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Registered nurses’ desire to work in nursing: An integrative review
No full textThe World Health Organization (WHO) estimates that, by 2030, nine million nurses and midwives will be needed because there is currently a global nursing shortage. The aim of this study was to describe registered nurses’ (RNs) desire to work in nursing based on previous studies. CINAHL, MEDLINE, NURSING AND ALLIED HEALTH databases were searched for original research. No time limit was used in the searches. The PRISMA checklist was used to reflect rigour of methods. Eighteen primary studies were appraised and included in the review. RNs expressed a desire to work in the nursing profession due to the rewarding work, smoothness of work, interesting work duties, versatile career opportunities, support for one's well-being and an inner desire to help others. Work–life balance is crucial for RNs’ well-being. Nursing management should offer flexible hours and shifts to improve retention. Adequate resources and visible appreciation for RNs are essential and, while fair pay is important, it alone is not enough to ensure long-term retention.Peer reviewe
Ionic adaptive network: A sustainable route to replace synthetic rubbers with natural polymers for high-temperature applications
No full textNatural rubber (NR) is a biopolymer consisting of cis-1,4-isoprene units extracted from the sap of rubber trees, mainly Hevea Brasiliensis. This rubber is widely used in the automotive and other industries due to its performance and elasticity. However, synthetic rubber has largely replaced natural rubber in many applications because of the poor heat resistance of natural rubber. On the other hand, non-recyclable sulfur-based synthetic rubber composites pose a major environmental issue from the viewpoint of sustainability. In this report, a flexible (non-directional) crosslinking network based on ionic bonds in modified natural rubber (epoxy-modified NR) using dicarboxylic acid and dimethylimidazole (DMI) is presented, which eliminates the disadvantages of natural rubber and outperforms synthetic rubber without compromising its mechanical performance. Accelerated aging, temperature scanning stress relaxation, compression set, and temperature-dependent FT-IR analyses confirm the high thermal stability of ionically crosslinked natural elastomer. The ionic crosslinked rubber shows a significant improvement in initial degradation temperature (196 °C) compared to thermally stable synthetic elastomers, such as NBR (acrylonitrile butadiene rubber), CR (polychloroprene rubber), and peroxide-cured EPDM (ethylene propylene diene monomer). Unlike sulfur-cured elastomers, the ionically crosslinked natural rubber exhibits superior cut growth resistance and self-repairing capabilities, as demonstrated by X-ray microtomography. These findings, along with the natural origin of the developed crosslinked elastomers, can reduce environmental damage and the carbon footprint associated with sulfur-cured and petroleum-based synthetic rubber products.Peer reviewe
Effect of Baseline Adjacent Segment Degeneration on Clinical Outcomes After Lumbar Fusion
No full textStudy Design: Cohort Study. Objectives: End-stage degenerative segments above fusion levels have been associated with lower rates for surgical adjacent segment disease. We aimed to explore how this degeneration translates into patient reported outcomes. Methods: A consecutive series of lumbar fusion patients for degenerative pathologies were enrolled. Preoperative cranial adjacent segment degeneration status was determined using the Combined Imaging Score (CIS). Based on CIS, patients were trichotomized into mild (CIS <7), advanced (CIS 7-10), and end-stage (CIS >10) degeneration tertiles. In analysis, tertiles were adjusted for age, sex, and fusion length to control for potential confounders. The Oswestry Disability Index (ODI) was collected at baseline, 3 months, 1, 2, 5, and 10 years. Results: 197 patients were included. Postoperative improvements were similar across all CIS tertiles at all time-points, except for the marginal 10-point difference at 2-years, in favor of higher degeneration. Despite similar changes, end-stage degeneration (CIS >10) implied marginally lower disability levels at baseline and throughout follow-up. The 10-year all-cause mechanical reoperation rate was lowest in the third tertile (28%, 27%, 22%). Reoperation history was associated with greater disability among advanced degeneration (CIS 7-10); the ODI score difference 9 points, P =.009. Postoperative sagittal alignment was not reflected on physical performance. Conclusions: Preoperative adjacent segment degeneration status was only marginally reflected on 10-year disability outcomes. End-stage adjacent segment degeneration signaled lower reoperation risk and favorable functional outcomes. Our findings support the assumption that collapsed, end-stage degenerative segments without stenosis can be safely excluded from fusion constructs.Peer reviewe
