60 research outputs found
Relationship of Ethical Knowledge to Action in Senior Baccalaureate Nursing Students
Nursing educators are expected to prepare students to practice in a complex health care environment yet nursing curriculums vary in how the ethical reasoning ability of students is developed. To effectively manage clinical situations that have ethical implications, practitioners need to be able to recognizing these situations and have the ability to take action. Using an established instrument known as Ketefian’s Judgments About Nursing Decisions (JAND) to survey nursing students, this study examined the relationship between knowledge of the Code of Ethics for Nurses to choices of action in senior nursing students in baccalaureate nursing programs enrolled in the last semester of classes before graduating. The research process also included exploration of individual characteristics of the students to determine what impact, if any, these had on the relationship between knowledge and choice of action. There was a positive, significant, correlation between knowledge and action in senior baccalaureate nursing students. There was no significant difference in this relationship as a result of education or experience within the student group but a large discrepancy in the numbers of participants in each group may have impacted this finding. Thus college credit in courses on ethics, previous experience with making health care decisions, and general experience in health care did not significantly impact this relationship, but did indicate a need for further research
A Systematic Review of Music Therapy Practice and Outcomes with Acute Adult Psychiatric In-Patients
PMCID: PMC3732280This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Multiplicity Statistics of Stars in the Sagittarius Dwarf Spheroidal Galaxy: Comparison to the Milky Way
We use time-resolved spectra from the Apache Point Observatory Galactic
Evolution Experiment (APOGEE) to examine the distribution of radial velocity
(RV) variations in 249 stars identified as members of the Sagittarius (Sgr)
dwarf spheroidal (dSph) galaxy by Hayes et al (2020). We select Milky Way (MW)
stars that have stellar parameters (, , and ) similar
to those of the Sagittarius members by means of a k-d tree of dimension 3. We
find that the shape of the distribution of RV shifts in Sgr dSph stars is
similar to that measured in their MW analogs, but the total fraction of RV
variable stars in the Sgr dSph is larger by a factor of . After ruling
out other explanations for this difference, we conclude that the fraction of
close binaries in the Sgr dSph is intrinsically higher than in the MW. We
discuss the implications of this result for the physical processes leading to
the formation of close binaries in dwarf spheroidal and spiral galaxies
What are emergency ambulance services doing to meet the needs of people who call frequently? A national survey of current practice in the United Kingdom
Background
Emergency ambulance services are integral to providing a service for those with unplanned urgent and life-threatening health conditions. However, high use of the service by a small minority of patients is a concern. Our objectives were to describe: service-wide and local policies or pathways for people classified as Frequent Caller; call volume; and results of any audit or evaluation.
Method
We conducted a national survey of current practice in ambulance services in relation to the management of people who call the emergency ambulance service frequently using a structured questionnaire for completion by email and telephone interview. We analysed responses using a descriptive and thematic approach.
Results
Twelve of 13 UK ambulance services responded. Most services used nationally agreed definitions for ‘Frequent Caller’, with 600–900 people meeting this classification each month. Service-wide policies were in place, with local variations. Models of care varied from within-service care where calls are flagged in the call centre; contact made with callers; and their General Practitioner (GP) with an aim of discouraging further calls, to case management through cross-service, multi-disciplinary team meetings aiming to resolve callers’ needs. Although data were available related to volume of calls and number of callers meeting the threshold for definition as Frequent Caller, no formal audits or evaluations were reported.
