Academic dishonesty in university nursing students: A scoping review.

OBJECTIVE: This review seeks to deepen our understanding of the factors contributing to nursing students' academic dishonesty and the repercussions of such behaviours on their learning in both classroom and clinical settings, and on the integrity of the nursing profession. DESIGN AND METHODS: It was a scoping review in which a five-stage methodological framework informed its process. Six databases were searched for relevant original studies. Other search methods were also conducted using Google Scholar, Trove, and ProQuest Dissertations for theses pertinent to the topic. An inductive descriptive approach was used to analyse and synthesise data. RESULTS: Twenty-seven studies and nine doctoral theses were selected and included in the scoping review. Of these, 25 studies used a quantitative approach, nine studies a qualitative one, and two studies used mixed methods. Three categorical factors, intrapersonal, interpersonal, and external, contributed to nursing students' academic dishonesty. CONCLUSION: Academic dishonesty in nursing students is concerning. Noted factors contributing to academic dishonesty include stress and pressure experienced by students, the prevalence of peer cheating, and lack of knowledge. Most alarming is the significant correlation between academic dishonesty and clinical dishonesty. The evidence suggests that students who engage in dishonest behaviour in academic settings may be more likely to engage in dishonest behaviour in clinical settings. This raises serious concerns about integrity, ethics, patient safety and the reputation of nursing students, universities, healthcare providers and health professionals.

Benchmarking Basis Sets for Density Functional Theory Thermochemistry Calculations: Why Unpolarized Basis Sets and the Polarized 6-311G Family Should Be Avoided.

Basis sets are a crucial but often largely overlooked choice in setting up quantum chemistry calculations. The choice of the basis set can be critical in determining the accuracy and calculation time of your quantum chemistry calculations. Clear recommendations based on thorough benchmarking are essential but not readily available currently. This study investigates the relative quality of basis sets for general properties by benchmarking basis set performance for a diverse set of 139 reactions (from the diet-150-GMTKN55 data set). In our analysis, we find the distributions of errors are often significantly non-Gaussian, meaning that the joint consideration of median errors, mean absolute errors, and outlier statistics is helpful to provide a holistic understanding of basis set performance. Our direct comparison of performance between most modern basis sets provides quantitative evidence for basis set recommendations that broadly align with the established understanding of basis set experts and is evident in the design of modern basis sets. For example, while zeta is a good measure of quality, it is not the only determining factor for an accurate calculation with unpolarized double- and triple-ζ basis sets (like 6-31G and 6-311G) having very poor performance. Appropriate use of polarization functions (e.g., 6-31G*) is essential to obtain the accuracy offered by double- or triple-ζ basis sets. In our study, the best performances for double- and triple-ζ basis sets are 6-31++G** and pcseg-2, respectively. However, the performances of singly polarized double-ζ and doubly polarized triple-ζ basis sets are quite similar with one key exception: the polarized 6-311G basis set family has poor parametrization, which means its performance is more like a double-ζ than a triple-ζ basis set. All versions of the 6-311G basis set family should be avoided entirely for valence chemistry calculations moving forward.

Structural racism in healthcare and research: A community-led model of curriculum development and implementation.

Structural racism in the USA has roots that extend deep into healthcare and medical research, and it remains a key driver of illness and early death for Black, Indigenous, People of Color (BIPOC). Furthermore, the persistence of racism within academic medicine compels an interrogation of education and research within this context. In the spirit of this interrogation, this article highlights a unique model of community-engaged education that integrates cultural humility. As an individual and institutional stance, cultural humility denotes lifelong learning and self-critique, the mitigation of power imbalances, and accountability. The integration of cultural humility emphasizes that when space is created for BIPOC communities to lead the way, education regarding healthcare and research can be effectively reimagined. Demonstrating this effectiveness, six community partners led the development and implementation of a five-module Structural Racism in Healthcare and Research course. Using a cohort model approach, the pilot course enrolled 12 community members and 12 researchers. The curriculum covered topics such as history of racism in healthcare and research, and introduced participants to a cultural resilience framework. Evaluation results demonstrated a significant increase in participants' knowledge and ability to identify and take action to address inequities related to racism in healthcare and research.

