The Development and Psychometric Testing of the Nurse Practitioner Role Transition Scale

Nurse practitioners (NPs) are formidable members of the health care system providing high quality, cost-effective care. Their transition into practice is often fraught with unexpected challenges. In support of this dissertation, a series of three studies was conducted to improve the process of NP role transition by increasing our knowledge and understanding of the defining constructs and the development and validation of the NP role transition scale (NPRTS). The NPRTS is a self-report survey designed to measure NP’s perceptions of role transition experiences during the first year of practice. Two individual studies supported the development and evolution of the NPRTS through factor analyses and reliability assessments. In a third study, a qualitative analysis including a subset of neonatal NPs was conducted to further our understanding of role transition constructs and support the revisions of the NPRTS. Two samples comprised of 182 and 427 NPs representing a variety of specialties and practice settings participated in the scale development studies. Multiple factor analyses provided empirical support for the existence of the resulting three factor eighteen indicator model. Internal consistency for the final three factors was high. A qualitative analysis of 70 neonatal NPs revealed four themes that described the reattainment of expert status during role transition: 1) First impressions: Am I prepared? 2) The transition, 3) Making it as a real NNP, and 4) The helpers and hinderers. The resulting NPRTS model is inferred as a valid and reliable measure of the constructs of NP role transition including: 1) confidence, comfort, and competence in the role; 2) collegial relationships; and 3) understanding of the role by clients. Implications for practice include the implementation of the NPRTS as a beginning model for NP role transition discussions and as a means to assess transition progress in the clinical setting. Continued research is warranted to progress the understanding of NP role transition and for the refinement and validation of the NPRTS

Additional Findings from the Common Research Model Natural Laminar Flow Wind Tunnel Test

An experimental investigation of the Common Research Model with Natural Laminar Flow (CRM-NLF) took place in the National Transonic Facility (NTF) at the NASA Langley Research Center in 2018. The 5.2% scale semispan model was designed using a new natural laminar flow design method, Crossflow Attenuated NLF (CATNLF). CATNLF enables laminar flow on typical transport wings with high sweep and Reynolds number by reshaping the wing airfoils to obtain specific pressure distribution characteristics that control the crossflow growth near the leading edge. The CATNLF method also addresses Tollmien- Schlichting transition, attachment line transition, and Grtler vortices. During the wind tunnel test, data were acquired to address three primary test objectives: validate the CATNLF design method, characterize the NTF laminar flow testing capabilities, and establish best practices for laminar flow wind tunnel testing. The present paper provides both experimental and computational data to understand the CRM-NLF laminar flow characteristics, as well as address the three primary test objectives. The effects of angle of attack and Reynolds number on the CRM-NLF laminar flow extent are studied, and the dominant transition mechanism is evaluated at a variety of test conditions. Critical N-factors are calculated for the NTF environment, and a discussion on best practices for laminar flow wind tunnel testing is provided. The CRM-NLF in the NTF provided initial confirmation of the ability of the CATNLF method to suppress crossflow growth and enable significant extents of laminar flow on transport wings with high sweep and Reynolds numbers

Discovering the Higgs Bosons of Minimal Supersymmetry with Muons and a Bottom Quark

We investigate the prospects for the discovery at the CERN Large Hadron Collider of a neutral Higgs boson produced with one bottom quark followed by Higgs decay into a muon pair. We work within the framework of the minimal supersymmetric model. The dominant physics background from the production of $b \mu^+\mu^-$, $j\mu^+\mu^-$, j=g,u,d,s,c, and $b {\bar b} W^+W^-$ is calculated with realistic acceptance cuts. Promising results are found for the CP-odd pseudoscalar ($A^0$) and the heavier CP-even scalar ($H^0$) Higgs bosons with masses up to 600 GeV. This discovery channel with one energetic bottom quark greatly improves the discovery potential of the LHC beyond the inclusive channel $pp\to \phi^0\to \mu^+\mu^- +X$.Comment: Version to appear in Phys. Rev. Let

