Knowledge and attitudes of Registered Nurses toward pain /

This research provided relevant data to support pain research literature that finds nurses do not have the knowledge base that they require to sufficiently provide effective pain management. The data demonstrated that nurses have mixed attitudes toward pain. These two findings have been observed in the literature for more than 20 years, but were important results for the hospitals and the nurses involved in the study. The purposes of this study were to identify the level of knowledge and attitudes in a sample of nurses fi-om the surgical and medical units in three hospitals, and determine whether a difference between these two groups existed. The institutional resources to support pain relief practices provided by each hospital were also documented. Data were collected using a convenience sample from the medical and surgical units of three hospitals. Ofthe 1 13 nurses who volunteered to participate, 78 worked in surgical units and 35 worked in medical units. Demographic data were collected about the participants. The established instruments used to obtain data about knowledge and attitude included: (a) Nurses Knowledge of Pain Issues Survey, (b)Attitude to Pain Control Scale, and (c) Andrew and Robert Vignette. Data collected were quantitative along with two open-ended questions for a rich, qualitative section. Inadequate knowledge and outdated attitudes were very evident in the responses. Data from the open-ended questions described how nurses assessed pain and the most conmion problems caring for patients in pain. Nursing practice implications for these hospitals involve initiating a process to develop an educational pain program for nurses throughout the hospital. Utilizing findings from other studies, the program should have an interdisciplinary approach to the planning, implementation, evaluation, and ongoing support. This study supports the belief that inadequate pain management has been attributed to many factors, most importantly to a lack of knowledge. Pain is a costly, unnecessary complication for the patient as well as the hospital. It follows then, that it is in the best interest of all involved to implement an educational pain program in order to influence practice.

Male reproductive competition in the field crickets : gryllus veletis and G. pennsylvanicus

Sexual behavior in the field crickets, Gryllus veletis and G. pennsylvanicus , was studied in outdoor arenas (12 m2) at high and low levels of population density in 1983 and 1984. Crickets were weighed, individually marked, and observed from 2200 until 0800 hrs for at least 9 continuous nights. Calling was measured at 5 min intervals, and movement and matings were recorded hourly. Continuous 24 hr observations were also conducted,·and occurrences of aggressive and courtship songs were noted. The timing of males searching, calling, courting, and fighting for females should coincide with female movement and mating patterns. For most samples female movement and matings occurred at night in the 24 hr observations and were randomly distributed with time for both species in the 10 hr observations. Male movement for G. veletis high density only was enhanced at night in the 24 hr observations, however, males called more at night in both species at high and low densities. Male movement was randomly distributed with time in the 10 hr observations, and calling increased at dawn for the G. pennsylvanicus 1984 high density sample, but was randomly distributed in other samples. Most courtship and aggression songs in the 24 hr observations were too infrequent for statistical testing and generally did not coincide with matings. Assuming residual reproductive value, and costs attached to a male trait in terms of future reproductive success decline with age, males should behave in more costly ways with age; by calling and moving more with age. Consequently, mating rates should increase with age. Female behavior may not change with age. G. veletis , females moved more with age at both low density samples, however, crickets moved less with age at high density. G. pennsylvanicus females moved more with age in the 1984 low density sample, whereas crickets moved less with age in the 1983 high density sample. For both species males in the 1984 high density samples called less with age. For G. pennsylvanicus in 1983 calling and mating rates increased with age. Mating rates decreased with age for G. veletis males in the high density sample. Aging may not affect cricket behavior. As population density increases fewer calling sites become available, costs of territoriality increase, and matings resulting from non-calling behavior should increase. For both species the amount of calling and in G. veletis the distance travelled per night was not different between densities. G. pennsylvanicus males and females moved more at low density. At the same deneity levels there were no differences in calling, mating, and, movement rates in G. veletis , however, G. pennsylvanicus males moved more at high density in 1983 than 1984. There was a positive relationship between calling and mating for the G. pennsylvanicus low density sample only, and selection was acting directly to increase calling. For both species no relationships between movement and mating success was found, however, the selection gradient on movement in the G. veletis high density population was significant. The intensity of selection was not significant and was probably due to the inverse relationship between displacement and weight. Larger males should call more, mate more, and move less than smaller males. There were no correlations between calling and individual weight, and an inverse correlation between movement and size in the G. veletis high density population only. In G. pennsylvanicus , there was a positive correlation between individual weight and mating, but, some correlate of weight was under counter selection pressure and-prevented significance of the intensity of selection. In contrast, there was an inverse correlation in the G.·veletis low density B sample. Both measures of selection intensities were significant and showed that weight only was under selection pressures. An inverse correlation between calling and movement was found for G. veletis at low density only. Because males are territorial, females are predicted to move more than males, however, if movement is a mode of male-male reproductive competition then males may move more than females. G. pennsylvanicus males moved more than females in all samples, however, G. veletis males and females moved similar distances at all densities. The variation in relative mating success explained by calling scores, movement, and weight for both species and all samples were not significant In addition, for both species and all samples the intensity of selection never equalled the opportunity for selection.

