Home About us Contact
|
Home About us Contact | ||
|
|
||
Frustration
Terms modified by Frustration Selected AbstractsExpanding the Scope of Metal-Free Catalytic Hydrogenation through Frustrated Lewis Pair Design,ANGEWANDTE CHEMIE, Issue 37 2010Gábor Er Frustration als Vorteil: Auf einem neuen Konzept beruhende, frustrierte Lewis-Säure-Base-Katalysatoren mit orthogonaler Reaktivität wurden entwickelt, die in metallfreien katalytischen Hydrierungen neben einer verbesserten Verträglichkeit mit funktionellen Gruppen auch eine einzigartige Chemoselektivität erzielen (siehe Schema). [source] Linkage Isomerism and Spin Frustration in Heterometallic Rings: Synthesis, Structural Characterization, and Magnetic and EPR Spectroscopic Studies of Cr7Ni, Cr6Ni2, and Cr7Ni2 Rings Templated About Imidazolium CationsCHEMISTRY - A EUROPEAN JOURNAL, Issue 47 2009Angelika Abstract The synthesis and structural characterization of three heterometallic rings templated about imidazolium cations is reported. The compounds are [2,4-DiMe-ImidH][Cr7NiIIF8(O2CtBu)16] 1 (2,4-DiMe-ImidH=the cation of 2,4-dimethylimidazole), [ImidH]2[Cr6NiII2F8(O2CCtBu)16] 2 (ImidH=the cation of imidazole), and [1-Bz-ImidH]2 [Cr7NiII2F9(O2CtBu)18] 3 (1-Bz-ImidH=the cation of 1-benzylimidazole). The structures show the formation of octagonal arrays of metals for 1 and 2 and a nonagon of metal centers for 3. In all cases the edges of the polygon are bridged by a single fluoride and two pivalate ligands, and the position of the divalent metal centers cannot be distinguished by X-ray diffraction. Magnetic studies combined with EPR spectroscopy allow the characterization of the magnetic states of the compounds. In each case the exchange is antiferromagnetic with a magnetic exchange parameter J,,5.8,cm,1, and it is not possible to differentiate the exchange between two CrIII centers (JCrCr) from the exchange between a CrIII and a NiII center (JCrNi). For 2 there is evidence for the presence of at least two, possibly four, linkage isomers of the heterometallic ring, caused by the presence of two divalent metal centers in the ring. The EPR spectroscopy of 3 suggests an S=1/2 ground state of the ring and that it is likely that only one linkage isomer is present. [source] Nordic Investments in the Former Soviet Baltic Frontier: A Survey of Firms and Selected Case StudiesGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 4 2000Harley Johansen Nordic companies have been leaders in the rapid expansion of Western business into Estonia, Latvia, Lithuania, and the St Petersburg area of Russia. While joint ventures were being developed prior to the demise of the USSR, investment rose sharply in early 1992. Our survey of companies from Nordic countries revealed a pattern of location and of adaptation to the conditions of former Soviet infrastructure, culture, politics and economy. Initial Nordic investment has renewed economic ties across the Baltic Sea, with inter-country links stronger between specific countries. Frustrations with changing government rules, communications, work ethic, quality expectations and other conditions were expressed in interviews with managers of Nordic companies in the Baltic area. Optimism was tempered by continued uncertainty about Russian governmental policies and market potential. [source] Overcoming Fears, Frustrations, and Competing Demands: An Effective Integration of Pain Medicine and Primary Care to Treat Complex Pain PatientsPAIN MEDICINE, Issue 7 2007Matthew J. Bair MD No abstract is available for this article. [source] A qualitative investigation of the views and health beliefs of patients with Type 2 diabetes following the introduction of a diabetes shared care serviceDIABETIC MEDICINE, Issue 10 2003S. M. Smith Abstract Aims A qualitative research approach was adopted in order to explore the views and health beliefs of patients with Type 2 diabetes who had experienced a new structured diabetes shared care service. Methods Patients from 15 general practices were randomly selected and invited to attend three focus groups. Two independent researchers adopted the ,Framework' technique to analyse the transcribed data and identify key themes expressed by patients. Results Themes relating to diabetes included frustration, victimization and powerlessness in relation to living with diabetes, controlling blood sugar, medication and economic barriers to care. Differences in emphases between patients and healthcare providers emerged. Patients were generally positive about shared care and largely identified it with the nurses involved. Conclusion This research highlights the importance of an in-depth exploration of patients' views during changes in diabetes care delivery to identify service delivery failures and gaps in patient knowledge such as lack of awareness of the extent of macrovascular risk. [source] Predicting life-time and regular cannabis use during adolescence; the roles of temperament and peer substance use: the TRAILS studyADDICTION, Issue 4 2010Hanneke E. Creemers ABSTRACT Aims The aim of the present study was to determine the mediating role of affiliation with cannabis-using peers in the pathways from various dimensions of temperament to life-time cannabis use, and to determine if these associations also contributed to the development of regular cannabis use. Methods Objectives were studied using data from 1300 participants of the Tracking Adolescents' Individual Lives Survey (TRAILS), a large, general population study of Dutch adolescents. We used parent-reports on the Early Adolescent Temperament Questionnaire to assess the dimensions of high-intensity pleasure, shyness, fearfulness, frustration and effortful control at age 10,12 years. By means of self-reports, life-time and regular cannabis use were determined at age 15,18 years, and proportion of substance-using peers