Effects of two intervention strategies on the behavior of nurses and nurse students related to advance directives

Advance directives are one mechanism for preserving the rights of individuals to exercise some control over their health care when serious illness may prevent them from direct participation. Nurses, as the health care providers with the closest and most sustained contact with critically ill and dying patients, are positioned to assist patients to plan for future health care needs. Although a majority of nurses favor the concept of advance directives for their patients and for themselves, they have not played a significant role in facilitating advance health care planning with their patients nor implemented advance health care planning for themselves.^ Research has also shown that differing forms of education and counseling increase the completion rates for advance directives in selected populations, mostly the elderly and seriously ill. Not yet developed are effective educational strategies to assist nurses and nurse students to make optimal contributions in assisting their clients' plans for future health care decision-making. This study sought to determine whether specific learning strategies (a) increased the involvement of nurses and nurse students in facilitating advance care planning with patients and (b) increased the percentage of the nurses' and nurse students' own personal advance care planning activities.^ The study compared two learning interventions and two populations, nurses and nurse students. The participants were randomly assigned to one of the two learning interventions, L1 or L2. Participants in L1 received a lecture, discussion and exploration of the forces impacting on advance directive behavior. Participants in L2 received the same intervention components with the additional component of group practice completing advance directives.^ Analysis of the data by chi-square and logistic regression did not support the hypotheses that the practice component would make a difference in the participants' facilitation of advance care planning with patients or in their own personal advance care planning activities. There were significant differences in post-intervention behavior between the nurse and nurse student groups. The nurses in the study did significantly more facilitation of advance care planning with patients and completed significantly more advance care documents than the nurse students post-intervention. However, the nurse students held more post-intervention family discussions than did the nurses. ^

The use of treatment theories and procedures for postural control in adult with hemiplegia: A national survey

This study investigated the use of treatment theories and procedures for postural control training used by Occupational Therapists (OTs) when working with hemiplegic adults who have had cerebrovascular accident (CVA) or traumatic brain injury (TBI). The method of data collection was a national survey of 400 randomly selected physical disability OTs with 127 usable surveys returned. Results showed that the most common used treatment theory was neurodevelopmental treatment (NDT), followed by motor relearning program (MRP), proprioceptive neuromuscular facilitation (PNF), Brunnstrom's approach, and the approach of Rood. The most common treatment posture used was sitting, followed by standing, mat activity, equilibrium reaction training, and walking. The factors affecting the use of various treatment theories procedures were years certified, years of clinical experience, work situation and work status. Pearson correlation coefficient analyses found significant positive relationships between treatment theories and postures. There were significant high correlations between usage of all pairs of treatment procedures. ^

Teams leading teams: Examining the role of leadership in multi-team systems

A major challenge of modern teams lies in the coordination of the efforts not just of individuals within a team, but also of teams whose efforts are ultimately entwined with those of other teams. Despite this fact, much of the research on work teams fails to consider the external dependencies that exist in organizational teams and instead focuses on internal or within team processes. Multi-Team Systems Theory is used as a theoretical framework for understanding teams-of-teams organizational forms (Multi-Team Systems; MTS's); and leadership teams are proposed as one remedy that enable MTS members to dedicate needed resources to intra-team activities while ensuring effective synchronization of between-team activities. Two functions of leader teams were identified: strategy development and coordination facilitation; and a model was developed delineating the effects of the two leader roles on multi-team cognitions, processes, and performance.^ Three hundred eighty-four undergraduate psychology and business students participated in a laboratory simulation that modeled an MTS; each MTS was comprised of three, two-member teams each performing distinct but interdependent components of an F-22 battle simulation task. Two roles of leader teams supported in the literature were manipulated through training in a 2 (strategy training vs. control) x 2 (coordination training vs. control) design. Multivariate analysis of variance (MANOVA) and mediated regression analysis were used to test the study's hypotheses. ^ Results indicate that both training manipulations produced differences in the effectiveness of the intended form of leader behavior. The enhanced leader strategy training resulted in more accurate (but not more similar) MTS mental models, better inter-team coordination, and higher levels of multi-team (but not component team) performance. Moreover, mental model accuracy fully mediated the relationship between leader strategy and inter-team coordination; and inter-team coordination fully mediated the effect of leader strategy on multi-team performance. Leader coordination training led to better inter-team coordination, but not to higher levels of either team or multi-team performance. Mediated Input-Process-Output (I-P-O) relationships were not supported with leader coordination; rather, leader coordination facilitation and inter-team coordination uniquely contributed to component team and multi-team level performance. The implications of these findings and future research directions are also discussed. ^

