Nurses’ perceptions of nursing presence and the relationship between nursing presence and moral sensitivity in nurses working with people with dementia in residential care

Aim: The aim of this study was to measure nursing presence among nurses caring for people with dementia in residential care settings, and to investigate the relationship between nursing presence and moral sensitivity. Background: Nursing presence is a core relational skill in nursing and holds many benefits for nurses and their patients. Moral sensitivity is defined as how one recognises the moral elements of a situation, and how one’s moral or ethical decision making may impact on an individual. Methods: A descriptive, cross sectional quantitative methodology was used with a sample of 150 registered nurses. The Presence of Nursing Scale for Registered Nurses was used to investigate nursing presence, and the Moral Sensitivity Questionnaire for moral sensitivity. Results: Findings from the study demonstrated that participants agreed with the majority of elements of nursing presence, (mean 76.97, SD= 7.51). A mean score of 36.22 was evidence of a well developed level of moral sensitivity in participants. Nurses who perceived themselves to be highly present to their patients also scored highest on certain elements of moral sensitivity such as moral strength. Nursing presence was also found to be more developed in those participants that rated themselves as having higher levels of expertise based on Benner’s (1984) definitions. Older nurses also scored higher on nursing presence. There was a high level of agreement that factors such as lack of time (n=133), and heavy workload influenced nursing presence. Nurses, who were older and had longer clinical experience, were shown to have greater moral strength. There were differences in elements of moral sensitivity between groups of nurses who ranked themselves according to Benner’s (1984) competence framework with higher scores evident in the more expert groups. Conclusion: Overall, this study showed that participants had a well developed level of nursing presence, and certain elements of moral sensitivity are positively related to nursing presence. Nursing presence appears to be linked to the level of expertise of the nurse but factors such as time and workload do influence nursing presence.

Solitons in Exciton-Polariton System: Reduced Modelling, Analysis, and Numerical Studies

In this dissertation, we study the behavior of exciton-polariton quasiparticles in semiconductor microcavities, under the sourceless and lossless conditions.

First, we simplify the original model by removing the photon dispersion term, thus effectively turn the PDEs system to an ODEs system,

and investigate the behavior of the resulting system, including the equilibrium points and the wave functions of the excitons and the photons.

Second, we add the dispersion term for the excitons to the original model and prove that the band of the discontinuous solitons now become dark solitons.

Third, we employ the Strang-splitting method to our sytem of PDEs and prove the first-order and second-order error bounds in the $H^1$ norm and the $L_2$ norm, respectively.

Using this numerical result, we analyze the stability of the steady state bright soliton solution. This solution revolves around the $x$-axis as time progresses

and the perturbed soliton also rotates around the $x$-axis and tracks closely in terms of amplitude but lags behind the exact one. Our numerical result shows orbital

stability but no $L_2$ stability.

Transferability of Regional Permafrost Disturbance Susceptibility Modelling Using Generalized Linear and Generalized Additive Models

To effectively assess and mitigate risk of permafrost disturbance, disturbance-p rone areas can be predicted through the application of susceptibility models. In this study we developed regional susceptibility models for permafrost disturbances using a field disturbance inventory to test the transferability of the model to a broader region in the Canadian High Arctic. Resulting maps of susceptibility were then used to explore the effect of terrain variables on the occurrence of disturbances within this region. To account for a large range of landscape charac- teristics, the model was calibrated using two locations: Sabine Peninsula, Melville Island, NU, and Fosheim Pen- insula, Ellesmere Island, NU. Spatial patterns of disturbance were predicted with a generalized linear model (GLM) and generalized additive model (GAM), each calibrated using disturbed and randomized undisturbed lo- cations from both locations and GIS-derived terrain predictor variables including slope, potential incoming solar radiation, wetness index, topographic position index, elevation, and distance to water. Each model was validated for the Sabine and Fosheim Peninsulas using independent data sets while the transferability of the model to an independent site was assessed at Cape Bounty, Melville Island, NU. The regional GLM and GAM validated well for both calibration sites (Sabine and Fosheim) with the area under the receiver operating curves (AUROC) N 0.79. Both models were applied directly to Cape Bounty without calibration and validated equally with AUROC's of 0.76; however, each model predicted disturbed and undisturbed samples differently. Addition- ally, the sensitivity of the transferred model was assessed using data sets with different sample sizes. Results in- dicated that models based on larger sample sizes transferred more consistently and captured the variability within the terrain attributes in the respective study areas. Terrain attributes associated with the initiation of dis- turbances were similar regardless of the location. Disturbances commonly occurred on slopes between 4 and 15°, below Holocene marine limit, and in areas with low potential incoming solar radiation

