Iron deficiency in infancy: is an immigrant more at risk?

QUESTIONS UNDER STUDY: Iron deficiency with or without anaemia is the most common deficiency in the world. Its prevalence is higher in developing countries and in low socioeconomic populations. We aimed at determining and comparing the prevalence of iron deficiency in an immigrant and non-immigrant population. METHODS: Every child scheduled for a routine check-up at 12 months of age was allowed to participate in the study. Haemoglobin, ferritin, anthropometric data, familial and nutritional status were measured. RESULTS: 586 infants were eligible and 463 were included in the study as they had assessment data at 12 months. Children were divided into two groups: immigrants' children and non-immigrants' children. The global prevalence of iron deficiency was 5.7% at 12 months. A significant difference for iron deficiency was noticed between the groups at 12 months (p = 0.01). Among risk factors, immigration (odds ratio 2.91; 95% CI 1.05-8.04) and unemployment (odds ratio 6.08; 95% CI 1.18-31.30) had the higher odds in the multivariable analysis. CONCLUSION: The prevalence of iron deficiency in the immigrant population is higher than in non-immigrants. Immigration and the category of employment are risk factors for iron deficiency, as starting baby cereals before 9 months is a protective factor. Good socioeconomic conditions in Switzerland, the quality of food for pregnant women and young infants may be the explanation. A study up to five years of age is necessary before drawing general conclusions on infancy.

Early high-dose treatment: SCT results from the European High Risk Neuroblastoma Study

Aims: The HR-NBL1 Study of the European SIOP Neuroblastoma Group (SIOPEN) randomised two high dose regimens to learn about potential superiority and toxicity profiles.Patients and Methods: At interim analysis 1483 high risk neuroblastoma patients (893 males) were included since 2002 with either INSS stage 4 disease (1383 pts) above 1 year, or as infants (59 pts) and stage 2&3 of any age (145 pts) with MYCN amplification. The median age at diagnosis was 2.9 years (1 month-19.9 years) with a median follow up of 3 years. Response eligibility criteria prior randomisation after Rapid Cojec Induction (J Clin Oncol, 2010) ± 2 courses of TVD (Cancer, 2003) included complete bone marrow remission and at least partial response at skeletal sites with no more than 3, but improved mIBG positive spots and a PBSC harvest of at least 3x10E6 CD34/kgBW. The randomised regimens were BuMel [busulfan oral till 2006, 4x150mg/m² in 4 ED; or intravenous use according to body weight as licenced thereafter; melphalan 140mg/m²/day) and CEM [carboplatinum ctn. infusion (4x AUC 4.1mg/ml.min/day, etoposid ctn. infusion (4x 338mg/m²/day or [4x 200mg/m²/day]*, melphalan (3x70mg/m²/day; 3x60mg/m²/day*;*reduced dosis if GFR< 100ml/min/1.73m²). Supportive care followed institutional guidelines. VOD prophylaxis included ursadiol, but randomised patients were not eligible for the prophylactic defibrotide trial. Local control included surgery and radiotherapy of 21Gy.Results: Of 1483 patients, 584 were being randomised for the high dose question at data lock. A significant difference in event free survival (3-year EFS 49% vs. 33%, p<0.001) and overall survival (3-year OS 61% vs. 48%, p=0.003) favouring the BuMel regimen over the CEM regimen was demonstrated. The relapse/progression rate was significantly higher after CEM (0.60±0.03) than after BuMel (0.48±0.03)(p<0.001). Toxicity data had reached 80% completeness at last analysis. The severe toxicity rate up to day 100 (ICU and toxic deaths) was below 10%, but was significantly higher for CEM (p= 0.014). The acute toxic death rate was 3% for BuMel and 5% for CEM (NS). The acute HDT toxicity profile favours the BuMel regimen in spite of a total VOD incidence of 18% (grade 3:5%).Conclusions: The Peto rule of P<0.001 at interim analysis on the primary endpoint, EFS was met. Hence randomization was stopped with BuMel as recommended standard treatment in the HR-NBl1/SIOPEN trial which is still accruing for the randomised immunotherapy question.