Community college adjunct policies and practices: Incumbents' perspectives and congruence with learning organization tenets

The primary research question was: What is the nature and degree of alignment between the tenets of learning organizations and the policies and practices of a community college concerning adjunct instructors? I investigated the employment experiences of 8 adjunct instructors at a large community college in the Southeastern U.S. to (a) describe and explain the perspectives of the adjuncts, (b) describe and explain my own adjunct employment experience at the same college, (c) determine how the adjunct policies and practices collectively encountered were congruent with or at variance with the tenets of learning organizations, and (d) to use this framework to support recommendations that may help the college achieve more favorable alignment with these tenets. ^ Data on perceived adjunct policies and practices were reduced into 11 categories and, using matrices, were compared with 5 major categories of learning organization tenets. The 5 categories of tenets were: (a) inputs, (b) information flow/communication, (c) employee inclusion/value, (d) teamwork, and (e) facilitation of change. The 11 categories of the college's policies and practices were (a) becoming an adjunct, (b) full-time employment aspirations, (c) salary, (d) benefits, (e) job security and predictability, (f) job satisfaction, (g) respect, (h) support services, (i) professional development, (j) institutional inclusion, and (k) future role of adjuncts. The reflective journal component relied on a 5-year (1995–2000) personal and professional journal maintained by me during employment with the same college as the participants. ^ Findings indicate that the college's adjunct policies and practices were most incongruent with 25 of the 70 learning organization tenets. These incongruencies spanned the 5 categories, although most occurred in the Employee/Inclusion/Value category. Adjunct instructors wanted inclusion, respect, value, trust, and empowerment in decision making processes that affect adjunct policies and practices of the college, but did not perceive this to be a part of the present situation. ^

Tests of the Intersensory Redundancy Hypothesis across early postnatal development

The Intersensory Redundancy Hypothesis (IRH; Bahrick & Lickliter, 2000, 2002, 2012) predicts that early in development information presented to a single sense modality will selectively recruit attention to modality-specific properties of stimulation and facilitate learning of those properties at the expense of amodal properties (unimodal facilitation). Vaillant (2010) demonstrated that bobwhite quail chicks prenatally exposed to a maternal call alone (unimodal stimulation) are able to detect a pitch change, a modality-specific property, in subsequent postnatal testing between the familiarized call and the same call with altered pitch. In contrast, chicks prenatally exposed to a maternal call paired with a temporally synchronous light (redundant audiovisual stimulation) were unable to detect a pitch change. According to the IRH (Bahrick & Lickliter, 2012), as development proceeds and the individual's perceptual abilities increase, the individual should detect modality-specific properties in both nonredundant, unimodal and redundant, bimodal conditions. However, when the perceiver is presented with a difficult task, relative to their level of expertise, unimodal facilitation should become evident. The first experiment of the present study exposed bobwhite quail chicks 24 hr after hatching to unimodal auditory, nonredundant audiovisual, or redundant audiovisual presentations of a maternal call for 10min/hr for 24 hours. All chicks were subsequently tested 24 hr after the completion of the stimulation (72 hr following hatching) between the familiarized maternal call and the same call with altered pitch. Chicks from all experimental groups (unimodal, nonredundant audiovisual, and redundant audiovisual exposure) significantly preferred the familiarized call over the pitch-modified call. The second experiment exposed chicks to the same exposure conditions, but created a more difficult task by narrowing the pitch range between the two maternal calls with which they were tested. Chicks in the unimodal and nonredundant audiovisual conditions demonstrated detection of the pitch change, whereas the redundant audiovisual exposure group did not show detection of the pitch change, providing evidence of unimodal facilitation. These results are consistent with predictions of the IRH and provide further support for the effects of unimodal facilitation and the role of task difficulty across early development.

