Barriers and Facilitators to Providing Palliative Care in Rural Communities: A Nursing Perspective

Nursing plays a key role in the coordination and delivery of palliative care services in rural settings. The purpose of this study is to identify barriers and enablers to providing palliative care in rural communities from a nursing perspective. This study utilized a qualitative descriptive design. Findings highlighted that the remoteness, limited access to resources and professional practice barriers created challenges for nurses as they tried to provide quality palliative care to their clients. System-related barriers were identified and included: lack of services, funding issues, and poor continuity of care. Despite these barriers, nurses drew from supports to optimize palliative care such as using a team approach to care, centers, utilizing local case managers and informal community members, and using palliative care resources. These results may help inform policy decisions around the needs of nurses who practice in rural settings to provide quality care to individuals who are dying and their families.

An Investigation towards colossal success of Larsen and Toubro Limited: Human resource management perspective

Larsen and Toubro (L&T) Limited is India’s largest construction conglomerate. L&T’s expertise is harnessed to execute high value projects that demand adherence to stringent timelines in a scenario where disparate disciplines of engineering are required to be coordinated on a critical path. However, no company can acquire such a feat without systematic management of its human resource. An investigation on the human resource management practices in orienting L&T’s success can help to identify some of the ethical human resource practices, especially in the context of Indian market. Accordingly, a well-designed employee satisfaction survey was conducted for assessment of the HRM practices being followed in L&T. Unlike other companies, L&T aims to meet the long-term needs of its employees rather than short-term needs. There were however few areas of concerns, such as yearly appraisal system and equality to treat the employees. It is postulated that the inequality to treat the male and female employees is primarily a typical stereotype due to the fact that construction is conventionally believed to be a male dominant activity. A periodic survey intended to provide 360° feedback system can help to avoid such irregularities. This study is thus expected to provide healthy practices of HRM to nurture the young talents of India. This may help them to evaluate their decisions by analyzing the complex relationship between HRM practices and output of an organization.

Comparison of dynamics of wildtype and V94M human UDP-galactose 4-epimerase-A computational perspective on severe epimerase-deficiency galactosemia

UDP-galactose 4'-epimerase (GALE) catalyzes the interconversion of UDP-galactose and UDP-glucose, an important step in galactose catabolism. Type III galactosemia, an inherited metabolic disease, is associated with mutations in human GALE. The V94M mutation has been associated with a very severe form of type III galactosemia. While a variety of structural and biochemical studies have been reported that elucidate differences between the wildtype and this mutant form of human GALE, little is known about the dynamics of the protein and how mutations influence structure and function. We performed molecular dynamics simulations on the wildtype and V94M enzyme in different states of substrate and cofactor binding. In the mutant, the average distance between the substrate and both a key catalytic residue (Tyr157) and the enzyme-bound NAD(+) cofactor and the active site dynamics are altered making substrate binding slightly less stable. However, overall stability or dynamics of the protein is not altered. This is consistent with experimental findings that the impact is largely on the turnover number (kcat), with less substantial effects on Km. Active site fluctuations were found to be correlated in enzyme with substrate bound to just one of the subunits in the homodimer suggesting inter-subunit communication. Greater active site loop mobility in human GALE compared to the equivalent loop in Escherichia coli GALE explains why the former can catalyze the interconversion of UDP-N-acetylgalactosamine and UDP-N-acetylglucosamine while the bacterial enzyme cannot. This work illuminates molecular mechanisms of disease and may inform the design of small molecule therapies for type III galactosemia.

