No longer eating their young, but eating their own: Developing capacity to decrease lateral aggression among nurses and leaders

Nursing is generally known as a profession of caring. The public identifies these professionals as one of the most trusted roles in a healthcare setting. Despite this, many behaviours contradict this paradigm. These uncivil behaviours may be overt or subtle, but they are contributing to a psychologically unsafe environment where nursing instability and increased turnover threaten the ability to provide competent care for current and future patients. The nursing literature often refers to the term, eating their young, to summarize a harmful concept where experienced nurses neglect, betray, or belittle junior nurses who are in need of support from their more experienced peers. Many stressors at micro, meso, and macro levels have led to the resurgence of lateral aggression in the nursing profession. These actions have permeated to novice nurses, who now act as perpetrators engaging in this cannibalistic behaviour. This creates psychologically unsafe environments and acts as a deterrent for nurses staying in a specialty area. In view of its costly health-related repercussions, the prevention of lateral aggression is crucial to conserve nurse well-being and safeguard the provision of competent nursing care into the future. A blended learning pathway is proposed for nurses and leaders to recognize, respond, and address lateral aggression in action on adult surgical units. Kotter’s 8-step change model, combined with CQI methodology, is used to guide a change implementation plan. Workforce metrics such as turnover rates, overtime usage, absenteeism, sick time, and safety occurrence reporting will serve as indicators of success

The agile strategies in IT Governance: Towards a framework of agile IT Governance in the banking industry

Digital transformation has changed corporate reality and, with that, firms’ IT environments and IT governance (ITG). As such, the perspective of ITG has shifted from the design of a relatively stable, closed and controllable system of a self-sufficient enterprise to a relatively fluid, open, agile and transformational system of networked co-adaptive entities. Related to this paradigm shift in ITG, this paper aims to clarify how the concept of an effective ITG framework has changed in terms of the demand for agility in organizations. Thus, this study conducted 33 qualitative interviews with executives and senior managers from the banking industry in Germany, Switzerland and Austria. Analysis of the interviews focused on the formation of categories and the assignment of individual text parts (codings) to these categories to allow for a quantitative evaluation of the codings per category. Regarding traditional and agile ITG dimensions, 22 traditional and 25 agile dimensions in terms of structures, processes and relational mechanisms were identified. Moreover, agile strategies within the agile ITG construct and ten ITG patterns were identified from the interview data. The data show relevant perspectives on the implementation of traditional and new ITG dimensions and highlight ambidextrous aspects in ITG in the German-speaking banking industry

“STUDI LABORATORIUM PENGARUH PENAMBAHAN SPERSENE TERHADAP LUMPUR DASAR BENTONITE PT. SUD CHEMIE DENGAN ADDITIVE K-PAM YANG TERKONTAMINASI GYPSUM.”

Pada operasi pemboran adakalanya terjadi kontaminasi pada lumpur pemboran yang kita gunakan, salah satunya adalah kontaminasi oleh Gypsum (CaSO4). Kontaminasi Gypsum (CaSO4) akan mengakibatkan terjadinya kerusakan pada lumpur pemboran dengan berubahnya sifat-sifat fisiknya, seperti kenaikkan yield point, gel strength, volume filtrate, mud cake dan juga plastic viscosity, selain itu juga dapat menurunkan pH lumpur. Berubahnya sifat-sifat fisik dari lumpur pemboran tersebut menyebabkan tidak sesuai lagi dengan standar API 13 A sehingga perlu dilakukan perbaikkan (treatment) pada lumpur pemboran tersebut. Dalam penelitian ini menggunakan lumpur dasar dengan bentonite PT. SUD CHEMIE yang ditambahkan dengan additive K-PAM sebesar 0,6 ppb, kemudian dikontaminasi dengan Gypsum (CaSO4) dengan variasi penambahan 0.5 ppb sampai 5 ppb. Setelah diketahui efek dari kontaminasi Gypsum (CaSO4) maka dilakukan treatment terhadap lumpur yang terkontaminasi Gypsum (CaSO4) tersebut dengan menambahkan additive Spersene dengan konsentrasi dari 3 ppb sampai 7 ppb. Penambahan dengan Spersene mengakibatkan penurunan pada beberapa sifat fisik lumpur, diantaranya yield point, gel strength, volume filtrate, mud cake, dan juga harga plastic viscosity. Dari hasil percobaan terhadap lumpur yang terkontaminasi Gypsum (CaSO4) 2.5 ppb maka penambahan dengan Spersene yang paling efektif adalah dengan konsentrasi 5.0 ppb