Patient-Related Factors Associated With the Initiation of Potentially Inappropriate Medication in Home Care: An Observational Study Based on Resident Assessment Instrument Data
No full textBackground: The harmful outcomes of potentially inappropriate medications (PIMs) are highlighted among multimorbid older home care clients using several medicines. The aim of this study was to identify patient-related factors associated with the initiation of PIMs. Methods: This register-based study used Resident Assessment Instrument-Home Care (RAI-HC) assessments (n = 6176) from year 2014 to 2015. PIMs were identified according to the Beers criteria. Generalised estimating equations were used to identify factors associated with the initiation of PIMs. Findings: A total of 228 (11.3%) clients initiated PIMs during the follow-up (mean 13 months). Factors associated with higher odds to initiate PIMs were higher education (OR = 1.36, 95% CI 1.02–1.82), cognitive impairment (OR = 1.70, 1.02–2.82), reduced social interaction (OR = 1.50, 1.06–2.13), independent activity outdoors (OR = 1.72, 1.18–2.51), diabetes (OR = 1.47, 1.12–1.94), Parkinson's disease (OR = 3.42, 1.86–6.27) and longer interval between RAI assessments (OR = 1.09 per month, 1.02–1.18). Conclusions: Incidence of PIMs among home care clients was common. The results help healthcare professionals to focus more attention on clients more susceptible to PIM prescribing. Preventing PIM use is essential, especially among older adults with cognitive impairment, to prevent further decline of health status and admission to long-term care.Peer reviewe
Structural Insights Into Aluminum-Doped Manganese Dioxides as Promising Materials for Direct Lithium Extraction: Modeling and Mechanism Study
No full textThis study aimed to provide new insights into lithium (Li) sorption and extraction mechanisms by systematically investigating the structure, surface properties, and defect vacancies of both doped and undoped manganese oxide sorbents. HMnO and Al-doped HMnO sorbents are successfully synthesized, and their formulas and vacancy ratios are determined using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, thermal gravimetric analysis (TGA), X-ray photoelectron spectroscopy (XPS), and inductively coupled plasma-atomic emission spectroscopy (ICP-AES) characterization. Among the materials tested, HMO-2.5Al exhibited the best performance in batch sorption experiments, enhancing Li⁺ sorption to 44.49 mg g−1 and reducing Mn loss to 3.38%. HMO-2.5Al also demonstrated exceptional lithium selectivity in the simulated brine test, with separation factors of αLiCa, αLiNa, αLiK and αLiMg being 3.33, 353.08, 1327.44, and 6552.76, respectively. The sorbent displayed sustained durability before and after five cycles of sorption-desorption. The ion exchange-surface complexation model is employed to investigate the titration behavior, pH effects, and sorption isotherms, providing insights into the mechanism underlying Li+ sorption. A two-stage sorption mechanism is proposed, involving a surface ion exchange reaction and a surface complexation reaction. Overall, the synthesized HMO-2.5Al sorbents demonstrate significant potential for direct lithium extraction from solutions with high concentrations of coexisting ions and contribute a novel mechanism to the field of lithium extraction study.Peer reviewe
Ohjaavan opettajan ohjauskäytänteet ja minäpystyvyys opetusharjoittelijoiden ohjaamisessa
Get PDFTämä tutkimus käsittelee varhaiskasvatuksen opettajaopintoihin kuuluvia opetusharjoitteluita ja siellä annettavaa ohjausta. Tarkoituksena on selvittää, millaisia ohjauskäytänteitä opetusharjoitteluissa on tunnistettavissa, sekä sitä, miten ohjaavan opettajan työkokemus varhaiskasvatuksessa sekä aiempi ohjauskokemus ovat yhteydessä ohjaavan opettajan minäpystyvyyteen. Tutkimus on tarpeellinen, jotta opetusharjoitteluissa annettavaa ohjausta pystytään kehittämään ja ohjaavia opettajia pystytään tukemaan sekä kouluttamaan uusimman tutkimustiedon mukaisesti.