DNA double strand break repair: a radiation perspective

SIGNIFICANCE:
Ionizing radiation (IR) can induce a wide range of unique deoxyribonucleic acid (DNA) lesions due to the spatiotemporal correlation of the ionization produced. Of these, DNA double strand breaks (DSBs) play a key role. Complex mechanisms and sophisticated pathways are available within cells to restore the integrity and sequence of the damaged DNA molecules.
RECENT ADVANCES:
Here we review the main aspects of the DNA DSB repair mechanisms with emphasis on the molecular pathways, radiation-induced lesions, and their significance for cellular processes.
CRITICAL ISSUES:
Although the main characteristics and proteins involved in the two DNA DSB repair processes present in eukaryotic cells (homologous recombination and nonhomologous end-joining) are reasonably well established, there are still uncertainties regarding the primary sensing event and their dependency on the complexity, location, and time of the damage. Interactions and overlaps between the different pathways play a critical role in defining the repair efficiency and determining the cellular functional behavior due to unrepaired/miss-repaired DNA lesions. The repair pathways involved in repairing lesions induced by soluble factors released from directly irradiated cells may also differ from the established response mechanisms.
FUTURE DIRECTIONS:
An improved understanding of the molecular pathways involved in sensing and repairing damaged DNA molecules and the role of DSBs is crucial for the development of novel classes of drugs to treat human diseases and to exploit characteristics of IR and alterations in tumor cells for successful radiotherapy applications.

Outward foreign direct investment and human capital development:A small country perspective

Purpose - The purpose of this paper is to examine the pattern of outward foreign direct investment (FDI) by Irish MNCs, and more specifically, to investigate their approach to human capital development and how these correspond to foreign MNCs in Ireland. In particular, it seeks to investigate training and development expenditure, adoption of succession planning, use of formal development programmes for senior management "potential", and also the presence of a specific "key group" development programme. Design/methodology/approach - Data were obtained through the largest, most representative study ever conducted on multinational companies (MNCs) in Ireland. The most senior human resources practitioner in these firms completed a questionnaire, through the personal interview medium, on various facets of their human resource management (HRM) practices. In total 260 usable interviews were completed equating to an overall response rate of 63 per cent. This represents a 78 per cent response rate for Irish MNCs, the primary focus of this paper, and 60 per cent for foreign MNCs. Findings - Overall, Irish MNCs tend to compare favourably with their foreign counterparts in terms of the human capital development mechanisms examined. Only one statistically significant association was found regarding differences between Irish and foreign owned MNCs, Irish MNCs were found to be significantly less likely to have formal management development programmes. Originality/value - The study is the first large scale, representative survey to be conducted on MNCs in Ireland helping to address the research lacuna on Irish owned MNCs. © Emerald Group Publishing Limited.

Infection control and meticillin-resistant Staphylococcus aureus decolonization:the perspective of nursing home staff

Infection control and meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes have started to assume greater importance in practice and policy.

Threats and knowledge gaps for ecosystem services provided by kelp forests: a northeast Atlantic perspective.

Kelp forests along temperate and polar coastlines represent some of most diverse and productive habitats on the Earth. Here, we synthesize information from >60 years of research on the structure and functioning of kelp forest habitats in European waters, with particular emphasis on the coasts of UK and Ireland, which represents an important biogeographic transition zone that is subjected to multiple threats and stressors. We collated existing data on kelp distribution and abundance and reanalyzed these data to describe the structure of kelp forests along a spatial gradient spanning more than 10° of latitude. We then examined ecological goods and services provided by kelp forests, including elevated secondary production, nutrient cycling, energy capture and flow, coastal defense, direct applications, and biodiversity repositories, before discussing current and future threats posed to kelp forests and identifying key knowledge gaps. Recent evidence unequivocally demonstrates that the structure of kelp forests in the NE Atlantic is changing in response to climate- and non-climate-related stressors, which will have major implications for the structure and functioning of coastal ecosystems. However, kelp-dominated habitats along much of the NE Atlantic coastline have been chronically understudied over recent decades in comparison with other regions such as Australasia and North America. The paucity of field-based research currently impedes our ability to conserve and manage these important ecosystems. Targeted observational and experimental research conducted over large spatial and temporal scales is urgently needed to address these knowledge gaps.