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Kirjallisuusarvostelu

Competence in intensive and critical care nursing - development of a basic assessment scale for graduating nursing students

Intensive and critical care nursing is a speciality in its own right and with its own nature within the nursing profession. This speciality poses its own demands for nursing competencies. Intensive and critical care nursing is focused on severely ill patients and their significant others. The patients are comprehensively cared for, constantly monitored and their vital functions are sustained artificially. The main goal is to win time to cure the cause of the patient’s situation or illness. The purpose of this empirical study was i) to describe and define competence and competence requirements in intensive and critical care nursing, ii) to develop a basic measurement scale for competence assessment in intensive and critical care nursing for graduating nursing students, and iii) to describe and evaluate graduating nursing students’ basic competence in intensive and critical care nursing by seeking the reference basis of self-evaluated basic competence in intensive and critical care nursing from ICU nurses. However, the main focus of this study was on the outcomes of nursing education in this nursing speciality. The study was carried out in different phases: basic exploration of competence (phase 1 and 2), instrumentation of competence (phase 3) and evaluation of competence (phase 4). Phase 1 (n=130) evaluated graduating nursing students’ basic biological and physiological knowledge and skills for working in intensive and critical care with Basic Knowledge Assessment Tool version 5 (BKAT-5, Toth 2012). Phase 2 focused on defining competence in intensive and critical care nursing with the help of literature review (n=45 empirical studies) as well as competence requirements in intensive and critical care nursing with the help of experts (n=45 experts) in a Delphi study. In phase 3 the scale Intensive and Critical Care Nursing Competence Scale (ICCN-CS) was developed and tested twice (pilot test 1: n=18 students and n=12 nurses; pilot test 2: n=56 students and n=54 nurses). Finally, in phase 4, graduating nursing students’ competence was evaluated with ICCN-CS and BKAT version 7 (Toth 2012). In order to develop a valid assessment scale of competence for graduating nursing students and to evaluate and establish the competence of graduating nursing students, empirical data were retrieved at the same time from both graduating nursing students (n=139) and ICU nurses (n=431). Competence can be divided into clinical and general professional competence. It can be defined as a specific knowledge base, skill base, attitude and value base and experience base of nursing and the personal base of an intensive and critical care nurse. Personal base was excluded in this self-evaluation based scale. The ICCN-CS-1 consists of 144 items (6 sum variables). Finally, it became evident that the experience base of competence is not a suitable sum variable in holistic intensive and critical care competence scale for graduating nursing students because of their minor experience in this special nursing area. ICCN-CS-1 is a reliable and tolerably valid scale for use among graduating nursing students and ICU nurses Among students, basic competence of intensive and critical care nursing was self-rated as good by 69%, as excellent by 25% and as moderate by 6%. However, graduating nursing students’ basic biological and physiological knowledge and skills for working in intensive and critical care were poor. The students rated their clinical and professional competence as good, and their knowledge base and skill base as moderate. They gave slightly higher ratings for their knowledge base than skill base. Differences in basic competence emerged between graduating nursing students and ICU nurses. The students’ self-ratings of both their basic competence and clinical and professional competence were significantly lower than the nurses’ ratings. The students’ self-ratings of their knowledge and skill base were also statistically significantly lower than nurses’ ratings. However, both groups reported the same attitude and value base, which was excellent. The strongest factor explaining students’ conception of their competence was their experience of autonomy in nursing. Conclusions: Competence in intensive and critical care nursing is a multidimensional concept. Basic competence in intensive and critical care nursing can be measured with self-evaluation based scale but alongside should be used an objective evaluation method. Graduating nursing students’ basic competence in intensive and critical care nursing is good but their knowledge and skill base are moderate. Especially the biological and physiological knowledge base is poor. Therefore in future in intensive and critical care nursing education should be focused on both strengthening students’ biological and physiological knowledge base and on strengthening their overall skill base. Practical implications are presented for nursing education, practice and administration. In future, research should focus on education methods and contents, mentoring of clinical practice and orientation programmes as well as further development of the scale.

