How nurses' and physicians' emotions, psychosocial factors, and professional roles influence the end-of-life decision making process: An interpretive description study.

BACKGROUND: Critical care physicians and nurses have significant roles in the complex process of end-of-life decision making. OBJECTIVE: To understand how nurses' and physicians' emotions, psychosocial factors and professional roles influence end-of-life decision making in critical care. RESEARCH DESIGN/METHODOLOGY: An interpretive descriptive qualitative approach was applied to collect and analyse data from semi-structured interviews with five critical care nurses and four critical care physicians from April to June 2018. SETTING: Four Canadian critical care units; three tertiary and one rural setting. FINDINGS: Three major themes arose: (1) the goal of avoiding futility as a shared mission, (2) ambiguity of the decision making process; and (3) influencing factors of subjective variability. The significant influencers shaping the dynamic and value-laden process were individual philosophy, moral weightiness, and family receptiveness. CONCLUSION: There is a need for a shared understanding of professional roles and clear communication of shared mission within health professional teams. Improved understanding of the end-of-life decision making process in critical care is essential to support nurses and physicians.

Inclusion and Quality of Life for Older Adults: Nurses Advocating for Policy Change.

Social inclusion and social determinants of health (SDH) are key to healthy aging, and a failure to adequately address these influences can lead to negative health consequences such as the development and worsening of chronic conditions. Health policy is needed that prioritizes aging well in place as an "upstream" approach to address SDH and thereby improve health outcomes and promote quality of life. Globally, nurses are well positioned to advocate for such policy, given their commitment to fostering social inclusion and quality of life for older adults. This article presents a policy submission, made by nurses enrolled in a graduate health policy course, to Canada's Standing Committee on Human Resources and Social Development and the Status of Persons with Disabilities, for the Committee's report on Advancing Inclusion of and Quality of Life for Seniors ().

Short communication: a simple method for performing worm-egg counts on sodium acetate formaldehyde-preserved samples.

The Kato Katz method is the most common way of performing worm-egg counts on human faecal samples, but it must be done in the field using freshly collected samples. This makes it difficult to use in remote, poorly accessible situations. This paper describes a simple method for egg counts on preserved samples collected in the field and sent to a central location for further processing.

Intrahippocampal administration of the alpha-keto acids accumulating in maple syrup urine disease provokes learning deficits in rats.

Learning disability is a common feature of patients affected by maple syrup urine disease (MSUD). However, the pathomechanisms underlying learning deficit in this disorder are poorly known. In the present study, we investigated the effect of acute administration of the alpha-keto acids accumulating in MSUD into the hippocampus on the behavior of rats in the open field and in the inhibitory avoidance tasks. Adult male Wistar rats received intrahippocampal injections of alpha-ketoisocaproic acid (KIC, 8 micromol), alpha-ketoisovaleric acid (KIV, 5 micromol), alpha-keto-beta-methylvaleric acid (KMV, 5 micromol), or NaCl (8 micromol) (controls) immediately after or 10 min before training. Testing session was performed 24 h later. Posttraining administration of the keto acids had no effect on learning in the open-field task. In contrast, pretraining administration of KIV and KMV impaired habituation in the open field. Similarly, pretraining administration of KIC, KIV, and KMV affected rat performance in the inhibitory avoidance task, suggesting disruption of acquisition. The results indicate that the alpha-keto acids accumulating in MSUD induce learning deficits in aversive and nonaversive tasks. We therefore suggest that these findings may be related to the psychomotor delay/mental retardation observed in MSUD, and may indicate the contribution of increased brain concentrations of these organic acids to the pathophysiology of the neurological dysfunction of MSUD patients.