Development of a Cultural and Spiritual Toolbox: A High Impact Interprofessional Project

Healthcare providers may not be prepared to incorporate cultural and spiritual aspects of patient care within their practice. The cultural and spiritual toolbox project will increase the opportunity for those working in a local three campus hospital system to deliver patient-centered care at the bedside by helping them recognize the nuances of various cultures and religions. An interprofessional team convened over a one year period to explore how these aspects of care could be met. To this end, the team researched and developed a “Cultural and Spiritual Toolbox” which offers information in an online format. This project will be fully implemented in late 2015. It was designed and approved for use in a large non-religious affiliated hospital system with three campuses. The software program provides healthcare workers with a diverse cultural and spiritual reference to assist patient-centered bedside care. Faculty and students from Rutgers and the Rowan University School of Osteopathic Medicine collaboratively developed a comprehensive guide which addresses religions, cultures and practical strategies for healthcare providers. This computer-based system was accepted by the ethics board on December 5, 2014. The toolbox modules were designed by an interprofessional team and reviewed by religious experts and ordained religious leaders from various faiths. It will be implemented once the computerized integration is completed. The program will be available to patients, families, caregivers, physicians, and staff members who seek assistance

Perceptions of Spiritual Care in Nursing

Nurses are challenged to delivery holistic care to their patients by the accreditation agencies. Holistic care includes care for the mind, body, and the spirit. The purpose of the study was to explore the perceptions of spirituality and spiritual care of practicing Registered Nurses (RNs) in a faith based and non-faith based hospital in the Midwest in order to increase self-awareness among practicing RNs. The research was guided by three questions: 1. What differences exist in the perceptions of spirituality among practicing RNs in a faith based and non-faith based hospital? 2. What differences exist in the perceptions of spiritual care among practicing RNs in a faith based and non-faith based hospital? 3. What relationship exists between the RNs who practice religion and do not practice religion and the perception of meeting the spiritual needs of the patient? A convenience sample of for the faith-based hospital was n = 209 and for the non-faith based hospital was n = 206. Data was analyzed using the Mann-Whitney U and a Chi- Square. The results demonstrated that there was a significant difference in spirituality and spiritual care in a faith based and non-faith based hospital. The results did not demonstrate a relationship between RNs’ who practice religion and do not practice religion and the perception of meeting the spiritual needs of the patient

Metal-Organic Nanosheets Formed via Defect-Mediated Transformation of a Hafnium Metal-Organic Framework

We report a hafnium-containing MOF, hcp UiO-67(Hf), which is a ligand-deficient layered analogue of the face-centered cubic fcu UiO-67(Hf). hcp UiO-67 accommodates its lower ligand:metal ratio compared to fcu UiO-67 through a new structural mechanism: the formation of a condensed “double cluster” (Hf12O8(OH)14), analogous to the condensation of coordination polyhedra in oxide frameworks. In oxide frameworks, variable stoichiometry can lead to more complex defect structures, e.g., crystallographic shear planes or modules with differing compositions, which can be the source of further chemical reactivity; likewise, the layered hcp UiO-67 can react further to reversibly form a two-dimensional metal–organic framework, hxl UiO-67. Both three-dimensional hcp UiO-67 and two-dimensional hxl UiO-67 can be delaminated to form metal–organic nanosheets. Delamination of hcp UiO-67 occurs through the cleavage of strong hafnium-carboxylate bonds and is effected under mild conditions, suggesting that defect-ordered MOFs could be a productive route to porous two-dimensional materials

Risk measures for direct real estate investments with non-normal or unknown return distributions