Inmigración y formación continuada en el colectivo de enfermería de la región sanitaria de Lleida

El aumento significativo de la inmigración en los últimos años supone un nuevo reto para la enfermería. Objetivos: conocer la situación actual de la formación de enfermería respecto a la inmigración, su interés por formarse y las dificultades y necesidades que tienen en materia de inmigración. Metodología: estudio descriptivo y transversal analizando una muestra representativa de todos los profesionales de enfermería colegiados en la provincia de Lleida. Para la recogida de datos se utilizó un cuestionario y el análisis estadístico se realizó con el programa informático SPSS versión 13.0. Resultados: más del 90% de los profesionales de enfermería de la provincia de Lleida son mujeres menores de 50 años y que mayoritariamente trabajan en atención hospitalaria. No obstante el interés expresado por temas relacionados con la inmigración, sólo el 24% ha realizado algún tipo de formación al respecto. La mayoría también reconoce tener problemas de comunicación con los inmigrantes. Las sugerencias recogidas en el cuestionario se categorizaron en modelos de integración y en formación. Conclusión: la formación de enfermería en inmigración es baja y se debe a su elevado coste y a que no se realiza en horario laboral. En términos generales, los profesionales de enfermería que se dedican a la Atención Primaria de salud, muestran mayor interés por formarse y mayor flexibilidad para modificar los protocolos y cuidados que sus homónimos hospitalarios.

Työhyvinvointi, koulutus ja toiminnan kehittäminen terveyskeskuksissa lääkäritilanteen näkökulmasta

Finnish health centres have suffered from a shortage of physicians in recent years. This is why more physicians are being educated, the tutelage of the young physicians has been improved and many tasks which were previously reserved for physicians have been transferred to nurses and other personnel of the health centres. Only a little research has been done about the effects of the shortage of physicians and education to the work atmosphere in the health centres The objectives of the study was to describe the situation of the physicians in the counties Satakunta and South-Western Finland at the time when the University of Turku started to decentralise its education to Satakunta and describe the health centres attitudes towards training and research co-operation with the University of Turku; to gain information about the training programmes for physicians in specific training in general medical practice (STPG); study how the shortage of physicians affects the job atmosphere, the job satisfaction and the operation of the health centres; study health centre employees opinions about their professional skills, their needs and interets in continuing education; study medical and nurse students professional indentity and their readiness to multiprofessional teamwork. The material of the study was gathered during 2003-2006 with three mail questionnaires and a questionnaire given to medical and nurse students who practised in the training health centre in Pori. The first questionnaire was sent to the chief physicians of the health centres in counties Satakunta and South-Western Finland to clarify the number of unfilled positions of physicians and the reasons for physician shortage as well as the readiness for practical training of medical students and research at the health centres. The second questionnaire was posted to doctors in specific training in general medical practice and their trainers at the health centres and it gained information about training programmes of young physicians at health centres. The third questionnaire was sent to personnel at health centres in Satakunta and South-Western Finland and included questions about job satisfaction and education. The survey for medical and nurse students gained information about their professional indentity and their readiness to multiprofessional teamwork. In spring 2003 the shortage of physicians was more severe in Satakunta than in South-Western Finland. Attitudes towards training of medical students and research co-operation with the universities were generally positive. The guidance of STGP doctors in health centres improved during 2003-2005. A shortage of physicians had only a slightly negative impact on employee job satisfaction. The shortage of physicians had also positive impact on the operation of the health centres because it led to reorganization of the operations. The personnel at Finnish health centres were willing to take more challenging tasks and also to acquire appropriate further education or training. The medical and nurse students had strong professional identity and they understood the significance of teamwork for the health care service system.

