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OALib Journal期刊

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The New RN and Emergency Patient Care Scenarios: How Simulation Can Help  [PDF]
Donna Driscoll
Open Access Library Journal (OALib Journal) , 2018, DOI: 10.4236/oalib.1103904
Abstract:
Failure to rescue a patient that is experiencing deteriorating symptoms is a major cause of mortality in the acute care settings. The nurse is at the fore-front of prevention and recognition of patient distress. Failure to rescue patients that are displaying symptoms of deterioration is becoming a national crisis due to treatment complications and missed signs and symptoms of impending arrest [1]. New nurse graduates must have additional training to assist them in the recognition of the signs of impending crisis. This paper will discuss the need for additional training after nursing school to address this issue and assist the new graduate nurse in their transition to practice. The development of a New Graduate Nurse simulation education program for Littleton Regional Healthcare and their Alliance Hospitals was the primary focus of this project. PICOT: How will the use of simulated emergency scenarios with intermittent audit/feedback impact the knowledge level and clinical reasoning of new nurse graduates in an acute care setting? High Fidelity Simulation patient scenarios of impending crisis were developed for a 4-hour educational workshop. New nurse graduates with under 2.5 years experience attended the training with results showing that high fidelity simulation training scenarios with intermittent audit feedback assisted the new nurses to recognize signs and symptoms of impending crisis, how to develop skills to work as a team member, and gave them more confidence in reporting mistakes and voicing concerns. The literature search completed for this study shows that the new graduate nurse needs to develop clinical reasoning skills and gain experience on how to respond to patients with clinical emergencies and simulation can assist with this knowledge to practice gap [2].
Alternative Transcripts and 3′UTR Elements Govern the Incorporation of Selenocysteine into Selenoprotein S
Jodi L. Bubenik, Angela C. Miniard, Donna M. Driscoll
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0062102
Abstract: Selenoprotein S (SelS) is a 189 amino acid trans-membrane protein that plays an important yet undefined role in the unfolded protein response. It has been proposed that SelS may function as a reductase, with the penultimate selenocysteine (Sec188) residue participating in a selenosulfide bond with cysteine (Cys174). Cotranslational incorporation of Sec into SelS depends on the recoding of the UGA codon, which requires a Selenocysteine Insertion Sequence (SECIS) element in the 3′UTR of the transcript. Here we identify multiple mechanisms that regulate the expression of SelS. The human SelS gene encodes two transcripts (variants 1 and 2), which differ in their 3′UTR sequences due to an alternative splicing event that removes the SECIS element from the variant 1 transcript. Both transcripts are widely expressed in human cell lines, with the SECIS-containing variant 2 mRNA being more abundant. In vitro experiments demonstrate that the variant 1 3′UTR does not allow readthrough of the UGA/Sec codon. Thus, this transcript would produce a truncated protein that does not contain Sec and cannot make the selenosulfide bond. While the variant 2 3′UTR does support Sec insertion, its activity is weak. Bioinformatic analysis revealed two highly conserved stem-loop structures, one in the proximal part of the variant 2 3′UTR and the other immediately downstream of the SECIS element. The proximal stem-loop promotes Sec insertion in the native context but not when positioned far from the UGA/Sec codon in a heterologous mRNA. In contrast, the 140 nucleotides downstream of the SECIS element inhibit Sec insertion. We also show that endogenous SelS is enriched at perinuclear speckles, in addition to its known localization in the endoplasmic reticulum. Our results suggest the expression of endogenous SelS is more complex than previously appreciated, which has implications for past and future studies on the function of this protein.
El saqueo de los bienes comunes teóricos: Commonwealth de Hardt y Negri. Rese a de "Commonwealth: el proyecto de una revolución del común" de Michael Hardt y Antonio Negri
Mark Driscoll
Tabula Rasa , 2011,
Abstract:
Smoothness of Density for the Area Process of Fractional Brownian Motion
Patrick Driscoll
Mathematics , 2010,
Abstract: We consider a process given by a two-dimensional fractional Brownian motion with Hurst parameter 1/3 < H < 1/2, along with an associated L\'evy area, and prove the smoothness of a density for this process with respect to Lebesgue measure.
