The accessibility of research-based knowledge for nurses in United Kingdom acute care settings

Background. The successful dissemination of the results of the National Health Service (NHS) research and development strategy and the development of evidence based approaches to health care rely on clinicians having access to the best available evidence; evidence fit for the purpose of reducing the uncertainties associated with clinical decisions. Aim. To reveal the accessibility of those sources of information actually used by nurses, as well as those which they say they use. Design. Mixed method case site, using interview, observational, Q sort and documentary audit data in medical, surgical and coronary care units (CCUs) in three acute hospitals. Results. Three perspectives on accessibility were identified: (a) the humanist-in which human sources of information were the most accessible; (b) local information for local needs-in which locally produced resources were seen as the most accessible and (c) moving towards technology-in which information technology begins to be seen as accessible. Nurses' experience in a clinical specialty is positively associated with a perception that human sources such clinical nurse specialists, link nurses, doctors and experienced clinical colleagues are more accessible than text based sources. Clinical specialization is associated with different approaches to accessing research knowledge. Coronary care unit nurses were more likely perceive local guidelines, protocols and on-line databases as more accessible than their counterparts in general medical and surgical wards. Only a third of text-based resources available to nurses oil the wards had any explicit research base. These, and the remainder were Out of date (mean age of textbooks 11 years), and authorship hard to ascertain. Conclusion. A strategy to increase the use of research evidence by nurses should harness the influence of clinical nurse specialists, link nurses and those engaged in practice development. These roles Could act as 'conduits' through which research-based messages for practice, and information for clinical decision making, could flow. This role should be explored and enhanced

Contextualising Teaching and Learning in Rural Primary Schools: Using Agricultural Experience - Volume 2

Teaching/Communication/Extension/Profession,

National child measurement programme: detailed analysis of the 2007/08 national dataset

This report presents detailed secondary analyses to further our understanding of the epidemiology of child height, weight and Body Mass Index (BMI) across England. It attempts to explain some of the findings presented in the NHS Information Centre for Health and Social Care 2007/08 NCMP report. The report provides analysis of PCT participation levels and investigates data quality issues in the collection of the 2007/08 NCMP dataset. Data on prevalence of underweight, healthy weight, overweight and obesity are analysed, comparing the 2007/08 data to the 2006/07, and the 1990 baseline. Analyses by deprivation and ethnic group are also included. The report further examines how the distribution of BMI differs by age and sex of the child sample population, and investigates changes since the 1990 baseline. It looks at the association between obesity prevalence and characteristics of the individual children and the PCTs in which they were measured using regression analysis

Ergodicity of the Δ3\Delta_3 statistic and purity of neutron resonance data

The $\Delta_3(L)$ statistic characterizes the fluctuations of the number of levels as a function of the length of the spectral interval. It is studied as a possible tool to indicate the regular or chaotic nature of underlying dynamics, detect missing levels and the mixing of sequences of levels of different symmetry, particularly in neutron resonance data. The relation between the ensemble average and the average over different fragments of a given realization of spectra is considered. A useful expression for the variance of $\Delta_3(L)$ which accounts for finite sample size is discussed. An analysis of neutron resonance data presents the results consistent with a maximum likelihood method applied to the level spacing distribution.Comment: 24 pages, 19 figures, 1 tabl

Tracking system analytic calibration activities for the Mariner Mars 1969 mission

Calibration activity of Deep Space Network in support of Mars encounter phase of Mariner Mars 1969 missio

Many-body Systems Interacting via a Two-body Random Ensemble (I): Angular Momentum distribution in the ground states

In this paper, we discuss the angular momentum distribution in the ground states of many-body systems interacting via a two-body random ensemble. Beginning with a few simple examples, a simple approach to predict P(I)'s, angular momenta I ground state (g.s.) probabilities, of a few solvable cases, such as fermions in a small single-j shell and d boson systems, is given. This method is generalized to predict P(I)'s of more complicated cases, such as even or odd number of fermions in a large single-j shell or a many-j shell, d-boson, sd-boson or sdg-boson systems, etc. By this method we are able to tell which interactions are essential to produce a sizable P(I) in a many-body system. The g.s. probability of maximum angular momentum $I_{max}$ is discussed. An argument on the microscopic foundation of our approach, and certain matrix elements which are useful to understand the observed regularities, are also given or addressed in detail. The low seniority chain of 0 g.s. by using the same set of two-body interactions is confirmed but it is noted that contribution to the total 0 g.s. probability beyond this chain may be more important for even fermions in a single-j shell. Preliminary results by taking a displaced two-body random ensemble are presented for the I g.s. probabilities.Comment: 39 pages and 8 figure

Spectroscopy with random and displaced random ensembles

Due to the time reversal invariance of the angular momentum operator J^2, the average energies and variances at fixed J for random two-body Hamiltonians exhibit odd-even-J staggering, that may be especially strong for J=0. It is shown that upon ensemble averaging over random runs, this behaviour is reflected in the yrast states. Displaced (attractive) random ensembles lead to rotational spectra with strongly enhanced BE2 transitions for a certain class of model spaces. It is explained how to generalize these results to other forms of collectivity.Comment: 4 pages, 4 figure

Spectral fluctuation properties of spherical nuclei

The spectral fluctuation properties of spherical nuclei are considered by use of NNSD statistic. With employing a generalized Brody distribution included Poisson, GOE and GUE limits and also MLE technique, the chaoticity parameters are estimated for sequences prepared by all the available empirical data. The ML-based estimated values and also KLD measures propose a non regular dynamic. Also, spherical odd-mass nuclei in the mass region, exhibit a slight deviation to the GUE spectral statistics rather than the GOE.Comment: 10 pages, 2 figure

The Mariner 6 and 7 flight paths and their determination from tracking data

Determination of orbit estimates for Mariner 6 and 7 space probe flight

Analysis of radiation-induced cell death in head and neck squamous cell carcinoma and rat liver maintained in microfluidic devices

Objective The aim of this study was to investigate how head and neck squamous cell carcinoma (HNSCC) tissue biopsies maintained in a pseudo in vivo environment within a bespoke microfluidic device respond to radiation treatment. Study Design Feasibility study. Setting Tertiary referral center. Subjects and Methods Thirty-five patients with HNSCC were recruited, and liver tissue from 5 Wistar rats was obtained. A microfluidic device was used to maintain the tissue biopsy samples in a viable state. Rat liver was used to optimize the methodology. HNSCC was obtained from patients with T1-T3 laryngeal or oropharyngeal SCC; N1-N2 metastatic cervical lymph nodes were also obtained. Irradiation consisted of single doses of between 2 Gy and 40 Gy and a fractionated course of 5×2 Gy. Cell death was assessed in the tissue effluent using the soluble markers lactate dehydrogenase (LDH) and cytochrome c and in the tissue by immunohistochemical detection of cleaved cytokeratin18 (M30 antibody). Results A significant surge in LDH release was demonstrated in the rat liver after a single dose of 20 Gy; in HNSCC, it was seen after 40 Gy compared with the control. There was no significant difference in cytochrome c release after 5 Gy or 10 Gy. M30 demonstrated a dose-dependent increase in apoptotic index for a given increase in single-dose radiotherapy. There was a significant increase in apoptotic index between 1×2 Gy and 5×2 Gy. Conclusion M30 is a superior method compared with soluble markers in detecting low-dose radiation-induced cell death. This microfluidic technique can be used to assess radiation-induced cell death in HNSCC and therefore has the potential to be used to predict radiation response