Nurse Preceptors\u27 Perceptions of Non-Traditional Education

Background: A preceptor is an experienced nurse who teaches and provides feedback to a new orientee on their professional practice for a designated time. The preceptor is the key educator for new nurses in their learning process. Continuing education for the nurse preceptor is necessary to foster the professional development of this complex role. Aims: The purpose of this study is to determine if nurse preceptors perceive non traditional education as effective as in person instruction for preceptor professional development. Methods: This descriptive study used a convenient sample. An educational journal was created covering a variety of topics that aide in the growth and development of the nurse preceptor. The education was sent electronically to nurse preceptors in a critical care setting. Preceptors were required to read the journal and complete a post test. Once completed, nurse preceptors were invited to participate in the study. A 25 item questionnaire, using a 5 point Likert scale, was sent via email. Nurse preceptors were given one month to voluntarily participate in the study. Responses to the survey were scored and averaged. Findings: There were a total of 14 participants. Not all items were answered by each participant. Eighty six percent were BSN prepared, 14% were MSN prepared. The majority of participants (71%, n= 10) have been preceptors for 2 or more years in their current practice setting. Some participants did not attend the previous in person preceptor education (4 out of 14). All participants completed the non traditional (journal) education. Nearly all participants (92%, n=12 out of 13) believed that the non traditional educational journal had high impact. When responding to educational preferences, 61.5% preferred to receive preceptor education in a non traditional format while 38% preferred to receive education in both non traditional and traditional formats. The study results provide a better understating of the educational preferences of the nurse preceptor. This information is vital for the development for future preceptor education programs. Tailoring education to the learners preferred methods can make education more impactful. Providing meaningful education to preceptors will improve their practice, further benefiting the experience of the newly hired/transferred nurses. The study may be applicable to other practice areas and/or organizations.https://scholarlycommons.henryford.com/nursresconf2021/1010/thumbnail.jp

Organ preservation and survival by clinical response grade in patients with rectal cancer treated with total neoadjuvant therapy: A secondary analysis of the OPRA randomized clinical trial

IMPORTANCE: Assessing clinical tumor response following completion of total neoadjuvant therapy (TNT) in patients with locally advanced rectal cancer is paramount to select patients for watch-and-wait treatment. OBJECTIVE: To assess organ preservation (OP) and oncologic outcomes according to clinical tumor response grade. DESIGN, SETTING, AND PARTICIPANTS: This was secondary analysis of the Organ Preservation in Patients with Rectal Adenocarcinoma trial, a phase 2, nonblinded, multicenter, randomized clinical trial. Randomization occurred between April 2014 and March 2020. Eligible participants included patients with stage II or III rectal adenocarcinoma. Data analysis occurred from March 2022 to July 2023. INTERVENTION: Patients were randomized to induction chemotherapy followed by chemoradiation or chemoradiation followed by consolidation chemotherapy. Tumor response was assessed 8 (±4) weeks after TNT by digital rectal examination and endoscopy and categorized by clinical tumor response grade. A 3-tier grading schema that stratifies clinical tumor response into clinical complete response (CCR), near complete response (NCR), and incomplete clinical response (ICR) was devised to maximize patient eligibility for OP. MAIN OUTCOMES AND MEASURES: OP and survival rates by clinical tumor response grade were analyzed using the Kaplan-Meier method and log-rank test. RESULTS: There were 304 eligible patients, including 125 patients with a CCR (median [IQR] age, 60.6 [50.4-68.0] years; 76 male [60.8%]), 114 with an NCR (median [IQR] age, 57.6 [49.1-67.9] years; 80 male [70.2%]), and 65 with an ICR (median [IQR] age, 55.5 [47.7-64.2] years; 41 male [63.1%]) based on endoscopic imaging. Age, sex, tumor distance from the anal verge, pathological tumor classification, and clinical nodal classification were similar among the clinical tumor response grades. Median (IQR) follow-up for patients with OP was 4.09 (2.99-4.93) years. The 3-year probability of OP was 77% (95% CI, 70%-85%) for patients with a CCR and 40% (95% CI, 32%-51%) for patients with an NCR (P \u3c .001). Clinical tumor response grade was associated with disease-free survival, local recurrence-free survival, distant metastasis-free survival, and overall survival. CONCLUSIONS AND RELEVANCE: In this secondary analysis of a randomized clinical trial, most patients with a CCR after TNT achieved OP, with few developing tumor regrowth. Although the probability of tumor regrowth was higher for patients with an NCR compared with patients with a CCR, a significant proportion of patients achieved OP. These findings suggest the 3-tier grading schema can be used to estimate recurrence and survival outcomes in patients with locally advanced rectal cancer who receive TNT. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02008656

