Exploring the role of organizational policies and procedures in promoting research utilization in registered nurses

<p>Abstract</p> <p>Background</p> <p>Policies and procedures (P&Ps) have been suggested as one possible strategy for moving research evidence into practice among nursing staff in hospitals. Research in the area of P&Ps is limited, however. This paper explores: 1) nurses' use of eight specific research-based practices (RBPs) and RBP overall, 2) nurses' use and understanding of P&Ps, and 3) the role of P&Ps in promoting research utilization.</p> <p>Methods</p> <p>Staff nurses from the eight health regions governing acute care services across the Canadian province of Newfoundland and Labrador completed an anonymous questionnaire regarding their use of eight RBPs and associated P&Ps. Data were also obtained from authorities in six of the eight regions about existing relevant P&Ps. We used descriptive statistics and multivariate regression analysis to assess the relationship between key independent variables and self-reported use of RBP.</p> <p>Results</p> <p>Use of the eight RBPs ranged from 7.8% to 88.6%, depending on the practice. Nurses ranked P&P manuals as their number one source of practice knowledge. Most respondents (84.8%) reported that the main reason they consult the P&P manual is to confirm they are practicing according to agency rules. Multivariate regression analysis identified three significant predictors of being a user versus non-user of RBP overall: awareness, awareness by regular use, and persuasion. Six significant predictors of being a consistent versus less consistent user of RBP overall were also identified: perception of P&P existence, unit, nursing experience, personal experience as a source of practice knowledge, number of existing research-based P&Ps, and lack of time as a barrier to consulting P&P manuals.</p> <p>Conclusion</p> <p>Findings suggest that nurses use P&Ps to guide their practice. However, the mere existence of P&Ps is not sufficient to translate research into nursing practice. Individual and organizational factors related to nurses' understanding and use of P&Ps also play key roles. Thus, moving research evidence into practice will require careful interplay between the organization and the individual. P&Ps may be the interface through which this occurs.</p

Identification of glucose transporters in Aspergillus nidulans

o characterize the mechanisms involved in glucose transport, in the filamentous fungus Aspergillus nidulans, we have identified four glucose transporter encoding genes hxtB-E. We evaluated the ability of hxtB-E to functionally complement the Saccharomyces cerevisiae EBY.VW4000 strain that is unable to grow on glucose, fructose, mannose or galactose as single carbon source. In S. cerevisiae HxtB-E were targeted to the plasma membrane. The expression of HxtB, HxtC and HxtE was able to restore growth on glucose, fructose, mannose or galactose, indicating that these transporters accept multiple sugars as a substrate through an energy dependent process. A tenfold excess of unlabeled maltose, galactose, fructose, and mannose were able to inhibit glucose uptake to different levels (50 to 80 %) in these s. cerevisiae complemented strains. Moreover, experiments with cyanide-m-chlorophenylhydrazone (CCCP), strongly suggest that hxtB, -C, and –E mediate glucose transport via active proton symport. The A. nidulans ΔhxtB, ΔhxtC or ΔhxtE null mutants showed ~2.5-fold reduction in the affinity for glucose, while ΔhxtB and -C also showed a 2-fold reduction in the capacity for glucose uptake. The ΔhxtD mutant had a 7.8-fold reduction in affinity, but a 3-fold increase in the capacity for glucose uptake. However, only the ΔhxtB mutant strain showed a detectable decreased rate of glucose consumption at low concentrations and an increased resistance to 2-deoxyglucose.The authors would like to thank the Fundacao de Amparo a Pesquisa do Estado de Sao Paulo and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico, Brazil for financial support. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Just regionalisation: rehabilitating care for people with disabilities and chronic illnesses

BACKGROUND: Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. DISCUSSION: Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. SUMMARY: This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of – or revisions to – a regionalised health care strategy

Whose knowledge, whose voices? Power, agency and resistance in disability studies for the global south

Meekosha (2011) maintains that research and theories about disability derive mainly from the global North. Disability Studies rarely include non-metropolitan thinkers. Even when they do, these studies tend to be seen as context specific, and the social theories which emanate from these studies are rarely refered to in research theorizing disability in the North. This chapter sets out to investigate how this one way transfer of knowledge affects the way Disability Studies is conceptualised - whose experiences are incorporated within these studies; and whose are left out. Multilateral debate and dialogue between Disability Studies academics and activists in different locations around the world would help add on to the knowledge already available in the field, while keeping others informed about what is taking place in 'similar' situations elsewhere.peer-reviewe

Screening potential pests of Nordic coniferous forests associated with trade in ornamental plants

Plant pests moved along with the trade in ornamental plants could pose a threat to forests. In this study plant pests potentially associated with this pathway were screened to identify pests that could pose a high risk to the coniferous forests of Finland, Sweden and Norway. Specifically, the aim was to find pests that potentially could fulfil the criteria to become regulated as quarantine pests. EPPO’s commodity study approach, which includes several screening steps, was used to identify the pests that are most likely to become significant pests of Picea abies or Pinus sylvestris. From an initial list of 1062 pests, 65 pests were identified and ranked using the FinnPRIO model, resulting in a top list of 14 pests, namely Chionaspis pinifoliae, Coleosporium asterum s.l., Cytospora kunzei, Dactylonectria macrodidyma, Gnathotrichus retusus, Heterobasidion irregulare, Lambdina fiscellaria, Orgyia leucostigma, Orthotomicus erosus, Pseudocoremia suavis, Tetropium gracilicorne, Toumeyella parvicornis, Truncatella hartigii and Xylosandrus germanus. The rankings of the pests, together with the collected information, can be used to prioritize pests and pathways for further assessment

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Simulation of Load Cycles in Pressurized SOFC Systems and Economic Evaluation

As known from literature [1], the pressurization of SOFC systems may lead to increased efficiencies and higher power output. These benefits will have to be utilized in future power generation in order to meet the requirements of higher electrical power demand as well as the goals of lower emissions. Operating a hybrid power plant at full load only is not always an option. Small power plants have to be able to run in load-following mode in order to keep the load of the grid low. By alternating the power of the gas turbine, a hybrid power plant would only be capable of following load in a band of 100 to 80%. Therefore, load alternation of the SOFC system is crucial for the operation of a hybrid power plant. The model of an SOFC system in a hybrid power plant has been presented before [2]. In this presentation we focus on the load-following capability of the modelled SOFC system. A series of step responses in load demand was applied to the system model, giving a close insight into the systems dynamic capabilities. These step responses will be discussed in detail and rules for dynamic system operation will be developed from these simulations. These rules have to be applied in order to keep the system within safe operation boundaries. Further complete load cycle simulations will be presented based on typical household load demands showing the dynamic capability of the pressurized fuel cell system. The prospects of pressurized SOFC systems in stationary power generation will be discussed on the basis of economical considerations. The operation of the SOFC at full load operation as well as at dynamic load conditions will be considered. 1. Virkar, The effect of pressure on solid oxide fuel cell performance. 1997, Westinghouse Electric Corporation, University of Utah, Department of Material's Science and Engineering. 2. F. Leucht and K. A. Friedrich, "SOFC System Modelling in the Hybrid Power Plant Project," in Proceedings of the 6th Symposium on Fuel Cell Modelling and Experimental Validation, Bad Herrenalb (Germany) (2009)