Reclaiming our sacredness as nurse healers

The nurse-patient relationship encompasses the richness of being in a relationship with another human being. When viewed through a healthcare lens a patient\u27s health, illness, and healing are often defined by procedural testing, diagnosis, and a plan for treatment. Within the community of professional nurses, it is known that healing involves more than an attempt to physically repair the human body. The use of nursing theory, caring science, and recognition of the patient in their wholeness guides nursing practice. Nurses incorporate the use of experiential wisdom (metis) in caring for the life force of another human being in the effort to restore the patient\u27s wholeness. During caring moments nurses have the ability to touch the patient\u27s soul so the individual can heal physically, emotionally, and spiritually. The profession of a nurse is physically, emotionally, and spiritually challenging. As a profession, there is a profound personal and professional responsibility to care for oneself before extending care to another human being. Nurses must care for their own souls so that nursing can reclaim the historic sacredness as nurse healers. The capacity for intentional caring is magnified when integrated with the use of healing rituals and ceremonies as self-care strategies and synthesized with caring, environment, and integral nursing theory

Intracellular calcium transients are necessary for platelet-derived growth factor but not extracellular matrix protein–induced vascular smooth muscle cell migration

AbstractPurposeVascular smooth muscle cell (SMC) migration is a critical component of the hyperplastic response that leads to recurrent stenosis after interventions to treat arterial occlusive disease. We investigated the relationship between intracellular calcium ([Ca2+]i) and migration of vascular SMCs in response to platelet-derived growth factor (PDGF) and extracellular matrix (ECM) proteins.MethodsHuman saphenous vein SMCs were used for all experiments. SMC migration in response to agonists was measured with a microchemotaxis assay. A standard fluorimetric assay was used to assess changes in [Ca2+]i in response to the various combinations of growth factors and ECM proteins.ResultsThe calcium ionophore A23187 produced a rapid rise in [Ca2+]i and a corresponding 60% increase in SMC migration, whereas chelation of [Ca2+]i with BAPTA (1,2-bis [aminophenoxy] ethane-N,N,N′,N′-tetraacetic acid) produced a fivefold decrease in PDGF-induced chemotaxis, suggesting that [Ca2+]i is both sufficient and necessary for SMC migration. Stimulation of SMCs with PDGF produced an early peak followed by a late plateau in [Ca2+]i. To establish a relationship between temporal fluctuations in [Ca2+]i and SMC migration, SMCs were pretreated with caffeine and ryanadine, which eliminated the initial peak but not the late plateau in [Ca2+]i, and had no effect on chemotaxis in response to PDGF. Incubation of SMCs with nickel chloride eliminated the late plateau, but had no effect on the initial peak in [Ca2+]i, and reduced PDGF-stimulated migration by fivefold. We then evaluated the role of calcium in SMC migration induced by ECM proteins such as laminin, fibronectin, and collagen types I and IV. All four matrix proteins stimulated SMC migration, but none produced an elevation in [Ca2+]i. Moreover, preincubation of SMCs with caffeine and ryanadine or nickel chloride had no effect on ECM protein-induced chemotaxis.Conclusion[Ca2+]i transients are necessary for PDGF but not ECM protein-induced SMC chemotaxis. Moreover, the ability of PDGF to stimulate vascular SMC migration appears dependent on influx of extracellular calcium through membrane channels.AbstractClinical relevanceRecurrent stenosis after angioplasty or surgical bypass remains a significant challenge in treating vascular occlusive disease. In addition to growth factors, extracellular matrix (ECM) proteins may be potent agonists of this process. In this study we show that the influx of extracellular calcium is an important mechanism for platelet-derived growth factor–induced smooth muscle cell migration but not ECM-induced migration. Of note, in clinical trials calcium channel blockers failed to inhibit recurrent stenosis. Our data provide mechanistic insight to help explain this negative outcome in that therapies designed to inhibit restenosis depend on the effects of both growth factors and ECM proteins

Breed type influences hypothalamic-pituitary-adrenal axis activity and responsiveness to exogenous bovine corticotropin-releasing hormone (hCRR) in beef steers