Evaluation of a model for induction of periodontal disease in dogs

There are several methods for inducing periodontal disease in animal models, being the bone defect one of the most reported. This study aimed to evaluate this model, through clinical, radiographic, tomographic and histological analyzes, thus providing standardized data for future regenerative works. Twelve dogs were subjected to the induction protocol. In a first surgical procedure, a mucoperiosteal flap was made on the buccal aspect of the right third and fourth premolars and a defect was produced exposing the furcation and mesial and distal roots, with dimensions: 5mm coronoapical, 5mm mesiodistal, and 3mm buccolingual. Periodontal ligament and cementum were curetted and the defect was filled with molding polyester, which was removed after 21 days on new surgical procedure. Clinical and radiographic examinations were performed after the two surgeries and before the collection of parts for dental tomography and histological analysis. All animals showed grade II furcation exposure in both teeth. Clinical attachment level increased after induction. Defect size did not change for coronoapical and buccolingual measurements, while mesiodistal size was significantly higher than at the time of defect production. Radiographic analysis showed decreased radiopacity and discontinuity of lamina dura in every tooth in the furcation area. The horizontal progression of the disease was evident in micro-computed tomography and defect content in the histological analysis. Therefore, it is concluded that this method promotes the induction of periodontal disease in dogs in a standardized way, thus being a good model for future work.

Perfil epidemiológico e análise microbiológica da infecção de sítio cirúrgico em pacientes humanos e animais de companhia

Resumo A infecção de sítio cirúrgico (ISC) tem sido apontada como a terceira causa mais comum de infecção nosocomial. Este estudo objetivou determinar o perfil epidemiológico da ISC e sua associação aos fatores de risco descritos. Trata-se de um estudo transversal, realizado no Hospital São João Batista de Viçosa-MG e na Clínica Cirúrgica de Cães e Gatos do Hospital Veterinário da Universidade Federal de Viçosa-MG, no período de setembro de 2012 a fevereiro de 2013. As taxas globais de ISC foram de 0,7% no hospital humano e 3,46% no veterinário. No hospital veterinário, a taxa de ISC não mostrou relação com o potencial de contaminação, apresentando a maior taxa nos procedimentos classificados como limpos. Quanto ao tipo de cirurgia, as ortopédicas são as mais comuns em ambos os hospitais e também as que apresentam maior taxa de ISC. Cirurgias com duração maior que 120 minutos corresponderam a 15,25% do total de procedimentos no hospital humano e são ainda menos comuns no veterinário, com 1,26%. A taxa de ISC não parece estar relacionada à duração da cirurgia nesta estratificação. As bactérias isoladas das feridas cirúrgicas foram multirresistentes e os dados levantados indicam que não houve critério quanto ao emprego da antibioticoprofilaxia, principalmente nas cirurgias limpas. Este cenário mostra que é de extrema relevância a atuação de uma comissão de controle de infecção hospitalar, a fim de garantir obtenção de dados fidedignos, para que se possa avaliar a qualidade do serviço prestado e assim promover a redução dos riscos de complicações pós- operatórias.

