185 research outputs found
Innovating a new knowledge base for water justice studies:hydrosocial, sociohydrology, and beyond
Creating a new knowledge base that centers water justice (Zwarteveen and Boelens, 2014; Sultana, 2018; Wölfle-Hazard, 2022) in hydrosocial and sociohydrology studies involves a broader discussion about why justice matters, how to work toward this goal, and what the implications for research praxis are. The articles in this Research Topic approach different angles of water justice: as law (Fernández and Alba), a social movement (Dame et al.), practice (Pool et al.; Reeves and Bonney), cases of injustice (Caretta et al.), and theory (Krueger and Alba). From this Research Topic, we find that the interrelated concepts of naturecultures and care can be mobilized to create fruitful collaborations between critical social scientists and sociohydrologists
High-speed integrated QKD system
Quantum key distribution (QKD) is nowadays a well-established method for generating secret keys at a distance in an information-theoretically secure way, as the secrecy of QKD relies on the laws of quantum physics and not on computational complexity. In order to industrialize QKD, low-cost, mass-manufactured, and practical QKD setups are required. Hence, photonic and electronic integration of the sender's and receiver's respective compo-nents is currently in the spotlight. Here we present a high-speed (2.5 GHz) integrated QKD setup featuring a transmitter chip in silicon photonics allowing for high-speed modulation and accurate state preparation, as well as a polarization-independent low-loss receiver chip in aluminum borosilicate glass fabricated by the femtosecond laser micromachining technique. Our system achieves raw bit error rates, quantum bit error rates, and secret key rates equivalent to a much more complex state-of-the-art setup based on discrete components [A. Boaron et al., Phys. Rev. Lett. 121, 190502 (2018)].& COPY; 2023 Chinese Laser Pres
Has the profile of heart transplantation recipients changed within the last three decades?
Heart transplantation remains the most durable treatment for patients with end-stage heart failure refractory to medical treatment. Central elements of the listing criteria for heart transplantation have remained largely unchanged in the last three decades whereas treatment of heart failure has significantly increased survival and reduced disease-related symptoms. It remains unknown whether the improvement of heart failure therapy changed the profile of heart transplantation candidates or affected post-transplant survival.
The study investigated a total of 323 heart transplant recipients of the Lausanne University Hospital with 328 transplant operations between 1987 and 2018. Patients were separated into three groups on the basis of availability of heart failure therapy: period 1 (1987-1998; n = 115) when renin-angiotensin system blockade and diuretic treatment were available; period 2 (1999-2010; n = 106) marked by the addition of beta-blocker and mineralocorticoid receptor antagonist treatment in severe heart failure, and the establishment of cardiac defibrillator and resynchronisation therapy; period 3 (2011-2018; n = 107) characterised by the increasing use of ventricular assist devices for bridge to transplantation.
The patient characteristics age (all: 53.4 years), male sex (all: 79%) and body mass index (all: 24.5 kg/m2) did not differ between periods. History of arterial hypertension was less prevalent in period 2 (period 1 vs 2 vs 3: 44 vs 28 vs 43%, p = 0.04) whereas other cardiovascular risk factors were equally distributed. Left ventricular ejection fraction, VO2max, and pulmonary vascular resistance were not different between the three periods. The prevalence of ischaemic cardiomyopathy was higher in periods 1 and 3; dilated non-ischaemic cardiomyopathy was more frequent in period 2. Post-transplant 1-year survival was highest in period 3 (1 vs 2 vs 3: 87.2 ± 3.2% vs 70.8 ± 4.4% vs 93.0 ± 2.6%, p always ≤0.02), and the Kaplan-Meier estimates of survivors of the first year post-transplant were not different between the three periods. In descriptive analysis, early mortality was not associated with acknowledged pretransplant predictors of post-transplant mortality.
Availability of different medical heart failure treatments did not result in greatly different pretransplant characteristics of heart transplantation recipients across the three periods. This suggests that the maintained central criteria of listing for heart transplantation still identify end-stage heart failure patients with a similar profile. This finding can explain the unchanged overall mortality on condition of 1-year survival across the three periods, since pretransplant characteristics are relevant for long-term survival after heart transplantation
Hubungan Kualitas Kehidupan Kerja dan Burnout pada Perawat terhadap Pelaksanaan Alokasi aasuhan Keperawatan (PAAK).
Kualitas kehidupan kerja dimaksudkan untuk digunakan dalam memperbaiki
kondisi kerja dengan mempertimbangkan kebutuhan fisik, mental, psikologis dan sosial
individu. Situasi kerja yang buruk dapat mengurangi kepuasan kerja yang disebabkan
karena munculnya burnout pada perawat. Burnout merupakan sindrom stres terkait
pekerjaan yang berdampak negatif pada penyedia layanan kesehatan, pasien, dan sistem
pemberian layanan kesehatan. Akibat adanya stres yang berlebihan dalam bekerja dan
timbulnya kejadian burnout pada perawat dapat menurunkan kepuasan kerja, sehingga
akan berdampak hasil yang merugikan berupa Pelaksanaan Alokasi Asuhan Keperawatan
(PAAK). PAAK menonjolkan adanya kesenjangan antara asuhan keperawatan ideal dan
praktik sehari-hari. Hal tersebut yang menyebabkan terjadinya kelalaian asuhan
keperawatan yang terlewat. Tingkat PAAK yang lebih tinggi telah dikaitkan dengan hasil
pasien yang negatif.