was determined at ages 12,15 and 15,18 years. Models were adjusted for age, sex, intelligence and parental cannabis use. Results High-intensity pleasure [odds ratio (OR) = 1.09, 95% confidence interval (CI) = 1.05,1.13] and effortful control (OR = 0.92, 95% CI = 0.89,0.96) affected the risk for life-time cannabis use through their influence on affiliation with cannabis-using peers. Shyness affected this risk independently from peer cannabis use. Only the pathway from effortful control was associated additionally with the development of regular cannabis use (OR = 0.93, 95% CI = 0.89,0.98). Conclusions Peer cannabis use and, to a lesser extent, certain temperamental characteristics affect an adolescent's risk of cannabis use, and should be considered in prevention programmes. We recommend future research to focus upon factors that potentially modify the association between temperament, affiliation with cannabis-using peers and cannabis use. [source] Understanding anorexia nervosa through analysis of thematic content of letters in an adolescent sampleEUROPEAN EATING DISORDERS REVIEW, Issue 5 2006Glen Freedman Abstract Objective Positive and negative themes about their illness have been identified in an adult population with anorexia nervosa. It was our goal to explore the thematic content of the letters written by an adolescent population in order to better our understanding of how this different population relates to the illness. Method Twenty-seven adolescents with anorexia nervosa were asked to write two letters to their eating disorder, one addressing it as a friend and the other, as an enemy. The coding scheme initially developed by Serpell and Treasure, with minor adjustments, was used to code the letters by two trained raters, with high inter-rater reliability. Results Many similarities and a few notable differences between the adolescent population and an adult population were noted. Compared to an adult population, adolescents valued to a greater degree the sense of feeling looked after by the disorder and the increased attention that they felt the disorder provided. In contrast, they did not view loss of periods as a benefit. Regarding perceived costs of anorexia nervosa, adolescents described a greater degree of psychological distress in relation to the disorder, and a greater sense of having been tricked by the disorder. They did not describe as much frustration with preoccupation with thoughts about food or of being controlled by food. All other themes were not considered appreciably different in terms of percentage of statements or of subjects. Discussion An understanding of how adolescents relate to their illness in terms of themes can help to provide the therapist with a sense of where a patient is in terms of motivation and readiness for recovery. This in turn can aid in the determination of an appropriate treatment approach that is most likely to foster an optimal therapeutic alliance and to enhance motivation to recover. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] The role of the Big Five personality factors in vigilance performance and workloadEUROPEAN JOURNAL OF PERSONALITY, Issue 3 2002Cynthia Laurie Rose Using the five-factor personality model, the present study explored the influence of personality factors on sustained attention and perceived workload. Ninety-six college-aged participants were administered a 12 minute vigilance fast event rate task. Following the vigil, participants were asked to first, rate their perceived workload of the task using the NASA-TLX, and then second, complete the NEO-PI-R personality inventory. Traditional measures of hits, false alarms, and reaction times were examined as well as the signal detection indices of perceptual sensitivity and response bias. Extraversion correlated with false alarms (r,=,0.181; eta2,=,0.055) and conscientiousness correlated with both false alarms (r,=,,0.275, eta2,=,0.097) and perceptual sensitivity (r,=,0.227, eta2,=,0.052). With regard to perceived workload, neuroticism was related to perceived frustration (r,=,0.238, eta2,=,0.057). The findings are discussed in terms of theoretical implications, impact of task parameters, and practical applications. Copyright © 2002 John Wiley & Sons, Ltd. [source] Ground Water Recharge and Chemical Contaminants: Challenges in Communicating the Connections and Collisions of Two Disparate WorldsGROUND WATER MONITORING & REMEDIATION, Issue 2 2004Christian G. Daughton Our knowledge base regarding the presence and significance of chemicals foreign to the subsurface environment is large and growing , the papers in this volume serving as testament. However, complex questions with few answers surround the unknowns regarding the potential for environmental or human health effects from trace levels of xenobiotics in ground water, especially ground water augmented with treated waste water. Public acceptance for direct or indirect ground water recharge using treated municipal waste water (especially sewage) spans the spectrum from unquestioned embrace to outright rejection. In this paper, I detour around the issues most commonly discussed regarding ground water recharge and instead focus on some of the less-recognized issues,those that emanate from the mysteries created at the many literal and virtual interfaces involved with the subsurface world. My major objective is to catalyze discussion that advances our understanding of the barriers to public acceptance of waste water reuse with its ultimate culmination in direct reuse for drinking. I pose what could be a key question as to whether much of the public's frustration or ambivalence in its decision-making process for accepting, or rejecting, water reuse (for various purposes including personal use) emanates from fundamental inaccuracies, misrepresentation, or oversimplification of what water