"That was a good shift".

Purpose The purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors' learning and improve patient management during the overtime shift. Design/methodology/approach A mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 "regular" shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews. Findings The intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors' engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors' total tasks. Interviews suggested the initiative reduced junior doctors' work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being. Originality/value Junior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors' learning and well-being.

Enantiospecific stereodivergent synthesis of trans- and cis-N(2),3-dimethyl-4-phenyl-1,2,3,4-tetrahydroisoquinolines.

The acid-promoted cyclizations of a range of N-benzylethanolamines (derived from pseudoephedrine or ephedrine) give the corresponding trans-N(2),3-dimethyl-4-phenyl-1,2,3,4-tetrahydroisoquinolines with high levels of diastereoselectivity and in good yields of isolated product. The cyclizations of the corresponding chromium tricarbonyl complexes are rendered completely stereoselective. Acid-promoted cyclization of N-(3',4'-dimethoxybenzyl)ephedrine and its chromium tricarbonyl complex occur with complementary diastereoselectivities to give trans- and cis-N(2),3-dimethyl-4-phenyl-6,7-dimethoxy-1,2,3,4-tetrahydro-isoquinoline, respectively, in >99:1 d.r. The latter is consistent with a "double inversion" mechanism, which involves neighboring group participation by the chromium tricarbonyl moiety followed by rearomatization to give the corresponding cis-tetrahydroisoquinoline with overall retention of configuration.

Synthesis and C-alkylation of hindered aldehyde enamines.

A new reactivity mode of hindered lithium amides with terminal epoxides is described whereby aldehyde enamines are produced via a previously unrecognized reaction pathway. Some of these aldehyde enamines display unprecedented C-alkylation reactivity toward unactivated primary and secondary alkyl halides. For comparison, the reactivity of aldehyde enamines synthesized via a traditional condensation method was examined. C- rather than N-alkylation was the dominant reaction pathway found with a range of electrophiles, making this route to alpha-alkylated aldehydes more synthetically useful than previously reported.

Fluid-balance monitoring, part of track and trigger.

This article (part four of four) explores urine output and fluid management, related conditions and nursing care.

Respiratory assessment as part of track and trigger.

The respiratory system's primary function is to provide oxygen to all the cells of the body for metabolism and to eliminate the by-product of this metabolism, carbon dioxide (Tortora and Grabowski, 2002). In this article (part three of four) we aim to explore respiratory rate and related care.

Monitoring the pulse as part of track and trigger.

This article (part two of four) aims to explore abnormalities of the pulse rate and the related nursing observations and actions. Measurement of the pulse is a fundamental nursing observation, which can detect a range of problems.

Blood pressure monitoring as part of track and trigger.

This article (part one of four) explores hypotension and hypertension and the related nursing observations and actions. Part two will explore pulse rate (bradycardia and tachycardia), related conditions and nursing care; part three will explore respiratory rate and related care; and part four will explore urine output and fluid management, related conditions and nursing care.

Deprotonation-electrophile trapping of terminal epoxides.

Organolithium-induced deprotonation of terminal epoxides in the presence of appropriate diamine ligands allows trapping with a range of electrophiles, yielding functionalised di- and tri-substituted epoxides in good yields and with control of stereochemistry at the epoxide.

Substituted epoxides by lithiation of terminal epoxides.

Diamine-ligand-assisted direct hydrogen-lithium exchange allows the generation of nonstabilized (H-substituted) oxiranyllithium species and their subsequent trapping by Bu(3)SnCl and carbonyl-based electrophiles. This reaction provides a new concise route to alpha,beta-epoxystannanes and substituted epoxides.