Changing clinical team practices in preparation of patients for Total Knee Replacement: Using Social Cognitive Theory to examine outcomes of an action research study

Aims and objectives: To examine, through the lens of Social Cognitive Theory, the process of change when developing a preparation programme for patients awaiting Total Knee Replacement Surgery. Background: Social Cognitive Theory has been used extensively in occupational psychology to explain and change human actions. It has not been widely used to examine the actions of clinical teams when developing practice. Design: Action research. Methods: Four action cycles were undertaken to develop an information booklet and multidisciplinary Knee Clinic at an acute hospital for patients waiting for Total Knee Replacement Surgery. The process of change, led by a staff and service user Project Management Group, was examined through fieldnotes, interviews, observation and a reflective diary. The data were analysed using the theoretical framework of Bandura’s Social Cognitive Theory. Results: The change process was influenced by personal, environmental and behavioural factors. Self-efficacy and outcomes expectations of staff and service users varied and impacted the level of their involvement in the study. Environmental factors influenced the scope of the project. The behaviour of the Project Management Group facilitated change through the development of team working and involvement in the action cycles. The results of this initiative achieved clinical changes which had not occurred during previous attempts at service development. Conclusion: Social Cognitive Theory is an appropriate and useful theoretical framework both for retrospective analysis and to inform planning of practice changes within the clinical setting

The Psychosocial Work Environment, Employee Mental Health and Organizational Interventions: Improving Research and Practice by Taking a Multilevel Approach

Although there have been several calls for incorporating multiple levels of analysis in employee health and wellbeing research, studies examining the interplay between individual, workgroup, organizational and broader societal factors in relation to employee mental health outcomes remain an exception rather than the norm. At the same time, organizational intervention research and practice also tends to be limited by a single-level focus, omitting potentially important influences at multiple levels of analysis. The aims of this conceptual paper are to help progress our understanding of work-related determinants of employee mental health by: (i) providing a rationale for routine multilevel assessment of the psychosocial work environment; (ii) discussing how a multilevel perspective can improve related organizational interventions and (iii) highlighting key theoretical and methodological considerations relevant to these aims. We present five recommendations for future research, relating to using appropriate multilevel research designs, justifying group level constructs, developing group-level measures, expanding investigations to the organizational level, and developing multilevel approaches to intervention design, implementation and evaluation

Beliaev theory of spinor Bose-Einstein condensates

By generalizing the Green's function approach proposed by Beliaev [1, 2], we investigate the effect of quantum depletion on the energy spectra of elementary excitations in an F = 1 spinor Bose-Einstein condensate, in particular, of 87Rb atoms in an external magnetic field. We find that quantum depletion increases the effective mass of magnons in the spin-wave excitations with quadratic dispersion relations. The enhancement factor turns out to be the same for both ferromagnetic and polar phases, and also independent of the magnitude of the external magnetic field. The lifetime of these magnons in a 87Rb spinor BEC is shown to be much longer than that of phonons. We propose an experimental setup to measure the effective mass of these magnons in a spinor Bose gas by exploiting the effect of a nonlinear dispersion relation on the spatial expansion of a wave packet of transverse magnetization. This type of measurement has practical applications, for example, in precision magnetometry.Comment: 76 pages, 13 figure

Developing Expert Medical Teams: Toward an Evidence-based Approach

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75129/1/j.1553-2712.2008.00232.x.pd

Does the Reading of Different Orthographies Produce Distinct Brain Activity Patterns? An ERP Study

Orthographies vary in the degree of transparency of spelling-sound correspondence. These range from shallow orthographies with transparent grapheme-phoneme relations, to deep orthographies, in which these relations are opaque. Only a few studies have examined whether orthographic depth is reflected in brain activity. In these studies a between-language design was applied, making it difficult to isolate the aspect of orthographic depth. In the present work this question was examined using a within-subject-and-language investigation. The participants were speakers of Hebrew, as they are skilled in reading two forms of script transcribing the same oral language. One form is the shallow pointed script (with diacritics), and the other is the deep unpointed script (without diacritics). Event-related potentials (ERPs) were recorded while skilled readers carried out a lexical decision task in the two forms of script. A visual non-orthographic task controlled for the visual difference between the scripts (resulting from the addition of diacritics to the pointed script only). At an early visual-perceptual stage of processing (∼165 ms after target onset), the pointed script evoked larger amplitudes with longer latencies than the unpointed script at occipital-temporal sites. However, these effects were not restricted to orthographic processing, and may therefore have reflected, at least in part, the visual load imposed by the diacritics. Nevertheless, the results implied that distinct orthographic processing may have also contributed to these effects. At later stages (∼340 ms after target onset) the unpointed script elicited larger amplitudes than the pointed one with earlier latencies. As this latency has been linked to orthographic-linguistic processing and to the classification of stimuli, it is suggested that these differences are associated with distinct lexical processing of a shallow and a deep orthography

Identifying work ability promoting factors for home care aides and assistant nurses

<p>Abstract</p> <p>Background</p> <p>In workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services.</p> <p>Methods</p> <p>This study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n = 58) and assistant nurses (n = 79) replied to a self-administered questionnaire (response rate 46%). Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1) and work ability (model 2) for care aides and assistant nurses separately.</p> <p>Results</p> <p>Perceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R²adj of 0.36, <it>p </it>< 0.001), while for care aides, the safety climate, seniority and age contributed to work ability (R²adj of 0.29, <it>p </it>= 0.001). Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R²adj of 0.24, <it>p </it>= 0.003 for care aides), and also by sex and age for the assistant nurses (R²adj of 0.31, <it>p </it>< 0.001).</p> <p>Conclusions</p> <p>The intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal wellbeing were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in practice and in further research. Proactive workplace interventions need to focus on potentially modifiable factors such as self-efficacy, safety climate, physical job demands and musculoskeletal wellbeing.</p

