3,281 research outputs found
Die Pflanzengesellschaften des Rubbenbruchs bei Osnabrßck und ihre Gefährdung durch Erholungsnutzung
Im Sommer 1987 wurde die Vegetation des Rubbenbruchs, etwa 3 km westlich von Osnabrßck, kartiert. Damit sollten der derzeitige Zustand dokumentiert und Veränderungen in der Pflanzenwelt seit 1872 bis heute aufgezeigt werden. Anhand von 120 Vegetationsaufnahmen wurde eine Vegetationskarte angefertigt. Eine Pflanzenliste zeigt 357 Pflanzen- und 27 Moosarten. Veränderungen in der Pflanzenwelt drßcken sich in einer bedenklichen Vereinheitlichung der Vegetation aus. Nur noch an wenigen Stellen sind typische Pflanzengesellschaften eines Niedermoores anzutreffen, und die Vermischung mit .Allerweltsarten" ist deutlich zu sehen. Die Gefährdung der Pflanzengesellschaften durch Erholungsnutzung wurde anhand von Literaturstudien bearbeitet und kann als besorgniserregend eingestuft werden. Der Konflikt zwischen Naturschutz und Erholung ist am ehesten dadurch zu lÜsen, daà das Gebiet unter Naturschutz gestellt und gleichzeitig ein Pflege- und Entwicklungsplan erarbeitet und realisiert wird
The educational needs of qualified nurses caring for children following trauma.
This study has identified the knowledge, skills and attitudes required by qualified nurses who care
for children in Accident and Emergency (A and E) following trauma. These requirements were
then compared with the current attributes of such nurses.
The researchm ethodologyw as carriedo ut in three phasesa fter an extensives urveyo f the relevant
literature. The identification of the level of knowledge, skill and attitudes required for best practice
was achieved by the first phase: a Delphi study, being a structured approach to collecting the
opinions of a panel of qualifieda nd experiencedc hildren's nurses.T he actualk nowledge,s kills
and attitudes that nurses have and apply in practice were identified by the second and third phases
of the research.R egisteredn ursesc aring for children in three A and E units were surveyedb y
questionnairew hilst further dataw as obtainedb y nine sessionso f participant observationi n three
A and E units.
Ile three sets of results have been compared and contrasted with each other and with the review
of the literature and this triangulation approach has led to a number of key findings. The care
needs of traurnatised children are different from those of adults; at present the majority of
children are not cared for by nurses with the necessary competence or within an appropriate
environment. Children need holistic care, not just the treatment of their medical injury.
ibis study has uncovered a specific education and training challenge, because most of the
registered nurses in this survey who do care for traumatiscd children think they arc competent in
that specific and distinct role, although the observations showed that this is not always the case.
Such nurses should be trained in both paediatric and A and E nursing skills. Tl-ýs can and should
be achievedb y personaliseda nd flexible courses.
The recommendationsa rising from the key outcomesh ave been made separatelyto educationa nd
training providers, to the nurses themselves and finally to the health care policy makers and
managers who control the clinical environment for the A and E nursing of children's care. 11c
recommendations to the education and training providers arc specific to the content of the
curricula for training nurses who care for children and to the structure of the corresponding
courses. Adult-trained nurses, however expert in that context, are recommended to seek the advice
of their child-traincd colleaguesw ho care for children. Managersa rc recommendedt o benchmark
the physical environment, culture and practices of their A and E Units against those in the
Children's hospital. Iley are also recommended to work with education and training providers to
support three different models of continuous professional development; models which reflect the
different backgrounds and initial levels of compctcncc of nurses who care for children.
The researchers uggeststh at, if theser ecommendationsa re actedu pon, then nursesc aring for children
wiH be better educated and in turn the practices of caring for traumatiscd chUdrcn in A and E wiU
also improve, and wiU better meet the needs of both the children and their families
The Effect of Marijuana Legalization on Anticipated Use: A Test of Deterrence Theory
Marijuana is the most frequently used illicit drug in the world (Erickson, Van Der Maas, and Hathaway, 2013:428). Here in the United States, public support for the legalization of marijuana for recreational use is substantial. With public support, both Colorado and Washington passed state initiatives in 2012 to legalize recreational use of marijuana for individuals aged 21 years and older. Even the federal government has recently reversed their initial position to continue to enforce federal drug laws within these states. With what appears to be increasingly liberal attitudes toward marijuana use and even toward legalization, some are concerned about what this may mean for drug use in America. To many, it appears obvious that with changing attitudes and more lenient policies, use of marijuana will increase and in turn exacerbate a host of individual and societal problems that marijuana use is thought to cause. The primary focus of this study examines the first part of these concerns: to what extent will marijuana use increase with these policy changes? Specifically, this research looks at what extent current abstainers of marijuana might use if it were legalized
Detecting short-term change and variation in health-related quality of life: within- and between-person factor structure of the SF-36 health survey.
