Instrumental and theoretical advancements in pulsed elution-LC × LC: Investigation of pulse parameters and application to wastewater effluent.

Due to the decoupling of the first (1D) and second (2D) dimension in pulsed elution-LC × LC (PE-LC × LC), method development is more flexible and straightforward compared to fast comprehensive LC × LC where the dependencies of key parameters between the two dimensions limits its flexibility. In this study we present a method for pulse generation, which is based on a switching valve alternating between one pump that delivers the gradient and a second pump that delivers low eluotrophic strength for the pause state. Consequently, the dwell volume of the system was circumvented and 7.5, and 3.75 times shorter pulse widths could be generated at flow rates of 0.2, and 0.4 mL/min with satisfactory accuracies between programmed and observed mobile phase composition (relative deviation of 6.0 %). We investigated how key parameters including pulse width and step height, 2D gradient time and flow rate affected the peak capacity in PE-LC × LC. The conditions yielding the highest peak capacity for the PE-LC × LC- high-resolution mass spectrometry (HRMS) system were applied to a wastewater effluent sample. The results were compared to a one dimensional (1D)-LC-HRMS chromatogram. The peak capacity increased with a factor 34 from 112 for the 1D-LC run to 3770 for PE-LC × LC-HRMS after correction for undersampling. The analysis time for PE-LC × LC-HRMS was 12.1 h compared to 67.5 min for the 1D-LC-HRMS run. The purity of the mass spectra improved for PE-LC × LC-HRMS by a factor 2.6 (p-value 3.3 × 10-6) and 2.0 (p-value 2.5 × 10-3) for the low and high collision energy trace compared to the 1D-LC-HRMS analysis. Furthermore, the signal-to-noise ratio (S/N) was 4.2 times higher (range: 0.06-56.7, p-value 3.8 × 10-2) compared to the 1D-LC-HRMS separation based on 42 identified compounds. The improvements in S/N were explained by the lower peak volume obtained in the PE-LC × LC-HRMS.

Application effect of BOPPPS teaching model on fundamentals of nursing education: a meta-analysis of randomized controlled studies.

Background: BOPPPS (bridge-in, learning objective, pretest, participatory learning, posttest, and summary) is a student-centered, closed-loop teaching model that emphasizes real-time communication and feedback. Objectives: The purpose of this study was to review and evaluate the effect of BOPPPS teaching model in "Fundamentals of Nursing" teaching. Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) based on the BOPPPS teaching model in "Fundamentals of Nursing" teaching. To review domestic and foreign databases for the period 2010 to September 2023. Finally, 13 RCTs were included and the teaching outcomes were measured and analyzed. Two researchers independently identified, selected, and extracted data from the study and examined the risk of bias. The primary outcomes were students' examination scores (theoretical scores: scores obtained in the nursing fundamentals course, reflecting students' understanding and mastery of the course content; practical scores: assessment results based on practical application or experimental skills, evaluating students' practical skill level). The secondary outcomes were self-learning ability score: indicators assessing students' self-directed learning ability, reflecting their competence in independent learning and autonomous exploration; and satisfaction rate of teaching effect: the overall satisfaction rate of students with the teaching effects experienced during teaching process reflects the proportion of students' acceptance and satisfaction with the teaching program. The results were evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) profiler software. The GRADE profiler software is used to assess and grade the recommendations according to the GRADE (Grading of Recommendations Assessment, Development, and Assessment) criteria. Results: A total of 13 studies were included, consisting of 2,991 nursing students. Among them, 1,465 students were in the BOPPPS teaching group, while 1,526 students were in the traditional teaching group. The summary analysis of the main outcomes showed that the BOPPPS teaching model had significantly higher scores in theoretical score (MD = 3.35, 95% CI: 2.35-4.35, Z = 6.56, p < 0.00001), practice score (MD = 4.50, 95% CI: 1.95-7.05, Z = 3.45, p = 0.0006), and self-learning ability score (MD = 6.76, 95% CI: 5.38-8.14, Z = 9.60, p < 0.00001) compared to the traditional teaching group. The satisfaction rate of students in the BOPPPS teaching group regarding teaching effectiveness was 89% (95% CI = 0.84-0.93). The differences were statistically significant (p < 0.05). The GRADE evidence level for theoretical score and satisfaction rate of teaching effect is low. The evidence level for practice score is very low, and for self-learning ability score is moderate. Conclusion: The BOPPPS teaching mode is helpful to improve the theoretical score, practice score, and self-learning ability score of "Fundamentals of Nursing," and improve the satisfaction rate of students to the teaching effect. The teaching effect is better than the traditional teaching method.

