An Examination of Students’ and Staff Nurses’ Opinions Affecting Interaction

As collegiate nursing students came to hospitals for learning experiences, it was foreseeable that a conflict of opinions might arise between nursing students and staff nurses as they interacted. The problem was to collect opinions regarding traits common to a selected group of nursing students and staff nurses and to examine similarities and differences of opinion between their concept of themselves, each other, and the importance of the traits as they affected interaction. Two graphic rating scales were constructed. Opinions of thirty-four students and twenty-eight staff nurses were measured. Thirty-three traits were classified under four trait complexes. A profile of nursing students and staff nurses was developed by computing complex indices for the opinions revealed, on seven-point bipolar scales, regarding the groups’ concept of themselves and each other and the way they thought each group would tend to see themselves. Traits were arranged on a five-point scale and opinions regarding importance of the traits were revealed. Indices computed for each of the trait complexes determined their relative importance. Analysis revealed that nursing students’ and staff nurses’ self-esteem was relatively high and that their concept of each other was positive for all complexes. The self-esteem and apparent acceptance of each group’s attributes suggested a basis for satisfactory interaction. One point of possible conflict was the students’ lower opinion of staff nurses’ human relations skill. Both groups agreed that the trait complexes were of similar and relatively high importance to effective interaction

Cultural Heritage at Conisbrough Castle: Expanding Resident Narratives, Public Education, and Aspects of Medieval Domestic Life for a Diverse Audience

English Heritage Trust (EH) prides itself on communicating the histories of its sites through playful forms of engagement. In the recent scholarship of EH heritage managers David Sheldon (2011), Joe Savage, and William Wyeth (2020), new forms of creating play and providing site histories are considered alongside the challenges of updating signage and activities to meet visitor expectations. Expanding castle narratives beyond the Norman origins, increasing representations of women and lesser-known historic figures, and addressing the domestic function of castles are a priority for Sheldon, Wyeth, and Savage as they create case-by-case programs for their many properties. This paper considers what pedagogical methodologies are utilized at EH’s Conisbrough Castle, the selected story for presentation and why, and what display methods can be expanded to add to the visitor understanding of Conisbrough’s longer story through the Middle Ages. Using a mix of display boards, video, and text-based signage, managers at Conisbrough recall the de Warenne family narrative and recognize the Conisbrough keep’s domestic function. This is a successful recollection of this one resident’s story, however, only featuring this narrative limits Consibrough’s history to the Norman period. As EH seeks to grow their castle histories, I propose creating new engagements through the current display media that emphasize the importance of multiple tenant stories across time in castle spaces. Increased opportunities to relate to the past and retain information through play will assist visitors as they come to recognize the home as witness to both domestic activity and those events that occurred on the world stage

Examination of Several Physiological and Psychosocial Factors Potentially Associated With Masked Hypertension Among Low-Risk Adults

We examined the association of factors in addition to prehypertensive office blood pressure (BP) level that might improve detection of masked hypertension (MH, defined as non-elevated office BP with elevated out-of-office BP average) among those otherwise at low-risk. This sample of 340 untreated adults 30 years and older with office BP average <140/90 mmHg all had two sets of paired office BP measurements and 24-hour ambulatory BP monitoring (ABPM) sessions one week apart. Other than BP levels, the only factors that were associated (at P<0.10) with MH at both sets were male sex (75% vs 66%) and working outside the home (72% vs 59% first set; 71% vs 45% second set). Adding these variables to BP level in the model did not appreciably improve detection of MH. We found no demographic, clinical, or psychosocial measures that improved upon prehypertension as a potential predictor of MH in this sample

Comparison of patients’ confidence in office, ambulatory, and home blood pressure measurements as methods of assessing for hypertension

Uncertainty exists when relying on office (clinic) blood pressure (BP) measurements to diagnose hypertension. Home BP monitoring and ambulatory BP monitoring (ABPM) provide measurements that are more strongly associated with cardiovascular disease. The degree to which patients exhibit uncertainty about office BP measurements is unknown, as is whether they would have less uncertainty about other BP measurement methods. We therefore assessed people's confidence in methods of BP measurement, comparing perceptions about office BP, home BP, and ABPM techniques

Levels of Office Blood Pressure and Their Operating Characteristics for Detecting Masked Hypertension Based on Ambulatory Blood Pressure Monitoring

BACKGROUND Masked hypertension (MH)—nonelevated office blood pressure (BP) with elevated out-of-office BP average—conveys cardiovascular risk similar to or approaching sustained hypertension, making its detection of potential clinical importance. However, it may not be feasible or cost-effective to perform ambulatory BP monitoring (ABPM) on all patients with a nonelevated office BP. There likely exists a level of office BP below which ABPM is not warranted because the probability of MH is low. METHODS We analyzed data from 294 adults aged ≥30 years not on BP-lowering medication with office BP <140/90mm Hg, all of whom underwent 24-hour ABPM. We calculated sensitivity, false-positive rate, and likelihood ratios (LRs) for the range of office BP cutoffs from 110 to 138mm Hg systolic and from 68 to 88mm Hg diastolic for detecting MH. RESULTS The systolic BP cutoff with the highest +LR for detecting MH (1.8) was 120mm Hg, and the diastolic cutoff with the highest +LR (2.4) was 82mm Hg. However, the systolic level of 120mm Hg had a false-positive rate of 42%, and the diastolic level of 82mm Hg had a sensitivity of only 39%. CONCLUSIONS The cutoff of office BP with the best overall operating characteristics for diagnosing MH is approximately 120/82mm Hg. However, this cutoff may have an unacceptably high false-positive rate. Clinical risk tools to identify patients with nonelevated office BP for whom ABPM should be considered will likely need to include factors in addition to office BP

