The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current literature

BACKGROUND: Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce. AIMS: To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research. DESIGN: Systematic, narrative review. DATA SOURCES: Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion. REVIEW METHODS: The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated. RESULTS: Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression. CONCLUSION: Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level

The use of heavy mineral correlation for determining the source of impact ejecta: A Manicouagan distal ejecta case study

Due to the nature of distal impact ejecta layers on Earth, preserved deposits are rare and are commonly altered by diagenetic/weathering processes. To establish the source of ejecta, trace element signatures of impact glasses have typically been used to establish the source crater of a deposit. However, in many cases, impact glasses in ejecta deposits are devitrified and altered to clays resulting in loss of original melt and original trace element composition. This is the case for the Late Triassic ejecta deposit of SW Britain where impact melt spherules have been completely altered to clay. This Late Triassic ejecta deposit was originally believed to be derived from two possible sources, the Rochechouart or Manicouagan impact structures. To accurately establish the source of this ejecta deposit an alternative correlation technique was developed using garnet major oxide data and radiometric whole grain fusion Ar-Ar dating of shocked biotite (U-Pb dating of zircon was also used but proved inconclusive). Radiogenic dating of shocked biotites (observed exclusively in the ejecta deposit) yielded ages consistent with the Grenvillian target rocks at Manicouagan and excluded Rochechouart as a potential source. Garnet major oxide compositions of garnets in the ejecta deposit were directly compared to garnets from the Manicouagan target rocks and impactite rocks. A strong garnet composition signature correlation between the samples from Manicouagan and the ejecta deposit provides convincing evidence that Manicouagan is the source of the SW Britain ejecta deposit. Furthermore, we suggest that heavy mineral correlation techniques should be considered in future studies as a correlation tool for establishing the source of ejecta

A precambrian proximal ejecta blanket from Scotland

Ejecta blankets around impact craters are rarely preserved on Earth. Although impact craters are ubiquitous on solid bodies throughout the solar system, on Earth they are rapidly effaced, and few records exist of the processes that occur during emplacement of ejecta. The Stac Fada Member of the Precambrian Stoer Group in Scotland has previously been described as volcanic in origin. However, shocked quartz and biotite provide evidence for high-pressure shock metamorphism, while chromium isotope values and elevated abundances of platinum group metals and siderophile elements indicate addition of meteoritic material. Thus, the unit is reinterpreted here as having an impact origin. The ejecta blanket reaches >20 m in thickness and contains abundant dark green, vesicular, devitrified glass fragments. Field observations suggest that the deposit was emplaced as a single fluidized flow that formed as a result of an impact into water-saturated sedimentary strata. The continental geological setting and presence of groundwater make this deposit an analogue for Martian fluidized ejecta blankets

Sulfur isotope signatures for rapid colonization of an impact crater by thermophilic microbes

In the 23-km-diameter Haughton impact structure, Canadian High Arctic, in sulfate-rich bedrock, widespread hydrothermal sulfide mineralization occurred in breccias formed during the impact. The sulfides exhibit extreme sulfur isotopic fractionation relative to the original sulfate, requiring microbial sulfate reduction by thermophiles throughout the crater. This evidence of widespread microbial activity demonstrates that colonization could occur within the lifetime of a moderately sized, impact-induced hydrothermal system. The pyrite was subsequently oxidized to jarosite, which may also have been microbially mediated. The successful detection of evidence for microbial life suggests that it would be a valuable technique to deploy in sulfate-rich impact terrain on Mars