Patient safety competencies in undergraduate nursing students: a rapid evidence assessment

Aims To identify patient safety competencies, and determine the clinical learning environments that facilitate the development of patient safety competencies in nursing students. Background Patient safety in nursing education is of key importance for health professional environments, settings, and care systems. To be effective, safe nursing practice requires a good integration between increasing knowledge and the different clinical practice settings. Nurse educators have the responsibility to develop effective learning processes and ensure patient safety. Design Rapid Evidence Assessment. Data Sources MEDLINE, CINAHL, SCOPUS, and ERIC were searched, yielding 500 citations published between 1 January 2004 - 30 September 2014. Review Methods Following the Rapid Evidence Assessment process, 17 studies were included in this review. Hawker's (2002) quality assessment tool was used to assess the quality of the selected studies. Results Undergraduate nursing students need to develop competencies to ensure patient safety. The quality of the pedagogical atmosphere in the clinical setting has an important impact on the students’ overall level of competence. Active student engagement in clinical processes stimulates their critical reasoning, improves interpersonal communication, and facilitates adequate supervision and feedback. Conclusion Few studies describe the nursing students’ patient safety competencies and exactly what they need to learn. In addition, studies describe only briefly which clinical learning environments facilitate the development of patient safety competencies in nursing students. Further research is needed to identify additional pedagogical strategies and the specific characteristics of the clinical learning environments that encourage the development of nursing students’ patient safety competencies

Burnout precursors in oncology nurses: A preliminary cross-sectional study with a systemic organizational analysis

Burnout negatively affects nurses' health and performance. Healthcare managers have an ethical duty to create healthy organizations that reduce burnout, especially within critical settings such as oncology. The aim of this study was twofold: (1) to measure the presence of nurses' burnout to formulate organizational strategies to prevent the syndrome onset, and (2) to evaluate the effect of recent organizational changes on the burnout phenomenon. A descriptive, cross-sectional design supported by a systemic organizational analysis was conducted in a Swiss Oncology Institute in 2013. Of 103 nurses working in the Institute, 52 (51.4%) completed the Burnout Potential Inventory (BPI) questionnaire. Data were analyzed using descriptive statistics and Mann-Whitney and Kruskal-Wallis tests. Burnout risk levels were low to moderate. Only 2 nurses out of the 52 showed moderate burnout risk levels. Inpatient nurses showed a higher risk of burnout than outpatient nurses, particularly due to ambiguity and feelings of powerlessness. Nurses with post-basic education showed a higher risk when considering poor teamwork values and ambiguity in the workplace. Poor middle-management was found to negatively influence worker wellbeing. The working environment set by management resulted in low burnout risk levels. Managers must carefully select middle-management because inappropriate leadership might promote the onset of burnout

Living organisms and sedimentary remains from high mountain lakes in the Alps

We publish a data set of environmental and biological data collected in 2000 during the ice-free period in high mountain lakes located above the local timberline in the Alps, in Italy, Switzerland and Austria. Environmental data include coordinates, geographical attributes and detailed information on vegetation, bedrock and land use in lake catchments. Chemical analyses of a sample for each lake collected at the lake surface in Summer 2000 are also reported. Biological data include phytoplankton (floating algae and cyanobacteria), zooplankton (floating animals), macroinvertebrates (aquatic organisms visible to the naked eye living in contact with sediments on lake bottom), benthic diatoms. Diatoms, cladocera and chironomids remains and algal and bacterial pigments were also analysed in lake sediments

First human impacts and responses of aquatic systems: a review of palaeolimnological records from around the world

Lake sediments constitute natural archives of past environmental changes. Historically, research has focused mainly on generating regional climate records, but records of human impacts caused by land use and exploitation of freshwater resources are now attracting scientific and management interests. Long-term environmental records are useful to establish ecosystem reference conditions, enabling comparisons with current environments and potentially allowing future trajectories to be more tightly constrained. Here we review the timing and onset of human disturbance in and around inland water ecosystems as revealed through sedimentary archives from around the world. Palaeolimnology provides access to a wealth of information reflecting early human activities and their corresponding aquatic ecological shifts. First human impacts on aquatic systems and their watersheds are highly variable in time and space. Landscape disturbance often constitutes the first anthropogenic signal in palaeolimnological records. While the effects of humans at the landscape level are relatively easily demonstrated, the earliest signals of human-induced changes in the structure and functioning of aquatic ecosystems need very careful investigation using multiple proxies. Additional studies will improve our understanding of linkages between human settlements, their exploitation of land and water resources, and the downstream effects on continental water

Slaughter weight rather than sex affects carcass cuts and tissue composition of Bisaro pigs

