The Use of Standardized Patients to Minimize Anxiety in Undergraduate Nursing Students in the Clinical Setting

Anxiety in undergraduate nursing students in the clinical setting is caused by many factors, including fear of harming patients, difficulty transitioning, and unsupportive relationships. This has negative effects which include compromised student learning, decreased clinical performance, increased risk for patient harm, and a long term effect of worsening of the nursing shortage. The issue of student anxiety in the clinical setting must be addressed by nurse educators. Implementing the use of standardized patients (SPs) is one strategy that may minimize anxiety while preparing students to enter the clinical setting. Standardized patients are trained to portray an illness or a scenario, while interacting with students to create a realistic, low-risk learning experience. Advantages of SPs for students include the realistic clinical experience in a non-threatening, low-risk environment; the integrative learning experience; the positive, meaningful experience; constructive feedback; and common learning experience for students. Advantages for faculty include control and consistency, versatility and practicality, and the constructive feedback faculty gain. The large expenses and increased faculty workload associated with SPs continue to create barriers for their implementation within nursing education; these barriers are compounded by the lack of evidence supporting the use of SPs to decrease student anxiety. Further research is needed to support the use of SPs as a strategy to decrease undergraduate nursing student anxiety in the clinical setting

Morphological Plasticity of Invasive Silver Carp in Divergent Midwestern Rivers

In the past decade, silver carp (SC; Hypopthalmicthys molitrix) have incited a great quantity of scientific research because their establishment and success in the Midwestern U.S. has led to concerns that they could invade the Great Lakes Basin. These previous studies have identified phenotypic plasticity in SC behavior and spawning as they invade novel environments. Although divergent habitats have been shown to elicit morphological plasticity in multiple fish species, similar research has not been conducted for SC despite their observed plasticity in other traits. I examined SC collected from two hydrogeomorphically divergent rivers, the Illinois River (IR) and middle Wabash River (MWR), as examples of rivers that support SC populations at different invasion stages. I compared differences in SC body shapes through geometric morphometric analysis and life history characteristics through population demographics between rivers. MWRSC were in better condition, lived longer, attained greater total lengths, and had higher GSIs than IRSC. Morphometric analysis revealed a significant divergence in body morphology between MWRSC and IRSC, whereby MWRSC had deeper body sections and narrow, tapered heads, while IRSC had shallower bodies and deeper heads. Principle component analysis indicated that contrasts in morphology were most strongly associated with river, as opposed to other factors like sex, hybrid status, and time sampled. While I do not assert causal evidence for the difference in shape based on specific environmental characteristics of the two rivers, I speculate that IRSC and MWRSC are undergoing different selection pressures due to population demographics and environmental characteristics of the two rivers. Regardless of the specific causal factors, it is clear that body shapes were different between the two rivers, suggesting that location-based selective agents are driving phenotypic outcomes in invasive SC

Assessment of Obesity and Fear of Fatness Among Inner-City Dublin Schoolchildren in a One-Year-Follow-Up Study

Background: Positive secular trends in adolescent obesity and an increased prevalence of fear of fatness, particularly among girls, have been documented world-wide. There is a lack of consensus about assessment criteria for childhood obesity and no standard exists for assessing Irish children. In 1990, the Irish National Nutrition Survey used body mass index (BMI) $26 kgm22 to describe the prevalence of overweight among Irish adolescents. Objectives: (1) To examine the range in classification of Dublin schoolchildren as overweight according to four standard assessment methods; (2) to assess changes in weight status, prevalence of fear of fatness and accompanying slimming practices in a one-year follow-up; and (3) to compare the prevalence of overweight with that documented in 1990 among adolescents of similar age. Design: A one-year follow-up study of 199 healthy schoolchildren (90 boys and 109 girls; mean age of 11 years at baseline) attending seven fee-paying (six single- and one mixed-sex) and eight non-fee-paying (four single- and four mixed-sex) primary schools in Dublin city centre. Measurements: Weight, height, waist circumference and triceps skinfold were measured and used in five definitions of overweight, including published cut-off points of BMI-for-age (Centers for Disease Control and Prevention BMI-for-age charts for boys and girls; BMI reference curves for the UK 1990; International Obesity Task Force age- and sex-specific BMI cut-offs), actual relative weight and BMI$ 26 kgm22. Assessment of body image perceptions and satisfaction (using figure line drawings) was reported in a questionnaire specifically designed for this study. Results: The prevalence of overweight within the total group differed between the four standard definitions of weight status, by 9% at baseline and 8% at follow-up. Accordingly, increasing trends over the year ranged from zero to 3%. Using the criterion BMI $ 26 kgm22, 6% of Dublin schoolchildren were overweight, compared with 1.9% of schoolchildren in 1990. Significantly more girls than boys were affected by fear of fatness and were trying to lose weight. Conclusion: A standard method for assessment of weight status is urgently needed for the evaluation of obesity prevention initiatives among Irish schoolchildren. Such initiatives need to be sensitive to the pervasiveness of fear of fatness among adolescent girls

