Perceived caring attributes and priorities of pre-registration nursing students throughout a nursing curriculum underpinned by person-centredness

Aim\ud This paper explores pre-registration nursing students’ caring attributes development through a person-centred focused curriculum.\ud Background\ud Developing caring attributes in student nurses to the point of registration has historically been challenging. Globally, curricula have not yet demonstrated the ability to sustain and develop caring attributes in this population, despite its centrality to practice.\ud Design and Methods\ud This longitudinal cohort study tracked how university pre-registration nursing students (N = 212) developed their caring attributes over the three years of their programme using repeated measures at the end of each year with the same cohort. The Caring Dimensions Inventory (35 item version with 25 caring items under three constructs (technical, intimacy and supporting) and 10 inappropriate or unnecessary construct items) was used and data analysed using Mokken Scaling Analysis to create a hierarchy of actions that students deemed as caring. Repeated measures of analysis of variance enabled evaluation of changes in responses over time.\ud Results\ud Students developed their caring attributes throughout their programme, ranking 22 out of 25 as caring (with statistical significance) at the end of year one, 18 at the end of year two and all 25 caring items at the end of their final year. No unnecessary or inappropriate construct items were ranked as caring at any data collection point. Participants consistently ranked assisting a person with an activity of living, listening to a patient, and involving them in their care as the most caring actions

N-Acetyl-S-(N,N-diethylcarbamoyl) cysteine in rat nucleus accumbens, medial prefrontal cortex, and in RAT and human plasma after disulfiram administration

Disulfiram (DSF), a treatment for alcohol use disorders, has shown some clinical effectiveness in treating addiction to cocaine, nicotine, and pathological gambling. The mechanism of action of DSF for treating these addictions is unclear but it is unlikely to involve the inhibition of liver aldehyde dehydrogenase (ALDH2). DSF is a pro-drug and forms a number of metabolites, one of which is N-acetyl-S-(N,N-diethylcarbamoyl) cysteine (DETC-NAC). Here we describe a LCMS/MS method on a QQQ type instrument to quantify DETC-NAC in plasma and intracellular fluid from mammalian brain. An internal standard, the N,N-di-isopropylcarbamoyl homolog (MIM: 291 > 128) is easily separable from DETC-NAC (MIM: 263 > 100) on C18 RP media with a methanol gradient. The method's linear range is 0.5–500 nM from plasma and dialysate salt solution with all precisions better than 10% RSD. DETC-NAC and internal standards were recovered at better than 95% from all matrices, perchloric acid precipitation (plasma) or formic acid addition (salt) and is stable in plasma or salt at low pH for up to 24 h. Stability is observed through three freeze-thaw cycles per day for 7 days. No HPLC peak area matrix effect was greater than 10%. A human plasma sample from a prior analysis for S-(N,N-diethylcarbamoyl) glutathione (CARB) was found to have DETC NAC as well. In other human plasma samples from 62.5 mg/d and 250mg/d dosing, CARB concentration peaks at 0.3 and 4 nM at 3 h followed by DETC-NAC peaks of 11 and 70 nM 2 h later. Employing microdialysis sampling, DETC-NAC levels in the nucleus accumbens (NAc), medial prefrontal cortex (mPFC), and plasma of rats treated with DSF reached 1.1, 2.5 and 80 nM at 6 h. The correlation between the appearance and long duration of DETC-NAC concentration in rat brain and the persistence of DSF-induced changes in neurotransmitters observed by Faiman et al. (Neuropharmacology, 2013, 75C, 95–105) is discussed

Food fortification and biofortification as potential strategies for prevention of vitamin D deficiency

Hypovitaminosis D (vitamin D deficiency) is widespread throughout the world. The cutaneous production of vitamin D through sunlight can be limited by several factors (e.g. skin pigmentation, sunscreen usage and, increasingly, indoor lifestyle). Thus, diet has become an important strategy to increase vitamin D intake and status {blood 25-hydroxyvitamin D [25(OH)D]}. However, there are a limited number of foods that naturally contain vitamin D, and concentrations can vary significantly between and within species. The need for vitamin Dfortified foods (including via direct fortification and biofortification) to support the adequacy of vitamin D status is a corollary of several limitations to synthesise vitamin D from sunlight. Ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) can be found in some mushrooms and animalderived foods, respectively. Evidence has shown vitamin D3 is more effective than vitamin D2 at raising 25(OH)D blood concentrations. The vitamin D metabolite, 25(OH)D3, is present in animal-derived foods (e.g. meat, eggs and fish), and several intervention trials have shown 25(OH)D3 to be more effective at raising blood 25(OH)D concentrations than vitamin D3. In addition, 25(OH)D3 supplements may prove to be preferable to vitamin D3 for patients with certain clinical conditions. However, there is limited evidence on the effects of 25(OH) D3-fortified foods on human vitamin D status and health, both in the general population and patients with certain conditions, and long-term randomised controlled trials are needed in this area

Serum Fatty Acid Binding Protein 4 (FABP4) Predicts Pre-eclampsia in Women with Type 1 Diabetes

OBJECTIVE To examine the association between fatty acid binding protein 4 (FABP4) and pre-eclampsia risk in women with type 1 diabetes. RESEARCH DESIGN AND METHODS Serum FABP4 was measured in 710 women from the Diabetes and Pre-eclampsia Intervention Trial (DAPIT) in early pregnancy and in the second trimester (median 14 and 26 weeks’ gestation, respectively). RESULTS FABP4 was significantly elevated in early pregnancy (geometric mean 15.8 ng/mL [interquartile range 11.6–21.4] vs. 12.7 ng/mL [interquartile range 9.6–17]; P &amp;lt; 0.001) and the second trimester (18.8 ng/mL [interquartile range 13.6–25.8] vs. 14.6 ng/mL [interquartile range 10.8–19.7]; P &amp;lt; 0.001) in women in whom pre-eclampsia later developed. Elevated second-trimester FABP4 level was independently associated with pre-eclampsia (odds ratio 2.87 [95% CI 1.24–6.68], P = 0.03). The addition of FABP4 to established risk factors significantly improved net reclassification improvement at both time points and integrated discrimination improvement in the second trimester. CONCLUSIONS Increased second-trimester FABP4 independently predicted pre-eclampsia and significantly improved reclassification and discrimination. FABP4 shows potential as a novel biomarker for pre-eclampsia prediction in women with type 1 diabetes. </jats:sec

Resummed event-shape variables in DIS

We complete our study of resummed event-shape distributions in DIS by presenting results for the class of observables that includes the current jet mass, the C-parameter and the thrust with respect to the current-hemisphere thrust axis. We then compare our results to data for all observables for which data exist, fitting for alpha_s and testing the universality of non-perturbative 1/Q effects. A number of technical issues arise, including the extension of the concept of non-globalness to the case of discontinuous globalness; singularities and non-convergence of distributions other than in the Born limit; methods to speed up fixed-order Monte Carlo programs by up to an order of magnitude, relevant when dealing with many x and Q points; and the estimation of uncertainties on the predictions.Comment: 41 page