A Proposal for Certification in Nursing Theory

The author proposes the development of different levels of certification in the knowledge of nursing theory that would be based on the level of formal education attained. At present, nurses are being required to obtain higher levels of formal education in order to serve patients safely in a technologically complex health care system. Although evidence-based practice is strongly desired in contemporary health care, less consideration has been given to the value of theory-based nursing practice or the relationship between theory and research. The author explains multiple background issues and then highlights several questions that are important for disciplinary discussion at this point in time

Guest Editorial: Working at the Edge of Unknown Knowledge

Whenever I teach the graduate level course in Nursing Theory, my students and I discuss why experienced, licensed, professional nurses will benefit from learning nursing theory very well. Our conversation revolves around the idea that leaders are those professional people who often work at the edge of unknown knowledge. What is unknown knowledge

The Utilization of Depression Screening Tools in Patients with Diabetes Type 2

Purpose/Background Diabetes and depression are highly prevalent and concerning conditions impacting millions worldwide. Evidence-based guidelines recommend regular depression screening of individuals with type II diabetes (DM2) to appropriately diagnose and treat depression and proactively enhance clinical outcomes. The gold standard for determining depression in patients with chronic disease is the diagnostic clinical interview; however, many clinicians have turned to brief, self-reported screening tools such as the PHQ-2 and the PHQ-9 whose use are recommended by evidence-based guidelines. This study aims to assess the utilization of the PHQ-2 and PHQ-9 versus no screening on DM2 patients in a primary care setting. Methods In this retrospective chart review, 29 charts of patients ages 18 and older diagnosed with DM2 were assessed to determine if a depression screening was completed. For subjects who met the study’s inclusion criteria, we obtained the sex, age, whether the patient was screened for depression at the office visit, and if they were screened, which depression screening tool was utilized. Results Between November 15, 2018, and November 8, 2021, 29 patients met the inclusion criteria for our retrospective chart review. In total, the patients were seen for a total of 102 visits, with 68% of patients screened for depression using either the PHQ-2 or the PHQ-9 screening tool. The average number of visits per patient was 3.5 visits. The average age of the patients was 52.8, with a median age of 51. Twenty-one of the subjects were female, while eight were male. Implications for Nursing Practice Based on the data collected, more research is needed to determine if the utilization of a screening tool such as the PHQ-2 and PHQ-9 would indeed be beneficial in treating depression in patients with chronic diseases such as diabetes. Confounding variables that hindered obtaining sufficient data include clinic participation in screening, readily available screening forms, and time constraints. Additionally, variables that could have resulted in a more robust study include a larger sample size, the collection of the patient’s ethnicity, hemoglobin A1c, PHQ-2, and PHQ-9 scores, and the initiation or referral for psychiatric treatment. Further areas of research are needed to determine the benefits of screening for depression in patients with chronic diseases such as diabetes

Controls on the formation of lunar multiring basins

Multiring basins dominate the crustal structure, tectonics, and stratigraphy of the Moon. Understanding how these basins form is crucial for understanding the evolution of ancient planetary crusts. To understand how preimpact thermal structure and crustal thickness affect the formation of multiring basins, we simulate the formation of lunar basins and their rings under a range of target and impactor conditions. We find that ring locations, spacing, and offsets are sensitive to lunar thermal gradient (strength of the lithosphere), temperature of the deep lunar mantle (strength of the asthenosphere), and preimpact crustal thickness. We also explore the effect of impactor size on the formation of basin rings and reproduce the observed transition from peak‐ring basins to multiring basins and reproduced many observed aspects of ring spacing and location. Our results are in broad agreement with the ring tectonic theory for the formation of basin rings and also suggest that ring tectonic theory applies to the rim scarp of smaller peak‐ring basins

Electrical generation and absorption of phonons in carbon nanotubes

The interplay between discrete vibrational and electronic degrees of freedom directly influences the chemical and physical properties of molecular systems. This coupling is typically studied through optical methods such as fluorescence, absorption, and Raman spectroscopy. Molecular electronic devices provide new opportunities for exploring vibration-electronic interactions at the single molecule level. For example, electrons injected from a scanning tunneling microscope tip into a metal can excite vibrational excitations of a molecule in the gap between tip and metal. Here we show how current directly injected into a freely suspended individual single-wall carbon nanotube can be used to excite, detect, and control a specific vibrational mode of the molecule. Electrons inelastically tunneling into the nanotube cause a non-equilibrium occupation of the radial breathing mode, leading to both stimulated emission and absorption of phonons by successive electron tunneling events. We exploit this effect to measure a phonon lifetime on the order of 10 nanoseconds, corresponding to a quality factor well over 10000 for this nanomechanical oscillator.Comment: 17 pages, 4 figure

