Subcritical water extraction of amino acids from Mars analog soils.

For decades, the Martian regolith has stymied robotic mission efforts to catalog the organic molecules present. Perchlorate salts, found widely throughout Mars, are the main culprit as they breakdown and react with organics liberated from the regolith during pyrolysis, the primary extraction technique attempted to date on Mars. This work further develops subcritical water extraction (SCWE) as a technique for extraction of amino acids on future missions. The effect of SCWE temperature (185, 200, and 215°C) and duration of extraction (10-120 min) on the total amount and distribution of amino acids recovered was explored for three Mars analog soils (JSC Mars-1A simulant, an Atacama desert soil, and an Antarctic Dry Valleys soil) and bovine serum albumin (as a control solution of known amino acid content). Total amounts of amino acids extracted increased with both time and temperature; however, the distribution shifted notably due to the destruction of the amino acids with charged or polar side chains at the higher temperatures. The pure bovine serum albumin solution and JSC Mars 1A also showed lower yields than the Atacama and Antarctic extractions suggesting that SCWE may be less effective at hydrolyzing large or aggregated proteins. Changing solvent from water to a dilute (10 mM) HCl solution allowed total extraction efficiencies comparable to the higher temperature/time combinations while using the lowest temperature/time (185°C/20 min). The dilute HCl extractions also did not lead to the shift in amino acid distribution observed at the higher temperatures. Additionally, adding sodium perchlorate salt to the extraction did not interfere with recoveries. Native magnetite in the JSC Mars-1A may have been responsible for destruction of glycine, as evidenced by its uncharacteristic decrease as the temperature/time of extraction increased. This work shows that SCWE can extract high yields of native amino acids out of Mars analog soils with minimal disruption of the distribution of those amino acids, even in the presence of a perchlorate salt.

An exploration of experts' perceptions on the use of interprofessional education to support collaborative practice in the care of community-living older adults.

Globally, as older adults are living longer and with more chronic conditions, there is a need to support their ability to age optimally in their homes and communities. Community-based interprofessional teams working closely with these older adults, their families, and informal caregivers will be instrumental in achieving this goal. Interprofessional education (IPE) is the means through which these teams can develop expertise in collaboratively working together with older adults. However, most IPE occurs in academic settings, and acute and long-term care sectors and little is known about IPE in the context of home and community care of older adults. The purpose of this study was to describe perceptions of academic and practice experts related to the current state of IPE in home and community care of older adults and the changes that are necessary to meet the future needs of practitioners and older adults. Using a qualitative descriptive design, interviews were conducted with 32 national and international key informants representing practitioners, educators, researchers, and health system decision-makers in the field of IPE. Thematic analysis of the data identified six themes: (a) client and family-centred care at the core of IPE, (b) the community as a unique learning setting across the learning continuum; (c) an aging-relevant IPE curriculum; (d) faculty commitment and resources for IPE; (e) technological innovation to support IPE; and (f) comprehensive IPE programme evaluation and research. These findings are explored through the lens of an interprofessional learning continuum model. The article concludes with a discussion of the study implications for IPE practice and research specifically in the care of community-living older adults.

Critical care nurses' perceptions of the outcomes of working overtime in Canada.

BACKGROUND: Nursing overtime is being integrated into the normal landscape of practice to ensure optimal staffing levels and addresses variations in patient volume and acuity. This is particularly true in critical care where fluctuations in either are difficult to predict. PURPOSE: The goal of this study was to explore critical care nurses' perceptions of the outcomes of working overtime. METHODS: Sally Thorne's interpretive description guided the collection and analysis of data. Participants were recruited from 11 different critical care units within three large teaching hospitals in Southern Ontario, Canada. A total of 28 full- and part-time registered nurses who had worked in an intensive care unit for at least one year took part in this study. Data were collected through semistructured, audio-recorded, individual interviews that took place in rooms adjacent to participants' critical care units. Template analysis facilitated the determination and abstraction of themes using NVivo for Mac 10.1.1. FINDINGS: Major themes highlighting the perceived outcomes of overtime included (a) physical effects, (b) impact on patient-centered care, (c) balancing family and work, (d) financial gain, and € safety is jeopardized. CONCLUSIONS: Nursing managers and institutions need to be accountable for staffing practices they institute, and nurses themselves may require further education regarding healthy work-life balance. There are both negative and positive consequences of nursing overtime for nurses and patients, but nurses at large valued the option to work it.

Integrative review: an evaluation of the methods used to explore the relationship between overtime and patient outcomes.

