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PubMedDate not supplied

Caring as an imperative for nursing education.

Caring is a universal need that is an important component in the delivery of nursing care. Nurse educators face the challenge of teaching the value of caring as a necessary part of nursing. Watson's theoretical framework, which focuses on interpersonal and transpersonal processes in human care, presents an effective model in understanding the concept of caring (1). Krathwohl, Bloom, and Masia's model of affective domain provides a taxonomy of affective competencies that guides the process of value development (2). Both models enhance our understanding of caring and provide the theoretical foundation for integrating caring into nursing education. This article describes an associate degree program's effort to thread the concept of caring across its curriculum. It includes an overview of the steps used for integrating caring in individual clinical courses and emphasizes teaching/learning and assessment strategies used in the educational process.

Affect↗
PubMed1997

The defeat of Philip Morris' 'California Uniform Tobacco Control Act'.

OBJECTIVES: This paper describes the strategies used by Philip Morris and other tobacco companies to promote a California initiative (Proposition 188) preempting local control of tobacco and those used by public health groups to defeat the initiative. METHODS: Interviews with key informants were conducted, and the written record was reviewed. RESULTS: Tobacco companies nearly succeeded in passing Proposition 188 by presenting it as a pro-health measure that would prevent children from obtaining cigarettes and provide protection against secondhand smoke. Public health groups defeated it by highlighting tobacco industry backing. A private charitable foundation also played an innovative role by financing a non-partisan public education campaign. CONCLUSIONS: Public health forces must be alert to sophisticated efforts by the tobacco industry to enact preemptive state legislation by making it look like tobacco control legislation. The coalition structure that emerged in the "No on 188" campaign represents an effective model for future tobacco control activities. The new role of charitable foundations defined in the Proposition 188 campaign can be used in other public health issues.

California↗
PubMed2026

Single-cell RNA sequencing reveals disease associated changes in brain endothelial cells in the 5XFAD mouse.

Vascular dysfunction is a key contributor to Alzheimer’s disease (AD) pathology, where changes to the endothelium and its crucial role in maintaining blood-brain barrier (BBB) integrity have been of particular emphasis. The transgenic 5XFAD (5X Familial Alzheimer’s Disease) mouse model, which exhibits AD-related amyloidosis through FAD associated mutations in amyloid precursor protein (APP) and presenilin-1 (PS1), has become a widely adopted preclinical model in AD-related research studies. The need for cross-study standardization, accessibility, and data reproducibility has led to the widespread implementation of the C57BL/6J genetic background for maintaining this model. However, its reliability for studying vascular dysfunction and BBB alterations has been questioned due to conflicting reports in the literature. This variation is often attributed to the previously documented protective nature of the C57BL/6J background and loss of genetic background diversity. Since prior studies have mostly relied on imaging or functional assays, we herein utilized single-cell RNA sequencing (scRNAseq) to investigate AD-related molecular changes to endothelial cell populations in the 5XFAD mouse model. To initially build this resource, we focused on 12-month-old male mice, which revealed differentially expressed genes between 5XFAD and wildtype animals that mapped to signaling pathways involved in DNA damage, immune reactivity, and inflammation, among others. Many of these transcriptomic changes were zonated along the arteriovenous axis and occurred in AD genome-wide association study (GWAS) risk-associated genes. Overall, we anticipate this resource will help clarify the use of the 5XFAD model for studying AD-associated vascular changes and provide the foundation for expanded molecular profiling of brain endothelial cells under AD-associated conditions.

Animals↗
PubMed2000

Role of the H protein in assembly of the photochemical reaction center and intracytoplasmic membrane in Rhodospirillum rubrum.

Rhodospirillum rubrum is a model for the study of membrane formation. Under conditions of oxygen limitation, this facultatively phototrophic bacterium forms an intracytoplasmic membrane that houses the photochemical apparatus. This apparatus consists of two pigment-protein complexes, the light-harvesting antenna (LH) and photochemical reaction center (RC). The proteins of the photochemical components are encoded by the puf operon (LHalpha, LHbeta, RC-L, and RC-M) and by puhA (RC-H). R. rubrum puf interposon mutants do not form intracytoplasmic membranes and are phototrophically incompetent. The puh region was cloned, and DNA sequence determination identified open reading frames bchL and bchM and part of bchH; bchHLM encode enzymes of bacteriochlorophyll biosynthesis. A puhA/G115 interposon mutant was constructed and found to be incapable of phototrophic growth and impaired in intracytoplasmic membrane formation. Comparison of properties of the wild-type and the mutated and complemented strains suggests a model for membrane protein assembly. This model proposes that RC-H is required as a foundation protein for assembly of the RC and highly developed intracytoplasmic membrane. In complemented strains, expression of puh occurred under semiaerobic conditions, thus providing the basis for the development of an expression vector. The puhA gene alone was sufficient to restore phototrophic growth provided that recombination occurred.