Tutkimuksen aineisto on kerätty osana OHOSKE-hanketta, joka on varhaiskasvatuksen verkosto tutkimusperustaisen harjoittelun ohjausosaamisen kehittämiseen. Verkostoon kuuluu kuusi yliopistoa, jotka kouluttavat varhaiskasvatuksenopettajia. Kyselyyn vastasi 210 varhaiskasvatuksen työntekijää, joista suurin osa oli varhaiskasvatuksen opettajia. Käytimme laajasta kyselylomakkeesta niitä osioita, jotka tutkimuskysymyksiimme liittyivät.
Ensimmäisessä tutkimuskysymyksessä selvitimme, millaisia ohjauskäytänteitä ohjaavien opettajien antamassa ohjauksessa on tunnistettavissa. Pääkomponenttianalyysin avulla saimme muodostettua kolme summamuuttujaa, joita tarkastelimme vastataksemme ensimmäiseen kysymykseen. Opiskelijan ammatillisen kasvun ja työelämävalmiuksien tukeminen sekä pedagoginen ohjaus nousivat paljon käytetyiksi käytänteiksi, kun taas keskustelu yliopiston ohjaavan opettajan kanssa aiheutti eniten hajontaa vastaajissa.
Toisessa tutkimuskysymyksessä selvitimme, miten ohjaavan opettajan työkokemus sekä ohjattujen opiskelijoiden lukumäärä ovat yhteydessä ohjaavan opettajan minäpystyvyyteen. Jaoimme minäpystyvyyden pääkomponenttianalyysin avulla kahteen osaan: minäpystyvyys opiskelijan pedagogisesta ohjaamisesta sekä minäpystyvyys opiskelijan ohjaamisesta osaksi työyhteisöä. Analysoimme näitä tarkastelemalla korrelaatiota sekä suorittamalla lineaarisen regressioanalyysin. Tulokset osoittavat, ettei työkokemus selittänyt tilastollisesti merkitsevästi minäpystyvyyttä pedagogisesta ohjaamisesta, mutta ohjattujen opiskelijoiden lukumäärä selitti. Minäpystyvyys opiskelijan ohjaamisesta osaksi työyhteisöä -summamuuttujaa selittivät sekä työkokemus että ohjattujen opiskelijoiden lukumäärä. Selitysasteet jäivät kuitenkin tilastollisesta merkitsevyydestä huolimatta pieniksi.
Tutkielman tulokset antavat arvokasta tietoa opetusharjoitteluiden ohjauskäytänteistä sekä ohjaavien opettajien minäpystyvyyteen vaikuttavista tekijöistä. Tuloksia voidaan hyödyntää opetusharjoitteluissa annettavan ohjauksen parantamiseen, ohjauskoulutusten kehittämiseen sekä ohjaavien opettajien tukemiseen
Common occurrence of atrophic gastritis in an ageing non-hospitalised population: an autopsy study
No full textBackground: Atrophic gastritis - the end stage of chronic gastritis - is an asymptomatic disease due to Helicobacter pylori infection causing decreased vitamin B12 and folate absorption, which may lead to severe haematological and neuropsychological disorders including Alzheimer's disease. The diagnosis requires endoscopy and biopsies from symptomatic patients, explaining why its true prevalence in the population is not well-known. Objective: We aimed to evaluate the prevalence of various stages of chronic gastritis in an autopsy series most closely representing the general population. Subjects and Methods: Gastric mucosa samples were collected prospectively from out-of-hospital deaths included in the Tampere Sudden Death Study (n = 70, mean age 63, age range 22-91 years). Antrum and corpus samples were stained with a H. pylori antibody and staged histopathologically. Results: Chronic gastritis with or without atrophic changes was detected in 40% of the cases. The proportion of healthy mucosa decreased age-dependently from 71.4% among individuals aged <50 years to 43.5% among the oldest individuals (>70 years), and that of chronic non-atrophic gastritis from 21.4% to 8.7%. In contrast, the prevalence of atrophic gastritis was 27.1% and increased in the age groups from 7.1% to 47.8% (P =. 019) among the oldest individuals, showing a strong association (P <. 0001) with H. pylori immunopositivity. Conclusions: Atrophic gastritis is a common feature of the ageing stomach, which is observed in every second individual aged 70+ years, showing a strong association with H. pylori immunopositivity. Atrophic gastritis may be a more common risk factor in old age for diseases associated with low serum B12 and folate levels than has been previously known.Peer reviewe
