Oxford Handbook of Surgical Nursing

2016 ◽  
Keyword(s):  
Multidisciplinary Team ◽  
Surgical Care ◽  
Surgical Patients ◽  
Care Needs ◽  
The Core ◽  
Before And After ◽  
Core Elements ◽  
Clinical Advances

The Oxford Handbook of Surgical Nursing is aimed at nurses who care for patients before and after surgery on the main ward areas of a surgical facility. The care needs of surgical patients are core to the role of the nurse and have undergone significant specialization, with the increasing technological and clinical advances in surgery. In addition, the role of the nurse in these areas has changed markedly, undertaking more procedures as well as aspects of assessment, investigation, and treatment as part of the multidisciplinary team. The Oxford Handbook of Surgical Nursing provides a guide relating to all the core elements of surgical care.

Surgical setup for cardiopulmonary bypass through central cannulation

2021 ◽  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Surgical Care ◽  
Heart Lung Machine ◽  
American College Of Surgeons ◽  
History Of ◽  
Central Cannulation ◽  
First John ◽  
Clinical Advances

The introduction of cardiopulmonary bypass was one of the most important clinical advances of 1952. In that year, John Gibbon performed the first successful cardiac surgery using cardiopulmonary bypass. The procedure has been described as “One of the most impressive evidences of the role of investigative surgery in the history of medicine in the persevering efforts of Dr. Gibbon for more than 20 years, which finally culminated in a practical heart-lung machine”, at the first John H. Gibbon, Jr. Lecture at the annual meeting of the American College of Surgeons. Due to on-going advancements in cardiopulmonary bypass, many patients with complex heart disease requiring surgical care undergo cardiac surgery while the other organs remain adequately oxygenated and perfused. This tutorial discusses the access, surgical technique, and initiation of cardiopulmonary bypass through central cannulation and describes the safeguards and pitfalls.

Reply to Comments

2019 ◽  
Vol 41 (2) ◽  
pp. 287-300
Author(s):  
Allen Buchanan ◽  
Russell Powell
Keyword(s):  
Social Sciences ◽  
Moral Psychology ◽  
Moral Theory ◽  
Moral Progress ◽  
Evolutionary Explanation ◽  
The Core ◽  
Use Of Data ◽  
The Social ◽  
Core Elements

Abstract Commentators on The Evolution of Moral Progress: A Biocultural Theory raise a number of metaethical and moral concerns with our analysis, as well as some complaints regarding how we have interpreted and made use of the contemporary evolutionary and social sciences of morality. Some commentators assert that one must already presuppose a moral theory before one can even begin to theorize moral progress; others query whether the shift toward greater inclusion is really a case of moral progress, or whether our theory can be properly characterized as ‘naturalistic’. Other commentators worry that we have uncritically accepted the prevailing evolutionary explanation of morality, even though it gives short shrift to the role of women or presupposes an oversimplified view of the environment in which the core elements of human moral psychology are thought to have congealed. Another commentator laments that we did not make more extensive use of data from the social sciences. In this reply, we engage with all of these constructive criticisms and show that although some of them are well taken, none undermine the core thesis of our book.

scholarly journals Modeling the role of voyaging in the coastal spread of the Early Neolithic in the West Mediterranean

2017 ◽  
Vol 114 (5) ◽  
pp. 897-902 ◽  
Author(s):  
Neus Isern ◽  
João Zilhão ◽  
Joaquim Fort ◽  
Albert J. Ammerman
Keyword(s):  
Long Range ◽  
Simulation Study ◽  
Cultural Interaction ◽  
Early Neolithic ◽  
The West ◽  
The Core ◽  
Core Elements

The earliest dates for the West Mediterranean Neolithic indicate that it expanded across 2,500 km in about 300 y. Such a fast spread is held to be mainly due to a demic process driven by dispersal along coastal routes. Here, we model the Neolithic spread in the region by focusing on the role of voyaging to understand better the core elements that produced the observed pattern of dates. We also explore the effect of cultural interaction with Mesolithic populations living along the coast. The simulation study shows that (i) sea travel is required to obtain reasonable predictions, with a minimum sea-travel range of 300 km per generation; (ii) leapfrog coastal dispersals yield the best results (quantitatively and qualitatively); and (iii) interaction with Mesolithic people can assist the spread, but long-range voyaging is still needed to explain the archaeological pattern.

