Exploring a Model of Clinical Leadership Grounded in Radiography: Developing Clinical Radiography Leaders

Purpose: The purpose of this study was to develop a model of clinical leadership that encompasses the specialized technical skills and leadership behaviors exhibited by clinical radiography leaders. This was accomplished by addressing the following research questions: (1) What were the commonly practiced clinical leadership behaviors associated with clinical radiography leaders? and (2) What were the common technical skills performed by radiographers that are associated with clinical radiography leaders? Theoretical Framework: This study was grounded in collaborative leadership which has been developed from the theoretical constructs of experiential learning and clinical supervision. Collaborative leadership occurs when multiple healthcare providers, including radiographers, utilize their clinical expertise and clinical decision-making skills to collectively image, care for, diagnose, and treat the patient. Methods: During this quantitative study, approximately 432 clinical radiography leaders, completed the Clinical Radiography Leadership Survey, which measured the technical skills and leadership behaviors aligned with clinical leadership in radiography. Data analysis included a correlational analysis to examine the relationships between the dimensions measuring technical skills and dimensions measuring leadership behaviors when defining clinical radiography leaders. Results: Participant responses were correlated individually, as well as aggregated by dimension, with p \u3e 0.3 being significant. The highest inter-dimensional correlation existed between Dimension 1 and 2 (p = .715) while exhibiting weak correlations to dimensions associated with clinical leadership behaviors. The results of confirmatory factor analysis revealed that a more global view of clinical leadership behaviors, as well as patient care and technical skills, informed participants’ view of clinical radiography leadership. Significance: This study explored a radiography-specific definition of clinical leadership that more appropriately captured the unique technical skills and leadership behaviors that are exhibited by clinical radiography leaders. By developing a more fine-grained and applicable definition of clinical leadership that is grounded in radiography, educators may embed competencies that align with clinical leadership in their program curriculum. By doing so, this will allow for the development of future clinical radiography leaders who display advanced clinical decision-making skills and provide higher levels of procedure performance and patient care

Modeling Drug Resistance Emergence and Transmission in HIV-1 in the UK

A deeper understanding of HIV-1 transmission and drug resistance mechanisms can lead to improvements in current treatment policies. However, the rates at which HIV-1 drug resistance mutations (DRMs) are acquired and which transmitted DRMs persist are multi-factorial and vary considerably between different mutations. We develop a method for the estimation of drug resistance acquisition and transmission patterns. The method uses maximum likelihood ancestral character reconstruction informed by treatment roll-out dates and allows for the analysis of very large datasets. We apply our method to transmission trees reconstructed on the data obtained from the UK HIV Drug Resistance Database to make predictions for known DRMs. Our results show important differences between DRMs, in particular between polymorphic and non-polymorphic DRMs and between the B and C subtypes. Our estimates of reversion times, based on a very large number of sequences, are compatible but more accurate than those already available in the literature, with narrower confidence intervals. We consistently find that large resistance clusters are associated with polymorphic DRMs and DRMs with long loss times, which require special surveillance. As in other high-income countries (e.g., Switzerland), the prevalence of sequences with DRMs is decreasing, but among these, the fraction of transmitted resistance is clearly increasing compared to the fraction of acquired resistance mutations. All this indicates that efforts to monitor these mutations and the emergence of resistance clusters in the population must be maintained in the long term

Wherever I may roam : organellar protein targeting and evolvability

Many functions of eukaryotic cells are compartmentalized within membrane-bound organelles. One or more cis-encoded signals within a polypeptide sequence typically govern protein targeting to and within destination organelles. Perhaps unexpectedly, organelle targeting does not occur with high specificity, but instead is characterized by considerable degeneracy and inefficiency. Indeed, the same peptide signals can target proteins to more than one location, randomized sequences can easily direct proteins to organelles, and many enzymes appear to traverse different subcellular settings across eukaryotic phylogeny. We discuss the potential benefits provided by flexibility in organelle targeting, with a special emphasis on horizontally transferred and de novo proteins. Moreover, we consider how these new organelle residents can be protected and maintained before they contribute to the needs of the cell and promote fitness.Peer reviewe

Relic Neutrinos and Z-Resonance Mechanism for Highest-Energy Cosmic Rays

The origin of the highest-energy cosmic rays remains elusive. The decay of a superheavy particle (X) into an ultra-energetic neutrino which scatters from a relic (anti-)neutrino at the Z-resonance has attractive features. Given the necessary X mass of $10^{14\sim15}$ GeV, the required lifetime, $10^{15\sim16}$ y, renders model-building a serious challenge but three logical possibilities are considered: (i) X is a Higgs scalar in SU(15) belonging to high-rank representation, leading to {\it power}-enhanced lifetime; (ii) a global X quantum number has {\it exponentially}-suppressed symmetry-breaking by instantons; and (iii) with additional space dimension(s) localisation of X within the real-world brane leads to {\it gaussian} decay suppression, the most efficient of the suppression mechanisms considered.Comment: 10 page LaTeX and one postscript figure. References adde

Performance Improvements from Heat Acclimation, Heat Acclimatization

Heat acclimation/acclimatization (HA/HAz) are important heat mitigation strategies that help develop heat tolerance from prolonged and repeated exposure to a hot environment, subsequently improving exercise performance in the heat. PURPOSE: To assess and quantify the magnitude of performance benefits of short- (STHA), medium- (MTHA), and long-term HA (LTHA) in endurance-trained athletes. METHODS: A literature search was conducted in PubMed, SPORTDiscus, Scopus, and Cochrane-Library, with data from 23 studies extracted for analysis. Subgroup analysis distinguished differences in performance and thermoregulatory adaptations between short-, medium- and long-term HA interventions. RESULTS: HA produced significant improvements in time trial performance (Effect size [95% confidence intervals] 0.72 [0.42– 1.03]), with LTHA displaying the most significant performance time decrease (-15.29%). MTHA and STHA showed a slight reduction in time trial performance time (-4.28% and -4.40%, respectively). Mean power output during exercise in the heat increased by 7.2% following MTHA, which was greater than STHA (-3.4%). HA showed a significant, small reduction in mean resting skin temperature (Tsk) (0.34 [0.00–0.68]) and core temperature (Tc) (0.40 [0.16–0.63]). Subgroup analysis demonstrated that mean Tsk reduction was more significant in the STHA (-0.35 ± 0.32°C) compared to MTHA (-0.24 ± 0.40°C), whereas Tc showed the greatest decrease in temperature from LTHA (0.66 [0.40–0.92]). CONCLUSION: Results indicate a noticeable improvement in endurance performances in the heat, with a trend towards longer-duration protocols eliciting the greatest performance adaptations. Findings show that long-term HA/HAz results in improved endurance performance in the heat which is influenced by thermoregulatory adaptations that increase thermal tolerance in hot and humid environments. These findings are important for athletes and their support teams to evidence-inform and individualize HA prescription