Pathways to emotional closeness in neonatal units - a cross-national qualitative study.

BACKGROUND: Research shows evidence for the importance of physical and emotional closeness for the infant, the parent and the infant-parent dyad. Less is known about how, when and why parents experience emotional closeness to their infants in a neonatal unit (NU), which was the aim of this study. METHODS: A qualitative study using a salutogenic approach to focus on positive health and wellbeing was undertaken in three NUs: one in Sweden, England and Finland. An 'emotional closeness' form was devised, which asked parents to describe moments/situations when, how and why they had felt emotionally close to their infant. Data for 23 parents of preterm infants were analyzed using thematic networks analysis. RESULTS: A global theme of 'pathways for emotional closeness' emerged from the data set. This concept related to how emotional, physical, cognitive and social influences led to feelings of emotional closeness between parents and their infants. The five underpinning organising themes relate to the: Embodied recognition through the power of physical closeness; Reassurance of, and contributing to, infant wellness; Understanding the present and the past; Feeling engaged in the day to day and Spending time and bonding as a family. CONCLUSION: These findings generate important insights into why, how and when parents feel emotionally close. This knowledge contributes to an increased awareness of how to support parents of premature infants to form positive and loving relationships with their infants. Health care staff should create a climate where parents' emotions and their emotional journey are individually supported.

Perceptions of European medical staff on the facilitators and barriers to physical closeness between parents and infants in neonatal units

AIM: Studies have provided insights into factors that may facilitate or inhibit parent-infant closeness in neonatal units, but none have specifically focused on the perspectives of senior neonatal staff. The aim of this study was to explore perceptions and experiences of consultant neonatologists and senior nurses in five European countries with regard to these issues. METHODS: Six small group discussions and three one-to-one interviews were conducted with 16 consultant neonatologists and senior nurses representing nine neonatal units from Estonia, Finland, Norway, Spain and Sweden. The interviews explored facilitators and barriers to parent-infant closeness and implications for policy and practice and thematic analysis was undertaken. RESULTS: Participants highlighted how a humanising care agenda that enabled parent-infant closeness was an aspiration, but pointed out that neonatal units were at different stages in achieving this. The facilitators and barriers to physical closeness included socio-economic factors, cultural norms, the designs of neonatal units, resource issues, leadership, staff attitudes and practices and relationships between staff and parents. CONCLUSION: Various factors affected parent-infant closeness in neonatal units in European countries. There needs to be the political motivation, appropriate policy planning, legislation and resource allocation to increase measures that support closeness agendas in neonatal units. This article is protected by copyright. All rights reserved.

Identification des stratégies déployées par les infirmières pour offrir des soins palliatifs en fin de vie dans des unités de soins aigus

La réalité veut que beaucoup de personnes en fin de vie meurent dans des unités de soins aigus. Aussi, les infirmières qui travaillent dans ce milieu ont à prodiguer des soins infirmiers à une clientèle à la fois de soins aigus et de soins palliatifs. Par contre, celles-ci ont à faire face, entre autres, à des contraintes et obstacles organisationnels et environnementaux qui viennent compliquer la prestation de soins infirmiers palliatifs au travers d’une clientèle majoritairement de soins aigus. Il importe donc de savoir comment elles y parviennent. Cette étude exploratoire descriptive a pour but d’explorer et de décrire les stratégies que les infirmières de milieux de soins aigus déploient pour favoriser une pratique optimale de soins palliatifs de fin de vie. Le cadre de référence utilisé est le profil des compétences générales et spécifiques en soins palliatifs attribué aux infirmières du MSSS (2008). Huit participantes (infirmières) travaillant dans des unités de médecine et de cardiologie dans les établissements du CHU de Québec ont été rencontrées. Beaucoup de stratégies ont été identifiées, dont une plus propice à ce milieu soit, « Optimiser le temps passé auprès du patient et sa famille ». La stratégie « Faire de l’enseignement et donner aux proches de l’information » est celle qui revient le plus souvent dans le discours de ces infirmières. Également, on note des divergences quant aux obstacles et aux facteurs favorables mentionnés dans la littérature générale en soins palliatifs.

The designation of documentary types, series and units in Spain. A contribution to archival theory (2).

The identification of archival records depends on description, being this last process summed up in designation. The title given to dif-ferent groups of documents will have a great incidence in archival func-tions. Taking this premise as our starting point, this paper presents theo-retical contributions made in Spain related to designation of documen-tary types, series and units. The status of the issue presented here tries to delimitate the concept of “documentary typology”, essential for Ar-chival Science.