Essays in dynamic optimal taxation: working experience, unemployment scarring and poverty

This thesis investigates the design of optimal tax systems in dynamic environments. The first essay characterizes the optimal tax system where wages depend on stochastic shocks and work experience. In addition to redistributive and efficiency motives, the taxation of inexperienced workers depends on a second-best requirement that encourages work experience, a social insurance motive and incentive effects. Calibrations using U.S. data yield higher expected optimal marginal income tax rates for experienced workers for most of the inexperienced workers. They confirm that the average marginal income tax rate increases (decreases) with age when shocks and work experience are substitutes (complements). Finally, more variability in experienced workers' earnings prospects leads to increasing tax rates since income taxation acts as a social insurance mechanism. In the second essay, the properties of an optimal tax system are investigated in a dynamic private information economy where labor market frictions create unemployment that destroys workers' human capital. A two-skill type model is considered where wages and employment are endogenous. I find that the optimal tax system distorts the first-period wages of all workers below their efficient levels which leads to more employment. The standard no-distortion-at-the-top result no longer holds due to the combination of private information and the destruction of human capital. I show this result analytically under the Maximin social welfare function and confirm it numerically for a general social welfare function. I also investigate the use of a training program and job creation subsidies. The final essay analyzes the optimal linear tax system when there is a population of individuals whose perceptions of savings are linked to their disposable income and their family background through family cultural transmission. Aside from the standard equity/efficiency trade-off, taxes account for the endogeneity of perceptions through two channels. First, taxing labor decreases income, which decreases the perception of savings through time. Second, taxation on savings corrects for the misperceptions of workers and thus savings and labor decisions. Numerical simulations confirm that behavioral issues push labor income taxes upward to finance saving subsidies. Government transfers to individuals are also decreased to finance those same subsidies.

The Pico de Navas slump (Burgos, Spain): a large rocky landslide caused by underlying clayey sand fluidification

The Pico de Navas landslide was a large-magnitude rotational movement, affecting 50x106m3 of hard to soft rocks. The objectives of this study were: (1) to characterize the landslide in terms of geology, geomorphological features and geotechnical parameters; and (2) to obtain an adequate geomechanical model to comprehensively explain its rupture, considering topographic, hydro-geological and geomechanical conditions. The rupture surface crossed, from top to bottom: (a) more than 200 m of limestone and clay units of the Upper Cretaceous, affected by faults; and (b) the Albian unit of Utrillas facies composed of silty sand with clay (Kaolinite) of the Lower Cretaceous. This sand played an important role in the basal failure of the slide due to the influence of fine particles (silt and clay), which comprised on average more than 70% of the sand, and the high content presence of kaolinite (>40%) in some beds. Its geotechnical parameters are: unit weight (δ) = 19-23 KN/m3; friction angle (φ) = 13º-38º and cohesion (c) = 10-48 KN/m2. Its microstructure consists of accumulations of kaolinite crystals stuck to terrigenous grains, making clayey peds. We hypothesize that the presence of these aggregates was the internal cause of fluidification of this layer once wet. Besides the faulted structure of the massif, other conditioning factors of the movement were: the large load of the upper limestone layers; high water table levels; high water pore pressure; and the loss of strength due to wet conditions. The 3D simulation of the stability conditions concurs with our hypothesis. The landslide occurred in the Recent or Middle Holocene, certainly before at least 500 BC and possibly during a wet climate period. Today, it appears to be inactive. This study helps to understand the frequent slope instabilities all along the Iberian Range when facies Utrillas is present.

Ultracompact Retrodirective Antenna Arrays With Superdirective Radiation Patterns

It is shown that the direction-of-arrival (DoA) information carried by an incident electromagnetic (EM) wave can be encoded into the evanescent near field of an electrically small resonance antenna array with a spatial rate higher than that of the incident field oscillation rate in free space. Phase conjugation of the received signal leads to the retrodirection of the near field in the antenna array environment, which in turn generates a retrodirected far-field beam toward the original DoA. This EM phenomenon enables electrically small retrodirective antenna arrays with superdirective, angular super-resolution, auto-pointing properties for an arbitrary DoA. A theoretical explanation of the phenomenon based on first principal observations is given and full-wave simulations demonstrate a realizability route for the proposed retrodirective terminal that is comprised of resonance dipole antenna elements. Specifically, it is shown that a three-element disk-loaded retrodirective dipole array with 0.15\lambda spacings can achieve a 3.4-dBi maximal gain, 3-dBi front-to-back ratio, and 13% return loss fractional bandwidth (at the 10-dB level). Then, it is demonstrated that the radiation gain of a three-element array can be improved to approximately 6 dBi at the expense of the return loss fractional bandwidth reduction (2%).