Grace under pressure: Mental health nurses' stories of resilience in practice.

Mental health nurses experience both organizational and practice-related stressors in their work. Resilience is an interactive process of positive adaptation following stress and adversity. There is limited evidence on how personal resilience is applied to mental health nursing practice. The aim of this interpretive narrative study was to explore mental health nurses' stories of resilience in their practice for the purpose of gaining an understanding of resilience resources they draw on when dealing with challenging workplace situations. A storytelling approach was used in semistructured phone interviews with 12 mental health nurses who measured high on resilience (Workplace Resilience Inventory) and caring behaviours (Caring Behaviours Inventory). Within and across case narrative analysis produced stories of resilient practice within four themes: proactively managing the professional self; sustaining oneself through supportive relationships; engaging actively in practice, learning and self-care; and seeking positive solutions and outcomes. Nurses displayed poise in stressful situations and grace under pressure in demanding and emotionally challenging interactions, holding dignity and respect for self and others, with the aim of achieving positive outcomes for both. Resilient practice is the responsibility of organizations as well as individuals. To develop practice and support staff retention, we recommend organizations use tailored professional development to cultivate a growth mindset in new and experienced staff, develop organizational strategies to build positive team cultures, and prioritize strategies to reduce workplace stressors and strengthen staff psychological safety and well-being. The use of narrative techniques in reflective practice and clinical supervision may help build nurses' resilience and practice.

Mental health nurses' resilience in the context of emotional labour: An interpretive qualitative study.

Strengthening mental health nurses' (MHNs) resilience may help mitigate the negative effects of the emotional labour (EL) of their work. There is no prior evidence on MHNs' experiences of resilience in the context of EL. This interpretive qualitative study sought to explore how MHNs build and maintain their resilience in the face of high levels of EL. Semi-structured interviews were conducted with 11 MHNs. Reflexive thematic analysis was used to analyse the data. Four main themes were constructed. The first three; Being attuned to self and others, Having a positive mindset grounded in purpose, and Maintaining psychological equilibrium through proactive self-care, describe how MHNs build and maintain their resilience. The fourth theme, Running on emotionally empty, describes what impedes MHNs' resilience. MHNs engaged in internal self-regulatory processes to manage their mental and emotional state. They maintained intra- and inter-personal boundaries and proactively used self-care strategies to maintain their well-being. Through this, they were able to replenish and sustain the energy required to maintain a state of equilibrium between themselves, their interpersonal practice, and their working environment, and to positively adapt to EL. However, lack of organizational support and high workplace demands can negatively impact MHNs' equilibrium and adaptive ability. There is a need for organizations to proactively work to reduce workplace stressors, and support MHNs' professional well-being and practice. Education and support strategies focused on strengthening MHNs' resilience, well-being, and mental health practice capabilities, including the provision of clinical supervision, and clear role expectations within MHNs' scope of practice are recommended.

Enablers of the interpersonal relationship between registered nurses and students on clinical placement: A phenomenological study.

AIM/OBJECTIVE: The aim of this qualitative study was to explore the lived experiences (nature and extent) of the interpersonal relationship between RNs and students during clinical placement. BACKGROUND: In Australia, as elsewhere, nursing students' clinical placements are facilitated and supervised by registered nurses (RNs). There is evidence of positive teaching and learning interactions between RNs and students influencing student placement outcomes. Comparatively, little is known about the value of interpersonal relationships between RNs and students in the contribution to positive placement experiences. DESIGN: A descriptive phenomenological approach was used to investigate the interpersonal relationship between RNs and students from the perspective of the lived experience of the RN. METHOD: In depth, semi-structured interviews were conducted with ten RNs and analysed using Colaizzi's seven-step analytical approach. RESULTS: Study findings revealed that RNs are committed to building positive interpersonal relationships with students to enhance learning and achieve successful clinical learning outcomes. Positive relationships are enabled through factors encompassing three overarching themes; Getting to know the student is essential; Effective communication is a reciprocal process, and Mutuality of engagement and commitment is critical. Vital to the relationship was the capacity to know the student, communicate with them openly and effectively, and have a mutually engaging, committed relationship with them. CONCLUSIONS: The establishment of positive interpersonal relationships is important to the RNs who facilitate and supervise the clinical learning of nursing students for meaningful learning and successful student outcomes. Key findings included that getting to know the student is essential, effective communication is a reciprocal process, and mutuality of engagement and commitment is critical to building a positive relationship. Findings can be utilised to advise professional development for RNs who work with students on clinical placement with regard to the importance of developing positive interpersonal relationships with students and the characteristics that enable that to occur. The primacy of the relationship, brought about through RNs requirement to facilitate student clinical learning needs acknowledgement. Also, the importance of the interpersonal relationship for RNs and students needs recognition by both, to help them achieve success in clinical placements through effective interpersonal and professional relationships which promote good learning opportunities.