The volatility of returns is probably the most widely used risk measure for real estate. This is rather surprising since a number of studies have cast doubts on the view that volatility can capture the manifold risks attached to properties and corresponds to the risk attitude of investors. A central issue in this discussion is the statistical properties of real estate returns—in contrast to neoclassical capital market theory they are mostly non-normal and often unknown, which render many statistical measures useless. Based on a literature review and an analysis of data from Germany we provide evidence that volatility alone is inappropriate for measuring the risk of direct real estate. We use a unique data sample by IPD, which includes the total returns of 939 properties across different usage types (56% office, 20% retail, 8% others and 16% residential properties) from 1996 to 2009, the German IPD Index, and the German Property Index. The analysis of the distributional characteristics shows that German real estate returns in this period were not normally distributed and that a logistic distribution would have been a better fit. This is in line with most of the current literature on this subject and leads to the question which indicators are more appropriate to measure real estate risks. We suggest that a combination of quantitative and qualitative risk measures more adequately captures real estate risks and conforms better with investor attitudes to risk. Furthermore, we present criteria for the purpose of risk classification

Exploring the barriers and supports of faith community nurses serving in Alaska: A qualitative study

Decades of research exist on the public health impact of faith community nurses (FCNs), particularly congregational health promotion and disease prevention. However, the literature exploring the barriers and supports FCNs experience when serving their communities is limited. Thus, guided by Ziebarth’s (2016) conceptual framework of faith community nursing, this study explored the lived experiences of FCNs (N = 8) delivering care to faith communities in Alaska. Thematic analyses of qualitative data revealed three major themes including 1) the descriptions, characteristics, and roles performed by FCNs (e.g., active listening, policy-level recommendations); 2) barriers and other factors impacting FCNs’ delivery of care to the communities served (e.g., COVID-19, health care system); and 3) the existing support systems as well as additional resources necessary for the sustainability of the FCN ministry (e.g., church leadership support, education for vulnerable populations). Study findings provide insight into what FCNs perceive as important community-level (e.g., church support) and environmental-level factors (e.g., COVID-19) impacting their ministry. Moreover, findings from this study highlight the need for future research to follow FCNs over time to identify and assess multi-level factors influencing the sustainability of the FCN ministry (e.g., funding, external resources, church support)

Impact of disaster-related mortality on gross domestic product in the WHO African Region

BACKGROUND: Disaster-related mortality is a growing public health concern in the African Region. These deaths are hypothesized to have a significantly negative effect on per capita gross domestic product (GDP). The objective of this study was to estimate the loss in GDP attributable to natural and technological disaster-related mortality in the WHO African Region. METHODS: The impact of disaster-related mortality on GDP was estimated using double-log econometric model and cross-sectional data on various Member States in the WHO African Region. The analysis was based on 45 of the 46 countries in the Region. The data was obtained from various UNDP and World Bank publications. RESULTS: The coefficients for capital (K), educational enrolment (EN), life expectancy (LE) and exports (X) had a positive sign; while imports (M) and disaster mortality (DS) were found to impact negatively on GDP. The above-mentioned explanatory variables were found to have a statistically significant effect on GDP at 5% level in a t-distribution test. Disaster mortality of a single person was found to reduce GDP by US$0.01828. CONCLUSIONS: We have demonstrated that disaster-related mortality has a significant negative effect on GDP. Thus, as policy-makers strive to increase GDP through capital investment, export promotion and increased educational enrolment, they should always keep in mind that investments made in the strengthening of national capacity to mitigate the effects of national disasters expeditiously and effectively will yield significant economic returns

Efetividade das intervenções individual e em grupo junto a pessoas com diabetes tipo 2 1

