843 research outputs found

    Validation of polish version of the Basel extent of rationing of nursing care revised questionnaire

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    Development of simple, valid and reliable instruments to determine nursing care rationing is a subject of ongoing research. One such instrument, which is gaining popularity worldwide and has significant research applicability, is the Basel Extent of Rationing of Nursing Care (BERNCA) and its revised version, the BERNCA-R. The aim of this study was to translate and adapt the BERNCA-R into a Polish-language version and to assess its reliability and validity in evaluating the level of implicit rationing of nursing care in Poland. Standard methodological requirements were followed during translation and cultural adaptation of the English version of the BERNCA-R questionnaire into Polish. The cross-sectional validation study was conducted between May and September 2017, which included 175 nurses undergoing specialisation and qualification courses at the European Postgraduate Education Centre in Wrocław, Poland. Cronbach’s alpha and inter-item correlations were used to analyse the internal consistency of the Polish BERNCA-R questionnaire. The mean total BERNCA-R score was 1.9 points (SD = 0.74) on a scale of 0-4. Cronbach’s alpha for the unidimensional scale was 0.96. The mean inter-item correlation was 0.4 (range 0.1-0.84), which indicates high internal consistency. A single-factor solution demonstrated stable loadings above 0.5 for almost all items of the Polish BERNCA-R questionnaire. The study using the Polish BERNCA-R questionnaire demonstrated that the instrument is valid and reliable for use in investigating care rationing in groups of Polish nurses

    Frequency Dispersion of Sound Propagation in Rouse Polymer Melts via Generalized Dynamic Random Phase Approximation

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    An extended generalization of the dynamic random phase approximation (DRPA) for L-component polymer systems is presented. Unlike the original version of the DRPA, which relates the (LxL) matrices of the collective density-density time correlation fumctions and the corresponding susceptibilities of polymer concentrated systems to those of the tracer macromolecules and so-called broken links system (BLS), our generalized DRPA solves this problem for (5xL)x(5xL) matrices of the coupled susceptibilities and time correlation functions of the component number, kinetic energy and flux densities. The presented technique is used to study propagation of sound and dynamic form-factor in disentangled (Rouse) monodisperse homopolymer melt. The calculated sound velocity and absorption coefficient reveal substantial frequency dispersion. The relaxation time is found to be N times less than the Rouse time (N is the degree of polymerization), which evidences strong dynamic screening because of interchain interaction. We discuss also some peculiarities of the Brillouin scattering in polymer melts. Besides, a new convenient expression for the dynamic structural function of the Rouse chain in (q,p)-representation is found.Comment: 37 pages, 2 appendices, 48 references, 1 figur

    Interprofessional communication with hospitalist and consultant physicians in general internal medicine : a qualitative study

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    This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist and consultant physicians, as well as the experiences of providers working with them. The implications of this research are globally important for understanding how to create opportunities for physicians and their colleagues to meaningfully and consistently participate in interprofessional communication which has been shown to improve patient, provider, and organizational outcomes

    School dropout, problem behaviour and poor academic achievement : a longitudinal view of portuguese male offenders

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    This study examines school drop outs from the perspective of male adults themselves through interviews with offenders currently serving sentences. Participants were 10 Portuguese male inmates, between the ages of 19 and 46 years of age, incarcerated in two prison facilities of the Azores. Qualitative and interpretative methods were carried out using a semi-structured in-depth individual interview that was audiorecorded and conducted on the basis of a list of topics. Interview transcripts and thematic analysis were used in data treatment and analysis. The findings primarily indicate that poor academic achievement and emotional and behavioural difficulties of participants played a particular role in early school drop out. The trajectories these individuals followed within the education system presented problem behaviour, learning disabilities, and/or foster care interventions. While school drop out circumstances were apparently various, analysis showed that they were underpinned by three distinct sets of conditions generally not addressed by the education system. The analysis of the triggering factors and the maintenance dynamics of school drop outs indicated three distinct types: retention/absenteeism, life turning points and positive resolution. Implications for secondary prevention and screening practices are discussed.FCT (SFRH/ BD/ 44245/ 2008)CIEC - unidade de investigação 317 da FC

    Improving access to emergent spinal care through knowledge translation : an ethnographic study

