Aim
To present and discuss the main themes that were revealed following an analysis of the qualitative research findings that were extracted from a national survey regarding the causes and effects of ...moral distress amongst New Zealand nurses.
Background/Introduction
Moral distress continues to be a major concern amongst nurses around the world. In New Zealand, a country where nurses have just been on strike over their working conditions and the deteriorating state of their roles within the health services, it remains a major issue.
Method
In the original research project, large numbers of nurses supplied not only quantitative data that revealed the extent and impact of moral distress on their practices, but also extensive notes that more specifically explained the causes and effects of their moral distress. This material has since been thematically analysed and is now presented.
Findings/results
The data strongly suggested that New Zealand nurses experienced and attempted to respond to several major issues; that is, they were not properly supported by ‘the system’, frequently experienced problems with managers and bullying, witnessing poor care practices and collegial incompetence, and suffered from ongoing problems caused by moral residue.
Conclusion
Under current working conditions, nurses are struggling under an increasing weight of moral residue to maintain their ethical standards within an increasingly difficult ethical climate.
Implications for nursing and health policy
This research suggests that although nurses clearly seek out and use various ways to cope with moral distress in their practices, there is a continuing need for moral courage and strengthening of moral resilience that involves greater input from not just nurses themselves, but nurse managers, educators and other health services representatives.
We derive rigorous truncation-error bounds for the spin-boson model and its generalizations to arbitrary quantum systems interacting with bosonic baths. For the numerical simulation of such baths, ...the truncation of both the number of modes and the local Hilbert-space dimensions is necessary. We derive superexponential Lieb-Robinson-type bounds on the error when restricting the bath to finitely many modes and show how the error introduced by truncating the local Hilbert spaces may be efficiently monitored numerically. In this way we give error bounds for approximating the infinite system by a finite-dimensional one. As a consequence, numerical simulations such as the time-evolving density with orthogonal polynomials algorithm (TEDOPA) now allow for the fully certified treatment of the system-environment interaction.
Background: Cancer survival is known to vary by socio-economic group. A review of studies published by 1995 showed this association to be universal and resilient to the many different ways in which ...socio-economic status was determined. Differences were most commonly attributed to differences in stage of disease at diagnosis. Materials and methods: A review of research published since 1995 examining the association of cancer survival with socio-economic variables. Results: An association between socio-economic status and cancer survival has continued to be demonstrated in the last decade of research. Stage at diagnosis and differences in treatment have been cited as the most important explanatory factors. Some research has evaluated the psychosocial elements of this association. Conclusions: Socio-economic differences in cancer survival are now well documented. The explanatory power of stage at diagnosis, although great, should not detract from the evidence of differential treatment between social groups. Neither factor can completely explain the observed socio-economic differences in survival, however, and the importance of differences in tumour and patient factors should now be quantified.
Two-dimensional (2D), layered transition metal dichalcogenides (TMDCs) can grow in two different growth directions, that is, horizontal and vertical. In the horizontal growth, 2D TMDC layers grow in ...planar direction with their basal planes parallel to growth substrates. In the vertical growth, 2D TMDC layers grow standing upright on growth substrates exposing their edge sites rather than their basal planes. The two distinct morphologies present unique materials properties suitable for specific applications, such as horizontal TMDCs for optoelectronics and vertical TMDCs for electrochemical reactions. Precise control of the growth orientation is essential for realizing the true potential of these 2D materials for large-scale, practical applications. In this Letter, we investigate the transition of vertical-to-horizontal growth directions in 2D molybdenum (or tungsten) disulfide and study the underlying growth mechanisms and parameters that dictate such transition. We reveal that the thickness of metal seed layers plays a critical role in determining their growth directions. With thick (>∼3 nm) seed layers, the vertical growth is dominant, while the horizontal growth occurs with thinner seed layers. This finding enables the synthesis of novel 2D TMDC heterostructures with anisotropic layer orientations and transport properties. The present study paves a way for developing a new class of 2D TMDCs with unconventional materials properties.
