Patient advocacy: Barriers and facilitators

Background: During the two recent decades, advocacy has been a topic of much debate in the nursing profession. Although advocacy has embraced a crucial role for nurses, its extent is often limited in practice. While a variety of studies have been generated all over the world, barriers and facilitators in the patient advocacy have not been completely identified. This article presents the findings of a study exploring the barriers and facilitators influencing the role of advocacy among Iranian nurses. Method: This study was conducted by grounded theory method. Participants were 24 Iranian registered nurses working in a large university hospital in Tehran, Iran. Semi-structured interviews were used for data collection. All interviews were transcribed verbatim and simultaneously Constant comparative analysis was used according to the Strauss and Corbin method. Results: Through data analysis, several main themes emerged to describe the factors that hindered or facilitated patient advocacy. Nurses in this study identified powerlessness, lack of support, law, code of ethics and motivation, limited communication, physicians leading, risk of advocacy, royalty to peers, and insufficient time to interact with patients and families as barriers to advocacy. As for factors that facilitated nurses to act as a patient advocate, it was found that the nature of nurse-patient relationship, recognizing patients' needs, nurses' responsibility, physician as a colleague, and nurses' knowledge and skills could be influential in adopting the advocacy role. Conclusion: Participants believed that in this context taking an advocacy role is difficult for nurses due to the barriers mentioned. Therefore, they make decisions and act as a patient's advocate in any situation concerning patient needs and status of barriers and facilitators. In most cases, they can not act at an optimal level; instead they accept only what they can do, which we called 'limited advocacy' in this study. It is concluded that advocacy is contextually complex, and is a controversial and risky component of the nursing practice. Further research is needed to determine the possibility of a correlation between identified barriers/ facilitators and the use of advocacy. © 2006Negarandeh et al; licensee BioMed Central Ltd

Caring behaviors of burn nurses and the related factors

This study aims to explore and describe nurses' perceptions of their caring behaviors and related factors in several Tehran burn units. Grounded theory was used as the method of analysis. Thirty-eight participants were recruited. Data was generated by unstructured interviews and participant observations, and analyzed by constant comparison. Results revealed that responses to burnout and the type of caring behavior exhibited were affected most markedly by the personal characteristics of nurses and patients and the interaction between these two factors. Long-standing and intense organizational pressures in the burn units of Tehran, in addition to the sensitivity of nurses' characteristics to these pressures, suggest that attributing more importance to the social, political and ethical aspects of caring may aid in executing stress reduction programs and improving nurses' morale. © 2006 Elsevier Ltd and ISBI

Modelling lubricated revolute joints in multibody mechanical systems

This work deals with the modelling of lubricated revolute joints in multibody mechanical systems. In most machines and mechanisms, the joints are designed to operate with some lubricant fluid. The high pressures generated in the lubricant fluid act to keep the journal and the bearing apart. Moreover, the thin film formed by lubricant reduces friction and wear, provides load capacity and adds damping to dissipate undesirable mechanical vibrations. In the dynamic analysis of journal–bearings, the hydrodynamic forces, which include both squeeze and wedge effects, produced by the lubricant fluid oppose the journal motion. These forces are obtained by integrating the pressure distribution evaluated with the aid of Reynolds’ equation written for the dynamic regime. The hydrodynamic forces are nonlinear functions of journal centre position and velocity relative to the bearing centre. In a simple way, the hydrodynamic forces built up by the lubricant fluid are evaluated from the state of variable of the system and included into the equations of motion of the mechanical system. Results for an elementary slider–crank mechanism, in which a lubricated revolute joint connects the connecting rod and slider, are used to discuss the assumptions and procedures adopted.Fundação para a Ciência e a Tecnologia (FCT

ANTINOCICEPTIVE PROPERTIES OF HYDRO ALCOHOLIC EXTRACTS OF ANETHUM GRAVEOLENS L. (DILL) SEED AND AERIAL PARTS IN MICE

Chronic pain and its treatment have always posed a significant challenge for medical practitioners and many attempts have been made to reduce and eliminate it, both in past and recent history. Research to discover new effective drugs with excellent safety profiles is ongoing. The aim of this study was to evaluate the suitability of the plant Anethum graveolens (dill) for use as an analgesic drug. Forty-two mice were divided randomly into seven groups (n=6). In the formalin test, the first group received normal saline; the second group, extract of plant seed (300 mg/kg); the third group, extract of plant crops (300 mg/kg) and the forth group received morphine (1 mg/kg). For the hot plate test, the first group received normal saline; the second group, extract of plant seed (300 mg/kg) and the third group received extract of plant crops (300 mg/kg). All injections consisted of 0.5 ml given intraperitoneally. In the early phase of formalin test, the animals treated with seed and crop extracts did not show analgesic effects compared to control group (P=0.386, P=0.284 respectively). In contrast, in the late phase of formalin test, seed and crop extracts significantly decreased indications of pain compared to the saline group with seed extracts showing stronger analgesic effects (P=0.004, P=0.023 respectively). In the hot plate test, crop and seed extracts showed hyperalgesic properties. This effect was stronger in animals treated with crop extracts as compared to seed extracts. These findings indicate that Anethum graveolens can reduce inflammatory pain, probably by inhibiting inflammatory mediators. In contrast, this plant has no analgesic effects on spinal nociception and conversely may exacerbate it. This study provides a basis for the use of Anethum graveolens extracts in popular folk medicine, but further studies are necessary to elucidate the mechanism of its analgesic actions

