Nurse Satisfaction and Interprofessional Interactions: The Impact of Nurses’ Professional Relationships on Job Satisfaction

Purpose: The purpose of this study was to identify the relationship between nurses’ interprofessional interactions and nurses’ job satisfaction. Methods: The study design utilized was a cross sectional retrospective analysis of survey results within a healthcare system. The Job Enjoyment Scale (JES) was used to measure job satisfaction and the Interprofessional Scale was used to measure interactions between nurses and specific disciplines (nursing, physicians, Advanced Practice Registered Nurses [APRN’s], pharmacists, therapists, and social workers). Pearson correlation coefficient analysis was computed to assess the relationship between JES and interprofessional variables at the unit level. Results: Results suggested a significant positive correlation between nurse satisfaction and overall interprofessional interaction, as well as significant positive correlation between nurse satisfaction and each specific discipline except for APRN’s, for which a significant correlation was not found. Implications: The data used in this retrospective study was collected during the COVID-19 pandemic. Thus, the results suggest the presence of positive interprofessional interactions during the unprecedented and challenging pandemic. Despite the challenges presented by the Covid-19 pandemic, positive interprofessional interactions among team members have a great impact on the job satisfaction of nurses

Management of complex symptoms in multiple sclerosis (MS)

People with MS can present with a complex range of symptoms. Some of these include dysautonomia (autonomic dysfunction), fatigue, cognitive impairment, and mood disorders. These symptoms must be managed in order to optimise intervention outcomes

Varieties of Homeland Security: An Assessment of US State-level Definitions

Homeland Security continues to struggle to define itself as a field of practice and scholarship. The difficulty in defining the field has led to a variety of conflicts over membership, content, and focus. This article reviews some of the prominent debates over the meaning of homeland security as a field of study and practice. It then defines a simple schema for definitions of homeland security inspired by the academic and legislative debates over the issue. A frequency cataloging of definitions from US state agencies illustrates the continued relevance of a “partial membership” approach to defining the field. The article concludes with a discussion of the implications of the diversity of homeland security definitions for the development of the field.Ye

Novel Protocol for Generating Physiologic Immunogenic Dendritic Cells

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Extended difficulties following the use of psychedelic drugs: a mixed methods study

Long-term adverse experiences following psychedelic use can persist for weeks, months, or even years, and are relatively unexplored in psychedelic research. Our convergent mixed-method study gained quantitative and qualitative data from 608 participants who reported extended difficulties following psychedelic experiences. Data was gathered on the context of use, the nature and duration of the challenges they experienced (including a written description of these), plus a range of possible risk factors and perceived causes. The most common forms of extended difficulty were feelings of anxiety and fear, existential struggle, social disconnection, depersonalization and derealization. For approximately one-third of the participants, problems persisted for over a year, and for a sixth, they endured for more than three years. It was found that a shorter duration of difficulties was predicted by knowledge of dose, drug type and lower levels of difficulty reported during the psychoactive experience, while a narrower range of difficulties was predicted by taking the drug in a guided setting. Implications for psychedelic harm reduction are discussed

Early phase clinical trials extension to the guidelines for the content of statistical analysis plans

This paper reports guidelines for the content of statistical analysis plans for early phase clinical trials, ensuring specification of the minimum reporting analysis requirements, by detailing extensions (11 new items) and modifications (25 items) to existing guidance after a review by various stakeholders

Child Mortality, Hypothalamic-Pituitary-Adrenal Axis Activity and Cellular Aging in Mothers

