The Origin of Magnetic Interactions in Ca3Co2O6

We investigate the microscopic origin of the ferromagnetic and antiferromagnetic spin exchange couplings in the quasi one-dimensional cobalt compound Ca3Co2O6. In particular, we establish a local model which stabilizes a ferromagnetic alignment of the S=2 spins on the cobalt sites with trigonal prismatic symmetry, for a sufficiently strong Hund's rule coupling on the cobalt ions. The exchange is mediated through a S=0 cobalt ion at the octahedral sites of the chain structure. We present a strong coupling evaluation of the Heisenberg coupling between the S=2 Co spins on a separate chain. The chains are coupled antiferromagnetically through super-superexchange via short O-O bonds.Comment: 5 Pages, 3 Figures; added anisotropy term in eq. 9; extended discussion of phase transitio

Expression of the costimulatory molecule B7-H3 is associated with prolonged survival in human pancreatic cancer

<p>Abstract</p> <p>Background</p> <p>Costimulatory signaling has been implicated as a potential regulator of antitumor immunity in various human cancers. In contrast to the negative prognostic value of aberrant B7-H1 expression by pancreatic cancer cells, the role of B7-H3 is still unknown. Therefore, we investigated the expression pattern and clinical significance of B7-H3 expression in human pancreatic cancer.</p> <p>Methods</p> <p>B7-H3 expression was evaluated by immunohistochemistry in 68 patients with pancreatic cancer who underwent surgical tumor resection. Expression data was correlated with clinicopathologic features and with the number of tumor-infiltrating T cells.</p> <p>Results</p> <p>B7-H3 expression was significantly upregulated in pancreatic cancer compared to normal pancreas (p < 0.05). In 60 of 68 examined tumors B7-H3 protein was detectable in pancreatic cancer cells. Patients with high tumor B7-H3 levels had a significantly better postoperative prognosis than patients with low tumor B7-H3 levels (p = 0.0067). Furthermore, tumor B7-H3 expression significantly correlated with the number of tumor-infiltrating CD8+ T cells (p = 0.018).</p> <p>Conclusion</p> <p>We demonstrate for the first time that B7-H3 is abundantly expressed in pancreatic cancer and that tumor-associated B7-H3 expression significantly correlates with prolonged postoperative survival. Our findings suggest that B7-H3 might play an important role as a potential stimulator of antitumor immune response in pancreatic cancer.</p

Stress in nurses : stress-related affect and its determinants examined over the nursing day

Peer reviewedPostprin

Empowerment, stress vulnerability and burnout among portuguese nursing staff

The work environment in Portuguese hospitals, characterized by economic cutbacks, can lead to higher levels of burnout experienced by nursing staff. Furthermore, vulnerability to stress can negatively affect the perception of burnout in the workplace. However, structural empowerment is an organizational process that can prevent and decrease burnout among nurses. Consequently, the aim of the study was to examine to what extent structural empowerment and vulnerability to stress can play a predictive role in core burnout in a sample of Portuguese nurses. A convenience sample of 297 nursing staff members from Portuguese hospitals was used in this study. Core burnout was negatively and significantly related to all the dimensions of structural empowerment, and it was positively and significantly related to vulnerability to stress. Regression models showed that core burnout was significantly predicted by access to funds, access to opportunities and vulnerability to stress. Organizational administrations must make every effort in designing interventions focused on structural empowerment, as well as interventions focused on individual interventions that enhance skills for coping with stress.info:eu-repo/semantics/publishedVersio

Is organizational justice climate at the workplace associated with individual-level quality of care and organizational affective commitment?:A multi-level, cross-sectional study on dentistry in Sweden

Purpose The aim of this study is to investigate whether organizational justice climate at the workplace level is associated with individual staff members’ perceptions of carequality and affective commitment to the workplace.Methods The study adopts a cross-sectional multi-level design. Data were collected using an electronic survey and a response rate of 75% was obtained. Organizational justice climate and affective commitment to the workplace were measured by items from Copenhagen Psychosocial Questionnaire and quality of care by three self-developed items. Non-managerial staff working at dental clinics with at least five respondents (n = 900 from 68 units) was included in analyses. A set of Level-2 random intercept models were built to predict individual-level organizational affective commitment and perceived quality of care from unit-level organizational justice climate, controlling for potential confoundingby group size, gender, age, and occupation.Results The results of the empty model showed substantial between-unit variation for both affective commitment (ICC-1 = 0.17) and quality of care (ICC-1 = 0.12). The overall results showed that the shared perception of organizational justice climate at the clinical unit level was significantly associated with perceived quality of care and affective commitment to the organization (p < 0.001).Conclusions Organizational justice climate at work unit level explained all variation in affective commitment among dental clinics and was associated with both the individualstaff members’ affective commitment and perceived quality of care. These findings suggest a potential for that addressing organizational justice climate may be a way to promote quality of care and enhancing affective commitment. However, longitudinal studies are needed to support causality in the examined relationships. Intervention research is also recommended to probe the effectiveness of actions increasingunit-level organizational justice climate and test their impact on quality of care and affective commitment

The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda

BACKGROUND: Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC) Clinics. METHODS: A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. RESULTS: Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. CONCLUSIONS: This community-university HIV innovative model was successful from the point of view of the nurses and nurse managers. This model shows promise in increasing effective, quality health service; HIV and other programs can build capacity and empower nurses and nurse managers to directly implement such services. It also demonstrates how MakCHS can be instrumental through partnerships in designing and testing effective strategies, building human health resources and improving Ugandan health outcomes

Looking ‘beyond the factory gates’:towards more pluralist and radical approaches to intra-organizational trust research