is and how it functions in the environment,just exactly what the water cycle is. These questions suggest it might behoove us to revisit some very elementary aspects of our science and how we are conveying them to the public. [source] Informal care: the views of people receiving careHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2002S. McCann BA MPsychSc Abstract Informal care is perceived to be the best option for people who require assistance to look after themselves. National and international studies of informal care have focused on the carer, not on the care provided, or the needs and experiences of the care recipients. In the present study, 55 people receiving informal care (21 males and 24 females, mean age = 67.6) were surveyed to determine the type of assistance that they receive, perceptions of the quality of their care, feelings about being looked after by a carer and their perceptions of the services which would be useful. A random sample of 531 households were selected as part of a larger study into informal care in the west of Ireland. A total of 98 carers were identified and 55 of the people they looked after were well enough to participate in the study. Over two-thirds of carers assisted with household chores (e.g. cleaning, preparing meals and shopping). Other activities which carers assisted with included keeping the person safe from household accidents (62%), personal care (42%), and dressing and undressing (31%). Whilst most were very satisfied with the quality of care, a minority reported dissatisfaction, and stated that their carer showed signs of anger and frustration. Common concerns related to the health of the carer, their safety when the carer is not available and the cost of being cared for. Financial support for the person receiving care and the carer were the main priorities for these individuals. The present study points to a need for greater involvement of care recipients in planning services relating to informal care, and support and access to health professionals for people receiving care. People receiving care are also concerned about the level of financial support for themselves and their carers. [source] The Cage of Nature: Modernity's History in JapanHISTORY AND THEORY, Issue 1 2001Julia Adeney Thomas "The Cage of Nature" focuses on the concept of nature as a way to rethink Japanese and European versions of modernity and the historical tropes that distance "East" from "West." This essay begins by comparing Japanese political philosopher Maruyama Masao and his contemporaries, Max Horkheimer and Theodor Adorno. Both sets of authors define modernity as the moment when humanity overcomes nature, but Maruyama longs for this triumph while Horkheimer and Adorno deplore its consequences. Maruyama insists that Japan has failed to attain the freedom promised by modernity because it remains in the thrall of nature defined in three ways: as Japan's deformed past, as the mark of Japan's tragic difference from "the West,"and as Japan's accursed sensuality, shackling it to uncritical bodily pleasures. In short, Maruyama sees Japan as trapped in the cage of nature. My argument is that Maruyama's frustration arises from the trap set by modern historiography, which simultaneously traces the trajectory of modernity from servile Nature to freedom of Spirit and at the same time bases the identity of the non-Western world on its closeness to nature. In other words, nature represents both the past and the East, an impossible dilemma for an Asian nationalist desirous of liberty. By revising our historical narratives to take into account the ways in which Western modernity continued to engage versions of nature, it becomes possible to reposition Japan and "the East" within modernity's history rather than treating them as the Other. [source] Infliximab improves quality of life in patients with Crohn's diseaseINFLAMMATORY BOWEL DISEASES, Issue 4 2002Dr. Gary R. Lichtenstein Abstract Objective The aim of this study was to assess the effect of infliximab on quality of life in patients with active Crohn's disease (CD) inadequately responsive to concomitant therapies. Methods We examined responses to the Inflammatory Bowel Disease Questionnaire (IBDQ) from patients enrolled in a previously reported, randomized, placebo-controlled study. Patients with active CD received a single intravenous infusion of either placebo or infliximab 5, 10, or 20 mg/kg. Most patients received stable doses of mesalamine, corticosteroids, azathioprine, or 6-mercaptopurine throughout the study. Changes from baseline in overall IBDQ score and individual dimensions at 4 weeks postinfusion were compared. Results Patients treated with infliximab had a significantly larger improvement in overall IBDQ score than those treated with placebo at 4 weeks (p < 0.001). Infliximab-treated patients also had larger improvements in all IBDQ dimensions: bowel (p = 0.007), social (p = 0.002), emotional (p < 0.001), and systemic (p < 0.001). A significantly larger proportion of infliximab-treated patients reported having normal or near-normal frequency of bowel movements in the past week (p < 0.001), full or a lot of energy (p = 0.019), and no or hardly any difficulty doing leisure or sports activities (p = 0.011), and being extremely or very satisfied with their personal life (p = 0.046). They also significantly differed in responses regarding fatigue, frustration, ability to work, general well-being, depression, anxiety, and anger resulting from bowel problems. Conclusions These results indicate that infliximab significantly improved quality of life in patients with active CD, increasing their ability to work and participate in leisure activities, and decreasing feelings of fatigue, depression, and anger. [source] Intervention program to reduce waiting time of a dermatological visit: