Wigner Near-Threshold Effects in the Photoelectron Angular Distribution of NO2.

High-resolution velocity map imaged photoelectron spectra of the nitrite anion NO2- are measured over a range of photodetachment wavelengths between 355 and 550 nm, resolving the vibrational and rotational structure of the NO2(X̃2A1) + e- ← NO2-(X̃1A1) + hν transition. A full rotational band model is constructed to define the spectroscopic constants of both the neutral and the lesser studied anion ground states. The corresponding photoelectron angular distributions are characterized by a large positive anisotropy parameter, with ß ≈ 1.5 gradually increasing to ß ≈ 1.7 upon approaching the threshold. However, at very low kinetic energies, within 0.1 eV of the threshold, ß dramatically drops to 0. This behavior is a consequence of the Wigner near-threshold selectivity of the electron partial-wave cross sections, whereby an atomic p-like orbital character adjacent to the threshold is favored. The full kinetic energy dependence of ß is reproduced by a new mixed spd orbital model, yielding a NO2-(X̃1A1) molecular-orbital decomposition of 2% p, 44% s, and 54% d character.

NOO Peroxy Isomer Exposed with Velocity-Map Imaging.

The chemistry of NO2, a key atmospheric trace gas, has historically been interpreted in terms of the C2v isomer ONO, with the peroxy isomer NOO only postulated to be stable. In this work, a velocity-map-imaged photoelectron spectrum of the nitrite anion, NO2-, reveals energetic-electron structure that may only occur by photodetachment from the NOO-(X̃1A') isomer. This measurement defines NOO(X̃2A') bond frequencies and an electron affinity of only 335(30) cm-1, which, supported by ab initio calculations, confirm the first observation of this important reactive species.

High-resolution photoelectron spectroscopy of linear ← bent polyatomic photodetachment transitions: the electron affinity of CS2.

A combination of high-resolution velocity-map-imaging photoelectron spectroscopy and isotopic substitution is used to show that precise electron affinities can be obtained from polyatomic photodetachment spectra, even for cases involving significant changes in equilibrium geometry between the molecular neutral and anion. The chosen example CS(2) (X (1)Σ(g)(+)) (linear) ← CS(2)(-) (X (2)A(1)) (bent) photodetachment transition is found to preferentially access highly-excited v(2) (bending) levels of the neutral, with no observation possible of the lowest-v(2) bands. Nevertheless, through (13)C isotopic substitution, the v(2) numbering is established unambiguously and the adiabatic electron affinity of CS(2) is found to be 4456(10) cm(-1) [0.5525(13) eV], by far the most precise value reported to date.

Descending pathways mediating cardiovascular response from dorsomedial hypothalamic nucleus.

Physiological and anatomic methods were used to determine whether neurons in the rostral ventrolateral medulla (RVLM), nucleus tractus solitarius (NTS), or hypothalamic paraventricular nucleus (PVN) mediate the cardiovascular response evoked from the dorsomedial hypothalamic nucleus (DMH), which is believed to play a key role in mediating responses to stress. In urethane-anesthetized rats, activation of neurons in the DMH by microinjection of bicuculline resulted in a large increase in arterial pressure, heart rate, and renal sympathetic nerve activity. The pressor and sympathoexcitatory responses, but not the tachycardic response, were greatly reduced after bilateral muscimol injections into the RVLM even when baseline arterial pressure was maintained at a constant level. These responses were not reduced by muscimol injections into the PVN or NTS. Retrograde tracing experiments identified many neurons in the DMH that projected directly to the RVLM. The results indicate that the vasomotor and cardiac components of the response evoked from the DMH are mediated by pathways that are dependent and independent, respectively, of neurons in the RVLM.

Stroke-specific FIM models in an urban population.

