Kooperativer Bibliotheksverbund

Berlin Brandenburg

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  • 1
    In: Nursing Education Perspectives, 2015, Vol.36(5), pp.304-310
    Description: AIM: The aim of this research was to replicate findings of enhanced clinical reasoning scores using a structured debriefing: Debriefing for Meaningful Learning© (DML). BACKGROUND: The direct effect of debriefing on clinical reasoning is not well studied. The nursing education literature supports debriefing as a reflective dialogue necessary to enhance clinical reasoning. METHOD: A quasi-experimental, pretest-posttest, repeated measure research design was used to evaluate nursing students’ clinical reasoning using the Health Sciences Reasoning Test (HSRT). RESULTS: The change in HSRT mean scores was determined to be significant for the intervention group at the .05 level and insignificant for the control group. The change in HSRT mean scores between the intervention and control groups was determined to be significant at the .10 level. CONCLUSION: Nursing students who had the DML debriefing scored significantly higher in their clinical reasoning than nursing students who had usual and customary debriefing.
    Keywords: Student Nurses ; Decision Making Process ; Education : Assessment ; Reflective Practice ; Decision Making ; Educational Evaluation ; Nursing Education ; Students ; Nursing Education;
    ISSN: 1536-5026
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  • 2
    Language: English
    In: Clinical Therapeutics, 2010, Vol.32(9), pp.1642-1650
    Description: The current American College of Cardiology/American Heart Association (ACC/AHA) clinical guidelines for heart failure (HF), published September 20, 2005, provide a summary of the best evidence for treatment, but these recommendations are not always reflected in clinical practice. The aims of this study were to compare 6-month prescribing habits in the United States before and after the publication of updated clinical guidelines for the evaluation and management of HF and the impact of these prescribing habits on health care resource use. This retrospective, observational cohort analysis used the Humana nationwide health insurance administrative claims database that includes −3.5 million covered members from all 50 states and Puerto Rico who are enrolled in a health maintenance organization, a preferred provider organization, or a Medicare plan. The data included demographics (age, sex, type of insurance, and geographic location), medical information with up to 9 diagnostic codes per encounter, codes for procedures and medical equipment, laboratory tests, and pharmacy-dispensed medications. HF medication prescriptions and health care utilization were evaluated for 2 cohorts: those identified from claims before guideline publication (January 1, 2005–June 30, 2005) and those identified from claims after publication (October 1, 2006–March 31, 2007). Patients were eligible if they were aged ≥45 years, had 12 months of continuous enrollment (6 months before and 6 months after the , defined as the date of diagnosis or hospitalization for HF), and had ≥1 claim for HF. The primary outcome was the proportion of patients who received prescriptions for HF medications individually or in combination. Secondary outcomes were adherence to medication, all-cause and HF-specific hospitalizations, and emergency department and outpatient physician visits. The mean (SD) age in the before-publication cohort (n = 29,784) was 75 (11) years; in the after-publication cohort (n = 33,598), it was 74 (11) years ( 〈 0.001). Half of all patients in each cohort were female (50% [n = 14,796 and n = 16,803, respectively]); 9% (n = 2539) of the before-publication cohort and 7% (n = 2283) of the after-publication cohort were classified as having moderate to severe HF based on the baseline number of hospitalizations ( 〈 0.001). Fewer patients in the before-publication cohort received angiotensin-converting enzyme inhibitors (43% [12,811/29,784] vs 44% [14,776/33,598]; = 0.01), β-blockers (37% [10,901/29,784] vs 41% [13,639/33,598]; 〈 0.01), angiotensin receptor blockers (10% [3008/29,784] vs 13% [4378/33,598]; 〈 0.01), or hydralazine (3% [865/29,784] vs 4% [1378/33,598]; 〈 0.01). Among those with moderate to severe HF, there were no significant differences between groups in the use of combination therapy (ie, β-blockers with any combination of isosorbide dinitrate, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or hydralazine; all combinations, = NS between cohorts), except for less use of a β-blocker with either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker among the before-publication cohort (23% [595/2539] vs38% [875/2283]; = 0.005). Therewere significantly fewer all-cause and HF-related outpatient visits, all-cause and HF-related hospitalizations, and all-cause and HF-related emergency department visits in the after-publication cohort (all, 〈 0.001); however, the absolute differences in the proportions of patients in each cohort who required such services were relatively small. Based on this analysis of real-world prescribing patterns, only small differences in prescribing practices were found before and after the 2005 publication of the ACC/AHA guidelines for HF treatment. Health care utilization was slightly, but significantly, reduced after publication of the guidelines.