Tujuan dari penelitian ini adalah untuk mengetahui hubungan langsung maupun
tidak langsung dari masing-masing variabel yaitu kualitas kehidupan kerja dan burnout
pada perawat serta pelaksanaan alokasi asuhan keperawatan (PAAK). Penelitian ini
menggunakan desai penelitian deskriptif dengan pendekatan eksplanasi secara crosssectional. Penelitian ini dilaksanakan di RSD dr. Soebandi Jember, dengan teknik nonprobability sampling dengan pendekatan purposive sampling, dan didapatkan sampel
sebanyak 125 perawat sesuai dengan kriteria inklusi yang telah ditetapkan oleh peneliti.
Instrumen penelitian yang pertama menggunakan kuesioner Quality of Nursing
Work Life (QNWL), dari 41 pertanyaan didapatkan 33 pertanyaan yang valid dengan rhitung ≥ 0,361 (r-tabel), dan Cronbach Alpha (1) dimensi kehidupan kerja dengan
Cronbach’s Alpha = 0,667; (2) dimensi desain kerja dengan Cronbach’s Alpha = 0,655; (3)
dimensi konteks kerja dengan Cronbach’s Alpha = 0,893; (4) dimensi dunia kerja
Cronbach’s Alpha = 0,641. Cronbach’s Alpha semua dimensi QNWL >0,60. Kuesioner
yang kedua menggunakan kuesioner Maslach Burnout Inventory-Human Services Survey
(MBI-HSS), terdapat 22 pertanyaan semua valid dengan r-hitung ≥ 0,27 (r-tabel), dan
Cronbach’s Alpha (1) dimensi kelalahan emosional dengan Cronbach’s Alpha = 0,845; (2)
dimensi depersonalisasi dengan Cronbach’s Alpha = 0,732; (3) dimensi pencapaian
prestasi pribadi dengan Cronbach’s Alpha = 0,858. Cronbach’s Alpha seluruh dimensi MBIHSS >0,6. Sedangkan kuesioner ketiga menggunakan Perceived Implicit Rationing of
Nursing Care (PIRNCA), dari 31 pertanyaan semua valid dengan r-hitung ≥ 0,488 (r-tabel),
Cronbach’s Alpha Cronbach’s Alpha = 0,900 (>0,60).
Analisis data univariat dengan bantuanan program SPSS, analisis data multivariat
secara Structural Equation Modeling-Partial Least Square (SEM-PLS) dengan software
SmartPLS 3.0. Data telah diasumsikan sesuai dengan persyaratan SEM-PLS, dan semua
instrumen dievaluasi dari outer model dan dinyatakan valid dan reliabel. Pengujian
selanjutnya dengan mengevaluasi inner model untuk mengetahui hubungan secara
langsung maupun tidak langsung.
Hasil penelitian menunjukkan: a) Hubungan kualitas kehidupan kerja terhadap
burnout signifikan dengan p = 0,000 (<0,05); b) Hubungan burnout terhadap PAAK tidak
signifikan dengan p = 0,163 (>0,05); c) Hubungan kualitas kehidupan kerja pada perawat
terhadap PAAK tidak signifikan dengan p = 0,538 (>0,05); dan d) Burnout tidak menjadi
mediator hubungan kualitas kehidupan kerja dengan PAAK dengan p = 0,228 (>0,05).
Kesimpulan dari penelitian Hasil temuan menyatakan bahwa organisasi
keperawatan di instutusi rumah sakit memiliki peranan yang sangat penting dalam
memahami situasi dan kondisi perawat dari segi sosiodemografi terhadap setiap tenaga
perawat yang bekerja di RSD dr. Soebandi. Diperlukan sebuah perencanaan strateg dalam menyusun peningkatan kualitas kehidupan kerja yang baik dan matang dengan
menciptakan lingkungan kerja dan dukungan sosial antara manajer-perawat serta antar
antar kolega multidisiplin profesional lainnya
Somatosensory and auditory deviance detection for outcome prediction during postanoxic coma.
Prominent research in patients with disorders of consciousness investigated the electrophysiological correlates of auditory deviance detection as a marker of consciousness recovery. Here, we extend previous studies by investigating whether somatosensory deviance detection provides an added value for outcome prediction in postanoxic comatose patients.
Electroencephalography responses to frequent and rare stimuli were obtained from 66 patients on the first and second day after coma onset.
Multivariate decoding analysis revealed an above chance-level auditory discrimination in 25 patients on the first day and in 31 patients on the second day. Tactile discrimination was significant in 16 patients on the first day and in 23 patients on the second day. Single-day sensory discrimination was unrelated to patients' outcome in both modalities. However, improvement of auditory discrimination from first to the second day was predictive of good outcome with a positive predictive power (PPV) of 0.73 (CI = 0.52-0.88). Analyses considering the improvement of tactile, auditory and tactile, or either auditory or tactile discrimination showed no significant prediction of good outcome (PPVs = 0.58-0.68).