Missed nursing care in surgical care- a hazard to patient safety: a quantitative study within the inCHARGE programme.

BACKGROUND: Missed nursing care occurs globally, and the consequences are severe for the patients when fundamental care needs are not fulfilled, nor delivered in a person-centred way. This study aimed to investigate the occurrence and cause of missed nursing care, and the relationship between registered nurses' and nursing assistants' perceptions of missed nursing care, in a surgical care context. METHODS: A quantitative study was performed using the MISSCARE survey, measuring missed nursing care and associated reasons, in three surgical wards with registered nurses and nursing assistants as the participants (n = 118), during May-November in 2022. The MISSCARE survey also covers background data such as job satisfaction and intention to leave. The survey was distributed paper-based and the response rate was 88%. RESULTS: Aspects of nursing care rated to be missed the most were 'attending interdisciplinary care conferences', 'turning patient every 2 h', 'ambulation 3 times per day or as ordered', and 'mouth care'. Differences between registered nurse and nursing assistant ratings were detected for eight out of 24 items, where registered nurses rated more missed nursing care. The uppermost reasons for missed nursing care were 'inadequate number of staff' and 'unexpected rise in patient volume and/or acuity on the unit'. Registered nurses and nursing assistants rated differently regarding six of 17 items. Almost every fourth staff member (24.6%, n = 29) had the intention to leave within a year in the present department. CONCLUSIONS: The occurrence of missed nursing care is frequent in the surgical context, and in combination with a high number of staff members intending to leave their employment, poses a hazard to patient safety. Registered nurses, holding higher educational levels, reported more missed care compared with the nursing assistants. The main reason for missed nursing care was an inadequate number of staff. These findings support a warranted investment in nursing within the organisation. The results can be used to form strategies and interventions, to reduce nurse attrition and optimise competence utilisation, and to achieve safe person-centered fundamental care.

Ultrasound fundamentals and their clinical implications for interventional cytopathologists.

OBJECTIVE: To describe the most important concepts in ultrasound physics that interventional cytopathologists need to understand in order to successfully perform ultrasound-guided needle biopsies. METHODS: Review of the literature. RESULTS: A deep understanding of ultrasound physics and the mathematics supporting it are not necessary. The most important concepts are frequency, attenuation, overall gain, time-gain compensation, focus, spatial resolution, temporal resolution and Doppler. CONCLUSION: By understanding these eight basic concepts of ultrasound physics and their clinical implications, interventional cytopathologists can faithfully reproduce the imaging findings of the radiologist and locate the target to precisely guide a needle for biopsy.

Photoelectrochemical Lithium Extraction from Waste Batteries.

The amount of global hybrid-electric and all electric vehicle has increased dramatically in just five years and reached an all-time high of over 10 million units in 2022. A good deal of waste lithium (Li)-containing batteries from dead vehicles are invaluable unconventional resources with high usage of Li. However, the recycle of Li by green approaches is extremely inefficient and rare from waste batteries, giving rise to severe environmental pollutions and huge squandering of resources. Thus, in this mini review, we briefly summarized a green and promising route-photoelectrochemical (PEC) technology for extracting the Li from the waste lithium-containing batteries. This review first focuses on the critical factors of PEC performance, including light harvesting, charge-carrier dynamics, and surface chemical reactions. Subsequently, the conventional and PEC technologies applying in the area of Li recovery processes are analyzed and discussed in depth, and the potential challenges and future perspective for rational and healthy development of PEC Li extraction are provided positively.

