Theories and practices of psychoanalysis in central Europe immediately after World War II.

Shortly after World War II, psychoanalytic societies in Central Europe were gradually resuming their pre-war activities. Starting in 1945, Austria, Hungary, Czechoslovakia and Poland saw the revival of their psychoanalytic circles which subsequently engaged in psychoanalytic knowledge transmission, especially in the face of the Communist state institutions' growing disapproval of psychoanalysis. This article traces the history of the psychoanalytic movement's rebirth in Central Europe. The author discusses the activities of Viennese, Budapestian, Praguian and Varsovian circles post-1945 in order to examine the practices of collective thinking and identify diverse models of the transmission of Freudianism. The attempt to explore the complex mechanisms of psychoanalytic knowledge dissemination in the immediate post-war period, both in its theoretical and practical dimensions, can contribute to a more profound understanding of the history of psychoanalysis in Central Europe after 1945. It also points to the significance of a more inquisitive approach to the internal dynamics of these intellectual circles which were forced to develop outside of state academic institutions due to socio-political reasons.

Research Ready Grant Program (RRGP) protocol: a model for collaborative multidisciplinary practice-research partnerships.

BACKGROUND: Little attention has been given to the process of implementing or evaluating a structured academic-clinician (university-health service) research capacity-building (RCB) model within healthcare settings. We have developed a model for collaborative multidisciplinary practice-research partnerships called the Research Ready Grant Program (RRGP). The RRGP is informed by Cooke's (BMC Fam Pract 6:44, 2005) RCB framework and principles. The aim of the study outlined in this protocol is to conduct a process and outcome evaluation of the programme. We will explore how the RRGP's structured mentor model contributes to RCB of clinician-led multidisciplinary research teams. We will identify key factors at the organization, team and individual levels that affect research capacity of health professionals working in one regional health service district. This protocol describes the RRGP design and outlines the methods we will employ to evaluate an RCB programme, the RRGP, delivered in a regional health service in Australia. METHODS: The study will adopt an exploratory concurrent mixed-methods approach designed to evaluate the process of implementing an RCB model across one regional hospital and health service. Both quantitative and qualitative data collection methods over a 12-month period will be implemented. Data triangulation will be applied to capture the complex issues associated with implementing collaborative multidisciplinary practice-research partnerships. DISCUSSION: The RRGP is an innovative RCB model for clinicians in their workplace. It is expected that the programme will facilitate a culture of collaborative multidisciplinary research and strengthen hospital-university partnerships.

Research capacity-building for clinicians: understanding how the research facilitator role fosters clinicians' engagement in the research process.

BACKGROUND: There is evidence reporting more positive outcomes from research capacity-building (RCB) programmes that include a research facilitator role. Further, it has been suggested that research facilitator roles can be a useful strategy in building the research capacity of healthcare clinicians. However, until now, little attention has been applied to identifying the characteristics of the research facilitator role and how this role contributes to clinicians' engagement with the research process. The aim of this present study is to explore the characteristics required of the research facilitator role in the educational workshop phase of an RCB programme. METHODS: This qualitative study employed an inductive approach and utilized face-to-face interviews to gather data from a purposely selected cohort. Professionally transcribed responses were thematically analysed. RESULTS: The role of the research facilitator emerged as comprising two main themes: (1) facilitating the research process and (2) engaging expert clinicians as novice researchers. Pragmatically, analysis of data led to the development of a table outlining the responsibilities, skills and attributes related to each theme. Conceptually, theme 1 encapsulates the research facilitators' skills and experience and their role as knowledge brokers and cocreators of knowledge. Theme 2 provides insight into the clinician-centric approach the research facilitators utilized to build and foster relationships and support the clinicians through their research journey. CONCLUSION: This study reports on the characteristics of the research facilitator role in one phase of an RCB programme in one regional health service district in Australia and explains how the role fosters clinicians' engagement with the research process. Findings from this study will inform the development of future RCB programmes, which is important considering that clinicians' increased engagement with the research process is vital for developing a sound evidence base to support decision-making in practice and leads to higher levels of skills and greater ability to perform useful research.

Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians.

