The influence of leadership practices on faculty job satisfaction in baccalaureate degree nursing program

Using a correlational, cross-sectional study design with self-administered questionnaires, this study explored the extent to which leadership practices of deans and department heads influence faculty job satisfaction in baccalaureate degree nursing programs. Using a simple random sampling technique, the study survey was sent to 400 faculty members. 300 faculty members were chosen out of 400 and106 faculty members who returned the questionnaires and employed full time in baccalaureate degree nursing programs in the southeastern part of the United States were selected for the study. The study participants completed the Weiss, Dawis, England, and Lofquist's (1977) Minnesota Satisfaction Questionnaire and Kouzes and Posner's (2003) Leadership Practices Inventory (LPI) survey. The study illuminated the relationship between leadership practices of university deans and department heads and faculty job satisfaction using a descriptive, correlational cross-sectional study design with self administered questionnaires. The findings indicated that nursing deans and department heads who implemented the leadership practices whereby their faculty felt encouraged and enabled to act more autonomously produced higher levels of job satisfaction

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Trends in Drug Tests among Children: A 22-Year Retrospective Analysis

There are several pathophysiological outcomes associated with substance abuse including metabolic disbalance, neurodegeneration, and disordered redox. Drug use in pregnant women is a topic of great concern due to developmental harm which may occur during gestation and the associated complications in the neonate after delivery. We sought to determine what the trajectory of drug use is like in children aged 0–4 years and mothers of neonates. Urine drug screen (UDS) results were obtained of our target demographic during 1998–2011 and 2012–2019 from LSU Health Sciences Center in Shreveport (LSUHSC-S). Statistical analysis was performed using R software. We observed an increase in cannabinoid-positive UDS results in both Caucasian (CC) and African American (AA) groups between 1998–2011 and 2012–2019 periods. Cocaine-positive UDS results decreased in both cohorts. CC children had higher UDS positive results for opiates, benzodiazepines, and amphetamines, while AA children had a higher percentage for illicit drugs such as cannabinoids and cocaine. Neonate’s mothers had similar UDS trends to that in children during 2012–2019. Overall, while percentage of positive UDS results for both AA and CC 0–4 year old children started to decline for opiate, benzodiazepine, and cocaine during 2012–2019, cannabinoid- and amphetamine (CC)-positive UDS steadily increased. These results suggest a shift in the type of drug use by mothers from opiates, benzodiazepines, and cocaine to cannabinoids and/or amphetamines. We also observed that 18-year-old females who tested positive for opiates, benzodiazepine, or cocaine had higher than average chances of testing positive for cannabinoids later in life

Effects of the Memo-Concentrator on Blood

A high flux, non-traumatic ultrafilter (UF) can be useful for controlling the volume in the cardiopulmonary bypass circuit. Recently three such devices have been made available. It is the purpose of this work to describe the direct effects of ultrafiltration with one of these devices, the HemoConcentrator, on blood. The effects were determined by calculating the net changes in blood components due to hemoconcentration of pump blood at the end of bypass. The net changes were calculated from measurements taken before and after the concentration process. Samples taken pre and post-transfusion of the concentrated blood to the patient were also compared. The blood volume left in the circuit, 2050 ± 136 cc was concentrated by circulation through the UF and a total of 1083 ± 74 cc of plasma water extracted at a rate of 87 ± 3cc/min. The % net change for glucose, chloride, CO2 , potassium, sodium, BUN, creatinine, and phosphorous approximated the net loss of the plasma water. There were no losses in hemoglobin, albumin, and fibrinogen and only 2.5% losses in white blood cells*

Evaluation of Blood Cardioplegia Administration Systems

Four different blood cardioplegia administration systems (CAS) were evaluated for ease of use, cooling capacity, uniformity of mixing and blood flow capability. The CAS were one single pass (SP) and three recirculating CAS (RC). Each of the RC had a different reservoir; the first a cardiotomy reservoir (CARD), the second a transfer bag, and the third the GISH system. Each CAS was primed and debubbled with crystalloid. For RC, blood was collected, potassium added, and the solution cooled to 10°C. With SP, the infusate temperature at the field was measured at different flows and oxygenator temperatures. Hematocrit and potassium were measured at the start and end of cardioplegia administration. Single pass had the least tubing, lowest priming volume and the simplest design. For RC, l0°C infusate temperature was obtained fastest with the heat exchanger at the pump outlet and slowest at the reservoir inlet. For SP, the temperature at the field increased as either the oxygenator temperature and/or the cardioplegia flow rate increased. Only RC with CARD produced nonuniform mixing (initial potassium and hematocrit compared to the end of infusion were 16 percent lower and 36 percent higher respectively). At 10°C infusate temperature, RC allowed higher flow rates than SP. The GISH administration tubing had high resistance (800 mmHg at 500 mllmin). GISH is flow-limited by resistance and SP by cooling capacity. Clinically, if oxygenator temperature and infusion flows are such that SP can be used it is preferred. Otherwise, RC with low resistance tubing and heat exchanger within the reservoir is optimal

Normal bone density and trabecular bone score, but high serum sclerostin in congenital generalized lipodystrophy.

CONTEXT: Berardinelli-Seip Congenital Lipodystrophy (BSCL) is a rare autosomal recessive syndrome characterized by a difficulty in storing lipids in adipocytes, low body fat mass, hypoleptinemia, and hyperinsulinemia. Sclerostin is a product of SOST gene that blocks the Wnt/β-catenin pathway, decreasing bone formation and enhancing adipogenesis. There are no data about sclerostin in people with BSCL. OBJECTIVE: We aimed to evaluate serum sclerostin, bone mineral density (BMD), and L1-L4 Trabecular Bone Score (TBS) in BSCL patients, generating new knowledge about potential mechanisms involved in the bone alterations of these patients. DESIGN, SETTING, AND PATIENTS: In this cross-sectional study, we included 11 diabetic patients with BSCL (age 24.7±8.1years; 6 females). Sclerostin, leptin, L1-L4 TBS, BMD were measured. Potential pathophysiological mechanisms have been suggested. RESULTS: Mean serum sclerostin was elevated (44.7±13.4pmol/L) and was higher in men than women (55.3±9.0 vs. 35.1±8.4pmol/L, p=0.004). Median of serum leptin was low [0.9ng/mL (0.5-1.9)]. Seven out of 11 patients had normal BMD, while four patients had high bone mass (defined as Z-score\u3e+2.5SD). Patients on insulin had lower sclerostin (37.3±9.2 vs. 52.6±13.4pmol/L, p=0.05). The mean TBS was 1.402±0.106, and it was higher than 1.300 in nine patients. CONCLUSIONS: Patients with lipoatrophic diabetes (BSCL) have high serum concentrations of sclerostin, normal or high BMD, and reasonable trabecular bone mass measured by TBS. This is the first report of high sclerostin and good bone microarchitecture (TBS) in BSCL patients