Competencies on environmental health and pedagogical approaches in the nursing curriculum: A systematic review of the literature.

It has been suggested that climate change is the biggest threat to public health for the 21st Century; increased demand on health services will impact on already overstretched resources and systems will need to be able to respond. However limited attention is given to climate change and sustainability in nursing education; there is no clear guidance on curricula content for nurses or recommendations regarding the skills and competencies that will be required. Literature published in Dutch, English, German, and Spanish was searched and 32 papers met the inclusion criteria for the review. Results suggests that holistic/systems thinking is relevant to healthcare so bringing a 'sustainability lens' to nursing curricula could be seen as being consistent with wider determinants of health. The literature review has identified the educational approaches necessary to provide a broad based curriculum and a cross-disciplinary approach. The findings suggest that topics such as the use of resources, food, health promotion, globalism, disease management, and the environmental impact of delivering healthcare, if embedded in nursing education could support the nursing profession's response for this new and important aspect of healthcare.

SID lysine requirement of immunologically and physically castrated male pigs during the grower, early and late finisher periods.

The main objective of this experiment was to determine the standardized ileal digestible (SID) Lys requirement of immunologically castrated (IC) and physically castrated (PC) male pigs during 3 growth phases. An additional objective was to compare the ADFI of PC and IC after the second anti-gonadotropin releasing factor (GnRF) injection. Three hundred male pigs (PIC 359 × C29), 150 each of IC and PC, were allotted to 1 of 5 treatments: 80, 90, 100, 110, or 120% of the estimated Lys requirement using the modeling program. Pigs remained on the same treatment throughout each of the 3 phases. Lysine requirements were determined at 3 stages of growth starting at a BW of 30.0 ± 0.8, 64.7 ± 1.4, and 111.9 ± 1.9 kg for IC and 32.4 ± 0.6, 69.8 ± 1.0, and 114.5 ± 1.3 kg for PC. Anti-GnRF injections were administered to IC at 11.5 and 19 wk (average BW = 96.3 ± 1.8 kg) of age. The one-slope broken line regression and quadratic plateau models were used, and the best model was selected based on the Akaike information criterion. The IC SID Lys requirements based on ADG were 1.03, 0.97, and 0.55% and for G:F, the requirements were 0.99, 0.72, and 0.55% for phases 1, 2, and 3, respectively. For PC, the SID Lys requirements based on ADG were 0.86, 0.62, and 0.47% and for G:F were 0.86, 0.58, and 0.47% for phases 1, 2, and 3, respectively. Immunologically castrated pigs had greater SID Lys requirements for phases 1 and 2 compared to PC (0.17 and 0.35% points greater for ADG and 0.13 and 0.14% points greater for G:F for phases 1 and 2, respectively). After the second injection, when IC pigs are believed to become physiologically more similar to PC pigs, the SID Lys requirements continue to be greater for IC (0.55 vs. 0.47% for both ADG and G:F). The ADFI of IC increased 4 d after the second injection relative to PC. By 2 wk post second injection, the ADFI of IC exceeded that of PC ( < 0.05). Adopting immunological castration as a management tool requires an understanding that IC need to be fed differently compared to PC, to maximize growth performance. Immunologically castrated pigs have a greater SID Lys requirement throughout the grower and finishing periods compared to the PC.

Comparison among gilts, physical castrates, entire males, and immunological castrates in terms of growth performance, nitrogen and phosphorus retention, and carcass fat iodine value.

The main objective was to determine the nitrogen and P retention and energy digestibility of immunological castrates (IC), entire males (EM), physical castrates (PC), and gilts (G) during 3 growth phases. A second objective was to compare growth performance among the sexes. The final objective was to determine the carcass iodine value (IV) among the sexes. Twelve individually housed pigs (PIC 337 × C22/29) of each sex with an initial mean BW of 35.7 ± 0.6 kg and a final BW of 145.0 ± 1.3 kg were evaluated. Anti-gonadotropin-releasing factor injections were administered at d 23 and 15 for groups 1 and 2, respectively. The second injection was given on d 56 of the 98-d experiment. Nitrogen, P, and energy digestibility were measured the last 3 d of the 10-d metabolism period starting at mean BW of 39.5 ± 0.6, 73.7 ± 0.8, and 105.5 ± 0.9 kg for periods 1, 2, and 3, respectively. The third collection started 14 d after the second injection. Entire males and IC had superior overall ADG compared to PC and G ( < 0.05). Entire males and G had the lowest overall ADFI, and PC had the greatest, with IC being intermediate ( < 0.05). Entire males were overall the most efficient, followed by IC, with PC and G being the least efficient ( < 0.05). Immunological castrates and EM had similar nitrogen retention (g/d) for the first 2 collection periods ( > 0.05). In the third collection period, nitrogen retention of IC was similar to that of both EM and PC ( < 0.05). Phosphorus retained (g/d) was not different among the sexes in the first collection; during the second collection, EM retained the greatest amount of P, G and PC retained the lowest, with IC being similar to all sexes. For the third collection, IC had P retention similar to that of EM, EM had retention similar to that of PC, and PC had retention similar to that of G ( > 0.05). However, G retained less P than EM or IC ( < 0.05). Apparent total tract digestibility of DM and GE and the DE of the diet did not differ among the sexes in any of the collection periods ( > 0.05). The jowl IV was the lowest in IC and PC and highest in EM, with G being similar to all sexes ( < 0.05). For the belly, EM had the highest IV, with the other 3 sexes being similar. In conclusion, 2 wk after the second injection, IC transition to become more similar to PC in terms of nitrogen utilization but are still similar to EM in P utilization. These data suggest a feeding program for IC that is intermediate between EM and PC is required to meet their nutritional requirements.

