Tougher Laws, Too Few Prosecutions? A Mixed Methods Study of Nurses’ Experiences Regarding the Reporting of Occupational Violence to the Police

ProblemAssaults on nurses by patients are common. To deter occupational violence against nurses, assaults attract penalties of longer imprisonment in many jurisdictions (domestically and internationally). However, the deterrent value of harsher penalties has been questioned when many assaults are underreported.AimTo identify the barriers and enablers to the reporting and prosecution of assaults experienced by nurses.MethodsIn this study participants were recruited using a snowballing technique through health workforce emails, social media channels, and professional organisations. The investigator-developed survey prompted for categorical and open-ended responses. Descriptive and qualitative content analyses were used to analyse the study data.FindingsOf the N = 275 respondents, n = 237 nurses had been assaulted at work. Assaulted nurses were typically female, over 31 years old, had more than five years of nursing experience, and worked in an emergency department. Overwhelmingly, nurses indicated receiving poor support when they wanted to report an assault to the police. Dominant themes (N = 6) identified systemic barriers that hinder criminal reporting, which was found to be a consequence of organisational and policing lapses, and self-limiting nursing culture.DiscussionThis study identified several barriers for nurses to report and prosecute assaultive patients in Australia. The barriers point to a strong imperative for organisations that employ nurses and police to fulfil their responsibilities to enable and support assaulted nurses to prosecute.ConclusionThe study findings led to important recommendations for organisations and police to support, encourage, and empower nurses to prosecute assaultive patients, and ultimately deter violence

A Physically-based, Subgrid Parametrization for the Production and Maintenance of Mixed-phase Clouds in a General Circulation Model

A physically based method for parametrizing the role of subgrid scale turbulence in the production and maintenance of supercooled liquid water and mixed-phase clouds is presented. The approach used is to simplify the dynamics of supersaturation fluctuations to a stochastic differential equation that can be solved analytically, giving increments to the prognostic liquid cloud fraction and liquid water content fields in a General Circulation Model (GCM). Elsewhere, it has been demonstrated that the approach captures the properties of decameter-resolution Large Eddy Simulations of a turbulent mixed-phase environment. In this paper it is shown that it can be implemented in a GCM and the effects that this has on Southern Ocean biases and on Arctic stratus are investigated

General practitioners' use and experiences of palliative care services: a survey in south east England

<p>Abstract</p> <p>Background</p> <p>The role of the General Practitioner (GP) is central to community palliative care. Good liaison between the different professionals involved in a patient's care is extremely important in palliative care patients. In cases where GPs have previously been dissatisfied with palliative services, this may be seen as a barrier to referral when caring for other patients. The aim of this survey is to investigate the use and previous experiences of GPs of two palliative care services, with particular emphasis on barriers to referral and to explore issues surrounding the GP's role in caring for palliative patients.</p> <p>Methods</p> <p>Design: Descriptive postal survey of use and experience of palliative care services with particular emphasis on barriers to referral. Setting: One Primary Care Trust (PCT), south London, England, population 298,500. Subjects: 180 GPs in the PCT, which is served by two hospice services (A&B).</p> <p>Results</p> <p>An overall questionnaire response rate of 77% (138) was obtained, with 69% (124) used in analysis. Over 90% of GPs were satisfied with the palliative care services over the preceding two years. Two areas of possible improvement emerged; communication and prescribing practices. GPs identified some patients that they had not referred, most commonly when patients or carers were reluctant to accept help, or when other support was deemed sufficient. Over half of the GPs felt there were areas where improvement could be made; with clarification of the rules and responsibilities of the multi disciplinary team being the most common. The majority of GPs were working, and want to work with, the specialist services as part of an extended team. However, a greater number of GPs want to hand over care to the specialist services than are currently doing so.</p> <p>Conclusion</p> <p>A large number of GPs were happy with the service provision of the palliative care services in this area. They suggested that 3 out of 4 terminally ill patients needed specialist input. Views of services were largely positive, and reasons for non referral were unrelated to previous experience of the specialist services.</p

Using keystroke logging to understand writers’ processes on a reading-into-writing test

Background Integrated reading-into-writing tasks are increasingly used in large-scale language proficiency tests. Such tasks are said to possess higher authenticity as they reflect real-life writing conditions better than independent, writing-only tasks. However, to effectively define the reading-into-writing construct, more empirical evidence regarding how writers compose from sources both in real-life and under test conditions is urgently needed. Most previous process studies used think aloud or questionnaire to collect evidence. These methods rely on participants’ perceptions of their processes, as well as their ability to report them. Findings This paper reports on a small-scale experimental study to explore writers’ processes on a reading-into-writing test by employing keystroke logging. Two L2 postgraduates completed an argumentative essay on computer. Their text production processes were captured by a keystroke logging programme. Students were also interviewed to provide additional information. Keystroke logging like most computing tools provides a range of measures. The study examined the students’ reading-into-writing processes by analysing a selection of the keystroke logging measures in conjunction with students’ final texts and interview protocols. Conclusions The results suggest that the nature of the writers’ reading-into-writing processes might have a major influence on the writer’s final performance. Recommendations for future process studies are provided