Data from the Functional Independence Measure (FIM) are important outcome measures in the stroke population undergoing rehabilitation. The FIM consists of 18 scales scored from 1 to 7; higher numbers mean greater ability. Several different scores can be obtained from the FIM: a total score (sum of all the scales), individual scale scores, and a physical and cognitive score (a two-dimensional interpretation). Research has shown that FIM data can have multidimensional components. That implies different groupings of scales may exist and with this the possibility of developing more sophisticated and robust measures within stroke populations. This study examined the multidimensional aspects of FIM using an urban sample of ischemic and hemorrhagic stroke patients. We found a three-dimensional FIM solution for both stroke groups that included self-care, cognitive function, and toileting as the major grouping of scales. These findings confirm a multidimensional nature of FIM scores and show a condition-specific pattern of FIM scores in stroke patients. This knowledge will help nurses, clinicians, and researchers develop more sensitive ways of recording care outcomes; improved prediction of stroke outcomes may also emerge from this knowledge.

Educational sources of stress in midwifery students.

This article presents the findings of a study that investigated educational sources of stress among student midwives working in England. The study set out to address the question, what are the clinical and educational experiences that can give rise to stress? Students were invited to complete a 45-item questionnaire which asked them to identify the extent to which a particular statement, in their experience, led to feelings of stress. There were four categories of response: 'not at all', 'a little', 'much' and 'very much'. Responses from 199 students (127 preregistration and 72 preregistration (shortened)) were obtained. Factor analysis was used to determine the structure of the data set, and two factors emerged. Factor 1, accounting for 29.6% of variance, was labelled 'organizational and learning experience' sources of stress, while factor 2, accounting for 6.6% of variance, was labelled 'home and family' sources of stress. Further analysis on those items that were reported as having proportionately large numbers of students responding 'very much' was performed. Results from three items, 'insufficient time to carry out assignments', "dealing with study vs. home/personal demands', and while on placements being exposed to "life and death situations', were found to be significantly different between preregistration and preregistration (shortened) students. These findings suggest that a wide variety of events cause students stress. While clinical sources of stress may be expected to exist, it must also be recognized that relationships with tutorial staff and aspects of the learning environment within colleges can also lead to stress.

Substitution in nursing practice: clinical, management and research implications.

The introduction of market forces into health care delivery systems has had a number of important influences on the roles nurses perform. There have been increasing efforts to find alternative and more cost-effective ways of delivering care. One facet of this situation has been the examination of the roles and responsibilities of registered nurses (RNs) with the view of exploring different ways of using professional skills and determining if RN services are always required. One result of this has been the increased use of unlicensed personnel. The substitution of professional nursing staff by unlicensed personnel has become a major concern for practitioner, manager and client alike. This paper reviews some of the concepts of economic substitution as well as the assumptions advanced for the use of unlicensed personnel in clinical areas as a substitute for nursing services. While there has been increased use of unlicensed staff, the evaluation of clinical outcomes has been poor. This paper reviews primarily the hospital-based evidence about the impact of using unlicensed personnel in practice, and suggests there are methodological problems with the research published to date. Findings suggest that substitute service providers generally 'do no harm'. By contrast, evidence is presented indicating the major contributions nurses make to client care when adopting advanced practice roles (acting as a substitute for other professionals).

Utilizing research findings in nursing: policy and practice considerations.

The implementation of research findings into practice has become an important consideration for nursing following the recent publication of the Department of Health (England) report Methods to Promote the Implementation of Research-Findings in the NHS. This report acknowledges the problems of change in practice, the relatively small amount of research conducted on the subject and the need to identify ways of implementing clinical innovation. While triggered by concerns over the efficiency and cost-effectiveness of interventions, this subject has great importance for nurses during the current National Health Service (NHS) reforms. A number of attempts have been made to increase the utilization of research findings into practice. What has emerged has been the identification of strategies that would prove difficult to generalize widely, and a number of organizational constraints. It has also become apparent that research implementation is an organizational issue, and not just a concern of the individual nurse, who may be seen as somehow 'failing' to provide the very best care by being unaware of the latest research findings. This paper reviews some of the issues of implementing research findings into practice, reviews research studies in this area and discusses a strategy for the future.

A 'new' psychological contract for nurses: some management implications.