Psychological challenges, including traumatic events, have been hypothesized to increase the age-related pace of biological aging. Here we test the hypothesis that psychological challenges can affect the pace of telomere attrition, a marker of cellular aging, using data from an ongoing longitudinal-cohort study of Kaqchikel Mayan women living in a population with a high frequency of child mortality, a traumatic life event. Specifically, we evaluate the associations between child mortality, maternal telomere length and the mothers’ hypothalamic-pituitary-adrenal axis (HPAA), or stress axis, activity. Child mortality data were collected in 2000 and 2013. HPAA activity was assessed by quantifying cortisol levels in first morning urinary specimens collected every other day for seven weeks in 2013. Telomere length (TL) was quantified using qPCR in 55 women from buccal specimens collected in 2013. Results: Shorter TL with increasing age was only observed in women who experienced child mortality (p = 0.015). Women with higher average basal cortisol (p = 0.007) and greater within-individual variation (standard deviation) in basal cortisol (p = 0.053) presented shorter TL. Non-parametric bootstrapping to estimate mediation effects suggests that HPAA activity mediates the effect of child mortality on TL. Our results are, thus, consistent with the hypothesis that traumatic events can influence cellular aging and that HPAA activity may play a mediatory role. Future large-scale longitudinal studies are necessary to confirm our results and further explore the role of the HPAA in cellular aging, as well as to advance our understanding of the underlying mechanisms involved

Bayesian approach to determining penetrance of pathogenic SDH variants.

BACKGROUND: Until recently, determining penetrance required large observational cohort studies. Data from the Exome Aggregate Consortium (ExAC) allows a Bayesian approach to calculate penetrance, in that population frequencies of pathogenic germline variants should be inversely proportional to their penetrance for disease. We tested this hypothesis using data from two cohorts for succinate dehydrogenase subunits A, B and C (SDHA-C) genetic variants associated with hereditary pheochromocytoma/paraganglioma (PC/PGL). METHODS: Two cohorts were 575 unrelated Australian subjects and 1240 unrelated UK subjects, respectively, with PC/PGL in whom genetic testing had been performed. Penetrance of pathogenic SDHA-C variants was calculated by comparing allelic frequencies in cases versus controls from ExAC (removing those variants contributed by The Cancer Genome Atlas). RESULTS: Pathogenic SDHA-C variants were identified in 106 subjects (18.4%) in cohort 1 and 317 subjects (25.6%) in cohort 2. Of 94 different pathogenic variants from both cohorts (seven in SDHA, 75 in SDHB and 12 in SDHC), 13 are reported in ExAC (two in SDHA, nine in SDHB and two in SDHC) accounting for 21% of subjects with SDHA-C variants. Combining data from both cohorts, estimated lifetime disease penetrance was 22.0% (95% CI 15.2% to 30.9%) for SDHB variants, 8.3% (95% CI 3.5% to 18.5%) for SDHC variants and 1.7% (95% CI 0.8% to 3.8%) for SDHA variants. CONCLUSION: Pathogenic variants in SDHB are more penetrant than those in SDHC and SDHA. Our findings have important implications for counselling and surveillance of subjects carrying these pathogenic variants

Diagnostic Accuracy of HPV16 Early Antigen Serology For HPV-Driven Oropharyngeal Cancer is Independent of Age and Sex

Funding information: This project was funded in part by NIH/NIDCR R01 DE025712 (Paul Brennan, Brenda Diergaarde and Neil Hayes). The Alcohol-Related Cancers and Genetic Susceptibility Study in Europe (ARCAGE) was funded by the European Commission’s fifth framework program (QLK1-2001-00182), the Italian Association for Cancer Research, Compagnia di San Paolo/FIRMS, Region Piemonte and Padova University (CPDA057222). We thank Dr. Wolfgang Ahrens, PhD (Universität Bremen, Germany) for his support in ARCAGE study. The Carolina Head and Neck Cancer Epidemiology (CHANCE) study was supported in part by the National Cancer Institute (R01-CA90731). The Head and Neck 5000 study was a component of independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0707-10034). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Core funding was also provided through awards from Above and Beyond, University Hospitals Bristol and Weston Research Capability Funding and the NIHR Senior Investigator award to Professor Andy Ness. Human papillomavirus (HPV) serology was supported by a Cancer Research UK Programme Grant, the Integrative Cancer Epidemiology Programme (grant number: C18281/A19169). The University of Pittsburgh head and neck cancer case-control study is supported by US National Institutes of Health grants P50CA097190 and P30CA047904. The MSH-PMH study was supported by Canadian Cancer Society Research Institute and Lusi Wong Programs at the Princess Margaret Hospital Foundation.Peer reviewedPublisher PD