BackgroundA major goal of much aging-related research and geriatric medicine is to identify early changes in health and functioning before serious limitations develop. To this end, regular collection of patient-reported outcome measure (PROMs) in a clinical setting may be useful to identify and monitor these changes. However, existing PROMs were not designed for repeated administration and are more commonly used as one-time screening tools; as such, their ability to detect variation and measurement properties when administered repeatedly remain unknown. In this study we evaluated the potential of the RAND SF-36 Health Survey as a repeated-use PROM by examining its measurement properties when modified for administration over multiple occasions.MethodsTo distinguish between-person (i.e., average) from within-person (i.e., occasion) levels, the SF-36 Health Survey was completed by a sample of older adults (Nâ=â122, M age â=â66.28Â years) daily for seven consecutive days. Multilevel confirmatory factor analysis (CFA) was employed to investigate the factor structure at both levels for two- and eight-factor solutions.ResultsMultilevel CFA models revealed that the correlated eight-factor solution provided better model fit than the two-factor solution at both the between-person and within-person levels. Overall model fit for the SF-36 Health Survey administered daily was not substantially different from standard survey administration, though both were below optimal levels as reported in the literature. However, individual subscales did demonstrate good reliability.ConclusionsMany of the subscales of the modified SF-36 for repeated daily assessment were found to be sufficiently reliable for use in repeated measurement designs incorporating PROMs, though the overall scale may not be optimal. We encourage future work to investigate the utility of the subscales in specific contexts, as well as the measurement properties of other existing PROMs when administered in a repeated measures design. The development and integration of new measures for this purpose may ultimately be necessary
Rethinking respite in Australia: a naturalistic effect study of a multicomponent community program to promote respite knowledge, attitudes and behaviours of carers of people with dementia
\u27Rethink Respite\u27 was a prospective, naturalistic cohort study conducted in the IllawarraâShoalhaven (NSW, Australia) to improve knowledge, attitudes and uptake of respite strategies in carers of people with dementia. A convenience sample of n = 70 carers were recruited in 2014-15 to establish a baseline for knowledge, attitudes and use of respite for a cohort of carers in the region. Carer perceived need for respite, burden and selfâefficacy were also assessed. A coâdesigned multiâcomponent communityâbased intervention was subsequently rolled at in the region from 2015 to 2016. The intervention supported: awareness raising media; carer education sessions; access to web and print respite information resources; and an option to participate in a tailored oneâonâone inâhome coaching program. At program completion, a followâup survey was administered to the cohort, with n = 44/70 responding. All n = 44 respondents reported participation in and exposure to \u27Rethink Respite\u27 media, information and education during the intervention period. Eighteen of the 44 also selfâselected to receive the active tailored coaching support. At followâup, few positive results were reported on the assessed carer variables for the cohort over time. However, post hoc subâgroup analyses found those who also selfâselected to receive active support (provided through coaching) (n = 18), showed improvements to their respite knowledge, attitudes and selfâefficacy (p \u3c .05). Intention to use respite, and levels of personal gain from caring in this subâgroup also increased (p \u3c .05). In contrast, carers who only participated in the informational/educational aspects of the program (and did not selfâselect to the respite coaching), experienced negative changes over time to their respite beliefs and \u27role captivity\u27. Overall, this pilot study suggests that passive respite information and educational strategies are insufficient, without more active supports (tailored respite coaching) to address observed carer decline over time. Future research should seek to replicate these results using a larger sample and an experimental design
Promoting respite for carers of people with dementia: a case study of social marketing effectiveness in hard to reach audiences
Purpose
This study aims to describe the development and approach of a theory-informed social marketing intervention that aimed to promote respite for carers of people with dementia. Despite a high need for respite, carers of people with dementia are often low users of available respite services. The reasons for this are complex, including knowledge, attitudinal, behavioural and systemic barriers. In the context of an aging population, effective strategies to support respite use by carers of people with dementia are needed. Design/methodology/approach
Via formative research, the authors gained an in-depth understanding of a hard-to-reach and vulnerable group (carers of people with dementia). The resulting intervention informed, persuaded and supported carers to rethink the use of respite addressing specific barriers to service use. The intervention was evaluated using a naturalistic effects model. Findings
Carers of people with dementia who were exposed to community-level campaign activities and also self-selected to take part in tailored coaching showed improvements to their respite knowledge, attitudes and self-efficacy. Intention to use respite and levels of personal gain from caring also increased. In contrast, carers only exposed to informational activities experienced negative changes to their respite beliefs and their sense of role captivity. Practical implications
Social marketing can be used to support carer respite knowledge, attitudes and service-use behaviours in carers of people with dementia. The case study highlights an untapped role for social marketers to work in partnership with health professionals to support improvements in aged care services. Originality/value