Cell-Level Implementation of Current-Sensorless On-Board Impedance Measurements in Multi-Cell Lithium-Ion Battery Stacks
No full textBattery impedance is an important parameter for estimation of the battery state parameters, such as, state-of-charge (SOC), state-of-health (SOH) and the temperature. However, complexity of the measurement implementation most often prevents wider utilization of the impedance measurement in on-board applications. This paper proposes a cell-level implementation of current-sensorless on-board impedance measurements in multi-cell battery stacks. In the proposed method, the current required for the impedance calculations is estimated based on the voltage measurements and the equivalent circuit resistance compensated by the circuit inductance. Comprehensive introduction on the appropriate battery stack prototype with on-board impedance measurements is presented. The performances of the methods and prototype are validated by experiments on several different different sets of nickel-manganese-cobalt-oxide (NMC) Lithium-ion cells.Peer reviewe
The Easy Way Out : Escapism as a central motive for addictions
Get PDFEskapismilla tarkoitetaan halua paeta tai välttää tosielämän ongelmia ja ristiriitoja. Ihmistä voivat ajaa todellisuuspakoon ajankohtaiset ihmissuhde-, talous- ja työongelmat tai psyykkiset tekijät kuten liiallinen itsensä tiedostaminen ja jatkuva oman käyttäytymisen arviointi tai traumaattiset elämänkokemukset. Toisaalta eskapismin taustalla voi nähdä syvällisen elämäntavan muutoksen, joka on tapahtunut teknologian, markkinatalouden ja yksilökeskeisyyden myötä. Ihmiseen vaikuttavat niin ulkoiset, yhteiskunnalliset kehityskulut kuin sisäiset mentaaliset prosessit, joiden kuormittama yksilö etsii ulospääsyä tai ainakin hetken helpotusta ahdistavasta todellisuudesta.
Tässä väitöskirjassa tutkitaan eskapismin yhteyttä addiktioihin ja riippuvuuskäyttäytymiseen. Ihmiset ovat kautta aikojen laukaisseet stressiä tai lääkinneet mieltään turvautumalla nopeisiin mielihyvänlähteisiin esimerkiksi ottamalla ryypyn tai polttamalla savukkeen. Kun riippuvuuskäyttäytyminen on monimuotoistunut ja addiktiot ilmiönä ovat tulleet osaksi päivittäistä elämäämme, on tarpeen selvittää, toimiiko eskapismi keskeisenä vaikuttimena riippuvuuksien syntymisessä. Väitöskirja koostuu kolmesta osajulkaisusta, joista ensimmäisessä tutkittiin eskapismin yhteyttä alkoholinkäyttöön, tupakointiin, huumeidenkäyttöön ja rahapelaamiseen. Artikkelissa hyödynnettiin kansallisen juomatapatutkimuksen kyselyaineistoa. Toisessa julkaisussa selvitettiin, ennustaako eskapismi liiallista online-rahapelaamista, digipelaamista ja internetin käyttöä. Kolmannessa julkaisussa analysoitiin, mitä yhteisiä piirteitä eskapistisesti käyttäytyvillä ihmisillä on, ja kuinka eskapismi yhdessä psykologisten perustarpeiden laiminlyömisen kanssa liittyy liialliseen rahapelaamiseen ja digipelaamiseen. Toisen ja kolmannen artikkelin aineistona käytettiin Rahapelit digiajassa -hankkeen pitkittäisasetelmaan perustuvaa kyselytutkimusta, joka edustaa suomalaista aikuisväestöä. Malleissa käytettiin lineaarista ja logistista regressioanalyysia sekä hybridimalleja, jotka mahdollistivat yksilön sisäisen ja henkilöiden välisten muutosten analysoinnin samanaikaisesti.