Designing State-of-the-Art Gas Sensors: From Fundamentals to Applications.

Gas sensors are crucial in environmental monitoring, industrial safety, and medical diagnostics. Due to the rising demand for precise and reliable gas detection, there is a rising demand for cutting-edge gas sensors that possess exceptional sensitivity, selectivity, and stability. Due to their tunable electrical properties, high-density surface-active sites, and significant surface-to-volume ratio, nanomaterials have been extensively investigated in this regard. The traditional gas sensors utilize homogeneous material for sensing where the adsorbed surface oxygen species play a vital role in their sensing activity. However, their performance for selective gas sensing is still unsatisfactory because the employed high temperature leads to the poor stability. The heterostructures nanomaterials can easily tune sensing performance and their different energy band structures, work functions, charge carrier concentration and polarity, and interfacial band alignments can be precisely designed for high-performance selective gas sensing at low temperature. In this review article, we discuss in detail the fundamentals of semiconductor gas sensing along with their mechanisms. Further, we highlight the existed challenges in semiconductor gas sensing. In addition, we review the recent advancements in semiconductor gas sensor design for applications from different perspective. Finally, the conclusion and future perspectives for improvement of the gas sensing performance are discussed.

Impacts on oral health attitude and knowledge after completing a digital training module among Swedish healthcare professionals working with older adults.

Oral health care is essential, and digital training may influence healthcare professionals' attitudes to and knowledge of oral health. The aim, therefore, was to evaluate the impact on attitudes to and knowledge of oral health after using a digital training module among Swedish healthcare professionals working within a municipality-run healthcare service for older adults. A secondary aim was to explore the healthcare professionals' experiences of using the digital module. The study comprised a survey of healthcare professionals (registered nurses (RNs), assistant nurses, and care assistants) caring for older adults in a municipality in Sweden. Pre-post-tests were conducted to evaluate the outcomes for attitudes to and knowledge of oral health and of their experiences of completing the digital training module in oral health. These were statistically explored by comparing differences between the pre-post-tests, while the open-ended questions were analysed with qualitative content analysis. The findings of this study indicate that healthcare professionals had similar perceptions of their attitudes to and knowledge of oral health both before and after the digital training module in oral health. The study also indicates that healthcare professionals experienced that it is easier to perform practical oral health care after completing the digital training. The results also show that healthcare professionals value oral health knowledge and that the digital training module was easy to use and to disseminate knowledge throughout the municipality. The findings have implications for developing, implementing, and promoting healthcare professionals' attitudes to and knowledge of oral health and in using a digital training module in combination with practical exercises in oral health in municipality health care.

The effects of introducing virtual reality communication simulation in students' learning in a fundamentals of nursing practicum: A pragmatic randomized control trials.

AIM: This study was conducted to examine the effectiveness of a virtual reality communication simulation (VRCS) in teaching communication skills in fundamentals of nursing practicum. BACKGROUND: Effective communication skills are an integral part of the nursing profession and the foundation of high-quality nursing care. Effective communication not only addresses the needs of patients but is also necessary for maintaining patient safety. Many studies have reported the inadequacy of nursing students in communicating with patients. Nursing students often experience stress due to their lack of adequate skills to communicate effectively with patients and their family members. DESIGN: A pragmatic randomized controlled trial research with four within-subjects assessments (at the baseline (T0), 1st week (T1) and 3rd week (T2) of the clinical practice and 1 week after the end of the clinical practice (T3)) and between-subjects assessments. SETTINGS AND PARTICIPANTS: Eighty-four nursing students at a university of Science and Technology in central Taiwan. METHODS: The students were randomly assigned to an experimental group (n = 42) and a control group (n = 42). The experimental group received a VRCS, whereas the control group received the nurse-patient communication teaching video. The data were collected from April 2022 to August 2022. The Kalamazoo Essential Element Communication Checklist, Communication Self-Assessment Scale, Learning Satisfaction Questionnaire and Stress Scale for Nursing Students in Clinical Practice were used for data collection. RESULTS: At baseline, the control group had higher scores on communication ability and confidence compared with the experimental group (t = -3.91, p <.001; and t = -2.35, p =.021). In the first week of clinical practice, the experimental group had significantly higher mean scores for communication ability compared with the control group (ß = 15.99, 95 % confidence interval [CI] 13.79, 18.18) and communication confidence and learning satisfaction compared with controls at T1, T2 and T3 of the clinical practice (all, p <.001). The clinical practice stress scores of the experimental group were significantly lower than those of the control group at T1, T2 and T3 of the clinical practice (all, p <.05). CONCLUSIONS: The newly developed VRCS is acceptable and worthwhile for training nursing students to develop communication abilities. This study suggests that VRCS practice should be arranged as early as possible in fundamentals of nursing practice courses and before the fundamentals of nursing practicum so as to facilitate the learning of effective communication. Follow-up research is needed to evaluate the long-term effects of virtual reality education in nursing practice.