BACKGROUND: Early warning systems (EWS) are most effective when clinicians monitor patients' vital signs and comply with the recommended escalation of care protocols once deterioration is recognised. OBJECTIVES: To explore sociocultural factors influencing acute care clinicians' compliance with an early warning system commonly used in Queensland public hospitals in Australia. METHODS: This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia. RESULTS: This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication. CONCLUSIONS: The overarching organisational context including the hospital's embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians' and teams' compliance or non-compliance with early warning system's monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff.

Person-centred rhetoric in chronic care: a review of health policies.

PURPOSE: The purpose of the paper is to explore how the national, state and organisational health policies in Australia support the implementation of person-centred care in managing chronic care conditions. DESIGN/METHODOLOGY/APPROACH: A qualitative content analysis was performed regarding the national, state and organisational Queensland Health policies using Elo and Kyngas' (2008) framework. FINDINGS: Although the person-centred care as an approach is well articulated in health policies, there is still no definitive measure or approach to embedding it into operational services. Complex funding structures and competing priorities of the governments and the health organisations carry the risk that person-centred care as an approach gets lost in translation. Three themes emerged: the patient versus the government; health care delivery versus the political agenda; and health care organisational processes versus the patient. RESEARCH LIMITATIONS/IMPLICATIONS: Given that person-centred care is the recommended approach for responding to chronic health conditions, further empirical research is required to evaluate how programs designed to deliver person-centred care achieve that objective in practice. PRACTICAL IMPLICATIONS: This research highlights the complex environment in which the person-centred approach is implemented. Short-term programmes created specifically to focus on person-centred care require the right organisational infrastructure, support and direction. This review demonstrates the need for alignment of policies related to chronic disease management at the broader organisational level. ORIGINALITY/VALUE: Given the introduction of the nurse navigator program to take up a person-centred care approach, the review of the recent policies was undertaken to understand how they support this initiative.

Pregnant in prison: An integrative literature review.

BACKGROUND: Pregnant women in prisons are recognised as a marginalised group. However, there is a limited understanding of the women's unique maternity needs and how correctional institutions and maternity service providers respond to these needs. AIM: The aims of the review are threefold. METHOD: An integrative literature review was undertaken. A comprehensive search strategy using seven electronic databases resulted in the retrieval of 363 articles. Of them, 32 peer-reviewed studies met the final selection criteria and were included in this review which utilised the Critical Appraisal Skills Program tools and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. Thematic analysis identified universal themes. FINDINGS: Three dominant themes emerged related to the experience of pregnant women in prison: (1) risks and vulnerability factors; (2) prison enablers and supports; and (3) prison barriers. Extant research on risks and vulnerability factors is disproportionate to research examining how prisons can enable or obstruct responding to the women's perinatal needs. Limited research on the midwifery support available to the women in prison is available. Significantly, only two out of 32 reviewed papers include research directly conducted with the pregnant women in prison. CONCLUSION: Pregnant women in prisons have complex needs. More research is required to understand how prisons can enhance the pregnancy experience by engaging pregnant women in prisons as research participants.

Facilitating an early career transition pathway to community nursing: A Delphi Policy Study.

Aim: To further develop and validate a new model of the early career transition pathway in the speciality of community nursing. Design: Delphi policy approach, guided by a previous systematic review and semi-structured interviews. Methods: Four rounds of an expert panel (N = 19). Rounds one, two and four were questionnaires consisting of a combination of closed (Likert response) and open-ended questions. Round three comprised of a focus group conducted using virtual meeting technology. Results: The final model demonstrated reliable and valid measures. There were deficiencies in "pre-entry"-where the marketing of community nursing was negligible and the support around orientation informal and minimal, mainly due to tight budgetary concerns. Community practice holds a whole new dimension for nurses transitioning from acute care as the concept of "knowing your community" took time and support-time to be accepted reciprocally and develop a sense of belonging to the community.

From incomer to insider: The development of the TRANSPEC model - A systematic review of the factors influencing the effective rapid and early career TRANsition to a nursing SPECiality in differing contexts of practice.

