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Exploring safe practice when handling cytotoxic drugs: findings from survey of UK cancer nurses
Get PDFBackground Cytotoxic drugs, including chemotherapy, potentially pose significant risks to cancer nurses. Therefore, it is important to take measures to protect them from the health effects associated with these drugs. Aim To determine UK cancer nurses’ perceptions and experiences regarding potential exposure to cytotoxic drugs, including their knowledge of hazards, use of personal protective equipment (PPE) and closed system transfer devices (CSTDs), and perceived health effects.Method A cross-sectional survey was conducted across the UK, facilitated through the UK Oncology Nursing Society. Descriptive analyses were employed.Results The survey revealed that the PPE predominantly used by respondents when administering cytotoxic drugs were plastic aprons (97%, n=723/747) and either gloves labelled for use with chemotherapy (62%, n=466/747) or other gloves (53%, n=393/747). Around 70% (n=521/747) of respondents had used CSTDs during administration. Perceived health effects associated with handling cytotoxic drugs were reported by 161 respondents.Conclusion This study indicates that most cancer nurses have a high level of knowledge of the hazards of cytotoxic drugs, and that plastic aprons and gloves are the primary protection used against occupational exposure. However, there appear to be variation in their use of CSTDs. Many cancer nurses perceive their health to be compromised due to the handling of cytotoxic drugs. It is recommended that all cancer treatment settings across the UK should implement CSTDs
Market mechanisms for energy transition: Fossil energy price shocks and irrational renewable energy financing
No full textChina is taking a leading role in the renewable energy industry and is dedicated to promoting the market-based operation mechanism of the energy transition. Nearly all media attribute it to industrial policies; however, this is insufficient to explain the periodic overcapacity risk behind the rapid development − neglecting the market irrationality behind the prosperity and failing to provide further guidance for the proactive government. Based on the micro-level evidence of enterprise business data, this study explores the market feedback mechanism between renewable energy business expansion and financing under the fossil energy price shocks to disclose the market irrationality mechanism triggered by coal, a key inducement. We first establish an empirical framework to explore the relationship, which remains stable under instrumental variable regression and dual-factor moderating effect with extreme weather damage. Furthermore, we compare the mechanisms of China and the United States to furnish more empirical evidence. The results demonstrate that China’s renewable energy financing displays irrationality in signal transmission and market financing feedback, as well as the possible presence of market overreaction by analyzing the financing feedback during the occurrence and disappearance of fossil energy price shocks. The findings offer further policy operability for the theory of active government
Diagnosis of Rotor Asymmetries in Induction Motors: A Steady State Approach Using Rotating Frame References
Get PDFThe diagnostic of electrical machines is of paramount importance, particularly with the Motor Current Signature Analysis (MCSA) method. MCSA stands out as a potent and non-intrusive tool for evaluating the condition of electric motors. This paper introduces an innovative approach for the diagnosis of rotor asymmetries, broken rotor bars, in induction machines operating in steady state directly fed from the grid, emphasising the decomposition of line currents within specific rotating frames. A novel methodology is proposed, and its results are meticulously compared with those obtained through the conventional Fast Fourier Transform (FFT) diagnostic technique. In particular, the newly introduced methodology exhibits enhanced sensitivity, surpassing the capabilities of conventional FFT. Additionally, the innovative approach is proven to be capable of quantifying the increase in fault harmonics in correlation with the load on the machine, aligning with the results observed through conventional FFT analysis. The findings strongly indicate that this pioneering technique offers a more robust and reliable means of diagnosing induction machines when compared to the traditional FFT method, by enhancing sensitivity and providing a nuanced understanding of fault harmonic variations with load changes
Establishing a Relationship between Particle size distribution & Thaw weakening Susceptibility in Soils
Get PDFSusceptibility to frost action in soils is an important consideration in cold and seasonably cold regions. Whilst the particle size distribution (PSD) is commonly used to measure susceptibility to frost action, this method is typically seen as unreliable. Moreover, susceptibility criteria are generally specific to frost heave despite heave and thaw weakening both being described by the term frost action. Therefore, the effect of PSD on thaw weakening has not been fully explored. This study sets out to establish a relationship between PSD and thaw weakening susceptibility considering a better set of PSD descriptors than those traditionally used (e.g. d50, Cu and Cc) towards the entire PSD. By examining available experimental data in the literature, in particular studies used to establish existing thaw weakening susceptibility criteria and testing set out in ASTM D5918–13, it was found that PSD influences thaw weakening susceptibility. PSDs located to the right of the stability line in the normalised entropy diagram (used to characterise PSDs) were found to be largely non-susceptible, whereas finer PSDs to the left the stability line were found to be highly susceptible to thaw weakening. It was also found that PSD greatly affects changes in bearing capacity after thawing. The analyses presented here demonstrate that the grading entropy stability criteria has significant potential as a method of predicting thaw weakening susceptibility
