Hold Research Articles

The new nurse manager survival guide Part 1.

Leading in a time of crisis We created this series to offer new nurse managers basic tenets of leadership to help them succeed in this pivotal organizational role Little did we imagine the chaos and disruption that were in store for all of us as the coronavirus pandemic has changed life as we know it Hospitals have been reconfigured for the sole purpose of creating maximum capacity for infected patients Elective surgeries and routine procedures have been canceled;ORs and postanesthesia care units have been turned into patient care units to provide ventilator support with anesthesia machines when there are no more ICU beds New protocols are being created and implemented in real time as physicians and nurses learn what to do and when to do it as they go Clinicians are required to make immediate choices about how to best care for huge numbers of very sick patients who appear in EDs with breathtaking rapidity, and the ethics of allocating scarce resources when the pace is fast and actions need to be decisive have their own emotional toll 1 Rigid hierarchies and siloed fiefdoms that have characterized hospitals are rapidly breaking down as new models of teamwork take hold This energy pulsating in hospitals is in sharp contrast to the eerily empty streets outside silenced by shelter-in-place orders 2 No nurse manager practicing today has experienced anything like the coronavirus pandemic;this will be a formative event for all nurses as we move into an unknown future None of us has managed this degree of chaos, complexity, and uncertainty before so, in a sense, we're all new nurse managers trying to find our way Here are some things to think about that may be helpful to you as you navigate this new reality

Scientific Learning Motivations as Predictors of Pre-service Elementary Grade Teachers’ Authentic Assessment Practices in Science

Teachers, as life-long learners, hold personal pedagogical and andragogical motivations towards learning which manifest in their procedures and practices towards specific disciplines. This study is aimed to determine the level of scientific learning motivations and assessment practices in science of pre-service elementary grade teachers and ascertain whether the respondents’ scientific learning motivations predict their assessment practices in the subject. Scientific learning motivations in this study include intrinsic and extrinsic goal orientation, task value, control of learning beliefs, expectancy, and affective components. Employing adopted questionnaires in a Descriptive-Predictive Research design, the respondents’ scientific learning motivations and assessment practices in science were determined and evaluated. Results showed that the pre-service elementary grade teacher-respondents had good to very good motivations in science learning and assessment practices towards the subject. Among the motivational factors in science learning, only expectancy component is related to their affordances in authentic assessment in science. Furthermore, self-efficacy for learning (an expectancy component of scientific learning motivations) was specifically seen to predict the pre-service elementary grade teachers’ affordances of authentic assessment practices towards the subject.

KETERHUBUNGAN SENSOR INDRA ANAK DENGAN ELEMEN ARSITEKTURAL TAMAN LALU LINTAS ADE IRMA SURYANI NASUTION

Abstrak- Ruang publik memegang peranan penting bagi suatu wilayah. Sebagai wadah aktivitas komunal, ruang publik perlu diintegrasikan pada perancangan kota secara menyeluruh. Sayangnya, para arsitek dan perancang kota sering melupakan bahwa subjek pengguna ruang publik tidak hanya orang dewasa. Anak-anak juga memerlukan adanya ruang publik sebagai tempat mereka untuk tumbuh dan berkembang. Proses perkembangan awal manusia atau lebih dikenal sebagai fase kanak-kanak perlu diakomodasi oleh wadah yang memadai, salah satu caranya adalah dengan perancangan area publik yang ramah anak. Area publik anak perlu menumbuhkan minat anak dalam mengenal lingkungan tanpa melupakan pengalaman yang menyenangkan selama berkegiatan di dalamnya. Area bermain dianggap sebagai bentuk ruang publik yang baik untuk anak-anak, terutama dalam tahapan pengenalan interaksi sosial serta stimulasi sensor indra. Tumbuh kembang anak sangat dipengaruhi oleh peran sensor indra, terutama indra peraba dan penglihatan. Dua hal ini menjadi titik fokus penelitian penyesuaian anak dengan elemen arsitektural ruang publik ramah anak.Pada lingkup Bandung, Taman Lalu Lintas Ade Irma Suryani Nasution merupakan salah satu ruang publik ramah anak yang terletak di tengah kota dan kerap kali ramai dikunjungi keluarga serta anak-anak. Pada tahun 2017 silam, taman ini mengalami revitalisasi besar oleh Labo+ Architecture and Design yang menajamkan kembali visi Yayasan Taman Lalu Lintas mengenai edukasi pejalan kaki dan pengendara. Ruang publik ramah anak ini menjadi elemen kota yang penting untuk dibahas dan diteliti lebih lanjut. Penelitian dilakukan dengan mendata karakteristik material area bermain anak, kemudian dilanjutkan dengan analisis perilaku dan preferensi anak-anak. Teknik observasi dipilih dalam proses penelitian, dengan jumlah sampel 30 balita dan atau anak-anak.Proses pembelajaran anak berlangsung pada area bermain. Pengalaman anak dalam mempelajari lingkungannya sangat dipengaruhi oleh penampilan visual serta bentuk dan tekstur material sarana bermain yang tersedia. Stimulus lingkungan fisik baik alami maupun buatan rupanya sangat berpengaruh pada respon anak-anak yang terlihat dari ekspresi wajah. Rupanya, pengalaman bermain pada Taman Lalu Lintas Ade Irma Suryani Nasution meninggalkan kesan yang positif pada anak-anak yang datang.