AIMS: To analyse, critically, methods employed to explore the relationship between nursing overtime and patient outcomes to strengthen future research. BACKGROUND: Nursing overtime hours have been increasing in the Western world since the 1980's; however, research detailing its implications for patient outcomes has not kept pace. Studies exploring the relationship between nursing overtime and patient outcomes have produced conflicting results and are deficient in number and rigour. DESIGN: Whittemore and Knafl's revised framework for integrative reviews guided the analysis. DATA SOURCES: A comprehensive multi-step search (1980-2012) of literature related to nursing overtime and patient outcomes in the CINAHL, Medline, PubMED, EMBASE and PsychInfo databases was performed. Reference lists and Google searches were completed for additional sources. Nine research papers met the inclusion criteria. REVIEW METHODS: All nine articles were included in the review. A systematic, iterative approach was used to extract and reduce the data to draw conclusions. RESULTS: There appears to be a positive relationship between nursing overtime and patient outcomes, however, eight of the nine studies revealed limitations in: (1) the definition and measurement of overtime; (2) data aggregation (organizationally and temporally) and (3) recognition or control of potential confounding variables. CONCLUSION: The quality in this research sample limits the ability of this body of work to be the basis of staffing policies. Future researchers need to be explicit in detailing their methods alongside a renewed commitment from administration to develop a tracking system of important parameters at the individual and bedside level.

A concept analysis of oral hygiene care in dependent older adults.

AIM: To report a concept analysis of oral hygiene care. BACKGROUND: Oral hygiene care, as it is provided to older patients in hospital and long-term care settings by nurses and their delegates, has the potential to contribute to the oral health of patients while preventing aspiration pneumonia as well as periodontitis, which itself has been associated with several systemic diseases. However, the state of oral cleanliness in such patients tends to be poor and despite the existence of guidelines, nursing care practices may be inadequate and not reflective of recent advances in knowledge. DESIGN: Concept analysis. DATA SOURCES: A search of electronic databases (2002-2012), use of internet search engines, and hand searching yielded an international data set of 66 research studies, reviews, and practice guidelines. REVIEW METHODS: The concept analysis method of Walker and Avant was used to explore the concept of oral hygiene care in the context of frail older patients. RESULTS: Oral hygiene care involves approaches informed by knowing the patient, inspecting the oral cavity, removing plaque, cleansing the oral tissues, decontaminating the oral cavity, using fluoride products and maintaining oral tissue moisture. Those attributes, along with their antecedents and consequences, form a conceptual framework from which a middle-range theory of nurse-administered oral hygiene care is derived that could be tested, evaluated, modified, and translated into practice. CONCLUSIONS: Clarity around the concept of oral hygiene care as a nursing intervention could enable nurses to impact oral health outcomes and possibly prevent systemic diseases in older patients.

A concept analysis of nursing overtime.

AIM: To report a concept analysis of nursing overtime. BACKGROUND: Economic constraints have resulted in hospital restructuring with the aim of reducing costs. These processes often target nurse staffing (the largest organizational expense) by increasing usage of alternative staffing strategies including overtime hours. Overtime is a multifaceted, poorly defined, and indiscriminately used concept. Analysis of nursing overtime is an important step towards development and propagation of appropriate staffing strategies and rigorous research. DESIGN: Concept analysis. DATA SOURCES: The search of electronic literature included indexes, grey literature, dictionaries, policy statements, contracts, glossaries and ancestry searching. Sources included were published between 1993-2012; dates were chosen in relation to increases in overtime hours used as a result of the healthcare structuring in the early 1990s. Approximately 65 documents met the inclusion criteria. REVIEW METHODS: Walker and Avant's methodology guided the analysis. DISCUSSION: Nursing overtime can be defined by four attributes: perception of choice or control over overtime hours worked; rewards or lack thereof; time off duty counts equally as much as time on duty; and disruption due to a lack of preparation. Antecedents of overtime arise from societal, organizational, and individual levels. The consequences of nursing overtime can be positive and negative, affecting organizations, nurses, and the patients they care for. CONCLUSION: This concept analysis clarifies the intricacies surrounding nursing overtime with recommendations to advance nursing research, practice, and policies. A nursing-specific middle-range theory was proposed to guide the understanding and study of nursing overtime.

Effective retention strategies for midcareer critical care nurses: a Q-method study.

