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PubMed1997

Undergraduate nursing students' perceptions of their clinical learning environment.

The clinical learning environment (CLE) is an interactive network of forces influencing student learning outcomes in the clinical setting. This study used mixed methods to identify factors characterizing students' perceptions of the CLE. The sample consisted of 229 undergraduate students in the second or third year of their biophysical nursing strand. The five subscales of the Clinical Learning Environment Scale, 'staff-student relationships', 'nurse manager commitment', 'patient relationships', 'student satisfaction' and 'hierarchy and ritual', were supported by qualitative data obtained from student interviews. Interpersonal relationships between the participants in the CLE were crucial to the development of a positive learning environment. Student satisfaction with the CLE was both a result of, and influential in creating, a positive learning environment. Nurse educators, clinical venues, and all others participating in the undergraduate nursing students' clinical education, must collaborate in order to create a CLE which promotes the development of well-educated registered nurses capable of providing safe, cost-effective patient care.

Adult↗
PubMed1998

Nurses' perceptions of their work environment in a Nursing Development Unit.

This descriptive study examined nurses' perceptions of their work environment in a Nursing Development Unit (NDU). A postal survey of 70 nurses working in three NDUs was conducted using the Work Environment Scale (WES) for data collection. The response rate was 76%. The aggregate scores from the WES indicate that the nurses surveyed were satisfied with their work environment. The ratings for the 10 subscales of the WES were higher than the norms given by the authors of the scale. However, the findings do not fully support the literature and previous research into nurses' satisfaction in NDUs. A significant finding of the study was the marked difference, in satisfaction with the work environment, between the three units surveyed. It is suggested that a larger scale study should be carried out to explore whether the findings of this study are reflected in other NDUs. Research into the management of change in NDUs is also suggested.

Female↗
PubMed1999

Patient initiatives during the assessment and planning of psychiatric nursing in a hospital environment.

The qualitative study reported in this paper aims to describe the planning and assessment of psychiatric nursing in a hospital environment. The theoretical framework consists of the three types of psychiatric nursing outlined in a developmental model of nursing: confirmatory, educational and catalytic. Confirmatory psychiatric nursing is based on a hierarchical and authoritarian model. Educational psychiatric nursing is based on a professionally driven and behavioural model. Catalytic psychiatric nursing is systematic, theoretical, and research-based. Catalytic psychiatric nursing may vary, depending on the patient's needs, from confirmatory and educational to situationally determined nursing. However, it always enables patient initiatives. The purpose of this paper is to describe patient initiatives during the assessment and planning of patient care by an interdisciplinary mental health team in a psychiatric hospital environment, and the assessment and planning as described by nurses working in a hospital environment. The data, which were collected in two psychiatric hospitals by videotaping interdisciplinary teamwork situations and recording interviews of nurses afterwards, consisted of 384 pages of written text. A total of 640 sentences were identified in the text as reflecting the assessment of care by the interdisciplinary team and by the nurses working in the hospital environment. Deductive content analysis techniques were used to analyse the written data. The results showed that nursing was described by the nurses to be catalytic in 13% of the cases, while the same nurses assessed psychiatric nursing to be most commonly educational (40%) or confirmatory (47%).

Humans↗
PubMed1999

The key elements in the development of a quality management environment for pathology services.

There is increasing recognition that many quality management initiatives in health care are undertaken without the appropriate development of a responsive and supportive organizational environment. In the present study, a multidisciplinary team was empowered to make appropriate changes in order to improve a variety of problem areas that affected the total pathology service of the hospital. Major changes were initially undertaken to develop a quality management environment. The four elements found to be important to the creation of the Total Quality Management (TQM) environment were change in management culture, development of teamwork, focus on customers, and continuous feedback to staff. The accomplishment of the TQM was assessed and confirmed using criteria developed by the Pathology Project TQM Team. As the TQM approach is process driven, it should be adaptable to other clinical situations and not just to pathology services. Potential barriers to achieving the required organizational environment are also explored.

Hospitals, Teaching↗
PubMedDate not supplied

Street music or the blues? The lived experience and social environment of depression.