Mythology as a key to historical ways of thinking

Kirjallisuusarvostelu

Qualidade sanitária e germinação de sementes de pinhão-manso

O pinhão-manso é uma espécie arbustiva que está se destacando pelo interesse para produção de biocombustível, porém, os estudos sobre controle de qualidade das sementes estão se iniciando. Neste trabalho objetivou-se estudar o efeito da temperatura e do tempo de contagem na germinação de sementes de pinhão-manso, conduzido em papel toalha bem como avaliar a qualidade sanitária das sementes, desinfestadas ou não com hipoclorito de sódio, a 2%. O estudo foi conduzido, com sementes de pinhão-manso extraídas de frutos maduros, coletados na planta. O teste de germinação foi conduzido nas temperaturas de 25 ºC e alternadas de 20-30 ºC, com contagens aos 6, 9 e 12 dias. O teste de sanidade foi conduzido a 20 ºC com fotoperíodo de 12 h por 7 dias. Foi utilizado o delineamento experimental inteiramente casualizado com quatro repetições e empregado o teste F na análise de variância dos dados de germinação e do índice de velocidade de germinação. As médias foram comparadas pelo teste de Tukey a 5% de probabilidade. O potencial máximo de germinação das sementes de pinhão-manso foi obtido na temperatura de 25 ºC, com contagens aos seis, nove e 12 dias, entretanto não apresentou diferença significativa com as temperaturas de 20-30 ºC, nas contagens aos 9 e 12 dias. As sementes de pinhão-manso analisadas apresentaram alta frequência de espécies fúngicas, independente da desinfestação superficial. A incidência de fungos em ordem decrescente foi dos gêneros: Alternaria, Macrophomina, Cladosporium, Colletotrichum, Fusarium, Pestalotiopsis, Phoma, Helminthosporium, Epicocum e Nigrospora a maioria destes fungos apresenta potencial patogênico.

1967 Administrative Staff

In October of 1967 the Administrative Staff moved to their new general offices at the Glenridge Campus. Pictured here from left to right are: Elizabeth Koschok, Roger Reynolds, Edith Toth, Jean Zurowski, Jenny Gurski, Ed. Mitchelson, Ruth Urbanic, and Jennie Balasak.

The essence of a tacit intersection : a heuristic inquiry into nature-based leisure and personal transformation

There are a considerable number of programs and agencies that count on the existence of a unique relationship between nature and human development. In addition, there are significant bodies of literature dedicated to understanding developmentally focused nature-based experiences. This research project was designed to flirther the understanding of this phenomenon. Consequently, the purpose of this research endeavour was to discover the essence ofthe intersection ofpersonal transformation and nature-based leisure, culminating in a rich and detailed account of this otherwise tacit phenomenon. As such, this research built on the assumption of this beneficial intersection of nature and personal transformation and contributes to the understanding ofhow this context is supporting or generating of selfactualization and positive development. Heuristic methods were employed because heuristics is concerned with the quality and essence of an experience, not causal relationships (Moustakas, 1990). Heuristic inquiry begins with the primary researcher and her personal experience and knowledge of the phenomenon. This study also involved four other coresearchers who had also experienced this phenomenon intensely. Co-researchers were found through purposeful and snowball sampling. Rich narrative descriptions of their experiences were gathered through in-depth, semi-structured interviews, and artifact elicitation was employed as a means to get at co-researchers' tacit knowledge. Each coresearcher was interviewed twice (the first interview focused on personal transformation, the second on nature) for approximately four and a half hours in total. Transcripts were read repeatedly to discern patterns that emerged from the study of the narratives and were coded accordingly. Individual narratives were consolidated to create a composite narrative of the experience. Finally, a creative synthesis was developed to represent the essence of this tacit experience. In conclusion the essence of the intersection of nature-based leisure and personal transformation was found to lie in the convergence of the lived experience of authenticity. The physical environment of nature was perceived and experienced to be a space and context of authenticity, leisure experiences were experienced as an engagement of authenticity, and individuals themselves encountered a true or authentic self that emanated from within. The implications of these findings are many, offering suggestions, considerations and implications from reconsidered approaches to environmental education to support for selfdirected human development.

Pyruvate dehydrogenase activity in response to skeletal muscle contraction at two stimulation frequencies in pyruvate dehydrogenase kinase 2 knockout mice