Working memory training in post-stroke aphasia: Near and far transfer effects

Purpose: Individuals with aphasia (IWA) show various impairments in speech, language, and cognitive functions. Working memory (WM), a cognitive system that functions to hold and manipulate information in support of complex, goal-directed behaviors, is one of the impaired cognitive domains in aphasia. The present study intended to examine the effects of a WM training program on both memory and language performance in IWA. Method: This quasi-experimental study with an active control group was performed on 25 people with mild or moderate Broca's aphasia aged 29�61 years resulting from left hemisphere damage following ischemic stroke. Participants were assigned into two groups, including a training group (n = 13) and a control group (n = 12). The treatment and control groups received WM training and routine speech therapy, respectively. Two separate lists of WM tests, including one list for both pre-training assessment and training program and a second list for the post-training assessment, were used in this study. Results: The treatment group showed significant improvements in both trained and non-trained WM tasks (near transfer effect) and language performance (far transfer effect) compared to the control group. Conclusion: Given the good generalizability of the WM training program on both WM and language performance, WM training is suggested as part of the rehabilitation program in aphasia. © 2020 Elsevier Inc

Iranian student nurses' experiences of clinical placement

Background: Nursing as a practice-based profession requires that student nurses learn how to become professional in the clinical environment. Many studies have addressed student nurses' clinical learning and related problems, but few have explored the whole clinical experience of being a student nurse. Aim: To understand and gain deeper insight into Iranian student nurses' lived experience of clinical placement. Method: Five student nurses were interviewed about their clinical experience during clinical placement. The researchers analysed the verbatim transcripts using van Manen's phenomenological methodology, keeping in mind the recommended six research activities. Findings: Five themes emerged by which the phenomenon of clinical experience could be illustrated. These themes were: caring-orientated relationships, attractive aspects of clinical experience, finding oneself in the clinical milieu, being supportive to classmates, and actualizing potential. Fourteen subthemes expanded and clarified the meaning of these themes. Conclusion: The attention paid and acknowledgement given to 'caring' and 'knowledge' by the student nurses showed that they are progressing toward their ultimate goal of being professional nurses. The student nurses' awareness of 'what is going on there?' and also support from other significant people facilitates the students' adaptation process and guarantees this progress. © 2005 International Council of Nurses

CFD investigation of a complete floating offshore wind turbine

This chapter presents numerical computations for floating offshore wind turbines for a machine of 10-MW rated power. The rotors were computed using the Helicopter Multi-Block flow solver of the University of Glasgow that solves the Navier-Stokes equations in integral form using the arbitrary Lagrangian-Eulerian formulation for time-dependent domains with moving boundaries. Hydrodynamic loads on the support platform were computed using the Smoothed Particle Hydrodynamics method. This method is mesh-free, and represents the fluid by a set of discrete particles. The motion of the floating offshore wind turbine is computed using a Multi-Body Dynamic Model of rigid bodies and frictionless joints. Mooring cables are modelled as a set of springs and dampers. All solvers were validated separately before coupling, and the loosely coupled algorithm used is described in detail alongside the obtained results

Direct Singular Positions of the Parallel Manipulator Tricept

[[abstract]]In this article, the direct singular positions of the parallel manipulator Tricept are determined. An alternative 3 x 3 Jacobian matrix, simpler than the existing one, is obtained in this study. For a given moving platform's orientation, the determinant of this Jacobian matrix may be expressed as a cubic polynomial in moving platform's equation length. Direct singular positions may thus be obtained by solving cubic polynomial equations. For an arbitrarily chosen moving platform's orientation, there exists at least one moving platform's extension length that causes direct kinematic singularity. It is found that if moving platform's size is larger than a specific value, then within the moving platform's domain there exist two regions, in which direct kinematic singularities can only occur at positions impossible to reach.[[notice]]補正完畢[[booktype]]紙本[[countrycodes]]GB

Physical structuring of injectable polymeric systems to controllably deliver nanosized extracellular vesicles

Extracellular vesicles (EVs) are emerging as a promising alternative approach to cell‐therapies. However, to realize the potential of these nanoparticles as new regenerative tools, healthcare materials that address the current limitations of systemic administration need to be developed. Here, two technologies for controlling the structure of alginate based microgel suspensions are used to develop sustained local release of EVs, in vitro. Microparticles formed using a shearing technique are compared to those manufactured using vibrational technology, resulting in either anisotropic sheet‐like or spheroid particles, respectively. EVs harvested from preosteoblasts are isolated using differential ultracentrifugation and successfully loaded into the two systems, while maintaining their structures. Promisingly, in addition to exhibiting even EV distribution and high stability, controlled release of vesicles from both structures is exhibited, in vitro, over the 12 days studied. Interestingly, a significantly greater number of EVs are released from the suspensions formed by shearing (69.9 ± 10.5%), compared to the spheroids (35.1 ± 7.6%). Ultimately, alterations to the hydrogel physical structures have shown to tailor nanoparticle release while simultaneously providing ideal material characteristics for clinical injection. Thus, the sustained release mechanisms achieved through manipulating the formation of such biomaterials provide a key to unlocking the therapeutic potential held within EVs