Life's complexity is a haunting melody of continuously interacting variables .... Professional practice in nursing seeks to promote symphonic interaction between man [sic] and environment. . . (Rogers, 1970, pp. 41, 122). The purpose of this phenomenological study was to explore the lived experience of clinical depression for women in the context of their social relations and environment. Twelve ethnically diverse female friend dyads were interviewed and completed the Beck Depression Inventory (BDI). Seventeen of these women had experienced a major depression in the past or were in treatment for clinical depression at the time of the study. This depression was characterized by dissonance experienced in childhood abuse and incest, uncontrollable moods despite self-medication, abusive or negligent therapy, failed social relationships in adulthood, and a lack of resources in the environment. In contrast, seven healthy women described their social environment as generally resonant and connected. Prevention of childhood abuse and racism, relief from economic hardships, early diagnosis, and safe, effective treatment are essential in helping women to survive clinical depression. Nurses in the community are in a unique position to affect this public health problem.

Adult↗
PubMed2006

Effect of an acute hot and dry exposure in moderately warm and humid environment on muscle performance at different times of day.

This study investigated whether 30 min of acute hot exposure has an additional passive warm-up effect for the improvement in muscle performance in a moderately warm and humid environment. We also sought to determine whether this effect is dependent on the diurnal variation in body temperature. Nine male subjects (age: 31.9 [+/- 5] years, height: 177 [+/- 6] cm, body mass: 69.3 [+/- 10] kg) were tested (CMJ, cycling sprints, and isokinetic contractions of the knee flexors and extensors) in a moderately warm and humid environment (24 [+/- 1] degrees C and 70 [+/- 4] % rh) with and without acute heat exposure (30 min of rest in a sauna at 76 [+/- 2] degrees C and 27 [+/- 1] % rh), both in the morning (07:00 - 09:00 h) and in the evening (17:00 - 19:00 h). Our results indicated a significant effect of both time-of-day and acute heat exposure on leg skin temperature (p < 0.01) but failed to show any effect of time-of-day or acute heat exposure on the various evaluated parameters (CMJ: speed, force, power and height; cycling power: over a half pedal revolution and a total pedal revolution; isokinetic torque: knee extensor and flexor muscles at 4.19 rad x s (-1), 3.14 rad x s (-1), 2.09 rad x s (-1), and 1.05 rad x s (-1)). In conclusion, our data suggest that 30 min of acute hot exposure does not have any passive warm-up effect in a moderately warm and humid environment. Furthermore, the diurnal variation in body temperature has no passive warm-up effect in a moderately warm and humid or in an extremely hot environment.

Adult↗
PubMed2006

Construction of environment states in quantum-chemical density-matrix renormalization group calculations.

The application of the quantum-chemical density-matrix renormalization group (DMRG) algorithm is cumbersome for complex electronic structures with many active orbitals. The high computational cost is mainly due to the poor convergence of standard DMRG calculations. A factor which affects the convergence behavior of the calculations is the choice of the start-up procedure. In this start-up step matrix representations of operators have to be calculated in a guessed many-electron basis of the DMRG environment block. Different possibilities for the construction of these basis states exist, and we first compare four procedures to approximate the environment states using Slater determinants explicitly. These start-up procedures are applied to DMRG calculations on a sophisticated test system: the chromium dimer. It is found that the converged energies and the rate of convergence depend significantly on the choice of the start-up procedure. However, since already the most simple start-up procedure, which uses only the Hartree-Fock determinant, is comparatively good, Slater determinants, in general, appear not to be a good choice as approximate environment basis states for convergence acceleration. Based on extensive test calculations it is demonstrated that the computational cost can be significantly reduced if the number of total states m is successively increased. This is done in such a way that the environment states are built up stepwise from system states of previous truncated DMRG sweeps for slowly increasing m values.

Journal Article↗
PubMed2002

Errors as a result of metal in the near environment when using an electromagnetic locator with freehand three-dimensional echocardiography.