Carcass cuts and tissue composition were assessed in Bisaro pigs (n=64) from two sexes (31 gilts and 33 entire males) reared until three target slaughter body-weights (BW) means: 17 kg, 32 kg, and 79 kg. Dressing percentage and backfat thickness increased whereas carcass shrinkage decreased with increasing BW. Slaughter weight affected most of the carcass cut proportions, except shoulder and thoracic regions. Bone proportion decreased linearly with increasing slaughter BW, while intermuscular and subcutaneous adipose tissue depots increased concomitantly. Slaughter weight increased the subcutaneous adipose tissue proportion but this impaired intramuscular and intermuscular adipose tissues in the loin primal. The sex of the pigs minimally affected the carcass composition, as only the belly weight and the subcutaneous adipose tissue proportions were greater in gilts than in entire males. Light pigs regardless of sex are recommended to balance the trade-offs between carcass cuts and their non-edible compositional outcomes.Work included in the Portuguese PRODER research Project BISOPORC – Pork extensive production of Bísara breed, in two alternative systems: fattening on concentrate vs chesnut, Project PRODER SI I&DT Medida 4.1 “Cooperação para a Inovação”. The authors are grateful to Laboratory of Carcass and Meat Quality of Agriculture School of Polytechnic Institute of Bragança ‘Cantinho do Alfredo’. The authors are members of the MARCARNE network, funded by CYTED (ref. 116RT0503).info:eu-repo/semantics/publishedVersio

Phytoplankton community and limnochemistry of Piburger See (Tyrol, Austria) 28 years after lake restoration

Phytoplankton community and limnochemistry of Piburger See, a small soft-water, meromictic lake situated at 913 m a.s.l. in a crystalline area of the Central Eastern Alps of Tyrol (Austria), were investigated 28 years after the beginning of lake restoration. Although long-term data of the lake show a declining trend in total phosphorus concentrations and phytoplankton biovolume, the response of Piburger See to the restoration measures carried out in 1970 was delayed by about 20 years. At present the lake is approaching its former oligotrophic level. The most evident difference between the past and present phytoplankton species composition of Piburger See is the actual absence of the Cyanophycean Oscillatoria limosa C. A. Agardh, which markedly increased during the first two decades after the lake restoration (1970-1987). The phytoplankton biovolume recorded in 1998 was lower than in the 1970s and 1980s, while seasonal patterns were similar to those recorded before and later on in the lake restoration. The lowest annual phytoplankton biovolume in 1998 occurred in early winter, while the absolute maximum was observed in metalimnetic water layers in late spring. In 1998 the intra-annual patterns of phytoplankton biovolume and chlorophyll-a compare well. Phytoplankton succession started in early 1998 under ice with coccal green algae followed by flagellated Chrysophyceae during spring. The mid-summer phytoplankton community was dominated by centric Bacillariophyceae, which were later replaced by coccal Cyanophyceae. During autumn, Dinophyceae and Chrysophyceae prevailed. Epilimnetic dominance of centric diatoms during mid summer appears to be a new feature, which in 1998 was related to a strong depletion of dissolved silica and nitrate. Long-term water chemistry and phytoplankton data were checked against local weather data in order to explain the delay in the re-oligotrophication process of Piburger See. However, no clear relationship could be detected between the trends observed in the lake and weather conditions during the past 30 years

Sediment diatoms of Lake Garda, the largest Italian lake.

Lake Garda is the largest Italian lake. The deep basin (350 m) is relatively little impacted by human activities and is suitable for reconstructions of long term environmental variability, including climate change and its effect on lake ecology. In contrast, the shallow basin (81 m) is strongly affected by human activities and for this reason is more suitable for studies on lake eutrophication. Lake Garda is one of the four large Central European lakes included in the EuLakes Project (Reg. Nr. 2CE243P3), launched in April 2010 within the Central European Initiative. The main project aims are to evaluate the lake vulnerability against specific human stressors (e.g. nutrients, hydroelectrical exploitation) in a climate change scenario, and to promote sustainable lake management. Sediment studies will be used to determine the lake reference conditions before stronger human impact during the 20th century. The long term evolution of Lake Garda will be investigated in greater detail within a PhD program partially funded by the EuLakes project, which will focus on ecological reconstruction based on sedimentary diatom and cladocera remains. Information will be integrated by X-ray fluorescence (XRF) analyses for trace metal concentrations and Fourier transform infrared spectroscopy (FTIRS) for sediment bio-geochemistry. The reconstruction will be validated by combining palaeolimnological results with monitoring data collected during the last two decades. This contribution presents results of the analyses carried out on one short sediment core (56 cm) collected from the deepest point of Lake Garda (Brenzone) in autumn 2009. The focus is posed on changes in sub-recent diatom assemblages since the early XX century, and in particular on the increase in planktonic Fragilariaceae and concomitant decrease in centric taxa, which has been observed since the documented nutrient enrichment in Lake Garda (i.e. since the early 1970ies)

