Obstacles to compassion-giving among nursing and midwifery managers: an international study.

AIM: To explore nursing and midwifery managers' views regarding obstacles to compassion-giving across country cultures. BACKGROUND: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. METHODS: Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. RESULTS: Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related. CONCLUSIONS: Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving.

3,3 diindolylmethane leads to apoptosis, decreases sperm quality, affects blood estradiol 17 ß and testosterone, oestrogen (α and ß) and androgen receptor levels in the reproductive system in male rats.

3,3 Diindolylmethane (DIM) is a major digestive product of indole-3 carbinol, obtained from Brassica family vegetables such as broccoli, cabbage and Brussels sprouts. This study aimed to investigate the effects of DIM on sperm parameters, histological structures of testicular tissues, blood testosterone (T) and estradiol 17-ß (E2) in male rats. Thirty-eight male Sprague Dawley rats were used. Rats were divided into four groups: Group I: referred as Control group, received corn oil only; Group II: as DIM-10, rats received 10 mg kg-1 DIM; Group III: as DIM-50, rats received 50 mg kg-1 DIM; Group IV: as DIM-100, received 100 mg kg-1 DIM during 53 days. Spermatological parameters, malondialdehyde (MDA) levels of testes and serum T and E2 levels were assayed. Histopathological examinations of tests were done. DIM caused an increase in MDA levels. It decreased motility and live sperm rates and increased degeneration of testicular tissues. While DIM-10 did not affect abnormal sperm rate, higher concentrations increased the abnormalities. Sperm density was higher in DIM-10 groups when compared to both other groups. Only DIM-50 had an anti-androgenic effect among all groups. Only, DIM-10 showed anti-estrogenic activity as compared to higher DIM groups. In conclusion, DIM (i) had side effect on some sperm characteristics, (ii) increased the MDA levels and (iii) led to histological degeneration of testicular tissues and apoptosis in a dose-dependent manner.

International study on nurses' views and experiences of compassion.

BACKGROUND: Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. AIM: The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. METHODS: An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. RESULTS: The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion. CONCLUSION: Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. LIMITATIONS: Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. IMPLICATIONS FOR NURSING POLICY: Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).

Views about perceived training needs of health care professionals in relation to socially assistive robots: an international online survey.

BACKGROUND: As Artificial Intelligence and social robots are increasingly used in health and social care, it is imperative to explore the training needs of the workforce, factoring in their cultural background. OBJECTIVES: Explore views on perceived training needs among professionals around the world and how these related to country cultures. DESIGN: Cross-sectional, descriptive, mixed-methods international online survey. METHODS: Descriptive statistical analysis explored the ranking across countries and relationships with three Hofstede cultural dimensions. Thematic analysis was conducted on the open-ended text responses. RESULTS: A sample of N = 1284 participants from eighteen countries. Knowing the capabilities of the robots was ranked as the top training need across all participating countries and this was also reflected in the thematic analysis. Participants' culture, expressed through three Hofstede's dimensions, revealed statistically significant ranking differences. CONCLUSIONS: Future research should further explore other factors such as the level of digital maturity of the workplace. IMPACT STATEMENT: Training needs of health and social care staff to use robotics are fast growing and preparation should factor in patient safety and be based on the principles of person- and culture-centred care.

Ultrasonographic examination of the scrotal content in the rabbit.

This study was performed to describe a practical technique for ultrasound examination of the scrotal content of the rabbit. The scrotal content of normal rabbits and those with induced lesions (i.e. needle biopsy of the testis and epididymal ligation) were viewed using a portable scanner connected to a 5 or 7.5 MHz real time, B-mode linear array transducer. The effect of frequency (5 and 7.5 MHz), pad material placed under the testicle (rubber, plastic and carton) and the presence of a water sack between the probe and organ were examined to optimize the technique. The best image quality was obtained using a 5-MHz probe when the testicle was fixed on a rubber pad and covered by a water sack. Testicular parenchyma was imaged as homogeneous and moderately echoic. Caput and cauda epididymis were identified as homogeneous and less echoic compared with the testis parenchyma. Variations in the testicular echotexture that occur secondarily to epididymal ligation and testis biopsy could be screened readily. In conclusion, real-time ultrasonography, performed as described in this study, may provide a valuable tool to screen scrotal contents and to identify certain pathological conditions that affect fertility in the rabbit.

The Input Signal Step Function (ISSF), a standard method to encode input signals in SBML models with software support, applied to circadian clock models.