Repertory grid adaptations in detecting connotative trends and social behaviour problems in education

Please consult the paper edition of this thesis to read. It is available on the 5th Floor of the Library at Call Number: Z 9999 E38 K66 1983

Frontal Lobe Function and Performance Monitoring following Total Sleep Deprivation

Imaging studies have shown reduced frontal lobe resources following total sleep deprivation (TSD). The anterior cingulate cortex (ACC) in the frontal region plays a role in performance monitoring and cognitive control; both error detection and response inhibition are impaired following sleep loss. Event-related potentials (ERPs) are an electrophysiological tool used to index the brain's response to stimuli and information processing. In the Flanker task, the error-related negativity (ERN) and error positivity (Pe) ERPs are elicited after erroneous button presses. In a Go/NoGo task, NoGo-N2 and NoGo-P3 ERPs are elicited during high conflict stimulus processing. Research investigating the impact of sleep loss on ERPs during performance monitoring is equivocal, possibly due to task differences, sample size differences and varying degrees of sleep loss. Based on the effects of sleep loss on frontal function and prior research, it was expected that the sleep deprivation group would have lower accuracy, slower reaction time and impaired remediation on performance monitoring tasks, along with attenuated and delayed stimulus- and response-locked ERPs. In the current study, 49 young adults (24 male) were screened to be healthy good sleepers and then randomly assigned to a sleep deprived (n = 24) or rested control (n = 25) group. Participants slept in the laboratory on a baseline night, followed by a second night of sleep or wake. Flanker and Go/NoGo tasks were administered in a battery at 1O:30am (i.e., 27 hours awake for the sleep deprivation group) to measure performance monitoring. On the Flanker task, the sleep deprivation group was significantly slower than controls (p's <.05), but groups did not differ on accuracy. No group differences were observed in post-error slowing, but a trend was observed for less remedial accuracy in the sleep deprived group compared to controls (p = .09), suggesting impairment in the ability to take remedial action following TSD. Delayed P300s were observed in the sleep deprived group on congruent and incongruent Flanker trials combined (p = .001). On the Go/NoGo task, the hit rate (i.e., Go accuracy) was significantly lower in the sleep deprived group compared to controls (p <.001), but no differences were found on false alarm rates (i.e., NoGo Accuracy). For the sleep deprived group, the Go-P3 was significantly smaller (p = .045) and there was a trend for a smaller NoGo-N2 compared to controls (p = .08). The ERN amplitude was reduced in the TSD group compared to controls in both the Flanker and Go/NoGo tasks. Error rate was significantly correlated with the amplitude of response-locked ERNs in control (r = -.55, p=.005) and sleep deprived groups (r = -.46, p = .021); error rate was also correlated with Pe amplitude in controls (r = .46, p=.022) and a trend was found in the sleep deprived participants (r = .39, p =. 052). An exploratory analysis showed significantly larger Pe mean amplitudes (p = .025) in the sleep deprived group compared to controls for participants who made more than 40+ errors on the Flanker task. Altered stimulus processing as indexed by delayed P3 latency during the Flanker task and smaller amplitude Go-P3s during the Go/NoGo task indicate impairment in stimulus evaluation and / or context updating during frontal lobe tasks. ERN and NoGoN2 reductions in the sleep deprived group confirm impairments in the monitoring system. These data add to a body of evidence showing that the frontal brain region is particularly vulnerable to sleep loss. Understanding the neural basis of these deficits in performance monitoring abilities is particularly important for our increasingly sleep deprived society and for safety and productivity in situations like driving and sustained operations.