ON THE RELEVANCE OF THE CORE HELIX ALPHA 6 TO KINESIN ACTIVITY GENERATION

2009 ◽  
Vol 04 (01n02) ◽  
pp. 63-75 ◽  
Author(s):  
NIKOLINA KALCHISHKOVA ◽  
KONRAD J. BÖHM
Keyword(s):  
Structural Organization ◽  
Atp Hydrolysis ◽  
Catalytic Core ◽  
Microtubule Binding ◽  
The Core ◽  
Activity Generation ◽  
Core Elements ◽  
High Level ◽  
Β Sheet

KIF5A and Eg5 are plus-end directed motor proteins with conserved motor domains. The catalytic cores of both motors comprise a central β-sheet consisting of eight β-strands surrounded by six α-helices. Notwithstanding the high level of similarity in their structural organization, Eg5 moves significantly slower than KIF5A. Recently, we reported that neck linker and neck elements of KIF5A and Eg5 contribute to velocity regulation. As the neck linker of both motors is known to be connected to the catalytic core via helix α6, the question arises if also helix α6 and strand β8 as the last core elements might be involved in velocity regulation. To elucidate the role these structures in kinesin activity generation we constructed KIF5A- and Eg5-based chimeras in which the β8 strand, helix α6, the neck linker, and the neck were interchanged. Additionally, we studied the role of α6 and β8 in ATP hydrolysis and microtubule binding by expression of truncated KIF5A and Eg5 constructs lacking both strand β8 and helix α6, or α6 only. The results obtained suggest that strand β8 and helix α6 are not involved in microtubule-binding, but α6 is an obligate and kinesin type-specific structure required to generate ATPase activity.

scholarly journals Comparison of strategies for adherence to venous thromboembolism prophylaxis in high-risk surgical patients: a before and after intervention study

2021 ◽  
Vol 10 (4) ◽  
pp. e001583
Author(s):  
Leopoldo Muniz da Silva ◽  
Helidea de Oliveira Lima ◽  
Ricardo Ferrer ◽  
Anthony M-H Ho ◽  
Saullo Queiroz Silveira ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
High Risk ◽  
Postoperative Period ◽  
Multidisciplinary Team ◽  
Intervention Study ◽  
Surgical Patients ◽  
Medical Documentation ◽  
Vte Prophylaxis ◽  
Before And After ◽  
Multiple Stages

BackgroundVenous thromboembolism (VTE) is a major cause of perioperative morbimortality. Despite significant efforts to advance evidence-based practice, prevention rates remain inadequate in many centres.ObjectiveTo evaluate the effectiveness of different strategies aimed at improving adherence to adequate VTE prophylaxis in surgical patients at high risk of VTE.MethodBefore and after intervention study conducted at a tertiary hospital. Adherence to adequate VTE prophylaxis was compared according to three strategies consecutively implemented from January 2019 to December 2020. A dedicated hospitalist physician alone (strategy A) or in conjunction with a nurse (strategy B) overlooked the postoperative period to ensure adherence and correct inadequacies. Finally, a multidisciplinary team approach (strategy C) focused on promoting adequate VTE prophylaxis across multiple stages of care—from the operating room (ie, preoperative team-based checklist) to collaboration with clinical pharmacists in the postoperative period—was implemented.ResultsWe analysed 2074 surgical patients: 783 from January to June 2019 (strategy A), 669 from July 2019 to May 2020 (strategy B), and 622 from June to December 2020 (strategy C). VTE prophylaxis adherence rates for strategies (A), (B) and (C) were (median (25th–75th percentile)) 43.29% (31.82–51.69), 50% (42.57–55.80) and 92.31% (91.38–93.51), respectively (p<0.001; C>A=B). There was a significant reduction in non-compliance on all analysed criteria (risk stratification (A (25.5%), B (22%), C (6%)), medical documentation (A (68%), B (55.2%) C (9%)) and medical prescription (A (51.85%), B (48%), C (6.10%)) after implementation of strategy C (p<0.05). Additionally, a significant increase in compliance with adequate dosage, dosing interval and scheduling of the prophylactic regimen was observed.ConclusionPerioperative VTE prophylaxis strategies that relied exclusively on physicians and/or nurses were associated with suboptimal execution and prevention. A multidisciplinary team-based approach that covers multiple stages of patient care significantly increased adherence to adequate VTE prophylaxis in surgical patients at high risk of developing perioperative VTE.

