Reflective Journaling Intervention to Impact Self-awareness, Professional Health, and Overall Well-being in Nurses

Background. Burnout among nurses has been on the rise and was exacerbated with the pandemic. Reflective journaling after work may be a strategy to decrease feelings of burnout. Reflective journaling, as an intervention, has been shown to improve self-awareness, compassion fatigue, and burnout among nurses. The purpose of this study was to pilot a 4-week reflective journaling intervention in hospital-based nurses and describe participant professional quality of life, self-awareness, and overall well-being. Theoretical Framework. The Theory of Reasoned Action (TRA) was chosen as the theoretical framework because it identifies the belief that performing a particular behavior will lead to a specific outcome. The model focuses on how intentions and behaviors are affected by attitudes over time. Methods. A single group pre/post quasi-experimental design was used with measures collected at baseline and immediately following the 4-week reflective journaling intervention. Nebraska hospital-based registered nurses who worked at least two shifts per week were asked to participate. The intervention included viewing a 15-minute training video on reflective journaling. Journaling prompts and reminders were sent via email twice a week. Participants were asked to journal at least five minutes after a shift using a journal prompt link that was sent via email using REDCap, a secure electronic database. Demographic data was collected only at baseline and measures of professional quality of life (ProQOL), self-awareness (SAOQ), and overall well-being (SF-36) were collected at baseline and at the completion of the study. Results. Twelve nurses were enrolled in total and completed baseline measures. The sample was comprised of all Caucasian females with an age range of 23-58 years and average of 7.1 years in nursing. The nurses worked in a variety of settings including emergency, intensive care, transport, oncology, organ transplant, pediatrics, and step-down critical care. Both night shift and 3 day shift nurses participated in the study. Five participants completed 50% (4/8) of the requested journal entries. Journal entries were between 1 and 306 words in length. Participants were separated between completers and non-completers. One component of the SF-36 was statistically significant, completers were more emotionally stressed than the non-completers. Topics written about included feelings of being overwhelmed, frustration, and gratitude for journaling as an outlet. Conclusions. Recruitment and intervention engagement of nurses on the front lines during a pandemic was a challenge and has implications for future interventions. Only one participant completed both pre and post measures and only half of the participants completed at least one journal. At baseline, participants who completed journaling reported a higher level of emotional problems that affected their ability to work effectively. Participant comments suggest reflective journaling has value, which should be investigated further. Strategies to recruit and retain participants in a reflective journaling intervention study will be needed

The Reproductive Ecology of Graptemys geographica in the Central Canal

Life for all organisms involves carefully managing a limited amount of resources. In many cases these resources affect how organisms Jive on a daily basis. In addition to competition from other species, organisms face competition within their own species, populations, and niches. Those individuals that manage their resources effectively will increase their chances of survival, reproduction, and the continuation of their genes in the gene pool. Studies that focus on life history characteristics of organisms aim to understand the mechanisms used by organisms to increase the chances that their genes will remain in thegenepoolpasttheirown Iifetime.Thegoal ofthesemechanisms istoensuresurvival and maximize reproduction. The techniques used for survival are often unique for a given species or population, and studying these techniques along with their associated life history characteristics provides scientists basic infonnation about how an organism interacts with its surrounding community. This infonnation can then be used to understand the consequences associated with modifications (whether natural or anthropogenic) to the organism\u27s environment, and ultimately be used to help conserve and protect organisms

Feasibility Study of a Thermal Spectrum Thorium Breeder Reactor Without Chemical Reprocessing

This thesis presents a feasibility study of a thorium fueled thermal spectrum breeder-burner reactor that operates without chemical reprocessing. Materials were evaluated for their potential as moderators using standard analytical methods. These materials were then used as moderators to evaluate criticality and enrichment in an infinite fuel pin lattice. The criticality and heavy metal mass of the system as a function of burnup were then used to calculate a neutron balance for each case. The neutron balance indicated that there are insufficient neutrons available in an infinite lattice to operate in a breed-and-burn configuration. A core model was developed to confirm the results of the infinite lattice. Design bounds were developed from the lattice investigation, and used by an optimization routine to evaluate reactor cores with one-quarter symmetry. The black-box optimization program, Gnowee, coupled to the neutronics and depletion code, SCALE, was used to facilitate the process. This procedure required the development of an automated core generation tool that could read the output perturbations from Gnowee and translate that into a new input for SCALE, and a tool to read the output of SCALE to inform the objective function and constraints in Gnowee. None of the core configurations operated with breeding while remaining critical. A two-region infinite lattice using annular fuel pins with enriched breeder blankets was used to test alternative fuel swapping schemes. The two-region infinite lattice analysis indicated that fuel in an annular geometry with an enriched blanket could remain critical while breeding in a breeder-burner configuration