The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children's Hospital, Cape Town, South Africa.

BACKGROUND: Paediatric poisoning is a common presentation to emergency departments worldwide. There is a paucity of data on the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS), in the management of paediatric poisoning in low-and middle-income countries (LMICs). In high-income countries, most studies are retrospective, and few include children. OBJECTIVE: The study describes the prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. METHODS: Children admitted with suspected poisoning between 1 January 2017 and 31 December 2017, were recruited. All patients had a urine and/or blood sample sent for LC-MS/MS toxicology. Data collected included demographic data, clinical features, investigations, management, outcome and social interventions. RESULTS: One hundred fifty-two children, with median age of 39 (IQR 25-61) months were enrolled of which 128 (84%) were poisoning cases. Of the 128 poisoning cases, 88 (69%) presented with a history of ingesting a known substance, 16 (12%) an unknown substance and 24 (19%) were cases of occult poisoning. LC-MS/MS was able to identify a substance in 92% of the cases of occult poisoning. In those who had presented with a seemingly known substance, LC-MS/MS found a different substance in 15 cases. LC-MS/MS was also able to detect multiple drugs in 40 patients. Of the poisoning cases, six (5%) cases were attempted homicide cases and 5 (4%) cases were attempted suicide cases. No children died. Individualized social interventions were instituted in poisoning cases. Emergency placement safety reasons was required in 6 children. CONCLUSION: When the limitations are known, LC-MS/MS is useful in identifying cases of occult poisoning, identifying patients who have ingested multiple substances and/or an unknown substance and when targeted towards child protection. As LC-MS/MS is an expensive test, it should be used judiciously in LMICs.

Consumers living with psychosis: Perspectives on sexuality.

Mental health clinicians work within a recovery framework that is rights based and emphasizes positive and respectful approaches to working with mental health consumers. Mental health nurses' practice is also predicated on holism and inclusiveness, yet consumers' sexuality is sometimes neglected and rights in this area overlooked. Also overlooked is sexuality as an area for investigation, particularly from a consumer perspective, even though it constitutes part of consumers' broader remit of sexual health. This paper reports findings from a case study where consumers were asked about their ability to negotiate and sustain sexual expression while residing in a long-stay mental health rehabilitation facility. There were three main findings. First, the physical space of the facility, inclusive of consumers' bedrooms, was policed by mental health clinicians with ongoing intrusions into consumers' privacy, which inhibited their sexual expression. The creation of barriers to sexual expression is counter to polices that promote recovery. Second, consumers reported significant medication-related weight gain which negatively affected their self-image and sexual sense of self. Third, the consumers spoke about their sexuality in ordinary, everyday language devoid of any hallmark of psychosis. This highlights the importance of relating to consumers about their sexuality and sexual needs from a humane rather than technical framework. Further, it foregrounds the relational aspect of the mental health nurses' role rather than the technical aspect. Yet sexuality is a topic that is often neglected, indicating that an upskilling of the mental health nursing workforce is required, to strengthen communication and relationship skills.

Madness, sex, and risk: A poststructural analysis.

The body of the one deemed mad often remains a sexual body with sexual needs. Mental health services respond to these demands of the body in various ways, including constructing rules around physical movement. In this context, we were interested in how mental health clinicians problematized the sexual needs and practices of residents of a long-stay mental health rehabilitation facility and how solutions were constructed in relation to the residents' sexual desires. This paper reports findings from mental health clinicians, as part of a case study where we addressed this question. Mental health clinicians responded to residents' sexuality from a discourse of risk. The notion of the engagement with each resident as a sexual subject was subordinated to the paternalistic notion of protecting the patient from risk. The resident became an object to be monitored and protected rather than a subject with sexual desire and agency. This paternalism also showed itself in relation to a 'no-sex on-site' rule that allowed for a shift of risk from the organization to the resident. Residents, rather than having a relatively safe place to have sexual relations, were required to find a place elsewhere, potentially unsafe, outside the facility.

