Differences in Health Literacy Knowledge and Experiences among Senior Nursing Students

Background: Low health literacy has been identified as a significant public health problem. Also, higher expenditures due to longer hospital stays have been reported for persons with low health literacy. Nurses can assist patients with low health literacy to reduce their hospital stays and increase compliance with discharge instructions. Methods: A quantitative, descriptive research design was employed to assess knowledge and experiences of 192 senior nursing students. These students were administered the Health Literacy Knowledge and Experiences Survey (HL-KES), a 2- part survey that included assessment of knowledge about health literacy and experience in working with populations of low health literacy. Additional questions to assist in describing the sample population were included. Analysis of variance (ANOVA) and post-hoc tests were used to measure differences. Results: The results reveal that, at this point in their nursing education, senior nursing students lack health literacy knowledge and experiences. Statistically significant differences were found for health literacy knowledge among participants in the same program and for those enrolled at different program sites. Differences were found for health literacy experiences among participants, but these were not statistically significant due to unequal sample sizes between BSN and RN to BSN, and LPN/LVN to BSN participants. Conclusions: Regardless of program site, senior nursing students have some health literacy knowledge, but gaps exist. Mean scores for health literacy knowledge varied for participants and as a whole for program sites. Thus, differences in health literacy knowledge are most likely the result of how health literacy is addressed by different programs

Differences in Health Literacy Knowledge and Experiences Among Senior Nursing Students

Background: Low health literacy has been identified as a significant public health problem. Also, higher expenditures due to longer hospital stays have been reported for persons with low health literacy. Nurses can assist patients with low health literacy to reduce their hospital stays and increase compliance with discharge instructions. Methods: A quantitative, descriptive research design was employed to assess knowledge and experiences of 192 senior nursing students. These students were administered the Health Literacy Knowledge and Experiences Survey (HL-KES), a 2-part survey that included assessment of knowledge about health literacy and experience in working with populations of low health literacy. Additional questions to assist in describing the sample population were included. Analysis of variance (ANOVA) and post-hoc tests were used to measure differences. Results: The results reveal that, at this point in their nursing education, senior nursing students lack health literacy knowledge and experiences. Statistically significant differences were found for health literacy knowledge among participants in the same program and for those enrolled at different program sites. Differences were found for health literacy experiences among participants, but these were not statistically significant due to unequal sample sizes between BSN and RN to BSN, and LPN/LVN to BSN participants. Conclusions: Regardless of program site, senior nursing students have some health literacy knowledge, but gaps exist. Mean scores for health literacy knowledge varied for participants and as a whole for program sites. Thus, differences in health literacy knowledge are most likely the result of how health literacy is addressed by different programs

Knowledge Sharing in Alliances and Alliance Portfolios

We develop a model of knowledge sharing in alliances and alliance portfolios. We show that, once the issue of encouraging effective collaboration is put center stage, many standard intuitions of the learning race view and alliance portfolio literature are overturned or qualified. Partners engage in learning races in some cases, but exhibit “altruistic” behaviors in other cases. They may reduce their own absorptive capacity or increase the transparency of their own operations to facilitate their partner’s learning. In alliance portfolios, we show that not all substitutability between alliance portfolio partners is bad. We distinguish between substitutability in implementation and substitutability in rival benefits and show that the latter is conducive to knowledge sharing. Our work contributes toward putting the literature on learning alliances on a more solid foundation by emphasizing the importance of commitments that leading firms can make to encourage collaboration

APPLICATION OF POLYURETHANE FOAM FOR IMPACT ABSORPTION AND THERMAL INSULATION FOR GENERAL PURPOSE RADIOACTIVE MATERIALS PACKAGINGS

Polyurethane foam has been employed in impact limiters for large radioactive materials packagings since the early 1980's. Its consistent crush response, controllable structural properties and excellent thermal insulating characteristics have made it attractive as replacement for the widely used cane fiberboard for smaller, drum size packagings. Accordingly, polyurethane foam was chosen for the overpack material for the 9977 and 9978 packagings. The study reported here was undertaken to provide data to support the analyses performed as part of the development of the 9977 and 9978, and compared property values reported in the literature with published property values and test results for foam specimens taken from a prototype 9977 packaging. The study confirmed that, polyurethane foam behaves in a predictable and consistent manner and fully satisfies the functional requirements for impact absorption and thermal insulation

APPLICATION OF POLYURETHANE FOAM FOR IMPACT ABSORPTION AND THERMAL INSULATION FOR RADIOACTIVE MATERIALS PACKAGINGS.