Interactions induced by electromagnetic fluctuations, such as van der Waals and Casimir forces, are of universal nature present at any length scale between any types of systems. Such interactions are ...important not only for the fundamental science of materials behavior, but also for the design and improvement of micro- and nanostructured devices. In the past decade, many new materials have become available, which has stimulated the need for understanding their dispersive interactions. The field of van der Waals and Casimir forces has experienced an impetus in terms of developing novel theoretical and computational methods to provide new insights into related phenomena. The understanding of such forces has far reaching consequences as it bridges concepts in materials, atomic and molecular physics, condensed-matter physics, high-energy physics, chemistry, and biology. This review summarizes major breakthroughs and emphasizes the common origin of van der Waals and Casimir interactions. Progress related to novel ab initio modeling approaches and their application in various systems, interactions in materials with Dirac-like spectra, force manipulations through nontrivial boundary conditions, and applications of van der Waals forces in organic and biological matter are examined. The outlook of the review is to give the scientific community a materials perspective of van der Waals and Casimir phenomena and stimulate the development of experimental techniques and applications.
Transition metal dichalcogenides (TMDCs) are a promising class of two-dimensional (2D) materials for use in applications such as 2D electronics, optoelectronics, and catalysis. Due to the van der ...Waals (vdW) bonding between layers, vdW heterostructures can be constructed between two different species of TMDCs. Most studies employ exfoliation or co-vapor growth schemes, which are limited by the small size and uneven distribution of heterostructures on the growth substrate. In this work we demonstrate a one-step synthesis procedure for large-area vdW heterostructures between horizontal TMDCs MoS2 and WS2. The synthesis procedure is scalable and provides patterning ability, which is critical for electronic applications in integrated circuits. We demonstrate rectification characteristics of large-area MoS2/WS2 stacks. In addition, hydrogen evolution reaction performance was measured in these horizontal MoS2 and WS2 thin films, which indicate that, in addition to the catalytically active sulfur edge sites, defect sites may serve as catalyst sites.
Changes in disturbance regimes due to climate change are increasingly challenging the capacity of ecosystems to absorb recurrent shocks and reassemble afterwards, escalating the risk of widespread ...ecological collapse of current ecosystems and the emergence of novel assemblages
. In marine systems, the production of larvae and recruitment of functionally important species are fundamental processes for rebuilding depleted adult populations, maintaining resilience and avoiding regime shifts in the face of rising environmental pressures
. Here we document a regional-scale shift in stock-recruitment relationships of corals along the Great Barrier Reef-the world's largest coral reef system-following unprecedented back-to-back mass bleaching events caused by global warming. As a consequence of mass mortality of adult brood stock in 2016 and 2017 owing to heat stress
, the amount of larval recruitment declined in 2018 by 89% compared to historical levels. For the first time, brooding pocilloporids replaced spawning acroporids as the dominant taxon in the depleted recruitment pool. The collapse in stock-recruitment relationships indicates that the low resistance of adult brood stocks to repeated episodes of coral bleaching is inexorably tied to an impaired capacity for recovery, which highlights the multifaceted processes that underlie the global decline of coral reefs. The extent to which the Great Barrier Reef will be able to recover from the collapse in stock-recruitment relationships remains uncertain, given the projected increased frequency of extreme climate events over the next two decades
.
There is a wide variety of cancer types yet, all share some common cellular and molecular behaviors. Most of the chemotherapeutic agents used in cancer treatment are designed to target common ...deregulated mechanisms within cancer cells. Many healthy tissues are also affected by the cytotoxic effects of these chemical agents. Fucoidan, a natural component of brown seaweed, has anti-cancer activity against various cancer types by targeting key apoptotic molecules. It also has beneficial effects as it can protect against toxicity associated with chemotherapeutic agents and radiation. Thus the synergistic effect of fucoidan with current anti-cancer agents is of considerable interest. This review discusses the mechanisms by which fucoidan retards tumor development, eradicates tumor cells and synergizes with anti-cancer chemotherapeutic agents. Challenges to the development of fucoidan as an anti-cancer agent will also be discussed.
The Large Underground Xenon (LUX) experiment is a dual-phase xenon time-projection chamber operating at the Sanford Underground Research Facility (Lead, South Dakota). The LUX cryostat was filled for ...the first time in the underground laboratory in February 2013. We report results of the first WIMP search data set, taken during the period from April to August 2013, presenting the analysis of 85.3 live days of data with a fiducial volume of 118 kg. A profile-likelihood analysis technique shows our data to be consistent with the background-only hypothesis, allowing 90% confidence limits to be set on spin-independent WIMP-nucleon elastic scattering with a minimum upper limit on the cross section of 7.6 × 10(-46) cm(2) at a WIMP mass of 33 GeV/c(2). We find that the LUX data are in disagreement with low-mass WIMP signal interpretations of the results from several recent direct detection experiments.
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