Nurses’ Experiences Empowering Hospitalized Patients

Four focus groups were conducted to explore acute care nurses’ experiences empowering patients and the facilitators and barriers they encountered during the process. Thirty-four nurses employed at four hospitals in the Midwestern United States participated in the study between February and April 2015. Facilitators of empowerment included establishing a therapeutic relationship, fostering communication, providing education, respecting patient autonomy, engaging support systems, and lifting spirit/giving hope. Barriers included conflicting information about plans of care, lack of time, fear and anxiety over unfamiliar environments and routines, ineffective or inadequate support systems, lack of/low accountability, and killing the soul. Nurses also described innovative strategies they used to overcome the barriers. The development of future inpatient empowerment interventions needs to focus on the innovative strategies nurses used to overcome barriers in addition to considering the facilitators and barriers to empowerment that nurses identified

Value of follow-up CT in head injury assessment

INTRODUCTION: The question of when and if to perform follow- up CT scanning of the brain in a patient with a proven head injury remains pertinent, and the answer is not clear cut. This is even more so compounded when one tries to compare and equate what happens in a developed country with that of a developing country such as South Africa. AIM: To evaluate referral patterns, associated time-delays and findings of follow-up CT as well as patient outcomes in patients with head injury at Groote Schuur Hospital. METHOD: A retrospective review, over a 6 month time period, of the CT scans and folders belonging to patients who underwent follow-up CT scanning of the brain after blunt trauma to the head. RESULTS: There were 313 follow-up studies performed in 212 patients, of which the majority, 135 /313 (43.1%) were referred for neurological reasons, whilst 103/313 (32.9%) were referred for conservative management reasons and 75/313 (24%) were referred as part of their post-surgical check-up. There were significant time delays from arrival of patients in casualty to their initial CT scan (mean 18.74 hours) as well as between the initial CT and the first follow-up scan (mean 121.78 hours). There was a significant amount of data missing regarding the time of actual injury for many patients. There were 74 neurosurgical interventions that took place as a result of CT scans performed. Of these, 54 (73%) took place after the initial CT scan, whilst only 20 (27%) occurred after a follow-up CT. Of those surgical interventions performed after a follow- up study, 6 (30%) were performed as a result of a scan performed for post-surgical check- up. 12 (60%) were performed as a result of a scan performed for neurological reasons. Two (10%) neurosurgical interventions occurred as a result of a scan performed for conservative management reasons (thus routine follow-up imaging). CONCLUSIONS: A routine single follow-up CT may be a reasonable approach with further follow-up imaging reserved for patients who have undergone surgery, those with possibly surgically manageable findings on initial CT (that do not undergo surgery) and those with new neurology. The routine use of follow-up CT beyond the first follow-up CT is unlikely to lead to a change in management when the above clinical, and prior CT findings are absent. However, the time delays across all aspects of imaging traumatic brain injuries in our setting are unpredictable and represent a major problem in standardising when CT scans are performed

Volatile isoprenoid emission potentials are correlated with essential isoprenoid concentrations in five plant species

This study offers new insight and data in support of the “opportunist hypothesis”. Five species of volatile isoprenoid-emitting plants (Eucalyptus globulus, Eucalyptus gunnii, Mucuna pruriens, Lycopersicon esculentum and Quercus ilex) were exposed to a wide range of imposed and natural stress conditions over a period of a few weeks in order to generate different levels of isoprenoid production potential. Volatile isoprenoid emissions and carotenoid concentrations were measured in all species and dimethylallyl diphosphate (DMAPP) concentrations were measured in E. globulus, E. gunnii, M. pruriens and L. esculentum. Generally, instantaneously emitted isoprenoid emissions were positively correlated with carotenoid concentrations, and were negatively correlated with DMAPP concentrations. In contrast, stored monoterpene emission potentials were negatively correlated with carotenoid concentrations, and positively correlated with DMAPP concentrations. These results support the possibility of a direct or indirect control of volatile isoprenoid emission potential via carotenoid synthesis at time scales of days to weeks

Spectroscopic Evidence Against Nitric Acid Trihydrate in Polar Stratospheric Clouds

Heterogeneous reactions on polar stratospheric clouds (PSC's) play a key role in the photochemical mechanisms thought to be responsible for ozone depletion in the Antarctic and the Arctic. Reactions on PSC particles activate chlorine to forms that are capable of photochemical ozone destruction, and sequester nitrogen oxides (NOx) that would otherwise deactivate the chlorine. Although the heterogeneous chemistry is now well established, the composition of the clouds themselves is uncertain. It is commonly thought that they are composed of nitric acid trihydrate, although observations have left this question unresolved. Here we reanalyse infrared spectra of type I PCS's obtained in Antarctica in September 1987, using recently measured optical constraints of the various compounds that might be present in PSC's. We find that these PSC's were not composed of nitric acid trihydrate but instead had a more complex composition perhaps that of a ternary solution. Because cloud formation is sensitive to their composition, this finding will alter our understanding of the locations and conditions in which PSCs form. In addition, the extent of ozone loss depends on the ability of the PSC's to remove NOx permanently through sedimentation. The sedimentation rates depend on PSC particle size which in turn is controlled by the composition and formation mechanism

Nitrogen Incorporation in CH_4-N_2 Photochemical Aerosol Produced by Far Ultraviolet Irradiation

Nitrile incorporation into Titan aerosol accompanying hydrocarbon chemistry is thought to be driven by extreme UV wavelengths (λ120 nm is presently unaccounted for in atmospheric photochemical models. We suggest that reaction with CH radicals produced from CH_4 photolysis may provide a mechanism for incorporating N into the molecular structure of the aerosol. Further work is needed to understand the chemistry involved, as these processes may have significant implications for how we view prebiotic chemistry on early Earth and similar planets. Key Words: Titan—Photochemical aerosol—CH_4-N_2 photolysis—Far UV—Nitrogen activation

Communication through story : story-making with a child diagnosed with selective mutism

This qualitative research study views the therapeutic use of story-making with a six-year-old girl diagnosed with selective mutism. The information gathered is presented as a descriptive case study and the therapeutic process is viewed through Renee Emunah's Integrative Five Phase Model. Mooli Lahad's Six-Piece Story-Making technique informed the story-making process, which was used in combination with other projective and psychodramatic techniques. Since verbal and emotional communication is usually the goal for children diagnosed with selective mutism, the primary research question investigated is: How does communication between a child with selective mutism and a therapist develop through story-making in a drama therapy setting? The study follows the detailed change in communication between the child and me as we move through several communication milestones prior to and during story-making

Computational approach to inquiry based science education

The paper sets out the context for the EU Seventh Framework ‘Pathway to Inquiry Based Science Education’ (IBSE) project. After the context has been outlined, the paper is organised into the following sections: 1. National situation with regard to Science Education in Ireland. 2. Inquiry approaches promoted by Pathway. 3. Adopting IBSE into the Science Education Curriculum. 4. ICT in IBSE. 5. Reflection on IBSE