Improving Education on Preeclampsia with Non-Severe Features and Frequency of Assessment Among Nurses in the Maternal-Child Postpartum Unit

Problem: This Quality Improvement (QI) project aims to improve preeclampsia education among nurses and reduce the frequency of preeclampsia assessments among patients(without severe features) (SF) in the Mother-Baby postpartum unit at Hospital A. Nurses often stated that patients are unable to have uninterrupted rest periods with frequent assessments, which research shows is necessary for reducing patient blood pressure. Context: The QI project is implemented in a 25-bed postpartum unit that cares for women and their newborns in the postpartum period. The unit’s nurse educator and nurse manager requested that the visiting University of San Francisco research group focus on simplifying the preeclampsia assessment along with providing refresher education on preeclampsia signs and symptoms. Interventions: Distribute brief questionnaires to registered nurses on the postpartum unit to determine the most beneficial information nurses need on preeclampsia signs and symptoms and recommendations for frequency of assessment. No intervention was implemented at this time. Measures: The improvement process began with a microsystem assessment using the 5Ps (see Appendix C) and distributing questionnaires (see Appendix G) that assisted us in assessing the comfort level of nurses. Edible incentives were provided to encourage active participation in the change process. Results: Our results were a combination of both qualitative and quantitative data. The response rates of the pre-assessment survey gave insight into the nurses’ opinions (see Appendix H), and the goal and direction of the QI project that would be most beneficial to the postpartum unit. The pre-assessment survey stated that refresher courses would be beneficial to 69.3% of nurses. Barriers to the QI included a lack of time for staff to complete surveys, and/or hesitation to complete the survey. Conclusion: Although the overall comfort level on the topic of preeclampsia was high, having more frequent refresher training courses was highly requested on the pre-assessment survey. Furthermore, after education was provided, quantitative and qualitative data from nurses on the postpartum unit showed an increase in preeclampsia education and satisfaction with assessment frequency among nurses

Bitou bush and boneseed eradication and containment in Australia

Bitou bush and boneseed (Chrysanthemoides monilifera subsp. rotundata (DC.) T.Norl. and C. monilifera subsp. monilifera (L.) T.Norl., respectively) are highly invasive environmental weeds that pose a serious threat to Australia’s natural ecosystems and biota. Bitou bush threatens coastal plant communities in New South Wales (NSW), eastern Victoria and southeast Queensland (Qld), while boneseed threatens inland and coastal native plant communities across NSW, South Australia (SA), Tasmania, Victoria, and Western Australia (WA). Over 200 plant species and ecological communities in Australia are negatively impacted by these weeds (ARMCANZ et al. 2000, DEC 2006) and over 15% (approx. 120 million ha) of Australia is susceptible to invasion (see maps in Weiss et al 2008). In 2000, the National Bitou Bush and Boneseed Strategic Plan (ARMCANZ et al. 2000) was approved as part of the Commonwealth’s Weeds of National Significance initiative. A key goal of this plan is to prevent the spread of bitou bush and boneseed in Australia. A national program sponsored by the Australian Government and the affected states has resulted in the development of national containment and eradication zones that prevent the spread of bitou bush and boneseed. This paper presents an overview of these bitou bush and boneseed containment and eradication programs

Magnetic excitations, phase diagram and order-by-disorder in the extended triangular-lattice Hubbard model

The dynamical structure factor is an important observable of quantum magnets but due to numerical and theoretical limitations, it remains a challenge to make predictions for Hubbard-like models beyond one dimension. In this work, we study the magnetic excitations of the triangular lattice Hubbard model including next-nearest neighbor hopping. Starting from the 120$^{\circ}$ and stripe magnetic orders we compute the magnon spectra within a self-consistent random phase approximation. In the stripe phase, we generically find accidental zero modes related to a classical degeneracy known from the corresponding $J_1$-$J_2$ Heisenberg model. We extend the order-by-disorder mechanism to Hubbard systems and show how quantum fluctuations stabilize the stripe order. In addition, the frustration-induced condensation of magnon modes allows us to map out the entire phase diagram which is in remarkable agreement with recent numerical works. We discuss connections to experiments on triangular lattice compounds and the relation of our results to the proposed chiral spin liquid phase

Characterization of a population of neural progenitor cells in the infant hippocampus.

