Recognition and management of critical illness by midwives: implications for service provision

This is the pre-peer reviewed version of the following article: Bench, Suzanne (2007) Recognition and management of critical illness by midwives: implications for service provision. Journal of Nursing Management, 15 (3). pp. 348-356. which has been published in final form at 10.1111/j.1365-2834.2007.00759.x.This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Aim  The aim of this study was to explore midwives’ recognition and management of critical illness in obstetric women in order to inform service provision. Background  Critical illness is not confined to Intensive Care. Limited published work was located examining factors affecting critical care provision by midwives. Methods  A multi-method design incorporating a paper and pencil simulation (n = 11) and in-depth interviewing (n = 5) was conducted with midwives from a large London National Health Service Trust. This study details and discusses the findings. Results  Findings indicated that frequency and type of critical illness experience impact upon midwives’ critical care knowledge and skills. Midwives, especially those who were more junior, expressed anxiety regarding this aspect of practice, and considered the support of senior midwives, medical and nursing staff as crucial to effective client management. Conclusion  This study has yielded important insights into midwives’ management of critical illness. Possible mechanisms to enhance the quality of service provision, and midwife support in this area are highlighted

Critical Care Nurses' Views and Experiences of Preanalytical Factors Influencing Point-of-Care Testing A Qualitative Study

The main users of point of care testing devices placed outside the central laboratory are clinicians, predominantly nurses. Understanding the factors influencing sample accuracy is important to ensure appropriate clinical decision making. Previous studies focus on the analysis process, however, errors can also occur during the pre-analytical phase, linked to user knowledge, skills and other factors associated with the wider context of care. This study explored adult critical care nurses’ views about point of care testing, the challenges they experience and their suggestions on how the pre-analytic phase might be improved. Using a qualitative design, four focus group discussions took place with 60 critical care nurses studying at two London based Universities between April and July 2019. Anonymized and verbatim-transcribed focus group data were uploaded into NVivo11 and underwent a standard process of inductive thematic analysis. Findings suggest that nurses’ concerns focus on three key areas: Training and competence; Sample frequency and volume; and impacts on patients, relatives and staff. Critical care nurses view POCT as a necessary task, which aids timely patient management. However, the process can detract nurses from performing other care duties. Being able to draw less blood was identified as an important way to increase patient comfort and to reduce risks. Collaborative working is key to ensure that improvements made to the pre-analytical process reflect users’ needs. Ensuring best use of nurses’ time by streamlining preanalytical processes and ensuring equipment is readily available for use is important to ensure other clinical priorities can be achieved

Clinical skills: assessing and treating shock: a nursing perspective

This document is the Accepted Manuscript version of a Published Work that appeared in final form in British Journal of Nursing copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see http://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2004.13.12.13260 This article outlines the pathophysiology associated with hypovolaemic, cardiogenic and distributive shock, and discusses how each of these might present clinically in the patient. Nursing assessment of a patient in shock is explored, and the use of tools such as the pulse oximeter are examined. The evidence base for a variety of interprofessional interventions is analysed, including fluid therapies such as blood transfusion, the use of crystalloids and colloids, and drug therapies such as the use of inotropic and vasoactive agents. The nursing role in managing the patient in shock is considered throughout. The importance of recognizing the clinical presentation of shock is highlighted, with an emphasis on understanding the pathophysiology and potential systemic effects. Treatment is discussed and covers: providing optimal oxygen therapy, appropriate patient monitoring and location of care, using effective communication skills, assisting with activities of living, psychological support, and working collaboratively to maximize the overall quality of patient care delivered

Born and Raised - Native Nevadans

This Fact Sheet highlights population shifts and investigates the adult population of Nevada counties. Data from a 2017 GOVERNING report details Nevada’s counties and their populations

Chmura Economic Diversity Index: Nevada Counties and Southwest Metros

This Fact Sheet highlights Nevada and Mountain West data from the 2018 Economic Diversity Index (EDI), prepared by Chmura Economics & Analysis the economic diversity data details the disparities within counties in Nevada. The tables below show the different levels of economic diversity that exist in Nevada’s counties and other relevant metropolitan statistical areas (MSAs)

