The Domain of Nursing: Developing Practice Through Action Research in the Intensive Care Unit

In the intensive care unit (ICU) the bedside nurse is the person who carries out the fundamental care to sustain life and comfort for that patient and is the conduit between the patient, their family/whanau, the doctors and the multi disciplinary team. Nursing practice has an indelible impact on that patient's life and future and for their family. This thesis presents a project on the reconnaissance phase of a future critical action research project. The project involved ICU nurses collectively defining their practice within the context of ICU and identifying aspects which needed development and change. As this was the first time that the nurses had met to define and discuss their practice it was essential for them to take this time in order to focus on the reconnaissance phase as this will guide and inform all future action. The study is informed by Habermas' Theory of Communicative Action which has an emancipatory focus. The action research approach enabled the nurses to reach mutual understanding of their practice and reach consensus on areas of practice they wish to develop to enhance their care of the patient. Mutual understanding and consensus have been achieved using focus groups and interviews involving self reflection as well as collective reflection. The reconnaissance phase as described in this thesis involves the nurse participants collectively identifying their ideals of ICU nursing, then defining where they are unable to meet these ideals in the reality of every day practice. The themes emerging from the discussions are defined in terms of relationships; nurse to patient, nurse to family/whanau, nurse to doctor and nurse to nurse. These relationships are interconnected and all occur within the overarching theme of professional standards of care. Through the process of discussion and consensus the nurses identified nurse to nurse communication and support as the most important aspect of practice needing development. Reconnaissance in this research defines the beginning of the change process as the transformation begins with the creation of the communicative space enabling the nurses to connect and together to look ahead at what changes might now be possible

Stress sensitization and adolescent depressive severity as a function of childhood adversity: A link to anxiety disorders

The goal of the present study was to determine whether exposure to adversity in childhood contributes to a differential threshold at which stressful life events provoke depressive reactions in adolescence. In addition, to address empirical and conceptual questions about stress effects, the moderating effect of anxiety disorder history was also explored. This examination was conducted in a sample of 816 children of depressed and nondepressed mothers, who were followed from birth to age 15. Information on adversities experienced in childhood was collected both from mothers during the first five years of their youth's life and from the youths themselves at age 15, and included information on the mother's relationship with her partner, maternal psychopathology, as well as youth-reported abuse. Results indicated that youths with both greater exposure to adversity in childhood and a history of an anxiety disorder displayed increased depressive severity following low levels of episodic stress compared to youths with only one or neither of these risk factors. The results are speculated to reflect the possibility that early anxiety disorders associated with exposure to adversity in childhood may be a marker of dysregulated stress responses, and may help to account for the comorbidity of depression and anxiety in some individuals

ENIGMA and global neuroscience: A decade of large-scale studies of the brain in health and disease across more than 40 countries

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of "big data" (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA's activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

The Domain of Nursing: Developing Practice Through Action Research in the Intensive Care Unit

In the intensive care unit (ICU) the bedside nurse is the person who carries out the fundamental care to sustain life and comfort for that patient and is the conduit between the patient, their family/whanau, the doctors and the multi disciplinary team. Nursing practice has an indelible impact on that patient's life and future and for their family. This thesis presents a project on the reconnaissance phase of a future critical action research project. The project involved ICU nurses collectively defining their practice within the context of ICU and identifying aspects which needed development and change. As this was the first time that the nurses had met to define and discuss their practice it was essential for them to take this time in order to focus on the reconnaissance phase as this will guide and inform all future action. The study is informed by Habermas' Theory of Communicative Action which has an emancipatory focus. The action research approach enabled the nurses to reach mutual understanding of their practice and reach consensus on areas of practice they wish to develop to enhance their care of the patient. Mutual understanding and consensus have been achieved using focus groups and interviews involving self reflection as well as collective reflection. The reconnaissance phase as described in this thesis involves the nurse participants collectively identifying their ideals of ICU nursing, then defining where they are unable to meet these ideals in the reality of every day practice. The themes emerging from the discussions are defined in terms of relationships; nurse to patient, nurse to family/whanau, nurse to doctor and nurse to nurse. These relationships are interconnected and all occur within the overarching theme of professional standards of care. Through the process of discussion and consensus the nurses identified nurse to nurse communication and support as the most important aspect of practice needing development. Reconnaissance in this research defines the beginning of the change process as the transformation begins with the creation of the communicative space enabling the nurses to connect and together to look ahead at what changes might now be possible

The Domain of Nursing: Developing Practice Through Action Research in the Intensive Care Unit

