Time for nursing to eradicate hair discrimination

Nurses worldwide have been rightly lauded for their tireless contributions during the global COVID‐19 pandemic. Amid a serious global shortage, nursing remains plagued by recruitment and retention problems as it struggles to attract, educate and retain the best potential nurses who reflect the diverse composition of their communities. The world has been shaken by the Black Lives Matter movement and the growing awareness that many health professions and workplaces are pervasively white, structurally and systemically racist and must change to become welcoming, encouraging places for all members of society. Amid all of this, it is incomprehensible that black nurses in particular continue to be subjected to organisations’ discriminatory ‘hair policies’ (Grant, 2018)

Will nurse leaders help to eradicate 'hair racism' from Nursing and Health Services?

Aims Nurse managers play key roles in creating and enforcing organisational hair policies and practices. This challenging paper will provoke discussion, debate and hopefully the dismantling of racist hair policies that disproportionately target black students and nurses. Background Black people have suffered from centuries of hair racism that continues today. Unfortunately, many nurse leaders underestimate the significance of this issue, while perpetuating the injustice. Evaluation This paper is based on research literature, media reports and authors’ lived experiences regarding hair racism experienced by black people and nurses in particular. Key Issues Nurse managers often create and police organisational hair policies and dress codes. As health services pledge to eradicate racism ‘in principle’, ending discriminatory hair policies offers nurse managers a practical way to make this principle a reality. Conclusions Hair racism is real and damaging for many black nurses and has no place in a modern health service. Rather than designing and policing such structural racism, nurse managers can be instrumental in ending it. Implications for Nursing Management Health service hair policies targeting black nurses especially are not ‘neutral’. Nurse managers can challenge this institutional discrimination, demonstrating health services’ commitment to ending racism in all of its guises

Non-deforestation drivers of fires are increasingly important sources of aerosol and carbon dioxide emissions across Amazonia

Deforestation rates have declined substantially across the Brazilian Legal Amazon (BLA) over the period from 2000–2017. However, reductions in fire, aerosol and carbon dioxide have been far less significant than deforestation, even when accounting for inter-annual variability in precipitation. Our observations and analysis support a decoupling between fire and deforestation that has exacerbated forest degradation in the BLA. Basing aerosol and carbon dioxide emissions on deforestation rates, without accounting for forest degradation will bias these important climate and ecosystem-health parameters low, both now and in the future. Recent increases in deforestation rate since 2014 will enhance such degradation, particularly during drought-conditions, increasing emissions of aerosol and greenhouse gases. Given Brazil’s committed Nationally Determined Contribution under the Paris Agreement, failure to account for forest degradation fires will paint a false picture of prior progress and potentially have profound implications for both regional and global climate

Natural-color maps via automated coloring of bivariate grid data

Natural ground color is useful for reference maps as well as maps where a realistic representation of the Earth's surface matters. Natural color schemes are less likely to be misinterpreted, as opposed to hypsometric color schemes, and are generally preferred by map readers. The creation of natural-color maps was once limited to manual cartographic techniques, but they can now be created digitally with the aid of raster graphics editing software. However, the creation of natural-color maps still requires many steps, a significant time investment, and fairly detailed digital land cover information, which makes this technique impossible to apply to global web maps at medium and large scales. A particular challenge for natural-color map creation is adjusting colors with location to create smoothly blending transitions. Adjustments with location are required to show land cover transitions between climate zones with a natural appearance. This study aims to take the first step in automating the process in order to facilitate the creation of medium- and large-scale natural-color maps for the web. A coloring method based on two grid inputs is presented. Here, we introduce an algorithmic method and prototype software for creating large-scale web maps with this technique. The prototype software allows the map author to interactively assign colors and design the appearance of the map in an automated way. This software can generate web map tiles at a global level for medium and large scales. Example natural-color web maps created with this automated coloring technique are provided.Keywords: Cartography, Land cover, Bivariate maps, Color in cartography, Web mapping, Natural color map

The Hudson Bay Lithospheric Experiment (HuBLE) : Insights into Precambrian Plate Tectonics and the Development of Mantle Keels

