Nurse leaders\u27 response to conflict and choice in the workplace.

This study examined moral reasoning used by nurses to resolve conflict and choice in the workplace. This study also focused on how nurses saw themselves as leaders and caregivers. Ten nurse leaders were purposively selected from a large urban acute care magnet hospital. In open-ended, semi-structured interviews, each participant discussed an actual workplace conflict that they experienced, the course of action taken, and evaluation. Nurse leaders also described themselves as leaders and as caregivers. Demographic data was gathered on age, sex, educational background and career positions. Two research questions were addressed in this study: How do nurse leaders respond to conflict and choice in the workplace? Does level of leadership influence response to conflict and choice? Interview data were analyzed using Carol Gilligan\u27s protocol described in the Reading Guide (Brown et al. 1988). The results indicate that nurse leaders used justice and care voices to respond to conflict and choice in the workplace. Seven out of ten used both a justice and care voice. Three of the leaders responded with only one voice: two with only a care voice and one with only a justice voice. In this study, leadership level did not influence choice of moral voice in workplace conflict. Managers and executives both used justice and care in describing their dilemmas. Nurse leaders described three kinds of workplace conflict: organizational, interpersonal and intrapersonal. Four themes emerged as central to how nurse leaders view themselves: the importance of relationships in the leader role; power as a piece of the leader role; the leader as a team member; standards as guides to decision-making. Nurse leaders underscored the importance of the worksetting and its influence on nursing\u27s ethic of care. Congruence of institutional philosophy, climate, and larger administrative presence with nursing\u27s professional care values are the contextual influences cited by the nurse leaders

The decolonization crisis in New Caledonia

195 leaves ; 28 cm.Includes bibliographical references (leaves 179-195).This paper analyses the origins of revolutionary anti-colonialism in New Caledonia. The development of capitalism in the colony, under direct French imperial control, has created a territory witb the most advanced development in the South Pacific. New Caledonia has served as both a colony of settlement and as a producer of raw materials, chiefly nickel and other minerals. A combination of unique features and consequences of capitalist development in New Caledonia has determined both the abnormally prolonged colonial status of the country and has generated powerful social forces that have favored the advent of a revolutionary situation. The major factor contributing to the anachronistic colonial status of the country is its possession of the largest known nickel reserves in the world. The international political economy of nickel must be understood in order to understand why New Caledonia is subject to unusually prolonged direct imperial control well into the era of neo-colonialism. The conclusion is that while the unique characteristics of the development of capitalism in New Caledonia are the source of the subjective and objective prerequisites for the revolutionary anti-colonial movement, the superior coercive capability of the modern state and the ethnic divisions within the territory will preclude the possibility of successful social revolution in New Caledonia. (Abstract shortened by UMI.

Exploring digital fiction as a tool for teenage body image bibliotherapy

This article reflects on the findings of the interdisciplinary ‘TransForm’ project, which ran between 2012 and 2014 and aimed to explore how reading and writing digital fictions (DFs) might support young women in developing frameworks for more positive thinking regarding their body image. The project comprised the following stages: (1) a review and compilation of DFs thematising and/or problematising female corporeality; (2) a series of cooperative inquiries with 3 groups of young women (aged 16–19 years) over a period of 5 weeks, examining participants’ responses to a selection of the previously compiled DFs, as well as the challenges these young women face in relation to body image and (3) an interventionist summer school in which participants aged 16–19 explored body image issues via writing DFs. This article reports on the main observations and findings of each stage, and draws conclusions for future research needs in this area

Association of state insurance mandates for fertility treatment with multiple embryo transfer after preimplantation genetic testing for aneuploidy

IMPORTANCE: Multiple gestation is one of the biggest risks after in vitro fertilization (IVF), largely due to multiple embryo transfer (MET). Single embryo transfer (SET) uptake has increased over time and has been attributed to various factors, such as mandated insurance coverage for IVF and preimplantation genetic testing for aneuploidy (PGT-A). OBJECTIVE: To investigate whether mandates for IVF insurance coverage are associated with decreased use of MET after PGT-A. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted using data on embryo transfers reported to the Society for Assisted Reproductive Technology between 2014 and 2016. Data were analyzed from January to October 2021. EXPOSURES: State-mandated coverage for fertility treatment and type of cycle transfer performed (PGT-A, untested fresh, and untested frozen). MAIN OUTCOMES AND MEASURES: Use of MET compared with SET, live birth, and live birth of multiples. RESULTS: There were 110 843 embryo transfers (mean [SD] patient age, 34.0 [4.5] years; 5520 individuals identified as African American [5.0%], 10 035 as Asian [9.0%], 5425 as Hispanic [4.9%], 45 561 as White [41.1%], and 44 302 as other or unknown race or ethnicity [40.0%]); 17 650 transfers used embryos that underwent PGT-A. Overall, among transferred embryos that had PGT-A, there were 9712 live births (55.0%). The odds of live birth were 70% higher with MET vs SET after frozen embryo transfer with PGT-A (OR, 1.70; 95% CI, 1.61-1.78), but the risk of multiples was 5 times higher (OR, 5.33; 95% CI, 5.22-5.44). The odds of MET in cycles with PGT-A in states with insurance mandates were 24% lower than in states without mandates (OR, 0.76; 95% CI, 0.68-0.85). CONCLUSIONS AND RELEVANCE: This study found that despite the promise of using SET with PGT-A, MET after PGT-A was not uncommon. This practice was more common in states without insurance mandates and was associated with a high risk of multiples

