The not-so-wild West

Federal Reserve District, 12th ; Economic conditions - West (U.S.)

Aluminum rebounding

Aluminum industry and trade

Western upturn

Federal Reserve District, 12th ; Economic conditions - West (U.S.)

'83: less than vintage year

Wine industry ; California

On the offensive

Money market funds ; Money market deposit account

Nurse Leader Influence And Nurse-Sensitive Outcomes In Critical Access Hospitals

Introduction: Rural residents of the United States are sicker, are at higher risk of death, and have shorter lifespans than those in metropolitan areas (Singh & Siahpush, 2014). Nurse leaders may have the opportunity to influence improved patient outcomes in rural areas. No exploration of nurse leader influence as it relates to nurse-sensitive outcomes in rural healthcare settings was found in the literature. The purpose of this study was to determine the differences among nurse leader influence and nurse-sensitive outcome scores in critical access hospitals, which are rural in nature, in North Dakota as compared to other states in the United States. Methods: A questionnaire was sent to nursing leaders at 600 critical access hospitals in 20 states in the United States, with results coming from a total of 19 states including North Dakota. The questionnaire included demographics, the Leadership Influence over the Professional Practices Environment Scale (LIPPES), nurse communication data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, and nursing transfer compliance data from the Emergency Department Transfer Communication (EDTC) survey. Reliability and validity have been established for these surveys. Results of the questionnaire were analyzed using descriptive statistics and comparison of means. Results: The sample included 28 nurse leaders in North Dakota and 44 nurse leaders from across 18 other states. Demographics showed similarities across the two groups. All categories of nurse leader influence scores in North Dakota were lower than across the other 18 states. Significant differences were found among four nurse leader influence factors of collegial administrative approach, internal strategy and resolve, access to resources, and the overall influence scores. No significant differences were among scores from the Emergency Department Transfer Communication (EDTC) compliance survey nor the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) compliance survey. Conclusions: Critical access hospital nurse leaders in North Dakota reported comparatively lower collegial administrative approach, access to resources, and internal strategy and resolve levels than those in 18 other states. Support mechanisms should be concentrated on those areas for the leaders in North Dakota. Further research should be conducted to understand the potentially different needs of critical access hospital nurse leaders from their counterparts in larger hospital settings

Factors influencing attrition of students in a baccalaureate nursing program

A nursing shortage is looming in Canada (Canadian Nurses Association, 1997, November 4). It is inperative that as many students graduate from nursing school as possible in order to alleviate this problem. This purpose o f this study was to discover the reasons for student attrition in a Canadian Baccalaureate School of Nursing. Tinto’s model o f college student attrition was applied as the conceptual framework. A Nursing Student Attrition Survey was completed by forty student persisters and nineteen student leavers. Comparisons between the two samples revealed significant differences in that older students, students from urban areas, and students whose mothers and fathers had less post-secondary education were more likely to leave the program of study prior to graduation. The same was found true for students with lower level intentions, goal and institutional commitment, and students with more external commitments. Students persisters were found to feel better about their academic performance and felt that they had more positive peer group interactions than did the student leavers

A Comprehensive Ex Vivo Functional Analysis of Human NKT Cells Reveals Production of MIP1-α and MIP1-β, a Lack of IL-17, and a Th1-Bias in Males

NKT cells contribute to the modulation of immune responses and are believed to be important in the pathogenesis of autoimmune and infectious diseases, as well as cancer. Variations in the composite NKT cytokine response may determine individual disease susceptibility or severity. Due to low frequencies in peripheral blood, knowledge of the breadth of ex vivo human NKT cell functions has been limited. To bridge this gap, we studied highly purified NKT cells from PBMC of healthy donors and assessed the production of 27 effector functions using sensitive Elispot and multiplex bead assays. We found the ex vivo human NKT cell response is predominantly comprised of the chemokines MIP1-α, and MIP1-β as well as the Th1 cytokines IFN-γ and TNF-α. Although lower in magnitude, there was also significant production of IL-2, IL-4, and perforin after mitogen stimulation. Surprisingly, little/no IL-5, IL-6, IL-10, or IL-13 was detected, and no subjects' NKT cells produced IL-17. Comparison of the NKT functional profiles between age-matched male and female subjects revealed similar IL-4 responses, but higher frequencies of cells producing IFN-γ and MIP1-α, from males. There were no gender differences in the circulating NKT subset distribution. These findings implicate chemokines as a major mechanism by which NKT cells control responses in humans. In addition, the panoply of Th2 and Th17 cytokine secretion by NKT cells from healthy donors may not be as pronounced as previously believed. NKT cells may therefore contribute to the gender bias found in many diseases

A cross-country comparison of intensive care physicians' beliefs about their transfusion behaviour : a qualitative study using the theoretical domains framework

Pub Med ID 22999460 PMCID: PMC3527303Peer reviewedPublisher PD

Lessons from the COVID-19 pandemic to improve the health and social care and wellbeing of minoritised ethnic groups with chronic conditions or impairments: protocol for the mixed methods intersectional asset-based study CICADA

BACKGROUND: The pandemic has inequitably impacted the experiences of people living with ill health/impairments or from minoritised ethnic groups across all areas of life. Given possible parallels in inequities for disabled people and people from minoritised ethnic backgrounds, their existence before the pandemic and increase since, and the discriminations that each group faces, our interest is in understanding the interplay between being disabled AND being from a minoritised ethnic group. OBJECTIVE: The overarching aim of the CICADA project, building on this understanding, is to improve pandemic and longer-term support networks and access to and experiences of care, services and resources for these under-served groups, both during the pandemic and longer term, reducing inequities and enhancing social, health and wellbeing outcomes. METHODS: This mixed methods study involves three 'sweeps' of a new UK survey, secondary analyses of existing cohort and panel surveys, a rapid scoping review, a more granular review, and qualitative insights from over 200 semi-structured interviews including social network/map/photo elicitation methods, and two subsequent sets of remote participatory research workshops. Separate stakeholder co-creation meetings, running through the study, will develop analyses and outputs. Our longitudinal study design enables us to explore significant relationships between variables in the survey data we collect, and also changes in variables with time, including consideration of varying pandemic contexts. The qualitative data will provide more granular detail. We will take a strengths and assets-based approach, underpinned by the social model of disability and by intersectional considerations, to challenge discrimination. Our exploration of the social determinants of health and wellbeing is framed by the social ecological model. RESULTS: The CICADA project was funded by the Health and Social Care Delivery Research (HSDR) Programme of the National Institute for Health and Care Research (NIHR) in March 2021 and began in May 2021. Further work within the project (84 interviews) was commissioned in March 2022, focussing on mental health specifically in North-East England, Greater Manchester and the North-West Coast. Data collection began in August 2021, with the last participants due to be recruited in September 2022. As of January 2022, 5,792 survey respondents and 227 interviewees had provided data. From April 2022, the time of article submission, we will recruit participants for the sub-study and wave 2 of the surveys and qualitative work. We expect results to be published by winter 2022. CONCLUSIONS: In studying the experiences of disabled people with impairments and those living with chronic conditions who come from certain minoritised ethnic groups, we are aiming for transformative research to improve their health and wellbeing. CLINICALTRIAL: INTERNATIONAL REGISTERED REPORT: DERR1-10.2196/38361