Quantum Machine Learning for 6G Network Intelligence and Adversarial Threats
Get PDFQuantum computing has been a major priority for several nations and prominent institutions in their pursuit of a transformative breakthrough in the fields of computation and encryption. By using the principles of quantum mechanics, particularly quantum superposition and entanglement, quantum computing and quantum machine learning (QML) have the potential to enhance artificial intelligence (AI) and achieve quantum supremacy with unprecedented computational power. However, despite its exceptional learning capabilities, QML-based applications face several emerging security threats. Unlike previous studies focused on classical quantum cryptography and secure quantum communications, this work investigates adversarial risks in QML-assisted network functions and digital twin applications. Specifically, we highlight vulnerabilities such as quantum kernel poisoning, backdoor attacks, and adversarial noise. Key findings reveal that adversaries can intercept quantum states in transit, manipulate parameterized quantum circuits (PQCs), and exploit variational quantum algorithms (VQAs) through adversarial qubit perturbations. These attacks can mislead QML-based optimization processes, leading to incorrect digital twin predictions, faulty resource allocation, or disruptions in QML-aided network functions. To mitigate these risks, defense strategies such as quantum-safe cryptography, data sanitization, adversarial training, defensive distillation, and gradient masking in quantum circuit design can be employed. However, the key issue is the absence of robust security solutions for real-world deployment. Future research should examine the trade-off between adversarial robustness and generative learning performance. Key areas include quantum state discrimination, secure quantum federated learning, quantum decoherence control, and secure quantum semantic communications for real-world deployment
When and how is abusive supervision enacted toward competent subordinates? The role of supervisors' power loss concern and downward envy
No full textIn general, supervisor abuse is directed toward low-performing subordinates. Similarly, envy is typically felt by professionals in lower ranks toward those in higher positions. By contrast, this study investigates the counterintuitive relationship between the abusive behavior of envious leaders toward their competent subordinates. Specifically, we argue that supervisors become envious of competent employees when they are anxious about losing power. Multisource, time-lagged data collected from dyads (198 supervisors and 198 subordinates) in Pakistan-based organizations support the proposed hypotheses. The findings show a positive relationship between perceptions of subordinate competence, supervisors' downward envy, and abusive supervision. In addition, the relationship between perceived subordinates' competence and supervisors' envy is strong when supervisors' power loss concerns are high. This study provides useful theoretical and practical insights for human resource managers dealing with unethical workplace behavior
Frailty determinants in heart failure: Inflammatory markers, cognitive impairment and psychosocial interaction
Get PDFAims: This study aimed to identify factors associated with frailty in heart failure (HF) patients, focusing on demographic, biochemical and health‐related variables. It also explored the correlation between frailty and comorbidities such as malnutrition, cognitive impairment and depression, assessing how these factors interact to influence frailty risk. Methods: A total of 250 HF patients (mean age 73.5 ± 7.2 years; 45.6% female) hospitalized for acute decompensated HF were included. Frailty was assessed using Fried phenotype criteria. Cognitive function, depression and nutritional status were evaluated using validated instruments [Mini‐Mental State Examination (MMSE), Patient Health Questionnaire‐9 (PHQ‐9) and Mini Nutritional Assessment (MNA)]. Biochemical markers included C‐reactive protein (CRP), N‐terminal prohormone of brain natriuretic peptide (NT‐proBNP), haemoglobin, estimated glomerular filtration rate (eGFR) and systolic blood pressure (SBP). Statistical analyses, including logistic regression, were performed to assess associations and odds ratios (ORs) for frailty, adjusted for inflammation and HF type. Results: Frailty was present in 60.4% of patients. Frail individuals exhibited significantly higher CRP (median 4.60 vs. 2.54 mg/L, P < 0.001) and NT‐proBNP (median 2558.8 vs. 1102.6 pg/mL, P = 0.001) and lower haemoglobin (13.7 vs. 14.3 g/dL, P = 0.012), eGFR (62 vs. 71 mL/min/1.73 m2, P = 0.025) and SBP (130 vs. 134 mmHg, P = 0.026). Each 10% increase in CRP was associated with a 5.5% increase in frailty odds (P < 0.001). Frailty was linked to cognitive impairment (OR 2.1, P = 0.018), malnutrition (OR 3.0, P < 0.001) and depression (OR 3.1, P < 0.001), while high adherence to treatment reduced frailty risk by 78.9% (P = 0.027). Interactions were observed between cognitive impairment and body mass index (BMI) (P = 0.020), where higher BMI mitigated the frailty odds difference between cognitively impaired and unimpaired patients. Depression's association with frailty odds varied by adherence levels (P = 0.034) and central obesity (P = 0.047), with the absence of depression offering protection against frailty in patients with central obesity. These interactions remained significant after adjustment for HF type and left ventricular ejection fraction (LVEF) and were consistent across stratifications by these factors. Conclusions: Frailty in HF is influenced by inflammatory markers, cognitive impairment and psychosocial factors. Elevated CRP and NT‐proBNP were strong predictors of frailty. Cognitive impairment and depression were key modifiable factors, interacting with BMI, adherence and obesity. Targeting these factors with early interventions could mitigate frailty risk, improving outcomes and quality of life in HF patients