Polyurethane foam has been widely used as an impact absorbing and thermal insulating material for large radioactive materials packages, since the 1980's. With the adoption of the regulatory crush test requirement, for smaller packages, polyurethane foam has been adopted as a replacement for cane fiberboard, because of its ability to withstand the crush test. Polyurethane foam is an engineered material whose composition is much more closely controlled than that of cane fiberboard. In addition, the properties of the foam can be controlled by controlling the density of the foam. The conditions under which the foam is formed, whether confined or unconfined have an affect on foam properties. The study reported here reviewed the application of polyurethane foam in RAM packagings and compared property values reported in the literature with published property values and test results for foam specimens taken from a prototype 9977 packaging. The study confirmed that, polyurethane foam behaves in a predictable and consistent manner and fully satisfies the functional requirements for impact absorption and thermal insulation

Lactation and neonatal nutrition: defining and refining the critical questions.

This paper resulted from a conference entitled "Lactation and Milk: Defining and refining the critical questions" held at the University of Colorado School of Medicine from January 18-20, 2012. The mission of the conference was to identify unresolved questions and set future goals for research into human milk composition, mammary development and lactation. We first outline the unanswered questions regarding the composition of human milk (Section I) and the mechanisms by which milk components affect neonatal development, growth and health and recommend models for future research. Emerging questions about how milk components affect cognitive development and behavioral phenotype of the offspring are presented in Section II. In Section III we outline the important unanswered questions about regulation of mammary gland development, the heritability of defects, the effects of maternal nutrition, disease, metabolic status, and therapeutic drugs upon the subsequent lactation. Questions surrounding breastfeeding practice are also highlighted. In Section IV we describe the specific nutritional challenges faced by three different populations, namely preterm infants, infants born to obese mothers who may or may not have gestational diabetes, and infants born to undernourished mothers. The recognition that multidisciplinary training is critical to advancing the field led us to formulate specific training recommendations in Section V. Our recommendations for research emphasis are summarized in Section VI. In sum, we present a roadmap for multidisciplinary research into all aspects of human lactation, milk and its role in infant nutrition for the next decade and beyond

Baseline characteristics of people experiencing homelessness with a recent drug overdose in the PHOENIx pilot randomised controlled trial

Background: Drug-related deaths in Scotland are the highest in Europe. Half of all deaths in people experiencing homelessness are drug related, yet we know little about the unmet health needs of people experiencing homelessness with recent non-fatal overdose, limiting a tailored practice and policy response to a public health crisis. Methods: People experiencing homelessness with at least one non-fatal street drug overdose in the previous 6 months were recruited from 20 venues in Glasgow, Scotland, and randomised into PHOENIx plus usual care, or usual care. PHOENIx is a collaborative assertive outreach intervention by independent prescriber NHS Pharmacists and third sector homelessness workers, offering repeated integrated, holistic physical, mental and addictions health and social care support including prescribing. We describe comprehensive baseline characteristics of randomised participants. Results: One hundred and twenty-eight participants had a mean age of 42 years (SD 8.4); 71% male, homelessness for a median of 24 years (IQR 12–30). One hundred and eighteen (92%) lived in large, congregate city centre temporary accommodation. A quarter (25%) were not registered with a General Practitioner. Participants had overdosed a mean of 3.2 (SD 3.2) times in the preceding 6 months, using a median of 3 (IQR 2–4) non-prescription drugs concurrently: 112 (87.5%) street valium (benzodiazepine-type new psychoactive substances); 77 (60%) heroin; and 76 (59%) cocaine. Half (50%) were injecting, 50% into their groins. 90% were receiving care from Alcohol and Drug Recovery Services (ADRS), and in addition to using street drugs, 90% received opioid substitution therapy (OST), 10% diazepam for street valium use and one participant received heroin-assisted treatment. Participants had a mean of 2.2 (SD 1.3) mental health problems and 5.4 (SD 2.5) physical health problems; 50% received treatment for physical or mental health problems. Ninety-one per cent had at least one mental health problem; 66% had no specialist mental health support. Participants were frail (70%) or pre-frail (28%), with maximal levels of psychological distress, 44% received one or no daily meal, and 58% had previously attempted suicide. Conclusions: People at high risk of drug-related death continue to overdose repeatedly despite receiving OST. High levels of frailty, multimorbidity, unsuitable accommodation and unmet mental and physical health care needs require a reorientation of services informed by evidence of effectiveness and cost-effectiveness. Trial registration UK Clinical Trials Registry identifier: ISRCTN 10585019