Magneettisairaalan työnantajakuvan merkitys lääkäri- ja sairaanhoitajaopiskelijoiden näkökulmasta tarkasteltuna

Tämä tutkimus tarkastelee valmistumassa olevien lääkäri- ja sairaanhoitajaopiskelijoiden näkemyksiä terveydenhuollon työnantajakuvaan ja sen vetovoimaisuuteen liittyen. Tarkastelun näkökulmina ovat strateginen henkilöstövoimavarojen johtaminen, rekrytointiprosessi ja motivaatio työhön hakeutumisessa. Aihetta on tutkittu toistaiseksi vähän terveydenhuollon opiskelijoiden näkökulmasta. Laadullisen tutkimuksen teoreettinen osuus toteutettiin kyselylomakkeella. Kyselylomakkeen vastausten (n=14) analyysissä käytettiin sisällönanalyysiä. Tulosten mukaan voidaan todeta, että terveydenhuollon työnantajakuvalla on melko suuri merkitys lääkäreiden ja sairaanhoitajien työhön hakeutumisessa. Työpaikan vetovoimaisuutta lisäävät tekijät liittyvät esimiehen hyviin johtamistaitoihin, ammatillisen osaamisen kehittämisen mahdollisuuksiin ja kilpailukykyiseen palkkaukseen. Lisäksi työpaikan sijainnilla ja tehtävän sisällöllä on vaikutusta työpaikkaan hakeutumisessa. Vetovoimaisuutta vähentävät vastaavasti huono työilmapiiri, huono palkka, esimiehen heikot johtamistaidot sekä konsultaatiomahdollisuuksien puute. Rekrytointiprosesseissa ja työnantajan markkinoinnissa on vaihtelua eri työnantajien välillä.

Understanding the Racial Nature of Police and Immigrant Relations In Finland. The Case of Africans in Turku

