Acute care nurses' perceptions of barriers to using research information in clinical decision-making

Aim. To examine the barriers that nurses feel prevent them from using research in the decisions they make. Background. A sizeable research literature focusing on research utilization in nursing has developed over the past 20 years. However, this literature is characterized by a number of weaknesses: self-reported utilization behaviour; poor response rates and small, nonrandom sampling strategies. Design. Cross-case analysis involving anonymised qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 h, and 122 nurses were involved in the Q modelling exercise (response rate of 64%). Results. Four perspectives were isolated that encompassed the characteristics associated with barriers to research use. These related to the individual, organization, nature of research information itself and environment. Nurses clustered around four main perspectives on the barriers to research use: (1) Problems in interpreting and using research products, which were seen as too complex, 'academic' and overly statistical; (2) Nurses who felt confident with research-based information perceived a lack of organizational support as a significant block; (3) Many nurses felt that researchers and research products lack clinical credibility and that they fail to offer the desired level of clinical direction; (4) Some nurses lacked the skills and, to a lesser degree, the motivation to use research themselves. These individuals liked research messages passed on to them by a third party and sought to foster others' involvement in research-based practice, rather than becoming directly involved themselves. Conclusions. Rejection of research knowledge is not a barrier to its application. Rather, the presentation and management of research knowledge in the workplace represent significant challenges for clinicians, policy-makers and the research community

The excess burden of cancer in men in the UK

In general men are at significantly greater risk than women from nearly all of the common cancers that occur in both sexes (with the exception of breast cancer) (White 2009, Wilkins 2006, DH 2007). This report will consider the current overall burden of cancer among men in the UK, estimated from the latest statistics, and outline the extent of the differences between the sexes. All figures and calculations reported here are based on data extracted from the Cancer Research UK CancerStats web pages extracted in June 2009 (Cancer Research UK, 2009)

The accessibility of research-based knowledge for nurses in United Kingdom acute care settings

Background. The successful dissemination of the results of the National Health Service (NHS) research and development strategy and the development of evidence based approaches to health care rely on clinicians having access to the best available evidence; evidence fit for the purpose of reducing the uncertainties associated with clinical decisions. Aim. To reveal the accessibility of those sources of information actually used by nurses, as well as those which they say they use. Design. Mixed method case site, using interview, observational, Q sort and documentary audit data in medical, surgical and coronary care units (CCUs) in three acute hospitals. Results. Three perspectives on accessibility were identified: (a) the humanist-in which human sources of information were the most accessible; (b) local information for local needs-in which locally produced resources were seen as the most accessible and (c) moving towards technology-in which information technology begins to be seen as accessible. Nurses' experience in a clinical specialty is positively associated with a perception that human sources such clinical nurse specialists, link nurses, doctors and experienced clinical colleagues are more accessible than text based sources. Clinical specialization is associated with different approaches to accessing research knowledge. Coronary care unit nurses were more likely perceive local guidelines, protocols and on-line databases as more accessible than their counterparts in general medical and surgical wards. Only a third of text-based resources available to nurses oil the wards had any explicit research base. These, and the remainder were Out of date (mean age of textbooks 11 years), and authorship hard to ascertain. Conclusion. A strategy to increase the use of research evidence by nurses should harness the influence of clinical nurse specialists, link nurses and those engaged in practice development. These roles Could act as 'conduits' through which research-based messages for practice, and information for clinical decision making, could flow. This role should be explored and enhanced

Single-strain-gage force/stiffness buckling prediction techniques on a hat-stiffened panel

Predicting the buckling characteristics of a test panel is necessary to ensure panel integrity during a test program. A single-strain-gage buckling prediction method was developed on a hat-stiffened, monolithic titanium buckling panel. The method is an adaptation of the original force/stiffness method which requires back-to-back gages. The single-gage method was developed because the test panel did not have back-to-back gages. The method was used to predict buckling loads and temperatures under various heating and loading conditions. The results correlated well with a finite element buckling analysis. The single-gage force/stiffness method was a valid real-time and post-test buckling prediction technique

MODEL SELECTION WITH TEMPORAL AND SPATIAL AGGREGATION: ALTERNATIVE MARKETING MARGIN MODELS

Marketing,

Fixed point scenario in the Two Higgs Doublet Model inspired by degenerate vacua

We consider the renormalisation group flow of Higgs and Yukawa couplings within the simplest non--supersymmetric two Higgs doublet extension of the Standard Model (SM). In this model the couplings are adjusted so that the multiple point principle (MPP) assumption, which implies the existence of a large set of degenerate vacua at some high energy scale $\Lambda$, is realised. When the top quark Yukawa coupling at the scale $\Lambda$ is large, the solutions of RG equations in this MPP inspired 2 Higgs Doublet Model (2HDM) converge to quasi--fixed points. We analyse the Higgs spectrum and couplings in the quasi--fixed point scenario and compute a theoretical upper bound on the lightest Higgs boson mass. When the scale $\Lambda$ is low, the coupling of the SM--like Higgs scalar to the top quark can be significantly larger in the considered model than in the SM, resulting in the enhanced production of Higgs bosons at the LHC.Comment: 16 pages, 3 figures, CERN preprint number added, references update

Students' epistemological framing in quantum mechanics problem solving

Students' difficulties in quantum mechanics may be the result of unproductive framing and not a fundamental inability to solve the problems or misconceptions about physics content. We observed groups of students solving quantum mechanics problems in an upper-division physics course. Using the lens of epistemological framing, we investigated four frames in our observational data: algorithmic math, conceptual math, algorithmic physics, and conceptual physics. We discuss the characteristics of each frame as well as causes for transitions between different frames, arguing that productive problem solving may occur in any frame as long as students' transition appropriately between frames. Our work extends epistemological framing theory on how students frame discussions in upper-division physics courses.Comment: Submitted to Physical Review -- Physics Education Researc