BACKGROUND: Quantitative ventriculography by freehand 3-dimensional (3D) echocardiography with an acoustic spatial locator has been proven to provide highly accurate reproducible measurements of left ventricular volume, mass, and function. It has been shown to be 2 to 3 times better than conventional 2-dimensional echocardiographic techniques. Although accurate, the acoustic spatial locator uses a spark gap to generate hypersound for locating and is somewhat bulky. The Bird direct current electromagnetic locator (Ascension Technology Corp, Burlington, Vt) is a notable alternative locator for the freehand 3D system because it is small and easily portable. However, conductive metals in the near environment may adversely affect electromagnetic locator accuracy. To determine the feasibility of using the electromagnetic locator in a freehand 3D echocardiographic system in the conventional hospital environment, a series of experiments was carried out assessing the accuracy of such a system under various conditions of exposure to conductive metal. METHODS: Using tissue equivalent ellipsoid phantoms of known volumes, we compared volume measurement accuracy of the freehand 3D echocardiographic system equipped with the standard Bird or miniBird electromagnetic locator systems with our freehand acoustic spatial locator 3D echocardiographic system in 3 experiments: (experiment 1) no metal within 30 in (76.2 cm) of the phantoms and electromagnetic locator; (experiment 2) phantoms placed on a standard metal hospital stretcher with conductive metal less than 10 in (25.4 cm) from the phantoms and electromagnetic locator and with the echocardiographic machine greater than 30 in (76.2 cm) from the electromagnetic locator; and (experiment 3) phantoms placed on the same stretcher with conductive metal less than 10 in (25.4 cm) from the phantoms and electromagnetic locator and with the echocardiographic machine in its usual position approximately 10 in (25.4 cm) from the electromagnetic locator. RESULTS: For experiment 1 there was no significant volume error (<1%) by any system; no significant difference among the 3 locator systems (acoustic, Bird, or miniBird). For experiment 2 there was significant volume underestimation error by both electromagnetic locator systems (-10.9%, P <.05). For experiment 3 there was significant and greater volume underestimation error by both electromagnetic locator systems (-14.7%, P <.05) in close proximity to the echocardiographic machine. Interobserver variability was 5.1%. CONCLUSION: For quantitative ventriculography by a freehand 3D echocardiographic system, electromagnetic locator systems should not be used if conductive metal is in the near environment (<30 in [76.2 cm] from the locator). Accurate quantitative ventriculography may be performed with an electromagnetic locator system if the near environment is free of conductive metals.

Echocardiography, Three-Dimensional↗
PubMed2002

Virtual reality: immersive hepatic surgery educational environment.

BACKGROUND: Understanding the spatial relationships among the liver segments, and intrahepatic portal and hepatic veins is essential for surgical treatment of liver diseases. Teleimmersive virtual reality enables improved visualization over conventional media because it supports stereo vision, viewer-centered perspective, large angles of view, and interactivity with remote locations. We report a successful pilot study teaching hepatic surgical principles using teleimmersion. METHODS: We developed a teleimmersive environment for teaching with biomedical models including virtual models of the liver segments and portal and hepatic veins. Using the environment, 1 instructor gave a workshop to 6 senior general surgery residents at 2 physical locations. A 24-question (36-point) examination was administered before and after the workshop. RESULTS: The workshop produced significant improvements in the mean test scores between the pretests and posttests (17.67 to 23.67, P <.02). We found no differences between residents who were with the instructor and those at the remote location. Six-month delayed testing demonstrated complete retention of new knowledge. CONCLUSIONS: The teleimmersive environment enabled surgeons to overcome some of the barriers to teaching complex surgical anatomic principles. Using teleimmersive environments, surgical educators and trainees can interact from locations worldwide using virtual anatomic information to achieve their educational goals.

Biliary Tract↗
PubMed2002

Benthic eukaryotic diversity in the Guaymas Basin hydrothermal vent environment.