BACKGROUND: Midcareer nurses continue to be overlooked in the current nursing shortage that is amplified in intensive care units (ICUs) requiring greater numbers of specialized nurses. OBJECTIVES: The aim of this study was to discover what midcareer critical care nurses perceive would be effective retention strategies. METHODS: As a combination of both qualitative and quantitative approaches, Q methodology was used to allow for the development of innovative strategies as well as to provide an understanding of a population of viewpoints and preferences that can guide retention efforts. Forty ICU nurses between the ages of 25 and 44 years from within a Canadian academic health science corporation completed a 45-item Q sort representing their ideas for increasing staff retention. Data were analyzed using centroid factor extraction and varimax rotation in PQMethod version 2.11. RESULTS: Four viewpoints emerged: The Healthy Workplace and Respect Seeker, The Flexibility and Reward Seeker, The Professional Development and Teamwork Seeker, and The Lifestyle Seeker. Correlations between the factors were appropriately weak, with seemingly distinct demographics characterizing each. DISCUSSION: These findings suggest a possible association between perceptions and both years of nursing experience as well as age. Implications from the study include the need to involve frontline nurses in developing strategies that will retain them. Following further investigation of the nurses' preferred strategies, it may be necessary for organizations to develop an array of retention strategies rather than implementing a single solution. In future research, generational preferences and the possible dissonance between nurse managers and frontline nurses' perceptions should be explored.

Migration: a concept analysis from a nursing perspective.

AIM: This article is a report of a concept analysis of nurse migration. BACKGROUND: International migration is increasing and nurse migrants are active participants in this movement. Migration is a complex term and can be examined from a range of perspectives. Analysis of nurse migration is needed to guide policy, practice and research. DATA SOURCES: A literature search was undertaken using electronic literature indexes, specific journals and websites, internet search engines and hand searches. No timeframe was placed on the search. Most literature found was published between 2001 and 2009. A sample of 80 documents met the inclusion criteria. METHOD: Walker and Avant's approach guided the analysis. DISCUSSION: Nurse migration can be defined by five attributes: the motivation and decisions of individuals; external barriers and facilitators; freedom of choice to migrate; freedom to migrate as a human right, and dynamic movement. Antecedents of migration include the political, social, economic, legal, historical and educational forces that comprise the push and pull framework. The consequences of migration are positive or negative depending on the viewpoint and its affect on the individual and other stakeholders such as the source country, destination country, healthcare systems and the nursing profession. CONCLUSION: This concept analysis clarified the complexities surrounding nurse migration. A nursing-specific middle-range theory was proposed to guide the understanding and study of nurse migration.

Case study methodology in nurse migration research: an integrative review.

The migration of nurses combined with a global nursing shortage affects the supply of nurses and access to health services in many countries. The purpose of this article was to conduct an integrative review of case study methodology (CSM) in nurse migration research. Findings identify where studies using CSM have been conducted, by whom, and the themes explored. More studies using CSM are required to answer the important "how" and "why" questions related to nurse migration. Nurses should take a leadership role in this research.

InAs/InAsSb Type-II Strained-Layer Superlattice Infrared Photodetectors.

The InAs/InAsSb (Gallium-free) type-II strained-layer superlattice (T2SLS) has emerged in the last decade as a viable infrared detector material with a continuously adjustable band gap capable of accommodating detector cutoff wavelengths ranging from 4 to 15 µm and beyond. When coupled with the unipolar barrier infrared detector architecture, the InAs/InAsSb T2SLS mid-wavelength infrared (MWIR) focal plane array (FPA) has demonstrated a significantly higher operating temperature than InSb FPA, a major incumbent technology. In this brief review paper, we describe the emergence of the InAs/InAsSb T2SLS infrared photodetector technology, point out its advantages and disadvantages, and survey its recent development.

Critical Care Nurses' Reasons for Working or Not Working Overtime.

BACKGROUND: Around the world, registered nurses are working increasing amounts of overtime. This is particularly true in critical care environments, which experience unpredictable fluctuations in patient volume and acuity, combined with a need for more specialized nurses. OBJECTIVE: To explore critical care nurses' reasons for working or not working overtime. METHODS: A semistructured interview guide was used to interview 28 frontline nurses from 11 critical care units in Ontario, Canada. Analysis was guided by Thorne's interpretive description methodology. RESULTS: Participants' reasons for working overtime included (1) financial gain (96% of participants); (2) helping and being with colleagues (68%); (3) continuity for nurses and patients (39%); and (4) accelerated career development (39%). Their reasons for not working overtime were (1) feeling tired and tired of being at work (50%); (2) having established plans (71%); and (3) not receiving enough notice (61%). CONCLUSIONS: Findings from this study provide important variations and extension of existing literature on the topic, and appear to be the first reported in Canadian critical care units. Additional research is required to understand administrative decision-making processes that lead to the use of overtime.