Hold the Foam: Why Topical Budesonide Remains Relevant for IBD Therapy

Hold the Foam: Why Topical Budesonide Remains Relevant for IBD Therapy

Towards Implementing the Grameen Bank Financing Model Among Micro Enterprises in Botswana: Is it a Possibility?

Micro Enterprises (MiEs) in Botswana are neglected by financial institutions in favor of Small and Medium Enterprises (SMEs) that have collateral security and financial records. MiEs could engage unemployed youths and adults to become self-employed and alleviate poverty; but MiEs struggle to finance their businesses because financial institutions require business proposals and collateral security; furthermore, micro lenders charge exorbitant interests. Currently there is no study specifically targeting MiEs financing in Botswana tailoring the Grameen Bank Model (GBM), hence the need for this study. This research explores how financial institutions can adopt the GBM from Bangladesh to finance Botswana MiEs. Apart from literature search, interviews were conducted among three commercial banks in Gaborone, Botswana to explore the banks’ awareness and willingness to apply the GBM in Botswana. Purposive sampling was used to select the three banks out of seven, in 2015. Findings show that commercial banks are not ready to accept the GBM as they fear losing money through defaulting customers. It is hoped that the findings will shed light on challenges and opportunities of implementing GBM in Botswana, and the possibility of applying it to reduce unemployment and alleviate poverty. It is recommended that Botswana Government invites Professor Yunus, Grameen Bank founder, to come and hold a workshop for bankers and other stakeholders; introducing GBM and its possible benefits to Botswana. The researchers recommend that local financial institutions should develop funding packages specifically for MiEs to grow their businesses.

SUPERVISION AS A STRATEGY IN QUALITY ASSURANCE IN SECONDARY SCHOOLS IN RIVERS STATE, NIGERIA

Supervision is an age old management practice usually employed to ensure functions are effectively carried out. It has remained a major strategy in education in order to hold teachers, learners’ providers, parents and even community accountable for the improvement and development of schools and their products. In this paper, supervision defined as provision of leadership in school setting is espoused as strategic tool to enthrone quality assurance in secondary schools. Article visualizations:

Retos de la implementación de los Sistemas de Archivos

En el documento se analiza la nueva dimensión otorgada a los archivos[ a partir de diversas reformas constitucionales y disposiciones legales relacionadas con los sistemas locales y nacional en materia de anticorrupción, fiscalización, transparencia, acceso a la información,datos personales y de archivos] que responsabiliza, a los sujetos obligados, a transitar de un concepto de archivo operativo a la de un archivo integrado a las políticas democratizadoras, como insumo de la transparencia, acceso a la información, derecho a la verdad y memoria colectiva, lo que conlleva obligaciones jurídicas, administrativas y sociales de alto nivel,entre ellas, el minimizar los riesgos por discrecionalidad y abuso de poder en la destrucción y /o extracción de documentos durante el proceso de implementación de los subsistemas institucionales (SSIAr) y sistema general de archivos (SGAr) especialmente en las épocas de transición, por relevos sexenales, trianuales o personales [entrega-recepción.

Current achievements and future developments of a novel AI based visual monitoring of beehives in ecotoxicology and for the monitoring of landscape structures.

Honey bees are valuable bioindicators. As such, they hold a vast potential to help shed light on the extent and interdependencies of factors influencing the decline in the number of insects. However, to date this potential has not yet been fully leveraged, as the production of reliable data requires large-scale study designs, which are very labour intensive and therefore costly. A novel Artificial Intelligence (AI) based visual monitoring system could enable the partial automatization of data collection on activity, forager loss and impairment of the central nervous system. The possibility to extract features from image data could prospectively also allow an assessment of pollen intake and a differentiation of dead bees, drones and worker bees as well as other insects such as wasps or hornets. The technology was validated in different studies with regards to its scalability and its ability to extract motion and feature related information. The prospective possibilities were analyzed regarding their potential to enable advances both within ecotoxicological research and the monitoring of pollinator habitats.