The governance of sexuality in a Recovery-oriented mental health service: Psychosis, consumers and clinical approaches.

WHAT IS KNOWN ON THE SUBJECT: The intersection of sexuality and psychosis has a long history, yet research in this area has been minimal over the past few decades. Mental health clinicians practice from within the confines of a mental health system that is founded on a conflict between containment and care and that positions the consumer as an object of care. At the same time, mental health services often have a Recovery approach to care. This presents a difficulty and tension in mental health clinical work because the Recovery approach is opposed to positioning the consumer as an object. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE: The findings suggest that sexuality and sexual needs are common to both clinicians and consumers, and via identification, make the two groups more similar than different. Sexuality can problematize and so open up questions about the objectification of consumers. Consideration of consumers' sexuality and sexual needs can therefore work as a resistance to the dominant mental health approach and, in doing so, produce a more Recovery-oriented approach to treatment in terms of how the consumer is positioned. Other aspects of living that escape capture by the diagnostic system may also operate as organizing factors for a more subject-to-subject approach to treatment. THE IMPLICATIONS FOR PRACTICE: Focusing on sexuality and other aspects of living that escape capture by the diagnostic system can bring into question the way consumers are objectified by the psychiatric model of care. Abstract Introduction The Recovery approach introduced a radical shift in the positioning of consumers as subjects rather than objects of mental health treatment. While this approach has been internationally adopted, the practice of Recovery has been under-researched and a knowledge gap exists regarding the intersection of sexuality and psychosis. Aim The study aim was to investigate how sexuality was governed in a long-stay mental health rehabilitation facility that was Recovery-oriented. Method A case study methodology with a conceptual framework using Foucault's work on disciplinary power was used. Results The findings illustrated how mental health clinicians were caught between two main and incompatible models of care: a psychiatric one and a Recovery one. Discussion While the policy framework authorized a Recovery approach, clinicians practised surveillance, hierarchical observation and normalization, which are tenants of a psychiatric model of care. However, the study found that sexuality was an area that opened questions about the psychiatric model for clinicians. Consideration of consumers' sexual needs allowed the clinicians to think of consumers more as subjects like themselves than as objects to be treated. Implications for practice Consideration of consumers' sexuality opens up possibilities for questioning the objectification of the consumer via the psychiatric model.

Understanding the effects of solvate ionic liquids as solvents on substitution processes.

The effects of solvate ionic liquids as solvents have been considered for two substitution processes where the solvent effects of typical ionic liquids have been extensively investigated previously; the bimolecular nucleophilic substitution (SN2) reaction between pyridine and benzyl bromide and the nucleophilic aromatic substitution (SNAr) reaction between ethanol and 1-fluoro-2,4-dinitrobenzene. It was found that use of solvate ionic liquids gave rise to similar trends in the activation parameters for both substitution processes as typical ionic liquids, implying the microscopic interactions responsible for the effects were the same. However, different effects on the rate constants compared to typical ionic liquids were observed due to the changes in the balance of enthalpic and entropic contributions to the observed rate constants. From these data it is clear that the reaction outcome for both of these substitution reactions fall within the 'predictive framework' established in previous studies with a cautionary tale or two of their own to add to the general knowledge of ionic liquid solvent effects for these processes, particularly with respect to potential reactivity of the solvate ionic liquids themselves.

Registered nurse buddies: Educators by proxy?

The informal clinical teaching role of the buddy nurse seems to be a uniquely Australian title, with little consistency in terminology for informal nurse educator roles internationally. Not all registered nurses are professionally developed for the informal role of facilitating the clinical learning of students in clinical settings, yet these roles are expected by nursing professional bodies. In Australia the registered nurses (RN) experience of being a buddy nurse has been reported as lacking clarity, being unsupported and structureless. Whist there is a plethora of literature published about formal RN educator roles, little is available on the informal buddy nurse role. A view of the buddy nurse role in reference to the limited but available literature in the Australian context is offered in this paper. International perspectives are also gathered describing informal clinical education RN's roles with similar responsibilities to the Australian buddy nurse. The significance of this dialogue is to ignite debate about the role, potentially informing policy for the improved support of the role within the Australian nursing landscape.