    Keywords: Heart Failure ; Pharmacology ; Morbidity ; Guidelines ; Medicine ; Pharmacy, Therapeutics, & Pharmacology
    ISSN: 0149-2918
    E-ISSN: 1879-114X
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  • 3
    Language: English
    In: Neonatal network : NN, 2008, Vol.27(5), pp.319-27
    Description: Although there is general agreement that noise in the neonatal intensive care unit should be reduced, there is controversy about the use of music as a developmental care strategy with prererm infants. Much literature supports using music with preterm infants, indicating that it enhances physiologic and neurobehavioral functioning, but some experts worry that music is overstimulating. This article presents evidence supporting the use of music with preterm infants as well as criticism of same. Recommendations for music interventions with preterm infants are discussed, although fUrther research is needed before specific guidelines can he established.
    Keywords: Infant, Premature ; Music Therapy
    ISSN: 0730-0832
    E-ISSN: 15392880
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  • 4
    Language: English
    In: Journal of Staff Development, Annual, 2009
    Description: This article describes how an effort to help two schools achieve high levels of teacher implementation of the Sheltered Instruction Observation Protocol (SIOP) resulted in a deeper understanding of the true learning value of a sustained and committed partnership among university faculty, district personnel, and school-based educators. The partnership began when, as faculty members at East Carolina University in Greenville, North Carolina, the authors facilitated a three-day summer workshop and developed a plan for ongoing follow-up with the schools. This effort yielded high levels of implementation of the model, improved teacher attitudes, and most importantly, developed higher levels of professionalism and leadership within the schools. Partnerships such as these create valuable relationships where university faculty are welcomed into schools, teachers and administrators benefit from research-proven methods, and all stakeholders learn. The goal of this partnership was to implement the SIOP model in rural North Carolina elementary schools. The SIOP model gives teachers the necessary skills to teach content while simultaneously focusing on academic language development. Primarily designed for use with English language learners (ELLs), the model is being implemented widely in schools with high ELL populations, where all students benefit from an approach that focuses on both language and content knowledge. The two schools in the study have a 40% ELL population, which makes them perfect for implementing the SIOP model. The positive relationship that developed between the school district and university has replaced former skeptics with true partners for the benefit of all stakeholders.
    Keywords: English (Second language) -- Study And Teaching ; Universities And Colleges -- Study And Teaching ; School Districts -- Study And Teaching
    ISSN: 0276-928X
    Source: Cengage Learning, Inc.
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  • 5
    In: Nature, 2010, Vol.469(7328), p.107
    Description: The fidelity and specificity of information flow within a cell is controlled by scaffolding proteins that assemble and link enzymes into signalling circuits (1,2). These circuits can be inhibited by bacterial effector proteins that post-translationally modify individual pathway components (3-6). However, there is emerging evidence that pathogens directly organize higher-order signalling networks through enzyme scaffolding (7,8), and the identity of the effectors and their mechanisms of action are poorly understood. Here we identify the enterohaemorrhagic Escherichia coli O157:H7 type III effector EspG as a regulator of endomembrane trafficking using a functional screen, and report ADP-ribosylation factor (ARF) GTPases and p21-activated kinases (PAKs) as its relevant host substrates. The 2.5 A crystal structure of EspG in complex with ARF6 shows how EspG blocks GTPase-activating-protein-assisted GTP hydrolysis, revealing a potent mechanism of GTPase signalling inhibition at organelle membranes. In addition, the 2.8 [Angstrom] crystal structure of EspG in complex with the autoinhibitory I[alpha]3-helix of PAK2 defines a previously unknown catalytic site in EspG and provides an allosteric mechanism of kinase activation by a bacterial effector. Unexpectedly, ARF and PAKs are organized on adjacent surfaces of EspG, indicating its role as a 'catalytic scaffold' that effectively reprograms cellular events through the functional assembly of GTPase-kinase signalling complex.
