Promoting civility and safety with cognitive rehearsal.

ABSTRACT: Uncivil behaviors have detrimental consequences that can impact healthcare team cohesion, resulting in conflicts and poor teamwork. This article details civil and uncivil behaviors and how the latter affects healthcare, and provides a tool to prepare nurses for uncivil encounters.

The effect of positive and negative evaluation on state anxiety and repetitive negative thinking in social evaluative situations: An experimental study.

The Bivalent Fear of Evaluation (BFOE) Model suggests that fears of negative and positive evaluation are core cognitive vulnerability and maintenance factors for social anxiety disorder The aim of this study was to experimentally assess cognitive and emotional effects of positive and negative feedback in social anxiety. False positive or negative feedback (vs no feedback) was provided following a speech task to high and low socially anxious individuals to investigate impacts on state anxiety and repetitive negative thinking (N = 152, Mage = 22.13, 69 % female). Measures were completed prior to the speech and after the false feedback but prior to an anticipated discussion with the group about participants' feedback and performance. High socially anxious participants reporting higher state anxiety and repetitive negative thinking than low socially anxious participants. There were no feedback type by group interactions, indicating that high socially anxious individuals experienced heightened social anxiety and repetitive negative thinking regardless of feedback type (or the absence of feedback). Exploratory analyses revealed that state fear of negative evaluation but not state fear of positive evaluation uniquely predicted both outcomes. Implications for theory and clinical practice are discussed.

A co-designed systematic review and meta-analysis of the efficacy of grief interventions for anxiety and depression in young people.

BACKGROUND: Grief in young people is common and associated with symptoms of anxiety and depression, yet grief interventions for this age group are under-researched. METHOD: We conducted a systematic review and meta-analysis to examine the efficacy of grief interventions in young people. The process was co-designed with young people and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PsycINFO, Medline, and Web of Science databases were searched in July 2021 (updated December 2022). RESULTS: We extracted results from 28 studies of grief interventions with young people (14-24 years) that measured anxiety and/or depression (N = 2803 participants, 60 % girls/women). Cognitive behavior therapy (CBT) for grief demonstrated a large effect for anxiety and medium effect for depression. A meta-regression indicated that CBT for grief that included a higher degree of CBT strategies, was not trauma focused, had >10 sessions, offered on an individual basis, and did not involve parents, was associated with larger effect sizes for anxiety. Supportive therapy had a moderate effect for anxiety and a small-moderate effect for depression. Writing interventions were not effective for anxiety or depression. LIMITATIONS: Studies are limited in number and there were few randomized controlled studies. CONCLUSIONS: Findings indicate that CBT for grief is an effective intervention for reducing symptoms of anxiety and depression in young people experiencing grief. CBT for grief should be offered as the first line treatment for grieving young people experiencing anxiety and depression. PROTOCOL REGISTRATION: PROSPERO (registration number CRD42021264856).

IgG antibody production and persistence to 6 months following SARS-CoV-2 vaccination: A Northern Ireland observational study.

BACKGROUND: This study evaluates spike protein IgG antibody response following Oxford-AstraZeneca COVID-19 vaccination using the AbC-19™ lateral flow device. METHODS: Plasma samples were collected from n = 111 individuals from Northern Ireland. The majority were >50 years old and/or clinically vulnerable. Samples were taken at five timepoints from pre-vaccination until 6-months post-first dose. RESULTS: 20.3% of participants had detectable IgG responses pre-vaccination, indicating prior COVID-19. Antibodies were detected in 86.9% of participants three weeks after the first vaccine dose, falling to 74.7% immediately prior to the second dose, and rising to 99% three weeks post-second vaccine. At 6-months post-first dose, this decreased to 90.5%. At all timepoints, previously infected participants had significantly higher antibody levels than those not previously infected. CONCLUSION: This study demonstrates that strong anti-spike protein antibody responses are evoked in almost all individuals that receive two doses of Oxford-AstraZeneca vaccine, and which largely persist beyond six months after first vaccination.