The choreographies of the elimination of faeces-An ethnographic study of the institutionalized body care practices of older people in different health care settings.

AIM: To explore the choreographies of the elimination of faeces of older people to gain insight into the institutionalized practices of body care of older people in hospitals and long-term care settings. DESIGN: A qualitative ethnographic study, drawing on a perspective of socio-material theory. Reported in accordance with the Standards for Reporting Qualitative Research. METHODS: A total of, 30 women and 11 men aged 80 years and above needing assistance with body care in a hospital ward, 2 nursing homes and home care and 32 care workers participated. Four individual interviews with older people and three focus group interviews with care workers were conducted, in addition to 135 h of participant observations, from December 2020 to September 2021. Data were analysed using a situational analysis approach. RESULTS: The assistance with the elimination of faeces is a multiplicity of ongoing dynamic practices where different actors interrelate. Dominating actors are time, space, materialities, different ideals and professional knowledge. The choreographies aim at order the elimination of faeces to happen at the right time at the right place, to provide dignified care. CONCLUSION: To assist older people with the elimination of faeces is complex institutionalized practices. The study argues for a greater focus on the ongoing relations between human and non-human actors to provide new understandings of an underexplored phenomenon in nursing. IMPACT: What problem did the study address? The elimination of faeces of older people as part of body care is an underexplored phenomenon in nursing, often subject to stigma and taboo, and delegated to other healthcare workers than registered nurses. Internationally, there are challenges in the delivery of fundamentals of nursing care to older people across healthcare settings. Few studies have explored body care as an institutionalized practice across different settings, taking into consideration the contextual aspects of care as well as the involvement of non-human actors in the care practices. What were the main findings? Multiple human and non-human actors are involved when older people need assistance with the elimination of faeces. Time, space, materialities, different ideals and professional knowledge are important actors. The elimination of faeces is not a homogeneous practice but ongoing, dynamic, and multiple practices. The context of care practices related to the elimination of faeces is not an outer macro level distant from care, but part of the ongoing daily practices of body care. Where and on whom will the research have an impact? The findings can inspire researchers and clinicians to develop a new understanding of fundamental care needs. The study offers a critical perspective on possibilities for providing care, since political ideals and governance are active actors in daily care practices. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. The study was conducted during the COVID-19 pandemic; restrictions limited the access to involving patients and care workers in the research process. An advisory board consisting of leaders from the different settings was a part of the design process and in the interpretation of data. RECOMMENDATIONS FOR FURTHER RESEARCH: The socio material theoretical perspective has a potential to unfold the complexities in nursing care practices focusing on aspects that are underexplored in nursing research.

Nurse managers' strategies promoting a Fundamentals of Care-based approach among nurses: A scoping review.

