On Trapezoid Inequality Via a Grüss Type Result and Applications

In this paper, we point out a Grüss type inequality and apply it for special means (logarithmic mean, identric mean, etc... ) and in Numerical Analysis in connection with the classical trapezoid formula

Bridges and Barriers: Patients\u27 Perceptions of the Discharge Process Including Multidisciplinary Rounds on a Trauma Unit

Discharge planning is a complex process and ideally begins early in the patient stay. Despite evidence about the importance of discharge readiness, there is limited literature about the patient\u27s view during this transition. The goal of this study was to explore patient perspectives about the discharge process, including multidisciplinary rounds. Multidisciplinary rounding is a process where care providers from various specialties meet to communicate, coordinate patient care, make decisions, and manage responsibilities. The theme found was “bridges and barriers to discharge.” Participants identified timelines and tasks, communication, social support, and motivation as helpful and medical setbacks, insurance limitations, and infrequent communication as hindrances to the discharge. Future research is recommended examining efficacy of various discharge models and examination of communication and support throughout hospitalization

A client focused perspective of the effectiveness of Counselling for Depression (CfD)

Background In the UK, only one in four people with a diagnosis of depression receive any form of treatment. To address this, the Improving Access to Psychological Therapies (IAPT) programme was established with the main therapeutic approach being cognitive behavioural therapy (CBT). This raised concern regarding client choice, prompting the development of a new evidence-based manualised therapy, namely ‘Counselling for Depression’ [CfD]. To date, the client's view of the effectiveness of CfD has not been researched. Aims The aims of this study were twofold: (1) to explore and evaluate CfD from the perspective of the client and (2) to inform the counselling profession of the client's perception of what is occurring within this therapeutic approach. Methodology This qualitative study used Interpretative Phenomenological Analysis, the ideographic aspect valuing each individual narrative and the contribution it makes towards a larger account of the phenomenon from a small group of people. Twelve participants receiving CfD completed a Helpful Aspects of Therapy questionnaire after each counselling session, with ten participating in a semi-structured interview post counselling. Findings Four superordinate themes were identified: A helpful process, Client's view of a counsellor, Gains and Negative aspects. Participants perceived this model of therapy as helpful, feeling understood by their counsellors and able to work through issues in a safe therapeutic relationship. Negative findings related to counselling being ‘hard work’ and a dislike of the time limitation that curtailed the work. Implications Participants believed this type of counselling met their needs, reassuring practitioners that CfD is helpful to their clients

Moral Distress in Critical Care Nursing: The State of the Science

Background: Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions. Objectives: An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions. Review Methods: This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies. Results: Synthesis of the scientific literature revealed inconsistencies in measurement, conflicting findings of moral distress and nurse demographics, problems with the professional practice environment, difficulties with communication during end-of-life decisions, compromised nursing care as a consequence of moral distress, and few effective interventions. Conclusion: Providing compassionate care is a professional nursing value and an inability to meet this goal due to moral distress may have devastating effects on care quality. Further study of patient and family outcomes related to nurse moral distress is recommended

Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties

AIMS: To examine the relationship between specific reasons for stopping breastfeeding and depressive symptoms in the postnatal period. BACKGROUND: Difficulty breastfeeding has been connected to postnatal depression although it is unclear whether difficulty breastfeeding precedes or succeeds a diagnosis. However, the concept of ‘breastfeeding difficulty’ is wide and includes biological, psychological and social factors. DESIGN: A cross‐sectional self‐report survey. METHODS: Data were collected between December 2012 and February 2013. 217 women with an infant aged 0‐6 months who had started breastfeeding at birth but had stopped before 6 months old completed a questionnaire examining breastfeeding duration and reasons for stopping breastfeeding. They further completed a copy of the Edinburgh Postnatal Depression Scale. RESULTS: A short breastfeeding duration and multiple reasons for stopping breastfeeding were associated with higher depression score. However, in a regression analysis only the specific reasons of stopping breastfeeding for physical difficulty and pain remained predictive of depression score. CONCLUSIONS: Understanding women's specific reasons for stopping breastfeeding rather than breastfeeding duration is critical in understanding women's breastfeeding experience and providing women with emotional support. Issues with pain and physical breastfeeding were most indicative of postnatal depression in comparison to psychosocial reasons highlighting the importance of spending time with new mothers to help them with issues such as latch

Tablet PCs in schools: Case study report: A report for Becta by the Open University

The publication provides an analysis of twelve case studies involving schools in England that were using Tablet PCs. The analysis is complemented by brief individual reports describing aspects of how each of these schools was using Tablet PCs

A Retrospective Cohort Study of U.S. Service Members Returning from Afghanistan and Iraq: Is Physical Health Worsening Over time?

Background: High rates of mental health disorders have been reported in veterans returning from deployment to Afghanistan (Operation Enduring Freedom: OEF) and Iraq (Operation Iraqi Freedom: OIF); however, less is known about physical health functioning and its temporal course post-deployment. Therefore, our goal is to study physical health functioning in OEF/OIF veterans after deployment. Methods: We analyzed self-reported physical health functioning as physical component summary (PCS) scores on the Veterans version of the Short Form 36 health survey in 679 OEF/OIF veterans clinically evaluated at a post-deployment health clinic. Veterans were stratified into four groups based on time post-deployment: (1Yr) 0 – 365 days; (2Yr) 366 – 730 days; (3Yr) 731 – 1095 days; and (4Yr+) > 1095 days. To assess the possibility that our effect was specific to a treatment-seeking sample, we also analyzed PCS scores from a separate military community sample of 768 OEF/OIF veterans evaluated pre-deployment and up to one-year post-deployment. Results: In veterans evaluated at our clinic, we observed significantly lower PCS scores as time post-deployment increased (p = 0.018) after adjusting for probable post-traumatic stress disorder (PTSD). We similarly observed in our community sample that PCS scores were lower both immediately after and one year after return from deployment (p < 0.001) relative to pre-deployment PCS. Further, PCS scores obtained 1-year post-deployment were significantly lower than scores obtained immediately post-deployment (p = 0.02). Conclusion: In our clinical sample, the longer the duration between return from deployment and their visit to our clinic, the worse the Veteran’s physical health even after adjusting for PTSD. Additionally, a decline is also present in a military community sample of OEF/OIF veterans. These data suggest that, as time since deployment length increases, physical health may deteriorate for some veterans

Quiet Time for Mechanically Ventilated Patients in The Medical Intensive Care Unit

Objective: Sleep disruption occurs frequently in critically ill patients. The primary aim of this study was to examine the effect of quiet time (QT) on patient sedation frequency, sedation and delirium scores; and to determine if consecutive QTs influenced physiologic measures (heart rate, mean arterial blood pressure and respiratory rate). Method: A prospective study of a quiet time protocol was conducted with 72 adult patients on mechanical ventilation. Setting: A Medical Intensive Care Unit (MICU) in the Midwest region of the United States. Results: Sedation was given less frequently after QT (p = 0.045). Those who were agitated prior to QT were more likely to be at goal sedation after QT (p \u3c 0.001). Although not statistically significant, the majority of patients who were negative on the Confusion Assessment Method (CAM-ICU) prior to QT remained delirium free after QT. Repeated measures analysis of variance (ANOVA) for three consecutive QTs showed a significant difference for respiratory rate (p = 0.035). Conclusion: QT may influence sedation administration and promote patient rest. Future studies are required to further understand the influence of QT on mechanically ventilated patients in the intensive care unit