Abnormalities of the hippocampus are associated with a range of diseases in children, including epilepsy and sudden death. A population of rod cells in part of the hippocampus, the polymorphic layer of the dentate gyrus, has long been recognized in infants. Previous work suggested that these cells were microglia and that their presence was associated with chronic illness and sudden infant death syndrome. Prompted by the observations that a sensitive immunohistochemical marker of microglia used in diagnostic practice does not typically stain these cells and that the hippocampus is a site of postnatal neurogenesis, we hypothesized that this transient population of cells were not microglia but neural progenitors

Music in Scotland during three centuries (1450-1750) : being contributions towards the history of music in Scotland

"“What is your unity?”, asked a French professor, when a student presented a dissertation upon an historical subject and, if by a unity the French professor meant a binding thread by which the scattered pages of some aspect of history might be held together, his question had a useful and penetrating quality. His question seemed to demand continuity in the narrative of the matter in hand, the rejections, maybe, of irrelevant excursions and the achievement of some formal plan. If one seeks for such a unity in the story of music in Scotland, it will be found that a stern continuity does not appear. There were periods, when the cultivation of music was prevalent all over the land and amongst all classes: but there were also stretches of time when musical creation seemed to have dried up and music had an insignificant place in the artistic and social life of the country. Of the antiquity of Scottish songs and dances, there can be no doubt for, as will be seen, many of our melodies, familiar to-day, date before the Union of the Crowns and may go back to the 15th century and the few pieces of music, composed for the Scottish Church during the half century before the Reformation establishment was firmly set, are bright spots in our history. But they are few in number, and the story of music in Scotland is of a sporadic character both in performance and in creation ... This survey suffers from the same defect as many others through its incompleteness. The music of the Highlands and the Hebridean melodies have been left unexplored and, what is very regrettable, precautions, incident to the war, have caused the best musical MSS. to be unavailable in the places of safety in which they are placed. All that can be expected is that the period from 1450 to 1750 will be explored with considerable fullness and the 17th century in particular be brought into contribution for the early melodies in. our national store. What follows is not truly a history but provides contributions towards an exhaustive history. The 17th century musical MSS have been almost all examined and in some cases copied or translated into modern notation. The contents in many cases have been traced to their origins wherever possible and examples of widely varying versions of different tunes have been included." -- From the Preface

Spin-Peierls instability of the U(1) Dirac spin liquid

Quantum spin liquids are tantalizing phases of frustrated quantum magnets. A complicating factor in their realization and observation in materials is the ubiquitous presence of other degrees of freedom, in particular lattice distortion modes (phonons). These provide additional routes for relieving magnetic frustration, thereby possibly destabilizing spin-liquid ground states. In this work, we focus on triangular-lattice Heisenberg antiferromagnets, where recent numerical evidence suggests the presence of an extended U(1) Dirac spin liquid phase which is described by compact quantum electrodynamics in 2+1 dimensions (QED$_3$), featuring gapless spinons and monopoles as gauge excitations. Its low energy theory is believed to flow to a strongly-coupled fixed point with conformal symmetries. Using complementary perturbation theory and scaling arguments, we show that a symmetry-allowed coupling between (classical) finite-wavevector lattice distortions and monopole operators of the U(1) Dirac spin liquid generally induces a spin-Peierls instability towards a (confining) 12-site valence-bond solid state. We support our theoretical analysis with state-of-the-art density matrix renormalization group simulations. Away from the limit of static distortions, we demonstrate that the phonon energy gap establishes a parameter regime where the spin liquid is expected to be stable.Comment: 23 pages, 10 figure

