Executive Nursing Leadership: Change and Conflict related to the Triple Aim

Executive nurses work at the top of organizations and face unique challenges in today’s healthcare system. This qualitative study investigated the lived experiences of executive nurses to better understand their leadership journey. This study explored the professional development of executive nurses navigating change and conflict. The study used phenomenological inquiry and gathered data through individual semi-structured interviews, workplace observations, and document reviews. Based on the collected data experiential themes were identified. The study focused on executive nursing and the Institute for Healthcare Improvement’s (IHI) “Triple Aim” of creating better patient experiences, reducing system cost, and improving population health. The study interpreted critical turning points in executive nurses’ careers and triangulated data to identify, then, analyze central themes. Through the analysis of themes, new insights were created which connected current executive nurse functioning and future healthcare design. As a result, this study informed future thinking. The semi-structured interviews uncovered points of major change and conflict; particularly, related to fundamental organizational transformation, strategic goals, and the “Triple Aim”. Six key themes affecting executive nurse leadership emerged. The six key themes included: Focusing on population health, relationships, knowledge of the healthcare environment, technical leadership and change management skills, defined professional competencies, and central business skills. To provoke innovation and thought leadership, the six themes were interpreted using Zweig’s (2012) Class Theory, Shiva’s (2005) Perceptions of Corporate Power, and Plato’s Allegory of the Cave (Duarte, 2012)

Gellan Gum Fluid Gels for Topical Administration of Diclofenac

Diclofenac topical formulations are often preferred for drug administration to patients who experience serious GIT problems. Absorption of the drug through the skin, however, can be challenging due to the natural protective feature of the stratum corneum (SC). In this article, fluid gels prepared from gellan gum were explored as a topical drug delivery vehicle. Rheological analysis of the formulations showed that it was possible to produce a topical gel with a viscosity and the mechanical strength similar to that of the commercially available Voltaren® gel using 1 % w/w of a 50:50 low acyl/high acyl (LA/HA) gellan blend. Soft-tribology was used to assess the lubrication properties of gellan fluid gels. The lubrication of the gellan gum fluid gel formulations at high rubbing speeds was similar to the lubrication of the Voltaren® gel. The use of gellan gum dramatically increased skin permeation of diclofenac when compared with the commercially available formulation and could be controlled by changing the gellan gum concentration and/or sodium ion concentration in the formulation. This study highlights the potential use of fluid gels that can be easily tuned to have physical properties suitable for topical formulations with the added advantage of increasing drug permeation

Mechanistic interplay between ceramide and insulin resistance

Recent research adds to a growing body of literature on the essential role of ceramides in glucose homeostasis and insulin signaling, while the mechanistic interplay between various components of ceramide metabolism remains to be quantified. We present an extended model of C16:0 ceramide production through both the de novo synthesis and the salvage pathways. We verify our model with a combination of published models and independent experimental data. In silico experiments of the behavior of ceramide and related bioactive lipids in accordance with the observed transcriptomic changes in obese/diabetic murine macrophages at 5 and 16 weeks support the observation of insulin resistance only at the later phase. Our analysis suggests the pivotal role of ceramide synthase, serine palmitoyltransferase and dihydroceramide desaturase involved in the de novo synthesis and the salvage pathways in influencing insulin resistance versus its regulation

Is Homosexuality a Paraphilia? The Evidence For and Against

Whether homosexuality should be described as one among many paraphilic sexual interests or an altogether different dimension of sexual interest has long been discussed in terms of its political and social implications. The present article examined the question instead by comparing the major correlates and other features of homosexuality and of the paraphilias, including prevalence, sex ratio, onset and course, fraternal birth order, physical height, handedness, IQ and cognitive neuropsychological profile, and neuroanatomy. Although those literatures remain underdeveloped, the existing findings thus far suggest that homosexuality has a pattern of correlates largely, but not entirely, distinct from that identified among the paraphilias. At least, if homosexuality were deemed a paraphilia, it would be relatively unique among them, taxonometrically speaking

Characterizing Precision Nutrition Discourse on Twitter: Quantitative Content Analysis

BackgroundIt is possible that tailoring dietary approaches to an individual’s genomic profile could provide optimal dietary inputs for biological functioning and support adherence to dietary management protocols. The science required for such nutrigenetic and nutrigenomic profiling is not yet considered ready for broad application by the scientific and medical communities; however, many personalized nutrition products are available in the marketplace, creating the potential for hype and misleading information on social media. Twitter provides a unique big data source that provides real-time information. Therefore, it has the potential to disseminate evidence-based health information, as well as misinformation. ObjectiveWe sought to characterize the landscape of precision nutrition content on Twitter, with a specific focus on nutrigenetics and nutrigenomics. We focused on tweet authors, types of content, and presence of misinformation. MethodsTwitter Archiver was used to capture tweets from September 1, 2020, to December 1, 2020, using keywords related to nutrition and genetics. A random sample of tweets was coded using quantitative content analysis by 4 trained coders. Codebook-driven, quantified information about tweet authors, content details, information quality, and engagement metrics were compiled and analyzed. ResultsThe most common categories of tweets were precision nutrition products and nutrigenomic concepts. About a quarter (132/504, 26.2%) of tweet authors presented themselves as science experts, medicine experts, or both. Nutrigenetics concepts most frequently came from authors with science and medicine expertise, and tweets about the influence of genes on weight were more likely to come from authors with neither type of expertise. A total of 14.9% (75/504) of the tweets were noted to contain untrue information; these were most likely to occur in the nutrigenomics concepts topic category. ConclusionsBy evaluating social media discourse on precision nutrition on Twitter, we made several observations about the content available in the information environment through which individuals can learn about related concepts and products. Tweet content was consistent with the indicators of medical hype, and the inclusion of potentially misleading and untrue information was common. We identified a contingent of users with scientific and medical expertise who were active in discussing nutrigenomics concepts and products and who may be encouraged to share credible expert advice on precision nutrition and tackle false information as this technology develops