Patient Seclusion and Restraint Practices in Psychiatric Hospitals - Towards Evidence Based Clinical Nursing

The overall goal of this study was to support evidence based clinical nursing regarding patient seclusion and restraint practices. This was done by ensuring professional competence through innovative learning methods. The data were collected in three phases between March 2007 and May 2009 on acute psychiatric wards. Firstly, psychiatric inpatients’ experiences and suggestions for seclusion and restraint practices were explored (n=30). Secondly, nursing and medical personnel’s perceptions of seclusion and restraint practices were explored (n=27). Thirdly, the impacts of a continuing vocational eLearning course on nurses’ professional competence was evaluated (n=158). Patients’ perspectives received insufficient attention during the seclusion and restraint process. Improvements and alternatives to seclusion and restraint as suggested by the patients focused on essential parts of clinical nursing, but were not extensively adopted. Also nursing and medical personnel thought that patients’ subjective perspective received little attention. Personnel proposed a number of alternatives to seclusion and restraint, and they expressed a need for education and support to adopt these in clinical nursing. Evaluation of impacts of eLearning course on nurses’ professional competence showed no statistical differences between an eLearning group and an education-as-usual group. This dissertation provides evidence based knowledge about the realization of seclusion and restraint practices and the impacts of eLearning course on nurses’ professional competence in psychiatric hospitals. In order to improve clinical nursing the patient perspective must be accentuated. To ensure personnel’s professional competence, there is a need for written clinical guidelines, education and support. Continuing vocational education should bring together written clinical guidelines, ethical and legal issues and the support for personnel. To achieve the ambitious goal of such integration, achievable and affordable educational programmes are required. This, in turn, yields a call for innovative learning methods.

Survey on control and management practices of equine helminthes infection

Twenty-nine stud farms were selected in the Medium Paraíba region of the Rio de Janeiro state, Brazil. After an interview with the person responsible for the animals, faecal samples were collected from mares and analyzed via the EPG technique, faecal cultures, Sedimentation-centrifugo-flotation, and modified Ueno and Baermann techniques. The prevalence of helminths in the mares and in the stud farms was calculated. The stocking rates of pasture, change of horse bedding, absence of pasture rotation, absence of technology in the property, and less frequent treatment of the animals were associated with a greater prevalence of helminths, showing that these variables must be considered in equine control programs. The intensity of the parasitism was also associated with the stocking rate of pasture, absence of dunghill, presence of the animals only in paddocks, lack of technology in the property, less frequent treatment of the animals, and absence of the use of rotation regarding the anthelmintic class.

Managing business risk relating to pending patent applications – A comparison U.S. and European practices

This thesis presents different IPR risk mitigation actions as well as enforcement practices and evaluates their usability in different situations. The focus is on pending patent applications, where the right is not officially recognized or established yet, but some references are made to granted patents as well. The thesis presents the different aspects when assessing the risk level created by patents and pending applications. At all times it compares the patent law of the United States and European Patent Convention. Occasionally some references are made to national law, when the European Patent Convention cannot be applied. The thesis presents two case examples, which bring the risk mitigation actions and enforcement practices closer to practice.

Effect of exercise training and carvedilol treatment on cardiac function and structure in mice with sympathetic hyperactivity-induced heart failure

The present investigation was undertaken to study the effect of β-blockers and exercise training on cardiac structure and function, respectively, as well as overall functional capacity in a genetic model of sympathetic hyperactivity-induced heart failure in mice (α2A/α2CArKO). α2A/α2CArKO and their wild-type controls were studied for 2 months, from 3 to 5 months of age. Mice were randomly assigned to control (N = 45), carvedilol-treated (N = 29) or exercise-trained (N = 33) groups. Eight weeks of carvedilol treatment (38 mg/kg per day by gavage) or exercise training (swimming sessions of 60 min, 5 days/week) were performed. Exercise capacity was estimated using a graded treadmill protocol and HR was measured by tail cuff. Fractional shortening was evaluated by echocardiography. Cardiac structure and gastrocnemius capillary density were evaluated by light microscopy. At 3 months of age, no significant difference in fractional shortening or exercise capacity was observed between wild-type and α2A/α2CArKO mice. At 5 months of age, all α2A/α2CArKO mice displayed exercise intolerance and baseline tachycardia associated with reduced fractional shortening and gastrocnemius capillary rarefaction. In addition, α2A/ α2CArKO mice presented cardiac myocyte hypertrophy and ventricular fibrosis. Exercise training and carvedilol similarly improved fractional shortening in α2A/α2CArKO mice. The effect of exercise training was mainly associated with improved exercise tolerance and increased gastrocnemius capillary density while β-blocker therapy reduced cardiac myocyte dimension and ventricular collagen to wild-type control levels. Taken together, these data provide direct evidence for the respective beneficial effects of exercise training and carvedilol in α2A/α2CArKO mice preventing cardiac dysfunction. The different mechanisms associated with beneficial effects of exercise training and carvedilol suggest future studies associating both therapies.