OBJETIVO: comparar a efetividade de duas intervenções educativas, utilizadas por uma operadora de saúde, no acompanhamento ao indivíduo com diabetes mellitus Tipo 2 (DM2), quanto ao conhecimento sobre a doença, impacto na qualidade de vida e adoção de ações de autocuidado. MÉTODOS: estudo comparativo, longitudinal, prospectivo, realizado com 150 indivíduos com diabetes tipo 2, analisados conforme a modalidade de participação no programa (individual e/ou em grupo). Os participantes da intervenção individual (II) realizaram consultas de enfermagem a cada seis meses e os da intervenção em grupo (IG), reuniões semanais por três meses. Os dados foram coletados mediante quatro questionários: Questionário de identificação, Questionário de Impacto na Qualidade de Vida em Diabetes (PAID), Questionário de Autocuidado em Diabetes (QAD) e Questionário de Conhecimento do Diabetes (DKN-A). Os dados foram analisados utilizando-se o Teste de Friedman e o Teste de Mann Whitney, considerando significância estatística para p ≤ 0,05. RESULTADOS: verificou-se aumento do conhecimento sobre a doença na II (pOBJECTIVE: to compare the effectiveness of two educational interventions used by a healthcare provider in the monitoring of individuals with type 2 diabetes mellitus (T2DM), regarding knowledge of the disease, impact on quality of life and adoption of self-care actions. METHODS: comparative, longitudinal, prospective study performed with 150 subjects with type 2 diabetes, analyzed according to the type of participation in the program (individual and/or group). Participants of the individual intervention (II) received nursing consultations every six months and those of the group intervention (GI) took part in weekly meetings for three months. Data were collected through four questionnaires: Identification questionnaire, Problem Areas in Diabetes Questionnaire (PAID), Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) and the Diabetes Knowledge Scale (DKN-A). Data were analyzed using the Friedman and Mann Whitney tests, considering a statistical significance of p ≤ 0.05. RESULTS: there was an increase in knowledge about the disease in the II (pOBJETIVO: comparar la efectividad de dos intervenciones educativas, utilizadas por una operadora de planes de salud, en el acompañamiento al individuo con diabetes mellitus Tipo 2 (DM2), sobre al conocimiento de la enfermedad, impacto en la calidad de vida y adopción de acciones de autocuidado. MÉTODOS: estudio comparativo, longitudinal, prospectivo, realizado con 150 individuos con diabetes tipo 2, analizados conforme la modalidad de participación en el programa (individual y/o en grupo). Los participantes de la intervención individual (II) realizaron consultas de enfermería a cada seis meses y los de intervención en grupo (IG), reuniones semanales por tres meses. Los datos fueron recolectados mediante cuatro cuestionarios: Cuestionario de identificación, Cuestionario de Impacto en la Calidad de Vida en Diabetes (PAID), Cuestionario de Autocuidado en Diabetes (CAD) y Cuestionario de Conocimiento de la Diabetes (DKN-A). Los datos fueron analizados utilizando el test de Friedman y el test de Mann Whitney, considerando significación estadística para p ≤ 0,05. RESULTADOS: se verificó aumento del conocimiento sobre la enfermedad en la II (

Bovine Tuberculosis and Badger Culling in England: A Utilitarian Analysis of Policy Options

Bovine tuberculosis (bovine TB) is an important animal health policy issue in Britain, which impacts farmers, the public, domestic farmed cattle and the wild badger population. The Westminster government’s badger culling policy in England, which began in 2013, has caused considerable controversy. This is in part because the Independent Scientific Group advised against culling, based on the Randomised Badger Culling Trial. Those opposed to badger culling support more stringent cattle-based measures and the vaccination of badgers. This paper argues for ethical analysis of public policy options which impact sentient species. It provides a summary Animal Welfare Impact Assessment of (1) a do-nothing approach, (2) badger culling, and (3) badger vaccination. A utilitarian analysis is then applied to these policy options considering human wellbeing and animal welfare. The analysis compares a badger culling policy that achieves a 19% reduction in bovine TB incidence, a badger vaccination model achieving a 12.5% reduction, and a do-nothing approach. Policy options are assessed over 9 years and a longer timeframe, and uncertainty is considered. The analysis finds that non-culling approaches, particularly badger vaccination, result in greater total utility, compared to badger culling. Badger culling causes 30% reduction in the badger population in England as well as substantial harms due to the culling process. Culling is opposed by public opinion and is associated with considerable risks and uncertainty. In contrast, non-culling approaches, such as cattle-based measures and badger vaccination, are supported by public opinion and are not associated with such risks