929 research outputs found
The Casimir Effect in Spheroidal Geometries
We study the zero point energy of massless scalar and vector fields subject
to spheroidal boundary conditions. For massless scalar fields and small
ellipticity the zero-point energy can be found using both zeta function and
Green's function methods. The result agrees with the conjecture that the zero
point energy for a boundary remains constant under small deformations of the
boundary that preserve volume (the boundary deformation conjecture), formulated
in the case of an elliptic-cylindrical boundary. In the case of massless vector
fields, an exact solution is not possible. We show that a zonal approximation
disagrees with the result of the boundary deformation conjecture. Applying our
results to the MIT bag model, we find that the zero point energy of the bag
should stabilize the bag against deformations from a spherical shape.Comment: 24 pages, 3 figures. To appear in Phys. Rev.
The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses
<p>Background: Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice.</p>
<p>Methods: A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data.</p>
<p>Results: The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task.</p>
<p>Conclusions: If health practitioners are to be effective at communicating research evidence, we suggest that more research and resources need to be focused on contextual factors, such as how research evidence is negotiated, appraised and communicated within the dynamic patient-practitioner relationship.</p>
Method and Apparatus for Enabling Digital Rights Management in File Transfers
Embodiments of the invention generally provide a method and apparatus for enabling digital rights management in file transfers. One embodiment of a method for transferring digital content from a first user to a second user, includes transferring ownership of an instance of the digital content to the second user, where the instance of the digital content resides on a first device belonging to the first user. Copies of the digital content are then deleted from one or more additional devices belonging to the first user (including at least one offline device)
Measuring the context of care in an Australian acute care hospital: a nurse survey
BACKGROUND: This study set out to achieve three objectives: to test the application of a context assessment tool in an acute hospital in South Australia; to use the tool to compare context in wards that had undergone an evidence implementation process with control wards; and finally to test for relationships between demographic variables (in particular experience) of nurses being studied (n = 422) with the dimensions of context. METHODS: The Alberta Context Tool (ACT) was administered to all nursing staff on six control and six intervention wards. A total of 217 (62%) were returned (67% from the intervention wards and 56% from control wards). Data were analysed using Stata (v9). The effect of the intervention was analysed using nested (hierarchical) analysis of variance; relationships between nurses' experience and context was examined using canonical correlation analysis. RESULTS: Results confirmed the adaptation and fit of the ACT to one acute care setting in South Australia. There was no difference in context scores between control and intervention wards. However, the tool identified significant variation between wards in many of the dimensions of context. Though significant, the relationship between nurses' experience and context was weak, suggesting that at the level of the individual nurse, few factors are related to context. CONCLUSIONS: Variables operating at the level of the individual showed little relationship with context. However, the study indicated that some dimensions of context (e.g., leadership, culture) vary at the ward level, whereas others (e.g., structural and electronic resources) do not. The ACT also raised a number of interesting speculative hypotheses around the relationship between a measure of context and the capability and capacity of staff to influence it.Timothy J. Schultz and Alison L. Kitso
Evaluation of the Casimir Force for a Dielectric-diamagnetic Cylinder with Light Velocity Conservation Condition and the Analogue of Sellmeir's Dispersion Law
We study the Casimir pressure for a dielectric-diamagnetic cylinder subject
to light velocity conservation and with a dispersion law analogous to
Sellmeir's rule. Similarities to and differences from the spherical case are
pointed out.Comment: 19 pages Latex, no figures; discussion expanded. To appear in Physica
Script
Reclaiming and redefining the Fundamentals of Care: Nursing's response to meeting patients' basic human needs
Executive Summary: A group of nurse leaders, health policy, health care researchers and clinicians attended a seminar at Green Templeton College, University of Oxford in June 2012 to debate and draw up an action plan around integrating the fundamentals of care (FOC) into the patient centred care (PCC) agenda. Participants at the seminar acknowledged that despite significant improvements in delivering more compassionate and patient-centred care, health systems continue to face challenges in meeting the basic needs of many of our most vulnerable patients due to a range of complex factors. The invitational group, over the course of two days, discussed a number of initiatives being used by health systems to improve patient care in this area. These included issues around regulation of care; preparation and training of nurses; ways that factors such as dignity, compassion and kindness can be promoted in health systems; the use of techniques such as hourly rounding, patient involvement in systems redesign and a number of other innovations required to build and redesign the health system around the patient. A framework to guide and shape the ongoing debate has emerged from the meeting. This framework, called The Fundamentals of Care (FOC) Framework comprises three core dimensions: statements about the nature of the relationship between the nurse and the patient within the care encounter; the way the nurse and the patient negotiate and integrate the actual meeting of the fundamentals of care; and the system requirements that are needed to support the forming of the relationship and the safe delivery of the fundamentals of care. The group has produced an implementation plan which is meant to stimulate discussion and debate within key stakeholder groups. These suggested actions are an attempt to turn the more abstract parts of the framework into practical actions at the level of the care encounter between any nurse and any patient in any health system where nursing takes place. There are proposed actions for clinicians and managers; the educators of nurses; and for researchers and policy makers. The framework will be further refined as part of the ongoing work of the International Learning Collaborative (ILC),one of the core groups of nurse leaders and academics who are leading this international agenda. Feedback is welcomed on this position paper.Alison Kitson, Tiffany Conroy, Kerry Kuluski, Louise Locock, Renee Lyon
Evaluating the successful implementation of evidence into practice using the PARiHS framework : theoretical and practical challenges
Background
The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified.