The relative contribution of shape and colour to object memory

The current studies examined the relative contribution of shape and colour in object representations in memory. A great deal of evidence points to the significance of shape in object recognition, with the role of colour being instrumental under certain circumstances. A key but yet unanswered question concerns the contribution of colour relative to shape in mediating retrieval of object representations from memory. Two experiments (N=80) used a new method to probe episodic memory for objects and revealed the relative contribution of colour and shape in recognition memory. Participants viewed pictures of objects from different categories, presented one at a time. During a practice phase, participants performed yes/no recognition with some of the studied objects and their distractors. Unpractised objects shared shape only (Rp–Shape), colour only (Rp–Colour), shape and colour (Rp–Both), or neither shape nor colour (Rp–Neither), with the practised objects. Interference effects in memory between practised and unpractised items were revealed in the forgetting of related unpractised items – retrieval-induced forgetting. Retrieval-induced forgetting was consistently significant for Rp–Shape and Rp–Colour objects. These findings provide converging evidence that colour is an automatically encoded object property, and present new evidence that both shape and colour act simultaneously and effectively to drive retrieval of objects from long-term memory

Phenotypic insights into ADCY5-associated disease

BACKGROUND: Adenylyl cyclase 5 (ADCY5) mutations is associated with heterogenous syndromes: familial dyskinesia and facial myokymia; paroxysmal chorea and dystonia; autosomal-dominant chorea and dystonia; and benign hereditary chorea. We provide detailed clinical data on 7 patients from six new kindreds with mutations in the ADCY5 gene, in order to expand and define the phenotypic spectrum of ADCY5 mutations. METHODS: In 5 of the 7 patients, followed over a period of 9 to 32 years, ADCY5 was sequenced by Sanger sequencing. The other 2 unrelated patients participated in studies for undiagnosed pediatric hyperkinetic movement disorders and underwent whole-exome sequencing. RESULTS: Five patients had the previously reported p.R418W ADCY5 mutation; we also identified two novel mutations at p.R418G and p.R418Q. All patients presented with motor milestone delay, infantile-onset action-induced generalized choreoathetosis, dystonia, or myoclonus, with episodic exacerbations during drowsiness being a characteristic feature. Axial hypotonia, impaired upward saccades, and intellectual disability were variable features. The p.R418G and p.R418Q mutation patients had a milder phenotype. Six of seven patients had mild functional gain with clonazepam or clobazam. One patient had bilateral globus pallidal DBS at the age of 33 with marked reduction in dyskinesia, which resulted in mild functional improvement. CONCLUSION: We further delineate the clinical features of ADCY5 gene mutations and illustrate its wide phenotypic expression. We describe mild improvement after treatment with clonazepam, clobazam, and bilateral pallidal DBS. ADCY5-associated dyskinesia may be under-recognized, and its diagnosis has important prognostic, genetic, and therapeutic implications. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society

What is the crisis of Western sciences?

© 2016, Springer Science+Business Media Dordrecht. This article is an attempt to formulate a clear definition of the concept of crisis of Western sciences introduced by Husserl in his last work. The attempt will be based on a reading of the Krisis, which will stress its underlying continuity with Husserl’s life-long concerns about the theoretical insufficiency of positive sciences, and downplay the novelty of the idea of crisis itself within Husserl’s work. After insisting on the fact that, according to Husserl, only an account of the shortcomings of the scientificity of Western sciences can justify the claim that they are undergoing a crisis, it will be argued that the common definition of the crisis of the sciences as the loss of their significance for life rests on a misunderstanding. The crisis of Western sciences will be characterized, instead, as the repercussion of the crisis of the scientificity of philosophy (and, specifically, of metaphysics) on the scientificity of positive sciences. The loss of significance of scientific knowledge for our existence will in turn appear as a further, inevitable consequence of the uprooting of the sciences from the soil of a universal philosophy culminating in metaphysics, and thus, as a phenomenon deeply intertwined with the crisis of Western sciences, but not identical to it

Origin of acidic surface waters and the evolution of atmospheric chemistry on early Mars

Observations from in situ experiments and planetary orbiters have shown that the sedimentary rocks found at Meridiani Planum, Mars were formed in the presence of acidic surface waters. The water was thought to be brought to the surface by groundwater upwelling, and may represent the last vestiges of the widespread occurrence of liquid water on Mars. However, it is unclear why the surface waters were acidic. Here we use geochemical calculations, constrained by chemical and mineralogical data from the Mars Exploration Rover Opportunity, to show that Fe oxidation and the precipitation of oxidized iron (Fe^(3+)) minerals generate excess acid with respect to the amount of base anions available in the rocks present in outcrop. We suggest that subsurface waters of near-neutral pH and rich in Fe^(2+) were rapidly acidified as iron was oxidized on exposure to O_2 or photo-oxidized by ultraviolet radiation at the martian surface. Temporal variation in surface acidity would have been controlled by the availability of liquid water, and as such, low-pH fluids could be a natural consequence of the aridification of the martian surface. Finally, because iron oxidation at Meridiani would have generated large amounts of gaseous H_2, ultimately derived from the reduction of H_2O, we conclude that surface geochemical processes would have affected the redox state of the early martian atmosphere