When, how, and why do fevers hold children hostage?

When, how, and why do fevers hold children hostage?

"Agrupados es la única forma” La experiencia solidaria y autónoma de la Cooperativa Chacay Mamil

espanolSon escasos los antecedentes de estudios sobre cooperativismo agrario en Patagonia, y mas aun en la region sur. Es por ello que el presente trabajo se propone analizar la conformacion y trayectoria de la cooperativa “Chacay Mamil” –ubicada en el departamento Tehuelches en la provincia de Chubut, Argentina–, como una estrategia de accion colectiva de un grupo de pequenos ganaderos. La cooperativa inicio sus actividades en el ano 2007 y en la actualidad participan activamente 35 asociados. La metodologia utilizada en el analisis y desarrollo de este trabajo es de caracter cualitativo, y el instrumento para la recoleccion de datos fue la entrevista en profundidad, realizada a diferentes socios, a quienes ocuparon y ocupan cargos directivos y a tecnicos que fueron parte de la gestion inicial. Asimismo, se analizaron fuentes documentales –libro de actas, memorias e informes de proyectos–. Del analisis de la trayectoria de la Cooperativa se desprende la importancia de los saberes previos y la experiencia acumulada de sus asociados a lo largo del proceso, como asi tambien el grado de independencia y autogestion alcanzada. Tambien queda en evidencia que la puesta en practica de los valores cooperativos les permitio dar respuesta a necesidades historicas. El trabajo posibilita ademas, reflexionar acerca del rol de las politicas publicas en el apoyo a iniciativas socio-organizativas en el ambito rural. EnglishThere are few studies on the history of agricultural cooperatives in Patagonia, and even more in the southern region. That is why the present work aims to analyze the conformation and trajectory of the cooperative “Chacay Mamil” –located in the department of Tehuelches in the province of Chubut, Argentina–, as a strategy of collective action of a group of small farmers. The cooperative began its activities in 2007 and currently 35 associates actively participate. The methodology used in the analysis and development of this work is of a qualitative nature, and the instrument for data collection was the in-depth interview, carried out with different partners, those who held and hold management positions and technicians who were part of the management initial. Likewise, documentary sources - minute book, memoirs and project reports - were analyzed. From the analysis of the trajectory of the Cooperative, the importance of previous knowledge and the accumulated experience of its associates throughout the process, as well as the degree of independence and self-management achieved, can be seen. It is also clear that the implementation of cooperative values allowed them to respond to historical needs. The work also makes it possible to reflect on the role of public policies in supporting socio-organizational initiatives in rural areas.

Sacks forcing and the shrink wrapping property

We consider a property stronger than the Sacks property, called the <em>shrink wrapping</em> property, which holds between the ground model and each Sacks forcing extension. Unlike the Sacks property, the shrink wrapping property does not hold between the

Voices: The Future of Metabolism

While reflecting upon the past five years of metabolic research, we asked leaders in the field what they envisioned the next five will hold and what challenges must be overcome. Here is an inspiring look onward to 2025, from leveraging technology and collaborations to advancing therapeutics and augmenting healthspan.

China: “What Kind of Government Is This?”

Inside the Outbreak “What kind of government is this?” Bella Zhang, a 25-year old perfume saleswoman with tinted blue hair asked as she sat outside a Wuhan hospital in February 2020 with her mother and younger brother, all three hooked to intravenous drips attached to a tree branch Since the hospital had no free beds, the whole family was quarantined at home, but visited the hospital for medication An epidemic could begin in any country, but not every political regime would labor to suppress news of its emergence (although the US president and Iran’s top leaders downplayed its dangers) 1 One saving grace for China was that its system could build new hospitals nearly overnight and regulate population movement to limit contagion Things fall apart;the centre cannot hold;Mere anarchy is loosed upon the world, The blood-dimmed tide is loosed, and everywhere The ceremony of innocence is drowned;Turning and turning in the widening gyre The best lack all conviction, while the worst Are full of passionate intensity The book contains sixty figures and tables illustrating such variables as “Increase in Chinese National Income Generated by One Unit of Fixed-Asset Investment, 1981–2012” and “China’s Gini Coefficient in Comparative Perspective ”

