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Findings suggest that a leadership intervention has the potential to influence nurses' use of guideline recommendations, but further work is required to refine the intervention and outcome measures. A taxonomy of leadership behaviors is proposed to inform future research.

BackgroundNewborn weight measurements are used as a key indicator of breastfeeding adequacy. The purpose of this study was to explore non-feeding factors that might be related to newborn weight loss. The relationship between the intravenous fluids women receive during parturition (the act of giving birth, including time in labour or prior to a caesarean section) and their newborn's weight loss during the first 72 hours postpartum was the primary interest.MethodsIn this observational cohort study, we collected data about maternal oral and IV fluids during labour or before a caesarean section. Participants (n = 109) weighed their newborns every 12 hours for the first three days then daily to Day 14, and they weighed neonatal output (voids and stools) for three days.ResultsAt 60 hours (nadir), mean newborn weight loss was 6.57% (SD 2.51; n = 96, range 1.83-13.06%). When groups, based on maternal fluids, were compared (≤1200 mls [n = 21] versus > 1200 [n = 53]), newborns lost 5.51% versus 6.93% (p = 0.03), respectively. For the first 24 hours, bivariate analyses show positive relationships between a) neonatal output and percentage of newborn weight lost (r(96) = 0.493, p < 0.001); and b) maternal IV fluids (final 2 hours) and neonatal output (r(42) = 0.383, p = 0.012). At 72 hours, there was a positive correlation between grams of weight lost and all maternal fluids (r(75) = 0.309, p = 0.007).ConclusionsTiming and amounts of maternal IV fluids appear correlated to neonatal output and newborn weight loss. Neonates appear to experience diuresis and correct their fluid status in the first 24 hours. We recommend a measurement at 24 hours, instead of birth weight, for baseline when assessing weight change. Because practices can differ between maternity settings, we further suggest that clinicians should collect and analyze data from dyads in their care to determine an optimal baseline measurement.

he public health sector is experiencing recruitment and retention issues similar to those in other areas of the Canadian health system; the current workforce is aging and replacing and retaining such expertise is challenging. 1-3 Job dissatisfaction has been linked to retention issues, absenteeism, increased costs, and ultimately diminished client outcomes. 4-6 As nurses constitute the largest professional group of national public health human resources, 1,3,7 it would be beneficial to gain a better understanding of the determinants of their job satisfaction. Given the direction of health system reform that necessitates moving clients quickly from acute care settings into the community, 8 some have predicted that 60% of the Canadian nursing workforce will work in the community sector by 2020. 9 This projected increase in demand will have to be addressed in the context of an estimated shortage of 60,000 registered nurses by 2022; 10 this constitutes over 25% of the current Canadian nursing workforce. 11 No data currently exist identifying the future demands for public health nurses (PHNs), a specialized subsector of community nurses, however Canadian public health realities-including an aging population, higher prevalence of chronic conditions, and threats from infectious disease-suggest that there will be a need to increase or, at minimum, maintain the current PHN workforce. Due to the use of varying nomenclature and the diversity of roles and responsibilities across the country, enumeration of Canadian PHNs is difficult. 12 In their day-today work, PHNs identify and act on the sociopolitical conditions that contribute to Canadian population health inequities and are in a position to provide valuable insight to inform policy decisions. 12,13 Recent research has identified that effective Canadian health human resource planning requires service delivery strategies ensuring that PHNs are used to their full potential. 14 Positive work environments and job satisfaction would facilitate this objective. This secondary analysis of data selected from the 2005 National Survey of the Work and Health of Nurses (NSWHN) was undertaken to determine the relationships between Canadian PHNs' job satisfaction and their autonomy, control-over-practice, and workload. Previous research has demonstrated the applicability of these

Interventions should be offered based on caregivers' needs rather than patients' health outcomes, and should focus on fostering caregivers' feelings of personal gain, assisting them with securing social support, and engaging in valued activities.

"Burden of care" is a term that describes the effects of the multifaceted stressors associated with providing care to an ill family member. Descriptions of burden of care in acute care populations, such as families of patients who have had coronary artery bypass grafting, are very limited. The three purposes of this study were to describe the burden of care in families of coronary artery bypass grafting surgery patients, to compare the burden of care in families grouped by length of stay, and to provide evidence for the validity of the Caregiving Burden Scale in acute care populations. A survey was done using a longitudinal design over the first six weeks following coronary artery bypass grafting surgery. The 124 spouses of coronary artery bypass grafting surgery patients who participated reported a moderate degree of burden in caring for post cardiac surgery family members. Providing emotional support, taking over household tasks, and monitoring patients' conditions created the greatest burden for the participants. Length of stay in hospital did not have an impact on burden of care. The analysis of the data supports the validity of the Care-giving Burden Scale when used in the cardiac surgery population. (Prog Cardiovasc).

Background: The Multistakeholder Framework of Rurality project was funded by Health Canada's Rural and Remote Health Innovations Initiative. The aim of this project was to develop a tool to assist rural communities with health human resource planning and to help governments and communities in recruiting and retaining health care providers in rural and remote communities. Methods: A national survey was sent to nurses, physicians, and pharmacists living in rural or remote communities to determine, among other factors, satisfaction with their personal and professional lives in those communities. One of the questions asked in the survey was “Do you plan to be in practice in the community in two years?” Results: Completed surveys were returned by 1019 pharmacists. Pharmacists who were married, had children living at home, were between the ages of 35 and 54 years, and had between 6 and 24 years in practice were more likely to say they would remain in the community. Communities where there were better working hours, better availability of coverage and backup, higher earning potential, and greater opportunities were more likely to retain pharmacists, as were communities where there were better opportunities for family members. Pharmacists were also more likely to state an intention to remain in communities where they had a sense of belonging and a sense of being appreciated. Multivariate predictors of pharmacists' intent to remain were children living at home, professional factors, and personal factors. Conclusions/Implications: Despite some study limitations, the results presented here could be used to help communities select pharmacists who are most likely to remain in practice in the communities for longer periods. Community attributes such as distance to large population centres cannot be changed, but attributes that contribute to personal and professional satisfaction could be altered.