User-centered, research-based design of futuristic intensive care units

Strategies for protecting intellectual property when using CUDA applications on graphics processing units

Recent advances in the massively parallel computational abilities of graphical processing units (GPUs) have increased their use for general purpose computation, as companies look to take advantage of big data processing techniques. This has given rise to the potential for malicious software targeting GPUs, which is of interest to forensic investigators examining the operation of software. The ability to carry out reverse-engineering of software is of great importance within the security and forensics elds, particularly when investigating malicious software or carrying out forensic analysis following a successful security breach. Due to the complexity of the Nvidia CUDA (Compute Uni ed Device Architecture) framework, it is not clear how best to approach the reverse engineering of a piece of CUDA software. We carry out a review of the di erent binary output formats which may be encountered from the CUDA compiler, and their implications on reverse engineering. We then demonstrate the process of carrying out disassembly of an example CUDA application, to establish the various techniques available to forensic investigators carrying out black-box disassembly and reverse engineering of CUDA binaries. We show that the Nvidia compiler, using default settings, leaks useful information. Finally, we demonstrate techniques to better protect intellectual property in CUDA algorithm implementations from reverse engineering.

Critère de validation croisée pour le choix des modèles des petits domaines au niveau des unités

Ce mémoire s’intéresse à l’étude du critère de validation croisée pour le choix des modèles relatifs aux petits domaines. L’étude est limitée aux modèles de petits domaines au niveau des unités. Le modèle de base des petits domaines est introduit par Battese, Harter et Fuller en 1988. C’est un modèle de régression linéaire mixte avec une ordonnée à l’origine aléatoire. Il se compose d’un certain nombre de paramètres : le paramètre β de la partie fixe, la composante aléatoire et les variances relatives à l’erreur résiduelle. Le modèle de Battese et al. est utilisé pour prédire, lors d’une enquête, la moyenne d’une variable d’intérêt y dans chaque petit domaine en utilisant une variable auxiliaire administrative x connue sur toute la population. La méthode d’estimation consiste à utiliser une distribution normale, pour modéliser la composante résiduelle du modèle. La considération d’une dépendance résiduelle générale, c’est-à-dire autre que la loi normale donne une méthodologie plus flexible. Cette généralisation conduit à une nouvelle classe de modèles échangeables. En effet, la généralisation se situe au niveau de la modélisation de la dépendance résiduelle qui peut être soit normale (c’est le cas du modèle de Battese et al.) ou non-normale. L’objectif est de déterminer les paramètres propres aux petits domaines avec le plus de précision possible. Cet enjeu est lié au choix de la bonne dépendance résiduelle à utiliser dans le modèle. Le critère de validation croisée sera étudié à cet effet.

Status of the beach management units development in Uganda

Fisheries plays a significant and important part in the economy of the country contributing to foreign exchange, food security and employment creation. Lake Victoria contributes over 50% of the total annual fish catch. The purpose of fisheries management is to ensure conservation, protection, proper use, economic efficiency and equitable distribution of the fisheries resources both for the present and future generations through sustainable utilization. The earliest fisheries were mainly at the subsistence level. Fishing gear consisted of locally made basket traps, hooks and seine nets of papyrus. Fishing effort begun to increase with the introduction of more efficient flax gillnets in 1905. Fisheries management in Uganda started in 1914. Before then, the fishery was under some form of traditional management based on the do and don'ts. History shows that the Baganda had strong spiritual beliefs in respect of "god Mukasa" (god of the Lake) and these indirectly contributed to sustainable management of the lake. If a fisherman neglected to comply witt'l any of the ceremonies related to fishing he was expected to encounter a bad omen (Rev. Roscoe, 1965) However, with the introduction of the nylon gill nets, which could catch more fish, traditional management regime broke down. By 1955 the indigenous fish species like Oreochromis variabilis and Oreochromis esculentus had greatly declined in catches. Decline in catches led to introduction of poor fishing methods because of competition for fish. Government in an attempt to regulate the fishing irldustry enacted the first Fisheries Ordinance in 1951 and recruited Fisheries Officers to enforce them. The government put in place minimum net mesh-sizes and Fisheries Officers arrested fishermen without explaining the reason. This led to continued poor fishing practices. The development of government centred management systems led to increased alienation of resource users and to wilful disregard of specific regulations. The realisation of the problems faced by the central management system led to the recognition that user groups need to be actively involved in fisheries management if the systems are to be consistent with sustainable fisheries and be legitimate. Community participation in fisheries management under the Comanagement approach has been adopted in Lake Victoria including other water bodies.

Incidence of violent behavior among patients in Psychiatric Intensive Care Units

Background and Objectives: Both psychiatric acute units and psychiatric intensive care units (PICUs) focus on acute treatment of behavioral disturbances such as violence and aggressive threats and acts. The aim of the present study is to describe the frequency of violent behavior; such as verbal or physical threats and physical attacks, among patients admitted to psychiatric intensive care unit (PICU). In addition the relationship between the episodes of threats and/or attacks in relation to time of the day, days of the week, and their seasonal variations was explored. Methods: All violent behavior was continuously assessed at the psychiatric emergency department. Data were collected during the period from May 2010 to May 2012. Results: Patients with only one hospitalization were less violent than those who have had two hospitalizations. There was a statistically significant difference in violence among patients without formal secondary education and those who have not formal education. Violent behavior showed two peaks during the day; the first occurring at 1 pm and the second at 8 pm. In regard to seasonality, summer had a higher incidence of violence. The most peaceful seasons of the year were spring and autumn. Conclusions: Violent behavior shows variation in daytime, days of the week and season in acute psychiatric intensive care. Daytime variation shows two peaks of violence at 1 pm and 8 pm, Sundays and Wednesdays being the quietest days regarding violence both in winter and summer. Patient's level of education and hospitalization status partially explain the variation.

