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Strategies to increase research-based practice: interplay with unit culture.

PURPOSE: A major focus of clinical nurse specialist nursing practice is the integration of research findings into practice. The purpose of this study was to describe strategies used to facilitate research utilization (RU) by nurses in a practice setting. DESIGN: This multiple-case study identified the strategies that clinical nurse specialists and master's degree-prepared nurse educators, working collaboratively, used to facilitate RU. SETTING/SAMPLE: The setting included 8 units in 4 sites of a university hospital with all willing nurses participating. METHODS: Open-ended focus groups and individual interviews and observational sessions were conducted using investigator-designed interview guides. Comprehensive qualitative analysis led to identification of categories and themes related to RU and the unit culture that supported it. FINDINGS: Findings demonstrated that strategies to facilitate RU by staff at the unit level included conducting original research, supporting nurses participating in research, assessing and meeting staff learning needs, promoting staff attendance at conferences, stimulating goal-setting for presentations and publications, encouraging and responding to new ideas, questioning practice and stimulating inquiry, capitalizing on expertise in research knowledge and skills, and generating information and material resources. Characteristics of unit culture were linked to varying degrees of success with these strategies. The interplay of strategies with unit culture and research-based practice is described. CONCLUSION: A wide repertoire of strategies is needed to facilitate RU, and the outcome of these strategies is influenced by the unit culture. IMPLICATIONS FOR PRACTICE: Consideration of the findings and the scope of the strategies used by nurses in the study can help clinical nurse specialist and other nursing leaders facilitate the building of practice on research.

Diffusion of Innovation↗
PubMed2002

Interplay of the static and dynamic restraints in glenohumeral instability.

Anterior glenohumeral instability is a common, yet complicated orthopaedic disorder. During the past few years, basic science research has improved the understanding of the glenohumeral joint stabilizing systems. The current authors review new contributions specifically detailing study of the interplay between the static and dynamic restraints. Simulation of the shoulder muscles in a recent study also has manifested the powerful contribution of the joint reaction force to concavity-compression. Continued advances, such as these, will improve the understanding, and allow better outcome, in treatment of glenohumeral instability.

Biomechanical Phenomena↗
PubMed1999

Nitric oxide and the renin-angiotensin system. Is there a physiological interplay between the systems?

Opposed actions for nitric oxide (NO) and angiotensin II (Ang II) in vascular contraction and vascular smooth muscle cell proliferation and apoptosis are well documented. In addition, various experimental approaches have shown that NO negatively modulates the renin-angiotensin system by inhibiting angiotensin-converting enzyme (ACE) activity and down-regulating AT1 receptors. On the other hand, Ang II and Ang-(1-7) positively stimulate NO synthesis and release. In this review, we analyse the data suggesting a mutual regulation between the renin-angiotensin and the nitric oxide-generating systems, and we propose a homeostatic interplay between both factors aimed at regulating cardiovascular function.

Angiotensin II↗
PubMed1993

Interplay between platelet-derived 5-hydroxytryptamine and arachidonic acid metabolites limits the thrombolytic efficacy of streptokinase against canine platelet-rich coronary thrombosis.

The comparative contributions of arachidonic acid (AA) metabolites and 5-hydroxytryptamine (5-HT) to the delay of reperfusion and rate of reocclusion after coronary thrombolysis with streptokinase were assessed in dogs using (a) single TXA2 synthase inhibition; (b) single 5-HT2-receptor blockade; (c) dual TXA2 synthase inhibition/PGH2 receptor antagonism; (d) 5-HT2-receptor blockade combined with TXA2 synthase inhibition; and (e) 5-HT2-receptor blockade combined with dual TXA2 synthase/PGH2-receptor antagonism. In open-chest anesthetized dogs, occluding coronary thrombi were induced by severe intimal injury in combination with critical artery stenosis. Fifty minutes after occlusive thrombus formation, the animals received intravenously (i) saline (S); (ii) ketanserin, 0.3 mg/kg (K), a 5-HT2-receptor antagonist; (iii) ridogrel, either at a low dose 0.3 mg/kg (R 0.3), exerting single TXA2 synthase inhibition; or (iv) at 5 mg/kg (R 5), exerting additional TXA2/PGH2-receptor antagonism; or (v) the combination of either dose of ridogrel with ketanserin. Ten minutes later, all dogs received streptokinase (SK; 1,000 IU/kg i.v. + 100 IU/kg/min i.v. infusion for 90 min). High-grade thrombolysis (> or = 50% coronary reperfusion vs. prethrombosis value as assessed by flow measurements) with SK occurred in 3/11 dogs treated with S, in 5/7 with R 0.3 and K, and in 7 of 7 dogs in the other medication groups; this occurred within > or = 55 min with S, R 0.3, and K, within 37 +/- 12 min with R 5 (p < 0.05 vs. solvent and R 0.3), and within 38 +/- 5 and 23 +/- 5 min with R 0.3 + K and R 5 + K, respectively (p < 0.05 vs. S, R 0.3, and K). The occurrence of reocclusion within 120 min after the cessation of SK administration was significantly reduced in all treatment groups, except K. That of cyclic flow reduction was reduced by R 5, R 0.3 + K, and R 5 + K. The peak extent of coronary reperfusion was highest in the K + R groups (S = 33% of preocclusion value; K = 60%; R 0.3 = 68%; R 5 = 76%; K + R 0.3 = 80%, p < 0.05 vs. S; and K + R 5 = 89%, p < 0.05 vs. solvent, R 0.3, and K). This study shows that the interplay between AA metabolites and 5-HT is involved in the platelet-dependent reduction in the thrombolytic efficacy of streptokinase in lysing coronary thrombi.