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    Background: For patients and family members, access to timely specialty medical care for emergent spinal conditions is a significant stressor to an already serious condition. Timing to surgical care for emergent spinal conditions such as spinal trauma is an important predictor of outcome. However, few studies have explored ethnographically the views of surgeons and other key stakeholders on issues related to patient access and care for emergent spine conditions. The primary study objective was to determine the challenges to the provision of timely care as well as to identify areas of opportunities to enhance care delivery. Methods: An ethnographic study of key administrative and clinical care providers involved in the triage and care of patients referred through CritiCall Ontario was undertaken utilizing standard methods of qualitative inquiry. This comprised 21 interviews with people involved in varying capacities with the provision of emergent spinal care, as well as qualitative observations on an orthopaedic/neurosurgical ward, in operating theatres, and at CritiCall Ontario’s call centre. Results: Several themes were identified and organized into categories that range from inter-professional collaboration through to issues of hospital-level resources and the role of relationships between hospitals and external organizations at the provincial level. Underlying many of these issues is the nature of the medically complex emergent spine patient and the scientific evidentiary base upon which best practice care is delivered. Through the implementation of knowledge translation strategies facilitated from this research, a reduction of patient transfers out of province was observed in the one-year period following program implementation. Conclusions: Our findings suggest that competing priorities at both the hospital and provincial level create challenges in the delivery of spinal care. Key stakeholders recognized spinal care as aligning with multiple priorities such as emergent/critical care, medical through surgical, acute through rehabilitative, disease-based (i.e. trauma, cancer), and wait times initiatives. However, despite newly implemented strategies, there continues to be increasing trends over time in the number of spinal CritiCall Ontario referrals. This reinforces the need for ongoing inter-professional efforts in care delivery that take into account the institutional contexts that may constrain individual or team efforts

    Altered translation of GATA1 in Diamond-Blackfan anemia

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    Ribosomal protein haploinsufficiency occurs in diverse human diseases including Diamond-Blackfan anemia (DBA)[superscript 1, 2], congenital asplenia[superscript 3] and T cell leukemia[superscript 4]. Yet, how mutations in genes encoding ubiquitously expressed proteins such as these result in cell-type– and tissue-specific defects remains unknown[superscript 5]. Here, we identify mutations in GATA1, encoding the critical hematopoietic transcription factor GATA-binding protein-1, that reduce levels of full-length GATA1 protein and cause DBA in rare instances. We show that ribosomal protein haploinsufficiency, the more common cause of DBA, can lead to decreased GATA1 mRNA translation, possibly resulting from a higher threshold for initiation of translation of this mRNA in comparison with other mRNAs. In primary hematopoietic cells from patients with mutations in RPS19, encoding ribosomal protein S19, the amplitude of a transcriptional signature of GATA1 target genes was globally and specifically reduced, indicating that the activity, but not the mRNA level, of GATA1 is decreased in patients with DBA associated with mutations affecting ribosomal proteins. Moreover, the defective hematopoiesis observed in patients with DBA associated with ribosomal protein haploinsufficiency could be partially overcome by increasing GATA1 protein levels. Our results provide a paradigm by which selective defects in translation due to mutations affecting ubiquitous ribosomal proteins can result in human disease.National Institutes of Health (U.S.) (Grant P01 HL32262)National Institutes of Health (U.S.) (Grant U54 HG003067-09

    Measuring affective well-being at work using short-form scales : implications for affective structures and participant instructions

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    Measuring affective well-being in organizational studies has become increasingly widespread, given its association with key work-performance and other markers of organizational functioning. As such, researchers and policy-makers need to be confident that well-being measures are valid, reliable and robust. To reduce the burden on participants in applied settings, short-form measures of affective well-being are proving popular. However, these scales are seldom validated as standalone, comprehensive measures in their own right. In this article, we used a short-form measure of affective well-being with 10 items: the Daniels five-factor measure of affective well-being (D-FAW). In Study 1, across six applied sample groups (N = 2624), we found that the factor structure of the short-form D-FAW is robust when issued as a standalone measure, and that it should be scored differently depending on the participant instruction used. When participant instructions focus on now or today, then affect is best represented by five discrete emotion factors. When participant instructions focus on the past week, then affect is best represented by two or three mood-based factors. In Study 2 (N = 39), we found good construct convergent validity of short-form D-FAW with another widely used scale (PANAS). Implications for the measurement and structure of affect are discussed
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