Comparison of indoor and outdoor fungi and particles in poultry units

A descriptive study was developed in order to compare indoor and outdoor air contamination caused by fungi and particles in seven poultry units. Twenty eight air samples of 25 litters were collected through the impaction method on malt extract agar. Air sampling and particles concentration measurement were done in the interior and also outside premises of the poultries’ pavilions. Regarding the fungal load in the air, indoor concentration of mold was higher than outside air in six poultry units. Twenty eight species / genera of fungi were identified indoor, being Scopulariopsis brevicaulis (40.5%) the most commonly isolated species and Rhizopus sp. (30.0%) the most commonly isolated genus. Concerning outdoor, eighteen species/genera of fungi were isolated, being Scopulariopsis brevicaulis (62.6%) also the most isolated. All the poultry farms analyzed presented indoor fungi different from the ones identified outdoors. Regarding particles’ contamination, PM2.5, PM5.0 and PM10 had a statistically significant difference (Mann-Whitney U test) between the inside and outside of the pavilions, with the inside more contaminated (p=.006; p=.005; p=.005, respectively). The analyzed poultry units are potential reservoirs of substantial amounts of fungi and particles and could therefore free them in the atmospheric air. The developed study showed that indoor air was more contaminated than outdoors, and this can result in emission of potentially pathogenic fungi and particles via aerosols from poultry units to the environment, which may post a considerable risk to public health and contribute to environmental pollution.

Air fungal contamination in ten hospitals’ food units from Lisbon

A descriptive study was developed to monitor air fungal contamination in ten food units from hospitals. Fifty air samples of 250 litres were collected through impaction method. Samples were collected in food storage facilities, kitchen, food plating, canteen and also, outside premises, since this is the place regarded as reference. Simultaneously, environmental parameters were also monitored, including temperature and relative humidity through the equipment Babouc, LSI Sistems and according to the International Standard ISO 7726.

Comparison of fungal contamination between hospitals and companies food units

A descriptive study was developed to compare air and surfaces fungal contamination in ten hospitals’ food units and two food units from companies. Fifty air samples of 250 litres through impaction method were collected from hospitals’ food units and 41 swab samples from surfaces were also collected, using a 10 by 10 cm square stencil. Regarding the two companies, ten air samples and eight surface samples were collected. Air and surface samples were collected in food storage facilities, kitchen, food plating and canteen. Outdoor air was also collected since this is the place regarded as a reference. Simultaneously, temperature, relative humidity and meal numbers were registered. Concerning air from hospitals’ food units, 32 fungal species were identified, being the two most commonly isolated genera Penicillium sp.

Processing traits of European catfish (Silurus glanis Linnaeus, 1758) from outdoor flow-through and indoor recycling aquaculture units

The quality of fish cultured using recycling units may differ from that of fish from outdoor farming units due to a range of deviating environmental determinants. This applies not only to flesh quality but also to morphological (processing) traits. This study evaluates processing yields of sibling fish cultured in two different farming units: (i) an outdoor pond aquaculture system with a flow-through regime (24.6 ± 0.2°C), and (ii) indoor tanks using a recirculation aquaculture system (RAS; 26.0 ± 1.0°C). Clear differences were observed in the most important processing traits, i.e. skinned trunk and fillet yields, which were both significantly higher (P < 0.01) in RAS fish due to significantly smaller (P < 0.05) head weight in fish of the flow-through system. Skin represented a significantly higher (P < 0.01) proportion of total weight in both RAS males and females. The most obvious difference was in the deposited fat weight, which was significantly higher (P < 0.01) in RAS fish. Visceral fat deposits were significantly higher (P < 0.01) in females and ventral and dorsal fat deposits higher (P > 0.05) in males.

Evaluation Of An Extended Duct Air Delivery System For Spaces Conditioned By Rooftop Units

Traditional air delivery to high-bay buildings involves ceiling level supply and return ducts that create an almost-uniform temperature in the space. Problems with this system include potential recirculation of supply air and higher-than-necessary return air temperatures. A new air delivery strategy was investigated that involves changing the height of conventional supply and return ducts to have control over thermal stratification in the space. A full-scale experiment using ten vertical temperature profiles was conducted in a manufacturing facility over one year. The experimental data was utilized to validated CFD and EnergyPlus models. CFD simulation results show that supplying air directly to the occupied zone increases stratification while holding thermal comfort constant during the cooling operation. The building energy simulation identified how return air temperature offset, set point offset, and stratification influence the building’s energy consumption. A utility bill analysis for cooling shows 28.8% HVAC energy savings while the building energy simulation shows 19.3 – 37.4% HVAC energy savings.