Quantitative relationships between standardized total tract digestible phosphorus and total calcium intakes and their retention and excretion in growing pigs fed corn-soybean meal diets.

An experiment was conducted to determine the quantitative relationships between standardized total tract digestible P (STTD P) and total Ca intakes with their retention and excretion by growing pigs fed corn-soybean meal diets. Forty-eight crossbred barrows (BW = 22.7 ± 2.9 kg) were allotted to 1 of 8 diets, housed individually in pens for 3 wk, and then moved to metabolism crates and allowed 4 d for adaptation and 5 d for collection of urine and fecal samples. Eight corn-soybean meal diets were formulated for similar NE, fat, and AA concentrations but to increase the STTD P from 0.16 to 0.62% using monocalcium phosphate. Dietary treatments were formulated for a constant Ca:STTD P ratio (2.2:1). The STTD P intake increased (P < 0.001) from 64 to 242% of the daily requirement (4.59 g/d of STTD P). Fecal and total excretion of P and Ca were linearly associated with mineral intake (P < 0.001). Constant urinary P excretion of 0.03 g/d P was observed, but at 4.96 g/d of STTD P intake, the urinary P excretion increased (P < 0.001). In contrast, Ca excretion in urine decreased (P < 0.001) with Ca intake, but constant excretion of 0.40 g/d Ca was reached at 17.97 g/d of Ca intake. The daily intakes of STTD P and Ca moderately explained the variation in urinary excretion of P (R2= 0.41) and Ca (R2= 0.64). The absorption and retention of P increased linearly (P< 0.001) with dietary P intake, whereas absorption and retention of Ca showed a quadratic response (P < 0.001). Absorption and retention of P and Ca were highly predictable from the STTD P and Ca intakes, with of 0.87 and 0.90, respectively. The femur mineral content (FMC) increased by 2.71 g with STTD P intake (P < 0.001) but reached a plateau (29.54 g of FMC) at 8.84 g/d of STTD P intake. The FMC was highly predictable from the STTD P intake (R2 = 0.89). The FMC affected the urinary P excretion ( P< 0.01), but moderately (R2= 0.19) explained the variation in urinary P. In conclusion, constant excretion of P in urine was observed but excretion increased linearly at STTD P intake levels above the requirement for maximum growth of growing pigs. The FMC increased with STTD P intake, but a plateau was reached at a STTD P intake level above the requirement. Dietary STTD P was used for growth and accumulated in bones until a plateau was reached and excess was excreted in urine. The predictability of P and Ca excretion in urine from the dietary STTD P and Ca intakes was moderate.

[Significant elements in nursing situations. Experience-orientated situational research in nursing]. / Bedeutsame Elemente in Pflegesituationen. Erlebnisorientierte Situationsforschung in der Pflege.

Patients or residents and nurses often do not perceive situations where nursing care is provided in their full complexity. Furthermore they attach different significance to the individual elements of such situations as e.g. the actions of the persons involved, the structures of the relationships, the results of the nursing care or the surrounding conditions. The qualitative research study presented in the following is based on a specifically elaborated situational perspective and reveals those elements leading to experience any situation where nursing care is provided as successful or unsuccessful on the part of patients and nurses. The reconstruction of complex situations where nursing care is provided reveals decisive aspects for the active development of nursing action and points out that effective nursing care is distinguished by being related to the present and adapted to the respective situation.

[The relationship of nursing competence, nursing autonomy and the limits of obedience of individual nurses]. / Zum Verhältnis von pflegerischem Wissen, pflegerischer Handlungsfreiheit und den Grenzen des Gehorsams der individuellen Pflegeperson.

This paper arises from a study of "nursing management", carried out at the Institute of Higher Professional Education in Osnabruck. The aim here is to demonstrate fundamental connections between knowledge and action on the one hand and indication of moral action on the other. In order to do justice to the complexity of the subject it is necessary to consider also adjoining areas of knowledge. There are no unequivocal or final answers to the questions raised in this study. The purpose of of this paper is to stimulate thought about the whole range of problems.