A Clinical Practice Change Initiative to Incorporate Animal Assisted Therapy in Advanced Practice Registered Nurses\u27 Clinical Practice for Children and Adolescents

Background: Children and adolescents mental healthcare needs is vital for the future of our nation’s welfare (American Psychology Association, 2014). Research has indicated AAT may be a considerable choice to help with pediatrics mental healthcare and may be utilized as an adjunct to enhance the care within the psychiatric healthcare field (Chandler, 2012). AAT has become popular within the healthcare realm (Friesen, 2009; Uyemura, 2016) and is a unique method for providing “patients” health care, which may improve patient outcomes (Chandler, 2012; Cowell, 2013; McCullough, 2016; McQuarrie & Urichuk, 2008). Research supports that “providers” in the health care field may “evade” this method of an alternative approach as an intervention due to lack of understanding (Berget, Ekeberg, & Braastad, 2008; Palley, O’Rourke, and Niemi, 2010; Uyemura, 2016; Williams & Jenkins, 2008). Purpose: The purpose of this doctoral capstone project was to (a) explore and assess perceptions of Advanced Practice Registered Nurses (APRNs) related to AAT with traditional Western treatment, as compared to only traditional treatment, at a behavioral health care center for the pediatric population, ages 4 to 16, and then (b) propose the acceptance of a practice change initiative. APRNs in mental health were of particular focus for this project. Methods: A descriptive exploratory study in a survey questionnaire Likert-scale format was implemented among the APRNs to assess their perception in utilizing AAT in clinical practice. Results: Six APRNs volunteered to participate in this capstone project at a small community based behavioral health care center. A 26-item questionnaire was administered as the pretest, followed by an educational component, the intervention about AAT program implementation and clinical practice guideline process. Immediately after the training the APRNs completed the same questionnaire as the posttest. Descriptive data reflected a significant difference observed between the tests that displayed a large effect in knowledge and utilization of AAT. Conclusion: A strong influence was detected on the APRNs professional understanding of AAT. Keywords: advanced practice registered nurses, alternative medicine - therapy, animal assisted activities - intervention - therapy, children and adolescents, healthcare provider, pediatric, pet therap

A “Hired Girl” Testifies against the “Son of a Prominent Family”: Bastardy and Rape on the Nineteenth-Century Nebraska Plains

In Red Cloud, Nebraska, in 1887, Anna “Annie” Sadilek (later Pavelka) pressed bastardy charges against the “son of a prominent family,” even though she could have, according to her pretrial testimony, pressed charges for rape. To the literary world, Sadilek is better known as Ántonia Shimerda, the powerful protagonist in Willa Cather’s 1918 novel, My Ántonia. However, it is Sadilek’s real-life experience that allows us to better understand life on the Nebraska Plains, specifically through an examination of the state’s rape laws and the ways these laws were subsequently interpreted by the courts. The Nebraska Supreme Court, between 1877 and 1886, established the need for the state to prove force as a primary component of the definition for rape, drew boundaries around acceptable reporting times, and solidified their stance on the requirement of corroborating testimony. These factors led Sadilek to charge Charley Kaley not with rape but with bastardy, a civil suit, which almost guaranteed a successful outcome for Sadilek and her child because it would not burden the county or state with their financial welfare. In analyzing Sadilek’s choices before the law, this article demonstrates the complexities of the gendered legal systems facing women like Sadilek who sought justice for crimes of a sexual nature. Additionally significant, this article draws attention to a space and place that lacks significant study in regard to the sexual power dynamics of the nineteenth-century Great Plains West, a multicultural contact zone highly susceptible to the influences of hypermasculine control

Targeted radiotherapy of neuroblastoma: future directions

No abstract available

The suppression of DNA repair induced by PARP-1 inhibitors rucaparib and olaparib in combination with the radiopharmaceutical 131I-MIBG in noradrenaline transporter-expressing xenograft tumors

No abstract available

Neurovascular Astrocyte Degeneration in the Hyperhomocysteinemia Model of Vascular Cognitive Impairment and Dementia (VCID)

