Implementation of Unit-Based Preceptor Orientation: The Effects on Perceived Orientee Competence and Self-Confidence of the Precepting CVICU Nurse

Purpose: The purpose of this study was to assess how unit-specific preceptor training impacted the perceived readiness of new graduate nurses, self-confidence of preceptors, and the correlated job satisfaction. Background: The nurse attrition rate is resulting in inexperience at the bedside. Nursing inexperience leads to lower quality patient care. If improving the efficiency of training and education can improve perceived readiness, then in turn we can increase the longevity of our new nurses. Improving the longevity of nurses has significant implications on the budget of each hospital, the patient outcomes, and the staff’s resulting job satisfaction. Methods: New graduate nurse preceptors received a survey of perceived competence and assessment of their learning after they completed the unit-specific orientation. Preceptors received formal training about how to be a preceptor under the new tiered competency system. Both the preceptor and orientee received a survey after the unit-based orientation and the required number of shifts worked to assess competency, self-confidence, and prevalence of completed first tier orientation requirements. That data was analyzed and compared to the pre-intervention survey the preceptors were given. Results: The results of this project include a non-statistically significant positive correlation between the preceptor orientation class and level of self-confidence. The preceptor class had a negative effect on feelings of support, accepted workload, and tier understanding. There remains a large gap in knowledge and training for preceptors that still requires improvement in teaching the tier system and workload management. Prevalence of completion of the required skills increased exponentially after the tiered system class. Conclusions: Simply altering a process that is already in place had a positive impact on the self-confidence of the preceptor. The orientee’s also expressed a successful learning of the ten most important and commonly forgotten aspects of the first tier of orientation. Improving nurse orientation can start fixing the national nursing shortage from the inside

Embracing Change: Adapting and Evolving Your Distance Learning Library Services to Embrace the New ACRL Distance Learning Library Services Standards

Distance learning continues to grow by leaps and bounds and almost all academic libraries are struggling to evolve and adapt to offer quality equivalent services and resources to their distance students. This interactive presentation will offer participants an in-depth analysis of the new ACRL Distance Learning Library Services Standards, offer forecasts regarding the future of distance learning, and will draw distinctions between the previous 2008 Standards for Distance Learning Library Services and the new standards. Practical advice on how to update distance learning library services to meet the new standards will be offered, and participants are encouraged to bring their own experiences and questions to the discussion

Mast cell clones: a model for the analysis of cellular maturation.

Cloned mouse mast cells resemble, by ultrastructure, immature mast cells observed in vivo. These mast cell clones can be grown in the absence of any other cells, facilitating direct investigations of their biochemistry and function. We find that cloned mast cells express plasma membrane receptors (Fc epsilon R) that bind mouse IgE with an equilibrium constant (KA) similar to that of normal mouse peritoneal mast cells. In addition, cloned mast cells do not display detectable la antigens and cannot enhance lg secretion when added to lymphocyte cultures or mediate natural killer lysis. In the presence of 1 mM sodium butyrate, cloned mast cells stop dividing and acquire abundant electron-dense cytoplasmic granules similar to those of mature mast cells. Their histamine content increases concomitant with cytoplasmic granule maturation and may exceed that of untreated mast cells by 50-fold. Unlike peritoneal mast cells, cloned mast cells incorporate 35SO4 into chondroitin sulfates rather than heparin. These findings demonstrate that, unlike fully differentiated mouse peritoneal mast cells, cloned immature mouse mast cells contain no heparin and low levels of histamine. In addition, they establish that high-affinity Fc epsilon R are expressed early in mast cell maturation, well before completion of cytoplasmic granule synthesis and mediator storage

Cloned mouse cells with natural killer function and cloned suppressor T cells express ultrastructural and biochemical features not shared by cloned inducer T cells.