Instrumentos administrativos para a efetivação igualitária do direito à saúde

Orientador: Daniel Wunder HachemMonografia (graduação) - Universidade Federal do Paraná, Setor de Ciências Jurídicas, Curso de Graduação em DireitoResumo: O objetivo fundamental do presente trabalho é demonstrar que a implementação integral, universal e igualitária do direito à saúde depende da atuação da Administração Pública. Para atingir tal objetivo é necessário estudar instrumentos administrativos que viabilizem uma atuação integral e isonômica do Poder Público. Portanto, este trabalho irá tratar, em suma: (i) do desenvolvimento histórico do direito à saúde no Brasil; (ii) do regime jurídico constitucional destinado ao direito à saúde após a promulgação da Constituição Federal de 1988; (iii) da excessiva judicialização como entrave para uma implementação igualitária do direito à saúde, demonstrando a necessidade da atuação da Administração Pública para a efetivação integral e universal deste direito; (iv) da aplicação da técnica do silêncio positivo como ferramenta para solucionar o problema da demora da Administração em responder as demandas de saúde apresentadas perante os entes administrativos; e (v) da observância dos precedentes administrativos e judiciais, por parte da Administração Pública, como instrumento administrativo capaz de efetivar o direito à saúde de forma igualitária, reduzindo, assim, o problema da desigualdade ocasionada pelo ativismo judicia

Reclassification of the polyphyletic genus Prosthecomicrobium to form two novel genera, Vasilyevaea gen. nov. and Bauldia gen. nov. with four new combinations: Vasilyevaea enhydra comb. nov., Vasilyevaea mishustinii comb. nov., Bauldia consociata comb. nov. and Bauldia litoralis comb. nov.

Species of the genus Prosthecomicrobium are noted for their numerous cellular appendages or prosthecae that extend from the cells. This investigation confirms that the genus is polyphyletic based on an extensive analysis of the 16S rRNA gene sequences of several named species of the genus. The analyses indicate that some Prosthecomicrobium species are more closely related to non-prosthecate genera, including Devosia, Labrenzia, Blastochloris, Methylosinus, Mesorhizobium and Kaistia, than they are to other species of the genus Prosthecomicrobium. For this reason, two of the Prosthecomicrobium clades which are polyphyletic with the type species, Prosthecomicrobium pneumaticum, are renamed as new genera. The currently named species Prosthecomicrobium enhydrum, Prosthecomicrobium mishustinii, Prosthecomicrobium consociatum and Prosthecomicrobium litoralum are reclassified in two new genera, Vasilyevaea gen. nov. and Bauldia gen. nov. with four new combinations: Vasilyevaea enhydra comb. nov. (the type species) and Vasilyevaea mishustinii comb. nov., and Bauldia consociata comb. nov. and Bauldia litoralis comb. nov. (the type species). The type strain of Vasilyevaea enhydra is strain 9bT (=ATCC 23634T =VKM B-1376T). The type strain of the other species in this genus is Vasilyevaea mishustinii strain 17T (=VKM B-2499T =CCM 7569T). The type strain of Bauldia litoralis is strain 524-16T (= NCIB 2233T =ATCC 35022T). The type strain of the other species in this genus is Bauldia consociata strain 11T (=VKM B-2498T =CCM 7594T)

Recommended standards for the description of new species of anoxygenic phototrophic bacteria

Recommended standards for the description of new species of the anoxygenic phototrophic bacteria are proposed in accordance with Recommendation 30b of the International Code of Nomenclature of Bacteria. These standards include information on the natural habitat, ecology and phenotypic properties including morphology, physiology and pigments and on genetic information and nucleic acid data. The recommended standards were supported by the Subcommittee on the taxonomy of phototrophic bacteria of the International Committee on Systematics of Prokaryotes. They are considered as guidelines for authors to prepare descriptions of new specie

Clinical, neuroradiological, and molecular characterization of mitochondrial threonyl-tRNA-synthetase (TARS2)-related disorder

PURPOSE: Biallelic variants in TARS2, encoding the mitochondrial threonyl-tRNA-synthetase, have been reported in a small group of individuals displaying a neurodevelopmental phenotype, but with limited neuroradiological data and insufficient evidence for causality of the variants. METHODS: Exome or genome sequencing was carried out in 15 families. Clinical and neuroradiological evaluation was performed for all affected individuals, including review of 10 previously reported individuals. The pathogenicity of TARS2 variants was evaluated using in vitro assays, and a zebrafish model. RESULTS: We report 18 new individuals harboring biallelic TARS2 variants. Phenotypically, these individuals show developmental delay/intellectual disability, regression, cerebellar and cerebral atrophy, basal ganglia signal alterations, hypotonia, cerebellar signs and increased blood lactate. In vitro studies showed that variants within the TARS2301-381 region had decreased binding to Rag GTPases, likely impairing mTORC1 activity. The zebrafish model recapitulated key features of the human phenotype and unraveled dysregulation of downstream targets of mTORC1 signaling. Functional testing of the variants confirmed the pathogenicity in a zebrafish model. CONCLUSION: We define the clinico-radiological spectrum of TARS2-related mitochondrial disease, unveil the likely involvement of the mTORC1 signaling pathway as a distinct molecular mechanism, and establish a TARS2 zebrafish model as an important tool to study variant pathogenicity