The focus of this study is to examine the role of police and immigrants’ relations, as less is known about this process in the country. The studies were approached in two different ways. Firstly, an attempt was made to examine how immigrants view their encounters with the police. Secondly, the studies explored how aware the police are of immigrants’ experiences in their various encounters and interactions on the street level. An ancillary aim of the studies is to clarify, analyse and discuss how prejudice and stereotypes can be tackled, thereby contributing to the general debate about racism and discrimination for better ethnic relations in the country. The data in which this analysis was based is on a group of adults (n=88) from the total of 120 Africans questioned for the entire study (n=45) police cadets and (n=6) serving police officers from Turku. The present thesis is a compilation of five articles. A summary of each article findings follows, as the same data was used in all five studies. In the first study, a theoretical model was developed to examine the perceived knowledge of bias by immigrants resulting from race, culture and belief. This was also an attempt to explore whether this knowledge was predetermined in my attempt to classify and discuss as well as analyse the factors that may be influencing immigrants’ allegations of unfair treatment by the police in Turku. The main finding shows that in the first paper there was ignorance and naivety on the part of the police in their attitudes towards the African immigrant’s prior experiences with the police, and this may probably have resulted from stereotypes or their lack of experience as well as prior training with immigrants where these kinds of experience are rampant in the country (Egharevba, 2003 and 2004a). In exploring what leads to stereotypes, a working definition is the assumption that is prevalent among some segments of the population, including the police, that Finland is a homogenous country by employing certain conducts and behaviour towards ethnic and immigrant groups in the country. This to my understanding is stereotype. Historically this was true, but today the social topography of the country is changing and becoming even more complex. It is true that, on linguistic grounds, the country is multilingual, as there are a few recognised national minority languages (Swedish, Sami and Russian) as well as a number of immigrant languages including English. Apparently it is vital for the police to have a line of communication open when addressing the problem associated with immigrants in the country. The second paper moved a step further by examining African immigrants’ understanding of human rights as well as what human rights violation means or entails in their views as a result of their experiences with the police, both in Finland and in their country of origin. This approach became essential during the course of the study, especially when the participants were completing the questionnaire (N=88), where volunteers were solicited for a later date for an in-depth interview with the author. Many of the respondents came from countries where human rights are not well protected and seldom discussed publicly, therefore understanding their views on the subject can help to explain why some of the immigrants are sceptical about coming forward to report cases of batteries and assaults to the police, or even their experiences of being monitored in shopping malls in their new home and the reason behind their low level of trust in public authorities in Finland. The study showed that knowledge of human rights is notably low among some of the participants. The study also found that female respondents were less aware of human rights when compared with their male counterparts. This has resulted in some of the male participants focussing more on their traditional ways of thinking by not realising that they are in a new country where there is equality in sexes and lack of respect on gender terms is not condoned. The third paper focussed on the respondents’ experiences with the police in Turku and tried to explore police attitudes towards African immigrant clients, in addition to the role stereotype plays in police views of different cultures and how these views have impacted on immigrants’ views of discriminatory policing in Turku. The data is the same throughout the entire studies (n=88), except that some few participants were interviewed for the third paper thirty-five persons. The results showed that there is some bias in mass-media reports on the immigrants’ issues, due to selective portrayal of biases without much investigation being carried out before jumping to conclusions, especially when the issues at stake involve an immigrant (Egharevba, 2005a; Egharevba, 2004a and 2004b). In this vein, there was an allegation that the police are even biased while investigating cases of theft, especially if the stolen property is owned by an immigrant (Egharevba, 2006a, Egharevba, 2006b). One vital observation from the respondents’ various comments was that race has meaning in their encounters and interaction with the police in the country. This result led the author to conclude that the relation between the police and immigrants is still a challenge, as there is rampant fear and distrust towards the police by some segments of the participating respondents in the study. In the fourth paper the focus was on examining the respondents’ view of the police, with special emphasis on race and culture as well as the respondents’ perspective on police behaviour in Turku. This is because race, as it was relayed to me in the study, is a significant predictor of police perception (Egharevba, 2005a; Egharevba and Hannikianen, 2005). It is a known scientific fact that inter-group racial attitudes are the representation of group competition and perceived threat to power and status (Group-position theory). According to Blumer (1958) a sense of group threat is an essential element for the emergence of racial prejudice. Consequently, it was essential that we explored the existing relationship between the respondents and the police in order to have an understanding of this concept. The result indicates some local and international contextual issues and assumptions that were of importance tackling prejudice and discrimination as it exists within the police in the country. Moreover, we have to also remember that, for years, many of these African immigrants have been on the receiving end of unjust law enforcement in their various countries of origin, which has resulted in many of them feeling inferior and distrustful of the police even in their own country of origin. While discussing the issues of cultural difference and how it affects policing, we must also keep in mind the socio-cultural background of the participants, their level of language proficiency and educational background. The research data analysed in this study also confirmed the difficulties associated with cultural misunderstandings in interpreting issues and how these misunderstandings have affected police and immigrant relations in Finland. Finally, the fifth paper focussed on cadets’ attitudes towards African immigrants as well as serving police officers’ interaction with African clients. Secondly, the police level of awareness of African immigrants’ distrustfulness of their profession was unclear. For this reason, my questions in this fifth study examined the experiences and attitudes of police cadets and serving police officers as well as those of African immigrants in understanding how to improve this relationship in the country. The data was based on (n=88) immigrant participants, (n=45) police cadets and 6 serving police officers from the Turku police department. The result suggests that there is distrust of the police in the respondents’ interaction; this tends to have galvanised a heightened tension resulting from the lack of language proficiency (Egharevba and White, 2007; Egharevba and Hannikainen, 2005, and Egharevba, 2006b) The result also shows that the allegation of immigrants as being belittled by the police stems from the misconceptions of both parties as well as the notion of stop and search by the police in Turku. All these factors were observed to have contributed to the alleged police evasiveness and the lack of regular contact between the respondents and the police in their dealings. In other words, the police have only had job-related contact with many of the participants in the present study. The results also demonstrated the complexities caused by the low level of education among some of the African immigrants in their understanding about the Finnish culture, norms and values in the country. Thus, the framework constructed in these studies embodies diversity in national culture as well as the need for a further research study with a greater number of respondents (both from the police and immigrant/majority groups), in order to explore the different role cultures play in immigrant and majority citizens’ understanding of police work.