Fast spectral fitting of hard X-ray bremsstrahlung from truncated power-law electron spectra

<p><b>Context:</b> Hard X-ray bremsstrahlung continuum spectra, such as from solar flares, are commonly described in terms of power-law fits, either to the photon spectra themselves or to the electron spectra responsible for them. In applications various approximate relations between electron and photon spectral indices are often used for energies both above and below electron low-energy cutoffs.</p> <p><b>Aims:</b> We examine the form of the exact relationships in various situations, and for various cross-sections, showing that empirical relations sometimes used can be highly misleading especially at energies below the low-energy cutoff, and consider how to improve fitting procedures.</p> <p><b>Methods:</b> We obtain expressions for photon spectra from single, double and truncated power-law electron spectra for a variety of cross-sections and for the thin and thick target models and simple analytic expressions for the non-relativistic Bethe-Heitler case.</p> <p><b>Results:</b> We show that below the low-energy cutoff Kramers and other constant spectral index forms commonly used are very poor approximations to accurate results, but that our analytical forms are a good match; and that above a low-energy cutoff, the Kramers and non-relativistic Bethe-Heitler results match reasonably well with results for up to energies around 100 keV.</p> <p><b>Conclusions:</b> Analytical forms of the non-relativistic Bethe-Heitler photon spectra from general power-law electron spectra are good match to exact results for both thin and thick targets and they enable much faster spectral fitting than evaluation of the full spectral integrations.</p&gt

The pathway to diagnosis of type 1 diabetes in children: a questionnaire study.

OBJECTIVE: To explore the pathway to diagnosis of type 1 diabetes (T1D) in children. DESIGN: Questionnaire completed by parents. PARTICIPANTS: Parents of children aged 1 month to 16 years diagnosed with T1D within the previous 3 months. SETTING: Children and parents from 11 hospitals within the East of England. RESULTS: 88/164 (54%) invited families returned the questionnaire. Children had mean±SD age of 9.41±4.5 years. 35 (39.8%) presented with diabetic ketoacidosis at diagnosis. The most common symptoms were polydipsia (97.7%), polyuria (83.9%), tiredness (75.9%), nocturia (73.6%) and weight loss (64.4%) and all children presented with at least one of those symptoms. The time from symptom onset to diagnosis ranged from 2 to 315 days (median 25 days). Most of this was the appraisal interval from symptom onset until perceiving the need to seek medical advice. Access to healthcare was good but one in five children presenting to primary care were not diagnosed at first encounter, most commonly due to waiting for fasting blood tests or alternative diagnoses. Children diagnosed at first consultation had a shorter duration of symptoms (p=0.022) and children whose parents suspected the diagnosis were 1.3 times more likely (relative risk (RR) 1.3, 95% CI 1.02 to 1.67) to be diagnosed at first consultation. CONCLUSIONS: Children present with the known symptoms of T1D but there is considerable scope to improve the diagnostic pathway. Future interventions targeted at parents need to address the tendency of parents to find alternative explanations for symptoms and the perceived barriers to access, in addition to symptom awareness.The study was funded by the Royal College of General Practitioners Scientific Foundation Board (SFB-2011-15). JUS was supported by a National Institute of Health Research (NIHR) Academic Clinical Fellowship and subsequently Clinical Lectureship, and FMW by an NIHR Clinician Scientist award. SJS was supported by the Medical Research Council www.mrc.ac.uk [Unit Programme number MC_UU_12015/1]. 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.This is the final version of the article. It was first published by BMJ Group at http://bmjopen.bmj.com/content/5/3/e006470.ful