Conclusions
Ambulance services are under pressure to meet challenging response times for high acuity patients. Tensions are apparent in the provision of care to patients who have complex needs and call frequently. Multi-disciplinary case management approaches may help to provide appropriate care, and reduce demand on emergency services. However, there is currently inadequate evidence to inform commissioning, policy or practice development
Community-based assessment of human rights in a complex humanitarian emergency: the Emergency Assistance Teams-Burma and Cyclone Nargis
<p>Abstract</p> <p>Introduction</p> <p>Cyclone Nargis hit Burma on May 2, 2008, killing over 138,000 and affecting at least 2.4 million people. The Burmese military junta, the State Peace and Development Council (SPDC), initially blocked international aid to storm victims, forcing community-based organizations such as the Emergency Assistance Teams-Burma (EAT) to fill the void, helping with cyclone relief and long-term reconstruction. Recognizing the need for independent monitoring of the human rights situation in cyclone-affected areas, particularly given censorship over storm relief coverage, EAT initiated such documentation efforts.</p> <p>Methods</p> <p>A human rights investigation was conducted to document selected human rights abuses that had initially been reported to volunteers providing relief services in cyclone affected areas. Using participatory research methods and qualitative, semi-structured interviews, EAT volunteers collected 103 testimonies from August 2008 to June 2009; 42 from relief workers and 61 from storm survivors.</p> <p>Results</p> <p>One year after the storm, basic necessities such as food, potable water, and shelter remained insufficient for many, a situation exacerbated by lack of support to help rebuild livelihoods and worsening household debt. This precluded many survivors from being able to access healthcare services, which were inadequate even before Cyclone Nargis. Aid efforts continued to be met with government restrictions and harassment, and relief workers continued to face threats and fear of arrest. Abuses, including land confiscation and misappropriation of aid, were reported during reconstruction, and tight government control over communication and information exchange continued.</p> <p>Conclusions</p> <p>Basic needs of many cyclone survivors in the Irrawaddy Delta remained unmet over a year following Cyclone Nargis. Official impediments to delivery of aid to storm survivors continued, including human rights abrogations experienced by civilians during reconstruction efforts. Such issues remain unaddressed in official assessments conducted in partnership with the SPDC. Private, community-based relief organizations like EAT are well positioned and able to independently assess human rights conditions in response to complex humanitarian emergencies such as Cyclone Nargis; efforts of this nature must be encouraged, particularly in settings where human rights abuses have been documented and censorship is widespread.</p
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
The Sloan Digital Sky Survey Reverberation Mapping project : key results
Funding: Y.S. acknowledges support from NSF grants AST-1715579 and AST-2009947. C.J.G. acknowledges support from NSF grants AST-2009949 and AST-2108667. J.I.L. is supported by the Eric and Wendy Schmidt AI in Science Postdoctoral Fellowship, a Schmidt Futures program. Y.H. was supported as an Eberly Research Fellow by the Eberly College of Science at the Pennsylvania State University. J.R.T. acknowledges support from NSF grants CAREER-1945546, AST-2009539, and AST-2108668. W.N.B. acknowledges support from NSF grant AST-2106990 and the Eberly Endowment at Penn State. L.C.H. was supported by the National Science Foundation of China (11721303, 11991052, 12011540375, 12233001) and the China Manned Space Project (CMS-CSST-2021-A04, CMS-CSST-2021-A06). C.T. acknowledges Tsinghua University for the support to her work.We present the final data from the Sloan Digital Sky Survey (SDSS) Reverberation Mapping (RM) project, a precursor to the SDSS-V Black Hole Mapper RM program. This data set includes 11 yr photometric and 7 yr spectroscopic light curves for 849 broad-line quasars over a redshift range of 0.1 < z < 4.5 and a luminosity range of Lbol = 1044−47.5 erg s−1, along with spectral and variability measurements. We report 23, 81, 125, and 110 RM lags (relative to optical continuum variability) for broad Hα, Hβ, Mg ii, and C iv using the SDSS-RM sample, spanning much of the luminosity and redshift ranges of the sample. Using 30 low-redshift RM active galactic nuclei with dynamical-modeling black hole masses, we derive a new estimate of the average virial factor of ⟨logf⟩ = 0.62±0.07 for the line dispersion measured from the rms spectrum. The intrinsic scatter of individual virial factors is 0.31 ± 0.07 dex, indicating a factor of 2 systematic uncertainty in RM black hole masses. Our lag measurements reveal significant R–L relations for Hβ and Mg ii at high redshift, consistent with the latest measurements based on heterogeneous samples. While we are unable to robustly constrain the slope of the R–L relation for C iv given the limited dynamic range in luminosity, we found substantially larger scatter in C iv lags at fixed L1350. Using the SDSS-RM lag sample, we derive improved single-epoch (SE) mass recipes for Hβ, Mg ii, and C iv, which are consistent with their respective RM masses as well as between the SE recipes from two different lines, over the luminosity range probed by our sample. The new Hβ and Mg ii recipes are approximately unbiased estimators at given RM masses, but there are systematic biases in the C iv recipe. The intrinsic scatter of SE masses around RM masses is ∼0.45 dex for Hβ and Mg ii, increasing to ∼0.58 dex for C iv.Peer reviewe
