2,315 research outputs found

    Electron impact promoted fragmentation of alkyl-N-(1-Phenylethyl)-carbamates of primary, secondary and tertiary alcohols

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    Mass spectra of alkyl carbamates derived from primary, secondary, and teriary alcohols by use of deuterium labeling and high resolution mass spectroscop

    Factors in the practice environment of nurses working in inpatient mental health: A partial least squares path modeling approach

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    Background: Developing a therapeutic relationship with consumers is considered as the central aspect of nursing work in mental health. The importance of this relationship stems from its association with enhanced patient care and improved patient outcomes. Factors within the practice environment may influence the nurse's ability to engage effectively in this relationship. Objective: This study explored a model that added characteristics of the individual and practice environment to a central framework incorporating therapeutic commitment: a nurse's ability and willingness to engage in a therapeutic relationship. Setting and participants: Data were collected at six mental health nursing units in five public general acute hospitals in New South Wales, Australia for 14 days per unit, between 2005 and 2006. All nurses in participating wards were invited to partake in the study. Seventy-six (51%) responses were analyzed. Method: The data were collected using a Nurse Survey inclusive of the Practice Environment Scale of the Nursing Work Index (NWI-PES), and the Mental Health Problems Perception Questionnaire (MHPPQ). A Unit Profile form was used concurrently to collect staffing, skill mix and patient turnover data. Partial least squares path modeling (PLS-PM) was chosen as the analytical method to test the model and identify the most influential factors. Results: Experienced nurses who perceived themselves to be competent and supported were more likely to express a willingness to engage therapeutically with patients. Environmental factors associated with these perceptions included foundations of quality nursing care, opportunities to participate in hospital affairs and clinical supervision. Not all elements in the proposed model were supported. Conclusion: Positive hospital practice environments can improve the capacity of nurses working in mental health to engage therapeutically with patients. Specific approaches may include access to preceptorship, continued education and career development opportunities, together with clinical supervision, improved continuity of care, and the involvement of mental health nurses in the governance of the hospital. © 2011 Elsevier Ltd

    The economic benefits of increased levels of nursing care in the hospital setting

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    Aim: To assess the economic impact of increased nursing hours of care on health outcomes in adult teaching hospitals in Perth, Western Australia. Background: Advancing technology and increased availability of treatment interventions are increasing demand for health care while the downturn in world economies has increased demand for greater efficiency. Nurse managers must balance nurse staffing to optimize care and provide efficiencies. Design: This longitudinal study involved the retrospective analysis of a cohort of multi-day stay patients admitted to adult teaching hospitals. Methods: Hospital morbidity and staffing data from September 2000 until June 2004, obtained in 2010 from a previous study, were used to analyse nursing-sensitive outcomes pre- and post-implementation of the Nurse Hours per Patient Day staffing method, which remains in place today. The cost of the intervention comprised increased nursing hours following implementation of the staffing method. Results: The number of nursing-sensitive outcomes was 1357 less than expected post-implementation and included 155 fewer \u27failure to rescue\u27 events. The 1202 other nursing-sensitive outcomes prevented were \u27surgical wound infection\u27, \u27pulmonary failure\u27, \u27ulcer, gastritis\u27, \u27upper gastrointestinal bleed\u27, and \u27cardiac arrest\u27. One outcome, pneumonia, showed an increase of 493. Analysis of life years gained was based on the failure to rescue events prevented and the total life years gained was 1088. The cost per life year gained was AUD$8907. Conclusion: The implementation of the Nurse Hours per Patient Day staffing method was cost-effective when compared with thresholds of interventions commonly accepted in Australia

    Avatars of Eurocentrism in the critique of the liberal peace

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    Recent scholarly critiques of the so-called liberal peace raise important political and ethical challenges to practices of postwar intervention in the global South. However, their conceptual and analytic approaches have tended to reproduce rather than challenge the intellectual Eurocentrism underpinning the liberal peace. Eurocentric features of the critiques include the methodological bypassing of target subjects in research, the analytic bypassing of subjects through frameworks of governmentality, the assumed ontological split between the ‘liberal’ and the ‘local’, and a nostalgia for the liberal subject and the liberal social contract as alternative bases for politics. These collectively produce a ‘paradox of liberalism’ that sees the liberal peace as oppressive but also the only true source of emancipation. However, the article suggests that a repoliticization of colonial difference offers an alternative ‘decolonizing’ approach to critical analysis through repositioning the analytic gaze. Three alternative research strategies for critical analysis are briefly developed

    High fat diet rescues disturbances to metabolic homeostasis and survival in the Id2 null mouse in a sex-specific manner

