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Prevocalic and postvocalic (unreleased) occurrences of a stop consonant differ in acoustic shape, but are not unrelated. In particular, the formant transitions taking place at release of a stop consonant approximately mirror in time the formant transitions occurring during closure, assuming that the vowel is the ~same. Several experiments have been performed using brief two-component tone burst approximations to the second and third formant transitions’ that occur in prevocalic and postvocalic allophones of/b, d, g/in order to determine whether such mirror-image acoustic patterns are perceptually related. Listener judgments of similarity within triads of these stimuli indicate that mirror-image patterrts representing the same place of articulation are less similar to each other than to patterns representing different places of articulation. Implications for the child who is acquiring language of the fact that mirror-image patterns in speech do not have inherent perceptual similarity are discussed.

Antibiotic treatment options for common infections are diminishing due to the proliferation of antimicrobial resistance (AMR). The impact of Antimicrobial Stewardship (AMS) programs seeking to preserve viable antibiotic drugs by governing their use in hospitals has hitherto been limited. Pharmacists have been delegated a critical role in antibiotic governance in AMS teams within hospitals but the experience of pharmacists in influencing antibiotic use has received limited attention. In this study we explore the experiences of pharmacists in antibiotic decision-making in two Australian hospitals.We conducted 19 semi-structured interviews to explore hospital-based pharmacists' perceptions and experiences of antibiotic use and governance. The analysis was conducted with NVivo10 software, utilising the framework approach.Three major themes emerged in the pharmacist interviews including (1) the responsibilities of pharmacy in optimising antibiotic use and the interprofessional challenges therein; (2) the importance of antibiotic streamlining and the constraints placed on pharmacists in achieving this; and (3) the potential, but often under-utilised expertise, pharmacists bring to antibiotic optimisation.Pharmacists have a critical role in AMS teams but their capacity to enact change is limited by entrenched interprofessional dynamics. Identifying how hospital pharmacy's antibiotic gatekeeping is embedded in the interprofessional nature of clinical decision-making and limited by organisational environment has important implications for the implementation of hospital policies seeking to streamline antibiotic use. Resource constraints (i.e. time limitation and task prioritisation) in particular limit the capacity of pharmacists to overcome the interprofessional barriers through development of stronger collaborative relationships. The results of this study suggest that to enact change in antibiotic use in hospitals, pharmacists must be supported in their negotiations with doctors, have increased presence on hospital wards, and must be given opportunities to pass on specialist knowledge within multidisciplinary clinical teams.

Abstract Background Nurses are put at high risk of work-related low back pain due to the nature of their work. The aim of this study was to develop and evaluate intervention based on the PRECEDE-PROCEED Model on promoting behaviors of low back health via two educational approaches. Methods This study was a community randomized-controlled clinical trial. The educational content was developed with six modules: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors, and behavior. Intervention was delivered by two modes: (1) in-person (n = 60) and (2) social media (n = 60). Data were evaluated by a self-designed questionnaire at baseline, 3, and 6 months. Baseline comparisons between groups were made with Mann-Whitney U Test and T-Test. Comparison of change scores between groups and two delivery types across the three time periods used the mixed between-within subject analysis of variance. Results A total of 120 nurses received the allocated intervention. All educational component scores increased at 3-months in both groups. At the 6-month follow-up scores increased for enabling factors and behavior in the intervention group, while in the control group all scores increased except for attitude. Based on Bonferroni Post hoc analysis social media was more effective in knowledge, self-efficacy, reinforcing factors, and behavior than the in-person intervention. Conclusion An educational program for low back health based on the PRECEDE-PROCEED model proved effective at improving all components. However, social media was more successful than in-person in the maintenance of behavior over the long term. Trial registration: IRCT20170313033054N2: 25-02-2018.https://www.irct.ir/trial/25598