Managed overbooking and service centralization as effective management toolsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2007Yuval Bibi MD Background, Long waiting times are an impediment of dermatological patient care world-wide, resulting in significant disruption of clinical care and frustration among carers and patients. Objective, To reduce waiting times for dermatological appointments. Methods, A focus group including dermatologists and management personnel reviewed the scheduling process, mapped potential problems and proposed a comprehensive intervention program. The two major approaches taken in the intervention program were revision of the scheduling process by managed overbooking of patient appointments and centralization of the dermatological service into a centralized dermatological clinic. Results, Following the intervention program, the average waiting time for dermatological appointments decreased from 29.3 to 6.8 days. The number of scheduled appointments per 6 months rose from 17,007 to 20,433. Non-attendance proportion (no-show) decreased from 33% to 28%. Dermatologist work-hours were without significant change. Conclusions, Waiting lists for dermatological consultations were substantially shortened by managed overbooking of patient appointments and centralization of the service. [source] Occupational violence and assault in mental health nursing: A scoping project for a Victorian Mental Health ServiceINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2008Brett McKinnon ABSTRACT:, The present study aimed to examine the prevalence of occupational assault against nurses at a Victorian Mental Health Service, including inpatient units and community teams. The results of this study will assist in developing strategies to minimize the occurrence of occupational assault and, more importantly, its impact for nursing staff. A survey methodology was used. All nurses from two adult acute psychiatric inpatient units as well as those from the community-based teams were invited to participate in a single survey (n = 90). The sample group for this research included all nursing staff from both inpatient units and community services. High levels of occupational violence against nurses overall and in the past year, underreporting of incidents, and high levels of staff fear are prominent findings of this study. There needs to be a total review of all policy relating to occupational violence with special focus given to the results of this study. The areas of risk management, training, sanctioning, and incident reporting should head the list, as well as addressing staff culture. Universally adopting a zero tolerance approach to occupational violence suggests that it is far from being part of the job. Further, management should consider a comprehensive orientation package that informs patients and their significant others about the role of the treating team. Communicating adequately with patients and their significant others is needed to clarify expectations and to avoid frustration and angry outbursts. [source] Treading on Tradition: Approaches to Teaching International Relations to the Nontraditional UndergraduateINTERNATIONAL STUDIES PERSPECTIVES, Issue 1 2002Nancy E. Wright Nontraditional undergraduates (NTUs), undergraduates who typically are older than average, work full-time, and/or are entrusted with substantial family responsibilities, pose a special challenge to international relations educators. Severe constraints on time and access to library facilities both impede progress and may give an erroneous impression that NTUs are not as committed to their education as more conventional college undergraduates. The lack of continuity in education that typifies the NTU experience often manifests itself in anxiety, frustration, and gaps in fundamental knowledge. At the same time, the maturity and sophistication that come with life experience often far exceed that of the more conventional college student. Furthermore, typical requirements of international relations and international studies majors, such as second and third language proficiency, internships with international organizations, and overseas study are often not feasible for the working student with family responsibilities. Possibilities for meeting the challenges of teaching NTUs include greater use of open-book examinations, research proposals, case studies, simulations, problem-based learning (PBL), use of the Internet, and the development of short-term intensive overseas study opportunities that accommodate the working student's schedule. [source] A systematic review of the effectiveness of nurse communication with patients with complex communication needs with a focus on the use of augmentative and alternative communicationJOURNAL OF CLINICAL NURSING, Issue 16 2008CCC-SLP, Erinn H Finke MS Aims and objectives., To systematically review the research regarding communication between nurses and patients with complex communication needs (CCN). The research was reviewed with respect to the following themes: (a) the importance of communication; (b) the barriers to effective communication; (c) the supports needed for effective communication; and (d) recommendations for improving the effectiveness of communication between nurses and patients with CCN. Augmentative and alternative communication (AAC) strategies that can be used by nurses to facilitate more effective communication with patients with CCN are discussed. Background., Effective nurse-patient communication is critical to efficient care provision. Difficulties in communication between nurses and patients arise when patients are unable to speak. This problem is further complicated because nurses typically receive little or no training in how to use AAC to communicate with patients with CCN. Design., Systematic review. Method., This