Vaccination Competence - The Concept and Evaluation

The purpose of this two-phase study was to define the concept of vaccination competence and assess the vaccination competence of graduating public health nurse students (PHN students) and public health nurses (PHNs) in Finland, with the goal of promoting and maintaining vaccination competence and developing vaccination education. The first phase of the study included semi-structured interviews with vaccination professionals, graduating PHN students and clients (a total of n=40), asking them to describe vaccination competence as well as the factors strengthening and weakening it. The data were analyzed through content analysis. In the second phase of the study, structured instruments were developed, and vaccination competence of PHN students (n=129) in Finland and PHNs (n=405) was assessed using a self-assessment scale (VAS) and taking a knowledge test. PHNs were used as a reference group, enabling us to determine whether a satisfactory level of vaccination competence was achieved by the end of studies, or whether it was gained through work experience vaccinating clients. The data were collected from five polytechnic institutions and seven health centers located in various parts of the country. The data were collected using instruments developed for this study, and were analyzed statistically. In the first phase, based on the results of the interviews, vaccination competence was defined as a large multi-faceted entity, including the concepts of competent vaccinator, competent implementation of the vaccination, and the outcome of the implementation. Semi-structured interviews revealed that factors strengthening and weakening vaccination competence were connected to the vaccinator, the client being vaccinated, the vaccination environment and vaccinator education. On the whole, factors strengthening and weakening vaccination were the opposite of each other. In the second phase, on the self-assessment of vaccination competence, students rated themselves as significantly lower than working professionals. On the knowledge test, the percentage of correct answers was lower for students than PHNs. When all background variables were taken into account in multivariate analysis, there was no longer a significant difference between the students and PHNs on the self-assessment. However, in multivariate analysis, the PHNs still performed better than students on the knowledge test. For this study, a satisfactory level of vaccination competence was defined as a mean of 8.0 on the self-assessment and 80% correct answers on the knowledge test. Based on these criteria, students almost reached the level of satisfactory in their overall self-assessment, and PHNs did. Both groups, however, did rank themselves as satisfactory in some sum variables. On the knowledge test the students did not achieve a level of satisfactory (80%) in their total score, though PHNs did. As before, both groups did achieve a level of satisfactory in several sum variables. Further research and development should focus on vaccination education, the testing of vaccination competence and vaccination practices in clinical practice, as well as on developing the measurement tools.

Intellectual Property Protection in China in the Cases of Outsourcing and own Manufacturing

The intellectual property (IP) environment in China is still very immature. There are several problems in legal, political, economic, social-cultural, competitive and labor environment which have hindered IP legal enforcement. Under such circumstances, IP misappropriation is a major concern especially for foreign small and medium-sized enterprises (SMEs) doing business in China. These circumstances require foreign companies, no matter whether they are multinational corporations (MNCs) or SMEs and have own manufacturing in China or not, to take strong IP actions. Therefore, the purpose of this study is to discuss how IP can be protected in China in the case of outsourcing and in the case of own manufacturing. The comparison will consider the process of outsourcing and own manufacturing consisting two stages: preparation stage and operation stage. In order to clarify the conceptual arguments, two illustrative case studies were studied. The case data bases on two semi-structured interviews of the managing directors, field notes and archival data. The findings propose that attention in IP protection should be given to following issues: integrating IP strategy into the company’s business strategy, protecting the most critical knowledge, regarding IP steps as a whole in the protection mechanism and making IP strategy as proactive as possible. The major difference between outsourcing and own manufacturing in IP protection is in the operation stage. Besides, the findings also provide managerial advice on IP protection, e.g. foreign managers should be prepared for IP risks in China, they should establish an own IP protection mechanism which matches the company’s situation and they should consider IP protection as an on-going process.