scholarly journals From inter-agency to multidisciplinary work in a sector generic mental health team

1996 ◽  
Vol 20 (6) ◽  
pp. 345-347 ◽  
Author(s):  
S. Marriott ◽  
A. Hassiotis ◽  
J. Ray ◽  
P. Tyrer
Keyword(s):  
Multidisciplinary Team ◽  
Clinical Skill ◽  
Case Managers ◽  
Mental Health Team ◽  
Agency Model ◽  
Community Psychiatric ◽  
Specialist Services ◽  
Before And After ◽  
Two Factors

The effects of establishing a full multidisciplinary community psychiatric team in central London are described. The nature of referrals, and referrers' satisfaction with the service were examined during two comparable six-month periods, before and after the changes. The number and severity of referrals increased, and referrers were more satisfied with the new service. In contrast to the inter-agency model, the new multidisciplinary team was associated with more appropriate referral of those patients with the greatest need for specialist services. Clinical skill mix in the team and referrer education are the two factors most likely to have promoted these important changes. The key role of the psychiatrist in a full multidisciplinary team who can empower multi-professional case managers in their day-to-day management of severely ill patients is highlighted.

Enunciation

2021 ◽  
Author(s):  
Russell Smith
Keyword(s):  
Literary Theory ◽  
Language Use ◽  
Jacques Lacan ◽  
Julia Kristeva ◽  
Human Sciences ◽  
The Core ◽  
Core Elements ◽  
General Linguistics ◽  
The Individual

Enunciation refers to the act of making a spoken or written statement, as opposed to the content of the statement. It is associated with the work of French linguist Émile Benveniste, whose Problems in General Linguistics (1966) argued that formalist and structuralist accounts of language fail to pay sufficient attention to the fact that many of the core elements of any language, such as the pronouns “I” and “you,” are entirely dependent for their function on the unique circumstances in which they are enunciated. Enunciation thus describes the process by which a speaker or writer takes up the position of a linguistic subject. Benveniste further argued that all acts of language use are fundamentally dialogical in nature, although the individual acts of speaking and listening, writing and reading may be widely separated in place and time. These questions played a pivotal role in the shift, both in literary theory and in the human sciences more broadly, from structuralism to poststructuralism through the course of the late 1960s and early 1970s. This involved a shift from the study of language as a signifying system, to the study of discourse as the range of different processes by which individual acts of speaking and writing, listening and reading, are framed in advance by formal and informal rules and conventions. Every actual instance of language use is inseparable from its enunciative situation, and this entails attention to the questions of who is speaking, to whom, and why? As developed in different ways by theorists such as Julia Kristeva and Jacques Lacan, Roland Barthes and Michel Foucault, the linguistics of enunciation would raise profound questions about the role of language in the formation of subjectivity and in the discursive operation of power.

scholarly journals Care needs of people with dementia in the peri-operative environment: A systematic review

Dementia ◽  
2018 ◽  
Vol 19 (6) ◽  
pp. 1889-1906 ◽  
Author(s):  
Alicia Diaz-Gil ◽  
Joanne Brooke ◽  
Olga Kozlowska ◽  
Sarah Pendlebury ◽  
Debra Jackson
Keyword(s):  
Healthcare Professionals ◽  
Hospital Setting ◽  
Surgical Care ◽  
Cognitive Status ◽  
Surgical Patients ◽  
Care Needs ◽  
Operative Outcomes ◽  
People With Dementia ◽  
Operative Care ◽  
Tract Infections