Higher Plasma LDL-Cholesterol is Associated with Preserved Executive and Fine Motor Functions in Parkinson's Disease.

Plasma low density lipoprotein (LDL) cholesterol has been associated both with risk of Parkinson's disease (PD) and with age-related changes in cognitive function. This prospective study examined the relationship between baseline plasma LDL-cholesterol and cognitive changes in PD and matched Controls. Fasting plasma LDL-cholesterol levels were obtained at baseline from 64 non-demented PD subjects (62.7 ± 7.9 y) and 64 Controls (61.3 ± 6.8 y). Subjects underwent comprehensive neuropsychological testing at baseline, 18-, and 36-months. Linear mixed-effects modeling was used to assess the relationships between baseline LDL-cholesterol levels and longitudinal cognitive changes. At baseline, PD patients had lower scores of fine motor (p<0.0001), executive set shifting (p=0.018), and mental processing speed (p=0.049) compared to Controls. Longitudinally, Controls demonstrated improved fine motor and memory test scores (p=0.044, and p=0.003), whereas PD patients demonstrated significantly accelerated loss in fine motor skill (p=0.002) compared to Controls. Within the PD group, however, higher LDL-cholesterol levels were associated with improved executive set shifting (ß=0.003, p<0.001) and fine motor scores (ß=0.002, p=0.030) over time. These associations were absent in Controls (p>0.7). The cholesterol - executive set shifting association differed significantly between PDs and Controls (interaction p=0.005), whereas the cholesterol - fine motor association difference did not reach significance (interaction, p=0.104). In summary, higher plasma LDL-cholesterol levels were associated with better executive function and fine motor performance over time in PD, both of which may reflect an effect on nigrostriatal mediation. Confirmation of these results and elucidation of involved mechanisms are warranted, and might lead to feasible therapeutic strategies.

'Risk or Right': a discourse analysis of midwifery and obstetric colleges' homebirth position statements.

Within the context of global debates about safety and ethics of supporting women to give birth at home, it is important to analyse documents governing midwifery and obstetric practice and influence decision-making around place of birth. In Australia, the United States and the United Kingdom, relatively small numbers of women choose to give birth at home despite their midwifery colleges' support. In the United States and Australia, the obstetric colleges do not support homebirth and these countries have lower numbers of women who birth at home, compared with the United Kingdom. There are numerous regulatory and industry challenges for midwives attending homebirths. This paper reports on a Foucauldian analysis of Australian obstetric and midwifery colleges' position statements about homebirth, who have conflicting views, with the view to understanding their arguments and underlying assumptions. The documents highlighted tensions between competing discourses of risk and autonomy and differences in academic argument. Opportunities for strengthening their statements are highlighted. The methodology is applicable for future analysis of similar documents governing practice in other countries.

Antiplasmodial activity, in vivo pharmacokinetics and anti-malarial efficacy evaluation of hydroxypyridinone hybrids in a mouse model.

