Preserving Dignity in Care: Nursing Student Perspectives

This paper presents findings from a study exploring nursing students’ perspectives on ‘people’ and ‘place’ influences on the preservation of dignity in care. Participants identified more ‘people’ factors than ‘place’ ones and ranked the former as being more important than the latter. A total of 31 participants were recruited from a three-year undergraduate preregistration adult nursing programme in the West of Scotland. Nominal Group Technique (NGT) and content analysis were used, and each participant attended one of five nominal groups. Following the NGT process of scoring and ranking, each group concluded with the identification of the group’s ‘Top 5’ most important influences on dignity in care. Findings raise questions around the extent to which behaviour and relationships are explicit in curricula, and how effectively students are enabled to consider the context which influences that behaviour

Regulation of suppressor of cytokine signalling-3 expression by cyclic-AMP in pro-myeloid cells

Suppressors of cytokine signalling (SOCS) protein induction via the "Janus kinase- signal transducer and activator of transcription" (JAK-STAT) pathway has been shown to be a critical negative feedback mechanism that prevents inappropriately sustained signalling from activated cytokine receptors. It also provides a mechanism by which other signalling modules could potentially regulate the JAK-STAT pathway. In this study, I have demonstrated that elevation of the prototypical second messenger cyclic AMP (cAMP) is capable of promoting the time- and concentration-dependent accumulation of the SOCS-3 isoform in U937 human promyeloid cells and HL60 human promyoblast cells. Experiments with MG132 demonstrated that cAMP specifically promoted SOCS-3 synthesis rather than blocking its degradation by the proteasome. The accumulation of SOCS-3 in U937 cells correlated with a reduced ability of the granulocyte-colony stimulating factor (G-CSF) receptor, which is a bona fide target for SOCS-3 in vivo, to promote the Tyr phosphorylation of STAT3 and the dual Thr/Tyr phosphorylation of ERK, suggesting that the cAMP-mediated accumulation of SOCS-3 is sufficient to suppress JAK-STAT pathway activation by this receptor. Further characterisation of the response demonstrated that SOCS-3 induction could not be blocked by H89, an inhibitor of cAMP-dependent protein kinase (PKA), suggesting that a PKA independent mechanism was responsible. Consistent with this hypothesis, selective activation of PKA with the selective cAMP analogue 6Be-cAMP failed to promote SOCS-3 accumulation. Surprisingly, selective activation of "Exchange protein activated by cAMP" (Epac), a recently identified PKA-independent intracellular sensor of cAMP, using the cAMP analogue 8pCPT- 20Me-cAMP also failed to promote SOCS-3 accumulation. Moreover, the inability of both 6Be-cAMP and 8pCPT-20Me-cAMP to promote SOCS-3 accumulation was not due to a lack of biological activity, since both were able to stimulate the phosphorylation of ERK in U937 cells at the concentrations used to assess SOCS-3 induction. Finally, preliminary experiments employing inhibitors of various signalling pathways revealed that cAMP-mediated SOCS-3 accumulation occurred via a JAK-, p38- and ERK-independent mechanism. Thus, it is proposed that cAMP elevation may promote the accumulation of SOCS-3 in U937 cells via a novel pathway leading to increased SOCS-3 synthesis that is independent of the known cAMP sensors PKA and Epac, and which may thus involve a currently unknown intracellular sensor of cAMP

A cancer cell-line titration series for evaluating somatic classification.

BackgroundAccurate detection of somatic single nucleotide variants and small insertions and deletions from DNA sequencing experiments of tumour-normal pairs is a challenging task. Tumour samples are often contaminated with normal cells confounding the available evidence for the somatic variants. Furthermore, tumours are heterogeneous so sub-clonal variants are observed at reduced allele frequencies. We present here a cell-line titration series dataset that can be used to evaluate somatic variant calling pipelines with the goal of reliably calling true somatic mutations at low allele frequencies.ResultsCell-line DNA was mixed with matched normal DNA at 8 different ratios to generate samples with known tumour cellularities, and exome sequenced on Illumina HiSeq to depths of >300×. The data was processed with several different variant calling pipelines and verification experiments were performed to assay >1500 somatic variant candidates using Ion Torrent PGM as an orthogonal technology. By examining the variants called at varying cellularities and depths of coverage, we show that the best performing pipelines are able to maintain a high level of precision at any cellularity. In addition, we estimate the number of true somatic variants undetected as cellularity and coverage decrease.ConclusionsOur cell-line titration series dataset, along with the associated verification results, was effective for this evaluation and will serve as a valuable dataset for future somatic calling algorithm development. The data is available for further analysis at the European Genome-phenome Archive under accession number EGAS00001001016. Data access requires registration through the International Cancer Genome Consortium's Data Access Compliance Office (ICGC DACO)