Changes within the health services are raising a number of employment issues for nurses. The idea that a professional qualification and a job will lead to security of employment and career development is rapidly changing. These assumptions, the 'old' psychological contract, is giving way to new expectations from employers and employees; the emergence of a 'new' psychological contract. A psychological contract is an implicit agreement between employer and employee that each party will treat the other fairly. Such contracts are maintained by virtue of all parties wanting to seek agreement on issues where possible and to maintain trust. While such a contract is not a legally binding agreement it is nonetheless a binding understanding between people. Changes to this psychological contract can have important implications for individuals and their employer in terms of work and organizational commitment. This paper will discuss some of the issues surrounding psychological contracts and the impact of violating them. It will also discuss, from a management perspective, how psychological contracts develop between employer and employee, and how to form a 'new' psychological contract based upon mutual benefit and shared values.

The assessment of student nurse learning styles using the Kolb Learning Styles Inventory.

The learning styles of 192 Registered General Nursing/DipHE students was determined using the Kolb Learning Styles Inventory prior to the students having any formal contact with lecturing staff. The percentage of students having a predominantly concrete learning style was 53.7%, while 46.3% were predominantly reflective. This finding is in keeping with those of Laschinger & Boss (1984), who suggest that they are supportive of Kolb's theoretical tenet that concrete learners tend to choose people-oriented professions. Chi-squared tests were used to determine if the respondent's learning styles varied with either age, sex or having been in employment prior to becoming a nursing student; no statistically significant associations were found. A further chi-squared analysis was performed to see if there was a relationship between learning style and those students who possessed: 1) only the DC test, 2) O-levels as highest qualifications, and 3) A-levels as highest qualifications--no statistically significant associations were found. There remain measurement problems with the Kolb inventory, and a discussion of some of these issues are presented. The findings have reinforced the need for using a variety of delivery styles with students, with an emphasis on participation and experiential learning. This need for variety is essential given the distribution of learning styles found with the students. Nurse educators are urged to re-examine perceptions and assumptions about student learning needs.

Matching instructional preference and teaching styles: a review of the literature.

There has been considerable impetus in nursing education to identify ways of ensuring that students utilize fully their opportunities for learning and achieve their fullest potential. To this end an avenue of research has evolved which sets out to identify the preferred learning styles of students. Claims are advanced that matching these preferences with teaching styles is important for maximizing learning for nurses. An evaluation of the current research on learning preferences and matching teaching styles is provided using evidence from both nursing and non-nursing areas. What has emerged from this review is that the age of the learner may influence learning preference, and that individual rather than group characteristics must be considered. There are conflicting findings about the importance of matching learning preferences and delivery styles, but multiple approaches to the delivery of materials are generally advocated with both theoretical and clinical materials.

Occupational stress in neurosurgical nursing.

Occupational stress in nursing has been a popular topic for investigation. While many practice areas have been studied, the neurosurgical intensive care units (ICUs) and neuromedical/surgical units have largely been overlooked. Using interviews, this exploratory study examined aspects of neurosurgical nursing that were perceived as stressful by staff. Findings suggest that being exposed to life and death situations among young children, being short of essential resources, being on duty with too few staff and dealing with aggressive relatives constituted major stressful events. The frequency of occurrence of stressors was also investigated; working unsocial hours, being short of essential resources, being exposed to life and death situations in adults, and dealing with fluctuations in workload were cited as common happenings. Stressors perceived as having the most effect on work included being exposed to life and death situations among children and adults and being short of essential resources. Comments made by staff suggest that performance at work is adversely influenced by stress. While no neurosurgery-specific stressors were identified, the conclusion from this study is that intensely stressful events do occur in these ICUs and although such events may not happen often, they can adversely affect work performance, according to the staff involved.

Occupational stress in neurosurgery: an exploratory study.

Occupational stress in nursing has been a popular topic for investigation. In particular, comparisons between practice areas such as the intensive care unit (ICU) and medical-surgical unit have attempted to identify what factors are stressful, and whether some nursing environments are more stressful than others. Such studies have led to inconclusive findings. While many practice areas have been studied, the neurosurgical ICU and neuromedical/neurosurgical units have largely been overlooked. Using interviews, this exploratory study examined aspects of nursing perceived as stressful by staff members working in ICU and medical-surgical units in a neuroscience center. Findings suggested that patient care, communication, workload, management and supervision, organizational and personal circumstances are major sources of stress. These findings are in keeping with studies of stress conducted in national and international non-neurosurgical nursing practice areas.