Current prevalence of multidrug-resistant organisms in long-term care facilities in the Rhine-Main district, Germany, 2013

Multidrug-resistant organisms (MDRO) and in particular multidrug-resistant Gram-negative organisms (MRGN) are an increasing problem in hospital care. However, data on the current prevalence of MDRO in long-term care facilities (LTCFs) are rare. To assess carriage rates of MDRO in LTCF residents in the German Rhine-Main region, we performed a point prevalence survey in 2013. Swabs from nose, throat and perineum were analysed for meticillin-resistant Staphylococcus aureus (MRSA), perianal swabs were analysed for extended-spectrum beta-lactamase (ESBL)-producing organisms, MRGN and vancomycin-resistant enterococci (VRE). In 26 LTCFs, 690 residents were enrolled for analysis of MRSA colonisation and 455 for analysis of rectal carriage of ESBL/MRGN and VRE. Prevalences for MRSA, ESBL/MRGN and VRE were 6.5%, 17.8%, and 0.4%, respectively. MRSA carriage was significantly associated with MRSA history, the presence of urinary catheters, percutaneous endoscopic gastrostomy tubes and previous antibiotic therapy, whereas ESBL/MRGN carriage was exclusively associated with urinary catheters. In conclusion, this study revealed no increase in MRSA prevalence in LTCFs since 2007. In contrast, the rate of ESBL/MRGN carriage in German LTCFs was remarkably high. In nearly all positive residents, MDRO carriage had not been known before, indicating a lack of screening efforts and/or a lack of information on hospital discharge

Reactivating TP53 signaling by the novel MDM2 inhibitor DS-3032b as a therapeutic option for high-risk neuroblastoma

Fewer than 50% of patients with high-risk neuroblastoma survive five years after diagnosis with current treatment protocols. Molecular targeted therapies are expected to improve survival. Although MDM2 has been validated as a promising target in preclinical models, no MDM2 inhibitors have yet entered clinical trials for neuroblastoma patients. Toxic side effects, poor bioavailability and low efficacy of the available MDM2 inhibitors that have entered phase I/II trials drive the development of novel MDM2 inhibitors with an improved risk-benefit profile. We investigated the effect of the novel MDM2 small molecular inhibitor, DS-3032b, on viability, proliferation, senescence, migration, cell cycle arrest and apoptosis in a panel of six neuroblastoma cell lines with different TP53 and MYCN genetic backgrounds, and assessed efficacy in a murine subcutaneous model for high-risk neuroblastoma. Re-analysis of existing expression data from 476 primary neuroblastomas showed that high-level MDM2 expression correlated with poor patient survival. DS-3032b treatment enhanced TP53 target gene expression and induced G1 cell cycle arrest, senescence and apoptosis. CRISPR-mediated MDM2 knockout in neuroblastoma cells mimicked DS-3032b treatment. TP53 signaling was selectively activated by DS-3032b in neuroblastoma cells with wildtype TP53, regardless of the presence of MYCN amplification, but was significantly reduced by TP53 mutations or expression of a dominant-negative TP53 mutant. Oral DS-3032b administration inhibited xenograft tumor growth and prolonged mouse survival. Our in vitro and in vivo data demonstrate that DS-3032b reactivates TP53 signaling even in the presence of MYCN amplification in neuroblastoma cells, to reduce proliferative capacity and cause cytotoxicity

Whitening toothpaste containing activated charcoal, blue covarine, hydrogen peroxide or microbeads: which one is the most effective?

