The Effect of Written Information and Reassurance on Patient Satisfaction, Anxiety, and Intent to Return for Emergency Care

Patients\u27 satisfaction is one of the primary goals of emergency department (ED) providers today. As emergency departments are overcrowded, stressful environments, anxious patients want to be kept informed. Nurses have the opportunity to meet these needs and possibly influence the patients\u27 perception of the experience and intent to return for future care. This study examined the effects of providing written information and reassurance on patient satisfaction, anxiety, and intent to return for emergency care. The design was a posttest design involving a comparison between the control and three experimental groups. Two hundred and forty patients participated in the study, approximately 60 per group. All subjects were asked to rate their level of anxiety on arrival and discharge from the ED, complete the Consumer Emergency Care Satisfaction Scale, and the Intent to Return scale. There were no statistically significant differences among the four groups (p \u3c.05). Patient satisfaction scores and intent to return scores were high. Anxiety scores were low. Implications and recommendations from this study were made for nursing research, clinical practice, need to conduct qualitative research on patient activity in the ED setting. Instruments measuring anxiety and satisfaction in the ED setting need to be developed and refined. Nursing interventions to improve the quality of the ED experience need to be identified and tested

The Rhetoric of Political Time: Tracing the Neoliberal Regime's Ascent

In this dissertation, I argue that Stephen Skowronek’s theory of political time can be used as analytic to better understand the rhetorical opportunities and constraints for presidents and presidential candidates. In particular, I look to Ronald Reagan as a case study: as a president who came on the heels of the end of FDR’s liberal era, Reagan set the tone for a new presidential regime, consisting of particular rhetorical and policy commitments that were all shaped through his neoliberal economic policy. After identifying the rhetorical hallmarks of the neoliberal era as constructed by Reagan, I analyze the rhetorical efforts of his successor, regime articulation president George H.W. Bush, to negotiate the changing domestic and international atmosphere within the rhetorical and policy constraints of Reagan’s neoliberalism. Finally, I identify and analyze the preemptive efforts of Bill Clinton and Ross Perot during the 1992 election as they attempted to renegotiate key aspects of Reagan’s rhetorical and policy commitments to win the presidency. The analysis of each individual’s rhetoric is aided by attention to both discursive and visual rhetoric: the rhetorical interiors and exteriors of regime discourse. The analysis of Reagan’s neoliberal regime emergence begins with the 1964 primary run against Barry Goldwater and continues through his presidency. Analysis of Bush begins with his 1980 primary election contest against Ronald Reagan and culminates in the 1992 election. Both Clinton and Perot were analyzed using stump speeches and advertisements from the primaries through the 1992 presidential election. For each individual, analysis of Time magazine covers provided visual confirmation or rejection of each rhetor’s rendition of neoliberal regime commitments. In the end, while Reagan was successful in establishing the rhetorical and policy commitments of the Neoliberal regime, Bush was unable to perform those commitments to the satisfaction of the base; as a result, Clinton’s rendition of the neoliberal regime, which he presented as a “third way” during the 1992 presidential election, succeeded in winning the presidency

Changing social inequalities in smoking, obesity and cause-specific mortality: Cross-national comparisons using compass typology

