Validation of the newly developed Advanced Practice Nurse Task Questionnaire: A national survey.

To describe psychometric validation of the newly developed Advanced Practice Nurse Task Questionnaire. Cross-sectional quantitative study. The development of the questionnaire followed an adapted version of the seven steps described in the guide by the Association for Medical Education in Europe. A nationwide online survey tested the construct and structural validity and internal consistency using an exploratory factor analysis, Cronbach's alpha coefficient and a Kruskal-Wallis test to compare the hypotheses. We received 222 questionnaires between January and September 2020. The factor analysis produced a seven-factor solution as suggested in Hamric's model. However, not all item loadings aligned with the framework's competencies. Cronbach's alpha of factors ranged between .795 and .879. The analysis confirmed the construct validity of the Advanced Practice Nurse Task Questionnaire. The tool was able to discriminate the competencies of guidance and coaching, direct clinical practice and leadership across the three advanced practice nurse roles clinical nurse specialist, nurse practitioner or blended role. A precise assessment of advanced practice nurse tasks is crucial in clinical practice and in research as it may be a basis for further refinement, implementation and evaluation of roles. The Advanced Practice Nurse Task Questionnaire is the first valid tool to assess tasks according to Hamric's model of competencies independently of the role or the setting. Additionally, it distinguishes the most common advanced practice nurse roles according to the degree of tasks in direct clinical practice and leadership. The tool may be applied in various countries, independent of the degree of implementation and understanding of advanced nursing practice. The STARD 2015 guideline was used to report the study. No patient or public contribution

International Journal of Organ Transplantation Medicine Original Article Differences in Medication Adherence between Living and Deceased Donor Kidney Transplant Patients

ABSTRACT Background: Literature review suggests that adherence to immunosuppressive drugs may be lower in recipients of living than of deceased donor kidney grafts, possibly because of profile differences

The ESPRI project: astrometric exoplanet search with PRIMA I. Instrument description and performance of first light observations

The ESPRI project relies on the astrometric capabilities offered by the PRIMA facility of the Very Large Telescope Interferometer for the discovery and study of planetary systems. Our survey consists of obtaining high-precision astrometry for a large sample of stars over several years and to detect their barycentric motions due to orbiting planets. We present the operation principle, the instrument's implementation, and the results of a first series of test observations. A comprehensive overview of the instrument infrastructure is given and the observation strategy for dual-field relative astrometry is presented. The differential delay lines, a key component of the PRIMA facility which was delivered by the ESPRI consortium, are described and their performance within the facility is discussed. Observations of bright visual binaries are used to test the observation procedures and to establish the instrument's astrometric precision and accuracy. The data reduction strategy for astrometry and the necessary corrections to the raw data are presented. Adaptive optics observations with NACO are used as an independent verification of PRIMA astrometric observations. The PRIMA facility was used to carry out tests of astrometric observations. The astrometric performance in terms of precision is limited by the atmospheric turbulence at a level close to the theoretical expectations and a precision of 30 micro-arcseconds was achieved. In contrast, the astrometric accuracy is insufficient for the goals of the ESPRI project and is currently limited by systematic errors that originate in the part of the interferometer beamtrain which is not monitored by the internal metrology system. Our observations led to the definition of corrective actions required to make the facility ready for carrying out the ESPRI search for extrasolar planets.Comment: 32 pages, 39 figures, Accepted for publication in Astronomy and Astrophysic

GLS-1, a Novel P Granule Component, Modulates a Network of Conserved RNA Regulators to Influence Germ Cell Fate Decisions

Post-transcriptional regulatory mechanisms are widely used to influence cell fate decisions in germ cells, early embryos, and neurons. Many conserved cytoplasmic RNA regulatory proteins associate with each other and assemble on target mRNAs, forming ribonucleoprotein (RNP) complexes, to control the mRNAs translational output. How these RNA regulatory networks are orchestrated during development to regulate cell fate decisions remains elusive. We addressed this problem by focusing on Caenorhabditis elegans germline development, an exemplar of post-transcriptional control mechanisms. Here, we report the discovery of GLS-1, a new factor required for many aspects of germline development, including the oocyte cell fate in hermaphrodites and germline survival. We find that GLS-1 is a cytoplasmic protein that localizes in germ cells dynamically to germplasm (P) granules. Furthermore, its functions depend on its ability to form a protein complex with the RNA-binding Bicaudal-C ortholog GLD-3, a translational activator and P granule component important for similar germ cell fate decisions. Based on genetic epistasis experiments and in vitro competition experiments, we suggest that GLS-1 releases FBF/Pumilio from GLD-3 repression. This facilitates the sperm-to-oocyte switch, as liberated FBF represses the translation of mRNAs encoding spermatogenesis-promoting factors. Our proposed molecular mechanism is based on the GLS-1 protein acting as a molecular mimic of FBF/Pumilio. Furthermore, we suggest that a maternal GLS-1/GLD-3 complex in early embryos promotes the expression of mRNAs encoding germline survival factors. Our work identifies GLS-1 as a fundamental regulator of germline development. GLS-1 directs germ cell fate decisions by modulating the availability and activity of a single translational network component, GLD-3. Hence, the elucidation of the mechanisms underlying GLS-1 functions provides a new example of how conserved machinery can be developmentally manipulated to influence cell fate decisions and tissue development