Introduction: In the last few years, shortcomings in caring for patient needs have promoted a growing interest in the Fundamentals of Care (FoC) to promote the quality of nursing care. However, which strategies nurse managers should implement to facilitate a FoC-based nursing care approach have not been mapped to date; therefore, the intent of this study was to map those strategies related to the nurse manager role that have been documented as being capable of promoting (or hindering), a FoC-based approach among nurses. Methods: A scoping review following the Preferred Reporting Items for Systematic Review and Meta-Analysis - Extension for Scoping Reviews (PRISMA-ScR) guidelines. The PubMed, CINAHL, Cochrane Library, Scopus and Web of Science databases and the conference proceedings of the International Learning Collaborative 2022 Annual International Conference were consulted. Studies exploring the relationship between FoC and nurse managers using any methodology, published from 2008 (year of birth of the FoC movement) to September 2022, in Italian or English, were eligible for inclusion. Findings were categorized narratively, according to their similarities and differences. Results: Four qualitative studies, four discussion papers, two reviews and one mixed-method study, published from 2017 to 2021, predominantly in Australia, were included. Several strategies have emerged as promoting a FoC-based care approach by nurse managers. At the macro level, there is a need to disseminate a culture of attention towards patients that should be incorporated in the strategy of the entire system; moreover, synergies and effective leadership styles should be promoted by also providing education both in the undergraduate and continuing education settings. At the micro levels, among others, the required resources should be available, and the quality of the environment promoted. Conclusion: Nurse managers may facilitate a FoC-based approach among nurses through a set of strategies that should be included and considered in their educational pathways.

Distinguishing Laparoscopic Surgery Experts from Novices Using EEG Topographic Features.

The study aimed to differentiate experts from novices in laparoscopic surgery tasks using electroencephalogram (EEG) topographic features. A microstate-based common spatial pattern (CSP) analysis with linear discriminant analysis (LDA) was compared to a topography-preserving convolutional neural network (CNN) approach. Expert surgeons (N = 10) and novice medical residents (N = 13) performed laparoscopic suturing tasks, and EEG data from 8 experts and 13 novices were analysed. Microstate-based CSP with LDA revealed distinct spatial patterns in the frontal and parietal cortices for experts, while novices showed frontal cortex involvement. The 3D CNN model (ESNet) demonstrated a superior classification performance (accuracy > 98%, sensitivity 99.30%, specificity 99.70%, F1 score 98.51%, MCC 97.56%) compared to the microstate based CSP analysis with LDA (accuracy ~90%). Combining spatial and temporal information in the 3D CNN model enhanced classifier accuracy and highlighted the importance of the parietal-temporal-occipital association region in differentiating experts and novices.

How does mHealth influence consulting practice between health professionals and individuals with low back pain? - A qualitative study from the perspective of health professionals.

PURPOSE: This study explored how health professionals experience in what way a digital self-monitoring solution influences their consulting practice targeting individuals with low back pain. MATERIAL AND METHODS: This was a qualitative study adopting a constructivist grounded theory approach. Nineteen health professionals participated in the pilot test of the digital self-monitoring solution BackTrace. Data were collected cross-sectionally and consisted of: (a) audio recordings from focus groups with health professionals, (b) field notes from participant observation of online meetings with health professionals, (c) field notes from participant observations of consultations between health professionals and individuals with low back pain and (d) audio recordings from workshops with health professionals. RESULTS: Two main themes and one sub-theme were identified, describing how BackTrace enabled more focused consulting practices, supported patient-self management and improved the relationship between individuals with low back pain and health professionals. Barriers were identified describing how the implementation of digital health solutions required a change in workflow, resources and culture - as well as management support. CONCLUSIONS: Findings indicated a need for a change at the system level, including a changed view of digitisation in healthcare systems containing a more supporting approach.

Low back pain is a leading cause of disability which not only impacts physically but restricts quality of life.This study shows how health professionals experience in what way digital self-monitoring solutions influence their consulting practices targeting individuals with low back pain.A digital self-monitoring solution may contribute to a more focused consulting practice and improve the quality of the relationship between individuals with low back pain and health professionals but require changes at a system level.A change in workflow and culture is recommended if digital health is to be a success.

Sexual health in diabetes care is a 'hot topic'-A qualitative study with Diabetes Specialist Nurses.

