Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: a systematic review

Background nurse shortages have been identified as central to workforce issues in healthcare systems globally and although interventions to increase the nursing workforce have been implemented, nurses leaving their roles, particularly in the first year after qualification, present a significant barrier to building the nurse workforce. Objective to evaluate the characteristics of successful interventions to promote retention and reduce turnover of early career nurses. Design this is a systematic review Data sources Online databases including Academic Search Complete, Medline, Health Policy reference Centre, EMBASE, Psychinfo, CINAHL and the Cochran Library were searched to identify relevant publications in English published between 2001 and April 2018. Studies included evaluated an intervention to increase retention or reduce turnover and used turnover or retention figures as a measure. Review methods The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were quality-assessed using the Joanna Briggs Institute Critical Appraisal tools for Quasi Experimental and Randomised Controlled Trials. Retention/turnover data were used to guide the comparison between studies and appropriate measures of central tendency and dispersion were calculated and presented, based on the normality of the data. Results A total of 11, 656 papers were identified, of which 53 were eligible studies. A wide variety of interventions and components within those interventions were identified to improve nurse retention. Promising interventions appear to be either internship/residency programmes or orientation/transition to practice programmes, lasting between 27-52 weeks, with a teaching and preceptor and mentor component. Conclusions Methodological issues impacted on the extent to which conclusions could be drawn, even though a large number of studies were identified. Future research should focus on standardising the reporting of interventions and outcome measures used to evaluate these interventions and carrying out further research with rigorous methodology. Clinical practice areas are recommended to assess their current interventions against the identified criteria to guide development of their effectiveness. Evaluations of cost-effectiveness are considered an important next step to maximise return on investment

Variational water-wave model with accurate dispersion and vertical vorticity

A new water-wave model has been derived which is based on variational techniques and combines a depth-averaged vertical (component of) vorticity with depth-dependent potential flow. The model facilitates the further restriction of the vertical profile of the velocity potential to n-th order polynomials or a finite-element profile with a small number of elements (say), leading to a framework for efficient modeling of the interaction of steepening and breaking waves near the shore with a large-scale horizontal flow. The equations are derived from a constrained variational formulation which leads to conservation laws for energy, mass, momentum and vertical vorticity. It is shown that the potential-flow water-wave equations and the shallow-water equations are recovered in the relevant limits. Approximate shock relations are provided, which can be used in numerical schemes to model breaking waves

Social presence in the 21st Century: an adjustment to the Community of Inquiry framework

The Community of Inquiry framework, originally proposed by Garrison, Anderson and Archer (2000) identifies teaching, social and cognitive presences as central to a successful online educational experience. This article presents the findings of a study conducted in Uruguay between 2007 and 2010. The research aimed to establish the role of cognitive, social and teaching presences in the professional development of 40 English language teachers on Continuous Professional Development (CPD) programmes delivered in blended learning settings. The findings suggest that teaching presence and cognitive presence have themselves 'become social'. The research points to social presence as a major lever for engagement, sense-making and peer support. Based on the patterns identified in the study, this article puts forward an adjustment to the Community of Inquiry framework, which shows social presence as more prominent within the teaching and cognitive constructs than the original version of the framework suggests

Risk factors for carriage of Neisseria meningitidis during an outbreak in Wales.

In a school outbreak of meningococcal disease in Wales, we compared risk factors for the carriage of Neisseria meningitidis B15 P1.16 with carriage of any meningococci. Students had throat swabs and completed a questionnaire. Sixty (7.9%) carried meningococci; risk for carriage was higher in those >14 years of age

Decision Support for Temperate Grasslands: Challenges and Pitfalls

Key points Successful adoption of decision support tools (DS tools) to address grassland management issues requires careful attention in design to ensure ease-of-use, accuracy in prediction and the flexibility to simulate actual practices. DS tools must handle spatial variability and where possible include facilities for automatic sourcing of essential information for initialisation. Advances in the development of DS tools will depend on resolution of scientific issues in grassland biology including investment in dedicated experiments to determine parameter values for model equations. The use of mechanistic models, the integration of remote sensing technology and cooperation between research groups to develop modular simulation frameworks to share models will enhance the value of DS tools in grassland management

Shear-banding in a lyotropic lamellar phase, Part 2: Temporal fluctuations

We analyze the temporal fluctuations of the flow field associated to a shear-induced transition in a lyotropic lamellar phase: the layering transition of the onion texture. In the first part of this work [Salmon et al., submitted to Phys. Rev. E], we have evidenced banded flows at the onset of this shear-induced transition which are well accounted for by the classical picture of shear-banding. In the present paper, we focus on the temporal fluctuations of the flow field recorded in the coexistence domain. These striking dynamics are very slow (100--1000s) and cannot be due to external mechanical noise. Using velocimetry coupled to structural measurements, we show that these fluctuations are due to a motion of the interface separating the two differently sheared bands. Such a motion seems to be governed by the fluctuations of $\sigma^\star$, the local stress at the interface between the two bands. Our results thus provide more evidence for the relevance of the classical mechanical approach of shear-banding even if the mechanism leading to the fluctuations of $\sigma^\star$ remains unclear

Complete analysis of phase transitions and ensemble equivalence for the Curie-Weiss-Potts model

Using the theory of large deviations, we analyze the phase transition structure of the Curie–Weiss–Potts spin model, which is a mean-field approximation to the nearest-neighbor Potts model. It is equivalent to the Potts model on the complete graph on n vertices. The analysis is carried out both for the canonical ensemble and the microcanonical ensemble. Besides giving explicit formulas for the microcanonical entropy and for the equilibrium macrostates with respect to the two ensembles, we analyze ensemble equivalence and nonequivalence at the level of equilibrium macrostates, relating these to concavity and support properties of the microcanonical entropy. The Curie–Weiss–Potts model is the first statistical mechanical model for which such a detailed and rigorous analysis has been carried out

Improving the scalability of parallel N-body applications with an event driven constraint based execution model

The scalability and efficiency of graph applications are significantly constrained by conventional systems and their supporting programming models. Technology trends like multicore, manycore, and heterogeneous system architectures are introducing further challenges and possibilities for emerging application domains such as graph applications. This paper explores the space of effective parallel execution of ephemeral graphs that are dynamically generated using the Barnes-Hut algorithm to exemplify dynamic workloads. The workloads are expressed using the semantics of an Exascale computing execution model called ParalleX. For comparison, results using conventional execution model semantics are also presented. We find improved load balancing during runtime and automatic parallelism discovery improving efficiency using the advanced semantics for Exascale computing.Comment: 11 figure