paper reviewed the published research focusing on the perspectives of nurses, patients with CCN and their caregivers regarding the challenges to effective communication between nurses and patients with CCN. Further, specific strategies (i.e., using AAC) that nurses can use to improve and facilitate communication with patients with CCN are provided. Conclusions., Communication between nurses and patients is critical to providing and receiving quality care. Nurses and patients have reported concern and frustration when communication is not adequate. Using AAC strategies will help nurses and patients better communicate with each other when speech is not an option. Relevance to clinical practice., Communication with all patients is very important to the provision of quality nursing care. Communication cannot always be achieved using the speech modality. Nurses need to have tools and skills that will allow them to communicate with all of their patients whether or not they can speak. [source] ICD: a qualitative study of patient experience the first year after implantationJOURNAL OF CLINICAL NURSING, Issue 8 2004Helen CM Kamphuis MSc Background., The experiences of how patients live with an implantable cardioverter defibrillator are still poorly understood. Only a few qualitative studies have investigated this phenomenon. This paper was undertaken as part of a larger project to evaluate quality of life and psychological well-being in those survivors of cardiac arrest who have received an implantable cardioverter defibrillator. Aims and objectives., The aim of this qualitative study was to explore how implantable cardioverter defibrillator recipients perceive their lives during the first year after implantation of the device. Methods., A sample of 21 patients who received an implantable cardioverter defibrillator was interviewed during three consecutive periods: one, six and 12 months postdischarge from the hospital. The semi-structured interviews were based on insights gained from a literature review. The transcripts were subjected to content analysis. Results., Analysis of the data revealed seven major categories: physical deterioration, cognitive changes, perceived social support, dependency, contact with the doctor, confrontation with mortality and uncertainty surrounding having a shock. Anxiety, uncertainty, disappointment, frustration, unexpected barriers, acceptance of and dependency on the implantable cardioverter defibrillator played a major role in the lives of implantable cardioverter defibrillator recipients. Well-being improved throughout the year. During the first months after discharge from the hospital the focus was on regaining physical health. During the early postimplantation period both the implantable cardioverter defibrillator recipient and family members had adapted to the situation. Reflection on the impact and consequences of the cardiac arrest was reported more often in the late postimplantation period. Conclusions., Content analysis is a resourceful approach giving answers to questions that have hardly been addressed within the domain of cardiology. Implantable cardioverter defibrillator recipients face a complex first year, especially the first 6 months. Cognitive deterioration and confrontation with mortality are problems that need to be researched further. Relevance to clinical practice., Caregivers are able to explain to future patients what they can expect in the first year after implantation. Caregivers may become more receptive to physical, psychological and social limitations and to emotional and social problems that occur in implantable cardioverter defibrillator recipients, enabling them to act upon them. [source] Unemployment and aggression: the moderating role of self-awareness on the effect of unemployment on aggressionAGGRESSIVE BEHAVIOR, Issue 1 2008Peter Fischer Abstract In February 2005, the unemployment rate in Germany surpassed the 10% mark. Derived from the revised version of the frustration,aggression hypothesis [Berkowitz, 1989], the present studies investigated the association between unemployment and aggression, as well as the moderating role of the self in this context. Because previous research on unemployment and aggression has been plagued by the cause-and-effect issue, the present research employed both an experimental and a correlational field approach. Three studies revealed that participants who expected to be unemployed after their degree (Studies 1 and 3), or who were currently unemployed (Study 2), reported stronger aggressive inclinations than participants who expected not to be unemployed or who were not unemployed at the time of data collection. However, this aggression-eliciting effect of expected or real unemployment only occurred for participants with low self-awareness. Participants who could actualize their self prior to reporting on aggression were not differently affected by different expectations or states of unemployment. Aggr. Behav. 