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

GRAIN EXPORTS AS A SOURCE OF AGRICULTURAL INSTABILITY

International Relations/Trade,

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

Spinor Dynamics-Driven Formation of a Dual-Beam Atom Laser

We demonstrate a novel dual-beam atom laser formed by outcoupling oppositely polarized components of an F=1 spinor Bose-Einstein condensate whose Zeeman sublevel populations have been coherently evolved through spin dynamics. The condensate is formed through all-optical means using a single-beam running-wave dipole trap. We create a condensate in the field-insensitive $m_F=0$ state, and drive coherent spin-mixing evolution through adiabatic compression of the initially weak trap. Such dual beams, number-correlated through the angular momentum-conserving reaction $2m_0\leftrightharpoons m_{+1}+m_{-1}$, have been proposed as tools to explore entanglement and squeezing in Bose-Einstein condensates, and have potential use in precision phase measurements.Comment: 4 pages, 4 figure

Towards Zeptosecond-Scale Pulses from X-Ray Free-Electron Lasers

The short wavelength and high peak power of the present generation of free-electron lasers (FELs) opens the possibility of ultra-short pulses even surpassing the present (tens to hundreds of attoseconds) capabilities of other light sources - but only if x-ray FELs can be made to generate pulses consisting of just a few optical cycles. For hard x-ray operation (~0.1nm), this corresponds to durations of approximately a single attosecond, and below into the zeptosecond scale. This talk will describe a novel method to generate trains of few-cycle pulses, at GW peak powers, from existing x-ray FEL facilities by using a relatively short 'afterburner'. Such pulses would enhance research opportunity in atomic dynamics and push capability towards the investigation of electronic-nuclear and nuclear dynamics. The corresponding multi-colour spectral output, with a bandwidth envelope increased by up to two orders of magnitudes over SASE, also has potential applications.Comment: Submitted to 35th International Free Electron Laser Conference, New York, 201

Transform-limited X-ray pulse generation from a high-brightness self-amplified spontaneous-emission free-electron laser

A method to achieve high-brightness self-amplified spontaneous emission (HB-SASE) in the free-electron laser (FEL) is described. The method uses repeated nonequal electron beam delays to delocalize the collective FEL interaction and break the radiation coherence length dependence on the FEL cooperation length. The method requires no external seeding or photon optics and so is applicable at any wavelength or repetition rate. It is demonstrated, using linear theory and numerical simulations, that the radiation coherence length can be increased by approximately 2 orders of magnitude over SASE with a corresponding increase in spectral brightness. Examples are shown of HB-SASE generating transform-limited FEL pulses in the soft x-ray and near transform-limited pulses in the hard x-ray. Such pulses may greatly benefit existing applications and may also open up new areas of scientific research

SIGAME simulations of the [CII], [OI] and [OIII] line emission from star forming galaxies at z ~ 6

Of the almost 40 star forming galaxies at z>~5 (not counting QSOs) observed in [CII] to date, nearly half are either very faint in [CII], or not detected at all, and fall well below expectations based on locally derived relations between star formation rate (SFR) and [CII] luminosity. Combining cosmological zoom simulations of galaxies with SIGAME (SImulator of GAlaxy Millimeter/submillimeter Emission) we have modeled the multi-phased interstellar medium (ISM) and its emission in [CII], [OI] and [OIII], from 30 main sequence galaxies at z~6 with star formation rates ~3-23Msun/yr, stellar masses ~(0.7-8)x10^9Msun, and metallicities ~(0.1-0.4)xZsun. The simulations are able to reproduce the aforementioned [CII]-faintness at z>5, match two of the three existing z>~5 detections of [OIII], and are furthermore roughly consistent with the [OI] and [OIII] luminosity relations with SFR observed for local starburst galaxies. We find that the [CII] emission is dominated by the diffuse ionized gas phase and molecular clouds, which on average contribute ~66% and ~27%, respectively. The molecular gas, which constitutes only ~10% of the total gas mass is thus a more efficient emitter of [CII] than the ionized gas making up ~85% of the total gas mass. A principal component analysis shows that the [CII] luminosity correlates with the star formation activity as well as average metallicity. The low metallicities of our simulations together with their low molecular gas mass fractions can account for their [CII]-faintness, and we suggest these factors may also be responsible for the [CII]-faint normal galaxies observed at these early epochs.Comment: 24 pages, 14 figures. Accepted for publication in the Astrophysical Journa

An ultra melt-resistant hydrogel from food grade carbohydrates

© 2017 The Royal Society of Chemistry. We report a binary hydrogel system made from two food grade biopolymers, agar and methylcellulose (agar-MC), which does not require addition of salt for gelation to occur and has very unusual rheological and thermal properties. It is found that the storage modulus of the agar-MC hydrogel far exceeds those of hydrogels from the individual components. In addition, the agar-MC hydrogel has enhanced mechanical properties over the temperature range 25-85 °C and a maximum storage modulus at 55 °C when the concentration of methylcellulose was 0.75% w/v or higher. This is explained by a sol-gel phase transition of the methylcellulose upon heating as supported by differential scanning calorimetry (DSC) measurements. Above the melting point of agar, the storage modulus of agar-MC hydrogel decreases but is still an elastic hydrogel with mechanical properties dominated by the MC gelation. By varying the mixing ratio of the two polymers, agar and MC, it was possible to engineer a food grade hydrogel of controlled mechanical properties and thermal response. SEM imaging of flash-frozen and freeze-dried samples revealed that the agar-MC hydrogel contains two different types of heterogeneous regions of distinct microstructures. The latter was also tested for its stability towards heat treatment which showed that upon heating to temperatures above 120 °C its structure was retained without melting. The produced highly thermally stable hydrogel shows melt resistance which may find application in high temperature food processing and materials templating