OBJECTIVE: Shortages in the speciality nursing workforce, both nationally and internationally are driving the need for the development of an evidence-based model to inform recruitment and retention into speciality nursing practice. This study aimed to identify the factors influencing rapid and early career transition into speciality nursing practice. METHODS: A comprehensive systematic review of the literature was undertaken using a convergent qualitative synthesis design where results from qualitative, quantitative and mixed methods studies were transformed into qualitative findings. Databases included CINAHL, Medline, Scopus and PsycINFO. Search terms were: nurse, early career, rapid career, transition, specialty, and Medical Subject Heading terms included: professional development and educational, nursing, and continuing. Using validated tools, papers were independently assessed by a minimum of two reviewers. RESULTS: Twenty-three research articles were included. There were no randomized control trials. Through thematic analysis and matrix mapping of the results, the TRANSPEC model was developed. The model outlines three phases of transition: pre-entry, incomer and insider. There has been little focus on pre-entry with programs being designed at the incomer and insider phases. Impacting on these phases are three concepts: the self (professional and personal), the transition processes (informal and formal) and a sense of belonging. The overarching theme influencing the phases and concepts is the context of practice. Enablers and inhibitors influence successful transition and therefore impact on recruitment and retention. Each nurse's transition is influenced by time. CONCLUSIONS: For successful transition, the enablers and inhibitors impacting on the three concepts, phases and the context of practice need to be considered when developing any program. It is apparent that while previous studies have focused on the transition processes, such as curricula, the development of the self and a sense of belonging are also essential to successful transition. Further studies should include the pre-entry phase.

Developing a community-based nursing and midwifery career pathway - A narrative systematic review.

INTRODUCTION: Community nursing and midwifery is changing in response to a shift in care from hospital to home, brought about by increasing costs to care because of an aging population and increasing chronicity. Until now, community nursing positions and scope of practice has been dependent on service focus and location, which has led to the role being unclearly defined. Lack of appeal for a career in community practice and a looming workforce shortage necessitates a review into how community nursing and midwifery transition to practice is supported. METHODS: This review sought to identify, assess and summarize available evidence relating to transitioning into community nursing and midwifery practice as a speciality. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A narrative synthesis was then undertaken on papers that examined community nursing and midwifery pathway perspectives which define, and enable or inhibit a contemporary pathway. Thematic analysis used a theoretical framework developed for early career and rapid transition to nursing specialty practice. RESULTS: There is a paucity of research that identifies community nursing and midwifery as a discreet scope of practice. Twelve papers were eventually included in the review. Verbatim findings were extracted from the papers and clustered into categories based on the chosen theoretical framework. Major themes were 'the self' (professional and personal); 'transition processes'; and, a 'sense of belonging'. Sub themes included narrative identifying inhibitors and enablers in each theme. DISCUSSION: No definition of community practice or pathway was identified in nursing, although midwifery was clearly defined. Community nursing practice was described as generalist in nature although specialist knowledge is required. Being part of the community in the professional sense and personal sense was considered important. The importance of transition was identified where pre-entry exposure to community practice was seen as important. Stages in transition to practice were recognised as pre-entry; incomer; insider; and, a sense of belonging. The process of transition should be planned and individualised acknowledging past experience whilst acknowledging the specialist nature of community-based practice.

Mechanisms of autophagy induction by sex steroids in bovine mammary epithelial cells.

In dairy cattle, mammary gland involution serves to remodel the secretory tissue and occurs in a period of overlap between mammogenic stimulation caused by the next developing pregnancy and tissue regression induced by milk stasis. At this time, high concentrations of 17ß-oestradiol (E2) and progesterone (P4) support the regeneration of the mammary tissue, as well as enhance autophagy, a cellular process induced in response to stressful conditions for energy generation and homeostasis maintenance. This study aimed to elucidate the mechanisms of autophagy induction by E2 and P4 using an in vitro model of involution based on 20-fold reduction of FBS content (from 10% to 0.5%) in the culture medium of BME-UV1 bovine mammary epithelial cells (MECs). Real-time RT-PCR, Western blot and EMSA analyses demonstrated that addition of E2 and P4 caused a genomic effect in BME-UV1 cells, stimulating the expression of autophagy-related genes (ATGs): BECN1, ATG5, LC3B and their corresponding proteins. Furthermore, knockdown of oestrogen receptor (ERα) and experiments with the use of oestrogen and progesterone antagonists (4-hydroxytamoxifen and RU-486, respectively) demonstrated that the observed genomic effect is mediated by steroid receptors. Finally, both steroids were shown to form complexes with beclin1 and regulate Bcl-2 phosphorylation, indicating that an indirect, non-genomic effect of E2 and P4 may also contribute to autophagy induction in bovine MECs.

Soluble insulin analogs combining rapid- and long-acting hypoglycemic properties - From an efficient E. coli expression system to a pharmaceutical formulation.

