The experience of nursing leadership in a crisis: A hermeneutic phenomenological study.

AIM: This study aimed to understand nursing leaders' experience during the pandemic. BACKGROUND: COVID-19 is a public health crisis that affects every nation in the world. METHODS: Purposeful sampling was used to recruit 28 leaders in a large health care system. Data were collected via semi-structured audiotaped interviews. Results were analysed using hermeneutic phenomenology. RESULTS: The structure in which leaders worked was described as: from the day-to-day grind to derailment and from manning the hospital to manning the frontlines. Five phenomenological themes were as follows: embodied leadership, navigating differently, trusting and earning trust, being the calm voice and envisioning the future. CONCLUSION: Disaster policies and procedures are needed that will alleviate leadership angst, maximize nursing resources, heighten trust and enhance communications. IMPLICATIONS FOR NURSING MANAGEMENT: In 2020, we witnessed a previously inconceivable media and public focus on the value of nursing care. Leaders can use this pivotal moment in time as a catalyst towards securing the support needed in planning for the next pandemic.

Alternatives for Conventional Alkane Solvents.

The studies described in this paper show that hydrocarbon oligomers are alternatives for low molecular weight alkane solvents. These oligomeric solvents are nontoxic, nonvolatile, and recyclable alternatives to heptane in thermomorphic solvent mixtures that use a polar solvent such as methanol, aqueous ethanol, or DMF or in biphasic mixtures that use acetonitrile. Regardless of which polar solvent is used, hydrocarbon oligomers like poly(α-olefin)s (PAOs) exhibit very low leaching into the polar phase. UV-visible spectroscopy studies show that these solvents have the solubility properties of heptane. For example, PAOs dissolve heptane soluble dyes and quantitatively separate them from polar phases in thermomorphic solvent mixtures. PAOs either as pure solvents or as additives in heptane act as antileaching agents, decreasing the already low leaching of such dyes into a polar phase in heptane/polar solvent mixtures. These oligomeric hydrocarbon solvents were also compared to heptane in studies of azo dye isomerization. The results show that thermal isomerization of an azo dye occurs at the same rate in heptane and a PAO. Further studies of carboxylic acid promoted dye isomerization in heptane and a PAO show that low molecular weight and oligomeric carboxylic acids are kinetically equivalent at accelerating this isomerization. The results suggest that these and other hydrocarbon oligomers behave as solvents like their low molecular weight nonpolar hydrocarbon solvents and that they can be substituted successfully for conventional solvents like heptane.

Inadvertent Perioperative Hypothermia.

Temperature regulation during the perioperative period plays an essential role in keeping patients safe while optimizing their recovery. The World Health Organization recommends preserving normothermia, identified as a core body temperature greater than 36°C, to minimize morbidity and mortality. The etiology of inadvertent perioperative hypothermia (IPH) varies in origin. Preoperative exposure, decreased ambient operating room (OR) temperature, skin exposure during preparation, unwarmed skin preparation and washout solutions, and lack of warming devices all contribute to IPH. Moreover, general and regional anesthesia blunt the physiologic response to hypothermia which originates in the hypothalamus. Postoperatively, patients with temperatures < 36°C are at greater risk for surgical site infection, increased mortality, longer length of hospital stay, higher 30-day readmission rates, among other complications. Identifying preoperative risk factors and OR practices that contribute to IPH, monitoring temperatures, and use of warming devices during the perioperative period can help to prevent IPH.

Exploring the intersections of college student poverty, grief, and racial/ethnic identity: a scoping review protocol.

BACKGROUND: College students who experience the negative impact of poverty, such as food, financial, and housing insecurity, are at higher risk for poor academic performance. One recent study examined grief in a college student sample and found students with a diverse racial or ethnic background were more likely to experience prolonged grief disorder, however, did not examine poverty in their sample. To date, no known reviews have examined poverty by racial and ethnic identity and the experience of grief due to the death of a family member or friend, and no reviews have examined how these three factors relate to interventions designed to support student academic performance and degree completion. METHODS: Our aim is to map the primary literature reporting on college students of any age who identify or are identified as non-white racial or ethnic groups who experience poverty and grief due to the death of a family member or friend. The mapping strategy includes extracting the various types of interventional support of academic performance and degree completion delivered from campus or community services in any geographic setting worldwide. We will conduct our scoping review with guidance from the latest version of the JBI Manual for Evidence Synthesis. Utilizing the framework as outlined by Arksey and O'Malley, we will conduct our scoping review with Arksey's five stages: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing, and reporting the results. For transparency and reproducibility, we will adhere to the PRISMA reporting guidelines. DISCUSSION: The purpose of this scoping review is to map the primary literature reporting college students, regardless of their age, who belong to non-white racial or ethnic groups and face poverty and grief resulting from the loss of a family member or friend. This analysis includes mapping the various types of intervention and support available both on and off campus, in any global setting, with the aim of enhancing academic performance and facilitating degree completion. The results of this review may inform the further research needed in this area to help prevent poor academic performance and dropout for many vulnerable college students. The results may be of value, particularly to college administrators developing prevention and interventional programs to support college student success. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework ( https://osf.io/enuwt ).