Algorithms and Complexity Results for Persuasive Argumentation

The study of arguments as abstract entities and their interaction as introduced by Dung (Artificial Intelligence 177, 1995) has become one of the most active research branches within Artificial Intelligence and Reasoning. A main issue for abstract argumentation systems is the selection of acceptable sets of arguments. Value-based argumentation, as introduced by Bench-Capon (J. Logic Comput. 13, 2003), extends Dung's framework. It takes into account the relative strength of arguments with respect to some ranking representing an audience: an argument is subjectively accepted if it is accepted with respect to some audience, it is objectively accepted if it is accepted with respect to all audiences. Deciding whether an argument is subjectively or objectively accepted, respectively, are computationally intractable problems. In fact, the problems remain intractable under structural restrictions that render the main computational problems for non-value-based argumentation systems tractable. In this paper we identify nontrivial classes of value-based argumentation systems for which the acceptance problems are polynomial-time tractable. The classes are defined by means of structural restrictions in terms of the underlying graphical structure of the value-based system. Furthermore we show that the acceptance problems are intractable for two classes of value-based systems that where conjectured to be tractable by Dunne (Artificial Intelligence 171, 2007)

COVID-19: The Impact on Small Businesses in Nevada

This Fact Sheet presents data on the number of small businesses (fewer than 250 employees) considered at risk due to the COVID-19 outbreak. The data collected originates from the Brookings Institution, and reports the economic effect of COVID-19 on small businesses in states and counties throughout the nation. Understanding this data can help policymakers and business owners alike make strategic decisions about navigating this crisis. This Fact Sheet focuses specifically on the State of Nevada and its 17 counties

Determining Relationships Between Kinematic Sequencing and Baseball Pitch Velocity Using pitchAITM

Professional baseball pitchers have consistently been increasing pitch velocity since 2008 (the first year of automated pitch tracking and classification at all 30 MLB stadiums) and increasing the number of pitches thrown over 95mph (Sullivan, 2019). Fastball velocity is a primary risk factor for elbow injuries as there is a general linear relationship with increased elbow torques (Aguinaldo & Chambers, 2009; Chalmers et al., 2016; Slowik et al., 2019). The kinematic sequence has been referred to as the order and magnitude of joint angular velocities during the pitch delivery and has been associated with pitch velocity and elbow torque (Nicholson et al., 2022a, 2022b; Scarborough, Leonard, et al., 2021). The purpose of the research was to identify kinematic sequence metrics associated with pitch velocity and use them to predict pitch velocity using pitchAITM (Dobos et al., 2022). A total of 80 pitchers (187.2 ± 8.2 cm, age 20.1 ± 3.3 years) ranging in skill level from high school to professional baseball participated in this study. Video for pitchAITM, player height and weight were collected at 2 baseball training facilities. Extracted pitchAITM data included the peak magnitudes and relative timings of pelvis rotation velocity, trunk rotation velocity, elbow extension velocity, and shoulder internal rotation velocity. Average pitch velocity in the data set was 85.3 ± 5.7 mph or 38.1 ± 2.5 m/s. Pitch velocity was predicted using both a multilinear regression, as well as a custom neural network model. The multilinear regression generated a significant prediction for pitch velocity with an R2 = 0.368 and p < 0.01. Pitcher weight (β = 0.535, p < 0.001), peak pelvis rotational velocity timing (β = -0.157, p = 0.001), peak elbow extension timing (β = 0.122, p = 0.006), and peak shoulder internal rotation timing (β = -0.113, p = 0.018), were significant contributors to the multilinear model. The neural network model significantly predicted velocity with an R2 = 0.372, p < 0.01. Actual and predicted velocity were not significantly different (p = 0.353). In conclusion, pitchAITM kinematic sequencing can predict pitch velocity using both a multilinear regression and custom neural network