34:34,45, 2008. © 2007 Wiley-Liss, Inc. [source] Staff survey results and characteristics that predict assault and injury to personnel working in mental health facilitiesAGGRESSIVE BEHAVIOR, Issue 1 2003Julie Cunningham Abstract The purpose of this study was to complete a mental health staff opinion survey to identify patient and staff characteristics associated with staff assault and injury in psychiatric treatment settings and to develop a model of prediction for staff assault and injury utilizing these survey variables. The data consisted of opinion surveys sent to staff of 15 child, adolescent, and adult psychiatry inpatient units in the United States. Multivariate logistic regression was used to determine the level of assault and staff-reported injury prediction that could be obtained from the staff-completed opinion survey. Responses indicated a high prevalence of reported aggression, with 62.3% of staff endorsing verbal and physical aggression, property destruction, and self-injurious behavior as being prevalent at their site, whereas only 4.1% rated none of these as prevalent. Staff working with children and adolescents in settings with high rates of psychiatric diagnoses reported increased frequency of assault and injury compared with those working with adults. Younger, less experienced staff reported higher rates of assault and injury. Staff working with female patients reported similar rates of assault and injury to those working with males. A logistic regression analysis using staff-reported survey results of both staff and patient characteristics predicted assault correctly 73.7% of the time and injury 66.1% of the time. Resources for violence prevention and staff training programs in violence prevention are needed in child and adolescent psychiatry wards. Results are consistent with theories emphasizing the importance of negative emotions and affects, impulsivity, and frustration in goal-directed activities in human aggression. Aggr. Behav. 29:31,40, 2003. © 2003 Wiley-Liss, Inc. [source] The Challenges of Chronic Total Coronary Occlusions: An Old Problem in a New PerspectiveJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 4 2004DAVID E. KANDZARI M.D. In spite of the remarkable technological innovation and improved outcomes with percutaneous coronary revascularization, chronic coronary artery total occlusions remain a familiar source of procedural frustration and clinical uncertainty. However, considering the recent development of catheter-based technologies specific for chronic total occlusion (CTO) recanalization and the potential for drug-eluting stents to reduce restenosis and reocclusion, this challenging lesion subset is now recognized as the last formidable barrier to percutaneous revascularization success. Further, consistent observations from more recent clinical trials support successful CTO revascularization to avoid subsequent adverse cardiac events and improve long-term overall survival. This review of total coronary occlusions provides an overview of CTO pathophysiology, describes the procedural and clinical outcomes associated with CTO revascularization, and presents future directions for clinical investigation. [source] Soldiers With Musculoskeletal InjuriesJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2008Bonnie M. Jennings Purpose: To describe Soldiers' (e.g., U.S. Army personnel) perspectives of the effect of musculoskeletal injuries. Design: Data were collected in the summer of 2003 using a prospective survey design. The survey was mailed to active duty Soldiers on modified work plans because of musculoskeletal injuries. These Soldiers were assigned to one Army installation in the US. Methods: Responses to the survey questions were analyzed using descriptive statistics. The numerous handwritten comments were evaluated qualitatively. Findings: Injuries most often involved the back and knees (18% each). At least 47% of the injuries were work related. Injuries interfered with Soldiers' abilities to perform military tasks such as road marching (80%) and organized physical training (69%). Although many respondents indicated they were not experiencing pain, at least some Soldiers reported mild pain for each of 19 anatomic locations. Severe pain was reported most often for the lower back (21%). In their written comments, Soldiers expressed a sense of frustration with their injuries, the healthcare system and providers, and their unit leaders. Conclusions: Healthcare personnel are challenged to better manage Soldiers with musculoskeletal injuries and expedite their return to full duty. Unit leaders are challenged to create work environments that focus on injury prevention and allow injured Soldiers time to heal. Clinical Relevance: The Soldiers in this study were often engaged in physically challenging work or sports activities when injured. Because people outside the Army engage in similar activities (e.g., construction workers, endurance athletes), the findings from this study might be applicable to nonmilitary communities. Additionally, with the number of Reserve and National Guard Soldiers currently on active duty, civilian nurses might be caring for Soldiers with musculoskeletal injuries. [source] Self-help CBT for depression: opportunities for primary care mental health nurses?JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 9 2009A. E. WARRILOW rn(mental health) bn(hons) Accessible summary ,,There is currently a big demand for effective and accessible treatments for common mental health problems, but waiting lists are often long. ,,The aim of this review is to discover whether self-help cognitive behavioural therapy materials are effective in the treatment of depression. ,,It explores a possible role for mental health nurses within primary care to provide access to and low-level support with, these materials. ,,A possible model for organizing such a service is suggested. Abstract Mental health treatments that are effective and accessible to the general population are in high demand. Cognitive behavioural therapy (CBT) has been shown to be effective and is popular but such treatments are difficult to access especially within primary care, causing delay, frustration and suffering. One approach to meeting demand would be through the use of self-help CBT materials that aim to address common mental health problems such as depression. The aim of this review is to discover whether self-help CBT materials are effective in the treatment of depression and how mental health nurses within primary care can use their skills to provide access and low-level support. Studies critiqued within this literature review indicate that self-help CBT is effective for the treatment of