Time-dependent light input is an important feature of computational models of the circadian clock. However, publicly available models encoded in standard representations such as the Systems Biology Markup Language (SBML) either do not encode this input or use different mechanisms to do so, which hinders reproducibility of published results as well as model reuse. The authors describe here a numerically continuous function suitable for use in SBML for models of circadian rhythms forced by periodic light-dark cycles. The Input Signal Step Function (ISSF) is broadly applicable to encoding experimental manipulations, such as drug treatments, temperature changes, or inducible transgene expression, which may be transient, periodic, or mixed. It is highly configurable and is able to reproduce a wide range of waveforms. The authors have implemented this function in SBML and demonstrated its ability to modify the behavior of publicly available models to accurately reproduce published results. The implementation of ISSF allows standard simulation software to reproduce specialized circadian protocols, such as the phase-response curve. To facilitate the reuse of this function in public models, the authors have developed software to configure its behavior without any specialist knowledge of SBML. A community-standard approach to represent the inputs that entrain circadian clock models could particularly facilitate research in chronobiology.

Analysis of signal propagation in an elastic-tube flow model.

We combine linear and nonlinear signal analysis techniques to investigate the transmission of pressure signals along a one-dimensional model of fluid flow in an elastic tube. We derive a simple, generally applicable measure for the robustness of a simulated vessel against in vivo pressure fluctuations, based on quantifying the degree of synchronization between proximal and distal pressure pulses. The practical use of this measure will be in its application to simulated pulses generated in response to a stochastic forcing term mimicking biological variations of root pressure in arterial blood flow.

Does metoprolol inhibit the cortical spreading depression? Acute effects of systematic metropol on CSD in rats.

Cortical spreading depression (CSD) is supposed to be the underlying biological basis of the migraine aura. Metoprolol was proven to be effective in migraine prophylaxis in clinical trials, but its mechanism of action has not been clarified yet. We studied direct effects of metoprolol on a continuous CSD induction model in rats. Six adult Wistar rats were anaesthetized with intraperitoneal thiopental (50 mg/kg). CSD was induced with application of 1 m KCL through a burr hole into the left frontal dura-mater, and recorded by an Ag/AgCl DC electrode on the left parietal dura-mater. After a basal recording of CSD induction during the first 40-min period, metoprolol (5 mg/kg) was infused within 4 min. Then DC recordings were maintained for a further 120 min. Any significant differences in total number and duration of CSDs before and after metoprolol administration were not detected. This study suggests that the mode of action of metoprolol in prophylaxis is not via direct CSD inhibition.

Nonlinear time series analysis of jerk congenital nystagmus.

Nonlinear dynamics provides a complementary framework to control theory for the quantitative analysis of the oculomotor control system. This paper presents a number of findings relating to the aetiology and mechanics of the pathological ocular oscillation jerk congenital nystagmus (jerk CN). A range of time series analysis techniques were applied to recorded jerk CN waveforms, and also to simulated jerk waveforms produced by an established model in which the oscillations are a consequence of an unstable neural integrator. The results of the analysis were then interpreted within the framework of a generalised model of the unforced oculomotor system.This work suggests that for jerk oscillations, the origin of the instability lies in one of the five oculomotor subsystems, rather than in the final common pathway (the neural integrator and muscle plant). Additionally, experimental estimates of the linearised foveation dynamics imply that a refixating fast phase induced by a near-homoclinic trajectory will result in periodic oscillations. Local dimension calculations show that the dimension of the experimental jerk CN data increases during the fast phase, indicating that the oscillations are not periodic, and hence that the refixation mechanism is of greater complexity than a homoclinic reinjection. The dimension increase is hypothesised to result either from a signal-dependent noise process in the saccadic system, or the activation of additional oculomotor components at the beginning of the fast phase. The modification of a recent saccadic system model to incorporate biologically realistic signal-dependent noise is suggested, in order to test the first of these hypotheses.

Eye movement instabilities and nystagmus can be predicted by a nonlinear dynamics model of the saccadic system.