The discovery of insulin led to a revolution in diabetes management. Since then, many improvements have been introduced to insulin preparations. The availability of molecular genetic techniques has enabled the creation of insulin analogs by changing the structure of the native protein in order to improve the therapeutic properties. A new expression vector pIBAINS for production of four recombinant human insulin (INS) analogs (GKR, GEKR, AKR, SR) was constructed and overexpressed in the new E. coli 20 strain as a fusion protein with modified human superoxide dismutase (SOD). The SOD gene was used as a signal peptide to enhance the expression of insulin. SOD::INS was manufactured in the form of insoluble inclusion bodies. After cleavage of the fusion protein with trypsin, the released insulin analogs were refolded and purified by reverse-phase high performance liquid chromatography (RP-HPLC). Elongation of chain A, described here for the first time, considerably improved the stability of the selected analogs. Their identity was confirmed with mass spectrometric techniques. The biological activity of the insulin derivatives was tested on rats with experimental diabetes. The obtained results proved that the new analogs described in this paper have the potential to generate prolonged hypoglycemic activity and may allow for even less frequent subcutaneous administration than once-a-day. When applied, all the analogs demonstrate a rapid onset of action. Such a combination renders the proposed biosynthetic insulin unique among already known related formulations.

pIGWZ12--A cryptic plasmid with a modular structure.

We studied the detailed structure of the cryptic plasmid pIGWZ12, which was isolated from an Escherichia coli strain. pIGWZ12 is composed of two structural modules of distinct evolutionary origin. The REP module, which contains all the features necessary for replication and stable maintenance in the bacterial cell, was assigned by genotyping to the IncF family. The MOB module, which is responsible for plasmid mobilization, shows significant homology to MOBQ modules from broad-host-range plasmids belonging to the RSF1010/R1162 family. We showed that iterons located in the origin of replication are the target for specific binding by the replication initiator protein RepApIGWZ12. Furthermore, we proved that the promoter for the repA gene overlaps with the iterons, and that the latter are the sole determinant of incompatibility. We performed a mutagenesis analysis of the MOBpIGWZ12 module and characterized the roles played by all identified genes (mobA and mobC), as well as the role played by oriT in mobilization. Finally, we showed that it was possible to remove the MOB module from pIGWZ12 without any loss in plasmid replication and stability. Furthermore, the MOBpIGWZ12 module was fully functional after subcloning into another plasmid. Therefore, pIGWZ12 is yet another example of modular structure in small cryptic plasmids.

New cloning and expression vector derived from Escherichia coli plasmid pIGWZ12; a potential vector for a two-plasmid expression system.

We constructed pIGPZ, a new cloning and expression vector derived from Escherichia coli plasmid pIGWZ12::Kan. pIGPZ contains a kanamycin resistance marker, a multiple-cloning-site (MCS) region, and a promoter for constitutive expression of cloned genes. pIGPZ has the same high level of stability as the original plasmid, even in the absence of antibiotic selection. Furthermore, we show that pIGPZ is compatible with ColE1-based plasmids and a pSC101-like plasmid. All the characteristic elements of theta-replicating plasmids were found in the pIGPZ putative origin of replication. Finally, we demonstrate that pIGPZ can be used in a double-plasmid expression system by co-expressing UBP1 protease from pIGPZ with ubi-interferon alpha (IFNA13; GenBank Accession No. NM_006900.3) or ubi-human growth hormone (ubi-hGH; patent No. WO 2005/066208 A2) cloned in another plasmid. In this system, both ubi-interferon alpha and ubi-human growth hormone were deubiquitinated efficiently in E. coli cells.

Role and regulation of autophagy in the development of acinar structures formed by bovine BME-UV1 mammary epithelial cells.