The conserved C-terminus of Sss1p is required to maintain the endoplasmic reticulum permeability barrier.

The endoplasmic reticulum (ER) is the entry point to the secretory pathway and major site of protein biogenesis. Translocation of secretory and integral membrane proteins across or into the ER membrane occurs via the evolutionarily conserved Sec61 complex, a heterotrimeric channel that comprises the Sec61p/Sec61α, Sss1p/Sec61γ, and Sbh1p/Sec61ß subunits. In addition to forming a protein-conducting channel, the Sec61 complex also functions to maintain the ER permeability barrier, preventing the mass free flow of essential ER-enriched molecules and ions. Loss in Sec61 integrity is detrimental and implicated in the progression of disease. The Sss1p/Sec61γ C terminus is juxtaposed to the key gating module of Sec61p/Sec61α, and we hypothesize it is important for gating the ER translocon. The ER stress response was found to be constitutively induced in two temperature-sensitive sss1 mutants (sss1ts ) that are still proficient to conduct ER translocation. A screen to identify intergenic mutations that allow for sss1ts cells to grow at 37 °C suggests the ER permeability barrier to be compromised in these mutants. We propose the extreme C terminus of Sss1p/Sec61γ is an essential component of the gating module of the ER translocase and is required to maintain the ER permeability barrier.

The Role of Pain Classification Systems in Pain Management.

Pain is a multidimensional experience that can significantly impair an individual's quality of life. This article describes the pain classification systems, including anatomic, etiologic, intensity, duration, pathophysiological, and conditions that are not easily classified. A holistic approach is taken by addressing key components to assist with effective pain management, including the psychological and spiritual aspects of care. A case study scenario demonstrates the implementation of pain classifications in pain management. Also discussed are current controversies, potential genetic impacts, and the barriers chronic pain sufferers face, including addiction, diversion, and socioeconomic factors.

Diminished Ost3-dependent N-glycosylation of the BiP nucleotide exchange factor Sil1 is an adaptive response to reductive ER stress.

BiP (Kar2 in yeast) is an essential Hsp70 chaperone and master regulator of endoplasmic reticulum (ER) function. BiP's activity is regulated by its intrinsic ATPase activity that can be stimulated by two different nucleotide exchange factors, Sil1 and Lhs1. Both Sil1 and Lhs1 are glycoproteins, but how N-glycosylation regulates their function is not known. Here, we show that N-glycosylation of Sil1, but not of Lhs1, is diminished upon reductive stress. N-glycosylation of Sil1 is predominantly Ost3-dependent and requires a functional Ost3 CxxC thioredoxin motif. N-glycosylation of Lhs1 is largely Ost3-independent and independent of the CxxC motif. Unglycosylated Sil1 is not only functional but is more effective at rescuing loss of Lhs1 activity than N-glycosylated Sil1. Furthermore, substitution of the redox active cysteine pair C52 and C57 in the N terminus of Sil1 results in the Doa10-dependent ERAD of this mutant protein. We propose that reductive stress in the ER inhibits the Ost3-dependent N-glycosylation of Sil1, which regulates specific BiP functions appropriate to the needs of the ER under reductive stress.

Energetic and informational masking of complex sounds by a bottlenose dolphin (Tursiops truncatus).

With few exceptions, laboratory studies of auditory masking in marine mammals have been limited to examining detection thresholds for simple tonal signals embedded in broadband noise. However, detection of a sound has little adaptive advantage without the knowledge of what produced the sound (recognition) and where the sound originated (localization). In the current study, a bottlenose dolphin's masked detection thresholds (energetic masking) and masked recognition thresholds (informational masking) were estimated for a variety of complex signals including dolphin vocalizations, frequency modulated signals, and a 10 kHz pure tone. Broadband noise types included recordings of natural sounds and computer generated sounds. Detection thresholds were estimated using a standard go, no-go adaptive staircase procedure. The same dolphin learned to associate whistle-like FM sounds with specific arbitrary objects using a three alternative, matching-to-sample (MTS) procedure. The dolphin's performance in the MTS task was then tested in the presence of the same masking noise types used in the detection task. Recognition thresholds were, on average, about 4 dB higher than detection thresholds for similar signal-noise conditions. The 4 dB difference is likely due to additional cognitive demands of recognition, including attention and pattern recognition.

