Practice nurses experiences of mentoring undergraduate nursing students in Australian general practice

Internationally, the delivery of health services has shifted from secondary to primary care, necessitating an exponential growth of the nursing workforce and expansion of the nursing role in general practice. This growth, and the subsequent need to develop this workforce, has created a need to expose undergraduate nurses to general practice nursing as a viable career option. Concurrently, universities are struggling to find sufficient clinical places for their undergraduate students to gain clinical experience. It is logical, therefore, to increase the number of undergraduate nursing student placements in general practice. Through qualitative research methods, this paper seeks to explore the experiences of practice nurses mentoring undergraduate students on clinical placements within the general practice setting. Findings are presented in the following three themes: (1) Promoting Practice Nursing: We really need to get students in, (2) Mentoring future co-workers: Patience and reassurance, and (3) Reciprocity in learning: It\u27s a bit of a two way street, which show the benefits of such placements. Clinical placements in general practice settings can be mutually beneficial in terms of providing quality teaching and learning experiences for students. Conversely, the experience provides an impetus for practice nurses to maintain currency of their clinical skills and knowledge through mentoring student nurses

NADPH oxidase deficiency results in reduced alveolar macrophage 5â lipoxygenase expression and decreased leukotriene synthesis

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141933/1/jlb1585.pd

Global Environmental Engineering for and with Historically Marginalized Communities

Marginalized communities lack full participation in social, economic, and political life, and they disproportionately bear the burden of environmental and health risks. This special issue of Environmental Engineering Science, the official journal of the Association of Environmental Engineering and Science Professors (AEESP), reports research on the unique environmental challenges faced by historically marginalized communities around the world. The results of community-based participatory research with an Afro-descendant community in Columbia, Native American communities in Alaska, United States, villagers in the Philippines, disadvantaged communities in California, United States, rural communities in Mexico and Costa Rica, homeless encampments in the San Diego River (United States) watershed entrepreneurs in Durban, South Africa, and remote communities in the island nation of Fiji are presented. The research reported in this special issue is transdisciplinary, bringing engineers together with anthropologists, sociologists, economists, and public health experts. In the 13 articles in this special issue, some of the topics covered include inexpensive technologies for water treatment, novel agricultural strategies for reversing biodiversity losses, and strategies for climate change adaptation. In addition, one article covered educational strategies for teaching ethics to prepare students for humanitarian engineering, including topics of poverty, sustainability, social justice, and engineering decisions under uncertainty. Finally, an article presented ways that environmental engineering professors can engage and promote the success of underrepresented minority students and enable faculty engaged in community-based participatory research

De novo identification of differentially methylated regions in the human genome

Background: The identification and characterisation of differentially methylated regions (DMRs) between phenotypes in the human genome is of prime interest in epigenetics. We present a novel method, DMRcate, that fits replicated methylation measurements from the Illumina HM450K BeadChip (or 450K array) spatially across the genome using a Gaussian kernel. DMRcate identifies and ranks the most differentially methylated regions across the genome based on tunable kernel smoothing of the differential methylation (DM) signal. The method is agnostic to both genomic annotation and local change in the direction of the DM signal, removes the bias incurred from irregularly spaced methylation sites, and assigns significance to each DMR called via comparison to a null model. Results: We show that, for both simulated and real data, the predictive performance of DMRcate is superior to those of Bumphunter and Probe Lasso, and commensurate with that of comb-p. For the real data, we validate all array-derived DMRs from the candidate methods on a suite of DMRs derived from whole-genome bisulfite sequencing called from the same DNA samples, using two separate phenotype comparisons. Conclusions: The agglomeration of genomically localised individual methylation sites into discrete DMRs is currently best served by a combination of DM-signal smoothing and subsequent threshold specification. The findings also suggest the design of the 450K array shows preference for CpG sites that are more likely to be differentially methylated, but its overall coverage does not adequately reflect the depth and complexity of methylation signatures afforded by sequencing. For the convenience of the research community we have created a user-friendly R software package called DMRcate, downloadable from Bioconductor and compatible with existing preprocessing packages, which allows others to apply the same DMR-finding method on 450K array data

Comparative Effectiveness of Smoking Cessation Medications among Schizophrenic Smokers

Objective: To examine which medication could lead to a higher short and long term smoking abstinence in patients with schizophrenia. Methods: A retrospective cohort study was conducted using General Electric (GE) medical records database (1995 – 2011). The cohort consisted of adult smokers with diagnosis of schizophrenia newly initiating cessation medication. Short term and long term outcomes of cessation were measured at 3 weeks and 1 year. Descriptive and chi-square analyses were used to determine the frequencies and associations of patient characteristics with the abstinence outcomes. Logistic regression models were carried out to determine the predictors of short term and long term abstinence. Results: The cohort consisted of 3,976 patients. Abstinence rate was highest for Varenicline, followed by Bupropion, NRT, and lastly combination at week 12. At one year, abstinence rate was highest for Varenicline, followed by combination, NRT, and lastly Bupropion. Age, race, household locations and receiving counseling were associated with abstinence. No significant differences were found between cessation medications. Conclusions: There were no statistically significant differences in quitting with type of cessation medication. Predictors of better abstinence identified included older age, white race, western household location. These factors should be considered when designing future interventions for schizophrenic population as this minority population may need more tailored approaches to achieve a successful cessation outcome