In the intensive care unit (ICU) the bedside nurse is the person who carries out the fundamental care to sustain life and comfort for that patient and is the conduit between the patient, their family/whanau, the doctors and the multi disciplinary team. Nursing practice has an indelible impact on that patient's life and future and for their family. This thesis presents a project on the reconnaissance phase of a future critical action research project. The project involved ICU nurses collectively defining their practice within the context of ICU and identifying aspects which needed development and change. As this was the first time that the nurses had met to define and discuss their practice it was essential for them to take this time in order to focus on the  reconnaissance phase as this will guide and inform all future action. The study is informed by Habermas' Theory of Communicative Action which has an emancipatory focus. The action research approach enabled the nurses to reach mutual understanding of their practice and reach consensus on areas of practice they wish to develop to enhance their care of the patient. Mutual understanding and consensus have been achieved using focus groups and interviews involving self reflection as well as collective reflection. The reconnaissance phase as described in this thesis involves the nurse participants collectively identifying their ideals of ICU nursing, then defining where they are unable to meet these ideals in the reality of every day practice. The themes emerging from the discussions are defined in terms of relationships; nurse to patient, nurse to family/whanau, nurse to doctor and nurse to nurse. These relationships are interconnected and all occur within the overarching theme of professional standards of care. Through the process of discussion and consensus the nurses identified nurse to nurse communication and support as the most important aspect of practice needing development. Reconnaissance in this research defines the beginning of the change process as the transformation begins with the creation of the communicative space enabling the nurses to connect and together to look ahead at what changes might now be possible.</p

Adult Outcomes of Youth Irritability: A 20-Year Prospective Community-Based Study

OBJECTIVE: Irritability is a widely occurring DSM-IV symptom in youths. However, little is known about the relationship between irritability in early life and its outcomes in mid-adulthood. This study examines the extent to which youth irritability is related to adult psychiatric outcomes by testing the hypothesis that it predicts depressive and generalized anxiety disorders. METHOD: The authors conducted a longitudinal community-based study of 631 participants whose parents were interviewed when participants were in early adolescence (mean age=13.8 years [SD=2.6]) and who were themselves interviewed 20 years later (mean age=33.2 years [SD=2.9]). Parent-reported irritability in adolescence was used to predict self-reported psychopathology, assessed by standardized diagnostic interview at 20-year follow-up. RESULTS: Cross-sectionally, irritability in adolescence was widely associated with other psychiatric disorders. After adjustment for baseline emotional and behavioral disorders, irritability in adolescence predicted major depressive disorder (odds ratio=1.33, 95% confidence interval [CI]=1.00–1.78]), generalized anxiety disorder (odds ratio=1.72, 95% CI=1.04–2.87), and dysthymia (odds ratio=1.81, 95% CI=1.06–3.12) at 20-year follow-up. Youth irritability did not predict bipolar disorder or axis II disorders at follow-up. CONCLUSIONS: Youth irritability as reported by parents is a specific predictor of self-reported depressive and anxiety disorders 20 years later. The role of irritability in developmental psychiatry, and in the pathophysiology of mood and anxiety disorders specifically, should receive further study

Mycobacterium tuberculosis sigma factor E regulon modulates the host inflammatory response

Mycobacterium tuberculosis survives in macrophages and usually subverts the bactericidal mechanisms of these phagocytes. The understanding of this host-pathogen interaction is relevant for the development of new treatments for tuberculosis. The adaptation of M. tuberculosis to intracellular life depends on its ability to regulate the expression of its genes. Sigma factors are important bacterial transcription activators that bind to the RNA polymerase and give it promoter specificity. Sigma factor E (SigE) controls the expression of genes that are essential for virulence. We have identified the SigE regulon during infection of macrophages, and we analyzed the impact of this regulon on the transcriptional response of phagocytes. Our results indicate that SigE regulates the expression of genes involved in the maintenance of M. tuberculosis cell envelope integrity and function during macrophage infection. Analysis of the phagocytes' transcriptional response indicates that the SigE regulon is involved in the modulation of the inflammatory response. © 2008 by the Infectious Diseases Society of America. All rights reserved.Fil: Fontán, Patricia A.. University of Medicine and Dentistry of New Jersey; Estados UnidosFil: Aris, Virginie. University of Medicine and Dentistry of New Jersey; Estados UnidosFil: Alvarez, Maria Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Academia Nacional de Medicina de Buenos Aires. Instituto de Investigaciones Hematológicas "Mariano R. Castex"; ArgentinaFil: Ghanny, Saleena. University of Medicine and Dentistry of New Jersey; Estados UnidosFil: Cheng, Jeff. University of Medicine and Dentistry of New Jersey; Estados UnidosFil: Soteropoulos, Patricia. University of Medicine and Dentistry of New Jersey; Estados UnidosFil: Trevani, Analía Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Academia Nacional de Medicina de Buenos Aires. Instituto de Investigaciones Hematológicas "Mariano R. Castex"; ArgentinaFil: Pine, Richard. University of Medicine and Dentistry of New Jersey; Estados UnidosFil: Smith, Issar. University of Medicine and Dentistry of New Jersey; Estados Unido