Factors influencing staff nurses' decisions for non-documentation of patient response to analgesia administration

• The purpose of this descriptive field study is to determine what factors influence staff nurses' decisions for non-documentation of patients' response to analgesic administration. • The study, based on Herbert Simon's descriptive model of decision making, has two components: (a) to determine staff nurses' perceptions of the factors that influence their documentation as well as how frequently they document analgesic administration and (b) to determine the actual frequency of nurses' documentation. • Data collected from 67 staff nurses using a questionnaire designed for this study and through an audit of 65 patients' charts allowed comparison of nurses' perceptions with their actual practice. • Analysis involved both quantitative and qualitative approaches. • The results of the study have implications for nurse educators and nurse administrators.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73890/1/j.1365-2702.1992.tb00112.x.pd

Casos de uso para el desarrollo de una aplicación de aprendizaje movil

Este artículo presenta los casos de uso desarrollados en una aplicación para el aprendizaje móvil, denominada MLEA (Mobile Learning Adapter), desarrollado en colaboración con la Universidad do Vale do Rio dos Sinos-UNISINOS, Brasil y la Universidad Tecnológica de Panamá-UTP la cual permite que usuarios de dispositivos móviles de base Android, puedan acceder mediante una plataforma sencilla a los cursos desarrollados en el sistema administrador de contenidos - Moodle. Se documenta un ejemplo de caso de uso, especificaciones de requisitos, diseño de interfases basadas en los patrones de Android , y los recursos de programación utilizados para permitir la comunicación entre los dispositivos móviles y la plataforma Moodle.Este artículo presenta los casos de uso desarrollados en una aplicación para el aprendizaje móvil, denominada MLEA (Mobile Learning Adapter), desarrollado en colaboración con la Universidad do Vale do Rio dos Sinos-UNISINOS, Brasil y la Universidad Tecnológica de Panamá-UTP la cual permite que usuarios de dispositivos móviles de base Android, puedan acceder mediante una plataforma sencilla a los cursos desarrollados en el sistema administrador de contenidos - Moodle. Se documenta un ejemplo de caso de uso, especificaciones de requisitos, diseño de interfases basadas en los patrones de Android , y los recursos de programación utilizados para permitir la comunicación entre los dispositivos móviles y la plataforma Moodle

MLEA: a solution for users of android in UTP Virtual

This paper describes a design of an educational platform for a mobile learning architecture, which is a state of the art topic in distance education. The product will allow users to interact in an efficient, flexible, and transparent fashion with a web-based education environment, in this case Module Object-Oriented Dynamic Learning Environment (Moodle), using Android mobile devices. In order to provide a strong and lasting architecture, the Service Oriented Architecture (SOA) methodology is used given that it allows easy software re-utilization as well as integration of heterogeneous services. The architecture is based on web services implemented with Representational State Transfer (REST), as it has been demonstrated to be lighter and less consuming than other protocols, for devices with limited resources such as mobile devices. Web services provide the communication means between the server side and the client side of the architecture, whereas agents are used to deliver the services itself. The authors propose the development of an environment that facilitates the integration of various educational resources to support m-learning. An important aspect of the proposal is the offering of a tool to provide customized alerts for students and teachers, enabling them to remain updated about activities taking place in the coursesThis paper describes a design of an educational platform for a mobile learning architecture, which is a state of the art topic in distance education. The product will allow users to interact in an efficient, flexible, and transparent fashion with a web-based education environment, in this case Module Object-Oriented Dynamic Learning Environment (Moodle), using Android mobile devices. In order to provide a strong and lasting architecture, the Service Oriented Architecture (SOA) methodology is used given that it allows easy software re-utilization as well as integration of heterogeneous services. The architecture is based on web services implemented with Representational State Transfer (REST), as it has been demonstrated to be lighter and less consuming than other protocols, for devices with limited resources such as mobile devices. Web services provide the communication means between the server side and the client side of the architecture, whereas agents are used to deliver the services itself. The authors propose the development of an environment that facilitates the integration of various educational resources to support m-learning. An important aspect of the proposal is the offering of a tool to provide customized alerts for students and teachers, enabling them to remain updated about activities taking place in the course