European luxury brands made in China: the effect of low-cost country manufacturing on brand image and purchase decisions

European luxury brands have an image of manufacturing their products in the same country where the brands originate. However, in the past years many luxury brands have shifted their manufacturing to countries outside Europe. China is now a common manufacturing country for European luxury brands despite the country’s poor image as a manufacturer. Chinese manufacturing is often associated with bad quality, bad labour conditions, mass production, and counterfeits. The image of China does not quite match the image luxury brands enjoy including characteristics such as high end quality, craftsmanship, details, design, or premium price. A negatively perceived country-of-manufacture may have an effect on a brand’s image and consumers’ purchase decisions. This thesis is focused on European luxury brands manufacturing in China, and how this effects the brand image and purchase decisions among luxury consumers. The empirical part of this thesis is based on focus group research, which is a popular method in the field of qualitative research. The main focus group is female luxury consumers in Finland. This main group has been divided into three categories: 1) the university students, 2) the young career women, 3) the experienced luxury consumers. This categorization has been done based on their different stages in luxury consumption. All in all, the empirical research consisted of 11 interviews and 29 participants. The main contribution of this thesis was that there is a difference between the opinions of the younger groups (university students and young career women) and the experienced luxury consumers when discussing the effect of country-of-manufacture on brand image and purchase decisions of luxury brands. The younger participants thought that manufacturing luxury products in China might affect the brand image, but their purchase decisions would not be that much affected by the country-of-origin. The experienced luxury consumers had quite a different view on the country-of-origin of luxury brands – they found it an important decisive factor prior making purchases. The majority of experienced luxury consumers would not buy luxury products made in China, and they would always check where these products are made in.

En vårdvetenskaplig teori om interkulturellt vårdande : att föda barn i en annan kultur

The aim of this dissertation is to develop a theory on intercultural caring to deepen the understanding of caring between nurses and patients who have different cultural backgrounds. The research questions are: 1) What is intercultural caring? 2) How is intercultural caring described and understood? 3) How is intercultural caring described and understood in a maternity care context from the patients’ perspective? 4) What is the substance in a theory on intercultural caring? 5) What is the substance in a theory on intercultural caring in maternity care from the patients’ perspective? The theoretical perspective is based on caritative theory and the caring science-tradition (Eriksson, 2001, 2002) and has a hermeneutic approach. In the first study, 19 texts of Campinha-Bacote, Kim-Godwin, Leininger and Ray are analysed through content analysis. A model for intercultural caring is then created abductively. The second study is a metasynthesis of 40 studies on intercultural caring in maternity care research. The third study is a focused ethnography, in which 17 immigrant mothers are interviewed and observed. The theory on intercultural caring is created through a hermeneutic synthesis of the three studies. A synthesis of the studies with a maternity context results in five patterns of interpretation: the experience of caring is related to power; the family is always present; childbearing and change of culture can give women multiple vulnerabilities; both the mother and the nurse change when they meet; conflicts can cause change. The theory and patterns of interpretation consolidate into a contextual theory on intercultural caring for clinical maternity praxis. In this theory, caring consists of four dimensions: universal, cultural, contextual, and unique caring, which permeate each other. Universal caring is nondependent of time and space. Cultural caring considers the cultural background, the acculturation and the equality of each mother. In the maternity care culture, cultural competence, cultural safety, and acculturation of the nurse are emphasised. Contextual caring considers the specific cultural features of the childbearing mother. In this respect, the nurse is expected to be an expert and to clarify cultural assumptions in maternity care. In unique caring, the mother expects good communication, respect for the family, goodwill and somebody who cares for her and meets her needs, in order for trust to be built. In this respect, the nurse listens to the woman’s narrative, is flexible, open, courageous, and non-judgemental. The nurse shows an understanding for the life situation of the woman, and strives for continuity to preserve the care relationship. It was found that external circumstances affect intercultural caring. Moreover, intercultural caring is expected to decrease misunderstandings and conflicts, alleviate suffering and promote health and life. The theory adds knowledge to the phenomenon of intercultural caring for the nursing and caring sciences, and for the nursing care of patients with other cultural backgrounds than the nurses. The theory can be used in nursing, education, research and administration.

