School Staff Perceptions of Connectedness with Students in a Low-Income Public Middle School: Implications for School Nursing Practice

School connectedness, defined as the belief by students that adults and peers within the school care about them and their learning, has been found to be a protective factor against suicidal thoughts and behaviors among adolescents. Since suicide is the second leading cause of death for ages 10-14, school connectedness is important for adolescent health. School connectedness can be fostered with trusting relationships within a positive school climate. While school nurses are positioned to collaborate with school staff in suicide interventions, there is minimal evidence of collaborative interventions cited within the literature. The purpose of this study was to examine the experiences of teachers and support staff that explain their perceptions of school climate and feeling connected to students and discuss implications for school nursing practice. A sequential explanatory mixed-methods secondary data analysis was conducted, guided by Bronfenbrenner's bioecological theory of human development. The site for the primary study was a rural public middle school in the Southeast United States. The quantitative data were obtained from a convenience sample of 6th, 7th, and 8th grade core and electives teachers (n = 14) and support staff (n = 5) who completed the Teacher School Connectedness Survey. Descriptive statistics were used to examine the culture related to school climate and connectedness. The qualitative data were obtained from five focus group transcripts with teachers (n = 20) and support staff (n = 6). Qualitative data were analyzed using in Vivo and Focused Coding. Themes were developed using thematic analysis. The quantitative and qualitative results diverged. The quantitative data revealed that more than half of the respondents described the climate as warm/positive and all felt positively connected to students. The major themes from the qualitative data, cloud of chaos, snowballing, and pushing through the fog, describe an environment characterized by disruptive, aggressive, and withdrawn student behaviors. The results suggest lower levels of connectedness and a school climate not conducive to fostering connectedness. Student behaviors may be masking underlying mental health issues, such as depression, a risk factor for suicide. Implications for school nursing practice to enhance school connectedness are discussed

Suicide care from the nursing perspective: a meta‐synthesis of qualitative studies

Aims: to explore nurses' experiences of suicide care and to identify and synthesize the most suitable interventions for the care of people with suicidal behaviour from a nursing perspective. Design: qualitative meta-synthesis. Data sources: comprehensive search of five electronic databases for qualitative studies published between January 2015 and June 2019. Review methods: the PRISMA statement was used for reporting the different phases of the literature search and the Critical Appraisal Skills Programme (CASP) qualitative research checklist was used as an appraisal framework. Data synthesis was conducted using Sandelowski and Barroso's method. Results: seventeen articles met the inclusion criteria. The data analysis revealed 13 subcategories from which four main categories emerged: 'Understanding suicidal behaviour as a consequence of suffering', 'Nurses' personal distress in suicide care', 'The presence of the nurse as the axis of suicide care' and, 'Improving nurses' relational competences for a better therapeutic environment'. Conclusion: further training of nurses on the therapeutic relationship, particularly in non-mental health care work settings, and monitoring of the emotional impact on nurses in relation to suicide is required to promote more effective prevention and care. Impact: this review provides new insights on how suicide is interpreted, the associated emotions, the way suicide is approached and proposals for improving clinical practice from the point of view of nurses. The results demonstrate that the nurse-patient relationship, ongoing assessment, and the promotion of a sense of security and hope are critical in nursing care for patients who exhibit suicidal behaviour. Consequently, to promote an effective nursing care of suicide, nurses should be provided with further training on the therapeutic relationship. Thus, health institutions do not only provide the time and space to conduct an adequate therapeutic relationship, but also, through their managers, they should supervise and address the emotional impact that is generated in nurses caring for patients who exhibit suicidal behaviour

Raman spectroscopy: a real-time tool for identifying microcalcifications during stereotactic breast core needle biopsies