Exercise training and detraining modify the morphological and mechanical properties of single cardiac myocytes obtained from spontaneously hypertensive rats

We determined the effects of exercise training and detraining on the morphological and mechanical properties of left ventricular myocytes in 4-month-old spontaneously hypertensive rats (SHR) randomly divided into the following groups: sedentary for 8 weeks (SED-8), sedentary for 12 weeks (SED-12), treadmill-running trained for 8 weeks (TRA, 16 m/min, 60 min/day, 5 days/week), and treadmill-running trained for 8 weeks followed by 4 weeks of detraining (DET). At sacrifice, left ventricular myocytes were isolated enzymatically, and resting cell length, width, and cell shortening after stimulation at a frequency of 1 Hz (~25°C) were measured. Cell length was greater in TRA than in SED-8 (161.30 ± 1.01 vs 156.10 ± 1.02 μm, P < 0.05, 667 vs 618 cells, respectively) and remained larger after detraining. Cell width and volume were unaffected by either exercise training or detraining. Cell length to width ratio was higher in TRA than in SED-8 (8.50 ± 0.08 vs 8.22 ± 0.10, P < 0.05) and was maintained after detraining. Exercise training did not affect cell shortening, which was unchanged with detraining. TRA cells exhibited higher maximum velocity of shortening than SED-8 (102.01 ± 4.50 vs 82.01 ± 5.30 μm/s, P < 0.05, 70 cells per group), with almost complete regression after detraining. The maximum velocity of relengthening was higher in TRA cells than in SED-8 (88.20 ± 4.01 vs70.01 ± 4.80 μm/s, P < 0.05), returning to sedentary values with detraining. Therefore, exercise training affected left ventricle remodeling in SHR towards eccentric hypertrophy, which remained after detraining. It also improved single left ventricular myocyte contractile function, which was reversed by detraining.

Purchasing Process of Industrial Solutions – Added Value, Difficulties and Good Practices

Purpose of this study is to clarify the industrial solutions purchasing process from purchaser companies’ point of view. Also customer’s view on value generating aspects and difficulties in purchases will be discussed as well as different purchas-ing entities where customers have ended up in their solution purchases. Current solution literature is mainly concentrated in supplier views and customer perspec-tive has been left without adequate attention. However, knowledge of the customer and the identification of customer need are at the core of a successful solution business. The focus of this thesis is on Finnish companies’ solution purchases that have been realized during last five years. Industrial solutions in this case are facto-ries or other large industrial plants. Industrial solutions’ purchasing process will be opened all the way from discovering the need until the start-up of the plant. Of in-terest is the customer experience of the success of the acquisition and the pur-chaser’s view on good practices allowing a successful procurement project.

Risk management in transportation companies: Russian and Finnish practices

Development of risk management practices became significant part of transportation companies’ strategy. Evolution from insurance management into enterprise risk management (ERM) led to development of risk management tools and methods. The purpose of this thesis is to design technique for evaluation of risk management practices of national transportation companies. The empirical research is made on the example of Russian and Finnish transportation companies. The required data was conducted with a help of survey. The result of the thesis is designed technique for risk management practices evaluation that allows to compare practices of different countries and organizations with different characteristics. The Master thesis has novelty in theoretical and practical contribution. It was designed new technique based on realization of the method of APIS. Moreover, it has practical implication as managers can utilize this method for comparison of practices between different countries, different organization and even different units within particular organization.

A conceptual analysis of research literature on teachers' ideology and literacy practices: extending the dialogue through a secondary analysis of high school English as an additional language contexts /

This thesis provides a conceptual analysis of research literature on teachers' ideology and literacy practices as well as a secondary analysis of three empirical studies and the ways in which the ideologies of the English as an Additional Language (EAL) (Street, 2005) teachers in these contexts impact the teaching of literacy in empowering/disabling ways. Several major theoretical components of Cummins (1996, 2000), Gee (1996, 2004) and Street (1995, 2001) are examined and integrated into a conceptual triad consisting of three main areas: power and ideology, validation of students ' cultural and linguistic backgrounds, and teaching that empowers. This triad provides the framework for the secondary analysis of three empirical studies on the ideologies of secondary EAL teachers. Implications of the findings from the conceptual and secondary analyses are examined in light of the research community and secondary school teachers of EAL.

Examining and describing professional development and continuing education in the personal training and fitness industry : sites and issues of disconnect

The following phenomenologically oriented study examines and describes the relevance and effectiveness of professional development and continuing education programs for real-world situations of personal trainers. The participants were personal trainers, facility managers, and persons involved in the accreditation process. Data collection took place in 3 phases. The first phase consisted of the participants completing the PUMP Questionnaire, followed by focus groups with personal trainers and interviews with managers. The study's 3 data sets required reduction via a content analysis by question, content analysis by existential categories, and further thematic analysis using the lived relation existential dimension. The discussion contains the salient sites and issues of disconnect between clients, personal trainers, and facility managers and how they might affect the personal training experience. The intergenerational disconnect emphasized between Boomers as clients and Millennials as personal trainers requires further exploration and dialogue and underscores the need for different approaches to content and delivery of professional development and continuing education experiences for personal trainers and managers of fitness facilities.

Human Resource Training and National Sport Organization Managers: Examining the Impact of Training on Individual and Organizational Performance

Within sport, a tremendous amount of effort is committed to the on-the-field performance of athletes and coaches, neglecting the off-the-field performance and development of sport managers. This study examines the impact of human resource training on the performance of five Canadian national sport organizations (NSO) and their managers (N=22). Data were collected on three outcome variables (learning, individual performance, organizational performance) and three mediating variables (motivation to transfer, training design, organizational climate) at three time measures (pre-training, post-training1, post-training2). Results indicate that training improves the learning and individual performance of sport managers, as well as the organizational performance of NSOs. Varying relationships were found at each of the three time measures, demonstrating that a progression to training-related performance change exists, while providing support for three levels of analysis (individual, organizational, systemic). Implications and future research directions are discussed and highlight the need for on-going training opportunities for Canadian sport managers.

Worbook 1. Modules V and VIII practices and exercises

UANL