Georgia College & State University Nursing Program

In order to evaluate the effectiveness of the Georgia College & State University (GC&SU) Nursing Program, a non-experimental, survey research study was conducted by senior nursing students in the Nursing Research class. The survey evaluated the teaching and learning strategies used in the program, the students\u27 perceptions of preparedness for nursing after graduation, and the students\u27 perceptions of the strengths and weaknesses of the GC&SU nursing curriculum. Each participant signed an informed consent form. Forty-five out of a possible 142 nursing students responded to the survey. A statistical analysis of the responses was conducted and comparisons of answers were analyzed across the different nursing cohorts. Implications and recommendations for changes for the GC&SU Nursing Program were stated. As demand for registered nurses continues to increase, nursing programs in the United States are rising to meet this need by educating clinically proficient nurses. GC&SU nursing program graduates approximately 80 nursing students per year. In May 2003, 94% of the nursing graduates passed the licensure exam, helping fill the need in healthcare settings. Nursing faculty realize that they must prepare nurses who are adept at performing essential nursing skills including assessment, safe medication administration, nursing care for ill clients and health teaching

Maintenance N-acetyl cysteine treatment for bipolar disorder : a double-blind randomised placebo controlled trial

Background N-acetyl cysteine (NAC) is a glutathione precursor that has been shown to have antidepressant efficacy in a placebo-controlled trial. The current study aimed to investigate the maintenance effects of NAC following eight weeks of open-label treatment for bipolar disorder.Method The efficacy of a double blind randomized placebo controlled trial of 2 g/day NAC as adjunct maintenance treatment for bipolar disorder was examined. Participants (n = 149) had a Montgomery Asberg Depression Rating Score of [greater than or equal to]12 at trial entry and, after eight weeks of open-label NAC treatment, were randomized to adjunctive NAC or placebo, in addition to treatment as usual. Participants (primarily outpatients) were recruited through public and private services and through newspaper advertisements. Time to intervention for a mood episode was the primary endpoint of the study, and changes in mood symptoms, functionality and quality of life measures were secondary outcomes.Results There was a substantial decrease in symptoms during the eight-week open-label NAC treatment phase. During the subsequent double-blind phase, there was minimal further change in outcome measures with scores remaining low. Consequently, from this low plateau, between-group differences did not emerge on recurrence, clinical functioning or quality of life measures.Conclusions There were no significant between-group differences in recurrence or symptomatic outcomes during the maintenance phase of the trial; however, these findings may be confounded by limitations. Trial Registration The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12607000074493)

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Effectiveness of nail bed repair in children with or without replacing the fingernail : NINJA multicentre randomized clinical trial

Background Surgery for nail bed injuries in children is common. One of the key surgical decisions is whether to replace the nail plate following nail bed repair. The aim of this RCT was to assess the clinical effectiveness and cost-effectiveness of nail bed repair with fingernail replacement/substitution compared with repair without fingernail replacement. Methods A two-arm 1 : 1 parallel-group open multicentre superiority RCT was performed across 20 secondary-care hospitals in the UK. The co-primary outcomes were surgical-site infection at around 7 days after surgery and cosmetic appearance summary score at a minimum of 4 months. Results Some 451 children presenting with a suspected nail bed injury were recruited between July 2018 and July 2019; 224 were allocated to the nail-discarded arm, and 227 to the nail-replaced arm. There was no difference in the number of surgical-site infections at around 7 days between the two interventions or in cosmetic appearance. The mean total healthcare cost over the 4 months after surgery was €84 (95 per cent c.i. 34 to 140) lower for the nail-discarded arm than the nail-replaced arm (P < 0.001). Conclusion After nail bed repair, discarding the fingernail was associated with similar rates of infection and cosmesis ratings as replacement of the finger nail, but was cost saving

Transforming the first-year engineering experience through authentic problem-solving: taking a models and modeling perspective.

