Preliminary Investigation of Coping Styles, Continuous Self-Improvement, & Self Efficacy: Impact on BSN Students

https://fuse.franklin.edu/ss2018/1028/thumbnail.jp

Assessment of BSN Student Attitudes Toward Patient Education & Three Patient Education Scenarios

https://fuse.franklin.edu/ss2018/1067/thumbnail.jp

A fundamental conflict of care: nurses' accounts of balancing sleep with taking vital signs observations at night.

AIMS AND OBJECTIVES: To explore why adherence to vital signs observations scheduled by an Early Warning Score protocol reduces at night. BACKGROUND: Regular vital signs observations can reduce avoidable deterioration in hospital. Early Warning Score protocols set the frequency of these observations by the severity of a patient's condition. Vital signs observations are taken less frequently at night, even with an Early Warning Score in place, but no literature has explored why. DESIGN: A qualitative interpretative design informed this study. METHODS: Seventeen semi-structured interviews with nursing staff working on wards with varying levels of adherence to scheduled vital signs observations. A thematic analysis approach was used. RESULTS: At night, nursing teams found it difficult to balance the competing care goals of supporting sleep with taking vital signs observations. The night-time frequency of these observations was determined by clinical judgement, ward-level expectations of observation timing and the risk of disturbing other patients. Patients with COPD or dementia could be under-monitored while patients nearing the end of life could be over-monitored. CONCLUSION: In this study we found an Early Warning Score algorithm focused on deterioration prevention did not account for long-term management or palliative care trajectories. Nurses were therefore less inclined to wake such patients to take vital signs observations at night. However the perception of widespread exceptions and lack of evidence regarding optimum frequency risks delegitimising the Early Warning Score approach. This may pose a risk to patient safety, particularly patients with dementia or chronic conditions. RELEVANCE TO CLINICAL PRACTICE: Nurses should document exceptions and discuss these with the wider team. Hospitals should monitor why vital signs observations are missed at night, identify which groups are under-monitored and provide guidance on prioritising competing expectations. Early Warning Score protocols should take account of different care trajectories. This article is protected by copyright. All rights reserved

Oral mucosal injury caused by mammalian target of rapamycin inhibitors: emerging perspectives on pathobiology and impact on clinical practice.

In recent years oral mucosal injury has been increasingly recognized as an important toxicity associated with mammalian target of rapamycin (mTOR) inhibitors, including in patients with breast cancer who are receiving everolimus. This review addresses the state-of-the-science regarding mTOR inhibitor-associated stomatitis (mIAS), and delineates its clinical characteristics and management. Given the clinically impactful pain associated with mIAS, this review also specifically highlights new research focusing on the study of the molecular basis of pain. The incidence of mIAS varies widely (2-78%). As reported across multiple mTOR inhibitor clinical trials, grade 3/4 toxicity occurs in up to 9% of patients. Managing mTOR-associated oral lesions with topical oral, intralesional, and/or systemic steroids can be beneficial, in contrast to the lack of evidence supporting steroid treatment of oral mucositis caused by high-dose chemotherapy or radiation. However, steroid management is not uniformly efficacious in all patients receiving mTOR inhibitors. Furthermore, technology does not presently exist to permit clinicians to predict a priori which of their patients will develop these lesions. There thus remains a strategic need to define the pathobiology of mIAS, the molecular basis of pain, and risk prediction relative to development of the clinical lesion. This knowledge could lead to novel future interventions designed to more effectively prevent mIAS and improve pain management if clinically significant mIAS lesions develop

Noun and Verb Morphology in Micmac Hieroglyphic Texts

Proceedings of the Sixteenth Annual Meeting of the Berkeley Linguistics Society: Special Session on General Topics in American Indian Linguistics (1990), pp. 128-13

SYNBIOSAFE e-conference: online community discussion on the societal aspects of synthetic biology

As part of the SYNBIOSAFE project, we carried out an open electronic conference (e-conference), with the aim to stimulate an open debate on the societal issues of synthetic biology in a proactive way. The e-conference attracted 124 registered participants from 23 different countries and different professional backgrounds, who wrote 182 contributions in six different categories: (I) Ethics; (II) Safety; (III) Security; (IV) IPR; (V) Governance and regulation; (VI) and Public perception. In this paper we discuss the main arguments brought up during the e-conference and provide our conclusions about how the community thinks, and thinks differently on the societal impact of synthetic biology. Finally we conclude that there is a chance for an open discourse on the societal issues of synthetic biology happening, and that the rules to govern such a discourse might be set up much easier and be respected more readily than many would suggest