Väitöskirjan tulokset osoittavat, että todellisuuspakoinen käyttäytyminen ennustaa päihteiden käyttöä, rahapelaamista, digipelaamista ja internetin käyttöä. Eskapismin yhteys liialliseen online-rahapelaamiseen, digipelaamiseen ja internetin käyttöön todettiin kahdella tasolla: yksilön kokeman eskapismin muuttuessa myös riippuvuuskäyttäytymisen intensiteetti nousi tai laski vastaavasti. Lisäksi keskimäärin todellisuuspakoisemmilla henkilöillä todettiin enemmän addiktioita kuin vähemmän eskapismia kokevilla. Autonomian ja kompetenssin vaje voimisti eskapismin yhteyttä digipelaamiseen ja kompetenssin vaje tehosti eskapismin yhteyttä rahapelaamiseen. Laajat aineistot ja pitkittäisasetelmat vahvistavat löydösten merkittävyyttä. Eskapismin ymmärtäminen addiktioiden keskeisenä motiivina auttaa sosiaali- ja terveydenhuollon ammattilaisia tunnistamaan paremmin riippuvuushäiriöiden ja - sairauksien juurisyitä sekä tarjoaa tutkijoille selitysvoimaisen tavan analysoida addiktioita.Escapism is a tendency to seek flight from reality or distraction from real-life problems and controversies. Anxious feelings arising from relationships, personal finances, work issues, or situational factors urge people to escape the present moment. Sometimes, escapism may originate from deeper psychological processes such as excessive self-awareness, agonizing self-evaluation, or traumatic life experiences. Further inducement for escapism stems from the pressures faced by a human being in the contemporary world, increasingly defined by technology, the market economy, and individualism. Both external societal developments and internal mental factors give rise to the need for momentary relief from a distressing reality.
This dissertation examines the link between escapism and addiction. The thought of getting a break from a troubling life situation by engaging in an instantly gratifying activity is quite intuitive. Using psychoactive substances or self-medicating as a means to cope with stress is familiar to many. As addictive behaviors have emerged in a variety of new forms and the addiction phenomenon has become an integral part of everyday life, it is necessary to study whether escapism serves as a central motive for addictions. This dissertation consists of three research articles, the first of which investigated the link between escapism, alcohol consumption, smoking, drug use, and gambling based on data from the Finnish Drinking Habits Survey 2016. The second article examined whether escapism predicts excessive gambling, gaming, and internet use. The third article analyzed what characteristics are shared by escapists and how escapism is associated with excessive gambling and gaming together with the frustration of being unable to attain basic psychological needs. The data for the second and third articles originated from the Gambling in the Digital Age Project 2021–2024, a multi-wave survey representing the Finnish adult population. The statistical methods were linear and logistic regression, as well as multilevel regression using hybrid models.
The findings of this dissertation show that escapism predicts addictions and addictive behaviors. It has a robust association with alcohol consumption and is consistently linked with smoking and drug use. Also, it has a strong effect on excessive online gambling, digital gaming, and internet use. The association between escapism and excessive online behaviors was registered on two levels: a within- person change in the level of escapism was reflected in the intensity of the addictive behavior whenever a person went through periods of heightened or lowered escapism. A between-person effect demonstrated that people who were generally more prone to escapism reported a higher level of addictions. A perceived lack of autonomy and competence, respectively, intensified the effect of escapism on digital gaming, and competence frustration amplified escapism’s effect on excessive gambling. The nationally representative and longitudinal datasets highlight the importance of the results. Recognizing escapism as a central motive for addictions helps social services and healthcare professionals better identify the root causes of addictive disorders. For researchers, escapism provides a versatile and powerful concept that can be applied in the study of addictions