Effect of combined care nursing on patient satisfaction, staff satisfaction, and quality of care /

This research evaluates the effect of combined care nursing on three outcomes: i) patient satisfaction; ii) staff satisfaction; and iii) quality of care. Oakville-Trafalgar Memorial Hospital was in the early planning stages of changing to combined care nursing from the traditional method of providing separate postpartum and nursery care to mothers and babies. The opportunity existed to evaluate formally the change to combined care. There were three hypotheses to be investigated. Data were collected from four sources: patient surveys, staff surveys, informal interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. The surveys were administered on three different occasions to patients and staff. Other sources of data included informal interviews with patients and staff who responded to the surveys, and chart audits.The study findings revealed that the majority of respondents had increased levels of satisfaction and perceptions of increased quality of care following implementation of combined care. These findings, related to combined care and the role of change in its implementation and evaluation, indicate that there are no right or easy answers about how to make new ideas become reality in a smooth, pleasant way.

Academics as parents--parents as academics : a study of the integration of intellectual and child-care labours /

Discussions concerning the challenges of combining work and family are certainly not new, and still actively continue. There is, however, a silence in the related literature regarding a comprehensive description of integrating specifically university academic ~. work and family responsibilities. This silence is especially evident for men who are parents as well as academics. With the participation of 4 key informants, this qualitative research study gave voice to men and women who participate in the academic labour of a Canadian university as professors, and as graduate students, along with the parenting labour of at least 1 child under the age of7. Methodology was developed to reveal in-depth perspectives regarding the work practices employed by 4 key informants as they combined intellectual and child-care responsibilities. Multiple data collection methods included journal reflections, day time observation sessions, a focus group, and a final evaluation questionnaire. Using research findings, together with information extrapolated from Three Models of the Family (Eichler, 1997), this study also took steps toward developing a Proposed "Three Models of the University," to offer explanation for the work practices of the key informants as academics/parents, and also for future consideration in university policy formation.

Systematic studies of the effect of pressure on magnetic and electronic properties of La2/3Ca1/3MnO3 thin films with various thicknesses /

Interest in mixed-valent perovskite manganese oxides of La\-xAxMnO^ (v4-divalent alkaline earth Ca, Sr or Ba), whose unusual properties were discovered nearly a half century ago, has recently been revived. The discovery of the colossal magnetoresistance and pressure effects introduced new questions concerning the complex interplay between lattice structure, magnetism and transport in doped perovskite manganites. In this study, we report our experimental investigations of pressure and magnetic field dependencies of La-i/sCai/sMnOs (LCMO) epitaxial films with various thickness on SrTiO$ substrate. An analysis of film thickness dependency of the resistivity of LCMO epitaxial films under pressure and magnetic field has been performed by taking into account substrate contributions. This verifies the correlation of lattice distortion with magnetic and transport properties. Strong dependencies of Mn — O — Mn bond bending and Mn — O bond stretching with pressure as well as Mn spin alignment with magnetic field, and the lattice distortion induced by the substrate are discussed.

Decision analysis of the effectiveness of lung cancer screening using autofluorescence bronchoscopy and computed tomography

Background: Lung cancer (LC) is the leading cause of cancer death in the developed world. Most cancers are associated with tobacco smoking. A primary hope for reducing lung cancer has been prevention of smoking and successful smoking cessation programs. To date, these programs have not been as successful as anticipated. Objective: The aim of the current study was to evaluate whether lung cancer screening combining low dose computed tomography with autofluorescence bronchoscopy (combined CT & AFB) is superior to CT or AFB screening alone in improving lung cancer specific survival. In addition, the extent of improvement and ideal conditions for combined CT & AFB screening were evaluated. Methods: We applied decision analysis and Monte Carlo simulation modeling using TreeAge Software to evaluate our study aims. Histology- and stage specific probabilities of lung cancer 5-year survival proportions were taken from Surveillance and Epidemiologic End Results (SEER) Registry data. Screeningassociated data was taken from the US NCI Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), National Lung Screening Trial (NLST), and US NCI Lung Screening Study (LSS), other relevant published data and expert opinion. Results: Decision Analysis - Combined CT and AFB was the best approach at Improving 5-year survival (Overall Expected Survival (OES) in the entire screened population was 0.9863) and in lung cancer patients only (Lung Cancer Specific Expected Survival (LOSES) was 0.3256). Combined screening was slightly better than CT screening alone (OES = 0.9859; LCSES = 0.2966), and substantially better than AFB screening alone (OES = 0.9842; LCSES = 0.2124), which was considerably better than no screening (OES = 0.9829; LCSES = 0.1445). Monte Carlo simulation modeling revealed that expected survival in the screened population and lung cancer patients is highest when screened using CT and combined CT and AFB. CT alone and combined screening was substantially better than AFB screening alone or no screening. For LCSES, combined CT and AFB screening is significantly better than CT alone (0.3126 vs. 0.2938, p< 0.0001). Conclusions: Overall, these analyses suggest that combined CT and AFB is slightly better than CT alone at improving lung cancer survival, and both approaches are substantially better than AFB screening alone or no screening.

Solute effects on the production and decay of primary species in the flash photolysis of indole

Maximum production rates ofs and decay kinetics for the hydrated electron, the indolyl neutral radical and the indole triplet state have been obtained in the microsecond, broadband (X > 260 nm) flash photolysis of helium-saturated, neutral aqueous solutions of indole, in the absence and in the presence of the solutes NaBr, BaCl2*2H20 and CdSCV Fluorescence spectra and fluorescence lifetimes have also been obtained in the absence and in the presence of the above solutes, The hydrated electron is produced monophotonically and biphotonically at an apparent maximum rate which is increased by BaCl2*2H20 and decreased by NaBr and CdSOif. The neutral indolyl radical may be produced monophotonically and biphotonically or strictly monophotonically at an apparent maximum rate which is increased by NaBr and CdSO^ and is unaffected by BaCl2*2H20. The indole triplet state is produced monophotonically at a maximum rate which is increased by all solutes. The hydrated electron decays by pseudo first order processes, the neutral indolyl radical decays by second order recombination and the indole triplet state decays by combined first and second order processes. Hydrated electrons are shown to react with H , H2O, indole, Na and Cd"*""1"". No evidence has been found for the reaction of hydrated electrons with Ba . The specific rate of second order neutral indolyl radical recombination is unaffected by NaBr and BaCl2*2H20, and is increased by CdSO^. Specific rates for both first and second order triplet state decay processes are increased by all solutes. While NaBr greatly reduced the fluorescence lifetime and emission band intensity, BaCl2*2H20 and CdSO^ had no effect on these parameters. It is suggested that in solute-free solutions and in those containing BaCl2*2H20 and CdSO^, direct excitation occurs to CTTS states as well as to first excited singlet states. It is further suggested that in solutions containing NaBr, direct excitation to first excited singlet states predominates. This difference serves to explain increased indole triplet state production (by ISC from CTTS states) and unchanged fluorescence lifetimes and emission band intensities in the presence of BaCl2*2H20 and CdSOt^., and increased indole triplet state production (by ISC from S^ states) and decreased fluorescence lifetime and emission band intensity in the presence of NaBr. Evidence is presented for (a) very rapid (tx ^ 1 us) processes involving reactions of the hydrated electron with Na and Cd which compete with the reformation of indole by hydrated electron-indole radical cation recombination, and (b) first and second order indole triplet decay processes involving the conversion of first excited triplet states to vibrationally excited ground singlet states.