The efficacy of whitening toothpastes is questionable and controversial. Clinicians, patients and researchers have expressed concern with whitening toothpastes due to the risk of wearing the dental structure and the potential for disappointment if the advertised cosmetic results are not achieved. Objective: This study compared the whitening performance of toothpastes with different whitening technologies after initial and continued use. Material and Methods: Ninety bovine incisors were stained using a concentrated solution of black tea. They were randomly distributed into 6 groups, according to the toothpaste whitening technology: activated charcoal (B&W), blue covarine (WAD), hydrogen peroxide (LWA), microbeads (Oral B 3D White Perfection – 3DW) and optimized abrasives (XW4D). They were compared to a traditional toothpaste without a whitening agent (TA – control). Specimens underwent a brushing machine with controlled pressure, time and temperature. A calibrated examiner measured the color using a VITAClassical scale before the first brushing cycle (T0), after the first brushing cycle (TI), and after a brushing cycle that simulates continuous use (TCU). Whitening performance was evaluated by the difference of shades (ΔSGU) between T0–TI and T0–TCU timepoints, using the Kruskal-Wallis and Dunn’s non-parametric test. The Wilcoxon test was used to evaluate the cumulative effect (α=0.05). Results: Statistically significant differences were observed between toothpastes in both TI and TCU (p<0.05). The time of use also had a significant effect (p<0.05). Conclusion: Only WAD and 3DW showed whitening performance after the first use (TI). The greatest whitening performance after continuous use was obtained by WAD, followed by LWA and 3DW. The use of conventional toothpaste (TA) promotes no tooth whitening. Clinical relevance: Microbead abrasives (3DW) and blue covarine (WAD) were the active technology tested that presented the best global tooth whitening performance

The impacts of vocational rehabilitation

Based on local variations in vocational rehabilitation (VR) priorities, we examine the impacts of alternative VR programs on short- and long-term labor market outcomes for temporary disability insurance (TDI) claimants in Norway. The analysis builds on rich and detailed administrative registers covering 345,000 claimants. We find that a strategy focusing on rapid placement in the regular labor market is superior to alternative strategies giving higher priority to vocational training or sheltered employment. Strategies prioritizing subsidized regular education also tend to be relatively successful in terms of final outcomes, but at the cost of protracted periods of benefit dependency first

Passenger gene co-amplifications create collateral therapeutic vulnerabilities in cancer

DNA amplifications in cancer do not only harbor oncogenes. We sought to determine whether passenger co-amplifications could create collateral therapeutic vulnerabilities. Through an analysis of >3,000 cancer genomes followed by the interrogation of CRISPR-Cas9 loss-of-function screens across >700 cancer cell lines, we determined that passenger co-amplifications are accompanied by distinct dependency profiles. In a proof-of-principle study, we demonstrate that co-amplification of the bona fide passenger gene DEAD-Box Helicase 1 (DDX1) creates an increased dependency to the mTOR pathway. Interaction proteomics identified tricarboxylic acid (TCA) cycle components as previously unrecognized DDX1 interaction partners. Live-cell metabolomics highlighted that this interaction could impair TCA activity, which in turn resulted in enhanced mTORC1 activity. Consequently, genetic and pharmacologic disruption of mTORC1 resulted in pronounced cell death in vitro and in vivo. Thus, structurally linked co-amplification of a passenger gene and an oncogene can result in collateral vulnerabilities. SIGNIFICANCE: We demonstrate that coamplification of passenger genes, which were largely neglected in cancer biology in the past, can create distinct cancer dependencies. Because passenger coamplifications are frequent in cancer, this principle has the potential to expand target discovery in oncology