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1.
J Nurs Adm ; 51(9): 439-447, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34432736

RESUMO

OBJECTIVE: The purpose of this study was to develop and test a tool to monitor a nursing orientee's progress to competence. BACKGROUND: The literature suggests that, during orientation, consistent documentation and communication among educators, preceptors, and nurse leaders facilitate a timely progression to independent practice for new nurses. METHODS: A 2-phase methodological study was conducted. Nurse educators clarified goals, identified essential competencies, and developed the Baptist Health Lexington Nursing Orientation Progression Tool (OPT). The tool was used to monitor orientees' progression through orientation. RESULTS: Content validity assessment of the OPT (content validity index = 0.98) demonstrated strong validity. Testing of the tool revealed 31 nurses completed orientation early, 12 completed orientation on time, and 18 nurses required extended orientation time. All requiring an extension were new graduates. CONCLUSION: The OPT guided preceptors to facilitate timely completion of orientation among newly hired nurses. Findings suggest that new graduates may need more assistance than experienced nurses.


Assuntos
Competência Clínica , Capacitação em Serviço , Liderança , Recursos Humanos de Enfermagem , Bacharelado em Enfermagem , Humanos , Preceptoria
3.
J Clin Invest ; 128(2): 655-667, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29251627

RESUMO

A critical event in the adaptation to extrauterine life is relaxation of the pulmonary vasculature at birth, allowing for a rapid increase in pulmonary blood flow that is essential for efficient gas exchange. Failure of this transition leads to pulmonary hypertension (PH), a major cause of newborn mortality associated with preterm birth, infection, hypoxia, and malformations including congenital diaphragmatic hernia (CDH). While individual vasoconstrictor and dilator genes have been identified, the coordination of their expression is not well understood. Here, we found that lung mesenchyme-specific deletion of CDH-implicated genes encoding pre-B cell leukemia transcription factors (Pbx) led to lethal PH in mice shortly after birth. Loss of Pbx genes resulted in the misexpression of both vasoconstrictors and vasodilators in multiple pathways that converge to increase phosphorylation of myosin in vascular smooth muscle (VSM) cells, causing persistent constriction. While targeting endothelin and angiotensin, which are upstream regulators that promote VSM contraction, was not effective, treatment with the Rho-kinase inhibitor Y-27632 reduced vessel constriction and PH in Pbx-mutant mice. These results demonstrate a lung-intrinsic, herniation-independent cause of PH in CDH. More broadly, our findings indicate that neonatal PH can result from perturbation of multiple pathways and suggest that targeting the downstream common effectors may be a more effective treatment for neonatal PH.


Assuntos
Hérnias Diafragmáticas Congênitas/etiologia , Proteínas de Homeodomínio/metabolismo , Pulmão/embriologia , Fator de Transcrição 1 de Leucemia de Células Pré-B/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Alelos , Animais , Apoptose , Proliferação de Células , Modelos Animais de Doenças , Ecocardiografia , Elastina/metabolismo , Feminino , Deleção de Genes , Hipertensão Pulmonar/etiologia , Pulmão/irrigação sanguínea , Camundongos , Camundongos Knockout , Músculo Liso Vascular/metabolismo , Miócitos de Músculo Liso/metabolismo , Miosinas/metabolismo , Parto , Fosforilação , Artéria Pulmonar/metabolismo , Respiração , Vasoconstrição/fisiologia
4.
Poult Sci ; 94(3): 331-7, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25717091

RESUMO

This study evaluates the impact of light-emitting diodes (LEDs), cold cathode fluorescent lamps (CCFLs), and incandescent lamps on broiler welfare in response to recent interest in the agriculture industry to transition to more energy-efficient lighting technologies. Male Ross 708 broilers (n=672) were raised to 6 wk age in 8 light-tight modified large colony houses under identical intermittent lighting conditions using 4 unique types of lamps, which were gradually dimmed throughout the study. Incandescent lamps served as the control; experimental technologies tested were a CCFL, and 2 different LED lamps. Each technology was tested in duplicate for each of the 4 trials (8 replications total per technology) conducted across the course of one year to account for seasonal variance. Birds were removed from each house at days 7, 14, 35, and 42 to be humanely euthanized and weighed for necropsy evaluation and comparison of body mass. Blood collection via cardiac puncture was performed to obtain heterophil to lymphocyte (H:L) ratios for evaluation of environmental stress. Birds raised under CCFLs had significantly lower body weights (2,871 g±53) than the control (3,000±33 g) by 42 d. Birds raised under CCFLs additionally had significantly higher H:L ratios (0.68±0.06) than the control (0.53±0.03), indicating that these birds may have been chronically stressed (P=0.03). There were not significant differences in the H:L ratio between LED technologies at α=0.05. A significant age and seasonal correlation in H:L ratios was observed across all technologies, along with significant differences among birds raised under the experimental technologies. This study indicates that variation in broiler body weight and stress may be attributed in part to lighting technologies implemented in broiler houses.