Starting out in village schools: learning to teach in Lao PDR

This ethnographic study, which examines how four young teachers working in rural primary schools in the Lao PDR began their teaching careers, is the first study in Laos to be focused on the everyday work of beginning teachers. The study provides a contextualized account of the professional experiences of the teachers and highlights the social and cultural conditions that impacted upon them as they struggled to come to grips with the realities of the school and the classroom. The research examines how their professional experiences influenced their evolving practices and considers how, and to what extent, they were able to adjust to their new roles. Over an 18-month period of fieldwork, observations and interviews were used as the primary research methods to construct the case studies. An initial period of six months was spent in southern Laos at the Pakse Teachers’ Training College (TTC) ‘following’ a cohort of trainee-teachers over the concluding half of their one-year teacher training diploma course. Then four of the trainees, now beginning teachers, participated for a further twelve months in the study during which time the researcher made a series of week-long visits to the four villages where the teachers had been posted. During these visits 155 lessons were formally observed, 121 semi-structured interviews were conducted and extensive journal notes kept of observations and conversations. An analysis of the data found that beginning teachers each experienced similar pressures from their colleagues to conform to the established patterns and behaviours in their school. In effect the ‘community of practice’, with all its potential for nurture and guidance, operated as a ‘community of compliance’. Professional struggles which each of the beginning teachers encountered over their first year are encapsulated in the study as five ‘dilemmas’ - whether or not to respond to requests from colleagues for help; whether to report student progress accurately or not; whether to seek professional help from colleagues or whether to remain silent; whether to employ learner-centred methods or whether to keep to ‘traditional’ methods; and whether to respond to the students’ learning needs or just simply teach to the textbook like everyone else. The four beginning teachers, unpaid ‘volunteers’ with no job security, had little resilience when faced with such choices. To resolve these dilemmas and maintain social harmony the four beginning teachers each typically adopted the strategy of ‘compliance’ with the dominant practices. However, at times they also adopted a strategy of ‘compromise’ as they struggled to find ways to assist their students to learn. Through the study the professional needs of beginning teachers in small rural primary schools in Laos have been identified. Outcomes of the study are two sets of recommendations for improving the quality of teacher education in Laos, grounded in the social and cultural contexts of the schools where the beginning teachers work. The first set of recommendations are directed at reconfiguring TTC pre-service programs while the second set puts forward ideas for developing a beginning teacher workplace support program

Mammographic breast density: comparison of methods for quantitative evaluation.

PURPOSE: To evaluate the results from two software tools for measurement of mammographic breast density and compare them with observer-based scores in a large cohort of women. MATERIALS AND METHODS: Following written informed consent, a data set of 36 281 mammograms from 8867 women were collected from six United Kingdom centers in an ethically approved trial. Breast density was assessed by one of 26 readers on a visual analog scale and with two automated density tools. Mean differences were calculated as the mean of all the individual percentage differences between each measurement for each case (woman). Agreement in total breast volume, fibroglandular volume, and percentage density was assessed with the Bland-Altman method. Association with observer's scores was calculated by using the Pearson correlation coefficient (r). RESULTS: Correlation between the Quantra and Volpara outputs for total breast volume was r = 0.97 (P < .001), with a mean difference of 43.5 cm(3) for all cases representing 5.0% of the mean total breast volume. Correlation of the two measures was lower for fibroglandular volume (r = 0.86, P < .001). The mean difference was 30.3 cm(3) for all cases representing 21.2% of the mean fibroglandular tissue volume result. Quantra gave the larger value and the difference tended to increase with volume. For the two measures of percentage volume density, the mean difference was 1.61 percentage points (r = 0.78, P < .001). Comparison of observer's scores with the area-based density given by Quantra yielded a low correlation (r = 0.55, P < .001). Correlations of observer's scores with the volumetric density results gave r values of 0.60 (P < .001) and 0.63 (P < .001) for Quantra and Volpara, respectively. CONCLUSION: Automated techniques for measuring breast density show good correlation, but these are poorly correlated with observer's scores. However automated techniques do give different results that should be considered when informing patient personalized imaging. (©) RSNA, 2015 Clinical trial registration no. ISRCTN 73467396.Supported by the National Institute for Health Research’s Health Technology Assessment Programme.This is the final version of the article. It first appeared at http://pubs.rsna.org/doi/full/10.1148/radiol.1414150

Popular attitudes to memory, the body, and social identity : the rise of external commemoration in Britain, Ireland, and New England

A comparative analysis of samples of external memorials from burial grounds in Britain, Ireland and New England reveals a widespread pattern of change in monument style and content, and exponential growth in the number of permanent memorials from the 18th century onwards. Although manifested in regionally distinctive styles on which most academic attention has so far been directed, the expansion reflects global changes in social relationships and concepts of memory and the body. An archaeological perspective reveals the importance of external memorials in articulating these changing attitudes in a world of increasing material consumption