Molecular microbial ecology studies have revealed remarkable prokaryotic diversity in extreme hydrothermal marine environments. There are no comparable reports of culture-independent surveys of eukaryotic life in warm, anoxic marine sediments. By using sequence comparisons of PCR-amplified small subunit ribosomal RNAs, we characterized eukaryotic diversity in hydrothermal vent environments of Guaymas Basin in the Gulf of California. Many sequences from these anoxic sediments and the overlaying seawater represent previously uncharacterized protists, including early branching eukaryotic lineages or extended diversity within described taxa. At least two mechanisms, with overlapping consequences, account for the eukaryotic community structure of this environment. The adaptation to anoxic environments is evidenced by specific affinity of environmental sequences to aerotolerant anaerobic species in molecular trees. This pattern is superimposed against a background of widely distributed aerophilic and aerotolerant protists, some of which may migrate into and survive in the sediment whereas others (e.g., phototrophs) are simply deposited by sedimentary processes. In contrast, bacterial populations in these sediments are primarily characteristic of anoxic, reduced, hydrocarbon-rich sedimentary habitats.

Animals↗
PubMed1990

Grazing in a turbulent environment: energy dissipation, encounter rates, and efficacy of feeding currents in Centropages hamatus.

The creation of feeding currents by calanoid copepods increases encounter rates of copepods with their food and provides and advantage in dilute nutritional environments. Small-scale turbulence has also been hypothesized to increase the encounter rate between planktonic predators and their food. Centropages hamatus was exposed to turbulent and nonturbulent environments at two prey concentrations to quantify the influence of turbulence on feeding current efficacy. Turbulent energy dissipation rates used in the experiment were in the range of 0.05-0.15 cm2. sec-3. In the nonturbulent environments, feeding currents increased the encounter rates of C. hamatus 3-5 times that of control encounter areas. In turbulent environments, encounter rates were not increased by feeding currents, yet C. hamatus continued to create feeding currents. Energetic calculations indicate a tradeoff in the value of turbulence to a copepod feeding on phytoplankton. While turbulence is probably beneficial at low food concentrations, it may be deleterious at high food concentrations.

Journal Article↗
PubMed1995

Three distinct structural environments of a transmembrane domain in the inwardly rectifying potassium channel ROMK1 defined by perturbation.

To probe the protein environment of an ion channel, we have perturbed the structure of a transmembrane domain by substituting side chains with those of two different sizes by using site-specific mutagenesis. We have used Trp and Ala as a high- and a low-impact perturbation probe, respectively, to replace each of 18 consecutive residues within the putative second transmembrane segment, M2, of an inwardly rectifying potassium channel, ROMK1. Our rationale is that a change in the channel function as a consequence of these mutations at a particular position will reflect the structural environment of the altered side chain. Each position can then be assigned to one of three classes of environments, as grated by different levels of perturbation: very tolerant (channel functions with both Trp and Ala substitutions), tolerant (function preserved with Ala but not with Trp substitution), and intolerant (either Ala or Trp substitution destroys function). We identify the very tolerant environment as being lipid-facing, tolerant as protein-interior-facing, and intolerant as pore-facing. We observe a strikingly ordered pattern of perturbation of all three environmental classes. This result indicates that M2 is a straight alpha-helix.

Alanine↗
PubMedDate not supplied

One-year occupational exposure to a cold environment alters lung function.

Numerous observations have shown that breathing cold air causes bronchospasm and increases respiratory tract secretions in asthmatic patients and normal individuals. However, few studies have been conducted on the respiratory effects of protracted daily exposures to a cold environment. In this 1-yr study, the authors examined individuals who spent 6 hr a day in cold stores (+3 degrees C to + 10 degrees C) and spent approximately 25% of that time at +3 degrees C. The protocol included a questionnaire about clinical symptoms, with measurements of baseline pulmonary function and airway responses to carbachol and to nasal inhalation of cold air (-5 degrees C). Eleven subjects were examined prior to their first occupational exposure to cold, and again following 6 mo and 12 mo of work in the cold environment. Compared with a control group of 6 subjects engaged at the same time but who did not work in cold stores, 6 of 11 individuals who worked 12 mo in a cold environment experienced increased symptoms of rhinitis, sore throat, and cough. Physiological measurements at 6 mo and 12 mo showed a progressive decrease in forced expiratory volume in 1 sec and a progressive increase in the baseline value of central airway resistance. Forced expiratory flow measured between 25% and 75% of vital capacity had decreased at 6 mo, but showed no further change at 12 mo. A progressive enhancement of bronchial reactivity to carbachol was noted at 6 mo and again at 12 mo, but airway response to nasal breathing of cold air did not vary. The authors concluded that 1 yr of daily exposure to a cold occupational environment elicits a modest--but significant--airflow limitation, accompanied by bronchial hyperresponsiveness, with the effects beginning within 6 mo of exposure.