AIM: The aim of this study is to illuminate Diabetes Specialist Nurses' experiences of having a conversation about sexual health with adults with diabetes. BACKGROUND: It is well known that diabetes mellitus may affect a person's sexual function. Interview studies with men and women living with diabetes show that conversations about sexual health are important. However, research on Diabetes Specialist Nurses' experiences of having such conversations is limited. DESIGN: A qualitative approach, with individual interviews, was used. METHOD: Purposive sampling was used to recruit 12 informants from adult diabetes care, within primary health care and within hospital settings in southern Sweden, between September and November 2021. A qualitative latent content analysis was used for data analysis. The COREQ guidelines were followed to ensure rigour for this study. RESULTS: One theme, 'Sexual health is a hot topic', could be understood in light of three categories: 'Obstructive factors that complicate the conversation', 'Promoting factors that facilitate the conversation' and 'Improvements that may facilitate the conversation'. The findings embrace the Diabetes Specialist Nurses' experiences of having a conversation about sexual health with persons with diabetes. CONCLUSIONS: Diabetes Specialist Nurses often experience difficulty having a conversation about sexual health with their patients. The findings provide a deeper understanding of their experiences of obstructive as well as promoting factors related to conversations about what is considered a 'hot topic'. RELEVANCE TO CLINICAL PRACTICE: To increase knowledge on how to have a conversation about sexual health within diabetes care, support is needed from the organisation; the organisation could, for instance, support the diabetes care staff in gaining education and training regarding sexual health. PATIENT OR PUBLIC CONTRIBUTION: Not applicable due to the current method.

Bedside nurses' perspective on the Fundamentals of Care framework and its application in clinical practice: A multi-site focus group interview study.

BACKGROUND: A changing nursing workforce and an increase in demands for care together with more complex care, raise arguments that leading and guiding nursing practice is more challenging than ever. Therefore, nurses need to have a shared agenda and a common language to show the importance of nursing care and the consequences of not addressing this in an appropriate way. In response to this the Fundamentals of Care framework was developed to also contribute to the delivery of person-centred care in an integrated way. However, to gain acceptance and applicability we need to ensure the framework's relevance to clinical practice from bedside nurses' perspectives. OBJECTIVE: To describe bedside nurses' perspectives on the Fundamentals of Care framework and how it can be applied in clinical practice. DESIGN: A descriptive qualitative design informed by the Fundamentals of Care framework. SETTING(S): The study was undertaken at seven hospitals in Sweden, Denmark and the Netherlands during 2019. PARTICIPANTS: A total sample of 53 registered nurses working at the bedside participated. Participants had a wide variety of clinical experience and represented a range of different nursing practice areas. METHODS: Twelve focus group interviews were used to collect data and analysed with a deductive content analysis approach. RESULTS: Bedside nurses perceived that the Fundamentals of Care framework was adequate, easy to understand and recognised as representative for the core of nursing care. The definition for fundamental care covered many aspects of nursing care, but was also perceived as too general and too idealistic in relation to the registered nurses' work. The participants recognised the elements within the framework, but appeared not to be using this to articulate their practice. Three main categories emerged for implications for clinical practice; guiding reflection on one's work; ensuring person-centred fundamental care and reinforcing nursing leadership. CONCLUSIONS: The Fundamentals of Care framework is perceived by bedside nurses as a modern framework describing the core of nursing. The framework was recognised as having clinical relevance and provides bedside nurses with a common language to articulate the complexity of nursing practice. This knowledge is crucial for bedside nurses both in clinical practice and in leadership roles to be able to speak up for the need to integrate all dimensions of care to achieve person-centred fundamental care. Various activities for reflection, person-centred care and leadership to apply the framework in clinical practice were presented, together with minor suggestions for development of the framework. TWEETABLE ABSTRACT: Bedside nurses recognise their clinical practice within the Fundamentals of Care framework, showing the core of modern nursing.

High aspect ratio diamond nanosecond laser machining.