Tailoring heme -thiolate proteins into efficient biocatalysts with high specificity and selectivity

Cytochrome P450 monooxygenases, one of the most important classes of heme-thiolate proteins, have attracted considerable interest in the biochemical community because of its catalytic versatility, substrate diversity and great number in the superfamily. Although P450s are capable of catalyzing numerous difficult oxidation reactions, the relatively low stability, low turnover rates and the need of electron-donating cofactors have limited their practical biotechnological and pharmaceutical applications as isolated enzymes. The goal of this study is to tailor such heme-thiolate proteins into efficient biocatalysts with high specificity and selectivity by protein engineering and to better understand the structure-function relationship in cytochromes P450. In the effort to engineer P450cam, the prototype member of the P450 superfamily, into an efficient peroxygenase that utilizes hydrogen peroxide via the “peroxide-shunt” pathway, site-directed mutagenesis has been used to elucidate the critical roles of hydrophobic residues in the active site. Various biophysical, biochemical and spectroscopic techniques have been utilized to investigate the wild-type and mutant proteins. Three important P450cam variants were obtained showing distinct structural and functional features. In P450camV247H mutant, which exhibited almost identical spectral properties with the wild-type, it is demonstrated that a single amino acid switch turned the monooxygenase into an efficient preoxidase by increasing the peroxidase activity nearly one thousand folds. In order to tune the distal pocket of P450cam with polar residues, Leu 246 was replaced with a basic residue, lysine, resulting in a mutant with spectral features identical to P420, the inactive species of P450. But this inactive-species-like mutant showed catalytic activities without the facilitation of any cofactors. By substituting Gly 248 with a histidine, a novel Cys-Fe-His ligation set was obtained in P450cam which represented the very rare case of His ligation in heme-thiolate proteins. In addition to serving as a convenient model for hemoprotein structural studies, the G248H mutant also provided evidence about the nature of the axial ligand in cytochrome P420 and other engineered hemoproteins with thiolate ligations. Furthermore, attempts have been made to replace the proximal ligand in sperm whale myoglobin to construct a heme-thiolate protein model by mimicking the protein environment of cytochrome P450cam and chloroperoxidase.

Analysis of global compliance and implementation of the goals of international environmental treaties: A case study of the Convention on Biodiversity (CBD)

The Convention on Biodiversity (CBD) was created in 1992 to coordinate global governments to protect biological resources. The CBD has three goals: protection of biodiversity, achievement of sustainable use of biodiversity and facilitation of equitable sharing of the benefits of biological resources. The goal of protecting biological resources has remained both controversial and difficult to implement. This study focused more on the goal of biodiversity protection. The research was designed to examine how globally constructed environmental policies get adapted by national governments and then passed down to local levels where actual implementation takes place. Effectiveness of such policies depends on the extent of actual implementation at local levels. Therefore, compliance was divided and examined at three levels: global, national and local. The study then developed various criteria to measure compliance at these levels. Both qualitative and quantitative methods were used to analyze compliance and implementation. The study was guided by three questions broadly examining critical factors that most influence the implementation of biodiversity protection policies at the global, national and local levels. Findings show that despite an overall biodiversity deficit of 0.9 hectares per person, global compliance with the CBD goals is currently at 35%. Compliance is lowest at local levels at 14%, it is slightly better at national level at 50%, and much better at the international level 64%. Compliance appears higher at both national and international levels because compliance here is paper work based and policy formulation. If implementation at local levels continues to produce this low compliance, overall conservation outcomes can only get worse than what it is at present. There are numerous weaknesses and capacity challenges countries are yet to address in their plans. In order to increase local level compliance, the study recommends a set of robust policies that build local capacity, incentivize local resource owners, and implement biodiversity protection programs that are akin to local needs and aspirations.^

Tailoring Heme-Thiolate Proteins into Efficient Biocatalysts with High Specificity and Selectivity