A models and modeling perspective led to Model-Eliciting Activities (MEAs), authentic mathematical modeling problems, being introduced into a first-year engineering program in 2002. A design research perspective then led to iterative improvements in the design of these activities, strategies for their implementation, and strategies for assessing student work to promote effective learning across multiple learning objectives. This paper describes two different research threads that have lead to significant transformation of the first-year engineering experience. The first thread relates to problem formulation. The second thread relates to the dimensions along which instructors evaluate students’ open-ended problem solutions

Intensified decadal variability in tropical climate during the late 19th century

To evaluate and extend the record of decadal climate variability, we present a synthesis of 23 coral oxygen isotope records from the tropical Indo-Pacific that extends back to A. D. 1850. Principal components analysis (PCA) on detrended records reveals a leading pattern of variance with significant interannual (3 - 5 year) and decadal (9 - 14 year) variability. The temporal evolution and spatial pattern of this variability closely resembles the El Nino/Southern Oscillation (ENSO) pattern across both time scales, suggesting that this decadal tropical variability is fundamentally related to ENSO. The 19th century experienced stronger decadal tropical climate variability, compared to the 20th. Decadal variability in the tropical oceans thus remains underestimated by analysis of direct observations. Citation: Ault, T. R., J. E. Cole, M. N. Evans, H. Barnett, N. J. Abram, A. W. Tudhope, and B. K. Linsley (2009), Intensified decadal variability in tropical climate during the late 19th century, Geophys. Res. Lett., 36, L08602, doi: 10.1029/2008GL036924

The efficacy of adjunctive N-Acetylcysteine in major depressive disorder: a double-blind, randomized, placebo-controlled trial

Objective: Major depressive disorder (MDD) is one of the most common psychiatric disorders, conferring considerable individual, family, and community burden. To date, treatments for MDD have been derived from the monoamine hypothesis, and there is a paucity of emerging antidepressants, especially with novel mechanisms of action and treatment targets. N-acetylcysteine (NAC) is a redox-active glutathione precursor that decreases inflammatory cytokines, modulates glutamate, promotes neurogenesis, and decreases apoptosis, all of which contribute to the neurobiology of depression. Method: Participants with a current episode of MDD diagnosed according to DSM-IV-TR criteria (N = 252) were treated with NAC or placebo in addition to treatment as usual for 12 weeks and were followed to 16 weeks. Data were collected between 2007 and 2011. Results: The omnibus interaction between group and visit for the Montgomery-Asberg Depression Rating Scale (MADRS), the primary outcome measure, was not significant (F₁,₅₂₀.₉ = 1.98, P = .067), and the groups did not separate at week 12 (t₃₆₀.₃ = -1.12, P = .265). However, at week 12, the scores on the Longitudinal Interval Follow-Up Evaluation-Range of Impaired Functioning Tool (LIFE-RIFT) differed from placebo (P = .03). Among participants with a MADRS score >/- 25, NAC separated from placebo at weeks 6, 8, 12, and 16 (P < .05). Additionally, the rate of change between baseline and week 16 was significant (t₂₂₁.₀₃ = -2.11, P = .036). NAC treatment was superior to placebo at week 16 for secondary readouts of function and clinical impression. Remission and response were greater in the NAC group at week 16, but not at week 12. The NAC group had a greater rate of gastrointestinal and musculoskeletal adverse events. Conclusions: Being negative at the week 12 end point, and with some positive secondary signals, the study provides only limited support for the role of NAC as a novel adjunctive therapy for MDD. These data implicate the pathways influenced by NAC in depression pathogenesis, principally oxidative and inflammatory stress and glutamate, although definitive confirmation remains necessary.Michael Berk, Olivia M. Dean, Sue M.Cotton, Susan Jeavons, Michelle Tanious, Kristy Kohlmann, Karen Hewitt, Kirsteen Moss, Christine Allwang, Ian Schapkaitz, Jenny Robbins, Heidi Cobb, Felicity Ng, Seetal Dodd, Ashley I. Bush, Gin S. Malh