Arquitectura para la configuración de escenarios de aprendizaje móvil, con el uso de la plataforma moodle

El desarrollo de la computación móvil y su aplicación en la educación, hizo surgir un nuevo enfoque de educación a distancia, denominado aprendizaje móvil (o m-learning), el cual facilita a los estudiantes el aprendizaje en cualquier momento y desde cualquier lugar. Este trabajo presenta el diseño de una arquitectura de apoyo al aprendizaje móvil, que facilita a los usuarios de los cursos virtuales, de la Universidad Tecnológica de Panamá, interactuar de forma eficiente, flexible y transparente en un ambiente colaborativo y personalizable de interacción y alertas, por medio de smartphones, tablets y reproductores multimedia con sistema operativo Android. Para ello se hace uso de la metodología SOA (Arquitectura Orientada a Servicios) que facilita la reutilización de módulos.El desarrollo de la computación móvil y su aplicación en la educación, hizo surgir un nuevo enfoque de educación a distancia, denominado aprendizaje móvil (o m-learning), el cual facilita a los estudiantes el aprendizaje en cualquier momento y desde cualquier lugar. Este trabajo presenta el diseño de una arquitectura de apoyo al aprendizaje móvil, que facilita a los usuarios de los cursos virtuales, de la Universidad Tecnológica de Panamá, interactuar de forma eficiente, flexible y transparente en un ambiente colaborativo y personalizable de interacción y alertas, por medio de smartphones, tablets y reproductores multimedia con sistema operativo Android. Para ello se hace uso de la metodología SOA (Arquitectura Orientada a Servicios) que facilita la reutilización de módulos

Arquitectura para la creacion de ambientes moviles de recomendación, interaccion y alertas para usuarios de una plataforma de EaD

El desarrollo de la computación móvil y su aplicación en la educación, hizo surgir un nuevo enfoque de educación a distancia, denominado aprendizaje móvil (o m-learning), el cual facilita a los estudiantes el aprendizaje a cualquier momento y en cualquier lugar. Este trabajo presenta la propuesta de diseño de una arquitectura de apoyo al aprendizaje móvil, que facilite a los usuarios del Programa de la Universidad Virtual, de la Universidad Tecnológica de Panamá, interactuar de forma eficiente, flexible y transparente en un ambiente colaborativo y personalizable de recomendación, interacción y alertas, por medio de teléfonos celulares con Sistema Android (Google) incrustado. Para ello se hace uso de la metodología SOA (Service Oriented Architecture) que facilita la reutilización de módulos.El desarrollo de la computación móvil y su aplicación en la educación, hizo surgir un nuevo enfoque de educación a distancia, denominado aprendizaje móvil (o m-learning), el cual facilita a los estudiantes el aprendizaje a cualquier momento y en cualquier lugar. Este trabajo presenta la propuesta de diseño de una arquitectura de apoyo al aprendizaje móvil, que facilite a los usuarios del Programa de la Universidad Virtual, de la Universidad Tecnológica de Panamá, interactuar de forma eficiente, flexible y transparente en un ambiente colaborativo y personalizable de recomendación, interacción y alertas, por medio de teléfonos celulares con Sistema Android (Google) incrustado. Para ello se hace uso de la metodología SOA (Service Oriented Architecture) que facilita la reutilización de módulos

Improved overall survival in patients with high-grade serous ovarian cancer is associated with CD16a+ immunologic neighborhoods containing NK cells, T cells and macrophages

BackgroundFor patients with high grade serous carcinoma of the ovary (HGSC), survival rates have remained static for the last half century. Despite the presence of tumor mutations and infiltration of immune cells, existing immunotherapies have achieved little success against HGSC. These observations highlight a gap in the understanding of how the immune system functions and interacts within HGSC tumors.MethodsWe analyzed duplicate core samples from 939 patients with HGSC to understand patterns of immune cell infiltration, localization, and associations with clinical features. We used high-parameter immunohistochemical/Opal multiplex, digital pathology, computational biology, and multivariate analysis to identify immune cell subsets and their associations with HGSC tumors.ResultsWe defined six patterns of cellular infiltration by spatially restricted unsupervised clustering of cell subsets. Each pattern was represented to some extent in most patient samples, but their specific distributions differed. Overall (OS) and progression-free survival (PFS) corresponded with higher infiltration of CD16a+ cells, and their co-localization with macrophages, T cells, NK cells, in one of six cellular neighborhoods that we defined with our spatial assessment.ConclusionsImmune cell neighborhoods containing CD16a+ cells are associated with improved OS and PFS for patients with HGSC. Patterns of immunologic neighborhoods differentiate patient outcomes, and could inform future, more precise approaches to treatment