depression. However, there is a lack of evidence that specifically considers self-help CBT for the treatment of depression in primary care. This review addresses the question of how much nurse client contact is needed to provide adequate support for the facilitation of self-help CBT in depression with primary care patients and recommends the use of a service delivery model. However, more research needs to be carried out on the application of self-help CBT for depression in primary care. [source] Caring for clients with dual diagnosis in rural communities in Australia: the experience of mental health professionalsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2005C. DEANS rmn, hv cert This paper identifies and describes the experiences of 13 rural mental health professionals who care for clients diagnosed with a mental illness and a coexisting alcohol and other drug disorder (dual diagnosis). Dual diagnosis is a common problem which is often poorly understood and managed by mental health professionals. The effect of excessive substance use on a person's mental well-being can present as a diagnostic challenge as each condition may mask symptoms of the other. The authors utilized a phenomenological approach to discover the experiences of a group of mental health professionals working in rural communities in Victoria, Australia. Caring for clients diagnosed with dual diagnosis was found to be a complex and stressful role that involved high levels of skill and knowledge. Despite the fact that health professionals in rural areas are expected to deliver the most appropriate care to individuals with a dual diagnosis, a number of these rural health professionals have limited preparation and experience in dealing with arising clinical diagnosis issues. Clinicians experience frustration, resentment and powerlessness in their attempt to understand their clients' drug misuse whilst simultaneously endeavouring to provide a quality mental health service. [source] Caring for people in the ,virtual ward': the practical ramifications for acute nursing workJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2003M. DEACON, ba (hons) m.phil rmn srn enb(810) This paper discusses an aspect of data analysis arising from an ethnographic study of acute mental health nursing conducted in an inner city psychiatric unit. The data were collected in the form of field notes. These were made during and following episodes of participant observation on one acute ward and on a psychiatric intensive care unit over a period of 20 months. Acute wards have been subject to continuing criticism as both sites of care and treatment for mentally ill people and of nursing work. However, the practical operations of this social world remain largely unexamined. It is argued that without this understanding, mundane work methods will always be regarded as an impediment to work that is regarded as ,therapeutic' and therefore, of importance. The focus will be on phenomena named the ,virtual ward'. The research has demonstrated that the boundaries of nurses' responsibility reach far beyond the ward's spatial environment, both physically and communicatively. The complexity of the work that takes place within the virtual ward and the skills required for its successful completion are taken for granted, but are also a practical source of frustration. Anonymized examples from the practice site studied are used to illuminate the discussion. Working within the virtual ward is part of the messy reality of nurses' work. It is argued that understanding and respecting this reality is necessary if we are to be seriously and consistently ambitious about practice development. [source] Sickle Cell Disease: Health Promotion and Maintenance and the Role of Primary Care Nurse PractitionersJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 9 2003APRN-BC, FNP-C, Ruth A. Tanyi BSJ Purpose To discuss the role of nurse practitioners (NPs) with regard to early identification of affected individuals, effective monitoring and screening, effective pain management and prophylaxis, and health education for patients with sickle cell disease (SCD). Data Sources Electronic database searches were performed using Medline, Cinahl, and PsycINFO. Data were obtained from medical textbooks, research, and review articles. Conclusions SCD is a chronic inherited disease belonging to a group of conditions called hemo-globinopathies. Individuals with SCD often require close medical care from specialists. Nonetheless, NPs are in ideal positions to facilitate the health promotion and health maintenance necessary to decrease the high rate of morbidity and mortality associated with this disease. Implications for Practice NPs must understand the importance of early identification of affected individuals, effective monitoring and screening, effective pain treatment, and prophylaxis. The unpredictable trajectory of SCD can lead to frustration, fear, helplessness, hopelessness, and emotional distress. Ineffective pain management is a major problem for people with SCD. NPs can overcome this problem by initiating effective and prompt pain management in a nonjudgmental manner. [source] Doctrine and fairness in the law of contract*LEGAL STUDIES, Issue 4 2009Andrew Phang This paper explores, through illustrations from the law of contract, the important central theme to the effect that the rules and principles, which constitute the doctrine of the law, are not ends in themselves but are, rather, the means through which the courts arrive at substantively fair outcomes in the cases before them. The paper focuses on the concept of ,radicalism', which relates to the point at which the courts decide that it is legally permissible to hold that a contract should come to an end because a radical or fundamental ,legal tipping point' has not only been arrived at