We have examined the morphology, cytochemistry, and biochemistry of mouse leukocyte subsets by analyzing cloned leukocyte populations specialized to perform different immunologic functions. Cloned cells expressing high-affinity plasma membrane receptors for IgE and mediating natural killer (NK) lysis and cloned antigen-specific suppressor T cells contained prominent osmiophilic cytoplasmic granules similar by ultrastructure to those of mouse basophils. Both clones also incorporated 35SO4 into granule-associated sulfated glycosaminoglycans, expressed a characteristic ultrastructural pattern of nonspecific esterase activity, incorporated exogenous [3H]5-hydroxytryptamine, and contained cytoplasmic deposits of particulate glycogen. By contrast, cloned inducer T cells lacked cytoplasmic granules and glycogen, incorporated neither 35SO4 nor [3H]5-hydroxytryptamine, and differed from the other clones in pattern of nonspecific esterase activity. These findings establish that certain cloned cells with NK activity and cloned suppressor T cells express morphologic and biochemical characteristics heretofore associated with basophilic granulocytes. However, these clones differ in surface glycoprotein expression and immunologic function, and the full extent of the similarities and differences among these populations and basophils remains to be determined

Before the Flood: Impact of Coordination of Care and Direct Admissions on Emergency Department Volumes

Background: Transfers of pediatric patients occur to access specialty and subspecialty care, but incur risk, and consume resources. Direct admissions to medical and surgical wards may improve patient experience and mitigate resource utilization. Objective: We sought to identify common elements for direct admissions, as well as the pattern of disposition for patients referred to our emergency department (ED). Design: A retrospective qualitative analysis of patients transferred to our pediatric hospital for 12 months was performed. Different physician groups were evaluated for use of direct admissions or evaluation in the ED. Patients referred to the ED were additionally tracked to evaluate their eventual disposition. Results: A total of 3982 transfers occurred during the 12-month analysis period. Of those, 3463 resulted in admission, accounting for 32.55% of all admissions. Transfers accepted by nonsurgical services accounted for 82% of the transfers, whereas 18% were facilitated by one of the surgical services. Direct admissions accounted for 1707 (44.8%) of all referrals and were used more often by nonsurgical services. Of patients referred to the ED (2101 or 55.2% of all referrals), most patients were admitted and 343 (16% of those referred to the ED) were discharged home. Conclusions: The direct admission process helped avoid ED assessments for some patients; however, some patients referred to the ED were able to be evaluated, treated, and discharged. Consistent triage of the patients being transferred as direct admissions may improve ED throughput and potentially improve the patient's experience, reduce redundant services, and expedite care

Two more disk galaxies with global gas counterrotation

We report a discovery of extended counterrotating gaseous disks in early-type disk galaxies NGC 2551 and NGC 5631. To find them, we have undertaken complex spectral observations including integral-field spectroscopy for the central parts of the galaxies and long-slit deep spectroscopy to probe the external parts. The line-of-sight velocity fields have been constructed and compared to the photometric structure of the galaxies. As a result, we have revealed full-size counterrotating gaseous disks, the one coplanar to the stellar disk in NGC 2551 and the other inclined to the main stellar disk in NGC 5631. We suggest that we observe the early stages of minor-merger events which may be two different stages of the process of lenticular galaxy formation in rather sparse environments.Comment: 8 pages, 8 EPS figures, accepted for publication in Ap

Dichotomy in host environments and signs of recycled AGN

We analyse the relation between AGN host properties and large scale environment for a representative red and blue AGN host galaxy sample selected from the DR4 SDSS. A comparison is made with two carefully constructed control samples of non-active galaxies, covering the same redshift range and color baseline. The cross-correlation functions show that the density distribution of neighbours is almost identical for blue galaxies, either active, or non-active. Although active red galaxies inhabit environments less dense compared to non-active red galaxies, both reside in environments considerably denser than those of blue hosts. Moreover, the radial density profile of AGN, relative to galaxy group centres is less concentrated than galaxies. This is particularly evident when comparing red AGN and non-active galaxies. The properties of the neighbouring galaxies of blue and red AGN and non active galaxies reflect this effect. While the neighbourhood of the blue samples is indistinguishable, the red AGN environs show an excess of blue-star forming galaxies with respect to their non-active counterpart. On the other hand, the active and non-active blue systems have similar environments but markedly different morphological distributions, showing an excess of blue early-type AGN, which are argued to be late stage mergers. This comparison reveals that the observable differences between active red and blue host galaxy properties including star formation history and AGN activity depends on the environment within which the galaxies form and evolve.Comment: 11 pages, 10 figures. Accepted for publication in MNRA

