The association between parent's and healthcare professional's behavior and children's coping and distress during venepuncture

Objectives: Examine the association between children’s distress and coping during venepuncture with parent’s and healthcare professional’s behavior in a sample from the UK. Methods: Fifty children aged 7–16 years accompanied by a carer were videotaped while having venepuncture. Verbalizations of children, parents, and healthcare professionals were coded using the Child–Adult Medical Procedure Interaction Scale-Revised. Results: Children’s distress was associated with child’s age, anxiety, and distress promoting behavior of adults (R2 = .91). Children’s coping was associated with age, anxiety, and coping promoting behaviors of adults (R2 = .57). Associations were stronger between healthcare professional’s behavior and child coping; and between parent’s behaviors and child distress. Empathizing, apologizing, and criticism were not frequently used by adults in this sample (<12%). Conclusion: This study supports and extends previous research showing adult’s behavior is important in children’s distress and coping during needle procedures. Clinical implications and methodological issues are discussed

Understanding needle-related distress in children with cystic fibrosis

Objective. To explore the nature and management of needle-related distress in children and adolescents with cystic fibrosis (CF). Design. Qualitative study using semi-structured interviews. Methods. Fourteen child–parent dyads took part. Children (5 male; 9 female) had a mean age of 12.4 years (range 7–17) and were mostly diagnosed with CF at birth (N= 11). Frequency of needle procedures ranged from once to six times a year. Parents (3 male; 11 female) had a mean age of 41.5 years and were from a variety of socio-economic backgrounds. Interviews were transcribed and analysed using thematic analysis. Results. Most participants identified previous needle experiences and pain as related to their needle anxiety. Over half of parents and children considered ‘taking control’ to be the optimum coping strategy. The majority of parents and children thought inhaled nitrous oxide gas during needle procedures was helpful in managing needle-related distress. Parent and staff influences on needle-related distress are also examined. Conclusions. Needle-related distress in children with CF has a substantial impact on children and their parents, and may lead to management problems and treatment refusal. Psychological and pharmacological interventions could reduce distress and aid management

Careful and Complete Observation of the Patient: Nurses and the Sociotechnical System of Medical Research, 1930-1962

ABSTRACT CAREFUL AND COMPLETE OBSERVATION OF THE PATIENT;” NURSES AND THE SOCIOTECHNICAL SYSTEM OF MEDICAL RESEARCH, 1930-1962 Amanda L. Mahoney, MS, RN Julie A. Fairman, PhD, RN, FAAN This study addresses the history of nurses working in medical research between 1930 and 1962, a time of tremendous growth in the use of experimentation to further clinical knowledge. Nurses were part of an intricate network of people, machines, knowledge and space—a socio-technical system—that made the clinical discoveries of the mid-20th century possible. Nurses were heavily involved in the day to day practices of medical research, thus this dissertation employs a microhistory approach, focusing on individual research projects conducted at the Hospital of the University of Pennsylvania (HUP) in Philadelphia, Pennsylvania. Archival sources related to clinical trials and nursing at HUP were examined as well as the historical records of funding agencies. Nurses performed important, skilled tasks including data collection and complex patient care. The requirements of research studies as well as the new technologies associated with clinical trials required nurses to develop methods and systems to accommodate an increased work load, collect data, and implement new treatments and techniques. This knowledge work was performed in the busy, understaffed world of the mid-20th century hospital. Nurses provided close observation and careful control of the patient, making metabolic research in particular feasible within hospitals. Nurses maintained the cooperation of research patients, a critical aspect to studies involving special diets. Within the hospital, nurses created a “zone of control” around the bedside of research patients, implementing research protocols, closely observing patients and gaining their compliance or cooperation. Using the work of bedside nurses as a historical lens reveals much about the world of medical research and the many factors that contributed to the growth and acceptance of experimentation as a normal part of clinical medicine. Marginalized actors have the agency and power to influence the success or failure of medical research even if they are denied official power. Nursing may hold the solutions to many of the challenges researchers face today

The Effects of Economic Globalization on Voter Turnout

Over the last 30 years, voter turnout, which is often considered to be an important sign of the vitality of a democracy, has been decreasing throughout the world. Traditional factors that drive voter turnout have not dramatically changed within the same period, suggesting that another factor is potentially at play. I contend that globalization, specifically economic globalization, has played a significant role in driving down voter turnout in the late 20th and early 21st centuries. First, economic globalization limits national autonomy in areas of economic policy by constraining national policymakers in their ability to implement substantive policy change. Second, as a result of the limiting effects of economic globalization on national autonomy, citizens increasingly view their vote as having less capacity to influence economic policy, which in turn causes them to be more likely consider the traditional costs of voting, such as time and effort. Through an analysis of over 180 countries spanning the time period of 1970 to 2018, I demonstrate that there is a negative relationship between levels of economic globalization and voter turnout. My findings suggest that the rate at which political elites within a particular country pursue economic globalization can directly influence how much of their electorate ultimately decide to vote in their country’s legislative elections, which has significant ramifications for the future as debates about the merits of globalization continue to dominate contemporary political discussion as the world emerges from the Covid-19 pandemic