Potential Dangers of Nursing Overtime in Critical Care.

Around the world, registered nurses are working increasing amounts of overtime. This is particularly true in critical care environments, which experience unpredictable fluctuations in patient volume and acuity combined with a need for greater numbers of specialized nurses. Although it is commonplace, little consensus exists surrounding the effects of overtime on nursing sick time and patient outcomes. Using data from 11 different critical care units nestled within three major academic health science centres in Southern Ontario, a multilevel-model Poisson regression analysis was used to evaluate the association between nursing overtime and nursing sick time, patient mortality and patient infection incidents. Most significantly, for every 10 hours of nursing overtime worked, study findings revealed an associated 3.3-hour increase in nursing sick time. Because of the potential cost and patient care ramifications, hospitals and nurse managers are encouraged to track collective and individual paid and unpaid hours to impose appropriate limits and ensure accountability. Further qualitative research should be commissioned to explore the underlying reasons for these findings and diversify the settings and, in turn, wider application.

Celecoxib and NS-398 enhance photodynamic therapy by increasing in vitro apoptosis and decreasing in vivo inflammatory and angiogenic factors.

Photodynamic therapy (PDT) elicits both apoptotic and necrotic responses within treated tumors and produces microvascular injury leading to inflammation and hypoxia. PDT also induces expression of angiogenic and survival molecules including vascular endothelial growth factor, cyclooxygenase-2 (COX-2), and matrix metalloproteinases. Adjunctive administration of inhibitors to these molecules improves PDT responsiveness. In the current study, we examined how the combination of PDT and COX-2 inhibitors improve treatment responsiveness. Photofrin-mediated PDT combined with either celecoxib or NS-398 increased cytotoxicity and apoptosis in mouse BA mammary carcinoma cells. Immunoblot analysis of protein extracts from PDT-treated cells also showed poly(ADP-ribose) polymerase cleavage and Bcl-2 degradation, which were further enhanced following combined therapy. Tumor-bearing mice treated with PDT and either celecoxib or NS-398 exhibited significant improvement in long-term tumor-free survival when compared with PDT or COX-2 inhibitor treatments alone. The combined procedures did not increase in vivo tumor-associated apoptosis. Administration of celecoxib or NS-398 attenuated tissue levels of prostaglandin E2 and vascular endothelial growth factor induced by PDT in treated tumors and also decreased the expression of proinflammatory mediators interleukin-1beta and tumor necrosis factor-alpha. Increased tumor levels of the antiinflammatory cytokine, interleukin 10, were also observed following combined treatment. This study documents for the first time that adjunctive use of celecoxib enhances PDT-mediated tumoricidal action in an in vivo tumor model. Our results also show that administration of COX-2 inhibitors enhance in vitro photosensitization by increasing apoptosis and improve in vivo PDT responsiveness by decreasing expression of angiogenic and inflammatory molecules.

A microfluidic sub-critical water extraction instrument.

This article discusses a microfluidic subcritical water extraction (SCWE) chip for autonomous extraction of amino acids from astrobiologically interesting samples. The microfluidic instrument is composed of three major components. These include a mixing chamber where the soil sample is mixed and agitated with the solvent (water), a subcritical water extraction chamber where the sample is sealed with a freeze valve at the chip inlet after a vapor bubble is injected into the inlet channels to ensure the pressure in the chip is in equilibrium with the vapor pressure and the slurry is then heated to ≤200 °C in the SCWE chamber, and a filter or settling chamber where the slurry is pumped to after extraction. The extraction yield of the microfluidic SCWE chip process ranged from 50% compared to acid hydrolysis and 80%-100% compared to a benchtop microwave SCWE for low biomass samples.

Employment goals, expectations, and migration intentions of nursing graduates in a Canadian border city: a mixed methods study.