A Relational Event Approach to Modeling Behavioral Dynamics

This chapter provides an introduction to the analysis of relational event data (i.e., actions, interactions, or other events involving multiple actors that occur over time) within the R/statnet platform. We begin by reviewing the basics of relational event modeling, with an emphasis on models with piecewise constant hazards. We then discuss estimation for dyadic and more general relational event models using the relevent package, with an emphasis on hands-on applications of the methods and interpretation of results. Statnet is a collection of packages for the R statistical computing system that supports the representation, manipulation, visualization, modeling, simulation, and analysis of relational data. Statnet packages are contributed by a team of volunteer developers, and are made freely available under the GNU Public License. These packages are written for the R statistical computing environment, and can be used with any computing platform that supports R (including Windows, Linux, and Mac).

Demography of SDSS early-type galaxies from the perspective of radial color gradients

We have investigated the radial g-r color gradients of early-type galaxies in the Sloan Digital Sky Survey (SDSS) DR6 in the redshift range 0.00<z<0.06. The majority of massive early-type galaxies show a negative color gradient (red-cored) as generally expected for early-type galaxies. On the other hand, roughly 30 per cent of the galaxies in this sample show a positive color gradient (blue-cored). These "blue-cored" galaxies often show strong H beta absorption line strengths and/or emission line ratios that are indicative of the presence of young stellar populations. Combining the optical data with Galaxy Evolution Explorer (GALEX) UV photometry, we find that all blue-cored galaxies show UV-optical colors that can only be explained by young stellar populations. This implies that most of the residual star formation in early-type galaxies is centrally concentrated. Blue-cored galaxies are predominantly low velocity dispersion systems. A simple model shows that the observed positive color gradients (blue-cored) are visible only for a billion years after a star formation episode for the typical strength of recent star formation. The observed effective radius decreases and the mean surface brightness increases due to this centrally-concentrated star formation episode. As a result, the majority of blue-cored galaxies may lie on different regions in the Fundamental Plane from red-cored ellipticals. However, the position of the blue-cored galaxies on the Fundamental Plane cannot be solely attributed to recent star formation but require substantially lower velocity dispersion. We conclude that a low-level of residual star formation persists at the centers of most of low-mass early-type galaxies, whereas massive ones are mostly quiescent systems with metallicity-driven red cores.Comment: 15 pages, 19 figures, accepted for publication in ApJ

Using interpretative phenomenological analysis to inform physiotherapy practice: An introduction with reference to the lived experience of cerebellar ataxia

The attached file is a pre-published version of the full and final paper which can be found at the link below.This article has been made available through the Brunel Open Access Publishing Fund.Qualitative research methods that focus on the lived experience of people with health conditions are relatively underutilised in physiotherapy research. This article aims to introduce interpretative phenomenological analysis (IPA), a research methodology oriented toward exploring and understanding the experience of a particular phenomenon (e.g., living with spinal cord injury or chronic pain, or being the carer of someone with a particular health condition). Researchers using IPA try to find out how people make sense of their experiences and the meanings they attach to them. The findings from IPA research are highly nuanced and offer a fine grained understanding that can be used to contextualise existing quantitative research, to inform understanding of novel or underresearched topics or, in their own right, to provoke a reappraisal of what is considered known about a specified phenomenon. We advocate IPA as a useful and accessible approach to qualitative research that can be used in the clinical setting to inform physiotherapy practice and the development of services from the perspective of individuals with particular health conditions.This article is available through the Brunel Open Access Publishing Fund