Cytochrome P450 monooxygenases, one of the most important classes of heme-thiolate proteins, have attracted considerable interest in the biochemical community because of its catalytic versatility, substrate diversity and great number in the superfamily. Although P450s are capable of catalyzing numerous difficult oxidation reactions, the relatively low stability, low turnover rates and the need of electron-donating cofactors have limited their practical biotechnological and pharmaceutical applications as isolated enzymes. The goal of this study is to tailor such heme-thiolate proteins into efficient biocatalysts with high specificity and selectivity by protein engineering and to better understand the structure-function relationship in cytochromes P450. In the effort to engineer P450cam, the prototype member of the P450 superfamily, into an efficient peroxygenase that utilizes hydrogen peroxide via the “peroxide-shunt” pathway, site-directed mutagenesis has been used to elucidate the critical roles of hydrophobic residues in the active site. Various biophysical, biochemical and spectroscopic techniques have been utilized to investigate the wild-type and mutant proteins. Three important P450cam variants were obtained showing distinct structural and functional features. In P450camV247H mutant, which exhibited almost identical spectral properties with the wild-type, it is demonstrated that a single amino acid switch turned the monooxygenase into an efficient preoxidase by increasing the peroxidase activity nearly one thousand folds. In order to tune the distal pocket of P450cam with polar residues, Leu 246 was replaced with a basic residue, lysine, resulting in a mutant with spectral features identical to P420, the inactive species of P450. But this inactive-species-like mutant showed catalytic activities without the facilitation of any cofactors. By substituting Gly 248 with a histidine, a novel Cys-Fe-His ligation set was obtained in P450cam which represented the very rare case of His ligation in heme-thiolate proteins. In addition to serving as a convenient model for hemoprotein structural studies, the G248H mutant also provided evidence about the nature of the axial ligand in cytochrome P420 and other engineered hemoproteins with thiolate ligations. Furthermore, attempts have been made to replace the proximal ligand in sperm whale myoglobin to construct a heme-thiolate protein model by mimicking the protein environment of cytochrome P450cam and chloroperoxidase.

Decisões comportamentais em contexto de forrageamento de dinoponera quadriceps

The behavioral decisions of animals do not occur randomly, because behaviors are adjusted to ensure the survival and reproduction of the animal. In this research, I examined behavioral decisions in the foraging context of the ant Dinoponera quadriceps with regard to orientation, food avaliation and foraging dynamic to individual level. The study was conducted at the Laboratory of Behavioral Biology at UFRN and in an area of secondary Atlantic Forest in FLONA-ICMBio Nísia Floresta/RN. In all observations and experiments, ants were marked individually with an alphanumeric code label fixed on the thorax. In the first part of the study, I analyzed the orientation cues used by D. quadriceps. The tests were performed in a maze of 17 compartments. Each forager was tested for 10 min in three sessions for six different treatments. The treatments consisted of the presence or absence of odor and superior or frontal visual cues. The workers demonstrated that the presence of odor is indispensable and front visual cues are more effective than superior visual cues. In the second part, I investigated the discrimination of food, considering the parameters, size, weight and volume. In a 'cafeteria' experiment, I offered cylindrical pieces of food (mortadella) in a Petri dish, within an experimental arena 1m². Initially, the pieces were of four different sizes; in a second step, the pieces were of the same size but with different weight; in the last step, the pieces had the same weight but different volumes. The results showed the effect of the size and weight parameters for food choice. In the third part of the study, I evaluated the influence of the activity of active foragers on inactive ones. In this part, the colonies were observed in a natural environment. The observations took place on three consecutive days in 10 episodes, total of 30 days for each colony, 12 hours/day. On the first day, I registered the output and input of workers; on the second day, the most active ants on the first day were taken and given back at the end of the observations; on the third day, the observations were similar to the first day. As a result, the workers of D. quadriceps show autostimulation and they do not show social facilitation and the colony compensates the absence of the most active workers. Based on the stated, I conclude that workers of D. quadriceps use chemical, frontal and superior visual orientation cues during their displacements. They discriminate the chosen food by size and weight. The regulation of activity dynamics of foragers is by autostimulation, an active worker does not influence the activity of an inactive worker, the successful search previous is the stimulus to the successful worker itself to continue foraging activity.