Laser processing of diamond has become an important technique for fabricating next generation microelectronic and quantum devices. However, the realization of low taper, high aspect ratio structures in diamond remains a challenge. We demonstrate the effects of pulse energy, pulse number and irradiation profile on the achievable aspect ratio with 532 nm nanosecond laser machining. Strong and gentle ablation regimes were observed using percussion hole drilling of type Ib HPHT diamond. Under percussion hole drilling a maximum aspect ratio of 22:1 was achieved with 10,000 pulses. To reach aspect ratios on average 40:1 and up to 66:1, rotary assisted drilling was employed using > 2 M pulse accumulations. We additionally demonstrate methods of obtaining 0.1° taper angles via ramped pulse energy machining in 10:1 aspect ratio tubes. Finally, effects of laser induced damage are studied using confocal Raman spectroscopy with observation of up to 36% increase in tensile strain following strong laser irradiation. However, we report that upon application of 600 °C heat treatment, induced strain is reduced by up to ~ 50% with considerable homogenization of observed strain. Supplementary Information: The online version contains supplementary material available at 10.1007/s00339-023-06755-2.

Prehistoric Plant Exploitation and Domestication: An Inspiration for the Science of De Novo Domestication in Present Times.

De novo domestication is a novel trend in plant genetics, where traits of wild or semi-wild species are changed by the use of modern precision breeding techniques so that they conform to modern cultivation. Out of more than 300,000 wild plant species, only a few were fully domesticated by humans in prehistory. Moreover, out of these few domesticated species, less than 10 species dominate world agricultural production by more than 80% today. Much of this limited diversity of crop exploitation by modern humans was defined early in prehistory at the emergence of sedentary agro-pastoral cultures that limited the number of crops evolving a favorable domestication syndrome. However, modern plant genetics have revealed the roadmaps of genetic changes that led to these domestication traits. Based on such observations, plant scientists are now taking steps towards using modern breeding technologies to explore the potential of de novo domestication of plant species that were neglected in the past. We suggest here that in this process of de novo domestication, the study of Late Paleolithic/Late Archaic and Early Neolithic/Early Formative exploration of wild plants and identification of neglected species can help identify the barriers towards domestication. Modern breeding technologies may then assist us to break these barriers in order to perform de novo domestication to increase the crop species diversity of modern agriculture.

Testing a model for person-centred pain management: A systematic review and synthesis guided by the Fundamentals of Care framework.

AIMS: To test a model for person-centred pain management using qualitative evidence in the literature and refine it based on the results. DESIGN: A qualitative systematic review with thematic synthesis using the Fundamentals of Care framework. METHODS AND DATA SOURCES: A literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the individual studies. Thematic analysis and the GRADE-CERQual approach were used in the synthesis including the assessment of confidence in the evidence. RESULTS: The model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process; The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non-pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions. CONCLUSIONS: The strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The model links the knowledge of pain management elements from individual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person-centred pain management in clinical practice. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. IMPACT: What Problem Did the Study Address? There is a need to transfer available evidence of person-centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person-centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient-nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non-pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain. REPORTING METHOD: Relevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.

Measuring person-centred pain management: Development of a questionnaire using the fundamentals of care framework.

AIM: To develop and test a questionnaire using the Fundamentals of Care framework to measure person-centred pain management. DESIGN: Cross-sectional exploratory descriptive design. METHODS: Development in three phases: (a) literature search for questionnaires measuring person-centred pain management, (b) seven-step process developing items using thematic analysis, (c) initial feasibility and validity testing. Theoretical and empirical evidence was used, including the 'Strategic and Clinical Quality Indicators in Postoperative Pain management' questionnaire, the Fundamentals of Care framework and person-centredness principles. Theoretical experts (n = 2) reviewed the questionnaire, further evaluated by providers (n = 5) and patients (n = 5) using a think-aloud process, and by additional questions in the questionnaire answered by n = 100 patients. The questionnaire was tested February to March 2021, at four surgical wards in a university hospital. RESULTS: The evaluation showed initial support for feasibility and validity, and the questionnaire was found to represent and be sensitive to capture the patients' experiences of person-centred pain management and being easy to answer. The 100 patients with acute abdominal pain who answered the questionnaire (aged 18-89 years, 46 women and 54 men), identified missing elements of fundamental care in their pain management, indicating that the questionnaire is sensitive to capture specific areas for improvement. CONCLUSION: This first attempt at transforming the essential components of person-centred pain management into measurable items in a questionnaire was found promising. The questionnaire is suggested to be further tested for psychometric properties and patient benefit to provide clinical guidance in acute surgical care to meet the patient care need of pain management. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The developed questionnaire addresses the need of nurses and nursing leaders to evaluate the delivery of person-centred pain management in acute surgical care, to relieve the patient from pain. PATIENT OR PUBLIC CONTRIBUTION: Patients and providers were involved in testing the questionnaire.