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    Inhibitor of DNA binding 2 (ID2) is a helix-loop-helix transcriptional repressor rhythmically expressed in many adult tissues. Our previous studies have demonstrated that Id2 null mice have altered expression of circadian genes involved in lipid metabolism, altered circadian feeding behavior, and sex-specific enhancement of insulin sensitivity and elevated glucose uptake in skeletal muscle and brown adipose tissue. Here we further characterized the Id2−/− mouse metabolic phenotype in a sex-specific context and under low and high fat diets, and examined metabolic and endocrine parameters associated with lipid and glucose metabolism. Under the low-fat diet Id2−/− mice showed decreased weight gain, reduced gonadal fat mass, and a lower survival rate. Under the high-fat diet, body weight and gonadal fat gain of Id2−/− male mice was comparable to control mice and survival rate improved markedly. Furthermore, the high-fat diet treated Id2−/− male mice lost the enhanced glucose tolerance feature observed in the other Id2−/− groups, and there was a sex-specific difference in white adipose tissue storage of Id2−/− mice. Additionally, a distinct pattern of hepatic lipid accumulation was observed in Id2−/− males: low lipids on the low-fat diet and steatosis on the high-fat diet. In summary, these data provides valuable insights into the impact of Id2 deficiency on metabolic homeostasis of mice in a sex-specific manner

    Security governance and networks: New theoretical perspectives in transatlantic security

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    The end of the Cold War has not only witnessed the rise of new transnational threats such as terrorism, crime, proliferation and civil war; it has also seen the growing role of non-state actors in the provision of security in Europe and North America. Two concepts in particular have been used to describe these transformations: security governance and networks. However, the differences and potential theoretical utility of these two concepts for the study of contemporary security have so far been under-examined. This article seeks to address this gap. It proposes that security governance can help to explain the transformation of Cold War security structures, whereas network analysis is particularly useful for understanding the relations and interactions between public and private actors in the making and implementation of national and international security policies

    The Use of unregulated staff: Time for regulation?

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    Internationally, shortages in the nursing workforce, escalating patient demands, and financial constraints within the health system have led to the growth of unlicensed nursing support workers. Recently, in relation to the largest publicly funded health system (National Health Service), it was reported that extensive substitution of registered nurses with unskilled nursing support workers resulted in inadequate patient care, increased morbidity and mortality rates, and negative nurse outcomes. We argue that it is timely to consider regulation of nursing support workers with their role and scope of practice clearly defined. Further, the addition of these workers in a complementary model of care (rather than substitutive model) should also be explored in future research, in terms of impact on patient and nurse outcomes

    Genetic covariance in immune measures and pathogen resistance in decorated crickets is sex and pathogen specific

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    Insects are important models for studying immunity in an ecological and evolutionary context. Yet, most empirical work on the insect immune system has come from phenotypic studies meaning we have a limited understanding of the genetic architecture of immune function in the sexes. We use nine highly inbred lines to thoroughly examine the genetic relationships between a suite of commonly used immune assays (haemocyte count, implant encapsulation, total phenoloxidase activity, antibacterial zone of inhibition and pathogen clearance) and resistance to infection by three generalist insect pathogens (the gram-negative bacterium Serratia marcescens, the gram-positive bacterium Bacillus cereus and the fungus Metarhizium robertsii) in male and female Gryllodes sigillatus. There were consistent positive genetic correlations between haemocyte count, antibacterial and phenoloxidase activity and resistance to S. marcescens in both sexes, but these relationships were less consistent for resistance to B. cereus and M. robertsii. In addition, the clearance of S. marcescens was genetically correlated with the resistance to all three pathogens in both sexes. Genetic correlations between resistances to the different pathogen species were inconsistent, indicating that resistance to one pathogen does not necessarily mean resistance to another. Finally, while there is ample genetic (co)variance in immune assays and pathogen resistance, these genetic estimates differed across the sexes and many of these measures were not genetically correlated across the sexes, suggesting that these measures could evolve independently in the sexes. Our finding that the genetic architecture of immune function is sex and pathogen specific suggests that the evolution of immune function in male and female G. sigillatus is likely to be complex. Similar quantitative genetic studies that measure a large number of assays and resistance to multiple pathogens in both sexes are needed to ascertain if this complexity extends to other species

    Microscopic Foundation of Nonextensive Statistics

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    Combination of the Liouville equation with the q-averaged energy Uq=qU_q = _q leads to a microscopic framework for nonextensive q-thermodynamics. The resulting von Neumann equation is nonlinear: iρ˙=[H,ρq]i\dot\rho=[H,\rho^q]. In spite of its nonlinearity the dynamics is consistent with linear quantum mechanics of pure states. The free energy Fq=UqTSqF_q=U_q-TS_q is a stability function for the dynamics. This implies that q-equilibrium states are dynamically stable. The (microscopic) evolution of ρ\rho is reversible for any q, but for q1q\neq 1 the corresponding macroscopic dynamics is irreversible.Comment: revte
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