Background In many countries smoking rates have declined and obesity rates have increased, and social inequalities in each have varied over time. At the same time, mortality has declined in most high-income countries, but gaps by educational qualification persist—at least partially due to differential smoking and obesity distributions. This study uses a compass typology to simultaneously examine the magnitude and trends in educational inequalities across multiple countries in: a) smoking and obesity; b) smoking-related mortality and c) cause-specific mortality. Methods Smoking prevalence, obesity prevalence and cause-specific mortality rates (35–79 year olds by sex) in nine European countries and New Zealand were sourced from between 1980 and 2010. We calculated relative and absolute inequalities in prevalence and mortality (relative and slope indices of inequality, respectively RII, SII) by highest educational qualification. Countries were then plotted on a compass typology which simultaneously examines trends in the population average rates or odds on the x-axis, RII on the Y-axis, and contour lines depicting SII. Findings Smoking and obesity. Smoking prevalence in men decreased over time but relative inequalities increased. For women there were fewer declines in smoking prevalence and relative inequalities tended to increase. Obesity prevalence in men and women increased over time with a mixed picture of increasing absolute and sometimes relative inequalities. Absolute inequalities in obesity increased for men and women in Czech Republic, France, New Zealand, Norway, for women in Austria and Lithuania, and for men in Finland. Cause-specific mortality. Average rates of smoking-related mortality were generally stable or increasing for women, accompanied by increasing relative inequalities. For men, average rates were stable or decreasing, but relative inequalities increased over time. Cardiovascular disease, cancer, and external injury rates generally decreased over time, and relative inequalities increased. In Eastern European countries mortality started declining later compared to other countries, however it remained at higher levels; and absolute inequalities in mortality increased whereas they were more stable elsewhere. Conclusions Tobacco control remains vital for addressing social inequalities in health by education, and focus on the least educated is required to address increasing relative inequalities. Increasing obesity in all countries and increasing absolute obesity inequalities in several countries is concerning for future potential health impacts. Obesity prevention may be increasingly important for addressing health inequalities in some settings. The compass typology was useful to compare trends in inequalities because it simultaneously tracks changes in rates/odds, and absolute and relative inequality measures.Peer reviewe

Potent and Broad Inhibition of HIV-1 by a Peptide from the gp41 Heptad Repeat-2 Domain Conjugated to the CXCR4 Amino Terminus.

HIV-1 entry can be inhibited by soluble peptides from the gp41 heptad repeat-2 (HR2) domain that interfere with formation of the 6-helix bundle during fusion. Inhibition has also been seen when these peptides are conjugated to anchoring molecules and over-expressed on the cell surface. We hypothesized that potent anti-HIV activity could be achieved if a 34 amino acid peptide from HR2 (C34) were brought to the site of virus-cell interactions by conjugation to the amino termini of HIV-1 coreceptors CCR5 or CXCR4. C34-conjugated coreceptors were expressed on the surface of T cell lines and primary CD4 T cells, retained the ability to mediate chemotaxis in response to cognate chemokines, and were highly resistant to HIV-1 utilization for entry. Notably, C34-conjugated CCR5 and CXCR4 each exhibited potent and broad inhibition of HIV-1 isolates from diverse clades irrespective of tropism (i.e., each could inhibit R5, X4 and dual-tropic isolates). This inhibition was highly specific and dependent on positioning of the peptide, as HIV-1 infection was poorly inhibited when C34 was conjugated to the amino terminus of CD4. C34-conjugated coreceptors could also inhibit HIV-1 isolates that were resistant to the soluble HR2 peptide inhibitor, enfuvirtide. When introduced into primary cells, CD4 T cells expressing C34-conjugated coreceptors exhibited physiologic responses to T cell activation while inhibiting diverse HIV-1 isolates, and cells containing C34-conjugated CXCR4 expanded during HIV-1 infection in vitro and in a humanized mouse model. Notably, the C34-conjugated peptide exerted greater HIV-1 inhibition when conjugated to CXCR4 than to CCR5. Thus, antiviral effects of HR2 peptides can be specifically directed to the site of viral entry where they provide potent and broad inhibition of HIV-1. This approach to engineer HIV-1 resistance in functional CD4 T cells may provide a novel cell-based therapeutic for controlling HIV infection in humans

Global university rankings : evidences of geographic and budgetary biases for Brazilian public institutions

Este artigo analisa a classificação de instituições brasileiras de ensino superior em dois dos principais rankings internacionais de universidades: o QS World University Ranking e o The Times Higher Education (THE). Para isso, foram avaliadas as restrições metodológicas e como essas restrições afetaram a classificação das universidades do país nesses rankings. Entre 2016 e 2019, 38 brasileiras foram classificadas no QS e no THE, em sua versão global. Devido a restrições metodológicas, a classificação das instituições brasileiras assumiu a característica de patamares, variando de 3 a 5 patamares. Denota-se que a classificação de uma instituição em um patamar mais alto depende de sua proximidade com um mercado de trabalho dinâmico e um orçamento maior, indicando a dificuldade dos rankings de diferenciar de fato qualidade além dessas duas dimensões.This paper analyzes the classification of Brazilian Universities and Higher Education Institutions in two of the main International University Rankings: QS World University Ranking and Times Higher Education (THE). We analyzed the methodological restrictions and how they affected the ranking of Brazilian Higher Education Institutions. Between 2016 and 2019, 38 Brazilian institutions were classified on QS and THE rankings in their global versions. Due to their methodological restrictions, this classification assumed a plateau patter, varying between 3 and 5 levels. The classification of an institution in a higher position seemed to depend to its proximity to a dynamic job market and larger budget, suggesting a bias towards these variables