Factors triggering the progressive detachment of nurses toward the fundamental needs of patients: findings from a qualitative study.

The progressive desensitization of nurses in relation to fundamental needs (FNs) has been documented in anecdotical, scientific, and policy literature with nurses spending limited time at the bedside, thus affecting the quality of care and clinical outcomes. A potential reason that has been recognized is the limited nursing staff available in the units. However, other cultural, social, and psychological factors which have not been investigated to date may have a role in triggering the phenomenon. To investigate nurses' perceptions of the reasons that progressively detach clinical nurses from the FNs of patients, was the main intent of the study. In 2020, a qualitative study based on grounded theory following the Standards for Reporting Qualitative Research guidelines was performed. Purposeful sampling was adopted, by including 22 clinical nurses designated as 'good nurses' according to the perception of nurses working in executive and academic position. All agreed to be interviewed face-to-face. The detachment of nurses from the patients' FNs has been explained by three main factors that are interconnected: namely 'Being personally and professionally convinced regarding the role of FNs', 'Being progressively detached from the FNs', and 'Being forced to be detached from FNs'. Nurses also identified a category including strategies aimed at preventing detachment and 'Rediscovering the FNs as the core of nursing'. Nurses are personally and professionally convinced about the relevance of the FNs. However, they distance themselves from the FNs due to: (a) factors mainly attributable to internal personal and professional forces, such as the emotional fatigue that daily work entails; and (b) external forces related to the work environment where nurses work. To prevent this detrimental process that may result in negative outcomes for patients and their relatives, several strategies at the individual, organizational, and educational levels should be implemented.

'Why doesn't anyone ask me'? Patients' experiences of receiving, performing and practices of oral care in an acute Orthopaedic Department.

AIMS AND OBJECTIVES: Oral care is an integrated part of everyday life. Within nursing, barriers related to providing oral care often lead to unmet caring needs. Poor oral care is associated with a risk of respiratory and cardiovascular complications during hospitalisation. Knowledge on patients' perspectives of maintaining or receiving oral care during admissions are limited. Following the Fundamentals of Care (FOC) framework, this study uses a person-centred approach to explore patients' perceptions and experiences of receiving or performing oral care, including the nursing staff's clinical practices. METHODOLOGICAL DESIGN AND JUSTIFICATION: A focussed ethnographic approach was used to explore patients' perspectives and clinical practices during acute admissions in an Orthopaedic Department. ETHICS ISSUES AND APPROVAL: The local Data Protection Agency and the Ethics Committee approved the study. RESEARCH METHODS, RESULTS AND CONCLUSIONS: Data were collected in an Orthopaedic ward at a Copenhagen University hospital, Hvidovre, and consisted of 14 days of field observations of clinical practices and 15 patient interviews. Data were analysed inductively using qualitative content analysis. Two themes were identified. The first, 'The purpose of oral care is defined by the eye of the beholder', describes the social implications for the patients and how patients reject the assumption of oral care being a transgressive act. The second, 'The unspoken need', focus on the lack of dialogue, including the limited provision of oral care and how the nursing staff assesses patients' ability to perform oral care (in)dependently without including the patients. CONCLUSION: Oral care is related to the patient's psychological and physical well-being and affects social appearance. When oral care is provided respectfully, patients do not experience oral care as a transgressive act. Nursing staff's self-assessments of the patients' (in)dependency to perform oral care risk leading to incorrect care. Developing and implementing interventions applicable to the clinical practice is needed.