Parents’ and carers’ experiences of transition and aftercare following a child's discharge from a paediatric intensive care unit to an in-patient ward setting:A qualitative systematic review

Objectives: To explore parents’ experiences of transition and aftercare following their child’s discharge from a pediatric intensive care unit to an inpatient ward.Methods: A qualitative systematic review was conducted. Electronic databases CINAHL, MEDLINE, EMBASE, Psych INFO, and ASSIA were searched for qualitative studies with no date limits imposed. Methodological quality was assessed using the JBI QARI standardised critical appraisal instrument. Data were extracted into a standardised data extraction tool. Findings were pooled using a meta-aggregative approach.Results: Four studies were included in the final review that included a total of 95 participants. Fortynine findings were extracted and through an iterative process resulting in four synthesised findings being developed. These included: (1) Dynamic emotional response pre, peri and post-transfer; (2) Involvement in care absent but fundamental to functioning; (3) Changes in care delivery and environment provoking adverse emotions; and (4) Transition as a physical, emotional and social balancing act.Conclusion: Transitioning from the pediatric intensive care unit to an in-patient ward can be a challenging time for parents, exposing them to a turbulent emotional and social status, and depleting their personal resources. Parents are aware of differences in the organisation and delivery of care between clinical areas which can compound the adversity experienced. Health professionals need to provide targeted support in order to mitigate these negative emotional, physical and social effects experienced

Running Clean: Discharges to Groundwater Hydrologically Connected to Navigable Waters as a Means for Asserted Clean Water Act Jurisdiction

On September 24, 2018, the United States Court of Appeals for the Sixth Circuit in Tennessee Clean Water Network v. Tennessee Valley Authority, held that the Clean Water Act (CWA) does not apply when a pollutant first traveled a short distance through groundwater before entering a navigable waterway. In doing so, the court held only direct discharges into navigable waters are governed by the CWA. This Comment argues that the Sixth Circuit’s decision runs counter to the CWA’s purpose and plain meaning; furthermore, it asserts that the Tennessee Clean Water Network decision will hamper the government’s ability to hold polluters accountable by opening up a significant loophole in the CWA’s jurisdiction

Climate Torts: It’s a Conspiracy!

As public concern about climate change grows, so does frustration with the federal government’s inability to develop a strategy for reducing greenhouse gas emission. Consequently, in the past decade, multiple states and municipalities have filed lawsuits seeking to address climate change through common law claims, such as public nuisance. Courts, however, dismissed many of these suits because the Supreme Court held in 2011, in American Electric Power Company v. Connecticut, that the Clean Air Act governs greenhouse gas emissions and therefore displaces the common law as a cause of action. Despite this unfavorable precedent, the past three years produced numerous new climate-related lawsuits against fossil fuel companies. Almost all these cases cite the fossil fuel industry’s decision to misrepresent and conceal the link between their products and climate change as a driving impetus for the lawsuits. Nevertheless, plaintiffs continue to base their complaints on the perilous legal foundation of public nuisance. This Note argues that plaintiffs seeking to hold fossil fuel companies accountable for climate change should instead bring causes of action for civil conspiracy and fraud. By combining civil conspiracy with fraudulent misrepresentation and fraudulent concealment, plaintiffs can require companies to pay for what has consistently delayed climate action: disinformation about the nature and causes of climate change

Computational Complexity of Geometric Symmetry Detection in Graphs

Constructing a visually informative drawing of an abstract graph is a problem of considerable practical importance, and has recently been the focus of much investigation. Displaying symmetry has emerged as one of the foremost criteria for achieving good drawings. Linear-time algorithms are already known for the detection and display of symmetry in trees, outerplanar graphs, and embedded planar graphs. The central results of this paper show that for general graphs, however, detecting the presence of even a single axial or rotational symmetry is NP-complete. A number of related results are also established, including the #P-completeness of counting the axial or rotational symmetries of a graph

The preparation of solid derivatives of monoalkyl ethers of ethylene glycol and diethylene glycol

Thesis (Ph.D.)--Boston UniversityIn the identification of any organic compound the final step is the formation of a solid derivative. This work was undertaken therefore, in an attempt to prepare solid compounds of the monoalkyl ethers of ethylene glycol and diethylene glycol which would be suitable for identification. Although several methods were tried, only two appeared to be suitable. The urethanes obtained by the use of p-nitrophenyl isocyanate and the picrates of the amino-ethers which resulted from the use of the 2-(4-morpholinyl)-ethyl chloride were, alone, applicable to analysis work

Transition of care from children’s to adult services

Transition service development is high on the agenda in contemporary healthcare improvement and there is a wealth of literature focusing on the shortcomings of many existing transition services. This literature review aims at identify and summarise research on the issues and needs surrounding transitional care from children’s to adult services, and to explore, critique and evaluate the effectiveness of interventions, processes and systems relating to supporting transitions for young people between children’s and adult services.Many studies focus on the transition of young people from children’s to adult services. Some areas of transitional care have been researched thoroughly, including the self-reported experiences of young people. A large number of studies have explored specific interventions aimed at young people and healthcare systems. A single approach or intervention to support transition appears to be neither beneficial for all young people, nor appropriate for all services. The effect of specific interventions is largely inconclusive

Increased human pathogenic potential of Escherichia coli from polymicrobial urinary tract infections in comparison to isolates from monomicrobial culture samples

The current diagnostic standard procedure outlined by the Health Protection Agency for urinary tract infections (UTIs) in clinical laboratories does not report bacteria isolated from samples containing three or more different bacterial species. As a result many UTIs go unreported and untreated, particularly in elderly patients, where polymicrobial UTI samples are especially prevalent. This study reports the presence of the major uropathogenic species in mixed culture urine samples from elderly patients, and of resistance to front-line antibiotics, with potentially increased levels of resistance to ciprofloxacin and trimethoprim. Most importantly, the study highlights that Escherichia coli present in polymicrobial UTI samples are statistically more invasive (P<0.001) in in vitro epithelial cell infection assays than those isolated from monomicrobial culture samples. In summary, the results of this study suggest that the current diagnostic standard procedure for polymicrobial UTI samples needs to be reassessed, and that E. coli present in polymicrobial UTI samples may pose an increased risk to human health