A Developmental Study of the NMDA Receptor

The N-methyl-D-aspartate type of glutamate receptor (NMDAR) is involved in the regulation of many neural functions, including neuroendocrine modulation of the vertebrate brain-pituitary-gonad axis. We have used a freshwater teleost, the platyfish (Xiphophorus maculatus), to document age- and gender-specific variations in NMDAR properties. We first localized immunoreactive (ir-) NMDAR in male and female platyfish brain at four stages of the lifespan. Distribution was limited to cells of the nucleus olfactoretinalis (NOR), a gonadotropin releasing hormone-containing nucleus. The number of ir-NMDAR cells was increased in pubescent and mature females when compared to immature and senescent animals. In males, there was no significant change in ir-NMDAR expression in the NOR at any time in their lifespan. The affinity of the antagonist MK-801 for the NMDA receptor, an indicator of subunit composition, was increased only in pubescent females. Maximum binding of MK-801 to NMDAR also varied with female development, reaching a significant maximum in mature females. In males, both maximum MK-801 binding and MK-801 affinity remained unchanged throughout development. Chronic injections of MK-801 to immature male and female platyfish resulted in a dose-dependent decrease in both the number of females in puberty and in their average size. Male puberty and growth were unaffected. Radioimmunoassay indicated an increased GnRH content in brain extracts from MK-801 treated females and no effect on GnRH content in treated males. Histological analysis showed decreased size of the gonadotropic zone in the anterior pituitary gland of treated females. There was no evidence that MK-801 directly influences the gonads. These studies are the first evidence of a sexually dimorphic relationship between the timing of NMDA receptor dynamics and neuroendocrine activity in the brain-pituitary gonad axis

Depression during pregnancy: detection, comorbidity and treatment

Depression during pregnancy is common (∼15%). Routine prenatal depression screening coupled with the use of physician collaborators to assist in connecting women with care is critical to facilitate treatment engagement with appropriate providers. Providers should be aware of risk factors for depression – including a previous history of depression, life events, and interpersonal conflict – and should appropriately screen for such conditions. Depression during pregnancy has been associated with poor pregnancy outcomes including preeclampsia, insufficient weight gain, decreased compliance with prenatal care, and premature labor. Current research has questioned the overall benefit of treating depression during pregnancy with antidepressants when compared to the risk of untreated depression for mother and child. Published guidelines favor psychotherapy above medication as the first line treatment for prenatal depression. Poor neonatal adaptation or withdrawal symptoms in the neonate may occur with fetal exposure in late pregnancy, but the symptoms are mild to moderate and transient. The majority of mothers who decide to stop taking their antidepressants during pregnancy suffer relapsing symptoms. If depression continues postpartum, there is an increased risk of poor mother–infant attachment, delayed cognitive and linguistic skills in the infant, impaired emotional development, and behavioral problems in later life. Bipolar depression, anxiety and substance use disorders, and/or presence of severe psychosocial stress can lead to treatment-resistance. Modified and more complex treatment algorithms are then warranted. Psychiatric medications, interpersonal or cognitive-behavioral therapy, and adjunctive parent–infant/family treatment, as well as social work support, are modalities often required to comprehensively address all issues surrounding the illness.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79238/1/j.1758-5872.2010.00051.x.pd

Food science and technology students self-evaluate soft and technical skills

Food Scientists and Technologists (FS&T) need diverse skills in the globalized food and drink sector: Food-specific or scientific / technical skills and generic or intuitive soft skills. This study determined how satisfied FS&T students were with overall improvement, and in key technical and soft skills, based on their university work; and if satisfaction was linked to geography, degree in progress, anticipated degree, anticipated work place or anticipated job responsibility. An on-line survey was completed by 267 students in over 20 countries using a 5-point Likert scale to evaluate satisfaction. Responses were analyzed by the Friedman or Kruskal Wallis tests for more than two groups, otherwise by the Wilcoxon Signed Rank or Mann-Whitney tests. There were no differences in Overall Satisfaction with technical and soft skills training. Among soft skills, training in Working with Others and Being Responsible were more often rated “Excellent” and students were more satisfied with their training than with Solving Problems, Communication and Positive Attitude. Students anticipating a job with high responsibility were more satisfied with overall soft skill training and with 3 of the 5 specific soft skills. Among technical skills, students were more satisfied with improvement in basic sciences (Microbiology, Chemistry, Processing, Safety), and those in Northern Europe were more satisfied with overall technical training. These data show variations in perception and/or efficacy of technical and soft skill training in Food Science programmes and underline the need for separate attention to the incorporation of soft skill training into the design of FS&T coursesinfo:eu-repo/semantics/publishedVersio

A comparison of adolescent and adult health state values for the Child Health Utility-9D using profile case best worst scaling

The main objective of this study was to compare and contrast adolescent and adult values for the Child Health Utility-9D (CHU9D), a new generic preference based measure of health related quality of life designed for application in the economic evaluation of treatment and preventive programmes for children and adolescents. Previous studies have indicated that there may be systematic differences in adolescent and adult values for identical health states but have failed to use a common valuation technique. An on-line survey including a series of best worst scaling discrete choice experiment questions for health states defined by the CHU9D, was administered to two general population samples comprising adults and adolescents respectively. The results highlight potentially important age related differences in the values attached to CHU9D dimensions. Adults, in general, placed less weight upon impairments in mental health (worried, sad, annoyed) and more weight upon moderate to severe levels of pain relative to adolescents. The source of values (adults or adolescents) has important implications for economic evaluation and may impact significantly upon health care policy. Profile case best worst scaling offers a promising approach for the elicitation and comparison of health state values across population groups.Financial support from a Flinders University seeding grant and an Australian NHMRC Project Grant 1021899 entitled 'Adolescent values for the economic evaluation of adolescent health care treatment and preventive programs' is gratefully acknowledged