but has, in fact, been crossed. It explores the role of this concept as embodied in the doctrines of frustration, common mistake, discharge by breach, as well as fundamental breach in the context of exception clauses , in particular, how ,radicalism' with regard to these doctrines can be viewed from the (integrated) perspectives of structure, linkage and fairness. The paper also touches briefly on linkages amongst the doctrines of economic duress, undue influence and unconscionability, as well as the ultimate aim these doctrines share of achieving fair outcomes in the cases concerned. [source] Synergistic Ordering of Side-Group Liquid Crystal Polymer and Small Molecule Liquid Crystal: Order and Phase Behavior of Nematic Polymer Solutions,MACROMOLECULAR CHEMISTRY AND PHYSICS, Issue 19-20 2007Neal R. Scruggs Abstract Addition of a small-molecule liquid crystal (5CB) to a cyanobiphenyl-based side-group liquid crystal polymer (SGLCP) stabilizes nematic order, increasing the isotropization temperature (TNI) more than 15,°C. Despite synergistic ordering at high concentration, small amounts of polymer destabilize nematic order. Even though TNI(SGLCP) is 27,°C greater than TNI(5CB), 2H NMR shows that the order parameter of the SGLCP is less than that of 5CB at concentrations for which monodomains were accessible (,10 wt.-%). The results imply that nematic order is frustrated in the bulk polymer and addition of small molecule LC relaxes this frustration by allowing greater configurational freedom. Conversely, adding small amounts of polymer to the bulk 5CB introduces frustration, resulting in the strong asymmetry of the phase diagram. [source] Morphology Transition of Block Copolymers under Curved ConfinementMACROMOLECULAR THEORY AND SIMULATIONS, Issue 8 2007Xingqing Xiao Abstract The morphology transitions in AB diblock and ABA triblock copolymers confined between flat and curved surfaces were investigated by MC simulations. Upon variation of the extent of frustration between thickness d and bulk lamellae period L0, parallel and vertical or distorted vertical lamellar structures appear in both flat and curved confinements. With increasing curvature, the compatibility of d and L0 becomes more perturbed so that perfectly parallel lamellae are formed with increasing difficulty. Owing to the smaller L0 of ABA as compared to AB, the transformation frequency of the incompatible region of d/L0(ABA) is more notable for ABA and the corresponding transformation period is larger than that of AB. [source] Morphology of Symmetric Diblock Copolymers Confined Between Two Stripe-Patterned Surfaces , Tilted Lamellae and MoreMACROMOLECULAR THEORY AND SIMULATIONS, Issue 2 2005Qiang Wang Abstract Summary: We report the first Monte Carlo simulations on the thin-film morphology of symmetric diblock copolymers confined between either symmetrically or antisymmetrically stripe-patterned surfaces. Under suitable surface configurations (where the lamellae can comply with the surface patterns and can have a period close to the bulk lamellar period L0), tilted lamellae are observed for film thicknesses D,,,2L0; the checkerboard morphology is obtained for smaller film thicknesses. The A-B interfaces in the tilted lamellae are basically perpendicular to the surfaces in their immediate vicinity, and exhibit undulations away from them. In some cases, the severe frustration imposed by the two patterned surfaces leads to irregular or unexpected morphologies, which represent locally stable states. The efficient sampling of our expanded grand-canonical Monte Carlo technique enables us to observe more than one locally stable morphologies and the flipping between them during a single simulation run. Tilted lamellae between symmetrically patterned surfaces (perpendicular to z) with a surface pattern period of 1.5L0 and a film thickness of 2.67L0. L0 is the bulk lamellar period and the black curves mark the A-B interfaces. [source] Older peoples' satisfaction with home-based dialysisNEPHROLOGY, Issue 4 2010SARAH DERRETT ABSTRACT: Background: The proportion of older people receiving dialysis is rapidly increasing. The typical choice for older patients is between home-based peritoneal dialysis (PD) and clinic-based haemodialysis (HD). Some centres have been successful in encouraging all patients , including older patients , to have home-based self-administered PD or HD. Aim: To (i) describe the overall satisfaction with renal services among older patients dialysing, or in training, with HD or PD at home; and (ii) examine the relationship between residential distance from the nephrology unit and satisfaction with home-based dialysis. Methods: Participants were aged 60 years or more; and were either dialysing at home or training for dialysis at home. Two methods of cross-sectional data collection were used: (i) structured quantitative interviews with all participants; and (ii) qualitative interviews with a selected subgroup. Results: Participants comprised 45 patients on dialysis (94% of 48 eligible). Their average age was 68 years. Duration of dialysis averaged 28 months (range 3,150 months). Ratings of ,very good or excellent' were reported for dialysis treatment by 40 (89%) patients. Patients on dialysis, despite experiencing frustration with dialysis itself, expressed satisfaction across four categories: staff, information provision, involvement in decision-making and confidence in managing dialysis. Dissatisfaction was infrequent. Conclusion: This pilot study suggests that older patients trained to dialyse at home using PD or HD are highly satisfied with the nephrology service , even when living remote from the nephrology unit. Home-based dialysis is possible in older patients with levels of comorbidity and disease severity as serious as elsewhere. [source] | ||||||||||||||||||||||||||||||||||||||||||||||