Empowering Patients With A Hotline To The Chief Nursing Officer

The purpose of this nursing research study was to explore the perceptions of patients who were provided with a direct line of communication via a “hotline” to the Chief Nursing Officer in order to provide them with a voice in decisions which directly involve their care.Qualitative analysis revealed recurring themes identifying the “hotline” as reassuring, and offering a level of security. Another theme involved the patients relating situations that needed to be remedied including noise within the hospital environment, waiting for pain medication or using the call light without receiving assistance in a timely manner. Some calls to the hotline centered on compliments for the nursing staff. The findings from this phenomenological study which viewed the hospital world through the lens of patients' eyes have many implications for nursing practice. Implications for nursing practice include enhanced communication among nurses and patients, increased patient satisfaction with their health care experience and improved staff satisfaction in the acute care environment. A hotline to the chief nursing officer is only one way to ensure that the patients’ voices are heard and acted upon but this direct line of communication was found to be an effective tool.

Improved precision on the experimental E0 decay branching ratio of the Hoyle state

Stellar carbon synthesis occurs exclusively via the $3\alpha$ process, in which three $\alpha$ particles fuse to form $^{12}$C in the excited Hoyle state, followed by electromagnetic decay to the ground state. The Hoyle state is above the $\alpha$ threshold, and the rate of stellar carbon production depends on the radiative width of this state. The radiative width cannot be measured directly, and must instead be deduced by combining three separately measured quantities. One of these quantities is the $E0$ decay branching ratio of the Hoyle state, and the current $10$\% uncertainty on the radiative width stems mainly from the uncertainty on this ratio. The $E0$ branching ratio was deduced from a series of pair conversion measurements of the $E0$ and $E2$ transitions depopulating the $0^+_2$ Hoyle state and $2^+_1$ state in $^{12}$C, respectively. The excited states were populated by the $^{12}$C$(p,p^\prime)$ reaction at 10.5 MeV beam energy, and the pairs were detected with the electron-positron pair spectrometer, Super-e, at the Australian National University. The deduced branching ratio required knowledge of the proton population of the two states, as well as the alignment of the $2^+_1$ state in the reaction. For this purpose, proton scattering and $\gamma$-ray angular distribution experiments were also performed. An $E0$ branching ratio of $\Gamma^{E0}_{\pi}/\Gamma=8.2(5)\times10^{-6}$ was deduced in the current work, and an adopted value of $\Gamma^{E0}_{\pi}/\Gamma=7.6(4)\times10^{-6}$ is recommended based on a weighted average of previous literature values and the new result. The new recommended value for the $E0$ branching ratio is about 14% larger than the previous adopted value of $\Gamma^{E0}_{\pi}/\Gamma=6.7(6)\times10^{-6}$, while the uncertainty has been reduced from 9% to 5%.Comment: Accepted for publication as a Regular Article in Phys. Rev. C on July 29 202

Long-term follow-up and treatment of congenital alveolar proteinosis

<p>Abstract</p> <p>Background</p> <p>Clinical presentation, diagnosis, management and outcome of molecularly defined congenital pulmonary alveolar proteinosis (PAP) due to mutations in the GM-CSF receptor are not well known.</p> <p>Case presentation</p> <p>A 2 1/2 years old girl was diagnosed as having alveolar proteinosis. Whole lung lavages were performed with a new catheter balloon technique, feasible in small sized airways. Because of some interstitial inflammation in the lung biopsy and to further improve the condition, empirical therapy with systemic steroids and azathioprin, and inhaled and subcutaneous GMCSF, were used. Based on clinical measures, total protein and lipid recovered by whole lung lavages, all these treatments were without benefit. Conversely, severe respiratory viral infections and an invasive aspergillosis with aspergilloma formation occurred. Recently the novel homozygous stop mutation p.Ser25X of the GMCSF receptor alpha chain was identified in the patient. This mutation leads to a lack of functional GMCSF receptor and a reduced response to GMCSF stimulation of CD11b expression of mononuclear cells of the patient. Subsequently a very intense treatment with monthly lavages was initiated, resulting for the first time in complete resolution of partial respiratory insufficiency and a significant improvement of the overall somato-psychosocial condition of the child.</p> <p>Conclusions</p> <p>The long term management from early childhood into young adolescence of severe alveolar proteinosis due to GMCSF receptor deficiency requires a dedicated specialized team to perform technically demanding whole lung lavages and cope with complications.</p

ElectrochemicalN-demethylation of tropane alkaloids

A practical, efficient, and selective electrochemicalN-demethylation method of tropane alkaloids to their nortropane derivatives is described. Nortropanes, such as noratropine and norscopolamine, are important intermediates for the semi-synthesis of the medicines ipratropium or oxitropium bromide, respectively. Synthesis was performed in a simple home-made electrochemical batch cell using a porous glassy carbon electrode. The reaction proceeds at room temperature in one step in a mixture of ethanol or methanol and water. The method avoids hazardous oxidizing agents such as H(2)O(2)orm-chloroperbenzoic acid (m-CPBA), toxic solvents such as chloroform, as well as metal-based catalysts. Various key parameters were investigated in electrochemical batch or flow cells, and the optimized conditions were used in batch and flow-cells at gram scale to synthesize noratropine in high yield and purity using a convenient liquid-liquid extraction method without any need for chromatographic purification. Mechanistic studies showed that the electrochemicalN-demethylation proceeds by the formation of an iminium intermediate which is converted by water as the nucleophile. The optimized method was further applied to scopolamine, cocaine, benzatropine, homatropine and tropacocaine, showing that this is a generic way ofN-demethylating tropane alkaloids to synthesize valuable precursors for pharmaceutical products

Improved precision on the experimental E0 decay branching ratio of the Hoyle state

Background: Stellar carbon synthesis occurs exclusively via the 3α process, in which three α particles fuse to form 12C in the excited Hoyle state, followed by electromagnetic decay to the ground state. The Hoyle state is above the α threshold, and the rate of stellar carbon production depends on the radiative width of this state. The radiative width cannot be measured directly, and must instead be deduced by combining three separately measured quantities. One of these quantities is the E0 decay branching ratio of the Hoyle state, and the current 10% uncertainty on the radiative width stems mainly from the uncertainty on this ratio. The rate of the 3α process is an important input parameter in astrophysical calculations on stellar evolution, and a high precision is imperative to constrain the possible outcomes of astrophysical models.The project was supported by the Australian Research Council Discovery Grants No. DP140102986, No. DP170101673, and No. DP170102423. Operation of the ANU Heavy Ion Accelerator Facility is supported by the NCRIS HIA capability. The support from technical staff for the development of the pair spectrometer, as well as during the long experimental runs, is greatly appreciated. This work was partially supported by the International Joint Research Promotion Program of Osaka University and JSPS KAKENHI Grant No. JP 17H02893, the Natural Sciences and Engineering Research Council of Canada, the National Research Foundation (NRF), South Africa, under Grants No. 93533 and No. 118645