Semantikos: proposta de interfaces para aplicativo mediador de técnica de diferencial semântico em mobile tablet

This research aims to systematize a proposal of developing a mobile tablet application in order to help implementing the Semantic Differential technique – SD, under the approach of Participatory Design. In 1975, Osgood et al. created the Semantic Differential technique. Since then, many experiments use it to measure the affective perception of individuals concerning objects and concepts by means of compounded scales of bipolar adjectives, based on the theoretical models that support the technique: the conductible, spatial and metric models. During the application of the technique with potential users, the researcher must simultaneously manage several contexts, that is, audio recorder, when authorized, and observe and record spontaneous reports of the respondent. It is noticeable that often occurs a cognitive overload during this event. Thus, the use of a single application whose interface is assigned to its users and respondents could assist researchers in applying the SD technique. This research aimed to understand the processes inherent to the task of implementing the Semantic Differential technique and obeyed the following steps: a) training of users, b) background questionnaire c) interview with Focus Group, and d) cooperative evaluation. Besides these procedures, one can also observe the degrees of facilitation or difficulty concerning the use of the conventional model, which is the development and application of scales with the aid of printed material, pencil, pens, clipboards, and recorder software for editing the document and data analysis. This paper comprises reactions and impressions from the experiences of users of SD technique. Considering the data recollected from the user’s observation, the hypothesis of the experiment proved to be right. It means that the development of the application for mobile tablet employing the technique of Semantic Differential is viable, since it assembles all the steps in one only tool, increases the accomplishment of the task between user/researcher and user/respondent resulting in their mutual satisfaction.

Plant diversity influencing structure and functioning of Caatinga vegetation

O estudo dos efeitos que a diversidade de espécies pode causar nos processos ecossistêmicos tem crescido vertiginosamente nas últimas duas décadas. Diversos trabalhos experimentais realizados no mundo todo têm demonstrado que uma maior diversidade de plantas contribui para o aumento da produtividade de ecossistemas terrestres. Além disso, esse efeito pode influenciar processos em diversos níveis tróficos, contribuindo assim para a estabilidade dos processos ecossistêmicos a longo prazo. Paralelamente com os estudos do efeito da diversidade, muita atenção tem sido dada para desvendar o papel das características funcionais das espécies no funcionamento dos ecossistemas. Isto porque as características funcionais das espécies têm se mostrado importantes "peças" no entendimento dos efeitos que espécies individuais podem exercer nos ecossistemas e suas respostas ao ambiente. Nesta tese de doutorado eu explorei algumas lacunas de conhecimento dentro dessa área em crescente desenvolvimento conhecida na literatura ecológica como "biodiversidade e funcionamento dos ecossistemas". No primeiro capítulo, eu busquei evidências para mecanismos que podem explicar a relação positiva entre diversidade e funcionamento com foco em cinco mecanismos relacionados às interações entre plantas, tendo como parâmetro de funcionamento a produtividade primária. No segundo capítulo, eu utilizei técnicas para a estimativa de padrões de diversidade em escalas biogeográficas e bases de dados de satélites com longa duração para desvendar se a biodiversidade em escalas macroecológicas promove a estabilidade da produtividade dos ambientes terrestres no semiárido brasileiro. Por fim, o objetivo do terceiro capítulo foi entender como a perda da cobertura vegetal originária do uso da terra por comunidades tradicionais no semiárido brasileiro influenciaria os processos de interações entre plantas e o papel das características funcionais das espécies nessas interações. Acredito que a contribuição individual de cada capítulo preenche lacunas de conhecimento importantes dessa área da Ecologia que ainda se encontra em expansão.

Relational restorative justice pedagogy in educator professional development

What would a professional development experience rooted in the philosophy, principles, and practices of restorative justice look and feel like? This article describes how such a professional development project was designed to implement restorative justice principles and practices into schools in a proactive, relational and sustainable manner by using a comprehensive dialogic, democratic peacebuilding pedagogy. The initiative embodied a broad, transformative approach to restorative justice, grounded in participating educators’ identifying, articulating and applying personal core values. This professional development focused on diverse educators, their relationships, and conceptual understandings, rather than on narrow techniques for enhancing student understanding or changing student behaviour. Its core practice involved facilitated critical reflexive dialogue in a circle, organized around recognizing the impact of participants’ interactions on others, using three central, recurring questions: Am I honouring? Am I measuring? What message am I sending? Situated in the context of relational theory (Llewellyn, 2012), this restorative professional development approach addresses some of the challenges in implementing and sustaining transformative citizenship and peacebuilding pedagogies in schools. A pedagogical portrait of the rationale, design, and facilitation experience illustrates the theories, practices, and insights of the initiative, called Relationships First: Implementing Restorative Justice From the Ground Up.

