789 research outputs found
The contribution of patch topology and demographic parameters to PVA predictions: the case of the European tree frog
Population viability analyses (PVA) are increasingly used in metapopulation conservation plans. Two major types of models are commonly used to assess vulnerability and to rank management options: population-based stochastic simulation models (PSM such as RAMAS or VORTEX) and stochastic patch occupancy models (SPOM). While the first set of models relies on explicit intrapatch dynamics and interpatch dispersal to predict population levels in space and time, the latter is based on spatially explicit metapopulation theory where the probability of patch occupation is predicted given the patch area and isolation (patch topology). We applied both approaches to a European tree frog (Hyla arborea) metapopulation in western Switzerland in order to evaluate the concordances of both models and their applications to conservation. Although some quantitative discrepancies appeared in terms of network occupancy and equilibrium population size, the two approaches were largely concordant regarding the ranking of patch values and sensitivities to parameters, which is encouraging given the differences in the underlying paradigms and input data
Evaluation of a theory-informed implementation of a nursing discharge teaching intervention for older adults.
To evaluate the implementation process of a multi-site trial of a novel discharge teaching intervention.
Hybrid type 3 trial.
A discharge teaching intervention for older adults was implemented in medical units from August 2020 to August 2021 with 30 nurse participants. The implementation process was guided by behaviour change frameworks. Outcome data comprised determinants of nurses' behaviours related to teaching and the acceptability, appropriateness, feasibility of the intervention and frequency of teaching activities received by the participants. This study adheres to StaRI and TIDieR reporting guidelines.
Twelve of 18 determinants of nurses' behaviour domains improved post-implementation. Being trained reinforced nurses' knowledge and skills in patient teaching. Practicing the intervention increased their awareness on the gaps between evidence-based teaching principles and their actual practice. The intervention was considered acceptable and moderately appropriate and feasible.
A theoretically informed implementation process can influence nurses' perceptions and behaviours related to discharge teaching by targeting specific behaviour domains. Practice change to improve discharge teaching will require organizational support from nursing management.
Although the conceptual foundations of the intervention tested in this study were informed by the priorities and experience of patients, this population was not directly involved in the design and conduct of the study.
ClinicalTrials.gov: NCT04253665
Neuropilins 1 and 2 mediate neointimal hyperplasia and re-endothelialization following arterial injury
AIMS: Neuropilins 1 and 2 (NRP1 and NRP2) play crucial roles in endothelial cell migration contributing to angiogenesis and vascular development. Both NRPs are also expressed by cultured vascular smooth muscle cells (VSMCs) and are implicated in VSMC migration stimulated by PDGF-BB, but it is unknown whether NRPs are relevant for VSMC function in vivo. We investigated the role of NRPs in the rat carotid balloon injury model, in which endothelial denudation and arterial stretch induce neointimal hyperplasia involving VSMC migration and proliferation. METHODS AND RESULTS: NRP1 and NRP2 mRNAs and proteins increased significantly following arterial injury, and immunofluorescent staining revealed neointimal NRP expression. Down-regulation of NRP1 and NRP2 using shRNA significantly reduced neointimal hyperplasia following injury. Furthermore, inhibition of NRP1 by adenovirally overexpressing a loss-of-function NRP1 mutant lacking the cytoplasmic domain (ΔC) reduced neointimal hyperplasia, whereas wild-type (WT) NRP1 had no effect. NRP-targeted shRNAs impaired, while overexpression of NRP1 WT and NRP1 ΔC enhanced, arterial re-endothelialization 14 days after injury. Knockdown of either NRP1 or NRP2 inhibited PDGF-BB-induced rat VSMC migration, whereas knockdown of NRP2, but not NRP1, reduced proliferation of cultured rat VSMC and neointimal VSMC in vivo. NRP knockdown also reduced the phosphorylation of PDGFα and PDGFβ receptors in rat VSMC, which mediate VSMC migration and proliferation. CONCLUSION: NRP1 and NRP2 play important roles in the regulation of neointimal hyperplasia in vivo by modulating VSMC migration (via NRP1 and NRP2) and proliferation (via NRP2), independently of the role of NRPs in re-endothelialization
Improving patient activation with a tailored nursing discharge teaching intervention for multimorbid inpatients: A quasi-experimental study.
Preliminary effectiveness test of a novel structured personalized discharge teaching intervention for multimorbid inpatients.
Using a 2-group sequential pre/post-intervention design, the sample comprised 68 pre-intervention control group and 70 post- intervention group participants. The discharge teaching intervention by trained clinical nurses used structured tools to engage patients and individualize discharge teaching. Outcomes measures included Patient Activation Measure, Readiness for Hospital Discharge Scale, Discharge Care Experiences Survey, and readmission with 10 days post-discharge.
The intervention had a statistically significant positive effect on improving patient activation (M=4.8; p = 0.05) from admission to post-discharge. The participation subscale of the Discharge Care Experiences Survey was higher in the intervention (M=4.1, SD=0.7) than the control group (M=3.8, SD=0.7; t (127)= -2.79, p = .01, effect size= .34). There were no significant between-group differences in Readiness for Hospital Discharge Scale and readmission.
Our results suggest that a structured personalized discharge teaching intervention can improve patient activation and participation in discharge care. Further refinement of the intervention is needed to evaluate and improve specific components of the intervention.
Structured personalized discharge teaching should include patient engagement strategies in the teaching-learning process
Emerging Roles for Neuropilin-2 in Cardiovascular Disease
Cardiovascular disease, the leading cause of death worldwide, is predominantly associated with atherosclerosis. Atherosclerosis is a chronic inflammatory disease characterised by the narrowing of large to medium-sized arteries due to a build-up of plaque. Atherosclerotic plaque is comprised of lipids, extracellular matrix, and several cell types, including endothelial, immune, and vascular smooth muscle cells. Such narrowing of the blood vessels can itself restrict blood flow to vital organs but most severe clinical complications, including heart attacks and strokes, occur when lesions rupture, triggering the blood to clot and obstructing blood flow further down the vascular tree. To circumvent such obstructions, percutaneous coronary intervention or bypass grafts are often required; however, re-occlusion of the treated artery frequently occurs. Neuropilins (NRPs), a multifunctional family of cell surface co-receptors, are expressed by endothelial, immune, and vascular smooth muscle cells and are regulators of numerous signalling pathways within the vasculature. Here, we review recent studies implicating NRP2 in the development of occlusive vascular diseases and discuss how NRP2 could be targeted for therapeutic intervention
Applying Moral Development Literature And Ethical Theories To The Administration Of Taxes In Kosovo
The population of Kosovo had suffered years of abuse, ethnic cleansing, turmoil, human atrocities, and constant conflict - the results of which plunged Kosovo into costly war. Following the war Kosovo was placed under the protection of the United Nations in 1999. Kosovo received many years of support and developmental assistance from the international community and became a sovereign nation in February 2008. It was very important for Kosovo’s government to serve the needs of the people without continued oversight and intervention by the United Nations. Public institutions are vital to the success of the government. There is no institution more important to the successful development of a sovereign nation and their economy than the ethical administration of a tax authority. In the spring of 2008, after Kosovo’s declaration of independence, this study was initiated to determine the moral maturity of the members of the Tax Authority of Kosovo. This study provides a review of the current situation in Kosovo and discusses ethical considerations in tax administration. The paper further provides a comprehensive discussion of ethical concerns and discusses the importance of moral development in the tax administration of Kosovo. Recommendations for managers and future research are presented
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