To the best of the authorsâ knowledge, this is the first known social marketing intervention promoting the use of respite to carers of people with dementia. Findings demonstrate that tailored support services are most effective in helping carers navigate and use respite services
An experimental in-vivo canine model for adult shunt infection
<p>Abstract</p> <p>Background</p> <p>Detailed human studies of the mechanisms and development of shunt infection in real time are not possible, and we have developed a canine hydrocephalus model to overcome this. The intention of this pilot study was to show that the canine hydrocephalus model could be shunted using conventional "human" shunts, and that a shunt infection could be established so that further studies could then be planned.</p> <p>Methods</p> <p>Hydrocephalus was induced in seven dogs (<it>Canis familiaris</it>) by fourth ventricle obstruction. Four weeks later they were shunted using a Hakim Precision valve. Four of the dogs received shunts whose ventricular catheter had been inoculated with <it>Staphylococcus epidermidis</it>, and three were uninoculated controls. Four weeks after shunting the dogs were sacrificed and necropsy was performed. Removed shunts and tissue samples were examined microbiologically and isolates were subjected to detailed identification and genomic comparison.</p> <p>Results</p> <p>All the dogs remained well after shunting. Examination of removed shunt components revealed <it>S. epidermidis </it>in the brain and throughout the shunt system in the four inoculated animals, but in two of these <it>Staphylococcus intermedius </it>was also found. <it>S. intermedius </it>was also isolated from all three "negative" controls. There were slight differences between <it>S. intermedius </it>strains suggesting endogenous infection rather than cross- infection from a point source.</p> <p>Conclusion</p> <p>Shunt infection was established in the canine model, and had the experiment been extended beyond four weeks the typical microbiological, pathological and clinical features might have appeared. The occurrence of unplanned shunt infections in control animals due to canine normal skin flora reflects human clinical experience and underlines the usual source of bacteria causing shunt infection.</p
Meningococcal Disease in Patients With Human Immunodeficiency Virus Infection: A Review of Cases Reported Through Active Surveillance in the United States, 2000-2008.
BackgroundAlthough human immunodeficiency virus (HIV) infection is an established risk factor for several bacterial infections, the association between HIV infection and meningococcal disease remains unclear.MethodsExpanded chart reviews were completed on persons with meningococcal disease and HIV infection reported from 2000 through 2008 from 9 US sites participating in an active population-based surveillance system for meningococcal disease. The incidence of meningococcal disease among patients meeting Centers for Disease Control and Prevention acquired immune deficiency syndrome (AIDS) surveillance criteria was estimated using data from the National HIV Surveillance System for the participating sites.ResultsThirty-three cases of meningococcal disease in individuals with HIV infection were reported from participating sites, representing 2.0% of all reported meningococcal disease cases. Most (75.8%) persons with HIV infection were adult males aged 25 to 64 years old. Among all meningococcal disease cases aged 25 to 64 years old, case fatality ratios were similar among HIV-infected and HIV-uninfected persons (13.3% vs 10.6%; P = .6). The cumulative, mean incidence of meningococcal disease among patients aged 25 to 64 years old with HIV infection ever classified as AIDS was 3.5 cases per 100000 person years (95% confidence interval [CI], 2.1-5.6), compared with 0.3 cases per 100000 person years (95% CI, 0.3-0.3) for persons of the same age group not reported to have AIDS (relative risk = 12.9; 95% CI, 7.9-20.9).ConclusionsIndividuals with HIV infection meeting the AIDS surveillance case definition have a higher incidence of meningococcal disease compared with the general adult population
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Direct observation by time-resolved infrared spectroscopy of the bright and the dark excited states of the [Ru(phen)2(dppz)]2+ light-switch compound in solution and when bound to DNA
The [Ru(phen)2(dppz)]2+ complex (1) is non-emissive in water but is highly luminescent in organic solvents
or when bound to DNA, making it a useful probe for DNA binding. To date, a complete mechanistic explanation for this âlight-switchâ effect is still lacking. With this in mind we have undertaken an ultrafast time resolved infrared (TRIR) study of 1 and directly observe marker bands between 1280â1450 cm-1, which characterise both the emissive âbrightâ and the non-emissive âdarkâ excited states of the complex, in CD3CN and D2O respectively. These characteristic spectral features are present in the [Ru(dppz)3]2+ solvent light-switch complex but absent in [Ru(phen)3]2+, which is luminescent in both solvents. DFT
calculations show that the vibrational modes responsible for these characteristic bands are predominantly localised on the dppz ligand. Moreover, they reveal that certain vibrational modes of the âdarkâ excited state couple with vibrational modes of two coordinating water molecules, and through these to the bulk solvent, thus providing a new insight into the mechanism of the light-switch effect. We also demonstrate that the marker bands for the âbrightâ state are observed for both L- and D enantiomers of 1 when bound to DNA and that photo-excitation of the complex induces perturbation of
the guanine and cytosine carbonyl bands. This perturbation is shown to be stronger for the L enantiomer, demonstrating the different binding site properties of the two enantiomers and the ability of
this technique to determine the identity and nature of the binding site of such intercalators
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