BACKGROUND: Internationally, nurse migration in border cities has received little attention. Nurses who graduate from nursing programs in Canadian border communities have the option of working in Canada or the United States. They are able to cross the international border each day as commuter migrants returning to their home country after work. Despite recent investment by Canada to increase the number of nursing students, the migration intentions of graduating nurses and the factors influencing their decision making has not been explored. OBJECTIVES: The objective of this study is to explore the migration intentions of a graduating class of baccalaureate nursing students in a Canadian border community and the factors influencing their decision making. METHODS: An explanatory sequential mixed methods design was used. In the first quantitative phase, data was collected by a web-based self-report survey. In the qualitative phase, semi-structured interviews were conducted. Data collection took place between February and July 2011. RESULTS: The response rate to the survey was 40.9% (n=115). Eighty-six percent of graduates preferred to work in Canada although two thirds identified that they were considering migrating for work outside of Canada. Knowing a nurse who worked in the US (Michigan) influenced intention to migrate and living in a border community was a strong predictor of migration. Migrants had significantly higher expectations that their economic, professional development, healthy work environment, adventure and autonomy values would be met in another country than Canada. Evidence from the interviews revealed that clinical instructors and clinical experiences played a significant role in framing students' perceptions of the work environment, influencing their choice of specialty, and where they secured their first job. CONCLUSION: The value-expectancy framework offered a novel approach to identifying job factors driving migration intentions. The study offered a snapshot of the graduates' perception of the work environment before entering the workforce. The graduates doubted that their future work environment would meet many of their job expectations, a troubling finding requiring further investigation. Expectations influenced their migration intentions and may be relevant to their integration and retention in the workforce.

The effects of organizational flexibility on nurse utilization and vacancy statistics in Ontario hospitals.

Social and economic changes in industrial societies during the past quarter-century encouraged organizations to develop greater flexibility in their employment systems in order to adapt to organizational restructuring and labour market shifts (Kallenberg 2003). During the 1990s this trend became evident in healthcare organizations. Before healthcare restructuring, employment in the acute hospital sector was more stable, with higher levels of full-time staff. However, in the downsizing era, employers favoured more flexible, contingent workforces (Zeytinoglu 1999). As healthcare systems evolved, staffing patterns became more chaotic and predicting staffing requirements more complex. Increased use of casual and part-time staff, overtime and agency nurses, as well as alterations in skills mix, masked vacancy counts and thus rendered this measurement of nursing demand increasingly difficult. This study explores flexible nurse staffing practices and demonstrates how data such as nurse vacancy statistics, considered in isolation from nurse utilization information, are inaccurate indicators of nursing demand and nurse shortage. It develops an algorithm that provides a standard methodology for improved monitoring and management of nurse utilization data and better quantification of vacancy statistics. Use of standard methodology promotes more accurate measurement of nurse utilization and shortage. Furthermore, it provides a solid base for improved nursing workforce planning, production and management.

The effect of cardiopulmonary bypass and inspired oxygen concentration on left ventricular contrast opacification with optison, a second-generation ultrasound contrast agent.

OBJECTIVE: To investigate the influence of cardiopulmonary bypass (CPB) and fraction of inspired oxygen (F(I)O(2)) on the contrast effect of Optison, a second-generation ultrasound contrast agent, in humans during coronary artery bypass graft (CABG) surgery with transesophageal echocardiography (TEE). DESIGN: Prospective, observational, repeated-measures design. SETTING: A single university hospital. PARTICIPANTS: Ten patients who underwent elective CABG surgery. INTERVENTIONS: A transgastric, midpapillary, short-axis view of the left ventricle was obtained with TEE in the conventional imaging mode. A central injection of 0.3 mL of Optison was administered at 4 stages: after induction of anesthesia at F(I)O(2) = 1.0 and F(I)O(2) = 0.43 +/- 0.02 and after protamine administration at F(I)O(2) = 1.0 and F(I)O(2) = 0.52 +/- 0.09. Background-corrected maximal pixel intensity (PImax(corr)) in the left ventricle was determined with videodensitometry. To estimate the magnitude of change in pixel intensities, point estimates of differences in PImax(corr) and their 95% and 99% confidence intervals were calculated after repeated measures analysis of variance. MEASUREMENTS AND MAIN RESULTS: Decreasing the F(I)O(2) from 1.0 to <1 did not alter PImax(corr) significantly before or after CPB (mean change = -4.2 and 0.8; SE = 2.0 and 1.9; p = 0.06 and 0.68). Values for PImax(corr) before and after CPB were not significantly different at either F(I)O(2) = 1.0 or F(I)O(2) <1 (mean change = -3.3 and 1.7; SE = 2.4 and 2.7; p = 0.26 and 0.54). Mean differences from initial values ranged from a 10% decrease to a 5% increase. CONCLUSION: In patients who undergo CABG surgery, the contrast opacification of Optison in the left ventricle is not changed by CPB or alterations in F(I)O(2) during intraoperative TEE. The application of Optison for enhancement of the endocardial border is not limited during cardiac surgery.