Benefits of mouth-dissolving turmeric lozenges among health-care workers: An Indian experience during COVID-19 pandemic

In this qualitative prospective survey, usefulness of a mouth-dissolving turmeric lozenge was evaluated among health-care workers (HCWs) directly involved in COVID-19 duty. 303, HCWs serving COVID-19 ward duties received a globally patented mouth-dissolving turmeric lozenge three times daily for 1 month as an additional protective intervention on top of the standard recommended preventive measures. An intervention that can control the portal of entry of the virus and its replication in the oral cavity must be considered for further research to control the pandemic. The preliminary results with this mouth-dissolving turmeric lozenge hold promise for further research in this area.

CLINICAL PROFILE AND OUTCOMES OF CRITICALLY ILL COVID-19 PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL

BACKGROUND: Ever since the COVID -19 pandemic took hold in India, its clinical characteristics, course of illness and outcome of critically ill patients requiring ICU care has not been studied in detail, especially in South India which bares almost one third of COVID-19 cases in India Hence this study is carried out to fill the gaps in identifying the population that are risk of severe illness and in management strategies AIM: To analyze the clinical profile and outcome of critically ill COVID -19 patients METHODOLOGY: This retrospective study was conducted in a tertiary care hospital based on medical records of those patients diagnosed with COVID -19 by RTPCR of nasopharyngeal and throat swabs or typical patterns on HRCT chest suggestive of COVID- 19 who required intensive care treatment RESULTS: Among study population (n=50), males were more commonly affected than females (82% versus 18%) The mean age of study population 55 96 ± 14 52years Dyspnea was the most common presenting symptom Diabetes Mellitus was the most common comorbidity The most common complication observed was ARDS(94%) History of smoking, hypertensives and those treated with tocilizumab had significantly higher mortality (p<0 05) Patients treated with antivirals has significantly better outcome The mean duration of ICU stay was 9 2±3 7 days mortality rate was 38% CONCLUSION: This study highlights the clinical characteristics, response to treatment and outcome among critically ill COVID -19 patients Delay in presentation, comorbidities and smoking history had higher chances of severe illness Early initiation of effective treatment can reduce the mortality rates

Re-Gendering the Hold: Fabienne Kanor's Ecological "Quarrel with History"

Re-Gendering the Hold: Fabienne Kanor's Ecological "Quarrel with History"

Democracy on Hold

Democracy on Hold

Treatment strategies of complicated extrahepatic bileduct stones

Complicated extrahepatic bile duct stone is defined as not easy to achieve the treatment standard of total stone clearance, stricture removal, unobstructed drainage and recurrence preventing in a single operation or combined with other liver diseases, which include hepatic hilar bile duct stones incarceration, distal bile duct stone incarceration, Mirizzi syndrome, residual cystic duct stones, recurrent extrahepatic bile duct stones, and combined with portal hypertension or intrahepatic bile duct stones. Through comprehensive and meticulous preoperative evaluation, we can clarify the cause of extrahepatic bile duct stones, the location of stones and bile duct stenosis, the variability of bile duct, the anatomy of the hepatoduodenal ligament, the condition of liver function and biliary tract infection, and make the proper surgery plan. During the surgery, we apply the perihilar surgical techniques, pancreatic hilar plate reduction techniques, Oddi sphincter incision and shaping, and choledochoscopic lithotripsy and lithotomy comprehensively to achieve the goal of reducing residual stone rate and recurrence rate. It is important that reasonably select endoscopic retrograde cholangiopancreatography indications, correctly hold indications of bilioenteric anastomosis, and prevent iatrogenic injury of extrahepatic bile ducts on the premise of clearing stones. Key words: Hepatolithiasis; Extrahepatic bileduct stone; Perihilar surgical techniques; Pancreatic hilar plate reduction techniques; Choledochoscope; Lithotripsy

An Argument for Existentialism

Existentialism about propositions is the view that a proposition expressed in a sentence containing a nonempty name or indexical depends ontologically on the referent of the name or indexical: the proposition could not exist if the referent did not. The paper focuses on names. It discusses some arguments for existentialism and then presents a novel one. That argument does not presuppose that propositions have constituents, and it could be accepted by those who hold broadly Fregean views about names. It shows that, for example, if Aristotle had not existed, no sentence could have meant that Aristotle is a philosopher. The paper also touches on the consequences of existentialism.

How to think about…INFORMATION

Information is a tricky concept to define. But get it right, and many physicists believe it could hold the secret to life, the universe and, yes, everything