Architecture for the creation of mobile recommendation, interaction and alert environments for users of an EaD platform

El desarrollo de la computación móvil y su aplicación en la educación, hizo surgir un nuevo enfoque de educación a distancia, denominado aprendizaje móvil (o m-learning), el cual facilita a los estudiantes el aprendizaje a cualquier momento y en cualquier lugar. Este trabajo presenta la propuesta de diseño de una arquitectura de apoyo al aprendizaje móvil, que facilite a los usuarios del Programa de la Universidad Virtual, de la Universidad Tecnológica de Panamá, interactuar de forma eficiente, flexible y transparente en un ambiente colaborativo y personalizable de recomendación, interacción y alertas, por medio de teléfonos celulares con Sistema Android (Google) incrustado. Para ello se hace uso de la metodología SOA (Service Oriented Architecture) que facilita la reutilización de módulos.The mobile computing development and its application in education haveallowed the emerging of a new distance education approach, mobile learning (m-learning), which lets students reach learning everywhere and anytime. This paper presents a proposal for the design of an architecture to support mobile learning that should allow users of the Online Education Environment of Technological University of Panama interact efficiently, flexibly and seamlessly in a collaborative environment, which can be customized for recommendations, interaction and alerts through cellphones based on Android. For this, SOA (Service Oriented Architecture) methodology is used given that it easies module reuse

Arquitectura para la creación de ambientes móviles de recomendación, interacción y alertas para usuarios de una plataforma de EaD

El desarrollo de la computación móvil y su aplicación en la educación, hizo surgir un nuevo enfoque de educación a distancia, denominado aprendizaje móvil (o m-learning), el cual facilita a los estudiantes el aprendizaje a cualquier momento y en cualquier lugar. Este trabajo presenta la propuesta de diseño de una arquitectura de apoyo al aprendizaje móvil, que facilite a los usuarios del Programa de la Universidad Virtual, de la Universidad Tecnológica de Panamá, interactuar de forma eficiente, flexible y transparente en un ambiente colaborativo y personalizable de recomendación, interacción y alertas, por medio de teléfonos celulares con Sistema Android (Google) incrustado. Para ello se hace uso de la metodología SOA (Service Oriented Architecture) que facilita la reutilización de módulos

International consensus conference recommendations on ultrasound education for undergraduate medical students

Objectives: The purpose of this study is to provide expert consensus recommendations to establish a global ultrasound curriculum for undergraduate medical students. Methods: 64 multi-disciplinary ultrasound experts from 16 countries, 50 multi-disciplinary ultrasound consultants, and 21 medical students and residents contributed to these recommendations. A modified Delphi consensus method was used that included a systematic literature search, evaluation of the quality of literature by the GRADE system, and the RAND appropriateness method for panel judgment and consensus decisions. The process included four in-person international discussion sessions and two rounds of online voting. Results: A total of 332 consensus conference statements in four curricular domains were considered: (1) curricular scope (4 statements), (2) curricular rationale (10 statements), (3) curricular characteristics (14 statements), and (4) curricular content (304 statements). Of these 332 statements, 145 were recommended, 126 were strongly recommended, and 61 were not recommended. Important aspects of an undergraduate ultrasound curriculum identified include curricular integration across the basic and clinical sciences and a competency and entrustable professional activity-based model. The curriculum should form the foundation of a life-long continuum of ultrasound education that prepares students for advanced training and patient care. In addition, the curriculum should complement and support the medical school curriculum as a whole with enhanced understanding of anatomy, physiology, pathophysiological processes and clinical practice without displacing other important undergraduate learning. The content of the curriculum should be appropriate for the medical student level of training, evidence and expert opinion based, and include ongoing collaborative research and development to ensure optimum educational value and patient care. Conclusions: The international consensus conference has provided the first comprehensive document of recommendations for a basic ultrasound curriculum. The document reflects the opinion of a diverse and representative group of international expert ultrasound practitioners, educators, and learners. These recommendations can standardize undergraduate medical student ultrasound education while serving as a basis for additional research in medical education and the application of ultrasound in clinical practice