Animals↗
PubMed2005

Commentary: Gene-environment interplay in the context of genetics, epigenetics, and gene expression.

OBJECTIVE: To comment on the article in this issue of the Journal by Professor Michael Rutter, "Environmentally Mediated Risks for Psychopathology: Research Strategies and Findings," in the context of current research findings on gene-environment interaction, epigenetics, and gene expression. METHOD: Animal and human studies are reviewed that differentiate the role of gene expression in developmental biology and psychopathology as well as studies that begin to specify the biological mechanisms involved in determining how genotype is translated into phenotype. RESULTS: Genetic instructions are not translated directly into phenotypic traits but are modified potentially at two levels: the transcription process wherein messenger RNA is produced, and translation when protein synthesis occurs. Interplay of genetic and environmental factors determines the final product of gene expression as measured by the when, where, and amount of protein synthesized. Epigenetic processes may operate at the level of messenger RNA to control gene expression. CONCLUSIONS: The field of developmental psychopathology is providing the theoretical and research framework to explore the conceptual space between the genome and the environment. Natural selection has provided mechanisms that operate within that space to facilitate adaptation to the environment. These mechanisms are more robust than genetics alone in determining the phenotype of each individual organism.

Chromosomes, Human, X↗
PubMed2004

Differential interplay between protein kinase C and Rho-kinase in the endothelin-1-induced and pressure-induced contractions of rat posterior cerebral artery.

To clarify the involvement of protein kinase C and Rho-kinase in the contractile activation of cerebral artery in response to endothelin-1 and pressurization, rat posterior cerebral artery (outer diameter, 100-200 microm) was mounted in arteriograph, and the changes in cytosolic Ca2+ and vessel diameter were measured by video-microscopy in connection with an Argus 50 system. Endothelin-1 (10 nM) induced a tonic contraction with a slight increase in cytosolic Ca2+, which was mostly dependent on protein kinase C (chelerythrine sensitive). Intraluminal pressurization (60 mmHg) also produced contraction with a low cytosolic Ca2+, which was myogenic in nature and dependent on both protein kinase C and Rho-kinase (Y-27632 sensitive). The results suggest differential interplay between protein kinase C and Rho-kinase in the endothelin-1-induced and pressure-induced tonic phase of contractions in the rat posterior cerebral artery.

Amides↗
PubMed2003

Nasal tip sutures part II: the interplays.