Pyruvate dehydrogenase (PDH) plays an important role in regulating carbohydrate oxidation in skeletal muscle. PD H is deactivated by a set of PD H kinases (PD K 1-4) with PDK2 and 4 being the predominant isoforms in skeletal muscle. PDK2 is highly sensitive to pyruvate inhibition, and is the most abundant isoform, while PDKI and 4 protein content are normally lower. This study examined the PDK isoform content and PDHa activation in muscle at rest and 10 and 40 Hz stimulation from PDK2 knockout (PDK2KO) mice to delineate the role of PDK2 in activating the PDH complex during low and moderate intensity muscle contraction. PDHa activity was lower in PDK2KO mice during contraction while total PDK actitvity was -4 fold lower. PDK4 protein was not different, however PDKI partially compensated for the lack of PDK2 and was -56% higher than WT. PDKI is a very potent inhibitor of the PDH complex due to its phosphorylation site specificity and allosteric regulation. These results suggest that the site specificity and allosteric regulatory properties of the individual PDK isoforms are more important than total PDK activity in determining transformation of the complex and PDHa activity during acute muscle contraction.

Horton Family collection, 1912, 1919, 1924, n.d.

Dr. William Hamilton Merritt, Jr. was born in 1865 and died in 1924. He was the son of Jedidiah Prendergast Merritt and Emily Prescott, grandson of William Hamilton Merritt. In 1892 he was married to Maud Claudman Hudson of Memphis, Tennessee and had a daughter and a son. During World War I he commanded the 14th battery at Flanders and after becoming ill served as part of the 9th Canadian Field Ambulance, 3rd Canadian Division, serving at a military hospital in Orpington, Kent, England and in 1917 at a military hospital in France. Dr. Merritt served as alderman and mayor for the city of St. Catharines, Ont. He was also a vice-president of the Imperial Bank of Canada, and served on the board of the Niagara Falls Suspension Bridge. A memorial service was held in St. Thomas Church, St. Catharines, Ont. on April 24, 1924.

Anne McPherson family fonds, 1852-2011 [non-inclusive]

Frank C. (Case) McCordick (1873-1946) was the son of William Henry (1849-1930) and Emily D. Howell (1851-1927) McCordick. William H. McCordick was in the coal business. The McCordick family included Frank Case, Mabel Gertrude, Ethel Howell and Arthur Stanley. Frank C. McCordick was educated in St. Catharines, and worked with his father in the coal business and eventually opened up a leather tanning operation. McCordick was active in the Lincoln Regiment and in 1906 was promoted to captain and in command of Company A, 19th Regiment. He was promoted to major and at the outbreak of war he was sent overseas as a commander of the 35th Battalion of the Canadian Expeditionary Forces (CEF). Upon arrival in France he was made officer commanding the 15th Battalion, King’s Own Yorkshire Light Infantry (KOYLI). After the war and his return to Canada he continued to play an active role in the local military units in the area as well as in Hamilton. After his retirement from the military in 1927 McCordick served as alderman and then mayor of St. Catharines from 1930 to 1931. He was a member of a large number of civic clubs, including St. Catharines Chamber of Commerce, Y.M.C.A., Lion’s Club, St. Catharines Golf Club, Detroit Boat Club, the St Catharines Club, as well as a member of several Masonic lodges. He continued to operate McCordick Tannery and other local investments. In 1903 Frank C. McCordick married May Beatrice Simson, daughter of Thomas E. Simson of Thorold. They had three children, E. (Edward) Frank McCordick, Bruce McCordick and (Margaret) Doris McCordick (m. Hubert Grigaut, d. 1977). The McCordick family resided at 82 Yates Street, near Adams Street. May Simson McCordick (b. 1873) was the daughter of Thomas Edward (1836-1908) and Julia Headlam (1844-1887) Simson of Thorold. Her siblings included: Edward, Frances, John, Augusta, Georgia and Gertrude. E. (Edward) Frank McCordick (1904-1980) was born in St. Catharines, Ont., attended Lake Lodge School in Grimsby, Ridley College in St. Catharines, Beechmont Preparatory School in England, Upper Canada College in Toronto and graduated from Royal Military College in Kingston, Ont. in 1925. Upon graduation he was made a lieutenant in the 10th (St. Catharines) Field Battery. In 1929 he married Helen Stanley Smith, daughter of Stanley George and Mary Walker Smith of St. Catharines. Col. McCordick, now promoted to Major, played an active role in the 10th (St. Catharines) Field Battery, being officer commanding the battery. In late 1939 McCordick headed to England for artillery tactical training and on December 6, 1939 the battery began the long trek overseas. McCordick saw action in Italy and in Holland. Upon his return to Canada at the end of the war he was the Liberal candidate in the federal election for Lincoln County. He remained active in the local military serving as honorary lieutenant-colonel of the 56th Field Regiment (ARCA) and in 1976 as the honorary colonel of the regiment. Col. McCordick held the Efficiency Decoration, the Order of the British Empire, granted in 1945 and was made an officer in the Order of St. John in 1978. He continued to serve his community in various capacities, including the Unemployment Insurance Canada Board, Royal Trust Company and the St. John Ambulance Society. He remained an active member of the alumni of Royal Military College, editing and compiling a newsletter and organizing reunion weekends. He kept in close contact with many of his classmates. Helen Stanley Smith McCordick lived in St. Catharines, Ont., attended Robertson School, and graduated from the University of Toronto in 1926 with a Bachelor of Arts degree in Modern Languages. During the war years (1939-1945) Helen was active in the Transport division of the local branch of the Canadian Red Cross and the Women’s Auxiliary of the 10th Field Battery. In 1932 E. Frank and Helen McCordick welcomed their only child, (Catharine) Anne McCordick. Helen continued to play an active role in her community until her passing in 1997. Stanley George Smith (1865-1960) was born in St. Catharines, Ont., the only child of William Smith (d. June 16, 1876) a native of Edinburgh, Scotland and his wife Hannah Louisa Maria Bulkeley a native of Fairfield, Connecticut. Stanley George Smith married Mary Walker of Guelph, Ont.(d. 1956) Mary was the daughter of Hugh and Elizabeth (d. 1924) Walker. Her siblings included Margaret, Agnes, Jessie, Isabella, Lorne, Ada, Alice, Eva, Alexander and George. Hugh Walker was a prominent fruit and vegetable merchant in Guelph. On 1904 their only child, Helen Stanley Smith was born. He was a post office clerk, and the treasurer for the James D. Tait Co. Ltd., a clothing and dry goods retailer in St. Catharines. The family lived at 39 Church Street in St. Catharines, Ont.