Are you ready for a tender project? – Analysis of organisational project management maturity in the Austrian-Hungarian border region

Are you ready for a tender project? – Analysis of organisational project management maturity in the Austrian- Hungarian border region. Since the 1990s the European Union has paid more and more attention to subsidising cross-border development. It is understandable that different funding from proposal sources is particularly important for the border area, especially to those of utmost importance that support co-operation and rural development. Therefore, they could become a driving force for development. The authors’ research analyses the organisational project management maturity of the projects implemented in the frame of the Austria-Hungary Cross-border Cooperation Programme 2007-2013 (AT-HU). Analysing this kind of organisation is an important issue, since the new call for proposals are open in 2016 and the results of this study may provide a self-evaluation opportunity to organisations that need to know if they are ready or mature enough for a new tender project. The aim of this study was twofold. First of all, those indicators that could be used to analyse the project management maturity of implementing organisations in the AT-HU programme were identified. Based on the empirical research these are the project experience accumulated by the organisation, the internal processes operating at the institution and the professional background. Secondly, factors that can affect this project management maturity were explored and we determined five influencing area: the organisational structure, culture, project managers motivation and the typical and important competences.

An active vision system integrating fast and slow processes

[EN]This paper describes an Active Vision System whose design assumes a distinction between fast or reactive and slow or background processes. Fast processes need to operate in cycles with critical timeouts that may affect system stability. While slow processes, though necessary, do not compromise system stability if its execution is delayed. Based on this simple taxonomy, a control architecture has been proposed and a prototype implemented that is able to track people in real-time with a robotic head while trying to identify the target. In this system, the tracking module is considered as the reactive part of the system while person identification is considered a background task.

From Screening to Synthesis: Using NVivo to Enhance Transparency in Qualitative Evidence Synthesis

Aims and objectives The aim of this qualitative evidence synthesis was to explore the experiences and perceptions of health care staff caring for people with dementia in the acute setting. This paper focuses on the methodological process of conducting framework synthesis using NVivo for each stage of the review: screening, data extraction, synthesis and critical appraisal. Background Qualitative evidence synthesis brings together many research findings in a meaningful way that can be used to guide practice and policy development. For this purpose, synthesis must be conducted in a comprehensive and rigorous way. There has been previous discussion on how using NVivo can assist in enhancing and illustrate the rigorous processes involved. Design Qualitative Framework Synthesis. Methods Twelve documents, or research reports, based on nine studies, were included for synthesis. Conclusion The benefits of using NVivo are outlined in terms of facilitating teams of researchers to systematically and rigorously synthesise findings. NVivo functions were used to conduct a sensitivity analysis. Some valuable lessons were learned and these are presented to assist and guide researchers who wish to use similar methods in future.

Lucrecio, "De rerum natura": Sentido y coherencia del prólogo

El prólogo del De rerum natura de Lucrecio (1.1-148) parece ser un tema gastado: ha sido tratado decenas de veces tanto por su excelente calidad como por los problemas que plantea. Pero esperamos poder dar un nuevo sentido y solución a ambos aspectos. En primer lugar, el himno a Venus no es una mera convención, sino que respira sentimiento religioso; Venus no personifica a la naturaleza, sino al placer y la felicidad y ni la hegemonía que se dice ejerce Venus, ni las plegarias que contiene el himno contradicen la teología epicúrea. Todavía más, nos parece que el himno constituye una auténtica epifanía religiosa muy propia de la teología epicúrea. En segundo lugar, suponiendo que el autor ha tomado como tema compartido los schemata o grados de dificultad de la intellectio retórica en el texto de 1.50-148, se intentan solucionar las dificultades de coherencia del texto.