PEDs anxiety

This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of anxiety in children

Intense isolectin-B4 binding in rat dorsal root ganglion neurons distinguishes c-fiber nociceptors with broad action potentials and high nav1.9 expression

Binding to isolectin-B4 (IB4) and expression of tyrosine kinase A (trkA) (the high-affinity NGF receptor) have been used to define two different subgroups of nociceptive small dorsal root ganglion (DRG) neurons. We previously showed that only nociceptors have high trkA levels. However, information about sensory and electrophysiological properties in vivo of single identified IB4-binding neurons, and about their trkA expression levels, is lacking. IB4-positive (IB4+) and small dark neurons had similar size distributions. We examined IB4-binding levels in >120 dye-injected DRG neurons with sensory and electrophysiological properties recorded in vivo. Relative immunointensities for trkA and two TTX-resistant sodium channels (Nav1.8 and Nav1.9) were also measured in these neurons. IB4+ neurons were classified as strongly or weakly IB4+. All strongly IB4+ neurons were C-nociceptor type (C-fiber nociceptive or unresponsive). Of 32 C-nociceptor-type neurons examined, ~50% were strongly IB4+, ~20% were weakly IB4+ and ~30% were IB4–. A{delta} low-threshold mechanoreceptive (LTM) neurons were weakly IB4+ or IB4–. All 33 A-fiber nociceptors and all 44 A{alpha}/beta-LTM neurons examined were IB4–. IB4+ compared with IB4– C-nociceptor-type neurons had longer somatic action potential durations and rise times, slower conduction velocities, more negative membrane potentials, and greater immunointensities for Nav1.9 but not Nav1.8. Immunointensities of IB4 binding in C-neurons were positively correlated with those of Nav1.9 but not Nav1.8. Of 23 C-neurons tested for both trkA and IB4, ~35% were trkA+/IB4+ but with negatively correlated immunointensities; 26% were IB4+/trkA–, and 35% were IB4–/trkA+. We conclude that strongly IB4+ DRG neurons are exclusively C-nociceptor type and that high Nav1.9 expression may contribute to their distinct membrane properties

Transporting cells over several days without dry-ice

This paper describes a simple, hazard-free and inexpensive procedure that allows researchers to send cultured cells across the globe at ambient temperatures. The method enables transit of up to 2 weeks without compromising cell recovery. Its use will assist collaborators in distant laboratories to exchange cells without using dry-ice

Advanced Practice Nursing in Nigerian Healthcare: Prospects and Challenges

This study explored the prospects and challenges of introducing advanced practice nursing (APN) in the Nigerian health system. It sought to address the following: career pathways for registered nurses and midwives, advanced duties performed by them and the circumstances, their views and willingness for autonomous practice, and doctors’ degree of acceptance. Research population composed of registered nurses, midwives and medical doctors in primary healthcare. The conceptual framework for this study was based on the scope of practice, standards and competencies of the APN established by the International Council of Nurses (2008). A 12-item checklist of typical duties of APN from the framework provided a guide for the design of eight main questions and 19 subquestions. Data was collected from 17 participants through in-depth interviews and group discussions and analyzed using Charmaz’s three simplified methods for qualitative data. Findings were that (a) registered nurses and midwives are constrained to perform advanced duties, (b) doctors delegate advanced roles to nurses and midwives, (c) nurses and midwives lacked pathways for advancement, (d) APN would substitute for doctor shortage, and (e) advocacy and lobbying has to done by the Nursing and Midwifery Council of Nigeria to change the current policy. The social change implication is that it offers insight into the potentials for APN in healthcare delivery. Keywords: advanced practic

Service Learning: A Natural Link to Interdisciplinary Studies

Service learning, which involves young adolescents helping others in their school or community, provides a unique opportunity to integrate curriculum and school activities

Meeting the Needs of Young Adolescents

During the past 40 years, research from more than 80 studies has shown that students in interdisciplinary programs do as well as, if not better than students in single­ subject curricular structures on standardized tests (Vars, 1991). In addition, the opportunities for teachers to work together to develop learning experiences for their students create school climates that focus efforts on student needs, curriculum and instructional improvement, and reflection (Clark and Clark, 1994a)