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Graphical abstract Highlights • Climate change and human toxicity important in LCA of electrical traction machines. • Complete manufacturing range within 1.7–2.0 g CO 2 -eq./km for all studied motors. • Copper production is significant for toxicity impacts and effects on human health. • Design focus: energy efficiency, housings, end-windings, laminates and disassembly. Abstract Ongoing development of electrified road vehicles entails a risk of conflict between resource issues and the reduction of greenhouse gas emissions. In this study, the environmental impact of the core design and magnet material for three electric vehicle traction motors was explored with life cycle assessment (LCA): two permanent magnet synchronous machines with neodymium-dysprosium-iron-boron or samarium-cobalt magnets, and a permanent magnet-assisted synchronous reluctance machine (PM-assisted SynRM) with strontium-ferrite magnets. These combinations of motor types and magnets, although highly relevant for vehicles, are new subjects for LCA. The study included substantial data compilation, machine design and drive-cycle calculations. All motors handle equal take-off, top speed, and driving conditions. The production (except of magnets) and use phases are modeled for two countries – Sweden and the USA – to exemplify the effects of different electricity supply. Impacts on climate change and human toxicity were found to be most important. Complete manufacturing range within 1.7–2.0 g CO 2 -eq./km for all options. The PM-assisted SynRM has the highest efficiency and lowest emissions of CO 2. Copper production is significant for toxicity impacts and effects on human health, with problematic emissions from mining. Resource depletion results are divergent depending on evaluation method, but a sensitivity analysis proved other results to be robust. Key motor design targets are identified: high energy efficiency, slender housings, compact end-windings, segmented laminates to reduce production scrap, and easy disassembly. [ABSTRACT FROM AUTHOR]

Background and Purpose: Nurses have been called to lead the transformation of health care to provide more efficient, safe, high quality care. However, little is known about how to prepare and enable critical access hospital (CAH) nurse executives to lead change. Research indicates that Magnet ®-designated hospitals have significantly better patient and organizational outcomes as compared to non-Magnet hospitals. The purpose of this study was to synthesize challenges faced by CAH nurse executives and provide research-informed recommendations for leading change to achieve Magnet standards in CAHs. Sample and Methods: A review of the literature was conducted to understand the historical development of CAHs and to identify challenges faced by CAH nurse executives. CINAHL, PubMed, and the Rural Health Information Hub databases were searched for relevant peer- reviewed studies and expert commentary published in English from 2007 to 2016. Thirty-four articles were synthesized. Findings: CAH nurse executives face significant challenges to ensuring their hospitals are providing high quality care including: (a) recruitment, retention, and appropriate staffing ratios; (b) the need for nursing staff with multispecialist knowledge; (c) fewer baccalaureate-prepared nurses; and (d) lack of financial and human resources to support new graduate nurse transition, continuing education, and evidence-based practice. Recommendations for CAH nurse executives seeking to achieve Magnet standards were developed from interviews with healthcare professionals (N = 27) at the first independent CAH to achieve Magnet designation. Conclusions: CAH nurse executives may consider the Magnet standards as a blueprint for leading change to improve organizational outcomes. Consideration should be given to: (a) securing administrative leadership support; (b) strategically planning for small, incremental change; (c) building shared governance, quality improvement, research, and education; (d) harnessing collective power; and (e) believing and staying committed to the purpose of improving staff and patient outcomes. [ABSTRACT FROM AUTHOR]

Nursing research in the United States (US) spans several decades. Many of the priorities/trends have stayed through the years. Today, the goal of producing evidence to support nursing care interventions coupled with the drive for Magnet Recognition has encouraged academic nurses (faculty) to work with nurse clinicians to form research teams. Interdisciplinary research teams have also formed to address growing concerns over patient safety and quality care. These issues are not just US issues but global ones. This article addresses US trends with the link to global research trends. The role that organizations such as the International Council of Nurses (ICN), the World Health Organization (WHO), and the Council of International Neonatal Nurses, Inc. (COINN) pay in shaping research agendas and promoting nursing research is highlighted. It emphasizes the key role that nurses, especially nurse leaders/administrators play in changing health outcomes through support of nursing research. [ABSTRACT FROM AUTHOR]