The UK component of HuBLE was supported by Natural Environment Research Council (NERC) grant NE/F007337/1, with financial and logistical support from the Geological Survey of Canada, Canada–Nunavut Geoscience Office, SEIS-UK (the seismic node of NERC), and First Nations communities of Nunavut. J. Beauchesne and J. Kendall provided invaluable assistance in the field. Discussions with M. St-Onge, T. Skulski, D. Corrigan and M. Sanborne-Barrie were helpful for interpretation of the data. D. Eaton and F. A. Darbyshire acknowledge the Natural Sciences and Engineering Research Council. Four stations on the Belcher Islands and northern Quebec were installed by the University of Western Ontario and funded through a grant to D. Eaton (UWO Academic Development Fund). I. Bastow is funded by the Leverhulme Trust. This is Natural Resources Canada Contribution 20130084 to its Geomapping for Energy and Minerals Program. This work has received funding from the European Research Council under the European Unions Seventh Framework Programme (FP7/2007-2013)/ERC Grant agreement no. 240473 ‘CoMITAC’.Peer reviewedPublisher PD

Biomass burning aerosol over the Amazon: analysis of aircraft, surface and satellite observations using a global aerosol model

Vegetation fires emit large quantities of aerosol into the atmosphere, impacting regional air quality and climate. Previous work has used comparisons of simulated and observed aerosol optical depth (AOD) in regions heavily impacted by fires to suggest that emissions of aerosol particles from fires may be underestimated by a factor of 2–5. Here we use surface, aircraft and satellite observations made over the Amazon during September 2012, along with a global aerosol model to improve understanding of aerosol emissions from vegetation fires. We apply three different satellite-derived fire emission datasets (FINN, GFED, GFAS) in the model. Daily mean aerosol emissions in these datasets vary by up to a factor of 3.7 over the Amazon during this period, highlighting the considerable uncertainty in emissions. We find variable agreement between the model and observed aerosol mass concentrations. The model reproduces observed aerosol concentrations over deforestation fires well in the western Amazon during dry season conditions with FINN or GFED emissions and during dry–wet transition season conditions with GFAS emissions. In contrast, the model underestimates aerosol concentrations over savanna fires in the Cerrado environment east of the Amazon Basin with all three fire emission datasets. The model generally underestimates AOD compared to satellite and ground stations, even when the model reproduces the observed vertical profile of aerosol mass concentration. We suggest it is likely caused by uncertainties in the calculation of AOD, which are as large as ∼90 %, with the largest sensitivities due to uncertainties in water uptake and relative humidity. Overall, we do not find evidence that particulate emissions from fires are systematically underestimated in the Amazon region and we caution against using comparison with AOD to constrain particulate emissions from fires

Cost effectiveness analysis of clinically driven versus routine laboratory monitoring of antiretroviral therapy in Uganda and Zimbabwe.

BACKGROUND: Despite funding constraints for treatment programmes in Africa, the costs and economic consequences of routine laboratory monitoring for efficacy and toxicity of antiretroviral therapy (ART) have rarely been evaluated. METHODS: Cost-effectiveness analysis was conducted in the DART trial (ISRCTN13968779). Adults in Uganda/Zimbabwe starting ART were randomised to clinically-driven monitoring (CDM) or laboratory and clinical monitoring (LCM); individual patient data on healthcare resource utilisation and outcomes were valued with primary economic costs and utilities. Total costs of first/second-line ART, routine 12-weekly CD4 and biochemistry/haematology tests, additional diagnostic investigations, clinic visits, concomitant medications and hospitalisations were considered from the public healthcare sector perspective. A Markov model was used to extrapolate costs and benefits 20 years beyond the trial. RESULTS: 3316 (1660LCM;1656CDM) symptomatic, immunosuppressed ART-naive adults (median (IQR) age 37 (32,42); CD4 86 (31,139) cells/mm(3)) were followed for median 4.9 years. LCM had a mean 0.112 year (41 days) survival benefit at an additional mean cost of $765 [95$7386 [3277,dominated] per life-year gained and $7793 [4442,39179] per quality-adjusted life year gained. Routine toxicity tests were prominent cost-drivers and had no benefit. With 12-weekly CD4 monitoring from year 2 on ART, low-cost second-line ART, but without toxicity monitoring, CD4 test costs need to fall below$3.78 to become cost-effective (<3xper-capita GDP, following WHO benchmarks). CD4 monitoring at current costs as undertaken in DART was not cost-effective in the long-term. CONCLUSIONS: There is no rationale for routine toxicity monitoring, which did not affect outcomes and was costly. Even though beneficial, there is little justification for routine 12-weekly CD4 monitoring of ART at current test costs in low-income African countries. CD4 monitoring, restricted to the second year on ART onwards, could be cost-effective with lower cost second-line therapy and development of a cheaper, ideally point-of-care, CD4 test

An experimental model to measure the ability of headphones with active noise control to reduce patient's exposure to noise in an intensive care unit.