A large-scale genome-wide association study meta-analysis of cannabis use disorder

Summary Background Variation in liability to cannabis use disorder has a strong genetic component (estimated twin and family heritability about 50–70%) and is associated with negative outcomes, including increased risk of psychopathology. The aim of the study was to conduct a large genome-wide association study (GWAS) to identify novel genetic variants associated with cannabis use disorder. Methods To conduct this GWAS meta-analysis of cannabis use disorder and identify associations with genetic loci, we used samples from the Psychiatric Genomics Consortium Substance Use Disorders working group, iPSYCH, and deCODE (20 916 case samples, 363 116 control samples in total), contrasting cannabis use disorder cases with controls. To examine the genetic overlap between cannabis use disorder and 22 traits of interest (chosen because of previously published phenotypic correlations [eg, psychiatric disorders] or hypothesised associations [eg, chronotype] with cannabis use disorder), we used linkage disequilibrium score regression to calculate genetic correlations. Findings We identified two genome-wide significant loci: a novel chromosome 7 locus (FOXP2, lead single-nucleotide polymorphism [SNP] rs7783012; odds ratio [OR] 1·11, 95% CI 1·07–1·15, p=1·84 × 10−9) and the previously identified chromosome 8 locus (near CHRNA2 and EPHX2, lead SNP rs4732724; OR 0·89, 95% CI 0·86–0·93, p=6·46 × 10−9). Cannabis use disorder and cannabis use were genetically correlated (rg 0·50, p=1·50 × 10−21), but they showed significantly different genetic correlations with 12 of the 22 traits we tested, suggesting at least partially different genetic underpinnings of cannabis use and cannabis use disorder. Cannabis use disorder was positively genetically correlated with other psychopathology, including ADHD, major depression, and schizophrenia. Interpretation These findings support the theory that cannabis use disorder has shared genetic liability with other psychopathology, and there is a distinction between genetic liability to cannabis use and cannabis use disorder. Funding National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Center for Genomics and Personalized Medicine and the Centre for Integrative Sequencing; The European Commission, Horizon 2020; National Institute of Child Health and Human Development; Health Research Council of New Zealand; National Institute on Aging; Wellcome Trust Case Control Consortium; UK Research and Innovation Medical Research Council (UKRI MRC); The Brain & Behavior Research Foundation; National Institute on Deafness and Other Communication Disorders; Substance Abuse and Mental Health Services Administration (SAMHSA); National Institute of Biomedical Imaging and Bioengineering; National Health and Medical Research Council (NHMRC) Australia; Tobacco-Related Disease Research Program of the University of California; Families for Borderline Personality Disorder Research (Beth and Rob Elliott) 2018 NARSAD Young Investigator Grant; The National Child Health Research Foundation (Cure Kids); The Canterbury Medical Research Foundation; The New Zealand Lottery Grants Board; The University of Otago; The Carney Centre for Pharmacogenomics; The James Hume Bequest Fund; National Institutes of Health: Genes, Environment and Health Initiative; National Institutes of Health; National Cancer Institute; The William T Grant Foundation; Australian Research Council; The Virginia Tobacco Settlement Foundation; The VISN 1 and VISN 4 Mental Illness Research, Education, and Clinical Centers of the US Department of Veterans Affairs; The 5th Framework Programme (FP-5) GenomEUtwin Project; The Lundbeck Foundation; NIH-funded Shared Instrumentation Grant S10RR025141; Clinical Translational Sciences Award grants; National Institute of Neurological Disorders and Stroke; National Heart, Lung, and Blood Institute; National Institute of General Medical Sciences.Peer reviewe