BACKGROUND: During the erythrocytic stage in humans, malaria parasites digest haemoglobin of the host cell, and the toxic haem moiety crystallizes into haemozoin. Chloroquine acts by forming toxic complexes with haem molecules and interfering with their crystallization. In chloroquine-resistant strains, the drug is excluded from the site of action, which causes the parasites to accumulate less chloroquine in their acid food vacuoles than chloroquine-sensitive parasites. 3-Hydroxylpyridin-4-ones are known to chelate iron; hydroxypyridone-chloroquine (HPO-CQ) hybrids were synthesized in order to determine whether they can inhibit parasites proliferation in the parasitic digestive vacuole by withholding iron from plasmodial parasite metabolic pathway. METHODS: Two HPO-CQ hybrids were tested against Plasmodium falciparum chloroquine-sensitive (D10 and 3D7) and -resistant strains (Dd2 and K1). The pharmacokinetic properties of active compounds were determined using a mouse model and blood samples were collected at different time intervals and analysed using LC-MS/MS. For in vivo efficacy the mice were infected with Plasmodium berghei in a 4-day Peters' test. The parasitaemia was determined from day 3 and the course of the infection was followed by microscopic examination of stained blood films every 2-3 days until a rise in parasitaemia was observed in all test subjects. RESULTS: IC50 values of the two compounds for sensitive and resistant strains were 0.064 and 0.047 µM (compound 1), 0.041 and 0.122 µM (compound 2) and 0.505 and 0.463 µM (compound 1), 0.089 and 0.076 µM (compound 2), respectively. Pharmacokinetic evaluation of these compounds showed low oral bioavailability and this affected in vivo efficacy when compounds were dosed orally. However, when dosed intravenously compound 1 showed a clearance rate of 28 ml/min/kg, an apparent volume of distribution of 20 l/kg and a half-life of 4.3 h. A reduction in parasitaemia was observed when compound 1 was dosed intravenously for four consecutive days in P. berghei-infected mice. However, a rise in parasitaemia levels was observed on day 6 and on day 9 for chloroquine-treated mice. CONCLUSION: The hybrid compounds that were tested were able to reduce parasitaemia levels in P. berghei-infected mice when dosed intravenously, but parasites recrudesced 24 h after the administration of the least dose. Despite low oral bioavailability, the IV data obtained suggests that further structural modifications may lead to the identification of more HPO-CQ hybrids with improved pharmacokinetic properties and in vivo efficacy.

Moments of speaking and silencing: Nurses share their experiences of manual handling in healthcare.

Nursing care involves complex patient handling tasks, resulting in high musculoskeletal injury rates. Epidemiological studies from the 1980s estimated a lifetime prevalence of lower back injuries for nurses between 35 and 80%. National and international studies continue to mirror these findings. Despite the development of programs intended to reduce manual handling injuries, sustainable solutions remain elusive. This paper reports on a study of nurses speaking about their perspectives on current manual handling practices. Qualitative research conducted in 2012 investigated nurses' perceptions and experiences relating to manual handling in the healthcare context and their participation in injury prevention programs. There were two research methods: semi-structured interviews and researcher reflective journaling. The research was framed in critical emancipatory methodology. Thirteen nurses from two Australian states participated in the study. Thematic analysis revealed an overarching theme of 'power relations' with a subcategory of '(mis)power' that comprised two subthemes, these being 'how to practice' and 'voicing practice issues'. Specifically, this paper explores nurses verbalising their views in the workplace and responses which left them feeling silenced, punished and disillusioned. The findings suggest that the sociopolitical context within which nurses practice impacts upon their ability to voice concerns or ideas related to manual handling. Inclusion of nurses in the manual handling dialogue may generate an expanded understanding of, and the potential to transform, manual handling practices in healthcare environments.

Interpersonal relationships between registered nurses and student nurses in the clinical setting--A systematic integrative review.

BACKGROUND: A significant proportion of undergraduate nursing education occurs in the clinical setting in the form of practising skills and competencies, and is a requirement of all nursing curriculum for registration to practice. Education in the clinical setting is facilitated by registered nurses, yet this interpersonal relationship has not been examined well. OBJECTIVE: To investigate the experience of interpersonal relationships between registered nurses and student nurses in the clinical setting from the point of view of the registered nurse. DESIGN: Integrative review Review methods: The databases of MEDLINE, CINAHL and OVID were searched. Key words used included: Registered Nurse, Preceptor, Buddy Nurse, Clinical Teacher, Mentor, Student Nurse, Nursing Student, Interpersonal Relationships, Attitudes and Perceptions. Additional review of the literature was manually undertaken through university library textbooks. RESULTS: 632 abstracts were returned after duplicates were removed. Twenty one articles were identified for full text read (quantitative n=2, mixed n=6, qualitative n=14); of these, seven articles addressed the experience of interpersonal relationships between registered nurses and student nurses in the clinical setting from the point of view of the registered nurse and these were reviewed. CONCLUSIONS: Providing education for registered nurses to enable them to lead student education in the clinical setting communicates the organizational value of the role. Registered nurses identified being supported in having the time-to-teach were considered important in facilitation of the clinical teaching role. The integrative review did not provide evidence related to the impact diverse clinical settings can have on the relationships between registered nurses and student nurses revealing an area for further examination.