Staff turnover among hospital nurses.

Nursing staff turnover remains a financial concern to public as well as private institutions, and it has an impact on staff morale and working practices. Evidence suggests that staff turnover could also have a detrimental effect on patient care. Numerous studies have examined the reasons why staff leave their jobs, but these have often produced conflicting findings and have frequently relied upon bivariate correlation or multiple regression techniques. The availability of analytical techniques such as structural modelling provides an opportunity to examine several aspects of turnover behaviour simultaneously, and overcome some of the methodological difficulties encountered by prior research. This study involved 221 female nurses working full-time in hospitals to examine aspects of the nursing turnover model. Using modelling techniques, this current study found job satisfaction and participation at work to be important variables in the turnover process. This is in keeping with other models of nursing turnover.

Job satisfaction of nursing staff working in hospitals.

Job satisfaction remains an important consideration for both employer and employee and, despite numerous investigations, many questions about it remain unanswered. Many research methodologies have been used with varying degrees of success. However, the trend is now away from simple correlational studies towards modelling techniques. Data from 221 female nurses working full-time in hospitals were collected using questionnaires delivered with monthly salary cheques. The model presented had many statistically significant path coefficients including (in order of size): benefits, participation in decision making, education, routine, promotion, and opportunity for advancement outside their institution. The level of salary was not found to be a statistically significant factor in determining job satisfaction.

Aspects of neurosurgical assessment using the Glasgow Coma Scale.

The Glasgow Coma Scale (GCS) has become a cornerstone of the neurological/surgical assessment of patients used by both nursing and medical staff. Since its development in the 1970s it has been used in a variety of clinical situations to monitor changes in a number of key neurological functions, including level of consciousness, pupil reaction and limb movement. During this time, however, there have been suggestions that there are problems with some of the measurement principles underlying its use, which in part has stimulated the development of other neuro-assessment tools. Irrespective of measurement device, there is always the possibility of error or incorrect assessment. In the field of neurosurgery, as with other high dependency environments, a patient's condition can change rapidly. Additionally, there is the association of certain assessment responses with nursing and medical interventions. Thus, accuracy in all aspects of assessment and recording is paramount. Despite the growing body of literature surrounding the GCS, little is known about the pattern of errors made by nursing staff using the GCS to assess neurosurgical patients. This study compared the assessment findings of Registered General Nurses (RGNs), Enrolled Nurses and Student Nurses after viewing videotaped neuro-assessments of patients in a high dependency unit. The criterion for judging the accuracy of subject's assessments was established by a panel of experts. As expected, RGNs had the highest proportion of correct assessments and students the least. Subjects were identified as having difficulty in determining the relative amounts of weakness that a patient exhibited, and in correctly distinguishing between flexion and extension.

The conflict management style of staff nurses and nurse managers.

Conflict is recognized as being a common occurrence in both everyday personal and professional nursing life, and it is now generally agreed that conflict can be both problematic and potentially beneficial to both individuals and organizations. There is a large amount of anecdotal and narrative literature about the nature and sources of conflict which fails to reflect upon the complexities and theoretical perspectives that exist. There are also few research studies which examine the nature of nursing conflict and how conflict is managed by nurses in the workplace. This study presents a review of some aspects of conflict and its management and specifically investigates the conflict management style of staff nurses and nurse managers in the hospital setting. The results suggest that avoidance is the most commonly used conflict management strategy, with competition being the least favoured.

Educational aspects of cardiopulmonary resuscitation (CPR) training.

The knowledge and skills surrounding the practice of cardiopulmonary resuscitation (CPR) have become essential to intensive care nurses and to nurses in general. With formalized training and refresher courses becoming more common in this country, it is evident that after relatively short periods of time the knowledge and skills acquired at such courses may be lost. While much consideration has been given to the content of both Basic and Advanced Cardiac Life Support (BCLS and ACLS) courses, relatively little attention has been paid to the educational issues surrounding CPR training. This paper explores some of these issues from the perspective of adult learning (andragogy). Research is cited from a wide range of sources to illustrate that CPR skill and knowledge deterioration is not unique to nursing, and that educational techniques exist which may improve current educational practices.