Provider Insight on Surmounting Specialty Practice Challenges to Improve Tdap Immunization Rates among Pregnant Women

Background Pertussis, or “whooping cough,” is an acute, contagious pulmonary disease that, despite being vaccine-preventable, has become an increasingly widespread problem in the United States. As a result, the Advisory Committee on Immunization Practices and American College of Obstetricians and Gynecologists updated recommendations stating clinicians should give a Tdap dose during every pregnancy, preferably at 27–36 weeks. Despite this recommendation, reported Tdap vaccine receipt rates during pregnancy vary from 16–61%, and previous studies have shown that clinician recommendation and vaccine administration are strongly associated with vaccine uptake among pregnant women. Methods Our aim was to inform new strategies to increase uptake of the Tdap vaccine among pregnant women and, ultimately, reduce pertussis-related morbidityand mortality in infants. We conducted interviewswith a sample of 24 ob-gyns. We subsequently performed grounded theory analyses of transcripts using deductive and inductive coding strategies followed by intercoder reliability assessment. Results All physicians interviewed were familiar with the most recent recommendation of giving the Tdap vaccine during the third trimester of every pregnancy, and the majority of physicians stated that they felt that the vaccine was important and effective due to the transfer of pertussis antibodies from the mother to the fetus. Most physicians indicated that they recommended the vaccine to patients during pregnancy, but not all reported administering it on site because it was not stocked at their practice. Implementation challenges for physicians included insurance reimbursement and other challenges (i.e., patient refusal). Tdap vaccinationduring pregnancy was a lower clinical priority for some physicians. Physicians recognized the benefits associated with Tdap vaccination during pregnancy. Conclusions Findings indicate while most ob-gyns recognize the benefits of Tdap and recommend vaccination during pregnancy, barriers such as insurance reimbursement and financial concerns for the practice can outweigh the perceived benefits. This resulted in some ob-gyns reporting choosing not to stock and administer the vaccine in their practice. Recommendations to address these concerns include 1) structural support for Tdap vaccine administration in ob-gyns practices; 2) Continuing medical education-equivalent educational interventions that address management techniques, vaccine coding, and other relevant information; and 3) interventions to assist physicians in communicating the importance of Tdap vaccination during pregnancy

Stigma, Help Seeking, and Substance Use

Researchers used path analysis to examine self-stigma, help seeking, and alcohol and other drug (AOD) use in a community sample of individuals (N = 406) recruited through the crowdsourcing platform MTurk. Self-stigma of help seeking contributed to AOD use and was mediated by help-seeking attitudes. We discuss the implications for advocacy and stigma reduction in substance use treatment. Counselors and counselor educators can implement and advocate for interventions and training that increase positive attitudes toward seeking help, such as providing appropriate training with supervisees and counselors-in-training, providing clients and the community with mental health literacy, and engaging in more advocacy. Moreover, they can challenge thoughts of seeking help as weakness, normalize seeking psychological help, and discuss the benefits of counseling and therapy to address the development and effects of self-stigma of help seeking for individuals with substance use issues

A practical guide to the systematic application of nominal group technique.

Background: Nominal group technique (NGT) is a highly structured, commonly used way of exploring areas of interest and developing consensus. However, it is sometimes conflated with focus group methods. Aim: To provide a rationale for selecting NGT as a research method and to examine its systematic application in a doctoral Q-methodology study exploring nursing students' perspectives of preserving dignity in care. Discussion: An outline of NGT is provided, and it is distinguished from focus group methods. As well as providing a step-by-step guide to using NGT, each step is illustrated with its practical application in the study, and the lessons learned concerning the limitations and strengths of NGT in the context of one study are shared. Conclusion: When applied systematically, NGT enables nurse researchers to collaborate in a meaningful and engaging way with participants and generate tangible outcomes relatively quickly. for practice This paper offers practical insight into the use of NGT to explore perceptions and develop consensus