Abstract: Foreign body ingestions are common in pediatric patients and represent a challenge for the pediatric endoscopist. The most common objects ingested by children in the United States are coins, although toys and batteries account for a significant fraction of ingestions. The timing of and requirement for endoscopy is based on the type of foreign body ingested, its location, and the presence or absence of symptoms. In some cases, ingested foreign bodies require urgent removal even in asymptomatic patients. This is the case, for example, with esophageal batteries. In smaller pediatric patients, the size of the foreign body is an important factor in determining the timing and requirement for endoscopy, and the management may differ as compared with adults. Areas of anatomic narrowing or disease may be an underlying reason why a foreign body becomes lodged, and endoscopists are cautioned against blindly advancing a foreign body or meat impaction distally. Various techniques and endoscopic equipment are used to remove ingested foreign bodies in children, including specialized forceps, baskets, snares, nets, and friction fit adapters, and these are discussed. [Copyright &y& Elsevier]

Objectives: We sought to magnetically tag endothelial progenitor cells (EPCs) with a clinical agent and target them to a site of arterial injury using a magnetic device positioned outside the body. Background: Circulating EPCs are involved in physiological processes such as vascular re-endothelialization and post-ischemic neovascularization. However, the success of cell therapies depends on the ability to deliver the cells to the site of injury. Methods: Human EPCs were labeled with iron oxide superparamagnetic nanoparticles. Cell viability and differentiation were tested using flow cytometry. Following finite element modeling computer simulations and flow testing in vitro, angioplasty was performed on rat common carotid arteries to denude the endothelium and EPCs were administered with and without the presence of an external magnetic device for 12 min. Results: Computer simulations indicated successful external magnetic cell targeting from a vessel with flow rate similar to a rat common carotid artery; correspondingly there was a 6-fold increase in cell capture in an in vitro flow system. Targeting enhanced cell retention at the site of injury by 5-fold at 24 h after implantation in vivo. Conclusions: Using an externally applied magnetic device, we have been able to enhance EPC localization at a site of common carotid artery injury. This technology could be more widely adapted to localize cells in other organs and may provide a useful tool for the systemic injection of cell therapies. [Copyright &y& Elsevier]

As part of the High Field Magnet program at Fermilab several NbTi and Nb3Sn strands were tested with particular emphasis on the study of voltage spikes and their relationship to superconductor instabilities. The voltage spikes were detected under various experimental conditions using voltage-current (V-I) and voltage-field (V-H) methods. Two types of spikes, designated ‘magnetization’ and ‘transport current’ spikes, have been identified. Their origin is most likely related to magnetization flux jump and transport current redistribution, respectively. Many of the signals observed appear to be a combination of these two types of spikes; the combination of these two instability mechanisms should play a dominant role in determining the minimum quench current. [ABSTRACT FROM AUTHOR]

Donabedian's Structure-Process-Outcome paradigm is used to analyze the evolution and research on the concept of magnetism through 4 phases. The identifying foci of the original 1983 study were 4 outcomes. A large number and array of structural features were derived from the identified Magnet hospitals. The quest for excellence in nursing care continued with the Gold Standard of Magnetism case studies utilizing all identified Magnet structures, processes, and outcomes. The advent of the American Nurses Credentialing Center Magnet Recognition Program stimulated much valuable and insightful research related to outcomes associated with the large group of magnetic structures. Magnet hospital staff nurses (SNs) identification of processes/functions most essential to quality patient care highlights the Process phase. Many of the vast array of structural features attributed to Magnet hospital in 1983 are outdated and differentially defined and have not been tested for their relationship to either processes or outcomes. Identification of magnetism from an SN perspective has lagged. Recommendations include updating and clarifying structural criteria; increasing focus on the SN perspective of magnetism by continuing identification of processes; and challenging leadership in Magnet hospitals to initiate multisite evidence-based practice initiatives to link structures with process-enabling outcomes. Now may well be the time for nursing to exert leadership in expanding the Magnet concept to the total patient-care operation in a hospital. [ABSTRACT FROM AUTHOR]

