How to identify and recruit nurses to a survey 14 and 24 years after graduation in a context of scarce data: lessons learnt from the 2012 nurses at work pilot study on nurses' career paths.

BACKGROUND: Nursing workforce data are scarce in Switzerland, with no active national registry of nurses. The worldwide nursing shortage is also affecting Switzerland, so that evidence-based results of the nurses at work project on career paths and retention are needed as part of the health care system stewardship; nurses at work is a retrospective cohort study of nurses who graduated in Swiss nursing schools in the last 30 years. Results of the pilot study are presented here (process and feasibility). The objectives are (1) to determine the size and structure of the potential target population by approaching two test-cohorts of nursing graduates (1988 and 1998); (2) to test methods of identifying and reaching them 14 and 24 years after graduation; (3) to compute participation rates, and identify recruitment and participation biases. METHODS: Graduates' names were retrieved from 26 Swiss nursing schools: 488 nurses from the 1988 cohort and 597 from 1998 were invited to complete a web-based questionnaire. Initial updated addresses (n = 278, seed sample) were found using the Swiss Nursing Association member file. In addition, a snowball method was applied for recruitment, where directly-contacted respondents provided additional names of graduate mates or sent them the invitation. The study was further advertized through the main employers, study partners, and a press release. RESULTS: Participation rate was 26.5% (n = 287), higher for the older cohort of 1988 (29.7%, n = 145) than for 1998 (15.6%, n = 93). Additional nurses (n = 363) not belonging to the test cohorts also answered. All schools were represented among respondents. Only 18 respondents (6%) worked outside nursing or not at all. Among respondents, 94% would 'probably' or 'maybe' agree to participate in the main study. CONCLUSION: The pilot study demonstrated that targeted nurses could be identified and approached. There is an overwhelming interest in the project from them and from policymakers. Recommendations to increase nurses' participation rate for nurses at work include: (1) to open nurses at work recruitment to all nurses in Switzerland, while recreating cohorts post-hoc for relevant analysis; (2) to define a comprehensive communication strategy with special attention to graduate nurses who are harder to reach

Statistics of microcavity polaritons under non-resonant excitation

A model describing amplification and quantum statistics of the exciton polaritons with k=0 in a non-resonantly excited semiconductor quantum well embedded in a microcavity is presented. Exploiting the bottleneck effect for exciton polaritons, it is assumed that the polaritons with k different from 0 act as a reservoir. The time evolution of the k=0 polaritons is described by a master equation, in which two- and one-polariton transitions between the mode with k=0 and the reservoir are accounted for. The k=0 mode exhibits a threshold depending on the material parameters and on the injected exciton density. Below threshold the quantum statistics of the emission is characteristic of an incoherent process, while above threshold it approaches that of a laser.Comment: 23 pages, 7 figure

Providing Feedback Following Leadership Walkrounds is Associated with Better Patient Safety Culture, Higher Employee Engagement and Lower Burnout

Background There is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance. Methods This cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture, employee engagement, burnout and work-life balance, across 829 work settings. Results 16 797 of 23 853 administered surveys were returned (70.4%). 5497 (32.7% of total) reported that they had participated in WR, and 4074 (24.3%) reported that they participated in WR with feedback. Work settings reporting more WR with feedback had substantially higher safety culture domain scores (first vs fourth quartile Cohen’s d range: 0.34–0.84; % increase range: 15–27) and significantly higher engagement scores for four of its six domains (first vs fourth quartile Cohen’s d range: 0.02–0.76; % increase range: 0.48–0.70). Conclusion This WR study of patient safety and organisational outcomes tested relationships with a comprehensive set of safety culture and engagement metrics in the largest sample of hospitals and respondents to date. Beyond measuring simply whether WRs occur, we examine WR with feedback, as WR being done well. We suggest that when WRs are conducted, acted on, and the results are fed back to those involved, the work setting is a better place to deliver and receive care as assessed across a broad range of metrics, including teamwork, safety, leadership, growth opportunities, participation in decision-making and the emotional exhaustion component of burnout. Whether WR with feedback is a manifestation of better norms, or a cause of these norms, is unknown, but the link is demonstrably potent

Interaction of the NRF2 and p63 transcription factors promotes keratinocyte proliferation in the epidermis

Epigenetic regulation of cell and tissue function requires the coordinated action of transcription factors. However, their combinatorial activities during regeneration remain largely unexplored. Here, we discover an unexpected interaction between the cytoprotective transcription factor NRF2 and p63-a key player in epithelial morphogenesis. Chromatin immunoprecipitation combined with sequencing and reporter assays identifies enhancers and promoters that are simultaneously activated by NRF2 and p63 in human keratinocytes. Modeling of p63 and NRF2 binding to nucleosomal DNA suggests their chromatin-assisted interaction. Pharmacological and genetic activation of NRF2 increases NRF2-p63 binding to enhancers and promotes keratinocyte proliferation, which involves the common NRF2-p63 target cyclin-dependent kinase 12. These results unravel a collaborative function of NRF2 and p63 in the control of epidermal renewal and suggest their combined activation as a strategy to promote repair of human skin and other stratified epithelia

Assessing the safety attitudes questionnaire (SAQ), German language version in Swiss university hospitals - A validation study