Sustained release delivery system for ruminant animals

Ten in vivo trials were conducted to study the slow release delivery system. Trials 1, 2, 5, and 6 involved the use of one ruminally fistulated steer and were designed to study the effect of the following variables on the rate of release of slow release delivery system (SRDS), paper weight (Kg basis) within one paper type, paper weights among different paper types, and different covering types (coarse vs dense vs none) used to cover the exposed ends of SRDS(s). Twenty-four nonfistulated mature Angus, Herferd, and Angus-Herferd cows were used for trial 3 to investigate the effect of diet and animal variation on the rate of release of cromium oxide from SRDS. Fecal samples were collected every other day and analysed for cromium. Trial 4 involved the use of 24 nonfistulated heifers to study the release of Rumensin® from SRDS(s). Daily gain, hay consumption, and feed efficiency were recorded for each animal and compared with responses of control animals and animals receiving orally administered Rumensin®. Trials 7, 8, 9, and 10 were employed using six ruminally fistulated Jersey females. In trials 7 and 8, the effect of diet and animal variation among and within animals, on the rate of release of SRDS\u27s (containing waterproof membranes) were studied. Trial 9 was conducted to evaluate consistency of release of Ciba-Geigy A-72662 (a systemic fly insecticide) from a SRDS. Fecal samples were collected from each animal on alternate days during the first and last two weeks of the trial and once a week per animal during other weeks. Trial 10 was employed to measure the release of Ciba-Geigy A-72662 from a modified SRDS design. Fecal samples were collected once a week per animal. Fecal samples from trials 9 and 10 will be analyzed for ovacidal properties. Weight of paper (Kg basis) had a significant effect (P\u3c.001) on rate of exposure of SRDS(s). There was a trend for thinner paper (13.6 Kg basis) to degrade at a faster rate than thicker paper (31.8 Kg basis). Moreover, there was a relatively large amount of variation in rate of exposure between different paper types and weights (Kg basis). Covering type also had a significant effect on rate of exposure of SRDS\u27s (P\u3c.01). The interaction of covering type and basis was highly significant (P\u3c.001). Day also had a significant curvilinear effect on the rate of exposure of SRDS (P\u3e.0002). Hence, the rate of paper membranes exposed per day decreased as the time SRDS(s) remained in the animal increased. No cromium oxide was detected in the feces collected from animals in trial 3. However, Rumensin® was successfully released from SRDS(s). Daily gain for animals receiving Rumensin® via SRDS was similar to heifers fed Rumensin® in supplement (.87 Kg/day vs .86 Kg/day). Rumensin® treated groups (either by SRDS or by supplement) had increased gains within the range experienced by other workers. Rumensin® treated heifers were also more efficient than heifers who received no Rumensin® (4.88, 3.70, and 5.59 pound hay/pound gain). Diet (fescue-legume vs fescue) had no effect on the rate of exposure of SRDS (P\u3e.1). Additionally, there was no variation among and within animals on the rate of exposure of SRDS(s) (P\u3e.1)

EVA momentum as a performance measure in the United States lodging industry

Numerous measures and metrics are used to evaluate lodging unit and company performance, but no single measure has been identified that captures the financial performance of a lodging firm. EVA Momentum emerged in 2009 as the newest economic value added (EVA)-related business performance measure. The objective of this study was to understand the value of EVA Momentum as a performance measure in the U.S. lodging industry by: (a) comparing EVA Momentum in similar and dissimilar industries, (b) determining if EVA Momentum was related to future value, and (c) understanding if EVA Momentum was more highly related to future performance than were traditional financial performance measures. Compustat and evaDimensions financial data from 2001-2008 for U.S.-based hotel, restaurant, and REIT companies were used in this study. T-test results showed no statistically significant difference between lodging and restaurant EVA Momentum. ANOVA test results found lodging EVA Momentum was higher than for fixed asset-intensive REITs, but the results were not statistically significant. Regression results showed EVA Momentum was not related to future financial performance as measured by market capitalization or total capitalization. Regression results also showed EVA Momentum was more highly related to future performance than were return on assets, return on sales, and earnings per share for the pooled sample, but not for the individual lodging, restaurant, and REIT samples. This is the first known empirical study of EVA Momentum as a performance measure. The results of the study provided support for using EVA Momentum to compare company performance across different industries, but did not find that EVA Momentum was related to future financial performance. Using a pooled sample, EVA Momentum was shown to be more highly related to future financial performance than were three traditional financial measures