Microcalcifications are an early mammographic sign of breast cancer and a target for stereotactic breast needle biopsy. We present here a Raman spectroscopic tool for detecting microcalcifications in breast tissue based on their chemical composition. We collected ex vivo Raman spectra from 159 tissue sites in fresh stereotactic breast needle biopsies from 33 patients, including 54 normal sites, 75 lesions with microcalcifications and 30 lesions without microcalcifications. Application of our Raman technique resulted in a positive predictive value of 97% for detecting microcalcifications. This study shows that Raman spectroscopy has the potential to detect microcalcifications during stereotactic breast core biopsies and provide real-time feedback to radiologists, thus reducing non-diagnostic and false negative biopsies

Primjena bioeseja i alfa-spektrometrije za neizravno praćenje španjolskih radnika izloženih obogaćenom uraniju

Workers at risk of exposure to uranium compounds should be monitored and their internal exposure quantified in terms of committed effective dose E(50) in mSv. In vitro bioassay methods can quantify uranium in urine and faeces at low activity levels. Alpha spectrometry (AS) is the most common method used for monitoring alpha-emitting radionuclides in internal dosimetry services. It provides isotopic information and low minimum detectable activity (MDA) values (≤0.50 mBq per sample). This study reports the results of a five-year monitoring of workers exposed to uranium at a Spanish Juzbado facility, which produces nuclear fuel elements enriched with up to 5 % of 235U. Monitoring included about 100 workers per year, most of whom had worked at the facility for more than 10 years before the individual monitoring programme was established. We analysed nearly 550 samples of more than 200 workers over five years. The obtained results indicate that workers were adequately protected from uranium exposure through inhalation and had an acceptably low chronic intake at the facility.Radnici koji su izloženi riziku od izloženosti spojevima s uranijem trebaju se pratiti i njihova unutrašnja izloženost mjeriti pomoću očekivane efektivne doze E(50) izražene u mSv. Uranij se može kvantificirati u mokraći čak i pri vrlo niskim razinama aktivnosti pomoću bioesejnih metoda in vitro. Najčešća metoda koja se rabi u internoj dozimetriji za praćenje/nadziranje razina radionuklida koji emitiraju alfa-čestice jest alfa-spektrometrija. Njome se identificiraju izotopi i može otkriti nisku minimalnu aktivnost (engl. minimum detectable activity, MDA) (≤0.50 mBq po uzorku). Ovdje donosimo rezultate petogodišnjega praćenja radnika izloženih uraniju u španjolskoj tvornici sastojaka za nuklearno gorivo Juzbado, u kojoj se sastojci obogaćuju izotopom 235U do udjela od 5 %. Pratilo se oko 100 radnika na godinu, a većina njih je radila u tvornici više od deset godina prije nego što je uveden program praćenja. Ukupno je u pet godina analizirano gotovo 550 uzoraka mokraće oko 200 radnika. Dobiveni rezultati upućuju na to da su radnici dobro zaštićeni od izloženosti uraniju udisanjem te da je kronični unos uranija u tvornici na prihvatljivo niskoj razini

Qualitative Data Analysis Retreats: Creating New Spaces for Doctoral Student Analytic Work

Qualitative data analysis is recognized as a threshold concept in research education and can be conceptually challenging for doctoral students. While retreats are common approaches to support dissertation writing, we propose an unconventional approach for doctoral education with the use of retreats for qualitative data analysis. Analytic autoethnography was used to examine what features of an off-campus retreat supported data analysis of dissertation research, With the use of a focused agenda, the retreat space offered opportunities for icebreakers to stimulate synthesis thinking, student-led analytic activities, and reflective writing. Data were collected from documents, analytic artifacts, photographs, and reflective journals. We identified three themes pertaining to retreat features to support qualitative analytic work: Analytic Immersion, Analytic Support, and Analytic Reflection. Findings suggest that retreat spaces can be used to support doctoral students navigating the challenges of knowledge acquisition associated with qualitative data analysis. We recommend four key considerations when designing a qualitative analysis retreat: (1) create a space for analytic immersion; (2) design activities to cultivate student agency; (3) situate faculty for optimal student mentoring and support; and (4) allocate time and space reflective practice. This paper contributes to the ongoing conversation of threshold concepts in doctoral education and offers a new approach for supporting students during data analysis