A systematic review and meta-analysis of the direct effects of nutrients on corals

Chronic exposure of coral reefs to elevated nutrient conditions can modify the performance of the coral holobiont and shift the competitive interactions of reef organisms. Many studies have nowquantified the links between nutrients and coral performance, but fewhave translated these studies to directly address coastal water quality standards. To address this management need, we conducted a systematic review of peer-reviewed studies, public reports, and gray literature that examined the impacts of dissolved inorganic nitrogen (DIN: nitrate, nitrite, and ammonium) and dissolved inorganic phosphorus (DIP: phosphate) on scleractinian corals. The systematic review resulted in 47 studies with comparable data on coral holobiont responses to nutrients: symbiont density, chlorophyll α (chl-α) concentration, photosynthesis, photosynthetic efficiency, growth, calcification, adult survival, juvenile survival, and fertilization. Mixed-effects meta-regression meta-analyses were used to determine the magnitude of the positive or negative effects of DIN and DIP on coral responses. Zooxanthellae density (DIN & DIP), chl-α concentration (DIN), photosynthetic rate (DIN), and growth (DIP) all exhibited positive responses to nutrient addition; maximum quantum yield (DIP), growth (DIN), larval survival (DIN), and fertilization (DIN) exhibited negative responses. In lieu of developing specific thresholds for the management of nutrients as a stressor on coral reefs, we highlight important inflection points in the magnitude and direction of the effects of inorganic nutrients and identify trends among coral responses. The responses of corals to nutrients are complex, warranting conservative guidelines for elevated nutrient concentrations on coral reefs

Effects of physical activity calorie expenditure (PACE) labeling: study design and baseline sample characteristics

Abstract Background Obesity and physical inactivity are responsible for more than 365,000 deaths per year and contribute substantially to rising healthcare costs in the US, making clear the need for effective public health interventions. Calorie labeling on menus has been implemented to guide consumer ordering behaviors, but effects on calories purchased has been minimal. Methods In this project, we tested the effect of physical activity calorie expenditure (PACE) food labels on actual point-of-decision food purchasing behavior as well as physical activity. Using a two-group interrupted time series cohort study design in three worksite cafeterias, one cafeteria was assigned to the intervention condition, and the other two served as controls. Calories from food purchased in the cafeteria were assessed by photographs of meals (accompanied by notes made on-site) using a standardized calorie database and portion size-estimation protocol. Primary outcomes will be average calories purchased and minutes of moderate to vigorous physical activity (MVPA) by individuals in the cohorts. We will compare pre-post changes in study outcomes between study groups using piecewise generalized linear mixed model regressions (segmented regressions) with a single change point in our interrupted time-series study. The results of this project will provide evidence of the effectiveness of worksite cafeteria menu labeling, which could potentially inform policy intervention approaches. Discussion Labels that convey information in a more readily understandable manner may be more effective at motivating behavior change. Strengths of this study include its cohort design and its robust data capture methods using food photographs and accelerometry

Reproducibility of masked hypertension among adults 30 years or older

Masked hypertension (MH) refers to non-elevated office blood pressure (BP) with elevated out-of-office BP, but its reproducibility has not been conclusively established. We examined one-week reproducibility of MH by home BP monitoring (HBPM) and ambulatory BP monitoring (ABPM)

De Novo Mutations in SIK1 Cause a Spectrum of Developmental Epilepsies

Developmental epilepsies are age-dependent seizure disorders for which genetic causes have been increasingly identified. Here we report six unrelated individuals with mutations in salt-inducible kinase 1 (SIK1) in a series of 101 persons with early myoclonic encephalopathy, Ohtahara syndrome, and infantile spasms. Individuals with SIK1 mutations had short survival in cases with neonatal epilepsy onset, and an autism plus developmental syndrome after infantile spasms in others. All six mutations occurred outside the kinase domain of SIK1 and each of the mutants displayed autophosphorylation and kinase activity toward HDAC5. Three mutations generated truncated forms of SIK1 that were resistant to degradation and also showed changes in sub-cellular localization compared to wild-type SIK1. We also report the human neuropathologic examination of SIK1-related developmental epilepsy, with normal neuronal morphology and lamination but abnormal SIK1 protein cellular localization. Therefore, these results expand the genetic etiologies of developmental epilepsies by demonstrating SIK1 mutations as a cause of severe developmental epilepsy