The aim of this paper is to suggest new avenues for trust research by critiquing the extant literature on this topic. We analyze the most influential research on intra-organizational trust from the perspective of a classic industrial sociology framework from the 1970s – Alan Fox’s work on frames of reference and trust dynamics. Our analysis of intra-organizational trust studies leads us to three conclusions. Firstly, the large majority of intra-organizational trust research has strong unitarist underpinnings, which support a managerial agenda that is potentially detrimental to employees’ and (indeed managers’) long-term interests. Secondly, most of this research fails to explain how trust in organizations is embedded in societal and field level institutions, hence it would benefit from looking ‘beyond the factory gates’ for a more complete understanding of trust dynamics in organizations. In this connection, we argue that Fox’s pluralist and radical perspectives, which are under-represented in intra-organizational trust research, could provide new lines of inquiry by locating internal trust relations in a wider institutional context. Thirdly, Fox’s explanation of how low and high trust dynamics in organizations are embedded in wider society may help address the concerns about under-socialized, endogenous explanations and open the way for structure-agency analyses of building, maintaining and repairing intra-organizational trust

Evaluating the quality of interaction between medical students and nurses in a large teaching hospital

BACKGROUND: Effective health care depends on multidisciplinary collaboration and teamwork, yet little is known about how well medical students and nurses interact in the hospital environment, where physicians-in-training acquire their first experiences as members of the health care team. The objective of this study was to evaluate the quality of interaction between third-year medical students and nurses during clinical rotations. METHODS: We surveyed 268 Indiana University medical students and 175 nurses who worked at Indiana University Hospital, the School's chief clinical training site. The students had just completed their third year of training. The survey instrument consisted of 7 items that measured "relational coordination" among members of the health care team, and 9 items that measured psychological distress. RESULTS: Sixty-eight medical students (25.4%) and 99 nurses (56.6%) completed the survey. The relational coordination score (ranked 1 to 5, low to high), which provides an overall measure of interaction quality, showed that medical students interacted with residents the best (4.16) and with nurses the worst (2.98; p < 0.01). Conversely, nurses interacted with other nurses the best (4.36) and with medical students the worst (2.68; p < 0.01). Regarding measures of psychological distress (ranked 0 to 4, low to high), the interpersonal sensitivity score of medical students (1.56) was significantly greater than that of nurses (1.03; p < 0.01), whereas the hostility score of nurses (0.59) was significantly greater than that of medical students (0.39; p < 0.01). CONCLUSION: The quality of interaction between medical students and nurses during third-year clinical rotations is poor, which suggests that medical students are not receiving the sorts of educational experiences that promote optimal physician-nurse collaboration. Medical students and nurses experience different levels of psychological distress, which may adversely impact the quality of their interaction

Building resilience in contemporary nursing practice

YesThe nursing profession is being threatened by staff shortages. Catherine Best explains why building resilience from within the profession is vital to safeguarding its future, by keeping newly qualified nurses in the job and preventing emotional ‘burnout’ across disciplines Resilience in nursing has been critiqued and challenged throughout the nursing literature. Trends in nursing have led to many nurses leaving the profession early in their career, often due to the immense pressures that they work under. There are many opinions on how nurses can develop the resilience needed to maintain professional integrity and continue to provide safe and effective care, while attempting to shoulder the considerable impact of political and professional drivers. This not only leaves nurses exhausted but often without hope. By taking collective action, this article argues that nurses may benefit from sharing ideas and learning from others, and in so doing rekindle hope and a belief that things can change

Fluids and barriers of the CNS establish immune privilege by confining immune surveillance to a two-walled castle moat surrounding the CNS castle

Neuronal activity within the central nervous system (CNS) strictly depends on homeostasis and therefore does not tolerate uncontrolled entry of blood components. It has been generally believed that under normal conditions, the endothelial blood-brain barrier (BBB) and the epithelial blood-cerebrospinal fluid barrier (BCSFB) prevent immune cell entry into the CNS. This view has recently changed when it was realized that activated T cells are able to breach the BBB and the BCSFB to perform immune surveillance of the CNS. Here we propose that the immune privilege of the CNS is established by the specific morphological architecture of its borders resembling that of a medieval castle. The BBB and the BCSFB serve as the outer walls of the castle, which can be breached by activated immune cells serving as messengers for outside dangers. Having crossed the BBB or the BCSFB they reach the castle moat, namely the cerebrospinal fluid (CSF)-drained leptomeningeal and perivascular spaces of the CNS. Next to the CNS parenchyma, the castle moat is bordered by a second wall, the glia limitans, composed of astrocytic foot processes and a parenchymal basement membrane. Inside the castle, that is the CNS parenchyma proper, the royal family of sensitive neurons resides with their servants, the glial cells. Within the CSF-drained castle moat, macrophages serve as guards collecting all the information from within the castle, which they can present to the immune-surveying T cells. If in their communication with the castle moat macrophages, T cells recognize their specific antigen and see that the royal family is in danger, they will become activated and by opening doors in the outer wall of the castle allow the entry of additional immune cells into the castle moat. From there, immune cells may breach the inner castle wall with the aim to defend the castle inhabitants by eliminating the invading enemy. If the immune response by unknown mechanisms turns against self, that is the castle inhabitants, this may allow for continuous entry of immune cells into the castle and lead to the death of the castle inhabitants, and finally members of the royal family, the neurons. This review will summarize the molecular traffic signals known to allow immune cells to breach the outer and inner walls of the CNS castle moat and will highlight the importance of the CSF-drained castle moat in maintaining immune surveillance and in mounting immune responses in the CNS