Our results show that in the acute phase of coma deviance detection is largely preserved for both auditory and tactile modalities. However, we found no evidence for an added value of somatosensory to auditory deviance detection function for coma-outcome prediction
Short term non-invasive ventilation post-surgery improves arterial blood-gases in obese subjects compared to supplemental oxygen delivery - a randomized controlled trial
<p>Abstract</p> <p>Background</p> <p>In the immediate postoperative period, obese patients are more likely to exhibit hypoxaemia due to atelectasis and impaired respiratory mechanics, changes which can be attenuated by non-invasive ventilation (NIV). The aim of the study was to evaluate the duration of any effects of early initiation of short term pressure support NIV vs. traditional oxygen delivery via venturi mask in obese patients during their stay in the PACU.</p> <p>Methods</p> <p>After ethics committee approval and informed consent, we prospectively studied 60 obese patients (BMI 30-45) undergoing minor peripheral surgery. Half were randomly assigned to receive short term NIV during their PACU stay, while the others received routine treatment (supplemental oxygen via venturi mask). Premedication, general anaesthesia and respiratory settings were standardized. We measured arterial oxygen saturation by pulse oximetry and blood gas analysis on air breathing. Inspiratory and expiratory lung function was measured preoperatively (baseline) and at 10 min, 1 h, 2 h, 6 h and 24 h after extubation, with the patient supine, in a 30 degrees head-up position. The two groups were compared using repeated-measure analysis of variance (ANOVA) and t-test analysis. Statistical significance was considered to be P < 0.05.</p> <p>Results</p> <p>There were no differences at the first assessment. During the PACU stay, pulmonary function in the NIV group was significantly better than in the controls (p < 0.0001). Blood gases and the alveolar to arterial oxygen partial pressure difference were also better (p < 0.03), but with the addition that overall improvements are of questionable clinical relevance. These effects persisted for at least 24 hours after surgery (p < 0.05).</p> <p>Conclusion</p> <p>Early initiation of short term NIV during in the PACU promotes more rapid recovery of postoperative lung function and oxygenation in the obese. The effect lasted 24 hours after discontinuation of NIV. Patient selection is necessary in order to establish clinically relevant improvements.</p> <p>Trial Registration#</p> <p>DRKS00000751; <url>http://www.germanctr.de</url></p
Ectomycorrhizal fungal communities of native and non-native Pinus and Quercus species in a common garden of 35-year-old trees
Non-native tree species have been widely planted or have become naturalized in most forested landscapes. It is not clear if native trees species collectively differ in ectomycorrhizal fungal (EMF) diversity and communities from that of non-native tree species. Alternatively, EMF species community similarity may be more determined by host plant phylogeny than by whether the plant is native or non-native. We examined these unknowns by comparing two genera, native and non-native Quercus robur and Quercus rubra and native and non-native Pinus sylvestris and Pinus nigra in a 35-year-old common garden in Poland. Using molecular and morphological approaches, we identified EMF species from ectomycorrhizal root tips and sporocarps collected in the monoculture tree plots. A total of 69 EMF species were found, with 38 species collected only as sporocarps, 18 only as ectomycorrhizas, and 13 both as ectomycorrhizas and sporocarps. The EMF species observed were all native and commonly associated with a Holarctic range in distribution. We found that native Q. robur had ca. 120% higher total EMF species richness than the non-native Q. rubra, while native P. sylvestris had ca. 25% lower total EMF species richness than non-native P. nigra. Thus, across genera, there was no evidence that native species have higher EMF species diversity than exotic species. In addition, we found a higher similarity in EMF communities between the two Pinus species than between the two Quercus species. These results support the naturalization of non-native trees by means of mutualistic associations with cosmopolitan and novel fungi
Comparing the social networks of service users with long term mental health needs living in community with those in a general adult in-patient unit
Background: Relationships are vital to recovery however, there is uncertainty whether users have different types of social networks in different mental health settings and how these networks may impact on users’ wellbeing.
Aims: To compare the social networks of people with long-term mental illness in the community with those of people in a general adult in-patient unit.
Method: A sample of general adult in-patients with enduring mental health problems, aged between 18 and 65, was compared with a similar sample attending a general adult psychiatric clinic. A cross-sectional survey collected demographic data and information about participants’ social networks. Participants also completed the Short Warwick Edinburgh Mental Well-Being Scale to examine well-being and the Significant Others Scale to explore their social network support.
Results: The study recruited 53 participants (25 living in the community and 28 current in-patients) with 339 named as important members of their social networks. Both groups recorded low numbers in their social networks though the community sample had a significantly greater number of social contacts (7.4 vs. 5.4), more monthly contacts with members of their network and significantly higher levels of social media use. The in-patient group reported greater levels of emotional and practical support from their network.
Conclusions: People with serious and enduring mental health problems living in the community had a significantly greater number of people in their social network than those who were in-patients while the in-patient group reported greater levels of emotional and practical support from their network. Recommendations for future work have been made
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