Recognition of Frequency Modulated Whistle-Like Sounds by a Bottlenose Dolphin (Tursiops truncatus) and Humans with Transformations in Amplitude, Duration and Frequency.

Bottlenose dolphins (Tursiops truncatus) use the frequency contour of whistles produced by conspecifics for individual recognition. Here we tested a bottlenose dolphin's (Tursiops truncatus) ability to recognize frequency modulated whistle-like sounds using a three alternative matching-to-sample paradigm. The dolphin was first trained to select a specific object (object A) in response to a specific sound (sound A) for a total of three object-sound associations. The sounds were then transformed by amplitude, duration, or frequency transposition while still preserving the frequency contour of each sound. For comparison purposes, 30 human participants completed an identical task with the same sounds, objects, and training procedure. The dolphin's ability to correctly match objects to sounds was robust to changes in amplitude with only a minor decrement in performance for short durations. The dolphin failed to recognize sounds that were frequency transposed by plus or minus ½ octaves. Human participants demonstrated robust recognition with all acoustic transformations. The results indicate that this dolphin's acoustic recognition of whistle-like sounds was constrained by absolute pitch. Unlike human speech, which varies considerably in average frequency, signature whistles are relatively stable in frequency, which may have selected for a whistle recognition system invariant to frequency transposition.

Multi-echo processing by a bottlenose dolphin operating in "packet" transmission mode at long range.

Bottlenose dolphins performing echolocation tasks at long ranges may utilize a transmission mode where bursts, or "packets," of echolocation clicks are emitted rather than single clicks. The clicks within each packet are separated by time intervals well below the two-way travel time, while the packets themselves are emitted at intervals greater than the two-way travel time. Packet use has been shown to increase with range; however, the exact function of packets and the advantages gained by their utilization remain unknown. In this study, the capability for dolphins to utilize multi-echo processing within packets of echoes was investigated by manipulating the number of available echoes within each packet as a dolphin performed a long-range echolocation task. The results showed an improvement in detectability with an increase in the number of echoes in each packet and suggest that packet use is an adaptation to allow multi-echo processing at long ranges without introducing range ambiguity.

The prevalence of cognitive impairment in emergency general surgery.

OBJECTIVES: Rates of all surgical procedures are increasing at a faster rate than the population is ageing. However, this encouraging statistic, necessitates a robust evidence base. The epidemiological evidence base in acute general surgery in the older person is sparse. This is the first assessment of the prevalence of cognitive impairment measured using the Montreal Cognitive Assessment tool (MoCA) in acute general surgery. METHODS: In three sites in Wales, England and Scotland comprising rural and urban populations, we studied consecutive patients aged over 65 years. We considered any older person admitted to the acute general surgical unit. We assessed them for baseline demographic data. They each underwent a MoCA assessment. RESULTS: We collected data on 245 people, mean age 76.9 years (8.1, standard deviation), 136 (55.5%) were women. Of these 201 completed the MoCA test, mean score of 18.9 and median score 20 (range 0-30). There were 37 (15.1%) MoCA scores in the normal range (≥26) and 44 (18%) people were unable to attempt (or complete) the MoCA. Increasing age (p < 0.01) but not sex (p = 0.14) predicted an abnormal MoCA. Considering only the 44 people who were unable to attempt the MoCA assessment, 11 (25%) were known to have a diagnosis of dementia, 9 (20.5%) were too unwell and the remainder unable to complete the assessment to due pre-existing disability. CONCLUSIONS: In a representative UK wide population, a high proportion of older people admitted with an acute general surgical problem had cognitive impairment when assessed using the MoCA.