The achievement of consistently superior results in rhinoplasty is rendered difficult in part by a number of complex interplays between the anatomical structures of the nose and the techniques used for their alteration, such as tip sutures. The effects of sutures depend largely on the magnitude of suture tightening, the intrinsic forces on the cartilages, cartilage thickness, and the degree of soft-tissue undermining. The tip complex is perhaps the most intricate of the nasal structures, exhibiting subtle but evident responses to manipulations of the lower lateral cartilages. The three-dimensional effects of nine suture techniques that are frequently used in nasal tip surgical procedures are discussed and illustrated. (1) The medial crura suture approximates the medial crura and strengthens the support of the tip. The suture also has effects that are less conspicuous immediately. There is slight narrowing of the columella, caudal protrusion of the lobule, and minimal caudal rotation of the lateral crura. (2) The middle crura suture approximates the most anterior portion of the medial crura. There is greater strengthening of the tip and some approximation of the domes with this suture. (3) The interdomal suture approximates the domes and can equalize asymmetric domes. However, the entire tip may shift to the short side if there is a significant difference in the heights of the domes because of short lateral and medial crura. (4) Transdomal sutures narrow the domal arch while pulling the lateral crura medially. The net results are increased tip projection, alar rim concavity, and the potential need for an alar rim graft. In addition, depending on suture position, cephalic or caudal rotation of the lateral crura may be observed. (5) The lateral crura suture increases the concavity of the lateral crura, reduces the interdomal distance, and may retract the alar rims. Perhaps the most significant inadvertent results of this suture are caudal rotation of the tip and elongation of the nose. This is important because patients who undergo rhinoplasty would often benefit from cephalic, rather than caudal, rotation of the tip. (6) The medial crura-septal suture not only increases tip projection but also rotates the tip cephalically and retracts the columella. (7) The tip rotation suture shifts the tip cephalad while retracting the columella. (8) The medial crura footplate suture approximates the footplates, narrows the columella base, and improves undesirable nostril shape. (9) The lateral crura convexity control suture alters the degree of convexity of the lateral crura. The nuances of these sutures and their multiplanar effects on the nasal tip are discussed.

Humans↗
PubMed2003

Formation of functional cell membrane domains: the interplay of lipid- and protein-mediated interactions.

Numerous cell membrane associated processes, including signal transduction, membrane sorting, protein processing and virus trafficking take place in membrane subdomains. Protein-protein interactions provide the frameworks necessary to generate biologically functional membrane domains. For example, coat proteins define membrane areas destined for sorting processes, viral proteins self-assemble to generate a budding virus, and adapter molecules organize multimolecular signalling assemblies, which catalyse downstream reactions. The concept of raft lipid-based membrane domains provides a different principle for compartmentalization and segregation of membrane constituents. Accordingly, rafts are defined by the physical properties of the lipid bilayer and function by selective partitioning of membrane lipids and proteins into membrane domains of specific phase behaviour and lipid packing. Here, I will discuss the interplay of these independent principles of protein scaffolds and raft lipid microdomains leading to the generation of biologically functional membrane domains.

Animals↗
PubMed2004

Interplay between DNA replication, recombination and repair based on the structure of RecG helicase.

Recent studies in Escherichia coli indicate that the interconversion of DNA replication fork and Holliday junction structures underpins chromosome duplication and helps secure faithful transmission of the genome from one generation to the next. It facilitates interplay between DNA replication, recombination and repair, and provides means to rescue replication forks stalled by lesions in or on the template DNA. Insight into how this interconversion may be catalysed has emerged from genetic, biochemical and structural studies of RecG protein, a member of superfamily 2 of DNA and RNA helicases. We describe how a single molecule of RecG might target a branched DNA structure and translocate a single duplex arm to drive branch migration of a Holliday junction, interconvert replication fork and Holliday junction structures and displace the invading strand from a D loop formed during recombination at a DNA end. We present genetic evidence suggesting how the latter activity may provide an efficient pathway for the repair of DNA double-strand breaks that avoids crossing over, thus facilitating chromosome segregation at cell division.

Chromosome Segregation↗
PubMed2003

Chromosome integrity in Saccharomyces cerevisiae: the interplay of DNA replication initiation factors, elongation factors, and origins.

The integrity of chromosomes during cell division is ensured by both trans-acting factors and cis-acting chromosomal sites. Failure of either these chromosome integrity determinants (CIDs) can cause chromosomes to be broken and subsequently misrepaired to form gross chromosomal rearrangements (GCRs). We developed a simple and rapid assay for GCRs, exploiting yeast artificial chromosomes (YACs) in Saccharomyces cerevisiae. We used this assay to screen a genome-wide pool of mutants for elevated rates of GCR. The analyses of these mutants define new CIDs (Orc3p, Orc5p, and Ycs4p) and new pathways required for chromosome integrity in DNA replication elongation (Dpb11p), DNA replication initiation (Orc3p and Orc5p), and mitotic condensation (Ycs4p). We show that the chromosome integrity function of Orc5p is associated with its ATP-binding motif and is distinct from its function in controlling the efficiency of initiation of DNA replication. Finally, we used our YAC assay to assess the interplay of trans and cis factors in chromosome integrity. Increasing the number of origins on a YAC suppresses GCR formation in our dpb11 mutant but enhances it in our orc mutants. This result provides potential insights into the counterbalancing selective pressures necessary for the evolution of origin density on chromosomes.

Cell Cycle Proteins↗
PubMed2006

Histone sumoylation is a negative regulator in Saccharomyces cerevisiae and shows dynamic interplay with positive-acting histone modifications.

