Context: Nurses are the primary hospital caregivers. Increasing the effi ciency and effectiveness of nursing care is essential to hospital function and the delivery of safe patient care.Objective: We undertook a time and motion study to document how nurses spend their time. The goal was to identify drivers of ineffi ciency in nursing work processes and nursing unit design.Design: Nurses from 36 medical-surgical units were invited to participate in research protocols designed to assess how nurses spend their time, nurse location and movement, and nurse physiologic response.Main Outcome Measures: Nurses' time was divided into categories of activities (nursing practice, unit-related functions, nonclinical activities, and waste) and locations (patient room, nurse station, on-unit, off-unit). Total distance traveled and energy expenditure were assessed. Distance traveled was evaluated across types of unit design.Results: A total of 767 nurses participated. More than threequarters of all reported time was devoted to nursing practice. Three subcategories accounted for most of nursing practice time: documentation (35.3%; 147.5 minutes), medication administration (17.2%; 72 minutes), and care coordination (20.6%; 86 minutes). Patient care activities accounted for 19.3% (81 minutes) of nursing practice time, and only 7.2% (31 minutes) of nursing practice time was considered to be used for patient assessment and reading of vital signs.Conclusion: The time and motion study identifi ed three main targets for improving the effi ciency of nursing care: documentation, medication administration, and care coordination. Changes in technology, work processes, and unit organization and design may allow for substantial improvements in the use of nurses' time and the safe delivery of care.

In order to determine the different roles of rice (Oryza sativa L.) cytosolic ascorbate peroxidases (OsAPXa and OsAPXb, GenBank accession nos. D45423 and AB053297, respectively) under salt stress, transgenic Arabidopsis plants over-expressing OsAPXa or OsAPXb were generated, and they all exhibited increased tolerance to salt stress compared to wild-type plants. Moreover, transgenic lines over-expressing OsAPXb showed higher salt tolerance than OsAPXa transgenic lines as indicated by root length and total chlorophyll content. In addition to ascorbate peroxidase (APX) activity, antioxidant enzyme activities of catalase (CAT), superoxide dismutase (SOD) and glutathione reductase (GR), which are also involved in the salt tolerance process, and the content of H2O2 were also assayed in both transgenic and wild-type plants. The results showed that the overproduction of OsAPXb enhanced and maintained APX activity to a much higher degree than OsAPXa in transgenic Arabidopsis during treatment with different concentrations of NaCl, enhanced the active oxygen scavenging system, and protected plants from salt stress by equilibrating H2O2 metabolism. Our findings suggest that the rice cytosolic OsAPXb gene has a more functional role than OsAPXa in the improvement of salt tolerance in transgenic plants.

Hutubi gas field, the largest gas storage field in China, has been operated on annual injection/extraction cycles since 9 June 2013. We study the seismicity near the gas field from 9 June 2013 to 22 October 2015, a time span that the gas field has experienced three injection periods and two extraction periods, and explore its physical mechanism based on the relationship between seismicity and field operation. We identify 273 events (ML > 1) in the region within 10 km of the gas field, with 97% of those occurring in the first two injection periods, 0.4% in the third injection period, and 1% in the two extraction periods. Seismicity in the first two injection periods occurs mostly as shallow clusters (focal depth < 2 km) at two locations: with one along the fault that marks the southern boundary of the gas field and the other about 2 km south to the southeastern tip of the gas field with the seismicity distributed along north‐south direction. The seismicity does not correlate with total gas injection volume, injection rate, or well pressure. It instead occurs 11–17 hr after simultaneous abrupt increases/decreases of gas injection rate and well pressure in the field operation in the first two injection periods when some accumulative injection has reached. Such relationship is consistent with a physical mechanism that the seismicity near Hutubi gas field is induced on pore‐pressured faults with a rate‐ and state‐dependent friction law through an abrupt change of stress in elastic and undrained poroelastic responses to simultaneous abrupt changes of injection rate and well pressure. Our study also points to the possibility that induced seismicity may be controllable in some practical field operations.

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