Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: a systematic review

Background nurse shortages have been identified as central to workforce issues in healthcare systems globally and although interventions to increase the nursing workforce have been implemented, nurses leaving their roles, particularly in the first year after qualification, present a significant barrier to building the nurse workforce. Objective to evaluate the characteristics of successful interventions to promote retention and reduce turnover of early career nurses. Design this is a systematic review Data sources Online databases including Academic Search Complete, Medline, Health Policy reference Centre, EMBASE, Psychinfo, CINAHL and the Cochran Library were searched to identify relevant publications in English published between 2001 and April 2018. Studies included evaluated an intervention to increase retention or reduce turnover and used turnover or retention figures as a measure. Review methods The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were quality-assessed using the Joanna Briggs Institute Critical Appraisal tools for Quasi Experimental and Randomised Controlled Trials. Retention/turnover data were used to guide the comparison between studies and appropriate measures of central tendency and dispersion were calculated and presented, based on the normality of the data. Results A total of 11, 656 papers were identified, of which 53 were eligible studies. A wide variety of interventions and components within those interventions were identified to improve nurse retention. Promising interventions appear to be either internship/residency programmes or orientation/transition to practice programmes, lasting between 27-52 weeks, with a teaching and preceptor and mentor component. Conclusions Methodological issues impacted on the extent to which conclusions could be drawn, even though a large number of studies were identified. Future research should focus on standardising the reporting of interventions and outcome measures used to evaluate these interventions and carrying out further research with rigorous methodology. Clinical practice areas are recommended to assess their current interventions against the identified criteria to guide development of their effectiveness. Evaluations of cost-effectiveness are considered an important next step to maximise return on investment

Asteroseismology of Massive Stars : Some Words of Caution

Although playing a key role in the understanding of the supernova phenomenon, the evolution of massive stars still suffers from uncertainties in their structure, even during their "quiet" main sequence phase and later on during their subgiant and helium burning phases. What is the extent of the mixed central region? In the local mixing length theory (LMLT) frame, are there structural differences using Schwarzschild or Ledoux convection criterion? Where are located the convective zone boundaries? Are there intermediate convection zones during MS and post-MS phase, and what is their extent and location? We discuss these points and show how asteroseismology could bring some light on these questions.Comment: 10 pages, 5 figures, IAU Symposium 307, New windows on massive stars: asteroseismology, interferometry, and spectropolarimetry, G. Meynet, C. Georgy, J.H. Groh & Ph. Stee, ed

Comparing different accelerometer cut-points for sedentary time in children

Actigraph accelerometers are hypothesized to be valid measurements for assessing children\u27s sedentary time. However, there is considerable variation in accelerometer cut-points used. Therefore, we compared the most common accelerometer sedentary cut-points of children performing sedentary behaviors. Actigraph Actitrainer uniaxial accelerometers were used to measure children\u27s activity intensity (29 children, 5-11 years old) during different activities, namely playing computer games, nonelectronic sedentary games, watching television and playing outdoors. A structured protocol was the criterion for assessing the validity of four common cut-points (100, 300, 800, 1100 counts/minute). The median counts during all sedentary behaviors were below the lowest comparison cut-point of 100 cpm. The 75th percentile values for the sedentary behaviors were always below the cut-point of 300 cpm. Our results suggest that the cut-point of <100 cpm is the most appropriate

Are the stars of a new class of variability detected in NGC~3766 fast rotating SPB stars?

A recent photometric survey in the NGC~3766 cluster led to the detection of stars presenting an unexpected variability. They lie in a region of the Hertzsprung-Russell (HR) diagram where no pulsation are theoretically expected, in between the $\delta$ Scuti and slowly pulsating B (SPB) star instability domains. Their variability periods, between $\sim$0.1--0.7~d, are outside the expected domains of these well-known pulsators. The NCG~3766 cluster is known to host fast rotating stars. Rotation can significantly affect the pulsation properties of stars and alter their apparent luminosity through gravity darkening. Therefore we inspect if the new variable stars could correspond to fast rotating SPB stars. We carry out instability and visibility analysis of SPB pulsation modes within the frame of the traditional approximation. The effects of gravity darkening on typical SPB models are next studied. We find that at the red border of the SPB instability strip, prograde sectoral (PS) modes are preferentially excited, with periods shifted in the 0.2--0.5~d range due to the Coriolis effect. These modes are best seen when the star is seen equator-on. For such inclinations, low-mass SPB models can appear fainter due to gravity darkening and as if they were located between the $\delta$~Scuti and SPB instability strips.Comment: 6 pages, 2 figures, to appear in the proceedings of the IAU Symposium 307, New windows on massive stars: asteroseismology, interferometry, and spectropolarimetr

The {\gamma} Dor stars as revealed by Kepler : A key to reveal deep-layer rotation in A and F stars