Lens-regulated retinoic acid signalling controls expansion of the developing eye

This research was funded by a Biotechnology and Biological Science Research Council (BBSRC) PhD studentship to H.M.W., a University of Aberdeen Institute of Medical Sciences PhD Studentship to J.N.S., and a grant from the University of Aberdeen Development Trust [OL 989 to L.E., J.M.C].Peer reviewedPublisher PD

Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design

Background: Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients\u27 health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients\u27 health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients\u27 needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. Objective: Our aim was to characterize patients\u27 use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients\u27 communication needs and preferences. Methods: This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study\u27s first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. Results: Participants\u27 rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6) attributes of the technology. Conclusions: The results of this study showed that participants consider multiple factors when choosing a Facebook mechanism for health information communication. Factors included what information they intended to share, what they were trying to accomplish, attributes of technology, and attributes and communication practices of their social networks. There is a need for consumer health IT that allows for a range of choices to suit the intersectionality of participants\u27 rationales. Technology that better meets patients\u27 needs may lead to better self-management of health conditions, and therefore, improve overall health outcomes

Neuromodulatory Interventions for Pain

Editorial on the Research Topic Neuromodulatory Interventions for Pain The opioid crisis has prompted a renewed interest in non pharmacological interventions for pain, with recent promising evidence for their effectiveness (Pillai Riddell et al., 2015; Veehof et al., 2016; Thompson et al., 2017, 2019; Franco et al., 2018; Owen et al., 2020). So called neuromodulatory interventions, which include neurofeedback and electrical and magnetic brain stimulation, are a novel class of non-pharmacological treatments that have attracted both intrigue and controversy. Despite a growing research literature, there remains a sense of uncertainty over whether they represent realistic alternatives to pain medication. The aim of this research topic was to stimulate new, much-needed research evaluating the effectiveness of such treatments and providing insights into their possible mechanisms. We present a collection of 11 articles focused primarily on neurofeedback, non-invasive brain stimulation and acupuncture that attempt to address some of these issues

MetaIPM: Placing Integral Projection Models Into a Metapopulation Framework

1. Metapopulation models include spatial population dynamics such as dispersion and migration between subpopulations. Integral projection models (IPMs) can include demographic rates as a function of size. Traditionally, metapopulation models do not included detailed populaiton models such as IPMs. In some situations, both local population dynamics (e.g. size-based survival) and spatial dynamics are important. 2. We present a Python package, MetaIPM, which places IPMs into a metapopulation framework, and allow users to readily construct and apply these models that combine local population dynamics within a metapopulation framework. 3. MetaIPM includes an IPM for each subpopulation that is connected to other subpopulations via a metapopulation movement model. These movements can include dispersion, migration or other patterns. The IPM can include for size-specific demographic rates (e.g. survival, recruitment) as well as management actions, such as length-based harvest (e.g. gear specific capture sizes, varying slot limits across political boundaries). The model also allows for changes in metapopulation connectivity between locations, such as a fish passage ladders to enhance movement or deterrents to reduce movement. Thus, resource managers can use MetaIPM to compare different management actions such as the harvest gear type (which can be length-specific) and harvest locations. 4. We demonstrate how MetaIPM may be applied to inform managers seeking to limit the spread of an invasive species in a system with important metapopulation dynamics. Specifically, we compared removal lengths (all length fish versus longer fish only) for an invasive fish population in a fragmented, inland river system. MetaIPM allowed users to compare the importance of harvesting source populations away from the invasion front, as well as species at the invasion front. The model would also allow for future comparisons of different deterrent placement locations in the system. 5. Moving beyond our example system, we describe how MetaIPM can be applied to other species, systems and management approaches. The MetaIPM packages includes Jupyter Notebooks documenting the package as well as a second set of JupyterNotebooks showing the application of the package to our example system