Cortisol reactivity to psychosocial stress is greater in sexual risk takers

Several studies have reported an association between deviant behaviour and cortisol reactivity to stress. However relatively few studies have investigated the relationship between psychobiological stress reactivity and sexual risk taking behaviours. In the present study, cortisol reactivity to the Trier Social Stress Test (TSST) was measured in 26 healthy young adults prior to the administration of a sexual health and behaviour questionnaire. The cortisol response to the TSST was greater in those individuals who reported that at least one of their previous two sexual partners was someone whom they had just met. Results are discussed in context of a model which suggests that early life stress dysregulates the hypothalamic-pituitary-adrenal (HPA) axis and increases the likelihood of later life risk taking behaviour. The findings have implications in terms of improving our understanding of psychobiological factors which predispose individuals to engage in adverse sexual health behaviours

Burgeoning Baigent?: A Critique of the Law commission's Analysis of Baigent's Case

Who is responsible when a Crown entity or State enterprise breaches an individual's rights under the New Zealand Bill of Rights Act 1990?  Is the Crown or the breaching entity primarily liable, or both?  The Law Commission investigated this question in relation to liability arising out of Baigent's case.  In its report the Law Commission recommended significantly narrowing the Crown's liability to exclude State enterprises and Crown entities.  This article investigates the Law Commission's reasoning and recommendations

Keeping Patients Vertical in the Intensive Care Unit

Problem: The critical care patients in a large medical center in Northern California are not consistently optimized medically for mobility and are not mobilized to their maximum capacity. The contributing factors to these problems include poor adherence to standard workflows, insufficient staff knowledge on use of mobility equipment and documentation of activities performed, inadequate provision and utilization of mobility equipment, reduced interdisciplinary staff motivation and skill, and inconsistencies in staffing levels/availability to meet the personnel needs to mobilize patients. Context: Microsystem and culture assessments with gap analysis were performed to assess the need for quality care improvement. The microsystem’s current practice on mobility is focused on ambulation for the most “able” patients; the more critical and unstable patients are not supported to avoid prolonged immobilization. The current performance data was reviewed and compared to the desired performance outcomes. The review revealed a performance gap in patient mobility and that key improvement efforts are needed to achieve the desired outcomes. Interventions: The mobility project “Keeping Patients Vertical in the Intensive Care Unit (ICU)” was initiated to mitigate the microsystem’s identified problem. Multiple interventions implemented include the following: mobility champions were established, education on equipment use and mobility documentation were completed, patient’s mobility information has been incorporated in the Nurse Knowledge Exchange (NKE) and daily multidisciplinary rounds (MDR). A process board was created to include mobility scores in huddles. The mobility equipment has been made available and more accessible for staff to use. Mobility exclusion criteria was established and the goal was set to include mobilizing two intubated patients daily that meet the established criteria. The Sara Combilizer (SC) was trialed for 90 days and was adopted for use to help maximize patient mobility. Measures: The performance outcome measures were identified as follows: the outcome measures are the Average Maximum Mobility (AMM) scores and the Percent Mobilized (PM). The AMM is the highest achieved scores the day prior, up to two highest mobility bouts. The PM is the percentage of patients with documented active mobility performed adhering to the existing time on the unit rules. The process measures are the percent lift utilization, which is the documentation of vertical lift and lift device usage on all ICU patients with Level I and II current level of function, and mobilizing two intubated patients that meet the established criteria. The balancing measures are the identified patient falls and staff injury related to mobilizing patients. Results: The implemented interventions positively impacted the outcomes. The ICU care team met the Outcome Metrics – AMM and PM reached target for three consecutive months (November 2019 – January 2020) after the project implementation. The Process Metrics were also met. Lift Device Utilization scores on 6 out 8 months were maintained at or above target of 75% from October 2019 through May 2020. Every day for a period of eight weeks, the ICU care team mobilized two intubated patients daily that meet the criteria. There were no staff or patient injuries related to mobilizing patients. Conclusions: The mobility project was a success and it resulted in notable changes and improvements in practices in mobilizing patients. By continuing the initiatives, the ICU care team is able to improve patient care experience, expedite patient recovery times, and help patients back to physical independence (Olavides, 2020). The overall extraordinary interdisciplinary engagement and commitment of the care team to mobilizing patients have added utmost value to the ICU in preventing patient harm and improving clinical outcomes

The Levels of Global Citizenship

True global citizenship must be found at all levels of human interaction. Individuals should be constantly evaluative of their own lives, government, and world, so as to allow for necessary change and not become preoccupied with apparently fixed ideals. Families and schools should help to foster an environment of broad, open, inclusive thinking to promote a world of interconnected individuals. Communities should hold town hall-style meetings, and local governments should bring in outside opinions. Governments should include personal stories from a diverse group to add perspective and keep debates grounded in real, current issues. On the national level, there should be equal rights for all, and society should embrace both similarities and differences, since we discover common ground in our similarities and learn from our differences. Through all of these different levels, there should be a universally accepted value in the common good that serves to promote the best life for all

The formation and study of titanium, zirconium, and hafnium complexes

Research involves the preparation and characterization of a series of Ti, Zr, Hf, TiO, and HfO complexes using the poly(pyrazole) borates as ligands. The study will provide increased understanding of the decomposition of these coordination compounds which may lead to the production of molecular oxygen on the Moon from lunar materials such as ilmenite and rutile. The model compounds are investigated under reducing conditions of molecular hydrogen by use of a high temperature/pressure stainless steel autoclave reactor and by thermogravimetric analysis

“Keeping us strong”: Negotiating power, literacies and learning in an Aboriginal context

This thesis is an ethnographic study of literacy and learning practices at a remote Aboriginal adult education centre in Western Australia. Drawing on theories of literacy as social practice, this research describes and analyses what happens in adult Aboriginal education at the level of practice: in particular, how one learning community negotiates engagement with education while ensuring that their personal autonomy, and the everyday contexts of their lives, are not compromised as a result