Top Research Priorities in Prehospital Care in Spain.

OBJECTIVE: The objective is to identify research priorities in prehospital care in Spain. METHOD: This was a Delphi-type study of three rounds with a panel of experts made up of members of the Red de Investigación en Emergencias Prehospitalarias (RINVEMER; Prehospital Emergency Research Network) Network and the Sociedad Española de Medicina de Urgencias y Emergencias (SEMES; Spanish Society of Emergency Medicine) Emergency Secretariat. In the first round, each participant identified up to 15 priorities. In the second round, they scored the 30 thematic areas on a Likert scale. In the third round, they ordered and scored from one to ten the first ten priorities among those that obtained a median greater than or equal to four in the second round. After adding the assigned scores, the ten priorities with the highest total score were obtained. RESULTS: The ten identified research priorities were: special clinical codes and time-dependent conditions; mass-casualty incident (MCI) coordination and management; innovation in Emergency Medical Services (EMS); human factor in decision making; triage, analysis, and management of calls in the Emergency Call Center; new technologies, telemedicine, and emergencies; adverse events, clinical safety, and quality in emergencies; cardiac arrest; continuous education and training (methodology, quality, and evaluation); and big data and emergencies. CONCLUSIONS: The research priorities perceived by emergency professionals are related to clinical care and organizational aspects of EMS, in addition to the need to incorporate innovative aspects and new data analysis technologies.

Development and validation of the mirror image comfort and avoidance scale (MICAS).

PURPOSE: The purpose of this study was to develop an instrument to measure the experience of viewing one's reflection in the mirror for use in rehabilitation, nursing, psychology, and in research studies designed to improve the mirror-viewing experience for those who have suffered psychological or bodily trauma. A secondary purpose was to explore demographic differences in each subscale of the instrument. METHODS: The developed items went through content expert validation, exploratory and confirmatory factor analyses, and internal consistency reliability testing. RESULTS: Using an exploratory factor analysis (n = 137) and a confirmatory factor analysis (n = 142), we validated a 17-item instrument for two distinct populations: veterans (n = 108) and individuals with upper and lower limb loss (n = 210). The mirror viewing comfort subscale (9 items; α = 0.90) and the mirror avoidance subscale (8 items, α = 0.94) were deemed reliable. Strong, significant correlations between pre-and post-comfort scores (r = 0.81, p < 0.001), as well as pre-and post-avoidance scores (r = 0.94, p < 0.001) provide evidence of test-retest reliability. Demographic differences were noted in the subscales. CONCLUSIONS: This instrument contributes to a greater understanding of the experience of mirror-viewing in clinical practice. In interventional research studies to improve the mirror-viewing experience, this instrument can act as a manipulation check or outcome measure.Implications for rehabilitationIndividuals who suffer actual or perceived body disfigurement due to surgery or trauma may suffer mirror discomfort or mirror trauma when viewing their bodies in a mirror. This reaction is due to a pre-frontal cortex neurological disruption and autonomic nervous system fright/flight or faint. Psychological disorders (e.g., devastation, shame, self-revulsion, decreased body image) may ensue.Falls have occurred due to mirror trauma due to an autonomic nervous system disturbance (faint) and may result in ongoing mirror avoidance. When mirrors are needed for incision visualization, mirror avoidance has led to severe surgical site infections.Although there were many scales available in the literature to measure several aspects of the effects of actual or perceived body disfigurement, there were no scales that measured the mirror-viewing experience.Clinicians and researchers can use the Mirror Comfort and Avoidance Scale (MICAS) to assess mirror comfort and avoidance.

Educating Nurses on Supported Mirror Viewing for Patients After Amputation and Other Visible Disfigurements.