Last updated: 6/12/200

Receiving Stocker Cattle Performance is Similar With Either Corn or Sorghum Wet Distillers Grains

Distillers grains are an excellent energy and protein feed source for beef cattle. Corn distillers grains have been fed to beef cattle for many years, but sorghum distillers grains are becoming more popular and may be more cost effective than corn. Sorghum is very comparable to corn in terms of energy, but has a higher crude protein value. All distillers grains are available in a wet and dry form. The moist texture of wet distillers grains can help to reduce sorting at the bunk and appears to improve intake in young calves. The objective of this study was to evaluate the effect of corn and sorghum wet distillers grains on performance and digestibility of receiving stocker calves

Trends in the Treatment of Adults with Ureteropelvic Junction Obstruction

Background and Purpose: Minimally invasive pyeloplasty is an effective treatment for patients with ureteropelvic junction obstruction that offers quicker convalescence than open pyeloplasty. Technical challenges, however, may have limited its dissemination. We examined population trends and determinants of surgical options for ureteropelvic junction obstruction. Patients and Methods: Using the State Inpatient and Ambulatory Surgery Databases for Florida, we identified adults who underwent ureteropelvic junction obstruction repair between 2001 and 2009. After determining the surgical approach (minimally invasive pyeloplasty, open pyeloplasty, or endopyelotomy), we estimated annual utilization rates and the effects of patient, surgeon, and hospital predictors on surgery type, using multilevel multinomial logistic regression. Results: Rates of minimally invasive pyeloplasty increased 360% (P for monotonic trendPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140371/1/end.2012.0017.pd

Ambulatory Surgery Centers and Their Intended Effects on Outpatient Surgery

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113726/1/hesr12278.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/113726/2/hesr12278-sup-0001-AppendixSA1.pd

Resurrecting immortal‐time bias in the study of readmissions

ObjectiveTo compare readmission rates as measured by the Centers for Medicare and Medicaid Services and the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) methods.Data Sources20 percent sample of national Medicare data for patients undergoing cystectomy, colectomy, abdominal aortic aneurysm (AAA) repair, and total knee arthroplasty (TKA) between 2010 and 2014.Study DesignRetrospective cohort study comparing 30‐day readmission rates.Data Collection/Extraction MethodsPatients undergoing cystectomy, colectomy, abdominal aortic aneurysm repair, and total knee arthroplasty between 2010 and 2014 were identified.Principal FindingsCystectomy had the highest and total knee arthroplasty had the lowest readmission rate. The NSQIP measure reported significantly lower rates for all procedures compared to the CMS measure, which reflects an immortal‐time bias.ConclusionsWe found significantly different readmission rates across all surgical procedures when comparing CMS and NSQIP measures. Longer length of stay exacerbated these differences. Uniform outcome measures are needed to eliminate ambiguity and synergize research and policy efforts.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154628/1/hesr13252-sup-0001-Authormatrix.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154628/2/hesr13252.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154628/3/hesr13252_am.pd

Horn Fly Control and Growth Implants are Effective Strategies for Heifers Grazing Flint Hills Pasture

Horn flies (Haematobia irritans (L.)) are considered the most important external parasite that negatively affects pasture-based beef systems with losses estimated to exceed $1 billion annually to the U.S. beef industry. Control strategies have relied heavily on insecticide applications to control horn flies and are implemented when the economic threshold of 200 flies/animal have been exceeded. When horn fly populations are maintained below 200 flies/animal by treating them with insecticides then the level of stress annoyance behaviors such as leg stomping, head throwing, and skin twitching decreases while grazing increases. While most stocker operators utilize some type of fly control these are rarely used as a single pharmaceutical technology to aid in performance of the animals. Additional pharmaceutical technologies are utilized in combination of others, with the use of de-wormers and implants showing the largest impact with performance of stockers. The objective of this study was to compare a commercial injectable insecticide, LongRange, to an insecticidal ear tag for horn fly control and determine the impact of weight performance on stockers when fly control technologies were used in combination with implants versus no implants