Ranking Objections to Christian Theism: A Survey of Subjective Declarations and their Correlations with Expert Opinions

There have been numerous books written on the top objections to Christianity—sometimes stated as “common,” “major,” “frequent,” “every day,” “cultural,” “tough,” “difficult” objections. However, there is a dearth of behavioral studies in the literature that show how and given population ranks objections to Christianity. As such, the apologist has had to rely on expert opinions from the books that have been authored. These expert opinions are based on familiarity with the literature in the field and contact with laity from university, church, and other speaking engagements. The purpose of this study is to document trends in how people report the relative strength of objections to Christian theism.[1] We analyze whether these trends correlate with popular works of Christian apologists—our baseline for expert opinion. Further, we determine whether there are any statistically significant relationships between reported demographics, rankings, and attitudes. Summary of Results and Analysis. Subjective declarations of respondents of the questionnaire showed that most participants were either 18-24 (marginally more than 55-64 and 65-74), male (marginally more than female), had some college (marginally more than bachelor’s, master’s degrees), lived in a suburban community, or lived in the South. In comparing the expert opinion baseline with the aggregate survey ranking results, we see similar rankings between the objection that “God is unloving/immoral” and that the “Bible is not inerrant” (ranked by both as 1st and 2nd, respectively) at the higher end of the spectrum. We found that those identified as agnostic seem to have the closest potential correlation to expert opinion (baseline). The mean of their rankings produced four objections that closely approximated the baseline, one objection that was about one rank removed from the baseline, and three objections that were about two ranks from the baseline. For demographics and rankings, we found statistically significant relationships between religious identification and the objection “God does not exist” with those who identified as atheists, giving it an average ranking of 3.74 (on a scale of 1-13; 1 = highest, 13 = lowest). For demographics and attitudes, we found statistically significant relationships between religious identification and age, religious discussion importance, and attitude toward Christian theism. (See “Analysis” section.) [1] The study was done under the School of Divinity Department at Liberty University in compliance with Liberty University’s Internal Review Board (Research Ethics Office). IRB-FY21-22-12. Policy: Post-2018 Rule. Submitted 07-06-2021. Last approved 09-07-2021, no expiration date applicable

Relationships between healthcare staff characteristics and the conduct of vital signs observations at night: results of a survey and factor analysis.

Aim: To explore the association of healthcare staff with factors relevant to completing observations at night. Design: Online survey conducted with registered nurses, midwives, healthcare support staff and student nurses who had worked at least one night shift in a National Health Service hospital in England. Methods: Exploratory factor analysis and mixed effects regression model adjusting for role, number of night shifts worked, experience and shift patterns. Results: Survey items were summarized into four factors: (a) workload and resources; (b) prioritization; (c) safety culture; (d) responsibility and control. Staff experience and role were associated with conducting surveillance tasks. Nurses with greater experience associated workload and resources with capacity to complete work at night. Responses of student nurses and midwives showed higher propensity to follow the protocol for conducting observations. Respondents working night shifts either exclusively or occasionally perceived that professional knowledge rather than protocol guided care tasks during night shifts

Atom lasers: production, properties and prospects for precision inertial measurement

We review experimental progress on atom lasers out-coupled from Bose-Einstein condensates, and consider the properties of such beams in the context of precision inertial sensing. The atom laser is the matter-wave analog of the optical laser. Both devices rely on Bose-enhanced scattering to produce a macroscopically populated trapped mode that is output-coupled to produce an intense beam. In both cases, the beams often display highly desirable properties such as low divergence, high spectral flux and a simple spatial mode that make them useful in practical applications, as well as the potential to perform measurements at or below the quantum projection noise limit. Both devices display similar second-order correlations that differ from thermal sources. Because of these properties, atom lasers are a promising source for application to precision inertial measurements.Comment: This is a review paper. It contains 40 pages, including references and figure