Vascular cognitive impairment and dementia (VCID) is the second leading cause of dementia behind Alzheimer’s disease (AD) and is a frequent co-morbidity with AD. Despite its prevalence, little is known about the molecular mechanisms underlying the cognitive dysfunction resulting from cerebrovascular disease. Astrocytic end-feet almost completely surround intraparenchymal blood vessels in the brain and express a variety of channels and markers indicative of their specialized functions in the maintenance of ionic and osmotic homeostasis and gliovascular signaling. These functions are mediated by end-foot enrichment of the aquaporin 4 water channel (AQP4), the inward rectifying potassium channel Kir4.1 and the calcium-dependent potassium channel MaxiK. Using our HHcy model of VCID we examined the time-course of astrocytic end-foot changes along with cognitive and neuroinflammatory outcomes. We found that there were significant astrocytic end-foot disruptions in the HHcy model. AQP4 becomes dislocalized from the end-feet, there is a loss of Kir4.1 and MaxiK protein expression, as well as a loss of the Dp71 protein known to anchor the Kir4.1, MaxiK and AQP4 channels to the end-foot membrane. Neuroinflammation occurs prior to the astrocytic changes, while cognitive impairment continues to decline with the exacerbation of the astrocytic changes. We have previously reported similar astrocytic changes in models of cerebral amyloid angiopathy (CAA) and therefore, we believe astrocytic end-foot disruption could represent a common cellular mechanism of VCID and may be a target for therapeutic development

Inhibition of glycolysis and mitochondrial respiration promotes radiosensitisation of neuroblastoma and glioma cells

Background: Neuroblastoma accounts for 7% of paediatric malignancies but is responsible for 15% of all childhood cancer deaths. Despite rigorous treatment involving chemotherapy, surgery, radiotherapy and immunotherapy, the 5-year overall survival rate of high-risk disease remains < 40%, highlighting the need for improved therapy. Since neuroblastoma cells exhibit aberrant metabolism, we determined whether their sensitivity to radiotherapy could be enhanced by drugs affecting cancer cell metabolism. Methods: Using a panel of neuroblastoma and glioma cells, we determined the radiosensitising effects of inhibitors of glycolysis (2-DG) and mitochondrial function (metformin). Mechanisms underlying radiosensitisation were determined by metabolomic and bioenergetic profiling, flow cytometry and live cell imaging and by evaluating different treatment schedules. Results: The radiosensitising effects of 2-DG were greatly enhanced by combination with the antidiabetic biguanide, metformin. Metabolomic analysis and cellular bioenergetic profiling revealed this combination to elicit severe disruption of key glycolytic and mitochondrial metabolites, causing significant reductions in ATP generation and enhancing radiosensitivity. Combination treatment induced G2/M arrest that persisted for at least 24 h post-irradiation, promoting apoptotic cell death in a large proportion of cells. Conclusion: Our findings demonstrate that the radiosensitising effect of 2-DG was significantly enhanced by its combination with metformin. This clearly demonstrates that dual metabolic targeting has potential to improve clinical outcomes in children with high-risk neuroblastoma by overcoming radioresistance

Internal Carotid Artery Redundancy is Significantly Associated With Dissection.

BACKGROUND AND PURPOSE: Redundant internal carotid arteries have been considered a risk factor in tonsillectomy, adenoidectomy, and surgical treatment of peritonsillar abscess and also a potentially treatable cause of stroke. However, an association between internal carotid artery redundancy and spontaneous dissection has not yet been clearly demonstrated. METHODS: We reviewed, for spontaneous carotid artery dissection, records of all patients admitted to our institution during the period from 1986 through 1992 with the diagnosis of stroke or transient ischemic attack. We also reviewed 108 percutaneous cerebral arteriograms performed between September 1992 and December 1992 for presence of carotid artery redundancies. RESULTS: Thirteen patients exhibited spontaneous dissection. Of these, 8 of 13 (62%) patients and 13 of 20 (65%) internal carotid arteries, viewed to the siphon, had significant redundancies, kinks, coils, or loops. Of 108 consecutive arteriograms of patients without dissection, in which 187 internal carotid arteries were viewed to the siphon, there were 20 (19%) patients and 22 (12%) of 187 vessels with significant redundancy. Five patients in the dissection group and 2 in the nondissection group had bilateral internal carotid artery redundancy (P = .0019 and P = .0001, respectively). CONCLUSIONS: We found a significant correlation between internal carotid artery redundancy and dissection, particularly if redundancy is present bilaterally