Teachers' experiences and perceptions of voluntary committee work as a vehicle for leadership development

In response to a looming leadership shortage, leadership development for teachers has become an increasingly important area of interest around the world. A review of the literature identified the key components of educational leadership development programs as effective curriculum, leadership practice, relationship building, and reflection. A gap in the research was found regarding the use of voluntary committee work as a vehicle for leadership practice. The purpose of this study was to explore teachers' perceptions of their experiences within board-level committees to determine the key factors that contributed, positively or negatively, to their leadership,pevelopment. A qualitative research design was employed using semistructured interviews with 8 participants. The key findings included a list of factors perceived by teachers as either supporting or hindering their leadership development. The supporting factors were: (a) leadership practice, (b) mentors and role models, (c) relationships and networks, and (d) positive outcomes for students. The hindering factors were: (a) lack of follow through and support, (b) committee members with a careerist approach to the experience, (c) personal and political agendas, and (d) overcommitment leading to burnout. Recommendations for practice focused on strategies to enhanc~_ the committee experience as a tool for leadership development. Recommendations for theory and research suggested more research be done on each of the 8 key factors, perceptions associated with teachers choosing to follow a leadership path, and how school boards can structure the committee process as an effective leadership development tool. This study provides a starting point for educators to begin to intentionally design, develop, and deliver voluntary committee experiences as a tool for leadership development.