Adult↗
PubMed2002

Maximal oxygen uptake during cycling is reduced in moving environments; consequences for motion-induced fatigue.

In previous studies on physical fatigue during simulated ship movements, the apparent exhaustion of subjects after experimentation suggested that the traditional index of physical workload, oxygen consumption expressed as the percentage of peak oxygen consumption (VO2-peak) measured in a separate graded exercise test (GXT), underestimates workload in a moving environment. In these studies, the GXT was carried out in a stationary environment, as is standard practice. To explain the underestimation, it was hypothesized that VO2-peak might have been less if the GXT had been carried out in the moving environment. This paper reports on three experimental tests of this hypothesis, performed with a ship motion simulator and aboard a ship at sea. In all three experiments, VO2-peak was indeed significantly reduced when the GXT was carried out in the moving environment. Theoretical reasons for this phenomenon are discussed and investigated, but a clear explanation is still lacking.

Adult↗
PubMed2005

Climate studies: can students' perceptions of the ideal educational environment be of use for institutional planning and resource utilization?

As educational climate strongly affects student achievement, satisfaction and success, it is important to get regular feedback from students on how they experience the educational environment. The Dundee Ready Education Environment Measure (DREEM) Inventory was administered on the same day to all first-, second- and third-year students at the Canadian Memorial Chiropractic College (CMCC) and the students were requested to complete the questionnaire as they were actually experiencing the educational environment at CMCC, and then to say what they would have wanted, or preferred it to be like. Valid returns were received from 146 (95%) first-, 123 (82%) second- and 73 (48%) third-year students (n = 342). The results indicated that the DREEM Inventory used in the Ideal mode, together with the responses in the Actual mode, could be used effectively to determine the dissonance between what they had and what they would have liked to have. It was found that there was a strong similarity in the areas of the educational environment that the different groups of students indicated as falling short of their ideal. The results of this study provided a useful basis for strategic planning and resource utilization.

Attitude↗
PubMed2003

CAREN (computer assisted rehabilitation environment): a novel way to improve shoe efficacy.

A new technical system, CAREN (computer assisted rehabilitation environment), is described, which makes it possible to do a total body movement analysis in a virtual environment. The virtual environment is reproducible and as close to natural environment as possible. In a case study it proved possible with this system to test different shoes and get insight in the movement problems. The importance of whole body analysis is demonstrated in this case study. The adjustments made in the shoes could be tested for their efficacy.

Adult↗
PubMedDate not supplied

Technology for seniors' living environment: directions for product development.

In May 1991, approximately 40 world experts on technology and aging were invited to Directions '91 in Winnipeg, Canada. The focus of the 3-day seminar was on living environments for seniors and on the research and development of products to meet the needs of an aging society. The built environment--furnishings and appliances, self-care, and leisure and recreation--was targeted in both plenary and breakout sessions. This article highlights the key concerns and recommendations developed at Directions '91. The "universal design" concept is stressed, particularly as it relates to our need to rethink the design of the built environment and the products that are currently being used by seniors seeking independence and dignity in their daily living. Consideration is also given to the physiological changes that occur in the natural process of aging and how these changes need to be accommodated in products designed for the living environment.

Aged↗
PubMedDate not supplied

Family environment, attitudes toward life and death, depression, and suicidality in elementary-school children.

This study examines whether perception of family environment, attitudes toward life and death, and depression predict suicidality in elementary-school children. Seventy-eight participants ages 8 to 13 recruited through an elementary school and a university were assessed for attitudes toward life and death, depression, suicidality, and family environment. A regression equation indicated that depression and attraction to life were the only variables accounting for variance in suicidality (49%). Family environment variables were moderately correlated with depression, indicating that family environment may play a role in the development and maintenance of depression, of which suicidality is a symptom. Concurrent treatment of family issues may not only ameliorate children's symptoms, but also provide a critical sense of support that may decrease the likelihood that these children will become suicidal in the future.

Adolescent↗