Alien Registration- Mcginley, Margaret (Fort Fairfield, Aroostook County)

https://digitalmaine.com/alien_docs/36511/thumbnail.jp

A qualitative service evaluation of nurses’ satisfaction with care in wards implementing hourly nursing rounds

BACKGROUND: The delivery of safe quality patient care with attention to addressing basic care needs is pertinent to the current concerns about care within the National Health Service (NHS). The introduction of hourly nursing rounds is one way in which such concerns can be addressed. Hourly nursing rounds involve the nurse routinely visiting every patient every hour to address the immediate needs of the patient based on the 3P’s which involves, pain, potty (continence) and positioning. This concept was brought across from the United States of America, and is now being implemented in trusts across the United Kingdom. The researcher was given the opportunity to explore how well this system is working in practice within two large teaching hospitals in a particular NHS Trust. AIM OF THE STUDY: To evaluate nurses’ satisfaction with care on wards implementing hourly nursing rounds. METHODS: Service evaluation with a qualitative approach was utilised. Ten nurses from four wards across two hospitals within one NHS trust were interviewed regarding their experiences in carrying out the hourly nursing rounds. FINDINGS: Four main themes were identified from the interviews: improving quality of patient care, patient safety, challenging ritualistic care and resourcing. These themes are evident in the literature, some of which contradict what is said, whereas others support what is said. Nurses are divided in opinion as to whether they feel hourly nursing rounds have had an impact on improving the quality of patient care and enhancing patient safety. Challenges to carrying out the rounds were identified as difficulties due to time and staffing issues. Nurses expressed the sometimes unrealistic expectations to carry out the rounds on all patients every hour. However the rounds provide a structured proactive approach to anticipate patients’ immediate care needs. CONCLUSION: The generalisability of this small scale study is limited; however it does illustrate nurses’ experiences of carrying out the hourly nursing rounds. It identifies implications for nursing practice and recommendations for future research

The development of vocabulary exercises to accompany social studies textbooks in the intermediate grades.

Thesis (Ed.M.)--Boston Universit

A qualitative service evaluation of nurses’ satisfaction with care in wards implementing hourly nursing rounds

BACKGROUND: The delivery of safe quality patient care with attention to addressing basic care needs is pertinent to the current concerns about care within the National Health Service (NHS). The introduction of hourly nursing rounds is one way in which such concerns can be addressed. Hourly nursing rounds involve the nurse routinely visiting every patient every hour to address the immediate needs of the patient based on the 3P’s which involves, pain, potty (continence) and positioning. This concept was brought across from the United States of America, and is now being implemented in trusts across the United Kingdom. The researcher was given the opportunity to explore how well this system is working in practice within two large teaching hospitals in a particular NHS Trust. AIM OF THE STUDY: To evaluate nurses’ satisfaction with care on wards implementing hourly nursing rounds. METHODS: Service evaluation with a qualitative approach was utilised. Ten nurses from four wards across two hospitals within one NHS trust were interviewed regarding their experiences in carrying out the hourly nursing rounds. FINDINGS: Four main themes were identified from the interviews: improving quality of patient care, patient safety, challenging ritualistic care and resourcing. These themes are evident in the literature, some of which contradict what is said, whereas others support what is said. Nurses are divided in opinion as to whether they feel hourly nursing rounds have had an impact on improving the quality of patient care and enhancing patient safety. Challenges to carrying out the rounds were identified as difficulties due to time and staffing issues. Nurses expressed the sometimes unrealistic expectations to carry out the rounds on all patients every hour. However the rounds provide a structured proactive approach to anticipate patients’ immediate care needs. CONCLUSION: The generalisability of this small scale study is limited; however it does illustrate nurses’ experiences of carrying out the hourly nursing rounds. It identifies implications for nursing practice and recommendations for future research

An Application of Electromyographic Biofeedback to Aphasia/Apraxia Treatment

TB

Choosing Healthcare Options by Involving Canada's Elderly: a protocol for the CHOICE realist synthesis project on engaging older persons in healthcare decision-making

Introduction: While patient and citizen engagement has been recognised as a crucial element in healthcare reform, limited attention has been paid to how best to engage seniors-the fastest growing segment of the population and the largest users of the healthcare system. To improve the healthcare services for this population, seniors and their families need to be engaged as active partners in healthcare decision-making, research and planning. This synthesis aims to understand the underlying context and mechanisms needed to achieve meaningful engagement of older adults in healthcare decision-making, research and planning. Methods and analysis: The CHOICE Knowledge Synthesis Project: Choosing Healthcare Options by Involving Canada's Elderly aims to address this issue by synthesising current knowledge on patient, family, and caregiver engagement. A realist synthesis will support us to learn from other patient and citizen engagement initiatives, from previous research, and from seniors, families and caregivers themselves. The synthesis will guide development or adaptation of a framework, leading to the development of best practice guidelines and recommendations for engagement of older people and their families and caregivers in clinical decision-making, healthcare delivery, planning and research. Ethics and dissemination: The components of this protocol involving consultation with patients or caregivers have received ethics clearance from the University of Waterloo, Office of Research Ethics (ORE# 19094). After completion of the project, we will amalgamate the information collected into a knowledge synthesis report which will include best practice guidelines and recommendations for patient, family and caregiver engagement in clinical and health system planning and research contexts. Results: Will be further disseminated to citizens, clinicians, researchers and policymakers with the help of our partners.Technology Evaluation in the Elderly Network (TVN, grant # KS2013-08), which is funded by the Government of Canada's Networks of Centres of Excellence (NCE) Progra

