L’étendue effective de la pratique d’infirmières en pédiatrie : ses déterminants et son influence sur la satisfaction professionnelle

Le déploiement optimal de l’étendue de la pratique infirmière, qui traduit la mise en œuvre du rôle professionnel, est essentiel à l’accessibilité, à la continuité, à la qualité ainsi qu’à la sécurité des soins, dont ceux dispensés aux enfants et à leur famille. Or, il semble que les infirmières éprouvent certaines difficultés à déployer pleinement leur étendue de pratique, ce qui pourrait également compromettre la satisfaction professionnelle, un enjeu majeur pour la rétention du personnel dans les organisations de soins de santé. Le but de cette étude est de mesurer l’étendue effective de la pratique d’infirmières en pédiatrie, ses déterminants et son influence sur la satisfaction professionnelle. Le cadre de référence, un modèle original développé dans cette thèse, prend appui sur la théorie des caractéristiques de l’emploi (Hackman & Oldham, 1974), le modèle tension-autonomie (Karasek, 1985), la théorie du rôle (Biddle, 1979) et les travaux de D’Amour et al. (2012) portant sur l’étendue de la pratique infirmière. Afin d’atteindre le but de cette étude, le modèle développé met en relation les caractéristiques du travail et les caractéristiques individuelles d’influence potentielle sur le déploiement de l’étendue de la pratique infirmière. Il présuppose également un lien entre l’étendue de la pratique infirmière et la satisfaction professionnelle. Un devis corrélationnel descriptif a été retenu pour cette étude. Une enquête par questionnaire auprès d’infirmières de cinq secteurs d’activités d’un centre hospitalier pédiatrique universitaire du Québec a été réalisée (N=301). Les associations entre les variables ont été examinées en utilisant des analyses bivariées, multivariées et un modèle d’équations structurelles. Les analyses effectuées révèlent une bonne concordance du modèle développé (ratio x²/dl= 1,68; RMSEA = ,049; CFI = ,985). Au total, le modèle explique 32,5 % de la variance de l’étendue de la pratique infirmière et 11,3% de la variance de la satisfaction professionnelle. Les résultats font état d’un déploiement non-optimal de l’étendue de la pratique infirmière (3,21/6; É.T.= ,707). Les variables significativement associées au déploiement de l’étendue de la pratique infirmière sont: la latitude décisionnelle (β = ,319; p <0,01), la surcharge de rôle (β = ,201; p <0,05), l’ambiguïté de rôle (β = ,297; p <0,05), le besoin de croissance individuelle de l’infirmière (β = ,151; p <0,05) et le niveau de formation (β = ,128; p <0,05). Il est également démontré que l’étendue de la pratique infirmière est associée positivement à la satisfaction professionnelle (β = ,118; p <0,01). Une description plus détaillée des résultats de l’étendue de la pratique infirmière en fonction du niveau de formation et du poste occupé met en lumière que les infirmières bachelières ont une étendue de pratique significativement plus élevée (3,35; É.T =,746) que les infirmières collégiales (3,12; É.T =,669). L’occupation d’un poste de clinicienne est aussi associée à une plus grande étendue de pratique infirmière. Précisément, les infirmières qui occupent un poste d’infirmière obtiennent un score de 3,13/6 (É.T =,664) alors que le score des infirmières qui occupent un poste de clinicienne s’élève à 3,48/6 (É.T =,798). Cette étude innove en présentant un modèle de référence qui a le potentiel de générer des connaissances importantes en sciences infirmières en lien avec le déploiement optimal de l’étendue de pratique infirmière. Prenant appui sur ce modèle novateur, les résultats révèlent les caractéristiques du travail sur lesquelles il y a urgence d’agir afin d’accroître le déploiement de l’étendue de la pratique infirmière et par le fait même la satisfaction professionnelle.

A Synergistic Approach to Human Rights and Public Health Ethics: Effective or a Source of Conflict?