PURPOSE: The aim of our study was to test an educational intervention to improve nurses' confidence in supporting and frequency of offering a mirror to patients who have recently suffered visible body disfigurement. DESIGN/METHODS: Forty-eight registered nurses who worked in two acute care hospitals took part in a mixed-method one-group repeated-measures (pretest and posttest) research study. The educational intervention included a video, a presentation, and a recorded discussion. RESULTS: Study participants experienced a significant increase in confidence in supporting and frequency of offering mirrors to patients. An overarching theme from the qualitative analysis was that the nurse participants perceived assisting patients in viewing their changed bodies in mirrors as "an act of compassion." Four subthemes emerged: (a) seeing mirrors differently, (b) there is only one first time, (c) how can we do this better, and (d) "me too" stories of their own and patients' difficult mirror-viewing experiences. CONCLUSION: Education enhances nurses' frequency of offering mirrors and supporting patients in mirror viewing after visible disfigurement because of trauma or surgery. CLINICAL RELEVANCE: Education provides nurses with the necessary skills to assist patients in adapting to an altered body image.

A Distinct Brain-Gut-Microbiome Profile Exists for Females with Obesity and Food Addiction.

BACKGROUND: Alterations in brain-gut-microbiome interactions have been implicated as an important factor in obesity. This study aimed to explore the relationship between food addiction (FA) and the brain-gut-microbiome axis, using a multi-omics approach involving microbiome data, metabolomics, and brain imaging. METHODS: Brain magnetic resonance imaging was obtained in 105 females. FA was defined by using the Yale Food Addiction Scale. Fecal samples were collected for sequencing and metabolomics. Statistical analysis was done by using multivariate analyses and machine learning algorithms. RESULTS: Of the females with obesity, 33.3% exhibited FA as compared with 5.3% and 0.0% of females with overweight and normal BMI, respectively (P = 0.0001). Based on a multilevel sparse partial least square discriminant analysis, there was a difference in the gut microbiome of females with FA versus those without. Differential abundance testing showed Bacteroides, Megamonas, Eubacterium, and Akkermansia were statistically associated with FA (q < 0.05). Metabolomics showed that indolepropionic acid was inversely correlated with FA. FA was also correlated with increased connectivity within the brain's reward network, specifically between the intraparietal sulcus, brain stem, and putamen. CONCLUSIONS: This is the first study to examine FA along the brain-gut-microbiome axis and it supports the idea of targeting the brain-gut-microbiome axis for the treatment of FA and obesity.

Collaborative Mentoring for Retaining Secondary Biology Teachers.

Veteran biology teachers are at risk of leaving the classroom due to burnout, feeling uninspired, and overall job dissatisfaction. One way to keep veteran teachers engaged is through continued mentoring. Yet current mentoring programs vary in scope, often focus too heavily on one-to-one talk, with mentors serving as therapists, and generally fail to include veteran teachers. Considering this is not how schools operate, we argue active mentoring for veteran teachers is best when embedded into regular school practice. Collaborative mentoring, as we have termed it, pairs experienced high school teachers with other veteran colleagues, including university professors, in professional development activities centering on improving classroom practices. We believe that collaborative mentoring holds potential to meet the needs of all stakeholders-high school students for support in learning laboratory and writing skills; university faculty for hands-on classroom work and reflective practice, as well as for sharing content and pedagogical knowledge with professionals in the field; and, specifically, veteran biology teachers for expanding access to meaningful professional development opportunities. Focusing on applicable classroom pedagogy serves as a cost-effective model for professional development for veteran teachers, possibly increasing job satisfaction and teacher retention in high schools across the nation.

Venous plasma nicotine correlates of hormonal effects of tobacco smoking.

The present study resolves some of the discrepancies in the literature by correlating the effects of tobacco smoking on hormone release with venous plasma nicotine levels. Cortisol, prolactin, and beta-endorphin concentrations were measured. Habitual male tobacco users smoked denicotinized (very low nicotine) and average nicotine cigarettes in the morning after overnight tobacco abstinence. Several venous blood samples were withdrawn before and during the smoking sessions for subsequent analyses. The increases in plasma nicotine correlated well with plasma cortisol and prolactin levels (correlation coefficients r=0.66 and 0.53, respectively, p<0.05). This study quantifies the well known increase in plasma cortisol and prolactin after nicotine postsmoking for about 1h with peak plasma levels up to 35 ng/ml. Contrary to most abused drugs which release dopamine and decrease prolactin, nicotine concentration correlated with increased prolactin release. Increases in maximal plasma beta-endorphin levels following tobacco smoking were barely statistically significant with insufficient data to obtain a correlation coefficient.