V1647 Orionis: Reinvigorated Accretion and the Re-Appearance of McNeil's Nebula

In late 2003, the young eruptive variable star V1647 Orionis optically brightened by over 5 magnitudes, stayed bright for around 26 months, and then decline to its pre-outburst level. In August 2008 the star was reported to have unexpectedly brightened yet again and we herein present the first detailed observations of this new outburst. Photometrically, the star is now as bright as it ever was following the 2003 eruption. Spectroscopically, a pronounced P Cygni profile is again seen in Halpha with an absorption trough extending to -700 km/s. In the near-infrared, the spectrum now possesses very weak CO overtone bandhead absorption in contrast to the strong bandhead emission seen soon after the 2003 event. Water vapor absorption is also much stronger than previously seen. We discuss the current outburst below and relate it to the earlier event.Comment: 6 pages, 3 figure

Carbon isotope discrimination in leaves of the common paperbark tree, Melaleuca quinquenervia, as a tool for quantifying past tropical and subtropical rainfall

Quantitative reconstructions of terrestrial climate are highly sought after but rare, particularly in Australia. Carbon isotope discrimination in plant leaves (Δleaf) is an established indicator of past hydroclimate because the fractionation of carbon isotopes during photosynthesis is strongly influenced by water stress. Leaves of the evergreen tree Melaleuca quinquenervia have been recovered from the sediments of some perched lakes on North Stradbroke and Fraser Islands, south-east Queensland, eastern Australia. Here, we examine the potential for using M. quinquenervia ∆leaf as a tracer of past rainfall by analysing carbon isotope ratios (δ13C) of modern leaves. We firstly assess Δleaf variation at the leaf and stand scale and find no systematic pattern within leaves or between leaves due to their position on the tree. We then examine the relationships between climate and Δleaf for an 11 year timeseries of leaves collected in a litter tray. M. quinquenervia retains its leaves for 1-4 years; thus cumulative average climate data are used. There is a significant relationship between annual mean ∆leaf and mean annual rainfall of the hydrological year for 1-4 years (i.e. 365-1460 days) prior to leaf fall (r2=0.64, p=0.003, n=11). This relationship is marginally improved by accounting for the effect of pCO2 on discrimination (r2=0.67, p=0.002, n=11). The correlation between rainfall and Δleaf, and the natural distribution of Melaleuca quinquenervia around wetlands of eastern Australia, Papua New Guinea and New Caledonia offers significant potential to infer past rainfall on a wide range of spatial and temporal scales

Nutritional B vitamin deficiency alters the expression of key proteins associated with vascular smooth muscle cell proliferation and migration in the aorta of atherosclerotic apolipoprotein E null mice.

Low B vitamin status is linked with human vascular disease. We employed a proteomic and biochemical approach to determine whether nutritional folate deficiency and/or hyperhomocysteinemia altered metabolic processes linked with atherosclerosis in ApoE null mice. Animals were fed either a control fat (C; 4 % w/w lard) or a high-fat [HF; 21 % w/w lard and cholesterol (0/15 % w/w)] diet with different B vitamin compositions for 16 weeks. Aorta tissue was prepared and global protein expression, B vitamin, homocysteine and lipoprotein status measured. Changes in the expression of aorta proteins were detected in response to multiple B vitamin deficiency combined with a high-fat diet (P < 0.05) and were strongly linked with lipoprotein concentrations measured directly in the aorta adventitia (P < 0.001). Pathway analysis revealed treatment effects in the aorta-related primarily to cytoskeletal organisation, smooth muscle cell adhesion and invasiveness (e.g., fibrinogen, moesin, transgelin, vimentin). Combined B vitamin deficiency induced striking quantitative changes in the expression of aorta proteins in atherosclerotic ApoE null mice. Deregulated expression of these proteins is associated with human atherosclerosis. Cellular pathways altered by B vitamin status included cytoskeletal organisation, cell differentiation and migration, oxidative stress and chronic inflammation. These findings provide new insight into the molecular mechanisms through which B vitamin deficiency may accelerate atherosclerosis

Brief motivational enhancement intervention to prevent or reduce postpartum alcohol use: a single-blinded, randomized controlled effectiveness trial

AIMS: The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use. DESIGN: This study is a single-blinded, randomized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10-30 minutes each and occurring at study enrollment, 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks postpartum. SETTING: The setting is in a large, urban, obstetrics clinic. PARTICIPANTS: Participants were women who were \u3e/= 18 years old,gestation, and consumed alcohol during pregnancy. Of 3438 women screened, 330 eligible women were assigned to usual care (n = 165) or intervention (n=165). Due to missing data, we analyzed 125 in the intervention group and 126 in the usual care group. MEASUREMENTS: The measurements were the proportion of women with any alcohol use and the number of drinks per day, reported via follow-up telephone interviews at 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks, 6 months, and 12 months postpartum. FINDINGS: In random effects models adjusted for confounders, the intervention group was less likely to use any alcohol (odds ratio 0.50; 95% confidence interval [CI], 0.23-1.09; P=0.08) and consumed fewer drinks per day (coefficient -0.11; 95% CI -0.23-0.01; P=0.07) than, the usual care group in the postpartum period but these differences were non-significant. Missing data during the prenatal period prevented us from modeling prenatal alcohol use. CONCLUSIONS: Brief motivational enhancement intervention delivered in an obstetrical outpatient setting did not conclusively decrease alcohol use during the postpartum period