Visually Driven Activation in Macaque Areas V2 and V3 without Input from the Primary Visual Cortex

Creating focal lesions in primary visual cortex (V1) provides an opportunity to study the role of extra-geniculo-striate pathways for activating extrastriate visual cortex. Previous studies have shown that more than 95% of neurons in macaque area V2 and V3 stop firing after reversibly cooling V1 [1], [2], [3]. However, no studies on long term recovery in areas V2, V3 following permanent V1 lesions have been reported in the macaque. Here we use macaque fMRI to study area V2, V3 activity patterns from 1 to 22 months after lesioning area V1. We find that visually driven BOLD responses persist inside the V1-lesion projection zones (LPZ) of areas V2 and V3, but are reduced in strength by ∼70%, on average, compared to pre-lesion levels. Monitoring the LPZ activity over time starting one month following the V1 lesion did not reveal systematic changes in BOLD signal amplitude. Surprisingly, the retinotopic organization inside the LPZ of areas V2, V3 remained similar to that of the non-lesioned hemisphere, suggesting that LPZ activation in V2, V3 is not the result of input arising from nearby (non-lesioned) V1 cortex. Electrophysiology recordings of multi-unit activity corroborated the BOLD observations: visually driven multi-unit responses could be elicited inside the V2 LPZ, even when the visual stimulus was entirely contained within the scotoma induced by the V1 lesion. Restricting the stimulus to the intact visual hemi-field produced no significant BOLD modulation inside the V2, V3 LPZs. We conclude that the observed activity patterns are largely mediated by parallel, V1-bypassing, subcortical pathways that can activate areas V2 and V3 in the absence of V1 input. Such pathways may contribute to the behavioral phenomenon of blindsight

Acceptability, Appropriateness and Feasibility of a Nurse-Led Integrated Care Intervention for Patients with Severe Exacerbation of COPD from the Healthcare Professional’s Perspective – A Mixed Method Study

Christine Hübsch,1,2 Christian Clarenbach,2,3 Paul Chadwick,4 Matthias Peterer,5 Sonja Beckmann,1 Rahel Naef,1,6 Gabriela Schmid-Mohler1,2 1Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland; 2Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland; 3Faculty of Medicine, University of Zurich, Zurich, Switzerland; 4Centre for Behaviour Change, University College London, London, UK; 5Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland; 6Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, SwitzerlandCorrespondence: Gabriela Schmid-Mohler, Centre of Clinical Nursing Science, University Hospital Zurich, Rämistrasse 100, Zurich, CH-8091, Switzerland, Tel +41 44 255 20 03, Email [email protected]: To improve inpatient care and self-management in patients with severe acute exacerbations of COPD, we implemented a nurse-led behavioral intervention. This study aimed to assess implementation outcomes from the perspective of the healthcare professionals (HCP) who delivered it.Methods: Using an explanatory sequential mixed method approach, we conducted an online questionnaire and two small group interviews. We applied descriptive statistics for quantitative data, a framework analysis for qualitative data, and a mixed methods matrix to integrate the results.Results: A total of 19 of 27 invited participants answered the online questionnaire; 9 of 19 participated in the group interviews. The intervention’s overall acceptability, appropriateness, and feasibility was rated high to very high (median 5/5; 4/5 and 4/5). Enablers to implementation included general recognition of the need for specialized care, sufficient knowledge of the intervention by HCP, and strong interprofessional collaboration. Main barriers included the lack of resident physician’s resources and difficulties in adaptability.Conclusion: While the acceptance of the intervention was very high, the perceived appropriateness and feasibility were affected by its complexity. The availability of a knowledgeable interprofessional core team is a strategy that supports the implementation of complex interventions.Keywords: COPD, self-management, complex intervention, implementation outcomes, program evaluation, behaviour change whee

Differences in Medication Adherence between Living and Deceased Donor Kidney Transplant Patients

Literature review suggests that adherence to immunosuppressive drugs may be lower in recipients of living than of deceased donor kidney grafts, possibly because of profile differences.status: publishe

Differences in medication adherence between living and deceased donor kidney transplant patients

BACKGROUND: Literature review suggests that adherence to immunosuppressive drugs may be lower in recipients of living than of deceased donor kidney grafts, possibly because of profile differences. OBJECTIVE: To compare the level of immunosuppressive adherence levels between patients with deceased and living (-related; -unrelated) donor grafts in Switzerland. METHODS: Using data from two similar cross-sectional studies at two transplant centers in Switzerland, the level of adherence between the two groups was compared. Medication adherence was assessed by self-report or electronic monitoring. Possible explanatory factors included age, beliefs regarding immunosuppressive drugs, depressive symptomatology, pre-emptive transplantation, and the number of transplants received, were also considered. Data were analyzed using logistic regression analysis. RESULTS: Unadjusted non-adherence odds were 2 to 3 times higher in living-related than deceased donor transplantation (ORs: 2.09-3.05; p<0.05). Adjustment for confounders showed that these differences were associated most with the younger age of living-related subjects and the belief that immunosuppressive drugs are less important for living-related donations. CONCLUSION: There is a lower immunosuppressive adherence in recipients of living-related donor kidneys, possibly owing to differences in patient profile (ie, health beliefs regarding their immunosuppressive needs), knowledge of which may enhance adherence if addressed