The {\gamma} Dor pulsating stars present high-order gravity modes, which make them important targets in the intermediate-and low-mass main-sequence region of the Hertzsprung-Russell diagram. Whilst we have only access to rotation in the envelope of the Sun, the g modes of {\gamma} Dor stars can in principle deliver us constraints on the inner layers. With the puzzling discovery of unexpectedly low rotation rates in the core of red giants, the {\gamma} Dor stars appear now as unique targets to explore internal angular momentum transport in the progenitors of red giants. Yet, the {\gamma} Dor pulsations remain hard to detect from the ground for their periods are close to 1 day. While the CoRoT space mission first revealed intriguing frequency spectra, the almost uninterrupted 4-year photometry from the Kepler mission eventually shed a new light on them. It revealed regularities in the spectra, expected to bear signature of physical processes, including rotation, in the shear layers close to the convective core. We present here the first results of our effort to derive exploitable seismic diagnosis for mid- to fast rotators among {\gamma} Dor stars. We confirm their potential to explore the rotation history of this early phase of stellar evolution.Comment: 4 pages, 1 figure, proceedings of the 22nd Los Alamos Stellar Pulsation Conference, "Wide-field variability surveys: a 21st-century perspective" held in San Pedro de Atacama, Chile, Nov. 28-Dec. 2, 201

Can an underestimation of opacity explain B-type pulsators in the SMC?

Slowly Pulsating B and $\beta$ Cephei are $\kappa$ mechanism driven pulsating B stars. That $\kappa$ mechanism works since a peak in the opacity due to a high number of atomic transitions from iron-group elements occurs in the area of $\log T \approx 5.3$. Theoretical results predict very few SPBs and no $\beta$ Cep to be encountered in low metallicity environments such as the Small Magellanic Cloud. However recent variability surveys of B stars in the SMC reported the detection of a significant number of SPB and $\beta$ Cep candidates. Though the iron content plays a major role in the excitation of $\beta$ Cep and SPB pulsations, the chemical mixture representative of the SMC B stars such as recently derived does not leave room for a significant increase of the iron abundance in these stars. Whilst abundance of iron-group elements seems reliable, is the opacity in the iron-group elements bump underestimated? We determine how the opacity profile in B-type stars should change to excite SPB and $\beta$ Cep pulsations in early-type stars of the SMC.Comment: 5 pages, 7 figures, to appear under electronic form in : Proceedings of the 4th HELAS International Conference: Seismological Challenges for Stellar Structur

High-pressure behaviour of GeO2: a simulation study

In this work we study the high pressure behaviour of liquid and glassy GeO2 by means of molecular dynamics simulations. The interaction potential, which includes dipole polarization effects, was parameterized from first-principles calculations. Our simulations reproduce the most recent experimental data to a high degree of precision. The proportion of the various GeOn polyhedra is determined as a function of the pressure: a smooth transition from tetrahedral to octahedral network is observed. Finally, the study of high-pressure, liquid germania confirms that this material presents an anomalous behaviour of the diffusivity as observed in analog systems such as silica and water. The importance of penta-coordinated germanium ions for such behaviour is stressed.Comment: 16 pages, 4 figures, accepted as a Fast Track Communication on Journal of Physics: Condensed Matte

Effects of a multi-component exercise program and calcium–vitamin-D3-fortified milk on bone mineral density in older men : a randomised controlled trial

Summary We examined the independent and combined effects of a multi-component exercise program and calcium&ndash;vitamin-D3-fortified milk on bone mineral density (BMD) in older men. Exercise resulted in a 1.8% net gain in femoral neck BMD, but additional calcium&ndash;vitamin D3 did not enhance the response in this group of older well-nourished men.Introduction This 12-month randomised controlled trial assessed whether calcium&ndash;vitamin-D3-fortified milk could enhance the effects of a multi-component exercise program on BMD in older men.Methods Men (n&thinsp; =&thinsp;180) aged 50&ndash;79 years were randomised into: (1) exercise + fortified milk; (2) exercise; (3) fortified milk; or (4) controls. Exercise consisted of high intensity progressive resistance training with weight-bearing impact exercise. Men assigned to fortified milk consumed 400 mL/day of low fat milk providing an additional 1,000 mg/day calcium and 800 IU/day vitamin D3. Femoral neck (FN), total hip, lumbar spine and trochanter BMD and body composition (DXA), muscle strength 25-hydroxyvitamin D and parathyroid hormone (PTH) were assessed.Results There were no exercise-by-fortified milk interactions at any skeletal site. Exercise resulted in a 1.8% net gain in FN BMD relative to no-exercise (p&thinsp;&lt;&thinsp;0.001); lean mass (0.6 kg, p&thinsp;&lt;&thinsp;0.05) and muscle strength (20&ndash;52%, p&thinsp;&lt;&thinsp;0.001) also increased in response to exercise. For lumbar spine BMD, there was a net 1.4&ndash;1.5% increase in all treatment groups relative to controls (all p&thinsp;&lt;&thinsp;0.01). There were no main effects of fortified milk at any skeletal site.Conclusion A multi-component community-based exercise program was effective for increasing FN BMD in older men, but additional calcium&ndash;vitamin D3 did not enhance the osteogenic response.<br /

Velocity profiles in shear-banding wormlike micelles

Using Dynamic Light Scattering in heterodyne mode, we measure velocity profiles in a much studied system of wormlike micelles (CPCl/NaSal) known to exhibit both shear-banding and stress plateau behavior. Our data provide evidence for the simplest shear-banding scenario, according to which the effective viscosity drop in the system is due to the nucleation and growth of a highly sheared band in the gap, whose thickness linearly increases with the imposed shear rate. We discuss various details of the velocity profiles in all the regions of the flow curve and emphasize on the complex, non-Newtonian nature of the flow in the highly sheared band.Comment: 4 pages, 5 figures, submitted to Phys. Rev. Let