Dual separable feedback systems govern firing rate homeostasis.

Firing rate homeostasis (FRH) stabilizes neural activity. A pervasive and intuitive theory argues that a single variable, calcium, is detected and stabilized through regulatory feedback. A prediction is that ion channel gene mutations with equivalent effects on neuronal excitability should invoke the same homeostatic response. In agreement, we demonstrate robust FRH following either elimination of Kv4/Shal protein or elimination of the Kv4/Shal conductance. However, the underlying homeostatic signaling mechanisms are distinct. Eliminating Shal protein invokes Krüppel-dependent rebalancing of ion channel gene expression including enhanced slo, Shab, and Shaker. By contrast, expression of these genes remains unchanged in animals harboring a CRISPR-engineered, Shal pore-blocking mutation where compensation is achieved by enhanced IKDR. These different homeostatic processes have distinct effects on homeostatic synaptic plasticity and animal behavior. We propose that FRH includes mechanisms of proteostatic feedback that act in parallel with activity-driven feedback, with implications for the pathophysiology of human channelopathies

First insights into the movements and vertical habitat use of blue marlin (Makaira nigricans) in the eastern North Atlantic

The blue marlin (Makaira nigricans) is a vulnerable migratory fish inhabiting tropical and subtropical pelagic waters of the Atlantic, Pacific and Indian Oceans. The biology and spatial ecology of the species in the eastern North Atlantic is poorly understood, despite being exploited in the region by recreational and commercial fisheries. Here, we present results of the first study to use pop-up satellite archival tags to track blue marlin off Madeira, Portugal (n = 3) and obtain insights into the movements and habitat use of the species within the eastern North Atlantic.publishedVersio

Development of Data Models for Nursing Assessment of Cancer Survivors Using Concept Analysis

Objectives: Sharing of cancer-related information among healthcare professionals is crucial to ensuring the quality of longterm care for cancer survivors. Appropriate distribution of the essential facts can be achieved using data models. The purpose of this study was to develop and validate suitable data models for use in the nursing assessment of cancer survivors. Methods: The models developed in this study were based on a modification of concept analysis developed by Walker and Avant. Our approach involved determining the purpose of the analysis, identifying data elements, defining these elements and their uses, determining critical attributes, value sets, and cardinalities, and ultimately constructing data models which were examined externally by domain experts. Results: We developed 112 data models with 112 data elements, 29 critical attributes, 102 value sets, and 6 data types for the assessment of cancer survivors. External validation revealed that the data elements, critical attributes, and value sets proposed were comprehensive, relevant, and sufficiently useful to encompass nursing issues related to cancer survivors. Conclusions: Data models developed in this study will contribute to ensuring the semantic consistency of data collected from cancer survivors, which will improve the quality of nursing assessments and in turn translate to improved long-term patient care

A Career in Surgical Oncology: Finding Meaning, Balance, and Personal Satisfaction

The practice of surgical oncology provides opportunities for both personal distress as well as personal satisfaction. While many surgical oncologists experience career burnout, others derive great meaning and satisfaction from their work. In this article, we review the literature on surgeon burnout, discuss potential personal and professional consequences, and consider steps individual surgeons can take to promote personal and professional satisfaction

Haemato-oncology and burnout: an Italian survey

This cross-sectional survey aimed to evaluate the prevalence of burnout and estimated psychiatric disorders among haemato-oncology healthcare professionals in Italy. The aspects of work that respondents perceive as stressful and satisfying have also been examined. The assessments were made using the Maslach Burnout Inventory (MBI), General Health Questionnaire and a study-specific questionnaire. Logistic regression models were applied to show associations between different sources of work-related stress and burnout. Three hundred and eighty-seven out of 440 (87.95%) returned their questionnaires. The scores on MBI subscales indicate a high level of emotional exhaustion in 32.2% of the physicians and 31.9% of the nurses; a high level of Depersonalisation in 29.8 and 23.6%, respectively; and a low level of personal accomplishment in 12.4 and 15.3% respectively. The estimated prevalence of psychiatric disorders was 36.4% in physicians and 28.8% in nurses. Statistical analysis confirmed age, sex, personal dissatisfaction, physical tiredness and working with demanding patients to be associated with burnout. In conclusion, haemato-oncology healthcare professionals report a level of burnout and estimated psychiatric morbidity comparable to other oncological areas. Knowledge of the mechanisms of burnout and preventing and dealing with them is therefore a fundamental requirement for the improvement of quality in health services and job satisfaction

Physician-assisted suicide: a review of the literature concerning practical and clinical implications for UK doctors

BACKGROUND: A bill to legalize physician-assisted suicide in the UK recently made significant progress in the British House of Lords and will be reintroduced in the future. Until now there has been little discussion of the clinical implications of physician-assisted suicide for the UK. This paper describes problematical issues that became apparent from a review of the medical and psychiatric literature as to the potential effects of legalized physician-assisted suicide. DISCUSSION: Most deaths by physician-assisted suicide are likely to occur for the illness of cancer and in the elderly. GPs will deal with most requests for assisted suicide. The UK is likely to have proportionately more PAS deaths than Oregon due to the bill's wider application to individuals with more severe physical disabilities. Evidence from other countries has shown that coercion and unconscious motivations on the part of patients and doctors in the form of transference and countertransference contribute to the misapplication of physician-assisted suicide. Depression influences requests for hastened death in terminally ill patients, but is often under-recognized or dismissed by doctors, some of whom proceed with assisted death anyway. Psychiatric evaluations, though helpful, do not solve these problems. Safeguards that are incorporated into physician-assisted suicide criteria probably decrease but do not prevent its misapplication. SUMMARY: The UK is likely to face significant clinical problems arising from physician-assisted suicide if it is legalized. Terminally ill patients with mental illness, especially depression, are particularly vulnerable to the misapplication of physician-assisted suicide despite guidelines and safeguards