The study of eye movements and oculomotor disorders has, for four decades, greatly benefitted from the application of control theoretic concepts. This paper is an example of a complementary approach based on the theory of nonlinear dynamical systems. Recently, a nonlinear dynamics model of the saccadic system was developed, comprising a symmetric piecewise-smooth system of six first-order autonomous ordinary differential equations. A preliminary numerical investigation of the model revealed that in addition to generating normal saccades, it could also simulate inaccurate saccades, and the oscillatory instability known as congenital nystagmus (CN). By varying the parameters of the model, several types of CN oscillations were produced, including jerk, bidirectional jerk and pendular nystagmus. The aim of this study was to investigate the bifurcations and attractors of the model, in order to obtain a classification of the simulated oculomotor behaviours. The application of standard stability analysis techniques, together with numerical work, revealed that the equations have a rich bifurcation structure. In addition to Hopf, homoclinic and saddlenode bifurcations organised by a Takens-Bogdanov point, the equations can undergo nonsmooth pitchfork bifurcations and nonsmooth gluing bifurcations. Evidence was also found for the existence of Hopf-initiated canards. The simulated jerk CN waveforms were found to correspond to a pair of post-canard symmetry-related limit cycles, which exist in regions of parameter space where the equations are a slow-fast system. The slow and fast phases of the simulated oscillations were attributed to the geometry of the corresponding slow manifold. The simulated bidirectional jerk and pendular waveforms were attributed to a symmetry invariant limit cycle produced by the gluing of the asymmetric cycles. In contrast to control models of the oculomotor system, the bifurcation analysis places clear restrictions on which kinds of behaviour are likely to be associated with each other in parameter space, enabling predictions to be made regarding the possible changes in the oscillation type that may be observed upon changing the model parameters. The analysis suggests that CN is one of a range of oculomotor disorders associated with a pathological saccadic braking signal, and that jerk and pendular nystagmus are the most probable oscillatory instabilities. Additionally, the transition from jerk CN to bidirectional jerk and pendular nystagmus observed experimentally when the gaze angle or attention level is changed is attributed to a gluing bifurcation. This suggests the possibility of manipulating the waveforms of subjects with jerk CN experimentally to produce waveforms with an extended foveation period, thereby improving visual resolution.

Interaction of extracellular matrix and activin-A in the initiation of follicle growth in the mouse ovary.

The precise mechanism for the initiation of follicle growth and progression through the earliest stages of follicle development remains largely unknown. Activins play a role during early follicle development, and evidence suggests that the extracellular matrix plays a role during later stages of follicular growth. We investigated the role of activin-A and extracellular matrix in follicle growth initiation and early follicular development in the mouse ovary. Ovaries were collected from 5-day-old mice and cultured for 10 days on polylysine, collagen, or laminin in the presence or absence of recombinant human activin-A. Follicle density, indices of follicle growth initiation (primary:primordial follicle [PY:PD] and primary:total follicle [PY:TF] ratios), ratios of multilayer follicle:total follicle (ML:TF), and follicle growth rates were compared between groups. Follicle densities were significantly higher in the extracellular matrix treatment group compared with the polylysine group (P < 0.01). Also, compared with polylysine, both collagen and laminin significantly increased indices of follicle growth initiation (PY:PD ratio: P < 0.001, odds ratio of 3.3; PY:TF ratio: P < 0.001, odds ratio of 2.5), and these were not altered by activin treatment. In the absence of activin-A, exposure to neither collagen nor laminin had an effect on multilayer follicle development. When activin-A was added, collagen and laminin had opposing effects on multilayer follicle development. Activin-A stimulated multilayer follicle development in the presence of laminin (ML:TF ratio: P = 0.01, odds ratio of 10.8), whereas it suppressed follicle growth in collagen (P = 0.01). Activin-A did not affect the ML:TF ratio in the polylysine-treated groups. These results strongly suggest that extracellular matrix components and activin-A interact with each other, and that they regulate follicle growth initiation and multilayer follicle development.

Detection of BCR/ABL gene rearrangement and the elimination of rearranged clone in chronic myelocytic leukemia patients.

Cytogenetic and molecular studies were performed on 20 interferon-alpha receiving Turkish chronic myelocytic leukemia patients. Four different restriction endonucleases and bcr-G probe were used for southern blot analysis to detect rearrangements of the bcr gene. The RT-PCR method was also applied to detect chimeric bcr/abl mRNA. Seventeen patients showed a chromosomal break within the 5.8 kb M-bcr region by southern blot analysis while three cases out of 20 have not shown any rearrangement. These three cases were further analysed by RT-PCR and they were also found to be carrying the Philadelphia translocation (Ph). However, in four years of follow-up this RT-PCR positivity has disappeared, which suggests an elimination of Ph clone with prolonged interferon-alpha treatment.