Water resources influenced by mountain permafrost: potentials, services, and future challenges

The subsurface ice contained in “rock glaciers, the most widespread evidence of mountain permafrost, represent a water resource that is increasingly attracting the attention of researchers and policy makers within the current context of climate warming, of which the retreat of Alpine glaciers represents one of the most striking effects. While glaciers are shrinking at accelerating pace, the hydrological and ecological relevance of permafrost-influenced water resources is growing. Indeed, these waters can partially buffer the effects of periods of drought in high elevation ecosystems, where they represent a key refuge for cold stenotherm aquatic organisms threatened with extinction by warming conditions. However, processes linked to the degradation of mountain permafrost can affect water quality by enhancing the concentration of solutes, including trace elements. The associated deterioration of water quality has important effects both on aquatic biodiversity and on the potential human use as drinking water supply, and for farming at high altitudes. We will discuss the potentials and challenges of the water resources influenced by permafrost in modulating the adaptation of the Alpine region to global change based on the results of recent and ongoing studies conducted in the Central-Eastern Alps in catchments with varying degrees of deglacialisatio

Effects of long term nutrient and climate variability on subfossil Cladocera in a deep, subalpine lake (Lake Garda, northern Italy)

Albeit subfossil Cladocera remains are considered as a reliable proxy for tracking historical lake development, they have been scarcely studied in large subalpine lakes south of the Alps. In this study, subfossil Cladocera remains from Lake Garda in northern Italy were analyzed to track the lake's environmental changes since the Middle Ages. One core was retrieved from the largest sub-basin of Lake Garda (Brenzone, 350 m deep) and two cores were retrieved from the profundal and littoral zone of the smaller lake sub-basin (Bardolino, 80 and 40 m deep, respectively). The species distribution of Cladocera remains in recent sediment layers was similar to that observed in contemporary water samples. The deepest sections of the three cores were characterized by species sensitive to water temperature, which suggest a key role of major climatic events in driving the lake response during the late Holocene. The most evident change in Cladocera assemblages in the studied cores was observed during the 1960s, when planktonic taxa such as Daphnia spp. and Bosmina spp. became dominant at the expense of littoral taxa. Despite the highly coherent general pattern of subfossil Cladocera, the cores showed a set of minor differences, which were attributed to different morphological and hydrological features of the two basins forming Lake Garda. Multivariate analysis revealed a clear relation of Cladocera to climate variability during periods of low lake nutrient levels (i.e. before the 1960s). This provides additional information on past ecological responses of Lake Garda, as contrast previous data from subfossil diatom and pigment analyses did not fully capture effects of climate change during the same period. Since the 1960s shifts in assemblage composition of Cladocera and diatoms were highly coherent, in response to nutrient increase and the following, less pronounced, decrease in nutrient concentrations. During the last five decades, the response of the Cladocera to climate variability appeared to be masked by nutrient change. This work points up the potential of the multi-proxy approach for disentangling the multifaceted biological responses to multiple environmental stressors in large and deep lakes

Different performances of independent sediment biological proxies in tracking ecological transitions in a small sub-alpine lake since the Little Ice Age

A comparative study of independent geochemical and biological proxies was carried out on a 83 cm long sediment core collected in 2011 from the deepest point of the small subalpine Lake Ledro (Trentino, N-Italy). The aim of the study was to compare the capability of subfossil photosynthetic pigments, diatoms and Cladocera in tracking lake ecological transitions related to major environmental perturbations occurred during the last three centuries, i.e. after the culmination of the Little Ice Age in the Alpine region. In relation to the sparse neo-limnological and climate data available for the lake, the study aimed also at defining of the lake trophic and ecological reference conditions, at improving the reconstruction of the nutrient enrichment process during the last decades, and at evaluating the effects of restoration measures initiated in the 1990s. The analysis of the selected proxies outlined a pronounced sensitivity of Lake Ledro to hydrological variability throughout the whole time span considered, but particularly during the 18th and 19th century, and revealed two major stages in the ecological evolution of the lake, which were mainly controlled by climate-related hydrological variability and lake nutrients. The results largely agree with the hypothesis that responses of sediment biological proxies to different natural and human stressors may differ in type, timing and magnitude. Diatoms and Cladocera showed a comparable capability in tracking ecological transitions related to lake hydrology and nutrient variability, while only diatoms demonstrated a certain capability to track changes in water temperature of the lake studied. The strong response of planktonic organisms to hydrological variability confirmed that they principally respond to climate variability in an indirect way. The reconstruction of the trophic development of Lake Ledro during the last decades revealed that the lake sensitivity to hydrological variability, beside congenital for the lake, is at present masked by responses to nutrient