Hospitals across the country have been struggling with nursing shortages for more than 2 decades. Today, more than 126,000 nursing positions are vacant, according to the American Nurses Credentialing Center, and that number is expected to skyrocket as an aging population puts unprecedented demands on the nation's healthcare system. Through the Magnet Designation program established by the American Nurses Credentialing Center, hospitals around the country are finding creative ways to attract and retain quality nurses. At Poudre Valley Hospital, the program also has improved patient outcomes, boosted market share, and created an employee culture of teamwork, empowerment, respect, integrity, and caring. [ABSTRACT FROM AUTHOR]

Objectives: To describe the emerging role of the nurse scientist in health care organizations. Historical perspectives of the role are explored along with the roles of the nurse scientist, facilitators, barriers, and future implications., Data Sources: Relevant literature on evidence-based practice and research in health care organizations; nurse scientist role; interview with University of Colorado nurse scientist., Conclusion: The nurse scientist role is integral for expanding evidence-based decisions and nursing research. A research mentor is considered the most important facilitator for a successful nursing research program., Implications for Nursing Practice: Organizations should consider including the nurse scientist role to facilitate evidence-based practice and expand opportunities for nursing research., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: The Magnet model proposes an accreditation for hospitals having demonstrated a healthy work environment and, as a result, positive staff and patient outcomes. Yet there are conflicting findings surrounding the actual impact of Magnet's organizational model on these outcomes, as well as a wide range of designs influencing the quality of these results., Objectives: To conduct a systematic review that explores the effect of Magnet accreditation on objective nurse and patient outcomes., Types of Participants: Magnet and non-Magnet accredited hospitals matched according to their similarity (e.g. size, type [urban or rural], level of acuity, location, etc.). Hospitals could be either university based or non-teaching hospitals and in any geographical location. As the focus of the study was outcomes specific to Magnet accreditation, studies reporting on "reputational Magnets" (the original hospitals), Magnet-aspiring and non-Magnet hospitals alone were excluded from the review. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: Exposure to Magnet accreditation. A Magnet hospital is defined as a hospital with American Nursing Credentialing Center -designated Magnet status at the time of study and having received this accreditation in the last four years, as this is the length of time for which the accreditation is valid, after which the hospital must reapply for another four-year accreditation. TYPES OF STUDIES: This review considered any quantitative study comparing nurse and patient outcomes in Magnet accredited hospitals with those in non-Magnet hospitals. Controlled clinical trials, controlled before and after and interrupted time series were considered first. When these were not available, case-controlled, descriptive comparative and descriptive correlational designs were considered. All studies presenting a "case study" with no comparison and other studies reporting on interviews and other qualitative data were excluded. TYPES OF OUTCOMES: The outcomes of interest were nurse outcomes related to turnover and absenteeism, as measured by the actual turnover rate if available, or the Anticipated Turnover Scale, the Revised Nursing Work Index or the Maslach Burnout Inventory, as well as nursing-sensitive patient outcomes (such as fall rates and hospital-acquired pressure ulcers) as measured by retrospective patient records, discharge abstracts, incident reports and reimbursement forms., Search Strategy: Both published and unpublished literature between 1994 and 2014 were searched. The electronic databases searched were the following: CINAHL, MEDLINE, EMBASE, Academic Search Complete and Web of Science. Other resources included ProQuest Dissertations & Theses Database /Dissertation Abstracts Online and OpenGrey, the American Hospital Association and the American Nurses Credentialing Center websites, and the Sigma Theta Tau International library of abstracts. In April 2015, a search update was conducted including the years 2014-2015 in the databases listed above., Methodological Quality: No cut-off point for the Joanna Briggs Institute appraisal tool criteria was selected for inclusion of studies., Data Extraction: Data from included studies were extracted using the Joanna Briggs Institute Data Extraction Form for experimental/observational studies. Two reviewers extracted the data independently and results were compared for accuracy and categorized according to nurse and patient outcomes., Data Synthesis: All the studies analyzed retrospective data obtained from either combined databases or from questionnaires. The methodological heterogeneity and poor quality of the designs did not make it possible to pool quantitative results in a statistical meta-analysis. Results are presented in descriptive narrative form., Results: From the 141 screened studies, ten met the inclusion criteria. Nine of these studies were retrospective analyses of data extracted from existing databases, one study collected original data. Of the seven studies examining patient outcomes, three found clear statistically significant improvements related to lower pressure ulcers, patient falls, failure to rescue and 30-day inpatient mortality in Magnet hospitals compared to non-Magnet hospitals. In the studies examining nurse outcomes, three found statistically significant improvements related to higher job satisfaction and lower intent to leave and turnover rates in Magnet compared to non-Magnet hospitals., Conclusions: Based on the mixed results and poor quality in the research designs in the ten included studies, it was not possible to conclude that Magnet accreditation has effects on nurse and patient outcomes. There is a need for more robust designs that can confidently measure the impact of hospital accreditation on objective outcomes., (The Joanna Briggs Institute.)