Covalent histone post-translational modifications such as acetylation, methylation, phosphorylation, and ubiquitylation play pivotal roles in regulating many cellular processes, including transcription, response to DNA damage, and epigenetic control. Although positive-acting post-translational modifications have been studied in Saccharomyces cerevisiae, histone modifications that are associated with transcriptional repression have not been shown to occur in this yeast. Here, we provide evidence that histone sumoylation negatively regulates transcription in S. cerevisiae. We show that all four core histones are sumoylated and identify specific sites of sumoylation in histones H2A, H2B, and H4. We demonstrate that histone sumoylation sites are involved directly in transcriptional repression. Further, while histone sumoylation occurs at all loci tested throughout the genome, slightly higher levels occur proximal to telomeres. We observe a dynamic interplay between histone sumoylation and either acetylation or ubiquitylation, where sumoylation serves as a potential block to these activating modifications. These results indicate that sumoylation is the first negative histone modification to be identified in S. cerevisiae and further suggest that sumoylation may serve as a general dynamic mark to oppose transcription.

Acetylation↗
PubMed2007

Widespread mRNA polyadenylation events in introns indicate dynamic interplay between polyadenylation and splicing.

mRNA polyadenylation and pre-mRNA splicing are two essential steps for the maturation of most human mRNAs. Studies have shown that some genes generate mRNA variants involving both alternative polyadenylation and alternative splicing. Polyadenylation in introns can lead to conversion of an internal exon to a 3' terminal exon, which is termed composite terminal exon, or usage of a 3' terminal exon that is otherwise skipped, which is termed skipped terminal exon. Using cDNA/EST and genome sequences, we identified polyadenylation sites in introns for all currently known human genes. We found that approximately 20% human genes have at least one intronic polyadenylation event that can potentially lead to mRNA variants, most of which encode different protein products. The conservation of human intronic poly(A) sites in mouse and rat genomes is lower than that of poly(A) sites in 3'-most exons. Quantitative analysis of a number of mRNA variants generated by intronic poly(A) sites suggests that the intronic polyadenylation activity can vary under different cellular conditions for most genes. Furthermore, we found that weak 5' splice site and large intron size are the determining factors controlling the usage of composite terminal exon poly(A) sites, whereas skipped terminal exon poly(A) sites tend to be associated with strong polyadenylation signals. Thus, our data indicate that dynamic interplay between polyadenylation and splicing leads to widespread polyadenylation in introns and contributes to the complexity of transcriptome in the cell.

Animals↗
PubMed2000

Symmetric polymer blend confined into a film with antisymmetric surfaces: interplay between wetting behavior and the phase diagram

We study the phase behavior of a symmetric binary polymer blend that is confined in a thin film. The film surfaces interact with the monomers via short-range potentials. We calculate the phase behavior within the self-consistent field theory of Gaussian chains. Over a wide range of parameters we find strong first-order wetting transitions for the semi-infinite system, and the interplay between the wetting/prewetting behavior and the phase diagram in confined geometry is investigated. Antisymmetric boundaries, where one surface attracts the A component with the same strength as the opposite surface attracts the B component, are applied. The phase transition does not occur close to the bulk critical temperature but in the vicinity of the wetting transition. For very thin films or weak surface fields one finds a single critical point at straight phi(c)=1 / 2. For thicker films or stronger surface fields the phase diagram exhibits two critical points and two concomitant coexistence regions. Only below a triple point there is a single two-phase coexistence region. When we increase the film thickness the two coexistence regions become the prewetting lines of the semi-infinite system, while the triple temperature converges toward the wetting transition temperature from above. The behavior close to the tricritical point, which separates phase diagrams with one and two critical points, is studied in the framework of a Ginzburg-Landau ansatz. Two-dimensional profiles of the interface between the laterally coexisting phases are calculated, and the interfacial and line tensions analyzed. The effect of fluctuations and corrections to the self-consistent field theory are discussed.

Journal Article↗
PubMed2002

Interplay between jamming and percolation upon random sequential adsorption of competing dimers and monomers.

