An examination of case management nurses\u27 role strain, participative decision making, and their relationships to patient satisfaction : utilization of King\u27s Theory of Goal Attainment in a managed care environment

One way of accommodating quality and cost contained health care in a managed care environment has been to incorporate a case management process. Producing Healthcare in this manner required the development of a new role, the Case ManagementNurse (CMN). Restructuring organizational communication processes, provides CMNs opportunities to collaborate with physicians to provide quality care. CMNs role strain,participation in decision making, and collaboration is examined in this study for their relationship with patient satisfaction.King\u27s Theory of Goal Attainment guides this study using a model of transactions which includes feedback, perception, reaction, interaction, and transaction. This study expands King\u27s Theory including physicians as die isomorphic equivalent of the client in the model of transactions. A descriptive correlational design was used to analyze responses from survey instruments sent to a group of CMNs and to patients who had been under the CMNs care, Pearson\u27s correlation coefficients were calculated resulting infindings that identify CMN role conflict and role ambiguity being positively related to participation in decision making and collaboration. Serendipitously, Baccalaureate or higher education CMN preparation was found to be positively related to role conflict, role ambiguity, participation in decision making, and patient satisfaction

Developing through mentoring or being mentored: ALDinHE’s new mentoring scheme and certified mentor recognition

ALDinHE is launching its new mentoring scheme and mentorship recognition to acknowledge, promote and recognise the importance of mentoring for learning development as a field that does not offer an official route into the profession. This Professional Development session introduced the mentoring scheme, explaining how to get involved, what support mentors and mentees can receive from ALDinHE and what benefits both sides can get from mentoring or being mentored. If you’re new to learning development or keen to develop more experience in a specific area with the help of a mentor, the mentoring scheme will offer you a brilliant framework to broaden your expertise. If you’re an experienced learning developer or have specific expertise you could share, find out how you could become recognised as a Certified Mentor (CeM) in learning development by ALDinHE

Measurement of liver iron by magnetic resonance imaging in the UK Biobank population

The burden of liver disease continues to increase in the UK, with liver cirrhosis reported to be the third most common cause of premature death. Iron overload, a condition that impacts liver health, was traditionally associated with genetic disorders such as hereditary haemochromatosis, however, it is now increasingly associated with obesity, type-2 diabetes and non-alcoholic fatty liver disease. The aim of this study was to assess the prevalence of elevated levels of liver iron within the UK Biobank imaging study in a cohort of 9108 individuals. Magnetic resonance imaging (MRI) was undertaken at the UK Biobank imaging centre, acquiring a multi-echo spoiled gradient-echo single-breath-hold MRI sequence from the liver. All images were analysed for liver iron and fat (expressed as proton density fat fraction or PDFF) content using LiverMultiScan™. Liver iron was measured in 97.3% of the cohort. The mean liver iron content was 1.32 ± 0.32 mg/g while the median was 1.25 mg/g (min: 0.85 max: 6.44 mg/g). Overall 4.82% of the population were defined as having elevated liver iron, above commonly accepted 1.8 mg/g threshold based on biochemical iron measurements in liver specimens obtained by biopsy. Further analysis using univariate models showed elevated liver iron to be related to male sex (p5.6% PDFF) was associated with a slight increase in prevalence of elevated liver iron (4.4% vs 6.3%, p=0.0007). This study shows that population studies including measurement of liver iron concentration are feasible, which may in future be used to better inform patient stratification and treatment

Molecular Composition of Carbonaceous Globules in the Bells (CM2) Chondrite

Some meteorites and IDPs contain micron-size carbonaceous globules that are associated with significant H and/or N isotopic anomalies. This has been interpreted as indicating that such globules may contain at least partial preserved organic species formed in the outer reaches of the proto-solar disk or the presolar cold molecular cloud. Owing to their small sizes, relatively little is known about their chemical compositions. Here we present in situ measurements of aromatic molecular species in organic globules from the Bells (CM2) chondrite by microprobe two-step laser mass spectrometry. This meteorite was chosen for study because we have previously found this meteorite to contain high abundances of globules that often occur in clusters. The Bells (CM2) globules are also noteworthy for having particularly high enrichments in H-2. and N-15. In this study, we identified individual globules and clusters of globules using native UV fluorescence

Observation and analysis of in situ carbonaceous matter in Nakhla: Part I

New analyses of indigenous secondary material in the martian meteorite Nakhla reveal amorphous carbon-rich veins and dendrites. The texture and chemistry of this material resembles that of biogenically altered sub-ocean basaltic glasses

IP-10/CXCL10 induction in human pancreatic cancer stroma influences lymphocytes recruitment and correlates with poor survival

Pancreatic ductal adenocarcinoma (PDAC) is characterized by an abundant desmoplastic reaction driven by pancreatic stellate cells (PSCs) that contributes to tumor progression. Here we sought to characterize the interactions between pancreatic cancer cells (PCCs) and PSCs that affect the inflammatory and immune response in pancreatic tumors. Conditioned media from mono- and cocultures of PSCs and PCCs were assayed for expression of cytokines and growth factors. IP-10/CXCL10 was the most highly induced chemokine in coculture of PSCs and PCCs. Its expression was induced in the PSCs by PCCs. IP-10 was elevated in human PDAC specimens, and positively correlated with high stroma content. Furthermore, gene expression of IP-10 and its receptor CXCR3 were significantly associated with the intratumoral presence of regulatory T cells (Tregs). In an independent cohort of 48 patients with resectable pancreatic ductal adenocarcinoma, high IP-10 expression levels correlated with decreased median overall survival. Finally, IP-10 stimulated the ex vivo recruitment of CXCR3+ effector T cells as well as CXCR3+ Tregs derived from patients with PDAC. Our findings suggest that, in pancreatic cancer, CXCR3+ Tregs can be recruited by IP-10 expressed by PSCs in the tumor stroma, leading to immunosuppressive and tumor-promoting effects