Cardiovascular Magnetic Resonance Characterization of Mitral Valve Prolapse

ObjectivesThis study sought to develop cardiovascular magnetic resonance (CMR) diagnostic criteria for mitral valve prolapse (MVP) using echocardiography as the gold standard and to characterize MVP using cine CMR and late gadolinium enhancement (LGE)-CMR.BackgroundMitral valve prolapse is a common valvular heart disease with significant complications. Cardiovascular magnetic resonance is a valuable imaging tool for assessing ventricular function, quantifying regurgitant lesions, and identifying fibrosis, but its potential role in evaluating MVP has not been defined.MethodsTo develop CMR diagnostic criteria for MVP, characterize mitral valve morphology, we analyzed transthoracic echocardiography and cine CMR images from 25 MVP patients and 25 control subjects. Leaflet thickness, length, mitral annular diameters, and prolapsed distance were measured. Two- and three-dimensional LGE-CMR images were obtained in 16 MVP and 10 control patients to identify myocardial regions of fibrosis in MVP.ResultsWe found that a 2-mm threshold for leaflet excursion into the left atrium in the left ventricular outflow tract long-axis view yielded 100% sensitivity and 100% specificity for CMR using transthoracic echocardiography as the clinical gold standard. Compared with control subjects, CMR identified MVP patients as having thicker (3.2 ± 0.1 mm vs. 2.3 ± 0.1 mm) and longer (10.5 ± 0.5 mm/m2 vs. 7.1 ± 0.3 mm/m2) indexed posterior leaflets and larger indexed mitral annular diameters (27.8 ± 0.7 mm/m2 vs. 21.5 ± 0.5 mm/m2 for long axis and 22.9 ±0.7 mm/m2 vs. 17.8 ± 0.6 mm/m2 for short axis). In addition, we identified focal regions of LGE in the papillary muscles suggestive of fibrosis in 10 (63%) of 16 MVP patients and in 0 of 10 control subjects. Papillary muscle LGE was associated with the presence of complex ventricular arrhythmias in MVP patients.ConclusionsCardiovascular magnetic resonance image can identify MVP by the same echocardiographic criteria and can identify myocardial fibrosis involving the papillary muscle in MVP patients. Hyperenhancement of papillary muscles on LGE is often present in a subgroup of patients with complex ventricular arrhythmias

Prognostic Value of Bronchiolitis Obliterans Syndrome Stage 0-p in Single-Lung Transplant Recipients

Rationale: Early diagnosis of bronchiolitis obliterans syndrome (BOS) is critical in understanding pathogenesis and devising therapeutic trials. Although potential-BOS stage (BOS 0-p), encompassing early changes in FEV1 and forced expiratory flow, midexpiratory phase (FEF25–75%), has been proposed, there is a paucity of data validating its utility in single-lung transplantation. Objective: The aim of this study was to define the predictive ability of BOS 0-p in single-lung transplantation. Methods: We retrospectively analyzed spirometric data for 197 single-lung recipients. Sensitivity, specificity, and positive predictive value of BOS 0-p were examined over time using Kaplan-Meier methodology. Results: BOS 0-p FEV1 was associated with higher sensitivity, specificity, and positive predictive value than the FEF25–75% criterion over different time periods investigated. The probability of testing positive for BOS 0-p FEV1 in patients with BOS (sensitivity) was 71% at 2 years before the onset of BOS. The probability of being free from development of BOS 0-p FEV1 in patients free of BOS at follow-up (specificity) was 93% within the last year. Of patients who met the BOS 0-p FEV1 criterion, 81% developed BOS or died within 3 years. The specificity and positive predictive value curves for the BOS 0-p FEV1 were significantly different between patients with underlying restrictive versus obstructive physiology (p = 0.05 and 0.01, respectively). Conclusion: The FEV1 criterion for BOS 0-p provides useful predictive information regarding the risk of development of BOS or death in single-lung recipients. The predictive value of this criterion is higher in patients with underlying restriction and is superior to the FEF25–75% criterion.Supported in part by National Institutes of Health grants K23 HL077719 and K24HL04212 and American Lung Association RG-1059-N.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91970/1/2005 AJRCCM - Prognostic Value of Bronchiolitis Obliterans Syndrome Stage 0-p in Single-Lung Transplant Recipients.pd

The Relationship Between Future orientation and Street Substance Use among Texas alternative School Students

Self-reported substance use data were collected from 963 alternative school students in grades 7-12 who were surveyed through the Safer Choices 2 study in Houston, Texas. Data were collected between October 2000 and March 2001. Logistic regression analyses indicated that lower levels of future orientation was significantly associated (OR = 0.88, 95% CI = 0.81-0.97) with thirty-day substance use after controlling for age and gender. In addition, lower levels of future orientation was found to have a significant association with students\u27 lifetime substance use (OR = 0.93, 95% CI = 0.87-.99) after controlling for age, race, and gender. While the relationships tested in this study are exploratory, they provide evidence for an important connection between future orientation and substance use among adolescents attending alternative schools