A Pharmacokinetic Study of Antimalarial 3,5-Diaryl-2-aminopyridine Derivatives.

Malaria caused by Plasmodium falciparum is responsible for approximately 80% of the incidence and 90% of deaths which occur in the World Health Organization (WHO) African region, with children and pregnant women having the highest incidence. P. falciparum has developed resistance, and therefore new effective candidate antimalarial drugs need to be developed. Previous studies identified 3,5-diaryl-2-aminopyridines as potential antimalarial drug candidates; therefore, derivatives of these compounds were synthesized in order to improve their desired properties and pharmacokinetic (PK) properties of the derivatives were investigated in a mouse model which was dosed orally and intravenously. Collected blood samples were analyzed using liquid chromatography coupled to mass spectrometer (LC-MS/MS). The mean peak plasma level of 1.9 µM was obtained at 1 hour for compound 1 and 3.3 µM at 0.5 hours for compound 2. A decline in concentration was observed with a half-life of 2.53 and 0.87 hours for compound 1 in mice dosed orally and intravenously, respectively. For compound 2 a half-life of 2.96 and 0.68 hours was recorded. The bioavailability was 69% and 59.7% for compound 1 and compound 2, respectively.

Slavery and jouissance: analysing complaints of suffering in UK and Australian nurses' talk about their work.

Nursing has a gendered and religious history where ideas of duty and servitude are present and shape its professional identity. The profession also promotes idealized notions of relationships with patients and of professional autonomy both of which are, in practice, highly constrained or even impossible. This paper draws on psychoanalytic concepts in order to reconsider nursing's professional identity. It does this by presenting an analysis of data from two focus group studies involving nurses in England and Australia held between 2010 and 2012. The studies gave rise to data where extremely negative talk about nursing work seemed to produce, or to be expressed with, a high degree of energy, and a particular kind of enjoyment. In our analysis, we focus on the nurses' apparent enjoyment derived from their expression of a position of powerlessness in which they describe themselves as 'slaves' or 'martyrs' in the health care system. We interpret this as jouissance and suggest that the positions of slave or martyr provide a possible response to what we argue is the impossibility of the nurse's role. We argue that a remnant of a quasi-religious ethic within the profession makes it acceptable for nurses to talk about self-sacrifice and powerlessness as part of their working subjectivity. We further argue that this analysis offers a new consideration of the issue of power and professional identity in nursing that goes beyond seeing nurses as simply overpowered by, or engaged in, a gendered power struggle with other professional groups. We suggest that powerlessness and victimhood hold particular attractions and advantages for nurses and are positions that are more available to nurses than to other occupational groups. This research shows how psychoanalytic theory can help produce new insights into the problems and complexity of nursing and extend existing study of the professions.

Anxiety and surplus in nursing practice: lessons from Lacan and Bataille.

It is well established, following Menzies' work, that nursing practice produces considerable anxiety. Like Menzies, we bring a psychoanalytic perspective to a theorization of anxiety in nursing and do so in order to consider nursing practice in the light of psychoanalytic theory, although from a Lacanian perspective. We also draw on Bataille's notion of 'surplus'. These concepts provide the theoretical framework for a study investigating how some clinical nurses are able to remain in clinical practice rather than leave the profession or seek work at a distance from the bedside. We conducted focus groups and present here an analysis of two fragments of nurses' speech. We found the nurses responded from one of two positions. In the first position, the nurses focus on doctors, complain about the surplus afforded them, and call for it to be eliminated. In this way, the nursing group is similar to other groups, considered by Bataille, who also attempt to get rid of a surplus. However, in the second position, the nurses stay with the surplus, tolerating it as they nurse the patient. This latter position is one where the nurse practises with a focus on the patient rather than being distracted by their dispute over the doctor's privilege. The importance of this paper is in its illustration of two distinct positions from which the nurse can practise: one that is not optimal because the nurse is distracted and the other that is more focused on practice, and thus the nurse is in a position to provide the best care possible to patients.