A descriptive-comparative study of medications used by older people prior to and following admission to a continuing care facility  [PDF]
Alysha Visram, Donna Wilson
Open Journal of Nursing (OJN) , 2012, DOI: 10.4236/ojn.2012.21002
Abstract: Medications are beneficial for curing or managing acute and chronic illnesses. Medications typically have positive outcomes, although older people are prone to drug-related problems. Community-dwelling seniors are at particularly high risk of polypharmacy, as they tend to receive many prescriptions over time and from different care providers. Continuing-care facility admission presents an excellent opportunity for a comprehensive medication review. A research study was conducted to describe and compare medications taken by community-dwelling seniors prior to and following admission to a continuing-care facility. This pilot project involved data being gathered from the charts of deceased residents, as required by a University Health Research Ethics Board, who had been cared for at one large local continuing-care facility. The facility administrators also approved this study, in part to evaluate their policy to conduct a medication review for all new residents within six weeks of entry. This study revealed a slight but statistically significant reduction in the number of medications following this review. Other issues such as medication interactions and required dosage changes were addressed by this medication review. Although this study was confined to one continuing-care facility and a small number of residents, the findings suggest medication reviews would be beneficial upon admission to all continuing-care facilities, and annually perhaps through other means for older persons living in the community.
Metformin Induces a Dietary Restriction–Like State and the Oxidative Stress Response to Extend C. elegans Healthspan via AMPK, LKB1, and SKN-1
Brian Onken,Monica Driscoll
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0008758
Abstract: Metformin, a biguanide drug commonly used to treat type-2 diabetes, has been noted to extend healthspan of nondiabetic mice, but this outcome, and the molecular mechanisms that underlie it, have received relatively little experimental attention. To develop a genetic model for study of biguanide effects on healthspan, we investigated metformin impact on aging Caenorhabditis elegans. We found that metformin increases nematode healthspan, slowing lipofuscin accumulation, extending median lifespan, and prolonging youthful locomotory ability in a dose-dependent manner. Genetic data suggest that metformin acts through a mechanism similar to that operative in eating-impaired dietary restriction (DR) mutants, but independent of the insulin signaling pathway. Energy sensor AMPK and AMPK-activating kinase LKB1, which are activated in mammals by metformin treatment, are essential for health benefits in C. elegans, suggesting that metformin engages a metabolic loop conserved across phyla. We also show that the conserved oxidative stress-responsive transcription factor SKN-1/Nrf2 is essential for metformin healthspan benefits in C. elegans, a mechanistic requirement not previously described in mammals. skn-1, which functions in nematode sensory neurons to promote DR longevity benefits and in intestines for oxidative stress resistance lifespan benefits, must be expressed in both neurons and intestines for metformin-promoted healthspan extension, supporting that metformin improves healthy middle-life aging by activating both DR and antioxidant defense longevity pathways. In addition to defining molecular players operative in metformin healthspan benefits, our data suggest that metformin may be a plausible pharmacological intervention to promote healthy human aging.
Motivational Interviewing in a Residential Treatment Programme
Colin O'Driscoll
Motivational Interviewing : Training, Research, Implementation, Practice , 2012, DOI: 10.5195/mitrip.2012.13
Abstract: An Irish entrepenuer and motivational interviewing specialist created a residential treatment programme for addictions in Ireland with motivational interviewing not only as the model for therapy but also as the guiding spirit for the treatment environment and repertoire of activities. This article describes the treatment programme, characterises those served by it, and presents results of a preliminary assessment of treatment outcomes. The article concludes with consideration of the challenges and successes of this unique residential programm
Editorial: Welcome to APL Materials
Judith MacManus-Driscoll
APL Materials , 2013, DOI: 10.1063/1.4813633
Abstract:
Don, Betty and Jackie Kennedy: On Mad Men and Periodisation
Prudence Black,Catherine Driscoll
Cultural Studies Review , 2012,
Abstract: Why is it that we watch Mad Men and think it represents a period? Flashes of patterned wallpaper, whiskey neat, babies born that are never mentioned, contact lining for kitchen drawers, Ayn Rand, polaroids, skinny ties, Hilton hotels, Walter Cronkite, and a time when Don Draper can ask ‘What do women want?’ and dry old Roger Sterling can reply ‘Who Cares?’ This essay explores the embrace of period detail in Mad Men finding it to be both loving and fetishistic, and belonging, like all period film, to the politics of the present.
Non-Perturbative Structure in Heterotic Strings from Dual F-Theory Models
Donal O'Driscoll
Physics , 1999, DOI: 10.1016/S0370-2693(99)00420-7
Abstract: We examine how to construct explicit heterotic string models dual to F-theory in eight dimensions. In doing so we learn about where the moduli spaces of the two theories overlap, and how non-perturbative features leave traces on a purely perturbative level. We also propose a modified T-duality linking M and F-theories based on non-perturbative structures of string theories in eight dimensions.
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