Nursing Satisfaction with the Electronic Medical Record: Implementing Meaningful Change at Seattle Children\u27s Hospital

Purpose: The purpose of this study is to describe nursing use, quality, and satisfaction with the electronic medical record before and during the course of the electronic medical record transition. In addition, this study examines the differences between nurse age, role, and area of work as these demographics relate to nursing use, quality, and satisfaction. Background: Nurses spend a large part of their shift using technology, including the electronic medical record, however the use, quality, and satisfaction of this tool as it relates to the nursing profession has not been formally evaluated. Methods: The design of this study is an analytic observational cohort study. Data was collected via survey responses from the nursing staff at Seattle Children’s Hospital pre and post a series of nursing led electronic medical record design sessions. Results: Nursing care coordinators reported the highest satisfaction (3.9 ± 0.9). Acute care RNs reported the highest satisfied clinical area (3.8 ± 0.9), and the highest satisfied age range was 60+ (3.6 ± 0.9). Finally, the highest satisfied tenure range occurred between 6-10 years (3.7 ± 1.0). Conclusion: There are differences between nursing satisfaction with the electronic medical record based on demographic variables. In addition, formatively evaluating nursing satisfaction with the electronic medical record represents a useful exercise that could benefit both individual organizations as well as the field of nursing informatics

Bacteriocins: Novel Solutions to Age Old Spore-Related Problems?

peer-reviewedBacteriocins are ribosomally synthesized antimicrobial peptides produced by bacteria, which have the ability to kill or inhibit other bacteria. Many bacteriocins are produced by food grade lactic acid bacteria (LAB). Indeed, the prototypic bacteriocin, nisin, is produced by Lactococcus lactis, and is licensed in over 50 countries. With consumers becoming more concerned about the levels of chemical preservatives present in food, bacteriocins offer an alternative, more natural approach, while ensuring both food safety and product shelf life. Bacteriocins also show additive/synergistic effects when used in combination with other treatments, such as heating, high pressure, organic compounds, and as part of food packaging. These features are particularly attractive from the perspective of controlling sporeforming bacteria. Bacterial spores are common contaminants of food products, and their outgrowth may cause food spoilage or food-borne illness. They are of particular concern to the food industry due to their thermal and chemical resistance in their dormant state. However, when spores germinate they lose the majority of their resistance traits, making them susceptible to a variety of food processing treatments. Bacteriocins represent one potential treatment as they may inhibit spores in the post-germination/outgrowth phase of the spore cycle. Spore eradication and control in food is critical, as they are able to spoil and in certain cases compromise the safety of food by producing dangerous toxins. Thus, understanding the mechanisms by which bacteriocins exert their sporostatic/sporicidal activity against bacterial spores will ultimately facilitate their optimal use in food. This review will focus on the use of bacteriocins alone, or in combination with other innovative processing methods to control spores in food, the current knowledge and gaps therein with regard to bacteriocin-spore interactions and discuss future research approaches to enable spores to be more effectively targeted by bacteriocins in food settings.KE, DF, CH, PC, MR, RR are supported by the Irish Government under the National Development Plan, through the Food Institutional Research Measure, administered by the Department of Agriculture, Fisheries and Food, Ireland (DAFM 13/F/462) to PC and MR, a Science Foundation Ireland (SFI) Technology and Innovation Development Award (TIDA 14/TIDA/2286) to DF, SFI-PI funding (11/PI/1137) to PDC and the APC Microbiome Insitute under Grant Number SFI/12/RC/2273

Direct pion-nucleus interactions in the resonance region

Bibliography: pages 141-143.The direct reactions of pions with nuclei in the energy region of the πN(3,3) resonance are examined in the eikonal formalism. In particular, the angular and energy dependence of the elastic scattering of πsup(+-) from the calcium isotopes 40Ca, 48Ca is studied, using a detailed phenomenological approach. Excellent agreement is obtained with experimental data. A closely related investigation is also made of the inelastic excitation of low-lying collective states of 40Ca, 48Ca by pions. The resulting one-parameter fits yield deformation lengths which are compared with simple collective model predictions. The total cross-sections for neutral pion scattering from 40Ca, 48Ca in the resonance region are investigated as well, and predictions are mad