Jet-veto in bottom-quark induced Higgs production at next-to-next-to-leading order

We present results for associated Higgs+n-jet production in bottom quark annihilation, for n=0 and n>=1 at NNLO and NLO accuracy, respectively. We consider both the cases with and without b-tagging. Numerical results are presented for parameters relevant for experiments at the LHC.Comment: 27 pages, 13 figures, 8 table

Cumulative Risk Effects in the Bullying of Children and Young People with Autism Spectrum Conditions

Students with autism are more likely to be bullied than their typically developing peers. However, several studies have shown that their likelihood of being bullied increases in the context of exposure to certain risk factors (e.g. behaviour difficulties, poor peer relationships). This study explores vulnerability to bullying from a cumulative risk perspective, where the number of risks rather than their nature is considered. 722 teachers and 119 parents of young people with ASC participated in the study. Established risk factors were summed to form a cumulative risk score in teacher and parent models. There was evidence of a cumulative risk effect in both models, suggesting that as the number of risks increased, so did exposure to bullying. A quadratic effect was found in the teacher model, indicating that there was a disproportionate increase in the likelihood of being bullied in relation to the number of risk factors to which a young person was exposed. In light of these findings, it is proposed that more attention needs to be given to the number of risks to which children and young people with ASC are exposed when planning interventions and providing a suitable educational environment

Symptoms of gastroesophageal reflux disease in severely mentally retarded people: a systematic review

<p>Abstract</p> <p>Background</p> <p>Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently backs up (or refluxes) into the gullet (or esophagus), and it has serious consequences for the quality of life. Usually this is felt as heartburn. Because severely mentally retarded people usually do not utter complaints of heartburn, it requires a high index of suspicion to discover possible GERD. Therefore it is relevant for care professionals such as nurses to have knowledge of those with a higher risk of GERD and of the possible manifestations of GERD.</p> <p>Methods</p> <p>Using a predefined search method, electronic databases were searched for studies relating the presence of symptoms to the presence of GERD. Relevant data were extracted and the methodological quality of the studies assessed. The results of the included studies were synthesized and conclusions about the level of evidence were drawn.</p> <p>Results</p> <p>Nineteen studies were found relating symptoms to the presence of GERD. Only four were of good methodological quality. The studies were very diverse concerning the studied population, the study method, and the kind of symptoms examined. This makes it difficult to synthesize the results of the studies. There is evidence that patients with cerebral palsy, patients using anticonvulsive drugs, and those with an IQ lower than 35 more frequently have GERD. There is also evidence that vomiting, rumination and hematemesis are associated with a higher risk of the presence of GERD, whereas there is no clear scientific evidence that particular behavior symptoms are indicative for GERD.</p> <p>Conclusion</p> <p>The possible manifestations of GERD are many and varied. A guideline will be made for care professionals to aid systematic observation of possible manifestations of GERD.</p

Observations of the Askaryan Effect in Ice

We report on the first observations of the Askaryan effect in ice: coherent impulsive radio Cherenkov radiation from the charge asymmetry in an electromagnetic (EM) shower. Such radiation has been observed in silica sand and rock salt, but this is the first direct observation from an EM shower in ice. These measurements are important since the majority of experiments to date that rely on the effect for ultra-high energy neutrino detection are being performed using ice as the target medium. As part of the complete validation process for the Antarctic Impulsive Transient Antenna (ANITA) experiment, we performed an experiment at the Stanford Linear Accelerator Center (SLAC) in June 2006 using a 7.5 metric ton ice target, yielding results fully consistent with theoretical expectations

New Limits on the Ultra-high Energy Cosmic Neutrino Flux from the ANITA Experiment

We report initial results of the first flight of the Antarctic Impulsive Transient Antenna (ANITA-1) 2006-2007 Long Duration Balloon flight, which searched for evidence of a diffuse flux of cosmic neutrinos above energies of 3 EeV. ANITA-1 flew for 35 days looking for radio impulses due to the Askaryan effect in neutrino-induced electromagnetic showers within the Antarctic ice sheets. We report here on our initial analysis, which was performed as a blind search of the data. No neutrino candidates are seen, with no detected physics background. We set model-independent limits based on this result. Upper limits derived from our analysis rule out the highest cosmogenic neutrino models. In a background horizontal-polarization channel, we also detect six events consistent with radio impulses from ultra-high energy extensive air showers.Comment: 4 pages, 2 table