Challenged life: How to live and cope with slow physical decline

In this research project a retrospective interview with a 32-year-old woman, who has been living with diagnosis of Multiple Sclerosis for more than ten years, was conducted and analysed. Over the course of time, the inner attitude of the research participant towards her disorder altered. Right after getting the diagnosis, her behaviour was shaped by strictly rejecting to ‘have’ the concerning disease. Starting about 3 years ago, a gradual change is described towards an accepting stance to her body abnormalities. But it is not an either-or logic – we have evidence of coexistence of contradictions. This curiosity about simultaneous existing contradictions is the field for negotiating the maintenance of the self-consistency under impending health deterioration

Predictors for Florida Nurse Practitioners\u27 Characterization of Organizational Climate

Healthcare managers are failing to meet the increasing demand for services while experiencing a growing shortage of healthcare workers. The restrictive scope of practice regulations and organizational barriers have a negative effect on the number and growth of nurse practitioners available to meet the required demand. Researchers have focused on the organizational climate of the nursing profession in general, yet there is an absence of research regarding the perceptions of the advanced registered nurse practitioners (ARNPs) in their local practice environment. The purpose of this study was to examine if ARNP role identification, autonomy, and collaboration were predictive of perceived organizational climate. Lewin’s field theory formed the theoretical framework for the study. A sample of 187 ARNPs practicing in the state of Florida specializing in primary care completed the nurse practitioner–primary care organizational climate questionnaire administered via an online third party survey administration service. The results of the multiple linear regression analyses indicated the model as a whole was able to significantly predict organizational climate F(3, 183) = 12.498, p = .001, R2 = .681. Role identification (β = .346) provided the most contribution to the model, followed by collaboration (β = .296) and autonomy (β = .275). The implications for social change could include providing Florida state policymakers and healthcare managers with the meaningful information needed to develop concrete strategies for optimizing and retaining the ARNP workforce. Improving nurse practitioner engagement could lead to improved patient results and safety

Fermion-parity duality and energy relaxation in interacting open systems

We study the transient heat current out of a confined electron system into a weakly coupled electrode in response to a voltage switch. We show that the decay of the Coulomb interaction energy for this repulsive system exhibits signatures of electron-electron attraction, and is governed by an interaction-independent rate. This can only be understood from a general duality that relates the non-unitary evolution of a quantum system to that of a dual model with inverted energies. Deriving from the fermion-parity superselection postulate, this duality applies to a large class of open systems.Comment: 5 pages + 19 pages of Supplementary Materia

Climate readiness in smallholder agricultural systems: lessons learned from REDD+

The debate around the role that agriculture should play in mitigating climate change and sequestering greenhouse gases is politically complex and technically complicated. In many countries, and particularly in developing countries with a large smallholder population, the agricultural sector faces competing priorities, such as national food security goals, poverty alleviation, addressing natural resource degradation and adapting to the already visible effects of climate change. Many of these goals are closer to the immediate, short-term priorities of national decision-makers, relegating climate change mitigation to a secondary priority. It is therefore essential to implement mitigation strategies in concert with strategies that increase the resilience and increase the productivity of agricultural systems. Despite differences in the forestry and the agricultural sectors, experiences from the REDD+ process, and particularly its readiness phase, can offer useful lessons for an agricultural readiness process. The REDD+ readiness process created an overall coherent structure, framework and process of guiding countries towards developing the technical and institutional ability to integrate mitigation activities into their forestry sectors. An overview of the lessons learned from REDD+ Readiness, organized by objectives, governance, process, scope and finance, is provided in this working paper

The Grant Equivalent of Foreign Aid Commitments: People\u27s Republic of China 1956-1974

The purpose of this thesis is to show the existing quantitative tool (model) measuring the true grant-value of foreign aid, expand that model somewhat to arrive at least at reasonably accurate input factors which are otherwise difficult to evaluate, and to document China\u27s foreign aid program on a recipient by recipient basis, both in terms of its nature and its estimated grant-components

Perceptibility of barriers and threats to successful and sustainable restoration of Heritage Buildings. A perspective of UK’s heritage practitioners

Purpose of this paper The research set out to examine whether, among heritage practitioners, there is unanimity as well as notable discrepancies in what they perceive as the barriers and threats to the successful and sustainable restoration of heritage buildings. Design/methodology/approach The study collected data from 87 practitioners. These included professional building surveyors, conservation officers, designers, main heritage as well as specialist heritage subcontractors. This heterogeneous sample was subject to the same research instrument. The data generated was chiefly non-parametric. Findings Principally, the notable barriers explored are ‘Prognosis–intervention barriers’. These are represented by a lack of knowledge about the principles of conservation and repair; followed by inconsistent repair standards. Even among the most dexterous heritage practitioners, the study noted a marked variation in the prognosis of structural failure as well as routine inconsistencies in the defects diagnosis methods. These challenges are contemporaneous within the sector as the likes of Historical England, (as custodians of Ancient Monuments) are continually seeking long term, and in some cases imminent interventional solutions. It is worrisome, however, to note that the custodians themselves are trapped in paralysis as the cycle between episodes of intervention become longer. The corollary is that, throughout the UK, most grade 1, grade II* and Ancient Monument structures are making the ‘risk register’: too many buildings, face the threat of being lost foreover. Research limitations The study concludes that a wider UK sample will be needed. This is because some of the applied technologies, preferred by practictioners, are not widely practised, especially in a sector where planning consent and wholesome depature from established principles, the local siginifcance attached to buildings are not only inimitable but demand solutions which are intagible and incomparable. Practical implications Within the heritage sector, the ongoing concerns about the slow rate of sustainable restoration merits considerable attention. Likewise, the challenges intrisic in the technical heritage doctrines such as ‘reversibility’ should in turn, be embraced as offering sustainable low carbon retrofit solutions. Indeed, by putting emphasis on the ‘reversibility’ ethos, a multi-perspective analysis unveils the fact that among practitioners, a sense of optimism is generally lacking. The study concludes that the sector lacks ‘can-do’ attitudes. As a result, it is diffuclt to innovate and to find solutions to the inexorable cycle of disrepair and the enormous restoration bill, currently estimated to run into several billions of Pound sterling. Sadly, locked-in with this, is the enormous high carbon foot print due to the ensuing restoration and repair activity

Clinical update: Heparin-induced thrombocytopenia: An update for the COVID-19 era

The increased use of heparin during the current COVID-19 pandemic has highlighted the risk of a rare but potentially serious complication of heparin therapy, viz. heparin-induced thrombocytopenia (HIT). This is a short review on the pharmacology of heparin and its derivatives, and the pathophysiology of HIT. Guidance on laboratory testing for and clinical management of HIT is presented in accordance with international guidelines. There are important similarities and differences between HIT and the new entity of vaccine-induced immune thrombotic thrombocytopenia, also known as thrombosis with thrombocytopenia syndrome, which clinicians need to be aware of