tends to locate masculinity in the actors, what if it is better located in the audience? What if masculinity was better understood as a kind of public spectacle? In addition, there are the naturally subversive elements of gender (e.g. think of drag performances); the game-like nature of masculinity (men might feel compelled to play along with expectations of masculinity—think of brutal playground expectations on boys—but it doesn’t mean they are not aware of its inauthenticity); and the inevitable—but less discussed link—with sexuality (see below)

“I Kiss Them Because I Love Them”: The Emergence of Heterosexual Men Kissing in British Institutes of Education.

In this article, we combined data from 145 interviews and three ethnographic investigations of heterosexual male students in the U.K. from multiple educational settings. Our results indicate that 89% have, at some point, kissed another male on the lips which they reported as being non-sexual: a means of expressing platonic affection among heterosexual friends. Moreover, 37% also reported engaging in sustained same-sex kissing, something they construed as non-sexual and non-homosexual. Although the students in our study understood that this type of kissing remains somewhat culturally symbolized as a taboo sexual behavior, they nonetheless reconstructed it, making it compatible with heteromasculinity by recoding it as homosocial. We hypothesize that both these types of kissing behaviors are increasingly permissible due to rapidly decreasing levels of cultural homophobia. Furthermore, we argue that there has been a loosening of the restricted physical and emotional boundaries of traditional heteromasculinity in these educational settings, something which may also gradually assist in the erosion of prevailing heterosexual hegemony

Malaysian primary care doctors' views on men's health: an unresolved jigsaw puzzle

<p>Abstract</p> <p>Background</p> <p>Men have been noted to utilise health care services less readily then women. Primary care settings provide an opportunity to engage men in health care activities because of close proximity to the target group (men in the community). Understanding attitudes towards men's health among Malaysian primary care doctors is important for the effective delivery of health services to men. We aimed to explore the opinions and attitudes of primary care doctors (PCDs) relating to men's health and help-seeking behaviour.</p> <p>Methods</p> <p>A qualitative approach to explore the opinions of 52 PCDs was employed, using fourteen in-depth interviews and eight focus group discussions in public and private settings. Purposive sampling of PCDs was done to ensure maximum variation in the PCD sample. Interviews were recorded and transcribed verbatim for analysis. Open coding with thematic analysis was used to identify key issues raised in the interview.</p> <p>Results</p> <p>The understanding of the concept of men's health among PCDs was fragmented. Although many PCDs were already managing health conditions relevant and common to men, they were not viewed by PCDs as "men's health". Less attention was paid to men's help-seeking behaviour and their gender roles as a potential determinant of the poor health status of men. There were opposing views about whether men's health should focus on men's <it>overall </it>health or a more focused approach to sexual health. There was also disagreement about whether special attention was warranted for men's health services. Some doctors would prioritise more common conditions such as hypertension, diabetes and hypercholesterolaemia.</p> <p>Conclusions</p> <p>The concept of men's health was new to PCDs in Malaysia. There was wide variation in understanding and opposing attitudes towards men's health among primary care doctors. Creating awareness and having a systematic approach would facilitate PCDs in delivering health service to men.</p