Commentaire / Commentary

Effective mass and dielectric constant mismatch effects in spherical multishell quantum dots

The role of effective mass and dielectric mismatches on chemical potentials and addition energies of many-electron multishell quantum dots (QDs) is explored within the framework of a recent extension of the spin density functional theory. It is shown that although the gross electronic density is located in the wells of these multishell QDs, taking position-dependent effective mass and dielectric constant into account can lead to the appearance of relevant differences in chemical potential and addition energies as compared to standard calculations in which the effective mass and the dielectric constant of the well is assumed for the whole multishell structure.

Power Profile of Effective Managers: An Exploration among the Branch Managers of a Commercial Bank in Kerala

Managers are central to any fuction in a complex and developed society. Their talents are reckoned to be cardinal in developed economies and a basic yearning of all developing economies.In order to survive and produce results in a turbulent and transient environment, the task is to understand the nature of factors contributing to managerial effectiveness. This study is an attempt towards this core issue of the present from a different perspective. This study tries to focus attention on a group of managers functioning in the field of banking, a core sector in the country's economy. The gamut of economic activities in Kerala being predominantly service-oriented, importance of commercial banking is almost indisputable. Though economists would argue that the disproportionate development of service sector is anomalous when viewed against the hazy scenarios in the primary and secondary sectors of the state’s economy, the extent and pace of growth in the banking sector has had its dole meted out by ambitious and productive managers fiinctioning in the field. Researcher’s attempt here is to thresh the grain and chaff among bank managers in terms of their effectiveness and to account for the variations in the light of their ability to affect the thoughts and actions of their subordinates. To put it succinctly, the attempt herein is to explain the effectiveness of bank managers in the light of their ‘Power Profile’ taken to be comprising Power Differentials, Power Bases, their Visibility and Credibility in the organisation and, the Power Styles typically used by them for influencing subordinates.

Studies on gaussian effective potentials in some models

In classical field theory, the ordinary potential V is an energy density for that state in which the field assumes the value ¢. In quantum field theory, the effective potential is the expectation value of the energy density for which the expectation value of the field is ¢o. As a result, if V has several local minima, it is only the absolute minimum that corresponds to the true ground state of the theory. Perturbation theory remains to this day the main analytical tool in the study of Quantum Field Theory. However, since perturbation theory is unable to uncover the whole rich structure of Quantum Field Theory, it is desirable to have some method which, on one hand, must go beyond both perturbation theory and classical approximation in the points where these fail, and at that time, be sufficiently simple that analytical calculations could be performed in its framework During the last decade a nonperturbative variational method called Gaussian effective potential, has been discussed widely together with several applications. This concept was described as a means of formalizing our intuitive understanding of zero-point fluctuation effects in quantum mechanics in a way that carries over directly to field theory.

Effective t-J model Hamiltonian parameters of monolayered cuprate superconductors from ab initio electronic structure calculations

The magnetic coupling constant of selected cuprate superconductor parent compounds has been determined by means of embedded cluster model and periodic calculations carried out at the same level of theory. The agreement between both approaches validates the cluster model. This model is subsequently employed in state-of-the-art configuration interaction calculations aimed to obtain accurate values of the magnetic coupling constant and hopping integral for a series of superconducting cuprates. Likewise, a systematic study of the performance of different ab initio explicitly correlated wave function methods and of several density functional approaches is presented. The accurate determination of the parameters of the t-J Hamiltonian has several consequences. First, it suggests that the appearance of high-Tc superconductivity in existing monolayered cuprates occurs with J/t in the 0.20¿0.35 regime. Second, J/t=0.20 is predicted to be the threshold for the existence of superconductivity and, third, a simple and accurate relationship between the critical temperatures at optimum doping and these parameters is found. However, this quantitative electronic structure versus Tc relationship is only found when both J and t are obtained at the most accurate level of theory.