Association of adult weight gain and nonalcoholic fatty liver in a cross-sectional study in Wan Song Community, China

Our objective was to examine associations of adult weight gain and nonalcoholic fatty liver disease (NAFLD). Cross-sectional interview data from 844 residents in Wan Song Community from October 2009 to April 2010 were analyzed in multivariate logistic regression models to examine odds ratios (OR) and 95% confidence intervals (CI) between NAFLD and weight change from age 20. Questionnaires, physical examinations, laboratory examinations, and ultrasonographic examination of the liver were carried out. Maximum rate of weight gain, body mass index, waist circumference, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, fasting blood glucose, cholesterol, triglycerides, uric acid, and alanine transaminase were higher in the NAFLD group than in the control group. HDL-C in the NAFLD group was lower than in the control group. As weight gain increased (measured as the difference between current weight and weight at age 20 years), the OR of NAFLD increased in multivariate models. NAFLD OR rose with increasing weight gain as follows: OR (95%CI) for NAFLD associated with weight gain of 20+ kg compared to stable weight (change <5 kg) was 4.23 (2.49-7.09). Significantly increased NAFLD OR were observed even for weight gains of 5-9.9 kg. For the “age 20 to highest lifetime weight” metric, the OR of NAFLD also increased as weight gain increased. For the “age 20 to highest lifetime weight” metric and the “age 20 to current weight” metric, insulin resistance index (HOMA-IR) increased as weight gain increased (P<0.001). In a stepwise multivariate regression analysis, significant association was observed between adult weight gain and NAFLD (OR=1.027, 95%CI=1.002-1.055, P=0.025). We conclude that adult weight gain is strongly associated with NAFLD.

Research on the quality of the wine grapes in corridor area of China

The corridor area of Gansu Province is one of the most important wine grape growing regions in China, and this strip of land results in a significant difference in terms of terroir between its regions. Chemical composition and antioxidant capacity of the main wine grape varieties (Vitis vinifera L.) cultivated in the corridor area of Gansu Province in northwest China were compared. Three regions (Zhangye, Wuwei, and Jiayuguan) were selected to explain the influence of soil and climate conditions on the quality of wine grapes. This study aims to investigate the effect of different regions on berry composition and antioxidant capacity, providing a general evaluation of red and white wine grapes quality in the corridor area of China. The results showed that ‘Merlot’ grapes grown in Zhangye had the best quality among the different varieties in the three regions of Gansu evaluated. The moderate temperature and nitrogen deficiency were associated with improved fruit quality. It was identified that the most suitable grape variety from Zhangye is ‘Merlot’, and that ‘Cabernet Sauvignon’ and ‘Italian Resling’ are the most suitable varieties from Wuwei and Jiayuguan, respectively.