Discussion
This being the case, the paper provides an integrated summary of our conceptual and theoretical thinking so far and introduces a typology (derived from social policy analysis) used to distinguish between the terms conceptual framework, theory and model – important definitional and conceptual issues in trying to refine theoretical and methodological approaches to knowledge translation.
Secondly, the paper describes the next phase of our work, in particular concentrating on the conceptual thinking and mapping that has led to the generation of the hypothesis that the PARiHS framework is best utilised as a two-stage process: as a preliminary (diagnostic and evaluative) measure of the elements and sub-elements of evidence (E) and context (C), and then using the aggregated data from these measures to determine the most appropriate facilitation method. The exact nature of the intervention is thus determined by the specific actors in the specific context at a specific time and place.
In the process of refining this next phase of our work, we have had to consider the wider issues around the use of theories to inform and shape our research activity; the ongoing challenges of developing robust and sensitive measures; facilitation as an intervention for getting research into practice; and finally to note how the current debates around evidence into practice are adopting wider notions that fit innovations more generally.
Summary
The paper concludes by suggesting that the future direction of the work on the PARiHS framework is to develop a two-stage diagnostic and evaluative approach, where the intervention is shaped and moulded by the information gathered about the specific situation and from participating stakeholders. In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches.
We also recommend further refinement of the definitions around conceptual framework, theory, and model, suggesting a wider discussion that embraces multiple epistemological and ontological perspectives
Fluorescent dyes as a probe for the localized field of coupled surface plasmon-related resonances
M. Kreiter, T. Neumann, S. Mittler, W. Knoll, and J. Roy Sambles, Physical Review B, Vol. 64, article 075406 (2001). "Copyright © 2001 by the American Physical Society."The fluorescence light of Cy5 dye molecules in the vicinity of a metal grating is studied for varying directions of both the exciting and the emitted light. A different angular dependence of the intensity of the emitted light is observed for different directions of excitation. Model calculations that take into account the localization of the electrical field of grating-coupled surface plasmon-related resonances are in good agreement with the experimental observations. In addition, the spatially inhomogenous photobleaching of the dye in the field of the coupled resonances is experimentally observed. These results can be viewed both as a way to use chromophores as molecular probes for the localized electrical near field of coupled surface plasmon-related resonances and as a way to manipulate dye molecules on a submicron scale
Process evaluation of appreciative inquiry to translate pain management evidence into pediatric nursing practice
Background
Appreciative inquiry (AI) is an innovative knowledge translation (KT) intervention that is compatible with the Promoting Action on Research in Health Services (PARiHS) framework. This study explored the innovative use of AI as a theoretically based KT intervention applied to a clinical issue in an inpatient pediatric care setting. The implementation of AI was explored in terms of its acceptability, fidelity, and feasibility as a KT intervention in pain management.
Methods
A mixed-methods case study design was used. The case was a surgical unit in a pediatric academic-affiliated hospital. The sample consisted of nurses in leadership positions and staff nurses interested in the study. Data on the AI intervention implementation were collected by digitally recording the AI sessions, maintaining logs, and conducting individual semistructured interviews. Data were analysed using qualitative and quantitative content analyses and descriptive statistics. Findings were triangulated in the discussion.
Results
Three nurse leaders and nine staff members participated in the study. Participants were generally satisfied with the intervention, which consisted of four 3-hour, interactive AI sessions delivered over two weeks to promote change based on positive examples of pain management in the unit and staff implementation of an action plan. The AI sessions were delivered with high fidelity and 11 of 12 participants attended all four sessions, where they developed an action plan to enhance evidence-based pain assessment documentation. Participants labeled AI a 'refreshing approach to change' because it was positive, democratic, and built on existing practices. Several barriers affected their implementation of the action plan, including a context of change overload, logistics, busyness, and a lack of organised follow-up.
Conclusions
Results of this case study supported the acceptability, fidelity, and feasibility of AI as a KT intervention in pain management. The AI intervention requires minor refinements (e.g., incorporating continued follow-up meetings) to enhance its clinical utility and sustainability. The implementation process and effectiveness of the modified AI intervention require evaluation in a larger multisite study
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