The competitive random coadsorption of dimers and monomers, with probabilities P(D) and P(M), such as P(D)+P(M)=1, respectively, is studied numerically by means of Monte Carlo simulations. Excluded volume and nearest-neighbor infinite repulsion between unlike species is considered. The subtle interplay between competitive coadsorption, jamming behavior and the emergency of percolation clusters is analyzed in detail. Taking P(M) as the single parameter of the model, five characteristic regions where the system exhibit different physical behavior can be identified: I) For P(M)< or =P(M1) approximately equal to 0.4025(25) the standard percolation of dimers is observed; II) Within the interval P(M1)<P(M)<P(*)(M1) approximately equal to 0.4375(25) clusters of all species (monomers, dimers, and empty sites) are finite (nonpercolating); III) For P(*)(M1)< or =P(M)< or =P(*)(M2) approximately equal to 0.5425(25) the percolation of homogeneous clusters of empty sites is observed; IV) Within the interval P(*)(M2)<P(M)<P(M2) approximately equal to 0.5575(25), the system behaves as in Region II; and finally, V) For P(M2)< or =P(M), one has the standard percolation of monomers.

Journal Article↗
PubMed2003

Two-vibron bound states in alpha-helix proteins: the interplay between the intramolecular anharmonicity and the strong vibron-phonon coupling.

The influence of the intramolecular anharmonicity and the strong vibron-phonon coupling on the two-vibron dynamics in an alpha-helix protein is studied within a modified Davydov model. The intramolecular anharmonicity of each amide-I vibration is considered, and the vibron dynamics is described according to the small polaron approach. A unitary transformation is performed to remove the intramolecular anharmonicity, and a modified Lang-Firsov transformation is applied to renormalize the vibron-phonon interaction. Then a mean field procedure is realized to obtain the dressed anharmonic vibron Hamiltonian. It is shown that the anharmonicity modifies the vibron-phonon interaction, which results in an enhancement of the dressing effect. In addition, both the anharmonicity and the dressing favor the occurrence of two different bound states whose properties strongly depend on the interplay between the anharmonicity and the dressing. This dependence was summarized in a phase diagram which characterizes the number and the nature of the bound states as a function of the relevant parameters of the problem. For a significant anharmonicity, the low-frequency bound states describe two vibrons trapped onto the same amide-I vibration, whereas the high-frequency bound states refer to the trapping of the two vibrons onto nearest neighbor amide-I vibrations.

Biophysical Phenomena↗
PubMed2005

Interplay between noise and boundary conditions in pattern formation in adsorbed substances.

We have studied the interplay between noise and boundary conditions on the possibility of noise induced pattern formation. With this aim, we have exploited a deterministic model for pattern formation in adsorbed substances--including the effect of lateral interactions--used to describe the phenomenon of adsorption in surfaces, where a multiplicative noise fulfilling a fluctuation-dissipation relation was added. We have found solutions for different boundary conditions, particularly corresponding to two stable and one unstable patterns, where one of the stable and the unstable one, are purely induced by the multiplicative noise. In the case of albedo boundary conditions we have found a transition from monostable to a noise induced bistable behavior as the albedo parameter is varied.

Journal Article↗
PubMed2005

Interplay between chemical reactions and transport in structured spaces.

The main motivation behind this study is to understand the interplay between the reactions and transport in a geometries that are not compact. Typical examples of compact geometries are a box or a sphere. A network made of containers C(1) , C(2),..., C(N) and tubes is an example of the space that is structured and noncompact. In containers, particles react with the rate lambda. Tubes connecting containers allow for the exchange of chemicals with the transport rate D. A situation is considered where a number of reactants is small and kinetics is noise dominated. A method is presented that can be used to calculate the average and higher moments of the reaction time. A number of different chemical reactions are studied and their performance compared in various ways. Two schemes are discussed in general, the reaction on a fixed geometry ensemble (ROGE) and the geometry on a fixed reaction ensemble, examples are given in the ROGE case. The most important findings are as follows. (i) There is a large number of reactions that run faster in a networklike geometry. Such reactions contain antagonistic catalytic influences in the intermediate stages of a reaction scheme that are best dealt with in a networklike structure. (ii) Antagonistic catalytic influences are hard to identify since they are strongly connected to the pattern of injected molecules (inject pattern) and depend on the choice of molecules that have to be synthesized at the end (task pattern). (iii) The reaction time depends strongly on the details of the inject and task patterns.

Algorithms↗
PubMed2000

Interplay between atomic and mesoscopic order on gold vicinal surfaces

Self-organization on Au(1,1,1) vicinal surfaces provides a unique opportunity to study the interplay between atomic and mesoscopic order. First, experimental results demonstrate the different interactions between steps and surface reconstruction on Au(1,1,1) vicinal surfaces. Depending on the step atomic structure, lines of discommensurations are found to be either parallel or perpendicular to the step edges. This leads to a complete understanding of the mesoscopic self-organization on theses surfaces, which drastically depends on the step structure. This points out the crucial role played by the edge energy cost which can monitor the faceting periodicity in a wide range of values.

Journal Article↗