Changing roles of nurse educators employed in acute and chronic care settings : the impact of professional and statutory mandates in Ontario at four sites of one hospital corporation /

The role of the hospital-employed nurse educator is evolving. Factors influencing this change include the introduction of standards for nurse educators by the College of Nurses of Ontario (CNO), a change in the way nurses are educated, the emergence of nursing as a profession, and hospital restructuring as a result of budgetary constraints. Two of these influencing factors: the introduction of the updated Standards of Practice for Registered Nurses and Registered Practical Nurses (1996) and hospital restructuring occurred over the last 7 years at several hospitals in southern Ontario. Current literature as well as the Standards of Practice (1996) were utilized to examine the current roles and responsibilities of nurse educators and subsequently develop a questionnaire to study the impact of these influencing factors on the role of the nurse educator. This questionnaire was piloted and revised before its distribution at 4 hospitals in southern Ontario. Twenty-five of the 41 surveys (61%) distributed were returned for analysis. The data reflected that the Standards of Practice had a positive influence on the role of the nurse educator, while hospital restructuring had a negative impact. In addition, many of the roles and responsibilities identified in the literature were indeed part of the current role of nurse educators, as well as several responsibilities not captured in the literature. The predictions for the future of this role in its current state were not positive given the financial status of the health care system as well as the lack of clarity for the role and the current level ofjob satisfaction among practicing nurse educators. However, a list of recommendations were generated which, if implemented, could add clarity to the role and improve job satisfaction. This could enhance the retention of current nurse educators and the possibility of recruiting competent nurse educators to the role in the future.

Management decision-making in nursing

This study developed a new, valid and reliable evaluation instrument to measure the level, type and pattern of management decisions of fifteen nursing students. The management decision score achieved using this instrument was correlated with two psychological determinants of management decision making: creativity and problem-solving ability. The instrument was a written patient management problem in case format, answered by a free form written response. The student responses were classified for type of management decision according to the sub-categories of technical, inter-personal, environmental and unique. Using statistical analysis a significant difference was found in the type of management decisions most frequently selected by the study sample. The students predominantly selected technical type decisions. This preference for one type of management decision may be due to a number of psychological and environmental factors. These factors may program and mold the type of management decisions student nurses make early in their career. Low but positive correlations were found between the total management score and the two psychological tests. This finding supports the authors cited in the literature who state that although creativity augments the type of management decision making, it is not present or encouraged widely in the nursing profession. These factors are worth considering when the profession becomes concerned over ritualization and lack of individuality in patient care. The tool is easy to administer, lends itself to a variety of professional settings and shows promise with further refinement for computer application.

Lorsque l'imaginaire migratoire rencontre les réalités de la migration : parcours de migrants volontaires et qualifiés de l'Afrique de l'Ouest au Québec

Différentes réalités et contextes actuels mondiaux font en sorte que de plus en plus de gens envisagent la migration comme projet de vie. La présente recherche s’intéresse à l’imaginaire migratoire comme facteur de mobilité, mais également comme facteur de modulation des réactions et du regard qu’entretiendra le migrant en rapport avec son vécu migratoire. Ainsi, la réflexion s’amorce en Afrique de l’Ouest, tandis que de jeunes Africains instruits et qualifiés élaborent un projet de migration volontaire vers le Canada, plus précisément dans la région du Québec. C’est investi de leur désir de l’Ailleurs, des représentations de l’Occident, de leur besoin de se réaliser et de l’impossibilité qu’ils rencontrent à accéder à la vie professionnelle souhaitée en Afrique qu’ils migrent vers le Canada. Quoiqu’ils soient dotés d’une détermination et d’un optimisme considérable, la rencontre entre l’imaginé et le quotidien de la vie au Québec comme immigrant et comme émigrant n’est pas toujours facile. Elle viendra révéler la profondeur du rêve, des mythes et des ambitions; les failles intérieures individuelles, les valeurs et les ambivalences de chacun, mais surtout la capacité qu’aura l’individu à revoir son imaginaire, à effectuer la réappropriation de son expérience migratoire et à élaborer de nouveaux projets. L’écart vécu par le sujet entre l’imaginé et le rencontré nous questionnera sur ce que véhiculent les messages et les images en circulation sur le Canada et l’Occident. Aussi, il témoignera de la prédominance de la préparation factuelle et psychologique de l’individu pour anticiper et mieux accueillir les réalités du parcours migratoire.