(Re) evaluating Critical Care Nurse Support Program(s) in a Tertiary Care Hospital: Intersecting the Art and Science of Nursing

There is a growing critical care nurse staffing shortage with increases in nurse vacancy rates. Moral distress has been exacerbated by the SARS-CoV-2 (COVID-19) pandemic and, in particular, impacting critical care nurses. COVID-19 is a significant contributor to staffing shortages and continued nursing crisis. Thus, the impetus for the Problem of Practice (PoP): the lack of support to address the psychological, emotional, and spiritual distress suffered by critical care registered nurses in a tertiary care hospital in Central Ontario. To comprehend the realities of working in the intensive care units, leaders must first understand nurses’ lived experiences, narratives, and what it means to work on the frontline in an intensive care unit. The Organizational Improvement Plan (OIP) is underpinned by interpretive phenomenology and authentic and transformational leadership approaches. Lewin’s three-stage force field model of change theory is utilized for leading change and Burke and Litwin’s performance change model for the organizational analysis. The overall goal of the OIP is to implement a change plan that brings leaders and critical care registered nurses together to co-create support program(s) to address critical care nurses’ psychological, emotional, and spiritual distress, decrease nurse attrition, and enhance critical care nurses’ well-being

Pressure profiles of distant galaxy clusters in the Planck catalog

Successive releases of Planck data have demonstrated the strength of the Sunyaev--Zeldovich (SZ) effect in detecting hot baryons out to the galaxy cluster peripheries. To infer the hot gas pressure structure from nearby galaxy clusters to more distant objects, we developed a parametric method that models the spectral energy distribution and spatial anisotropies of both the Galactic thermal dust and the Cosmic Microwave Background, that are mixed-up with the cluster SZ and dust signals. Taking advantage of the best angular resolution of the High Frequency Instrument channels (5 arcmin) and using X-ray priors in the innermost cluster regions that are not resolved with Planck, this modelling allowed us to analyze a sample of 61 nearby members of the Planck catalog of SZ sources ($0 < z < 0.5$, $\tilde{z} = 0.15$) using the full mission data, as well as to examine a distant sample of 23 clusters ($0.5 < z < 1$, $\tilde{z} = 0.56$) that have been recently followed-up with XMM-Newton and Chandra observations. We find that (i) the average shape of the mass-scaled pressure profiles agrees with results obtained by the Planck collaboration in the nearby cluster sample, and that (ii) no sign of evolution is discernible between averaged pressure profiles of the low- and high-redshift cluster samples. In line with theoretical predictions for these halo masses and redshift ranges, the dispersion of individual profiles relative to a self-similar shape stays well below 10 % inside $r_{500}$ but increases in the cluster outskirts.Comment: 12 pages, 10 figure

Selecting background galaxies in weak-lensing analysis of galaxy clusters

In this paper, we present a new method to select the faint, background galaxies used to derive the mass of galaxy clusters by weak lensing. The method is based on the simultaneous analysis of the shear signal, that should be consistent with zero for the foreground, unlensed galaxies, and of the colors of the galaxies: photometric data from the COSMic evOlution Survey are used to train the color selection. In order to validate this methodology, we test it against a set of state-of-the-art image simulations of mock galaxy clusters in different redshift [$0.23-0.45$] and mass [$0.5-1.55\times10^{15}M_\odot$] ranges, mimicking medium-deep multicolor imaging observations (e.g. SUBARU, LBT). The performance of our method in terms of contamination by unlensed sources is comparable to a selection based on photometric redshifts, which however requires a good spectral coverage and is thus much more observationally demanding. The application of our method to simulations gives an average ratio between estimated and true masses of $\sim 0.98 \pm 0.09$. As a further test, we finally apply our method to real data, and compare our results with other weak lensing mass estimates in the literature: for this purpose we choose the cluster Abell 2219 ($z=0.228$), for which multi-band (BVRi) data are publicly available.Comment: MNRAS, Accepted 2016 February 2

Do Flexible Employment Contracts Change Household Income Differences in Italy?

This paper examines whether the growing use of non-permanent contracts may have in uenced the intra-family income differences in Italy over time. After the 1996, a number of reforms were implemented to reduce the levels of employment protection. Thus we aim at providing evidence on the determinants of potential changes to personal level of income before and after the introduction of such rules. In particular, we calculate the contribution of each individual within the family using two Italian longitudinal data (namely ECHP and IT-Silc). We perform estimations for men and women, separately. Our results conrm that the amount of contribution changes over the span considered. Fathers are generally more likely to support other family members. Sons are instead money receivers, and the magnitude of the coefficient is especially large when labour market exibility has been already introduced. Individuals with part time temporary contracts face less favourable financial conditions. Finally, those who are out of the labour market (i.e. retired, unemployed, inactive) contribute negatively within the family