Lasater clinical judgment rubric in nursing education: a Turkish validity and reliability study
Get PDFIntroduction: Gaining clinical judgment competence among student nurses is a significant outcome of nursing education. In this education process, an assessment tool based on observable behaviors is needed for evaluating students’ clinical judgment skills. Objective: This study aimed to evaluate the validity and reliability of the Turkish version of the Lasater Clinical Judgment Rubric, which assesses student nurses’ stages of clinical judgment competency in simulation-based education. Method: This study was conducted using a cross-sectional methodological design between April and August 2024. For the cultural adaptation and psychometric evaluation of the rubric, simulation videos of 3rd and 4th-year nursing students from a foundation university were used. The language validity of the rubric was performed according to the 10-step translation and cultural adaptation guide of the International Society for Pharmacoeconomics and Outcomes Research; expert opinions were obtained for content validity. The final version of the rubric comprises four stages of the Tanner Model of Clinical Judgment (noticing, interpreting, responding, and reflecting) and 11 dimensions. Four levels of achievement describe the development of each of the 11 dimensions. Sixty-four scenario records of the simulation-based education of 4th -year students in the nursing undergraduate program of a foundation university were examined, and the students were evaluated by two independent observers using the Turkish version of the rubric. The construct validity of the scale was examined using confirmatory factor analysis, and reliability was measured using Cronbach’s alpha coefficient. Interobserver agreement was analyzed using the kappa and intraclass correlation coefficients. Moreover, the discrimination of the rubric was evaluated using an independent samples t-test between the lower and upper 27% groups. Results: Confirmatory factor analysis revealed that the scale formed a four-factor structure of noticing, interpreting, responding, and reflecting in accordance with the original rubric. Furthermore, confirmatory factor analysis showed that the four-factor structure model had an acceptable and generally good fit and was statistically significant and valid. The fit indices for the model were calculated as χ2/df = 1.70, root mean square error of approximation = 0.06, comparative fit index = 0.94, and root mean square residual = 0.03. Kappa values ranged between 0.72 and 0.92, indicating a significant fit for all the items. The intraclass correlation coefficient values ranged between 0.70 and 0.90 and were statistically significant for all the items. The Cronbach’s alpha value of the rubric was 0.91 and ranged between 0.80 and 0.84 in its subdimensions. Conclusion: Therefore, the Turkish version of the rubric is a valid and reliable tool for evaluating student nurses’ clinical judgment competency in simulation-based training
Dementia Friendly Buildings—Approach on Architectures
Get PDFDementia’s escalating incidence, coupled with its economic burden, highlights the need for architectural designs and forms that benefit people living with dementia. This research explores strategies and design principles that focus on establishing supportive spaces for the prolonged autonomy, well-being, and safety of dementia patients. Contemporary research emphasizes the implementation of effective navigational techniques, via visual cues, familiar landmarks, and simplified layouts. For greater navigational signage, the intentional use of contrasting colors, textures, and lighting are recommended to demarcate functional areas within a structure. Incorporating familiar objects in personalized areas enhances treatment outcomes, e.g., reminiscence therapy leverages familiar objects, environmental cues, scents, sounds, and tactile features to trigger and retain memory. Integrating safety precautions such as slip-resistant flooring, handrails, and accessible bathrooms helps mitigate falls for the cognitively impaired. From a therapeutic perspective, this study draws attention towards incorporating gardens and outdoor spaces, which offers sensory stimulation, encourages physical activity, and fosters social engagement. Additionally, the integration of scents, sounds, and tactile features enriches the sensory experience for individuals with dementia. Through comprehensive consideration of design elements, this research highlights how intentionally crafted, dementia-friendly environments can convert spaces into empowering therapeutic settings tailored to address the unique need of this vulnerable group. This architectural approach acts as a valuable complement to the medical and therapeutic interventions in the treatment and care of people living with dementia and their families
Writing for publication: The basics
Get PDFProblem: Writing for publication can be a challenging experience. Whilst midwives develop writing skills through their university education, writing a journal article can be quite different. Purpose: To explain some basic skills of scientific writing when preparing a paper for publication to support midwives in engaging in scientific writing. Overview: Four basic elements of scientific writing will be presented: the importance of careful word choices, the use of active and passive voice, sentence and paragraph structures, and review and editing. Examples of poor and better writing are given to illustrate these basic elements of good academic writing. We hope potential midwifery authors will read and refer to this article when writing. As editors, the elements addressed here are common problems found when reviewing submitted manuscripts that, with guidance, can be easily overcome
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