BACKGROUND: Defining the association between excessive noise in intensive care units, sleep disturbance and morbidity, including delirium, is confounded by the difficulty of implementing successful strategies to reduce patient's exposure to noise. Active noise control devices may prove to be useful adjuncts but there is currently little to quantify their ability to reduce noise in this complex environment. METHODS: Sound meters were embedded in the auditory meatus of three polystyrene model heads with no headphones (control), with headphones alone and with headphones using active noise control and placed in patient bays in a cardiac ICU. Ten days of recording sound levels at a frequency of 1 Hz were performed, and the noise levels in each group were compared using repeated measures MANOVA and subsequent pairwise testing. RESULTS: Multivariate testing demonstrated that there is a significant difference in the mean noise exposure levels between the three groups (p < 0.001). Subsequent pairwise testing between the three groups shows that the reduction in noise is greatest with headphones and active noise control. The mean reduction in noise exposure between the control and this group over 24 h is 6.8 (0.66) dB. The use of active noise control was also associated with a reduction in the exposure to high-intensity sound events over the course of the day. CONCLUSIONS: The use of active noise cancellation, as delivered by noise-cancelling headphones, is associated with a significant reduction in noise exposure in our model of noise exposure in a cardiac ICU. This is the first study to look at the potential effectiveness of active noise control in adult patients in an intensive care environment and shows that active noise control is a candidate technology to reduce noise exposure levels the patients experience during stays on intensive care

Nursing heroism in the 21st Century'

Abstract Background The Vivian Bullwinkel Oration honours the life and work of an extraordinary nurse. Given her story and that of her World War II colleagues, the topic of nursing heroism in the 21st century could not be more germane. Discussion Is heroism a legitimate part of nursing, or are nurses simply 'just doing their job' even when facing extreme personal danger? In this paper I explore the place and relevance of heroism in contemporary nursing. I propose that nursing heroism deserves a broader appreciation and that within the term lie many hidden, 'unsung' or 'unrecorded' heroisms. I also challenge the critiques of heroism that would condemn it as part of a 'militarisation' of nursing. Finally, I argue that nursing needs to be more open in celebrating our heroes and the transformative power of nursing achievements. Summary The language of heroism may sound quaint by 21st Century standards but nursing heroism is alive and well in the best of our contemporary nursing ethos and practice.</p

Novel molecular changes induced by Nrg1 hypomorphism and Nrg1-cannabinoid interaction in adolescence : a hippocampal proteomic study in mice

Neuregulin 1 (NRG1) is linked to an increased risk of developing schizophrenia and cannabis dependence. Mice that are hypomorphic for Nrg1 (Nrg1 HET mice) display schizophrenia relevant behavioural phenotypes and aberrant expression of serotonin and glutamate receptors. Nrg1 HET mice also display idiosyncratic responses to the main psychoactive constituent of cannabis, Δ9 -tetrahydrocannabinol (THC). To gain traction on the molecular pathways disrupted by Nrg1 hypomorphism and Nrg1-cannabinoid interactions we conducted a proteomic study. Adolescent wildtype (WT) and Nrg1 HET mice were exposed to repeated injections of vehicle or THC and their hippocampi were submitted to 2D gel proteomics. Comparison of WT and Nrg1 HET mice identified proteins linked to molecular changes in schizophrenia that have not been previously associated with Nrg1. These proteins are involved in vesicular release of neurotransmitters such as SNARE proteins; enzymes impacting serotonergic neurotransmission, and; proteins affecting growth factor expression. Nrg1 HET mice treated with THC expressed a distinct protein expression signature compared to WT mice. Replicating prior findings, THC caused proteomic changes in WT mice suggestive of greater oxidative stress and neurodegeneration. We have previously observed that THC selectively increased hippocampal NMDA receptor binding of adolescent Nrg1 HET mice. Here we observed outcomes consistent with heightened NMDA-mediated glutamatergic neurotransmission. This included differential expression of proteins involved in NMDA receptor trafficking to the synaptic membrane; lipid raft stabilization of synaptic NMDA receptors; and homeostatic responses to dampen excitotoxicity. These findings uncover for the first time novel proteins altered in response to Nrg1 hypomorphism and Nrg1-cannabinoid interactions that improves our molecular understanding of Nrg1 signaling and Nrg1-mediated genetic vulnerability to the neurobehavioural effects of cannabinoids