RANKINGS UNIVERSITÁRIOS INTERNACIONAIS - EVIDÊNCIAS GEOGRÁFICAS E ORÇAMENTÁRIAS PARA INSTITUIÇÕES BRASILEIRAS

Este artigo analisa a classificação de instituições brasileiras de ensino superior em dois dos principais rankings internacionais de universidades: o QS World University Ranking e o The Times Higher Education (THE). Para isso, foram avaliadas as restrições metodológicas e como essas restrições afetaram a classificação das universidades do país nesses rankings. Entre 2016 e 2019, 38 brasileiras foram classificadas no QS e no THE, em sua versão global. Devido a restrições metodológicas, a classificação das instituições brasileiras assumiu a característica de patamares, variando de 3 a 5 patamares. Denota-se que a classificação de uma instituição em um patamar mais alto depende de sua proximidade com um mercado de trabalho dinâmico e um orçamento maior, indicando a dificuldade dos rankings de diferenciar de fato qualidade além dessas duas dimensões

Unraveling Molecular Recognition of Glycan Ligands by Siglec-9 via NMR Spectroscopy and Molecular Dynamics Modeling

Funding Information: The Bilbao lab acknowledge the NMR resources and the technical support provided by the Euskadi NMR lab (LRE) of the ICTS “Red de Laboratorios de RMN de biomoléculas (R-LRB)” of Spain.F.M. and J.J.B. acknowledge to the European commission for the COST Action 18132 GLYCONANOPROBES. We thank Agencia Estatal de Investigación of Spain for grants PID2019-107770RA-I00 (J.E.-O.) and the Severo Ochoa Center of Excellence Accreditation CEX2021-001136-S, all funded by MCIN/AEI/10.13039/501100011033. We also thank CIBERES, an initiative of Instituto de Salud Carlos III (ISCIII, Madrid, Spain). Publisher Copyright: © 2024 The Authors. Published by American Chemical Society.Human sialic-acid-binding immunoglobulin-like lectin-9 (Siglec-9) is a glycoimmune checkpoint receptor expressed on several immune cells. Binding of Siglec-9 to sialic acid containing glycans (sialoglycans) is well documented to modulate its functions as an inhibitory receptor. Here, we first assigned the amino acid backbone of the Siglec-9 V-set domain (Siglec-9d1), using well-established triple resonance three-dimensional nuclear magnetic resonance (NMR) methods. Then, we combined solution NMR and molecular dynamic simulation methods to decipher the molecular details of the interaction of Siglec-9 with the natural ligands α2,3 and α2,6 sialyl lactosamines (SLN), sialyl Lewis X (sLeX), and 6-O sulfated sLeX and with two synthetically modified sialoglycans that bind with high affinity. As expected, Neu5Ac is accommodated between the F and G β-strands at the canonical sialic acid binding site. Addition of a heteroaromatic scaffold 9N-5-(2-methylthiazol-4-yl)thiophene sulfonamide (MTTS) at the C9 position of Neu5Ac generates new interactions with the hydrophobic residues located at the G-G′ loop and the N-terminal region of Siglec-9. Similarly, the addition of the aromatic substituent (5-N-(1-benzhydryl-1H-1,2,3-triazol-4-yl)methyl (BTC)) at the C5 position of Neu5Ac stabilizes the conformation of the long and flexible B′-C loop present in Siglec-9. These results expose the underlying mechanism responsible for the enhanced affinity and specificity for Siglec-9 for these two modified sialoglycans and sheds light on the rational design of the next generation of modified sialoglycans targeting Siglec-9.publishersversionpublishe