Service Learning in Higher Education: A Road Map

As institutions of higher education struggle to stay relevant, competitive, accessible, and flexible, they are scrambling to attend to a shift in focus for new students. This shift involves experiential learning. The purpose of this major research paper was to examine the existing structures, to seek gaps in the experiential learning programs, and to devise a framework to move forward. The specific focus was on experiential learning at Brock University in the Faculty of Applied Health Sciences. The methodology was underscored with cognitive constructivism and appreciative theory. Data collection involved content analysis steps established by Krippendorff (2004) and Weber (1985). Data analysis involved the four dimensions of reflection designed by LaBoskey, including the purpose, context, content, and procedures. The results developed understandings on the state of formal processes and pathways within service learning. A tool kit was generated that defines service learning and offers an overview of the types of service learning typically employed. The tool kit acts as a reference guide for those interested in implementing experiential learning courses. Importantly, the results also provided 10 key points in experiential learning courses by Emily Allan. A flow chart illustrates the connections among each of the 10 points, and then they are described in full to establish a strategy for the way forward in experiential learning.

La poétique du roman historique de Eveline Hasler

À l'aide des tout derniers modèles narratologiques développés entre autres par Ansgar Nünning, nous nous penchons sur l'oeuvre d'Eveline Hasler, une voix phare de la littérature alémanique contemporaine. À partir d’un corpus de six romans, nous examinons de façon systématique sa poétique du roman historique au regard 1) des techniques narratives, 2) de la marginalité de ses personnages en société, 3) de la conception de l’Histoire, 4) de l'image critique qu'elle présente de la Suisse. Il en ressort un portrait très nuancé de l'oeuvre de Hasler, puisqu’elle allie un récit principalement réaliste, plutôt traditionnel, mais aussi inspiré du langage cinématographique, à des passages métahistoriographiques postmodernes, où une narratrice assimilable à l’auteure fait part au « je » de ses réflexions sur l'Histoire. Même si ces brefs passages relativement rares rappellent sans contredit la posture de l’historien, ils s’inscrivent toutefois dans la fiction, laquelle actualise le passé dans la perspective historique d’un lecteur contemporain. De fait, l’œuvre de Hasler se présente comme un jeu habile avec la liberté poétique et le souci de véracité historique, ce à quoi concourt l’imbrication de documents originaux en italique dans le roman. Par ailleurs, la question de la marginalité en société joue un rôle prépondérant chez Hasler, car tous ses personnages principaux sont autant de marginaux, de Außenseiter. Cette problématique montre entre autres les limites de l’Aufklärung, étant donné que ses tenants, les adversaires des marginaux, se targuent le plus souvent d’être motivés par la pensée éclairante pour mieux la pervertir. Il en résulte la mise à l’écart des individus dérangeants — la prétendue sorcière, le géant et les femmes qui remettent en cause l’organisation patriarcale. Or, certains marginaux de Hasler parviennent à s’arracher un espace de liberté dans la marge, au prix de leurs racines helvétiques. Ainsi, ces marginaux peinent à s’inscrire dans l’Histoire dite officielle, ce que Hasler tente de rectifier en leur redonnant une voix. Sur le plan individuel, la plupart d’entre eux expérimentent une évolution circulaire, puisqu’ils ne parviennent pas à sortir de la marge (sauf peut-être Henry Dunant). Cette impression de tourner en rond s’oppose à une conception de l’Histoire humaine qui se déroule en continuum, puisque les exclusions d’hier préfigurent celles d’aujourd’hui. Au-delà de cette mesure humaine du temps, l’horizon temporel de la nature s’inscrit pour sa part dans la permanence. Ainsi, Hasler développe une conception historique qui varie selon des points de vue coexistants. Cet amalgame est le plus souvent marqué par un certain pessimisme, comme le dénote la vie d’Emily Kempin associée au mythe d’Icare. Finalement, tous les acteurs historiques de Hasler appartiennent au contexte helvétique et en présentent une image assez rétrograde, laquelle se dévoile non seulement à travers la fictionnalisation des lieux, mais aussi par des références à trois symboles nationaux : les Alpes, le réduit helvétique et la légende de Guillaume Tell. Hasler fait le procès de ces mythes, associés à la liberté et à la sauvegarde de ce « peuple de bergers », en montrant que la Suisse n’apporte pas de solution originale aux défis de l’Occident.