Este artículo presenta aspectos de la investigación sobre productividad en enfermería, realizada como trabajo de grado por las estudiantes de enfermería Castellanos, García y Gómez (1), de la Facultad de Enfermería de la Universidad Nacional de Colombia, y dirigida por la profesora Myriam Abaunza de González quien es consciente de la importancia de realizar estudios en enfermería relacionados con su productividad. La investigación plantea como principal objetivo identificar en qué consiste la productividad en enfermería y utiliza como método la monografía, mediante una matriz de análisis bibliográfico. En la discusión la investigación referencia conceptos e investigaciones de diferentes autores sobre productividad en enfermería y reflexiona sobre los resultados y hallazgos encontrados. Destaca como resultados que la productividad se relaciona y se centra en la eficiencia, la eficacia y la efectividad, aspectos que se vinculan con los productos o intervenciones que realiza enfermería, los cuales es necesario conocer y dar a conocer exactamente, así como establecer sus logros. De igual manera se aprecia la relación de la productividad en enfermería con los conceptos de calidad, ambiente laboral y costos, y que las principales características comunes que relacionan, determinan, afectan o definen la productividad en enfermería son condiciones laborales, condiciones personales y factores externosEsse artigo apresenta aspectos da pesquisa sobre produtividade na enfermagem, realizado como trabalho de formatura pelas estudantes de enfermagem, Castellanos, García eGómez (1), da Faculdade de Enfermagem da Universidade Nacional da Colômbia, e dirigida pela professora Myriam Abaunza de González quem é consciente da importância de realizar estudos sobre enfermagem relativos à produtividade. A pesquisa coloca como principal objetivo identificar a definição da produtividade no contexto da enfermagem e utiliza como método a monografia, mediante uma matriz de analise bibliográfico. Na discussão a pesquisa se refere a conceitos e pesquisas de diferentes autores sobre produtividade no contexto da enfermagem e reflete sobre os resultados e achados encontrados. Salienta como resultado que a produtividade está relacionada e focada na eficiência, na eficácia e na efetividade, aspectos vinculados com os produtos ou intervenções realizadas na área da enfermagem, os quais, conjuntamente com seus logros, devem ser conhecidos e dados a conhecer com precisão. Igualmente, evidencia-se a relação da produtividade no âmbito da enfermagem com os conceitos de qualidade, ambiente de trabalho e custos, e que as principais características comuns que se relacionam, determinam, afetam ou definem a produtividade correspondem a condições pessoais e fatores externosThis article presents aspects of the research on nursing productivity, carried out as graduation work by the nursing students Castellanos, García and Gómez (1), of the Nursing Faculty of the Universidad Nacional de Colombia and directed by professor Myriam Abaunza de González who is aware of the importance of carrying out nursing studies concerning productivity. The main objective of the research is to identify what nursing productivity is and it uses a monograph as the method through a bibliographic analysis matrix. In the discussion, the research indexes concepts and research by different authors on nursing productivity and reflects over the results and findings. It highlights as results that productivity is related to and focused on efficiency, efficacy and effectiveness, aspects linked to products or interventions performed by nursing practitioners, whichshouldbeknown anddisseminated, andtheir achievements should be established. Also, the relationship between nursing productivity and quality concepts, work environment and costs is clearly seen, as well as the fact that the common characteristics that link, determine, affect or define nursing productivity are work conditions, personal conditions and external aspects

Summary ‘Partnership caring’ emphasizes the current paediatric practices and their importance in paediatric nursing Today. The importance in not compromising care in a rapidly changing health scene is described when shrinking resources and increasing constraints put pressure on the health services. Important concepts such as pre‐admission programmes, creating the right environment for the child, family‐centred care, parent participation, family accommodation and supporting services, nursing documentation, the rights of the child and family, specialist and community nursing services as well as children's out‐patient services providing the vital link in the continuum of care are all emphasized. They show how these became ideas 5–6 years ago but are now firmly established in the philosophy of family‐centred care. In the new health service today, paediatric nurses face new challenges which emanate from the children and parents served, but also from within new clinical directorate structures. ‘However, within our new world of clinical directorates and when the clinical director has the executive authority to make and influence decisions, and when segmentalization of paediatric services becomes a real threat (and in some places this is happening now!) paediatric nurses must remember the children. We must stand firm in our values and beliefs and above all we must not allow these changes to compromise the care we give to children and their families.’