Sexualidade e saúde mental: construindo sentidos entre pessoas usuárias de um CAPS

When expressed by mental health services users, sexuality is typically denied by professionals, viewed as another symptom or as if these people are not capable of practicing it. Once Brazilian health professionals haven’t shown lots of investment in this theme, and few are the studies in this field, it is necessary the attention to be focused on researches involving this public. Therefore, the main goal of this study was understand the meanings of sexuality of the mental health services users, which were negotiated in sexuality workshops. The secondary goals were: a) understand the meanings of themes about sexuality brought by users through their experiences of everyday life; b) to evaluate the facilitating experience of the workshops on sexuality at CAPS. Thus, 10 workshops on sexuality were held, with an average of an hour and twenty minutes each, distributed from December 2014 and April 2015. There were 43 participants, 29 women and 14 men. The meetings had the following central themes: sexuality; sexuality and mental health; myths, beliefs and sexual taboos; gender identity; sexual orientation; sexual and reproductive rights; safe sex; and STD/AIDS. The data collection was through audio-recording of these meetings. Later, was made the transcript of the workshops, a careful reading of these transcripts and then its analysis. It was identified categories to analyze the interfaces that permeate the focus of the study. Initially, the categories relating to mental health and sexuality: meanings about sexuality; gender issues; gender and religion; sexual rights, STD/AIDS prevention and attention or denial of sexuality at CAPS. Later, those relating to the workshops facilitating process: challenges in facilitating the workshops; and the perception of the participants. A variety of meanings about sexuality could be noticed in the users’ statements, relating it more with affection and respect than with intercourse. The gender issues that emerged during the workshops were related to marital relationship, sexism, domestic violence, psychological violence and male and female roles in society. Moreover, were also revealed some situations that associated gender differences with religious issues, such as the submission of women and homosexuality. It was also noticed some experiences of the participants involving worrying situations of family violence, suicidal ideation and chemical castration, were often mismanaged or ignored by the service professionals. With regard to the facilitation of the workshops, it was possible to legitimize it as places where users were able to talk openly about the suggested themes and highlight its importance to the study site. Besides, it’s possible to list a few challenges of its facilitation in a mental health service, which was in general positively evaluated by the participants. Thus, the research highlights the need for sexuality theme discussion in mental health services, in order to understand, discuss and inform the users. Also, it’s important to problematize the stigma created in the theme relation with the users, the professionals and the society, working its specificities and avoiding a pathological bias.

Psychometric functions for detection and discrimination with and without flankers.

Recent studies have reported that flanking stimuli broaden the psychometric function and lower detection thresholds. In the present study, we measured psychometric functions for detection and discrimination with and without flankers to investigate whether these effects occur throughout the contrast continuum. Our results confirm that lower detection thresholds with flankers are accompanied by broader psychometric functions. Psychometric functions for discrimination reveal that discrimination thresholds with and without flankers are similar across standard levels, and that the broadening of psychometric functions with flankers disappears as standard contrast increases, to the point that psychometric functions at high standard levels are virtually identical with or without flankers. Threshold-versus-contrast (TvC) curves with flankers only differ from TvC curves without flankers in occasional shallower dippers and lower branches on the left of the dipper, but they run virtually superimposed at high standard levels. We discuss differences between our results and other results in the literature, and how they are likely attributed to the differential vulnerability of alternative psychophysical procedures to the effects of presentation order. We show that different models of flanker facilitation can fit the data equally well, which stresses that succeeding at fitting a model does not validate it in any sense.

Motivational, volitional and multiple goal predictors of walking in people with type 2 diabetes

Acknowledgment MN's PhD scholarship was provided by Ministry of Health and Medical Education (Islamic Republic of Iran). This study was funded by the University of Aberdeen. FFS is funded by Fuse, the UK Clinical Research Collaboration Centre of Excellence for Translational Research in Public Health. The researchers gratefully acknowledge all the Type 2 diabetic patients and their household members who participated in the study for their contribution to this study; without them there would be no data. The researchers gratefully acknowledge the SDRN for providing the list of Type 2 diabetes and helping for sampling.