Assuntos
Criação de Animais Domésticos/métodos , Galinhas/fisiologia , Luz , Iluminação/métodos , Animais , Peso Corporal , Linfócitos , Masculino , Fotoperíodo , Estresse Fisiológico/efeitos da radiação
5.
Poult Sci ; 94(3): 408-14, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25628420

RESUMO

This study evaluates the impact of light-emitting diode (LED), cold cathode fluorescent (CCFL), and incandescent lamps on broiler performance. Male Ross 708 broilers (n=672) were raised to 6 wk age in 8 black-out modified large colony houses, under identical intermittent lighting conditions using 4 unique types of lamps, which were gradually dimmed throughout the study. Incandescent lamps served as the control; experimental technologies tested included CCFL and 2 different LED lamps. Each technology was tested in duplicate for each of 4 trials (8 replications total per technology) conducted across the course of one year to account for seasonal variance. Live performance for each technology was evaluated using live broiler body weight (BW), weight gain, feed conversion, and mortality. Birds were removed from each house at 7, 14, 35, and 42 d to be humanely euthanized, weighed, and necropsied for allometric tissue sample analysis. Relative to the technologies tested, results indicate that birds raised under incandescent lamps had significantly higher BW by 42 d, compared to birds raised under CCFL lamps, which had poorer BW performance (P=0.03). Birds raised under both LED technologies grew to final BWs similar to those raised under incandescent light, with significant differences in neither feed conversion nor mortality.


Assuntos
Criação de Animais Domésticos/métodos , Galinhas/fisiologia , Metabolismo Energético , Luz , Iluminação/métodos , Fenômenos Fisiológicos da Nutrição Animal , Animais , Galinhas/crescimento & desenvolvimento , Masculino , Ganho de Peso
7.
Am J Dermatopathol ; 36(12): 997-1001, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24562050

RESUMO

Few reports of cutaneous Burkitt lymphoma exist in the literature. Here, the authors describe the case of a human immunodeficiency virus-positive individual with the rare diagnosis of cutaneous Burkitt lymphoma. Three weeks before the development of his cutaneous lesions, the patient experienced bilateral lower extremity paralysis, and an epidural mass was found. Bone marrow biopsy findings and serum protein electrophoresis seemed consistent with multiple myeloma. The visible appearance of the skin lesions raised concern for cutaneous involvement by myeloma; however, the skin biopsy showed morphological and immunohistochemical features of Burkitt lymphoma. In this case report, the authors discuss the histopathologic findings of the cutaneous lesions in consideration with the bone marrow biopsy findings.


Assuntos
Medula Óssea/patologia , Linfoma de Burkitt/patologia , Soropositividade para HIV/complicações , Mieloma Múltiplo/patologia , Neoplasias Cutâneas/patologia , Neoplasias da Coluna Vertebral/patologia , Biópsia , Linfoma de Burkitt/química , Humanos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/química , Neoplasias Cutâneas/química , Neoplasias da Coluna Vertebral/química
8.
Breast Cancer Res Treat ; 122(2): 515-20, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20052539

RESUMO

In order to shed light on genetic and environmental factors contributing to breast cancer health disparities, anonymous data from the cancer registry in Brooklyn, NY and two countries in the Caribbean, have been analyzed and compared. De-identified data were obtained on 3,710 women from three cancer registries in Brooklyn (New York), Guyana, and Trinidad, all having been diagnosed with breast cancer between 1995 and 2007, with follow-up through to early 2009. There was a significant difference in breast cancer survival according to race, place of birth, and place of residence. Women of African origin had a significantly worse survival than White women. Women born in the Caribbean had significantly worse survival in comparison to their counterpart born in the US, independently from their ethnic background (adjusted hazard ratio: 1.6; 95% CI: 1.2-2.1). A significant lower breast cancer survival was observed in African Caribbean women living in the Caribbean (HR: 1.8; 95% CI: 1.6-2.1) versus African-Caribbean women born in the Caribbean and living in the US (HR: 1.3; 95% CI 1.1-1.7), versus African-descent women born and living in the US. This study suggests that biological, behavioral, environmental, and clinical factors play a significant role in the observed difference in breast cancer outcome in women of Afro Caribbean descent.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Neoplasias da Mama/etnologia , Neoplasias da Mama/mortalidade , Características de Residência/estatística & dados numéricos , Adulto , Idoso , Distribuição de Qui-Quadrado , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Guiana/epidemiologia , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Prognóstico , Modelos de Riscos Proporcionais , Sistema de Registros , Medição de Risco , Fatores de Risco , Fatores de Tempo , Trinidad e Tobago/epidemiologia
9.
Int J Law Psychiatry ; 28(3): 269-89, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15923037

RESUMO

This study explores the performance of 132 female maximum-security inmates on the Psychopathy Checklist-Revised (PCL-R) and the HCR-20 (Historical, Clinical, and Risk Management Scheme) to examine the concordance between these two risk assessment instruments, and to assess their potential usefulness in determining level of risk for violent behavior and other forms of criminality. The two instruments demonstrated consistent and highly significant correlations across total scores, factor scores, and subscale scores. When the two instruments were entered into a multiple regression analysis to predict violent and non-violent crime, the HCR-20 did not add to the variance explained by the PCL-R. These results confirm earlier research that suggests that there is little or no difference between these two risk assessment instruments in their relationship to community or institutional violence. Further, Receiver Operating Characteristics (ROC) analyses show that both instruments demonstrated an inverse ability to predict convictions for murder, a close to chance ability to predict violent crime, but a shared ability to predict property and minor crime. Broadly, these results suggest that psychopathic women are involved in chronic patterns of non-violent criminality, while women charged and convicted of murder generally do not have elevated scores on the PCL-R or HCR-20. The relevance of these findings to rehabilitation and treatment is discussed.


Assuntos
Psicologia Criminal/instrumentação , Psicopatologia , Violência , Mulheres/psicologia , Adulto , Crime/classificação , Crime/estatística & dados numéricos , Feminino , Humanos , Medição de Risco/métodos , Fatores de Risco , Sensibilidade e Especificidade , Estados Unidos
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