Non-hydrostatic gas in the core of the relaxed galaxy cluster A1795

Chandra data on A1795 reveal a mild edge-shaped discontinuity in the gas density and temperature in the southern sector of the cluster at r=60/h kpc. The gas inside the edge is 1.3-1.5 times denser and cooler than outside, while the pressure is continuous, indicating that this is a "cold front", the surface of contact between two moving gases. The continuity of the pressure indicates that the current relative velocity of the gases is near zero, making the edge appear to be in hydrostatic equilibrium. However, a total mass profile derived from the data in this sector under the equilibrium assumption, exhibits an unphysical jump by a factor of 2, with the mass inside the edge being lower. We propose that the cooler gas is "sloshing" in the cluster gravitational potential well and is now near the point of maximum displacement, where it has zero velocity but nonzero centripetal acceleration. The distribution of this non-hydrostatic gas should reflect the reduced gravity force in the accelerating reference frame, resulting in the apparent mass discontinuity. Assuming that the gas outside the edge is hydrostatic, the acceleration of the moving gas can be estimated from the mass jump, a ~ 800 h km/s/(10^8 yr). The gravitational potential energy of this gas that is available for dissipation is about half of its current thermal energy. The length of the cool filament extending from the cD galaxy (Fabian et al.) may give the amplitude of the gas sloshing, 30-40/h kpc. Such gas bulk motion might be caused by a disturbance of the central gravitational potential by past subcluster infall.Comment: Minor text clarifications to correspond to published version. 5 pages, 1 figure in color, uses emulateapj.sty. ApJ Letters in pres

Progressive high-fluence epithelium-on accelerated corneal crosslinking: a novel corneal photodynamic therapy for early progressive keratoconus

Purpose: To assess the preliminary clinical results of a new, progressively higher fluence-pulsed light Epi-On accelerated crosslinking nomogram (PFPL M Epi-On ACXL) in the treatment of progressive keratoconus (KC). Setting: Siena Crosslinking Center, Siena, Italy. Methods: A prospective pilot open, non-randomized interventional study, including 32 eyes of 32 young-adult patients over 26 years old with Stages I-III progressive KC undergoing PFPL M Epi-On ACXL, was conducted. Riboflavin loading was performed by using Paracel I 0.25% for 4 min and Paracel II 0.22% for 6 min. The Avedro KXL System (Glaukos-Avedro, Burlington, USA) was used for pulsed-light accelerated crosslinking (ACXL) at air room 21% oxygenation and 13 min of UV-A irradiation. The treatment fluence was set at 7.2 J/cm2, 8.6 J/cm2, and 10.0 J/cm2 in corneas with baseline pachymetry &lt;420 μm (group 1: 8 eyes), ≥ 420 μm &lt;460 μm (group 2, 11 eyes), and ≥ 460 μm (group 3, 13 eyes), respectively. Uncorrected distance visual acuity (UDVA), best-spectacle corrected visual acuity (BSCVA), Scheimpflug corneal tomography, and anterior segment OCT (AS-OCT) data were collected at baseline and postoperatively at 1, 3, and 6 months. Results: UDVA and BSCVA improved in all groups (P ≤ 0.05). Maximum keratometry values (K max) showed a significant decrease in the 10.0 J/cm2 group (Δ −1.68 D). The coma (HOAs) value improved significantly by the sixth month in all groups. OCT average demarcation lines were 211 ± 19 μm in group 1, 245 ± 23 μm in group 2, and 267 ± 21 μm in group 3. Conclusions: The preliminary results show that pachymetry-based PFPL M Epi-On ACXL nomogram stabilizes ectasia progression. Higher fluence Epi-On ACXL increases CXL penetration, with better functional outcomes in the absence of complications

Progressive high-fluence epithelium-on accelerated corneal crosslinking: a novel corneal photodynamic therapy for early progressive keratoconus

Purpose: To assess the preliminary clinical results of a new, progressively higher fluence-pulsed light Epi-On accelerated crosslinking nomogram (PFPL M Epi-On ACXL) in the treatment of progressive keratoconus (KC). Setting: Siena Crosslinking Center, Siena, Italy. Methods: A prospective pilot open, non-randomized interventional study, including 32 eyes of 32 young-adult patients over 26 years old with Stages I- III progressive KC undergoing PFPL M Epi-On ACXL, was conducted. Riboflavin loading was performed by using Paracel I 0.25% for 4min and Paracel II 0.22% for 6min. The Avedro KXL System (Glaukos-Avedro, Burlington, USA) was used for pulsed-light accelerated crosslinking (ACXL) at air room 21% oxygenation and 13min of UV-A irradiation. The treatment fluence was set at 7.2 J/cm2, 8.6 J/cm2, and 10.0 J/cm2 in corneas with baseline pachymetry &lt;420μm(group 1: 8 eyes), 420μm&lt;460μm(group 2, 11 eyes), and 460μm(group 3, 13 eyes), respectively. Uncorrected distance visual acuity (UDVA), best-spectacle corrected visual acuity (BSCVA), Scheimpflug corneal tomography, and anterior segment OCT (AS-OCT) data were collected at baseline and postoperatively at 1, 3, and 6 months. Results:UDVA and BSCVA improved in all groups (P 0.05).Maximumkeratometry values (K max) showed a significant decrease in the 10.0 J/cm2 group (1 −1.68 D). The coma (HOAs) value improved significantly by the sixthmonth in all groups. OCT average demarcation lines were 211 ± 19μm in group 1, 245 ± 23μm in group 2, and 267 ± 21μm in group 3. Conclusions: The preliminary results show that pachymetry-based PFPL M Epi-On ACXL nomogram stabilizes ectasia progression. Higher fluence Epi-On ACXL increases CXL penetration, with better functional outcomes in the absence of complications