Alternative Splicing of RNA Triplets Is Often Regulated and Accelerates Proteome Evolution

Thousands of human genes contain introns ending in NAGNAG (N any nucleotide), where both NAGs can function as 3′ splice sites, yielding isoforms that differ by inclusion/exclusion of three bases. However, few models exist for how such splicing might be regulated, and some studies have concluded that NAGNAG splicing is purely stochastic and nonfunctional. Here, we used deep RNA-Seq data from 16 human and eight mouse tissues to analyze the regulation and evolution of NAGNAG splicing. Using both biological and technical replicates to estimate false discovery rates, we estimate that at least 25% of alternatively spliced NAGNAGs undergo tissue-specific regulation in mammals, and alternative splicing of strongly tissue-specific NAGNAGs was 10 times as likely to be conserved between species as was splicing of non-tissue-specific events, implying selective maintenance. Preferential use of the distal NAG was associated with distinct sequence features, including a more distal location of the branch point and presence of a pyrimidine immediately before the first NAG, and alteration of these features in a splicing reporter shifted splicing away from the distal site. Strikingly, alignments of orthologous exons revealed a ~15-fold increase in the frequency of three base pair gaps at 3′ splice sites relative to nearby exon positions in both mammals and in Drosophila. Alternative splicing of NAGNAGs in human was associated with dramatically increased frequency of exon length changes at orthologous exon boundaries in rodents, and a model involving point mutations that create, destroy, or alter NAGNAGs can explain both the increased frequency and biased codon composition of gained/lost sequence observed at the beginnings of exons. This study shows that NAGNAG alternative splicing generates widespread differences between the proteomes of mammalian tissues, and suggests that the evolutionary trajectories of mammalian proteins are strongly biased by the locations and phases of the introns that interrupt coding sequences.Damon Runyon Cancer Research Foundation (DRG 2032-09)National Science Foundation (U.S.). (no. 0821391)United States. National Institutes of Healt

Plasma microRNAs as potential biomarkers for non-small-cell lung cancer

Non-small-cell lung cancer (NSCLC) is the leading cause of cancer-related death. Developing minimally invasive techniques that can diagnose NSCLC, particularly at an early stage, may improve its outcome. Using microarray platforms, we previously identified 12 microRNAs (miRNAs) the aberrant expressions of which in primary lung tumors are associated with early-stage NSCLC. Here, we extend our previous research by investigating whether the miRNAs could be used as potential plasma biomarkers for NSCLC. We initially validated expressions of the miRNAs in paired lung tumor tissues and plasma specimens from 28 stage I NSCLC patients by real-time quantitative reverse transcription PCR, and then evaluated diagnostic value of the plasma miRNAs in a cohort of 58 NSCLC patients and 29 healthy individuals. The altered miRNA expressions were reproducibly confirmed in the tumor tissues. The miRNAs were stably present and reliably measurable in plasma. Of the 12 miRNAs, five displayed significant concordance of the expression levels in plasma and the corresponding tumor tissues (all r>0.850, all P<0.05). A logistic regression model with the best prediction was defined on the basis of the four genes (miRNA-21, -126, -210, and 486-5p), yielding 86.22% sensitivity and 96.55% specificity in distinguishing NSCLC patients from the healthy controls. Furthermore, the panel of miRNAs produced 73.33% sensitivity and 96.55% specificity in identifying stage I NSCLC patients. In addition, the genes have higher sensitivity (91.67%) in diagnosis of lung adenocarcinomas compared with squamous cell carcinomas (82.35%) (P<0.05). Altered expressions of the miRNAs in plasma would provide potential blood-based biomarkers for NSCLC

The rehabilitation of face recognition impairments: A critical review and future directions

While much research has investigated the neural and cognitive characteristics of face recognition impairments (prosopagnosia), much less work has examined their rehabilitation. In this paper, we present a critical analysis of the studies that have attempted to improve face-processing skills in acquired and developmental prosopagnosia, and place them in the context of the wider neurorehabilitation literature. First, we examine whether neuroplasticity within the typical face-processing system varies across the lifespan, in order to examine whether timing of intervention may be crucial. Second, we examine reports of interventions in acquired prosopagnosia, where training in compensatory strategies has had some success. Third, we examine reports of interventions in developmental prosopagnosia, where compensatory training in children and remedial training in adults have both been successful. However, the gains are somewhat limited-compensatory strategies have resulted in labored recognition techniques and limited generalization to untrained faces, and remedial techniques require longer periods of training and result in limited maintenance of gains. Critically, intervention suitability and outcome in both forms of the condition likely depends on a complex interaction of factors, including prosopagnosia severity, the precise functional locus of the impairment, and individual differences such as age. Finally, we discuss future directions in the rehabilitation of prosopagnosia, and the possibility of boosting the effects of cognitive training programmes by simultaneous administration of oxytocin or non-invasive brain stimulation. We conclude that future work using more systematic methods and larger participant groups is clearly required, and in the case of developmental prosopagnosia, there is an urgent need to develop early detection and remediation tools for children, in order to optimize intervention outcome. © 2014 Bate and Bennetts