Background: Improving patient safety has become a major focus of clinical care and research over the past two decades. An institution's patient safety climate represents an essential component of ensuring a safe environment and thereby can be vital to the prevention of adverse events. Covering six patient safety related factors, the Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure the patient safety climate in clinical areas. The objective of this study was to assess the psychometric properties of the German language version of the SAQ. Methods. A survey was carried out in two University Hospitals in Switzerland in autumn 2009 where the SAQ was distributed to a sample of 406 nurses and physicians in medical and surgical wards. Following the American Educational Research Association guidelines, we tested the questionnaire validity by levels of evidence: content validity, internal structure and relations to other variables. Confirmatory factor analysis was used to examine factor structure. Cronbach's alphas and inter-item correlations were calculated to examine internal consistency reliability. Results: A total of 319 questionnaires were completed representing an overall response rate of 78.6%. For three items, the item content validity index was <0.75. Confirmatory factor analysis showed acceptable model fit (RMSEA = 0.045; CFI = 0.944) for the six-factor model. Additional exploratory factor analysis could not identify a better factor model. SAQ factor scores showed positive correlations with the Safety Organizing Scale (r =.56 -.72). The SAQ German version showed moderate to strong internal consistency reliability indices (Cronbach alpha =.65 -.83). Conclusions: The German language version of the SAQ demonstrated acceptable to good psychometric properties and therefore shows promise to be a sound instrument to measure patient safety climate in Swiss hospital wards. However, the low item content validity and large number of missing responses for several items suggest that improvements and adaptations in translation are required for select items, especially within the perception of management scale. Following these revisions, psychometric properties should reassessed in a randomly selected sample and hospitals and departments prior to use in Swiss hospital settings. © 2013 Zimmermann et al.; licensee BioMed Central Ltd

And-or tableaux for fixpoint logics with converse: LTL, CTL, PDL and CPDL

Over the last forty years, computer scientists have invented or borrowed numerous logics for reasoning about digital systems. Here, I would like to concentrate on three of them: Linear Time Temporal Logic (LTL), branching time Computation Tree temporal Logic (CTL), and Propositional Dynamic Logic (PDL), with and without converse. More specifically, I would like to present results and techniques on how to solve the satisfiability problem in these logics, with global assumptions, using the tableau method. The issues that arise are the typical tensions between computational complexity, practicality and scalability. This is joint work with Linh Anh Nguyen, Pietro Abate, Linda Postniece, Florian Widmann and Jimmy Thomson

A SAT-Based Encoding of the One-Pass and Tree-Shaped Tableau System for LTL

A new one-pass and tree-shaped tableau system for LTL sat- isfiability checking has been recently proposed, where each branch can be explored independently from others and, furthermore, directly cor- responds to a potential model of the formula. Despite its simplicity, it proved itself to be effective in practice. In this paper, we provide a SAT-based encoding of such a tableau system, based on the technique of bounded satisfiability checking. Starting with a single-node tableau, i.e., depth k of the tree-shaped tableau equal to zero, we proceed in an incremental fashion. At each iteration, the tableau rules are encoded in a Boolean formula, representing all branches of the tableau up to the current depth k. A typical downside of such bounded techniques is the effort needed to understand when to stop incrementing the bound, to guarantee the completeness of the procedure. In contrast, termination and completeness of the proposed algorithm is guaranteed without com- puting any upper bound to the length of candidate models, thanks to the Boolean encoding of the PRUNE rule of the original tableau system. We conclude the paper by describing a tool that implements our procedure, and comparing its performance with other state-of-the-art LTL solvers

The contribution of staff call light response time to fall and injurious fall rates: an exploratory study in four US hospitals using archived hospital data

Abstract Background Fall prevention programs for hospitalized patients have had limited success, and the effect of programs on decreasing total falls and fall-related injuries is still inconclusive. This exploratory multi-hospital study examined the unique contribution of call light response time to predicting total fall rates and injurious fall rates in inpatient acute care settings. The conceptual model was based on Donabedian's framework of structure, process, and health-care outcomes. The covariates included the hospital, unit type, total nursing hours per patient-day (HPPDs), percentage of the total nursing HPPDs supplied by registered nurses, percentage of patients aged 65 years or older, average case mix index, percentage of patients with altered mental status, percentage of patients with hearing problems, and call light use rate per patient-day. Methods We analyzed data from 28 units from 4 Michigan hospitals, using archived data and chart reviews from January 2004 to May 2009. The patient care unit-month, defined as data aggregated by month for each patient care unit, was the unit of analysis (N = 1063). Hierarchical multiple regression analyses were used. Results Faster call light response time was associated with lower total fall and injurious fall rates. Units with a higher call light use rate had lower total fall and injurious fall rates. A higher percentage of productive nursing hours provided by registered nurses was associated with lower total fall and injurious fall rates. A higher percentage of patients with altered mental status was associated with a higher total fall rate but not a higher injurious fall rate. Units with a higher percentage of patients aged 65 years or older had lower injurious fall rates. Conclusions Faster call light response time appeared to contribute to lower total fall and injurious fall rates, after controlling for the covariates. For practical relevance, hospital and nursing executives should consider strategizing fall and injurious fall prevention efforts by aiming for a decrease in staff response time to call lights. Monitoring call light response time on a regular basis is recommended and could be incorporated into evidence-based practice guidelines for fall prevention.http://deepblue.lib.umich.edu/bitstream/2027.42/112579/1/12913_2011_Article_2004.pd

On the Theory of Vibronic Superradiance

The Dicke superradiance on vibronic transitions of impurity crystals is considered. It is shown that parameters of the superradiance (duration and intensity of the superradiance pulse and delay times) on each vibronic transition depend on the strength of coupling of electronic states with the intramolecular impurity vibration (responsible for the vibronic structure of the optical spectrum in the form of vibrational replicas of the pure electronic line) and on the crystal temperature through the Debye-Waller factor of the lattice vibrations. Theoretical estimates of the ratios of the time delays, as well as of the superradiance pulse intensities for different vibronic transitions well agree with the results of experimental observations of two-color superradiance in the polar dielectric KCl:O2-. In addition, the theory describes qualitatively correctly the critical temperature dependence of the superradiance effect.Comment: 8 pages, 1 figur