The PRECICE(®) Intramedullary Limb Lengthening System (Ellipse Technologies Inc., CA, USA) is a remotely controlled, magnetically driven, implantable limb lengthening intramedullary nail system. It has both CE mark and US FDA clearance for its first- (2011) and second-generation (2013) implants. It is indicated for the treatment of limb length discrepancy and short stature. It has been used worldwide in over 1000 cases. Its reported and published results in over 250 cases has been excellent with less pain and lower complication rates than with external fixation methods or previous implantable nail systems.

The number of board-certified RNs in the United States continues to increase, but cost and fear of failure inhibit many from seeking certification. In 2009, the Pediatric Nursing Certification Board developed a no-risk program called No Pass, No Pay (NPNP) for its Certified Pediatric Nurse (CPN®) exam. In 2012, 49% of the 2299 nurses earning CPN certification did so through NPNP. This article explores program structure, successes, and findings from 2011 stakeholder surveys of NPNP hospital leaders, NPNP program facilitators, and nurses who attained CPN certification through NPNP. Aspects of NPNP may prove applicable to other certification boards., (Copyright © 2014 Elsevier Inc. All rights reserved.)

A national research agenda is needed to promote inquiry into the impact of credentialing on health care outcomes for nurses, patients, and organizations. Credentialing is used here to refer to individual credentialing, such as certification for nurses, and organizational credentialing, such as American Nurses Credentialing Center Magnet recognition for health care organizations or accreditation of providers of continuing education in nursing. Although it is hypothesized that credentialing leads to a higher quality of care, more uniform practice, and better patient outcomes, the research evidence to validate these views is limited. This article proposes a conceptual model in which both credentials and standards are posited to affect outcomes in health care. Potential research questions as well as issues in research design, measurement, data collection, and analysis are discussed. Credentialing in nursing has implications for the health care professions and national policy. A growing body of independent research that clarifies the relationship of credentialing in nursing to outcomes can make important contributions to the improvement of health care quality., (Copyright © 2014 Elsevier Inc. All rights reserved.)

This study describes the epidemiology of rare-earth magnet ingestion by children by retrospectively analyzing 72 cases of magnet ingestion collected from Saferproducts.gov and the US Consumer Product Safety Commission from 2000 through 2012. The mean child age was 6.4 years. Patients ingested between 1 and 40 magnets, most often 1 to 4 magnets. Unique circumstances of ingestion included faux piercing (19.4%) and mistaking magnets for candy (6.9%). Surgery was required in 69.7% of cases where treatment was reported. Fifty-three patients were hospitalized (73.6%), and the length of hospital stay was reported in 58.5% of those cases, ranging from 1 to 54 days. Approximately half (50.7%) of the magnets causing injury were products intended for use by adults. Study findings demonstrate that pediatric ingestion of rare-earth magnets can cause serious gastrointestinal injury. Establishing a performance standard that limits the attraction force of these magnets offers the best prevention solution to this important pediatric public health problem.