The factors influencing the effective early career and rapid transition to a nursing specialty in differing contexts of practice: a modified Delphi consensus study

(c) The Author/s 2019Objectives: This study aimed to test and further develop the ‘Early Career and Rapid Transition to a Nursing Specialty’ (TRANSPEC) model to a nursing specialty developed from a systematic review. Semi-structured interviews of specialist clinically based nurses and a consensus Delphi study with an expert panel were used to expand and achieve consensus, agreement, reliability and stability of the model. Design: A modified Delphi, two rounds (64 and 52 Likert items) of reiterative online questionnaires and one round as a nominal group technique, was informed by qualitative thematic analysis of semi-structured interviews. Setting and participants: Interviews with 14 specialists clinical practicing registered nurses and a panel of 25 national experts participated in the Delphi study. Results: The interview participants experienced 14 rapid transitions and three were early career transition. The overarching themes from the preliminary model were confirmed and further expanded. These were the self (personal and professional); the transition processes (final and informal); a sense of belonging; and the overarching context of practice over a time continuum. In the Delphi, the highest rating item was ‘Specialty work colleagues respect, include, support, and accept specialist nurse on completion of transition processes’. Pre-entry was highlighted as an important time point prior to transition. All items reaching consensus were included in the final model. Cronbach α increased from 0.725 to 0.875 for the final model. Conclusions: The TRANSPEC model is a valid and reliable evidence-based tool for use in the career pathway and development of nursing specialists. Using the Benner model ‘Novice to Expert’ after the novice incomer phase is achieved, further lifelong learning development will transform the novice specialist over time continuum

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

Biofilms of non-Candida albicans Candida species : quantification, structure and matrix composition

Most cases of candidiasis have been attributed to C. albicans, but recently, non- Candida albicans Candida (NCAC) species have been identified as common pathogens. The ability of Candida species to form biofilms has important clinical repercussions due to their increased resistance to antifungal therapy and the ability of yeast cells within the biofilms to withstand host immune defenses. Given this clinical importance of the biofilm growth form, the aim of this study was to characterize biofilms produced by three NCAC species, namely C. parapsilosis, C. tropicalis and C. glabrata. The biofilm forming ability of clinical isolates of C. parapsilosis, C. tropicalis and C. glabrata recovered from different sources, was evaluated by crystal violet staining. The structure and morphological characteristics of the biofilms were also assessed by scanning electron microscopy and the biofilm matrix composition analyzed for protein and carbohydrate content. All NCAC species were able to form biofilms although these were less extensive for C. glabrata compared with C. parapsilosis and C. tropicalis. It was evident that C. parapsilosis biofilm production was highly strain dependent, a feature not evident with C. glabrata and C. tropicalis. Scanning electron microscopy revealed structural differences for biofilms with respect to cell morphology and spatial arrangement. Candida parapsilosis biofilm matrices had large amounts of carbohydrate with less protein. Conversely, matrices extracted from C. tropicalis biofilms had low amounts of carbohydrate and protein. Interestingly, C. glabrata biofilm matrix was high in both protein and carbohydrate content. The present work demonstrates that biofilm forming ability, structure and matrix composition are highly species dependent with additional strain variability occurring with C. parapsilosis.Fundação para a Ciência e a Tecnologia (FCT) - SFRH/BD/28341/2006, PDTC/BIO/61112/200

A Chandra and XMM View of the Mass & Metals in Galaxy Groups and Clusters

X-ray observations with Chandra and XMM are providing valuable new measurements of the baryonic and dark matter content of groups and clusters. Masses of cD clusters obtained from X-ray and gravitational lensing studies generally show good agreement, therefore providing important validation of both methods. Gas fractions have been obtained for several clusters that verify previous results for a low matter density (Omega_m ~0.3). Chandra has also provided measurements of the mass profiles deep down into several cluster cores and has generally found no significant deviations from CDM predictions in contrast to the flat core density profiles inferred from the rotation curves of low-surface brightness galaxies and dwarf galaxies; i.e., there is no evidence for self-interacting dark matter in cluster cores. Finally, initial studies of the iron and silicon abundances in centrally E-dominated groups show that they have pronounced gradients from 1-2 solar values within the central 30-50 kpc that fall to values of 0.3-0.5 solar at larger radii. The Si/Fe ratios are consistent with approximately 80% of the metals originating from Type Ia supernovae. Several cD clusters also display central Fe enhancements suggestive of Type Ia supernova enrichment, though some have central dips that may provide a vital clue for solving the cooling flow mystery

Mechanisms and treatment of ischaemic stroke: insights from genetic associations

The precise pathophysiology of ischaemic stroke is unclear, and a greater understanding of the different mechanisms that underlie large-artery, cardioembolic and lacunar ischaemic stroke subtypes would enable the development of more-effective, subtype-specific therapies. Genome-wide association studies (GWASs) are identifying novel genetic variants that associate with the risk of stroke. These associations provide insight into the pathophysiological mechanisms, and present opportunities for novel therapeutic approaches. In this Review, we summarize the genetic variants that have been linked to ischaemic stroke in GWASs to date and discuss the implications of these associations for both our understanding and treatment of ischaemic stroke. The majority of genetic variants identified are associated with specific subtypes of ischaemic stroke, implying that these subtypes have distinct genetic architectures and pathophysiological mechanisms. The findings from the GWASs highlight the need to consider whether therapies should be subtype-specific. Further GWASs that include large cohorts are likely to provide further insights, and emerging technologies will complement and build on the GWAS findings

The nucleoporin ALADIN regulates Aurora A localization to ensure robust mitotic spindle formation

