The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews.

BACKGROUND: Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing. METHODS: Reviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised. RESULTS: Nine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant. CONCLUSIONS: In making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave. TRIAL REGISTRATION: PROSPERO Registration 17 March 2015: CRD42015017613

Genetic susceptibility to burnout in a Swedish twin cohort

Most previous studies of burnout have focused on work environmental stressors, while familial factors so far mainly have been overlooked. The aim of the study was to estimate the relative importance of genetic influences on burnout (measured with Pines Burnout Measure) in a sample of monozygotic (MZ) and dizygotic (DZ) Swedish twins. The study sample consisted of 20,286 individuals, born 1959–1986 from the Swedish twin registry who participated in the cross-sectional study of twin adults: genes and environment. Probandwise concordance rates (the risk for one twin to be affected given that his/her twin partner is affected by burnout) and within pair correlations were calculated for MZ and DZ same—and opposite sexed twin pairs. Heritability coefficients i.e. the proportion of the total variance attributable to genetic factors were calculated using standard biometrical model fitting procedures. The results showed that genetic factors explained 33% of the individual differences in burnout symptoms in women and men. Environmental factors explained a substantial part of the variation as well and are thus important to address in rehabilitation and prevention efforts to combat burnout

Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology

Contains fulltext : 97171.pdf (postprint version ) (Open Access)BACKGROUND: Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. METHODS/DESIGN: A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences.This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce. DISCUSSION: RN4CAST is one of the largest nurse workforce studies ever conducted in Europe, will add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe

The look of the con: Eleven thoughts on the historical absence of subtitles in film analysis

This article considers the lack of dialogue between Audio-Visual Translation and Film & Media Studies, despite the fact that both disciplines clearly have shared interests in the content of audio-visual texts. The apparent lack of any developed and consistent overlap between these areas of study is the starting point for a series of eleven ‘thoughts' that identify commonalities and differences in how film and television texts might be studied and analysed. Inspired and led by the specific example of a scene from Ocean’s Eleven (2001), the article explores the potential for interdisciplinary research collaborations through ideas of authorship, genre, history, technology, industry labour, and reception and audience studies. While identifying areas where different theories might clash or complicate collaboration, the article also highlights potent areas where shared experience and different perspectives could enrich both fields

Pros and cons of different therapeutic antibody formats for recombinant antivenom development.

Antibody technologies are being increasingly applied in the field of toxinology. Fuelled by the many advances in immunology, synthetic biology, and antibody research, different approaches and antibody formats are being investigated for the ability to neutralize animal toxins. These different molecular formats each have their own therapeutic characteristics. In this review, we provide an overview of the advances made in the development of toxin-targeting antibodies, and discuss the benefits and drawbacks of different antibody formats in relation to their ability to neutralize toxins, pharmacokinetic features, propensity to cause adverse reactions, formulation, and expression for research and development (R&D) purposes and large-scale manufacturing. A research trend seems to be emerging towards the use of human antibody formats as well as camelid heavy-domain antibody fragments due to their compatibility with the human immune system, beneficial therapeutic properties, and the ability to manufacture these molecules cost-effectively

Comment André Breton a suicidé Jacques Vaché

Cet article retrace comme André Breton (avec l\u27aide de Louis Aragon) construit la thèse du suicide de Jacques Vaché, personnage sur lequel il fonde la mythologie du surréalisme

Separation and Characterisation of the C

The purpose of this work is to isolate and characterise the light fraction of Safaniya, a conventional nonbiodegraded type II crude oil. This fraction is devoted to perform a kinetic study on the thermal stability of the light aromatic fraction of crude oil. The light cut <250°C, corresponding to the C15- components, was obtained by fractionated distillation. This cut contains saturated and aromatic hydrocarbons. Kinetic studies on the thermal stability of aromatics require to separate the aromatic fraction without any trace of saturated compounds and derive detailed information on its composition. We have therefore developed a method permitting to achieve a clear-cut separation of these two families. Liquid phase chromatography on activated silica gel column was thus optimised for separating a complete and pure aromatic fraction, in large enough amounts for characterisation and all subsequent kinetic studies. Thereafter, Preparative High Performance Liquid Chromatography (PHPLC) of an aliquot was used to separate the aromatic compounds according to aromatic ring number into monoaromatics, indenes, diaromatics and biphenyls. Detailed molecular characterisation of the aromatic sub-fractions thus obtained was achieved by Gas Chromatography coupled to Mass Spectrometry (GC/MS). Then, individual aromatic compounds were quantified by GC-FID. These compounds are benzene, C1-C7 benzenes, naphthalene, C1-C7 naphthalenes, indane, C1-C4 indanes, indene, C1-C7 indenes, C1-C3 tetralins and and sulphur-containing aromatics (methyl- and ethylbenzothiophenes). The detailed knowledge thus derived on the composition of different class and its relative abundance in the total C15- aromatics will allow following its temporal evolution during subsequent pyrolysis experiments

Inadequate teamwork and burnoutas predictors of intent to leave nursing according to seniority. Stability of associations in a one-year intervalin the European NEXT Study.

Contains fulltext : 138772.pdf (publisher's version ) (Open Access)9 p