Shapley Supercluster Survey: Ram-Pressure Stripping vs. Tidal Interactions in the Shapley Supercluster

We present two new examples of galaxies undergoing transformation in the Shapley supercluster core. These low-mass (stellar mass from 0.4E10 to 1E10 Msun) galaxies are members of the two clusters SC-1329-313 (z=0.045) and SC-1327-312 (z=0.049). Integral-field spectroscopy complemented by imaging in ugriK bands and in Halpha narrow-band are used to disentangle the effects of tidal interaction (TI) and ram-pressure stripping (RPS). In both galaxies, SOS-61086 and SOS-90630, we observe one-sided extraplanar ionized gas extending respectively 30kpc and 41kpc in projection from their disks. The galaxies' gaseous disks are truncated and the kinematics of the stellar and gas components are decoupled, supporting the RPS scenario. The emission of the ionized gas extends in the direction of a possible companion for both galaxies suggesting a TI. The overall gas velocity field of SOS-61086 is reproduced by ad hoc N-body/hydrodynamical simulations of RPS acting almost face-on and starting about 250Myr ago, consistent with the age of the young stellar populations. A link between the observed gas stripping and the cluster-cluster interaction experienced by SC-1329-313 and A3562 is suggested. Simulations of ram pressure acting almost edge-on are able to fully reproduce the gas velocity field of SOS-90630, but cannot at the same time reproduce the extended tail of outflowing gas. This suggests that an additional disturbance from a TI is required. This study adds a piece of evidence that RPS may take place in different environments with different impacts and witnesses the possible effect of cluster-cluster merger on RPS.Comment: 27 pages, 28 figures, MNRAS accepte

A2163: Merger events in the hottest Abell galaxy cluster II. Subcluster accretion with galaxy-gas separation

Located at z = 0.203, A2163 is a rich galaxy cluster with an intra-cluster medium (ICM) that exhibits extraordinary properties, including an exceptionally high X-ray luminosity, average temperature, and a powerful and extended radio halo. The irregular and complex morphology of its gas and galaxy structure suggests that this cluster has recently undergone major merger events that involve two or more cluster components. In this paper, we study the gas structure and dynamics by means of spectral-imaging analysis of X-ray data obtained from XMM-Newton and Chandra observations. From the evidence of a cold front, we infer the westward motion of a cool core across the E-W elongated atmosphere of the main cluster A2163-A. Located close to a galaxy over-density, this gas 'bullet' appears to have been spatially separated from its galaxy (and presumably dark matter component) as a result of high-velocity accretion. From gas brightness and temperature profile analysis performed in two opposite regions of the main cluster, we show that the ICM has been adiabatically compressed behind the crossing 'bullet' possibly because of shock heating, leading to a strong departure of the ICM from hydrostatic equilibrium in this region. Assuming that the mass estimated from the Yx proxy best indicates the overall mass of the system and that the western cluster sector is in approximate hydrostatic equilibrium before subcluster accretion, we infer a merger scenario between two subunits of mass ratio 1:4, leading to a present total system mass of M500 $\propto 1.9 \times 1015 M_{\odot}$. The exceptional properties of A2163 present various similarities with those of 1E0657-56, the so-called 'bullet-cluster'. These similarities are likely to be related to a comparable merger scenario.Comment: A&A, in pres

The nucleus of 103P/Hartley 2, target of the EPOXI mission

103P/Hartley 2 was selected as the target comet for the Deep Impact extended mission, EPOXI, in October 2007. There have been no direct optical observations of the nucleus of this comet, as it has always been highly active when previously observed. We aimed to recover the comet near to aphelion, to a) confirm that it had not broken up and was in the predicted position, b) to provide astrometry and brightness information for mission planning, and c) to continue the characterisation of the nucleus. We observed the comet at heliocentric distances between 5.7 and 5.5 AU, using FORS2 at the VLT, at 4 epochs between May and July 2008. We performed VRI photometry on deep stacked images to look for activity and measure the absolute magnitude and therefore estimate the size of the nucleus. We recovered the comet near the expected position, with a magnitude of m_R = 23.74 \pm 0.06 at the first epoch. The comet had no visible coma, although comparison of the profile with a stellar one showed that there was faint activity, or possibly a contribution to the flux from the dust trail from previous activity. This activity appears to fade at further epochs, implying that this is a continuation of activity past aphelion from the previous apparition rather than an early start to activity before the next perihelion. Our data imply a nucleus radius of \le 1 km for an assumed 4% albedo; we estimate a ~6% albedo. We measure a colour of (V-R) = 0. 26 \pm 0.09.Comment: 5 pages, 4 figures, accepted for publication in A&