'Against the World': Michael Field, female marriage and the aura of amateurism'

This article considers the case of Katherine Bradley and Edith Cooper, an aunt and niece who lived and wrote together as ‘Michael Field’ in the fin-de-siècle Aesthetic movement. Bradley’s bold statement that she and Cooper were ‘closer married’ than the Brownings forms the basis for a discussion of their partnership in terms of a ‘female marriage’, a union that is reflected, as I will argue, in the pages of their writings. However, Michael Field’s exclusively collaborative output, though extensive, was no guarantee for success. On the contrary, their case illustrates the notion, valid for most products of co-authorship, that the jointly written work is always surrounded by an aura of amateurism. Since collaboration defied the ingrained notion of the author as the solitary producer of his or her work, critics and readers have time and again attempted to ‘parse’ the collaboration by dissecting the co-authored work into its constituent halves, a treatment that the Fields too failed to escape

El Nino Influence on Holocene Reef Accretion in Hawai'i

New observations of reef accretion from several locations show that in Hawai'i accretion during early to middle Holocene time occurred in areas where today it is precluded by the wave regime, suggesting an increase in wave energy. Accretion of coral and coralline algae reefs in the Hawaiian Islands today is largely controlled by wave energy. Many coastal areas in the main Hawaiian Islands are periodically exposed to large waves, in particular from North Pacific swell and hurricanes. These are of sufficient intensity to prevent modern net accretion as evidenced by the antecedent nature of the seafloor. Only in areas sheltered from intense wave energy is active accretion observed. Analysis of reef cores reveals patterns of rapid early Holocene accretion in several locations that terminated by middle Holocene time, ca. 5000 yr ago. Previous analyses have suggested that changes in Holocene accretion were a result of reef growth "catching up" to sea level. New data and interpretations indicate that the end of reef accretion in the middle Holocene may be influenced by factors in addition to sea level. Reef accretion histories from the islands of Kaua'i, O'ahu, and Moloka'i may be interpreted to suggest that a change in wave energy contributed to the reduction or termination of Holocene accretion by 5000 yr ago in some areas. In these cases, the decrease in reef accretion occurred before the best estimates of the decrease in relative sea-level rise during the mid-Holocene high stand of sea level in the main Hawaiian Islands. However, reef accretion should decrease following the termination of relative sea-level rise (ca. 3000 yr ago) if reef growth were "catching up" to sea level. Evidence indicates that rapid accretion occurred at these sites in early Holocene time and that no permanent accretion is occurring at these sites today. This pattern persists despite the availability of hard substrate suitable for colonization at a wide range of depths between -30 m and the intertidal zone. We infer that forcing other than relative sea-level rise has altered the natural ability to support reef accretion on Hawaiian insular shelves. The limiting factor in these areas today is wave energy. Numbers of both large North Pacific swell events and hurricanes in Hawai'i are greater during El Nino years. We infer that if these major reef-limiting forces were suppressed, net accretion would occur in some areas in Hawai'i that are now wave-limited. Studies have shown that El Nino/Southern Oscillation (ENSO) was significantly weakened during early-mid Holocene time, only attaining an intensity similar to the current one ca. 5000 yr ago. We speculate that this shift in ENSO may assist in explaining patterns of Holocene Hawaiian reef accretion that are different from those of the present and apparently not related to relative sea-level rise

Light quark distributions in the proton sea

We use the meson cloud model to calculate $\bar{d}(x) - \bar{u}(x)$ and $\bar{d}(x)/\bar{u}(x)$ in the proton. We show that a modification of the symmetric, perturbative part of the light quark sea provides better agreement with the ratio $ \bar{d}(x)/\bar{u}(x).Comment: 4 pages, 2 figures, LaTeX. Talk presented at PANIC 9