Mania Triggered by Sleep Loss: Implications for Postpartum Psychosis

Background and Aims To examine whether a history of mood episodes triggered by sleep loss is associated with (1) postpartum psychosis (PP) and (2) more broadly-defined postpartum mood episodes that included postnatal depression (PND), in women with bipolar disorder (BD). Methods Participants were 622 parous women with a diagnosis of bipolar-I disorder recruited in the UK to the Bipolar Disorder Research Network. Diagnosis and perinatal episodes were assessed via interview and case note data. Women were also asked during the interview whether episodes of mania and/or depression were triggered by sleep loss. We compared the rates of PP and PND within women who did and did not endorse sleep loss as a trigger of mood episodes. Results Women who reported that their episodes of mania were usually triggered by sleep loss were twice as likely to have experienced an episode of PP (OR = 2.00, 95% CI = 1.20–3.36) than women who did not report this. This effect remained significant when controlling for clinical and demographic factors. We found no significant associations between depression triggered by sleep loss and PP. Analyses in which we defined postpartum episodes at a broader level to include both PP and PND were not significant. Conclusions In pregnant women with BD, a history of mania following sleep loss could be a potential marker of vulnerability to severe postpartum episodes. Further study in prospective samples is required in order to confirm these findings, which may have important implications for understanding the aetiology of PP and of mood disorders more generally.

Intimate Partner Violence and Pregnancy Intentions: A Qualitative Study

Aim and Objective In this qualitative study we explored women’s pregnancy intentions and experiences of intimate partner violence before, during and after pregnancy. Background Unintended pregnancies in the context of intimate partner violence can have serious health, social and economic consequences for women and their children. Design Feminist and phenomenological philosophies underpinned the study to gain a richer understanding of women’s experiences. Methods Eleven women who had been pregnant in the previous two years were recruited from community-based women’s refuges in one region of the United Kingdom. Of the eleven women, eight had unplanned pregnancies, two reported being coerced into early motherhood, and only one woman had purposively planned her pregnancy. Multiple in-depth interviews focused on participants’ accounts of living with intimate partner violence. Experiential data analysis was used to identify, analyse and highlight themes. Results Three major themes were identified: men’s control of contraception, partner’s indiscriminate response to the pregnancy, and women’s mixed feelings about the pregnancy. Participants reported limited influence over their sexual relationship and Accepted Article This article is protected by copyright. All rights reserved. birth control. Feelings of vulnerability about themselves and fear for their unborn babies’ safety were intensified by their partners’ continued violence during pregnancy. Conclusion Women experiencing intimate partner violence were more likely to have an unintended pregnancy. This could be attributed to male dominance and fear, which impacts on a woman’s ability to manage her birth control options. The women’s initial excitement about their pregnancy diminished in the face of uncertainty and ongoing violence within their relationship. Relevance to clinical practice Women experiencing violence lack choice in relation to birth control options leading to unintended pregnancies. Interpreting the findings from the victim-perpetrator interactive spin theory of intimate partner violence provides a possible framework for midwives and nurses to better understand and respond to women’s experiences of violence during pregnancy.

Storage stability of bevacizumab in polycarbonate and polypropylene syringes

Purpose To compare and examine the storage stability of compounded bevacizumab in polycarbonate (PC) and polypropylene (PP) syringes over a 6-month period. PC syringes have been used in a recent clinical study and bevacizumab stability has not been reported for this type of syringe. Methods Repackaged bevacizumab was obtained from Moorfields Pharmaceuticals in polycarbonate (PC) and polypropylene (PP) syringes. Bevacizumab from the stored syringes was analysed at monthly time points for a 6-month period and compared with bevacizumab from a freshly opened vial at each time point. SDS-PAGE electrophoresis and size-exclusion chromatography (SEC) was used to observe aggregation and degradation. Dynamic light scattering (DLS) provided information about the hydrodynamic size and particle size distribution of bevacizumab in solution. VEGF binding and the active concentration of bevacizumab was determined by surface plasmon resonance (SPR) using Biacore. Results SDS-PAGE and SEC analysis did not show any changes in the presence of higher molecular species (HMWS) or degradation products in PC and PP syringes from T0 to T6 compared to bevacizumab sampled from a freshly opened vial. The hydrodynamic diameter of bevacizumab in the PC syringe after six months of storage was not significantly different to bevacizumab taken from a freshly opened vial. Using SPR, the VEGF binding activity of bevacizumab in the PC syringe was comparable with bevacizumab taken from a freshly opened vial. Conclusion No significant difference over a 6-month period was observed in the quality of bevacizumab repackaged into prefilled PC polycarbonate and PP polypropylene syringes when compared to bevacizumab that is supplied from the vial.