The Sloan Digital Sky Survey Reverberation Mapping Project: Key Results
We present the final data from the Sloan Digital Sky Survey Reverberation
Mapping (SDSS-RM) project, a precursor to the SDSS-V Black Hole Mapper
Reverberation Mapping program. This data set includes 11-year photometric and
7-year spectroscopic light curves for 849 broad-line quasars over a redshift
range of 0.1<z<4.5 and a luminosity range of Lbol=1E44-47.5 erg/s, along with
spectral and variability measurements. We report 23, 81, 125, and 110
reverberation mapping lags (relative to optical continuum variability) for
broad Halpha, Hbeta, MgII and CIV using the SDSS-RM sample, spanning much of
the luminosity and redshift ranges of the sample. Using 30 low-redshift RM AGNs
with dynamical-modeling black hole masses, we derive a new estimate of the
average virial factor of =0.62+-0.07 for the line dispersion measured
from the RMS spectrum. The intrinsic scatter of individual virial factors is
0.31+-0.07 dex, indicating a factor of two systematic uncertainty in RM black
hole masses. Our lag measurements reveal significant R-L relations for Hbeta
and MgII at high redshift, consistent with the latest measurements based on
heterogeneous samples. While we are unable to robustly constrain the slope of
the R-L relation for CIV given the limited dynamical range in luminosity, we
found substantially larger scatter in CIV lags at fixed L1350. Using the
SDSS-RM lag sample, we derive improved single-epoch (SE) mass recipes for
Hbeta, MgII and CIV, which are consistent with their respective RM masses as
well as between the SE recipes from two different lines, over the luminosity
range probed by our sample. The new Hbeta and MgII recipes are approximately
unbiased estimators at given RM masses, but there are systematic biases in the
CIV recipe. The intrinsic scatter of SE masses around RM masses is ~0.45 dex
for Hbeta and MgII, increasing to ~0.58 dex for CIV.Comment: 33 pages. Data products available at
ftp://quasar.astro.illinois.edu/public/sdssrm/final_result
Moving in the anthropocene: global reductions in terrestrial mammalian movements
Animal movement is fundamental for ecosystem functioning and species survival, yet the effects of the anthropogenic footprint on animal movements have not been estimated across species. Using a unique GPS-tracking database of 803 individuals across 57 species, we found that movements of mammals in areas with a comparatively high human footprint were on average one-half to one-third the extent of their movements in areas with a low human footprint. We attribute this reduction to behavioral changes of individual animals and to the exclusion of species with long-range movements from areas with higher human impact. Global loss of vagility alters a key ecological trait of animals that affects not only population persistence but also ecosystem processes such as predator-prey interactions, nutrient cycling, and disease transmission
2023 EULAR classification criteria for hand osteoarthritis
The objective of this study is to develop classification criteria for overall hand osteoarthritis (OA), interphalangeal OA and thumb base OA based on self-reported data and radiographic features. The classification criteria sets were developed in three phases. In phase 1, we identified criteria that discriminated hand OA from controls. In phase 2, we used a consensus-based decision analysis approach to derive a clinician-based evaluation of the relative importance of the criteria. In phase 3, we refined the scoring system, determined the cut-offs for disease classification and compared the sensitivity and specificity of the European Alliance of Associations for Rheumatology (EULAR) criteria with the 1990 American College of Rheumatology (ACR) criteria. In persons with hand symptoms and no other disease (including psoriasis) or acute injury that can explain the hand symptoms (mandatory criteria), hand OA can be classified based on age, duration of morning stiffness, number of joints with osteophytes and joint space narrowing, and concordance between symptoms and radiographic findings. Using a sum of scores based on each diagnostic element, overall hand OA can be classified if a person achieves 9 or more points on a 0-15 scale. The cut-off for interphalangeal OA and thumb base OA is 8 points. While the EULAR criteria demonstrated better sensitivity than the ACR criteria in the phase 1 data set, the performance of the two criteria sets was similar in two external cohorts. International experts developed the EULAR criteria to classify overall hand OA, interphalangeal OA and thumb base OA in clinical studies using a rigorous methodology
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