    Keywords: Gtpases -- Physiological Aspects ; Cellular Signal Transduction -- Research ; Dna Binding Proteins -- Physiological Aspects ; Dna Binding Proteins -- Health Aspects ; Bacterial Proteins -- Properties;
    ISSN: 0028-0836
    E-ISSN: 14764687
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  • 6
    In: New Blackfriars, February 2002, Vol.83(972), pp.86-93
    Keywords: Religion -- Theology -- Systematic theology ; Biological sciences -- Biology -- Physiology ; Social sciences -- Communications -- Narratives ; Health sciences -- Medical conditions -- Diseases ; Behavioral sciences -- Psychology -- Cognitive psychology ; Philosophy -- Epistemology -- Subjectivity ; Philosophy -- Metaphysics -- Philosophy of mind ; Law -- Criminal law -- Criminal offenses ; Philosophy -- Metaphysics -- Philosophy of mind ; Behavioral sciences -- Human behavior -- Violence;
    ISSN: 0028-4289
    E-ISSN: 1741-2005
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  • 7
    Language: English
    In: Proceedings of the National Academy of Sciences of the United States of America, 12 April 2011, Vol.108(15), pp.6211-6
    Description: Invariant natural killer T cells (iNKT cells) are innate-like T cells important in immune regulation, antimicrobial protection, and anti-tumor responses. They express semi-invariant T cell receptors, which recognize glycolipid antigens. Their positive selection is mediated by double-positive (DP) thymocytes, which present glycolipid self-antigens through the noncanonical MHC class I-like molecule CD1d. Here we provide genetic and biochemical evidence that removal of the transcription factor Bcl11b in DP thymocytes leads to an early block in iNKT cell development, caused by both iNKT cell extrinsic and intrinsic defects. Specifically, Bcl11b-deficient DP thymocytes failed to support Bcl11b-sufficient iNKT precursor development due to defective glycolipid self-antigen presentation, and showed enlarged lysosomes and accumulation of glycosphingolipids. Expression of genes encoding lysosomal proteins with roles in sphingolipid metabolism and glycolipid presentation was found to be altered in Bcl11b-deficient DP thymocytes. These include cathepsins and Niemann-Pick disease type A, B, and C genes. Thus, Bcl11b plays a central role in presentation of glycolipid self-antigens by DP thymocytes, and regulates directly or indirectly expression of lysosomal genes, exerting a critical extrinsic role in development of iNKT lineage, in addition to the intrinsic role in iNKT precursors. These studies demonstrate a unique and previously undescribed role of Bcl11b in DP thymocytes, in addition to the critical function in positive selection of conventional CD4 and CD8 single-positive thymocytes.
    Keywords: Antigen Presentation -- Genetics ; Autoantigens -- Immunology ; Glycolipids -- Immunology ; Natural Killer T-Cells -- Immunology ; Repressor Proteins -- Metabolism ; T-Lymphocytes -- Immunology ; Tumor Suppressor Proteins -- Metabolism
    ISSN: 00278424
    E-ISSN: 1091-6490
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  • 8
    In: New Blackfriars, May 1997, Vol.78(915), pp.218-229
    Keywords: Religion;
    ISSN: 0028-4289
    E-ISSN: 1741-2005
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  • 9
    Language: English
    In: Feminist Theology, September 1996, Vol.5(13), pp.8-30
    Keywords: Religion ; Women'S Studies
    ISSN: 0966-7350
    E-ISSN: 1745-5189
    Source: Sage Journals (Sage Publications)
    Source: SAGE HSS (Sage Publications)
    Source: SAGE Religion (Sage Publications)
    Source: SAGE Journals (Sage Publications)
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  • 10
    In: Journal of Nursing Education and Practice, 08/22/2014, Vol.4(11)
    Keywords: Nursing;
    ISSN: 1925-4040
    E-ISSN: 1925-4059
    Source: CrossRef
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