Autophagy is a catabolic process providing an alternative energy source for cells under stressful conditions such as starvation, growth factor deprivation or hypoxia. During involution of the bovine mammary gland autophagy is induced in mammary epithelial cells (MECs) as a survival mechanism, and is tightly regulated by hormones and growth factors necessary for gland development. In the present study we adapted the three-dimensional culture model to investigate the role of autophagy during formation of alveoli-like structures by bovine BME-UV1 MECs grown on extracellular matrix (ECM) components. Using confocal microscopy and Western-blot analyses of autophagic and apoptotic markers: LC3, and cleaved caspase-3, we showed that autophagy was induced in centrally localized cells within the developing acini. These cells lacked a direct contact with ECM, and formed a distinct population from the outer layer of cells. Induction of autophagy preceded apoptosis, but did not inhibit the formation of a hollow lumen. In the presence of steroid hormones: 17ß-estradiol and progesterone, although autophagy was augmented, acini formation proceeded normally. In contrast, the major lactogenic hormone: prolactin, which supports functional differentiation of alveoli, did not alter induction of autophagy within the spheroids. BME-UV1 cells cultured on Matrigel in the presence of growth factors IGF-I and EGF formed larger, underdeveloped acini without lumens due to caspase-3 inhibition, and sustained autophagy in the centre of the spheroids, while TGF-ß1 accelerated apoptosis, and increased autophagy significantly. Our observations suggest that sex steroids 17ß-estradiol and progesterone, as well as growth factor TGF-ß1 may regulate the development of the bovine mammary gland by inducing autophagy in addition to regulating proliferation and apoptosis of MECs. These data indicate that autophagy may play an important role during alveolargenesis.

IGF-I, EGF, and sex steroids regulate autophagy in bovine mammary epithelial cells via the mTOR pathway.

Mammary gland growth and involution are based on a dynamic equilibrium between proliferation and apoptosis of mammary epithelial cells (MEC). The main type of cell death responsible for bovine mammary gland involution is apoptosis, but MEC also exhibit morphological features of autophagy. The present study has been undertaken in order to examine factors, which are responsible for the regulation of autophagy in bovine MEC. We used a model of in vitro mammary gland involution known to be dependent on fetal bovine serum (FBS) deficiency in the culture of bovine BME-UV1 cells. We investigated the effects of insulin-like growth factor-1 (IGF-I) and epidermal growth factor (EGF) signaling, as well as sex steroids and rapamycin (a specific inhibitor of mammalian target of rapamycin, mTOR, kinase) on autophagy in the MEC line BME-UV1. Our main focus was on the role of mTOR in the regulation of autophagy by growth factors and hormones. Laser scanning cytometry, electron microscopy, Western-blot analysis, GFP-LC3 reporter-based expression analysis, and LysoTracker Green-related fluorescence were used to determine the activity of autophagy in BME-UV1 cells. We found that FBS deficiency induced both autophagy and apoptosis with the highest intensity of both processes after 48h of MEC exposure to the deficient medium (0.5% FBS). Addition of IGF-I or/and EGF to the FBS-deficient medium clearly diminished autophagy. We also show that IGF-I and EGF are involved in the activation of mTOR in bovine MEC, whereas inhibition of mTOR by rapamycin abrogated the suppressive effects of IGF-I and EGF on autophagy. This suggests that mTOR links IGF-I and EGF signaling in inhibiting the autophagy pathways. Contrary to IGF-I and EGF, 17beta-estradiol and progesterone exerted stimulatory effects on autophagy in bovine MEC. At the same time we observed a suppressive effect of both steroids on mTOR activation/phosphorylation. In conclusion, autophagy in bovine MEC undergoes complex regulation, where its activity is controlled by survival pathways dependent on IGF-I and EGF, which are involved in suppression of autophagy, and by pregnancy steroids, which act as inducers of the process.

Regulation of autophagy in bovine mammary epithelial cells.

The bovine mammary gland undergoes intensive remodelling during the lactation cycle, and the escalation of this process is observed during dry periods. The main type of cell death responsible for bovine mammary gland involution is apoptosis; however, there are also a lot of cells exhibiting morphological features of autophagy during drying off. Our in vitro and in vivo studies of bovine mammary gland physiology suggest that the enhanced process of autophagy, observed at the end of lactation and during dry periods, is the result of: (1) decreased level of lactogenic hormones (GH, IGF-I), (2) decreased GH-R and IGF-IR alpha expression, (3) increased expression of auto/paracrine apoptogenic peptides (IGFBPs, TGFbeta), (4) increased influence of sex steroids (17beta-estradiol and progesterone) and (5) enhanced competition between the between the intensively developing fetus and the mother organism for nutritional and bioactive compounds. The above conditions may create a state of temporary malnutrition of mammary epithelial cells, which forces the cells to the induction of autophagy, as a mechanism for stabilizing intracellular supplies of energy and amino acids, especially during the enhanced activity of apoptogenic factors.