Thermodynamics and Heat Transport of doped Spin-Ice Materials

In this thesis the low-temperature magnetism of the spin-ice systems Dy2Ti2O7 and Ho2Ti2O7 is investigated. In general, a clear experimental evidence for a sizable magnetic contribution kappa_{mag} to the low-temperature, zero-field heat transport of both spin-ice materials is observed. This kappa_{mag} can be attributed to the magnetic monopole excitations, which are highly mobile in zero field and are suppressed by a rather small external field resulting in a drop of kappa(H). Towards higher magnetic fields, significant field dependencies of the phononic heat conductivities kappa_{ph}(H) of Ho2Ti2O7 and Dy2Ti2O7 are found, which are, however, of opposite signs, as it is also found for the highly dilute reference materials (Ho0.5Y0.5)2Ti2O7 and (Dy0.5Y0.5)2Ti2O7. The dominant effect in the Ho-based materials is the scattering of phonons by spin flips which appears to be significantly stronger than in the Dy-based materials. Here, the thermal conductivity is suppressed due to enhanced lattice distortions observed in the magnetostriction. Furthermore, the thermal conductivity of Dy2Ti2O7 has been investigated concerning strong hysteresis effects and slow-relaxation processes towards equilibrium states in the low-temperature and low-field regime. The thermal conductivity in the hysteretic regions slowly relaxes towards larger values suggesting that there is an additional suppression of the heat transport by disorder in the non-equilibrium states. The equilibration can even be governed by the heat current for particular configurations. A special focus was put on the dilution series Dy2Ti2O7x. From specific heat measurements, it was found that the ultra-slow thermal equilibration in pure spin ice Dy2Ti2O7 is rapidly suppressed upon dilution with non-magnetic yttrium and vanishes completely for x>=0.2 down to the lowest accessible temperatures. In general, the low-temperature entropy of (Dy1-xYx)2Ti2O7, considerably decreases with increasing x, whereas its temperature-dependence drastically increases. Thus, it could be clarified that there is no experimental evidence for a finite zero-temperature entropy in (Dy1-xYx)2Ti2O7 above x>=0.2, in clear contrast to the finite residual entropy S_{P}(x) expected from a generalized Pauling approximation. A similar discrepancy is also present between S_{P}(x) and the low-temperature entropy obtained by Monte Carlo simulations, which reproduce the experimental data from 25 K down to 0.7 K, whereas the data at 0.4 K are overestimated. A straightforward description of the field-dependence kappa(H) of the dilution series with qualitative models justifies the extraction of kappa_{mag}. It was observed that kappa_{mag} systematically scales with the degree of dilution and its low-field decrease is related to the monopole excitation energy. The diffusion coefficient D_{mag} for the monopole excitations was calculated by means of c_{mag} and kappa_{mag}. It exhibits a broad maximum around 1.6 K and is suppressed for T<=0.5 K, indicating a non-degenerate ground state in the long-time limit, and in the high-temperature range for T>=4 K where spin-ice physics is eliminated. A mean-free path of 0.3 mum is obtained for Dy2Ti2O7 at about 1 K within the kinetic gas theory.

Big bang bifurcations in von Bertalanffy’s dynamics with strong and weak Allee effects

The main purpose of this work was to study population dynamic discrete models in which the growth of the population is described by generalized von Bertalanffy's functions, with an adjustment or correction factor of polynomial type. The consideration of this correction factor is made with the aim to introduce the Allee effect. To the class of generalized von Bertalanffy's functions is identified and characterized subclasses of strong and weak Allee's functions and functions with no Allee effect. This classification is founded on the concepts of strong and weak Allee's effects to population growth rates associated. A complete description of the dynamic behavior is given, where we provide necessary conditions for the occurrence of unconditional and essential extinction types. The bifurcation structures of the parameter plane are analyzed regarding the evolution of the Allee limit with the aim to understand how the transition from strong Allee effect to no Allee effect, passing through the weak Allee effect, is realized. To generalized von Bertalanffy's functions with strong and weak Allee effects is identified an Allee's effect region, to which is associated the concepts of chaotic semistability curve and Allee's bifurcation point. We verified that under some sufficient conditions, generalized von Bertalanffy's functions have a particular bifurcation structure: the big bang bifurcations of the so-called box-within-a-box type. To this family of maps, the Allee bifurcation points and the big bang bifurcation points are characterized by the symmetric of Allee's limit and by a null intrinsic growth rate. The present paper is also a significant contribution in the framework of the big bang bifurcation analysis for continuous 1D maps and unveil their relationship with the explosion birth and the extinction phenomena.