The formation of the mitotic spindle is a complex process that requires massive cellular reorganization. Regulation by mitotic kinases controls this entire process. One of these mitotic controllers is Aurora A kinase, which is itself highly regulated. In this study, we show that the nuclear pore protein ALADIN is a novel spatial regulator of Aurora A. Without ALADIN, Aurora A spreads from centrosomes onto spindle microtubules, which affects the distribution of a subset of microtubule regulators and slows spindle assembly and chromosome alignment. ALADIN interacts with inactive Aurora A and is recruited to the spindle pole after Aurora A inhibition. Of interest, mutations in ALADIN cause triple A syndrome. We find that some of the mitotic phenotypes that we observe after ALADIN depletion also occur in cells from triple A syndrome patients, which raises the possibility that mitotic errors may underlie part of the etiology of this syndrome

Candida glabrata : a review of its features and resistance

Candida species belong to the normal microbiota of the oral cavity and gastrointestinal and vaginal tracts, and are responsible for several clinical manifestations, from mucocutaneous overgrowth to bloodstream infections. Once believed to be non-pathogenic, Candida glabrata was rapidly blamable for many human diseases. Year after year, these pathological circumstances are more recurrent and problematic to treat, especially when patients reveal any level of immunosuppression. These difficulties arise from the capacity of C. glabrata to form biofilms and also from its high resistance to traditional antifungal therapies. Thus, this review intends to present an excerpt of the biology, epidemiology, and pathology of C. glabrata, and detail an approach to its resistance mechanisms based on studies carried out up to the present.The authors are grateful to strategic project PTDC/SAU-MIC/119069/2010 for the financial support to the research center and for Celia F. Rodrigues' grant

A new framework for cortico-striatal plasticity: behavioural theory meets In vitro data at the reinforcement-action interface

Operant learning requires that reinforcement signals interact with action representations at a suitable neural interface. Much evidence suggests that this occurs when phasic dopamine, acting as a reinforcement prediction error, gates plasticity at cortico-striatal synapses, and thereby changes the future likelihood of selecting the action(s) coded by striatal neurons. But this hypothesis faces serious challenges. First, cortico-striatal plasticity is inexplicably complex, depending on spike timing, dopamine level, and dopamine receptor type. Second, there is a credit assignment problem—action selection signals occur long before the consequent dopamine reinforcement signal. Third, the two types of striatal output neuron have apparently opposite effects on action selection. Whether these factors rule out the interface hypothesis and how they interact to produce reinforcement learning is unknown. We present a computational framework that addresses these challenges. We first predict the expected activity changes over an operant task for both types of action-coding striatal neuron, and show they co-operate to promote action selection in learning and compete to promote action suppression in extinction. Separately, we derive a complete model of dopamine and spike-timing dependent cortico-striatal plasticity from in vitro data. We then show this model produces the predicted activity changes necessary for learning and extinction in an operant task, a remarkable convergence of a bottom-up data-driven plasticity model with the top-down behavioural requirements of learning theory. Moreover, we show the complex dependencies of cortico-striatal plasticity are not only sufficient but necessary for learning and extinction. Validating the model, we show it can account for behavioural data describing extinction, renewal, and reacquisition, and replicate in vitro experimental data on cortico-striatal plasticity. By bridging the levels between the single synapse and behaviour, our model shows how striatum acts as the action-reinforcement interface

Recent advances in unveiling active sites in molybdenum sulfide-based electrocatalysts for the hydrogen evolution reaction

Hydrogen has received significant attention as a promising future energy carrier due to its high energy density and environmentally friendly nature. In particular, the electrocatalytic generation of hydrogen fuel is highly desirable to replace current fossil fuel-dependent hydrogen production methods. However, to achieve widespread implementation of electrocatalytic hydrogen production technology, the development of highly active and durable electrocatalysts based on Earth-abundant elements is of prime importance. In this context, nanostructured molybdenum sulfides (MoS x ) have received a great deal of attention as promising alternatives to precious metal-based catalysts. In this focus review, we summarize recent efforts towards identification of the active sites in MoS x -based electrocatalysts for the hydrogen evolution reaction (HER). We also discuss recent synthetic strategies for the engineering of catalyst structures to achieve high active site densities. Finally, we suggest ongoing and future research challenges in the design of advanced MoS x -based HER electrocatalysts

Both Positive and Negative Selection Pressures Contribute to the Polymorphism Pattern of the Duplicated Human CYP21A2 Gene.

The human steroid 21-hydroxylase gene (CYP21A2) participates in cortisol and aldosterone biosynthesis, and resides together with its paralogous (duplicated) pseudogene in a multiallelic copy number variation (CNV), called RCCX CNV. Concerted evolution caused by non-allelic gene conversion has been described in great ape CYP21 genes, and the same conversion activity is responsible for a serious genetic disorder of CYP21A2, congenital adrenal hyperplasia (CAH). In the current study, 33 CYP21A2 haplotype variants encoding 6 protein variants were determined from a European population. CYP21A2 was shown to be one of the most diverse human genes (HHe=0.949), but the diversity of intron 2 was greater still. Contrary to previous findings, the evolution of intron 2 did not follow concerted evolution, although the remaining part of the gene did. Fixed sites (different fixed alleles of sites in human CYP21 paralogues) significantly accumulated in intron 2, indicating that the excess of fixed sites was connected to the lack of effective non-allelic conversion and concerted evolution. Furthermore, positive selection was presumably focused on intron 2, and possibly associated with the previous genetic features. However, the positive selection detected by several neutrality tests was discerned along the whole gene. In addition, the clear signature of negative selection was observed in the coding sequence. The maintenance of the CYP21 enzyme function is critical, and could lead to negative selection, whereas the presumed gene regulation altering steroid hormone levels via intron 2 might help fast adaptation, which broadly characterizes the genes of human CNVs responding to the environment