The care of people with dementia within the hospital setting is challenging for healthcare professionals. Hospital design and services are not optimized for people with dementia, owing to the lack of preparation of healthcare professionals and the busy environment of the acute hospital. The peri-operative environment may present particular difficulties but little is known about the experience and care of people with dementia in this setting. The aim of this review was to examine the care of surgical patients who have dementia and their family members in peri-operative environments and describe strategies adopted by healthcare professionals. A systematic search of the following databases was completed: BNI, CINAHL, PubMED and PsychINFO in accordance with PRISMA guidelines. Data were extracted and analysed within a thematic analysis framework as described by Braun and Clarke . Ten papers based on eight studies were included, five (n = 355,010 participants) containing quantitative data and five reporting qualitative data (n = 395 participants). People with dementia who go undergo surgery experienced higher adverse post-operative outcomes such as respiratory problems or urinary tract infections. The key elements in surgical care for people with dementia included: health assessment throughout the surgical trajectory (pre-, intra- and post-operative) and the resources used by healthcare professionals in the peri-operative care. Healthcare professionals reported difficulties in the completion of health assessments due to the cognitive status of people with dementia and a lack of skills in dementia management. The use of restraints was still a common practice and a source of conflict. Dementia-specific training and guidelines focused on the care of surgical patients who have dementia in peri-operative environments are required to improve care and post-operative outcomes. More research is required to develop effective interventions to improve care and decrease the risk of complications for people with dementia in the peri-operative care environment.

Financialization, securitization and the decline of pubs in Britain

2020 ◽  
Vol 20 (6) ◽  
pp. 1293-1311
Author(s):  
Liam Keenan
Keyword(s):  
Political Economy ◽  
Shareholder Value ◽  
Rapid Rate ◽  
Short Term ◽  
Firm Level ◽  
Unit Of Analysis ◽  
The Core ◽  
Core Elements ◽  
Political Economy Approach

Abstract Pubs in Britain are closing at a rapid rate. While changing regulatory, demographic and consumer trends have weakened the viability of pubs businesses in recent years, less is known about the role of Pub Companies, or ‘pubcos’, in contributing to the decline of the sector. Reflecting the core elements of financialization, pubcos acquire assets through securitization, prioritize shareholder value and operate under short-term financial targets and metrics. Adopting an institutionally sensitive geographical political economy approach, this article analyzes the ways in which pubcos, through financialization and securitization, have transformed the ownership and geographies of pubs in Britain. Foregrounding the firm as the unit of analysis, it emphasizes the importance of firm agency in creating more granular understandings of the geographical causes and implications of securitization. Analyzing the interrelationships between actors involved in the securitization process, particularly tensions between shareholders and bondholders, this article makes a novel contribution around the variegated, contradictory and conflicted nature of firm-level financialization.

Environments for Entrepreneurship Development: Key Dimensions and Research Implications

1994 ◽  
Vol 18 (4) ◽  
pp. 43-62 ◽  
Author(s):  
Devi R. Gnyawali ◽  
Daniel S. Fogel
Keyword(s):  
Environmental Conditions ◽  
New Venture ◽  
New Venture Creation ◽  
Venture Creation ◽  
Five Dimensions ◽  
Creation Process ◽  
The Core ◽  
Core Elements ◽  
Key Dimensions

An integrated framework is not available for studying the environmental conditions conducive for entrepreneurship despite their importance for the emergence and growth of enterprises in a country. This paper develops such a framework consisting of five dimensions of entrepreneurial environments and links these dimensions to the core elements of the new venture creation process. Specific emphasis is given to the role of environmental conditions in developing opportunities and in enhancing entrepreneurs’ propensity and ability to enterprise. The paper outlines some propositions and research implications of the integrated model and offers initial guidelines for formulating public policies to develop entrepreneurial environments.

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