The First Year Colloquium: Creating a Safe Space for Students to Flourish

College is one of the most formative times in an individual’s life. Its intense living-learning environment can promote students’ extreme self-confidence and positive development, or alternatively, can result in low levels of well-being. The first year in college is an opportunity for faculty and staff to engage with students to help them build learning skills, a sense of responsibility, and ownership of their college experiences. The aim of this study was to examine the impacts of a first year colloquium on student well-being. In the fall of 2015, 91 entering first year students at a private university in the U.S. participated in a mixed method study using written reflection responses and in a pre/post survey using Keyes (2009) Mental Health Continuum-Short Form (MHC-SF). Gains were seen in psychological well-being with an increase in flourishing as compared to early semester moderate flourishing. Students reported that having one course that provided a safe space for them in their first semester, and that addressed well-being in college, was critical for them to succeed and thrive in their first year

Doxorubicin In Vivo Rapidly Alters Expression and Translation of Myocardial Electron Transport Chain Genes, Leads to ATP Loss and Caspase 3 Activation

BackgroundDoxorubicin is one of the most effective anti-cancer drugs but its use is limited by cumulative cardiotoxicity that restricts lifetime dose. Redox damage is one of the most accepted mechanisms of toxicity, but not fully substantiated. Moreover doxorubicin is not an efficient redox cycling compound due to its low redox potential. Here we used genomic and chemical systems approaches in vivo to investigate the mechanisms of doxorubicin cardiotoxicity, and specifically test the hypothesis of redox cycling mediated cardiotoxicity.Methodology/principal findingsMice were treated with an acute dose of either doxorubicin (DOX) (15 mg/kg) or 2,3-dimethoxy-1,4-naphthoquinone (DMNQ) (25 mg/kg). DMNQ is a more efficient redox cycling agent than DOX but unlike DOX has limited ability to inhibit gene transcription and DNA replication. This allowed specific testing of the redox hypothesis for cardiotoxicity. An acute dose was used to avoid pathophysiological effects in the genomic analysis. However similar data were obtained with a chronic model, but are not specifically presented. All data are deposited in the Gene Expression Omnibus (GEO). Pathway and biochemical analysis of cardiac global gene transcription and mRNA translation data derived at time points from 5 min after an acute exposure in vivo showed a pronounced effect on electron transport chain activity. This led to loss of ATP, increased AMPK expression, mitochondrial genome amplification and activation of caspase 3. No data gathered with either compound indicated general redox damage, though site specific redox damage in mitochondria cannot be entirely discounted.Conclusions/significanceThese data indicate the major mechanism of doxorubicin cardiotoxicity is via damage or inhibition of the electron transport chain and not general redox stress. There is a rapid response at transcriptional and translational level of many of the genes coding for proteins of the electron transport chain complexes. Still though ATP loss occurs with activation caspase 3 and these events probably account for the heart damage

Perceived clinical readiness of senior medical students asoutcomes of online clerkship in the Philippines: newnormal in medical education

NTRODUCTION: COVID-19 formed new challenges to the medical institutions; itresulted in the transition from the usual face-to-face classes and direct clerkship training withinthe hospital to a new remote learning with online lectures and virtual clinical experience. Giventhe new online interactive setting, problems were raised given the limited patient care andinteraction as well as restricted bedside teaching opportunities and its impact on how medicalstudents can acquire and hone their clinical skills. OBJECTIVE: To determine the perceived clinicalreadiness of the medical clerks in the new normal setting in the Philippines. METHODOLOGY:Convenience sampling was used to gather respondents who were asked to answer an onlinesurvey questionnaire. The questions pertained to: academic training profile, clinical skills, patientmanagement, communication, understanding clinical guidelines, and personal development. Afteranalyzing the data, the scales of readiness from these subjects were gathered. RESULTS: Themedical clerks in the Philippines perceived that they were ready with regards to understandingclinical guidelines, communication, personal development, and patient management. They weremoderately ready in the different clinical skills in the departments of Family and CommunityMedicine, Internal Medicine, Pediatrics, Surgery and Obstetrics and Gynecology with somespecific skills in Surgery and Obstetrics and Gynecology being perceived as less ready than therest. CONCLUSION: The impact of the pandemic has disrupted the student’s confidence andreadiness. This shows that online clerkship in this time of pandemic may have provided learningto a certain degree but it is not enough to replace what face-to-face training could offer