Nisin in Combination with Cinnamaldehyde and EDTA to Control Growth of Escherichia coli Strains of Swine Origin

peer-reviewedPost-weaning diarrhoea (PWD) due to enterotoxigenic Escherichia coli (ETEC) is an economically important disease in pig production worldwide. Although antibiotics have contributed significantly to mitigate the economic losses caused by PWD, there is major concern over the increased incidence of antimicrobial resistance among bacteria isolated from pigs. Consequently, suitable alternatives that are safe and effective are urgently required. Many naturally occurring compounds, including the antimicrobial peptide nisin and a number of plant essential oils, have been widely studied and are reported to be effective as antimicrobial agents against pathogenic microorganisms. Here, we evaluate the potential of nisin in combination with the essential oil cinnamaldehyde and ethylenediaminetetraacetic acid (EDTA) to control the growth of E. coli strains of swine origin including two characterized as ETEC. The results reveal that the use of nisin (10 μM) with low concentrations of trans-cinnamaldehyde (125 μg/mL) and EDTA (0.25–2%) resulted in extended lag phases of growth compared to when either antimicrobial is used alone. Further analysis through kill curves revealed that an approximate 1-log reduction in E. coli cell counts was observed against the majority of targets tested following 3 h incubation. These results highlight the potential benefits of combining the natural antimicrobial nisin with trans-cinnamaldehyde and EDTA as a new approach for the inhibition of E. coli strains of swine origin

Reduced state conducting polymers

The work presented in this thesis is concerned with reduced state conducting polymers, and in particular with poly(pyridine). The electroreductive polymerisation of 2,5-dibromopyridine based on either the Ni(⁰)(PPh₃)₄] or [Ni(⁰)(bpy)₃ClO₄)₂] systems was investigated. The results obtained via both routes are discussed in terms of their respective mechanisms. The initial steps of the polymerisation based on the latter system are analysed using a specially developed kinetic theory. Although the theory was designed specifically to better understand the mechanism of electrosynthesis of poly(pyridine), it has a broader usage for the electrochemist because it describes the limiting current responses of second order ECE reactions at RDEs. The nature of poly(pyridine) prepared by both routes is investigated, and the results obtained are discussed in terms of their structural implications. Although the definitive nature of the polymers is still unclear, a particularly interesting possibility is that the polymers prepared from the [Ni(⁰)(bpy)₃ClO₄)₂]/2,5-Br₂Py/TEAP/AN system are “pyridylonickel strings”. The electrosynthesis of poly(azines) using the [Ni(⁰)(bpy)₃ClO₄)₂]route is reported, and demonstrates that this strategy can be successfully exploited in the preparation of novel reduced state conducting polymers. Suggestions for further work forming an extension to this thesis are given in the final chapter

Bacteriocin-Antimicrobial Synergy: A Medical and Food Perspective

peer-reviewedThe continuing emergence of multi-drug resistant pathogens has sparked an interest in seeking alternative therapeutic options. Antimicrobial combinatorial therapy is one such avenue. A number of studies have been conducted, involving combinations of bacteriocins with other antimicrobials, to circumvent the development of antimicrobial resistance and/or increase antimicrobial potency. Such bacteriocin-antimicrobial combinations could have tremendous value, in terms of reducing the likelihood of resistance development due to the involvement of two distinct mechanisms of antimicrobial action. Furthermore, antimicrobial synergistic interactions may also have potential financial implications in terms of decreasing the costs of treatment by reducing the concentration of an expensive antimicrobial and utilizing it in combination with an inexpensive one. In addition, combinatorial therapies with bacteriocins can broaden antimicrobial spectra and/or result in a reduction in the concentration of an antibiotic required for effective treatments to the extent that potentially toxic or adverse side effects can be reduced or eliminated. Here, we review studies in which bacteriocins were found to be effective in combination with other antimicrobials, with a view to targeting clinical and/or food-borne pathogens. Furthermore, we discuss some of the bottlenecks which are currently hindering the development of bacteriocins as viable therapeutic options, as well as addressing the need to exercise caution when attempting to predict clinical outcomes of bacteriocin-antimicrobial combinations.HM is a researcher in Teagasc Food Research Centre and the APC Microbiome Institute, funded by the Science Foundation of Ireland (SFI)-funded Centre for Science, Engineering and Technology and the APC Microbiome Institute Grant Number SFI/12/RC/2273. Research in PC, CH, MR, and RP laboratories is supported by the Science Foundation of Ireland (SFI)-funded Centre for Science, Engineering and Technology and the APC Microbiome Institute