The role of dynamical polarization of the ligand-to-metal charge transfer excitations in the ab initio determination of effective exchange parameters

The role of the bridging ligand on the effective Heisenberg coupling parameters is analyzed in detail. This analysis strongly suggests that the ligand-to-metal charge transfer excitations are responsible for a large part of the final value of the magnetic coupling constant. This permits us to suggest a variant of the difference dedicated configuration interaction (DDCI) method, presently one of the most accurate and reliable for the evaluation of magnetic effective interactions. This method treats the bridging ligand orbitals mediating the interaction at the same level than the magnetic orbitals and preserves the high quality of the DDCI results while being much less computationally demanding. The numerical accuracy of the new approach is illustrated on various systems with one or two magnetic electrons per magnetic center. The fact that accurate results can be obtained using a rather reduced configuration interaction space opens the possibility to study more complex systems with many magnetic centers and/or many electrons per center.

First principles LDA+U and GGA+U study of cerium oxides: Dependence on the effective U-parameter

The electronic structure and properties of cerium oxides (CeO2 and Ce2O3) have been studied in the framework of the LDA+U and GGA(PW91)+U implementations of density functional theory. The dependence of selected observables of these materials on the effective U parameter has been investigated in detail. The examined properties include lattice constants, bulk moduli, density of states, and formation energies of CeO2 and Ce2O3. For CeO2, the LDA+U results are in better agreement with experiment than the GGA+U results whereas for the computationally more demanding Ce2O3 both approaches give comparable accuracy. Furthermore, as expected, Ce2O3 is much more sensitive to the choice of the U value. Generally, the PW91 functional provides an optimal agreement with experiment at lower U energies than LDA does. In order to achieve a balanced description of both kinds of materials, and also of nonstoichiometric CeO2¿x phases, an appropriate choice of U is suggested for LDA+U and GGA+U schemes. Nevertheless, an optimum value appears to be property dependent, especially for Ce2O3. Optimum U values are found to be, in general, larger than values determined previously in a self-consistent way.

Effects of new nonlinear couplings in relativistic effective field theory

We extend the relativistic mean field theory model of Sugahara and Toki by adding new couplings suggested by modern effective field theories. An improved set of parameters is developed with the goal to test the ability of the models based on effective field theory to describe the properties of finite nuclei and, at the same time, to be consistent with the trends of Dirac-Brueckner-Hartree-Fock calculations at densities away from the saturation region. We compare our calculations with other relativistic nuclear force parameters for various nuclear phenomena.

Superheavy nuclei in relativistic effective Lagrangian model

Isotopic and isotonic chains of superheavy nuclei are analyzed to search for spherical double shell closures beyond Z=82 and N=126 within the new effective field theory model of Furnstahl, Serot, and Tang for the relativistic nuclear many-body problem. We take into account several indicators to identify the occurrence of possible shell closures, such as two-nucleon separation energies, two-nucleon shell gaps, average pairing gaps, and the shell correction energy. The effective Lagrangian model predicts N=172 and Z=120 and N=258 and Z=120 as spherical doubly magic superheavy nuclei, whereas N=184 and Z=114 show some magic character depending on the parameter set. The magicity of a particular neutron (proton) number in the analyzed mass region is found to depend on the number of protons (neutrons) present in the nucleus.

Atomic parity nonconservation, neutron radii, and effective field theories of nuclei

Accurately calibrated effective field theories are used to compute atomic parity nonconserving (APNC) observables. Although accurately calibrated, these effective field theories predict a large spread in the neutron skin of heavy nuclei. Whereas the neutron skin is strongly correlated to numerous physical observables, in this contribution we focus on its impact on new physics through APNC observables. The addition of an isoscalar-isovector coupling constant to the effective Lagrangian generates a wide range of values for the neutron skin of heavy nuclei without compromising the success of the model in reproducing well-constrained nuclear observables. Earlier studies have suggested that the use of isotopic ratios of APNC observables may eliminate their sensitivity to atomic structure. This leaves nuclear structure uncertainties as the main impediment for identifying physics beyond the standard model. We establish that uncertainties in the neutron skin of heavy nuclei are at present too large to measure isotopic ratios to better than the 0.1% accuracy required to test the standard model. However, we argue that such uncertainties will be significantly reduced by the upcoming measurement of the neutron radius in 208^Pb at the Jefferson Laboratory.