Bacterial Proteins↗
PubMed2004

Innovative strategic Canadian research training from TomorrOw's Research Cardiovascular Health Care Professionals (TORCH).

Cardiovascular research training is experiential, and "skills" are traditionally acquired through a master-apprentice paradigm. The complexity of contemporary clinical research requires a new model for research training. Facilitated through a Strategic Training Program Initiative, the Canadian Institutes of Health Research (CIHR), with its partners the Alberta Heritage Foundation for Medical Research and the Heart and Stroke Foundation, supported the Universities of Alberta and Calgary to create a new and innovative training model. Tomorrow's Research Cardiovascular Health Professionals (TORCH) is an integrated 2-year program for health care professionals from diverse disciplines to be mentored toward careers as leaders in translational cardiovascular research, applying discovery to human health. This report describes the vision, mission, core values, objectives, design and curriculum of the program. Our vision is the development of a new generation of cardiovascular research clinician-scientists, with particular emphasis on thought, leadership and collaboration. The program incorporates 4 core values: innovation and discovery, a translational and transdisciplinary focus, an emphasis on collaboration and integration of research concepts, and the teaching of a core body of research knowledge coupled with real-world "survival" skills. The core curriculum, organized according to a cluster concept, traverses the 4 pillars of the CIHR. Through the medium of 1-hour weekly videoconferences, the curriculum cycles through case studies, seminars and a journal club in focused areas of cardiovascular research. Mentors in the TORCH program have diverse backgrounds that epitomize the transdisciplinary translational aspects of the program and are chosen for their proven record of research accomplishment and prior history of successful mentoring. The program has recruited 19 trainees from a broad cross-section of disciplines, integrating 2 University of Alberta campuses. The preliminary experience has been both favourable and gratifying.

Canada↗
PubMed1996

Current-voltage relations and steady-state characteristics of Na+-Ca2+ exchange: characterization of the eight-state consecutive transport model.

An analytical expression for Na+-Ca2+ exchange currents in cardiac cells has been obtained for an eight-state model. The equation obtained has been used to derive theoretical expressions for current-voltage relationships, maximum Na+-Ca2+ exchange currents, and half-saturating concentrations for Na+ and Ca2+. These equations were analyzed over a wide range of cytoplasmic and extracellular Na+ and Ca2+ concentrations, under forward and reverse "zero-trans" conditions. Correspondence of theoretical results with those obtained from giant excised patch experiments are presented. Rate constants from published reports were used to evaluate turnover rates for Na+-Ca2+ exchange in the forward and reverse directions. A factor, epsilon, is introduced that permits prediction of the extent to which the Na+-Ca2+ exchange cycle is under voltage or diffusion control. This factor can be conveniently used for data interpretation and comparison. The derived equations also provide a foundation for continuing experimental evaluation of the fidelity of this model.

Animals↗
PubMed2002

A field evaluation of the impact of transfer efficiency on worker exposure during spray painting.

This paper presents a mathematical model to predict breathing-zone overspray concentrations produced during spray painting as a function of the overspray generation rate, ventilation and work practices. The overspray generation rate required an estimate of the spray gun transfer efficiency, which was provided by a previously developed mathematical model. These models were evaluated in the field under two different scenarios: first in a controlled environment that approximated the assumptions of models, and then under actual spray painting conditions. Results from the first test showed the model overestimated transfer efficiency, but the measured exposures and predicted exposures were not significantly different. During actual spray painting operations, all task exposures were within a factor of three of the model predictions, and there was no statistical difference between the measured and predicted values. The predicted average exposure of each worker was within the 95% confidence interval. The overall mean exposure was within one standard error of the model prediction. The current study expands on the original exposure model by including a transfer efficiency model to provide a better estimate of the overspray generation rate. The theoretical foundation between exposure and its primary determinants is established, and this knowledge can be applied to design and can evaluate optimal control interventions. Also, the general methodology presented here for developing an exposure model is applicable to operations other than spray painting.

Aerosols↗
PubMed1983

Transport of radon through cracks in a concrete slab.

A model involving the use of line sources is developed to describe the transport of radon through the cracks or gaps which appear in concrete slabs used in building foundations. The strength of these sources is determined from the results of the diffusion model proposed by Landman in a previous work. Once the strength of the source is known, additional transport mechanisms can be treated in a simple manner. Pressure differences across the slab and in the underlying soil are discussed. The rate of exhalation through a portion of the cracked slab is determined and compared to the rate of exhalation from the same surface area of bare soil. In typical cases, their ratios vary from 0.25 to 0.50. Therefore, these transport mechanisms account for a larger portion of the levels of radon found in many houses than do previous models.

Background Radiation↗
PubMed1990

Evaluation of cytoplasmic genetic effects in beef cattle using an animal model.

Mixed model techniques were used to evaluate the importance of cytoplasmic genetic effects on beef cattle performance. Birth weight (BWT), preweaning average daily gain (ADG), weaning weight (WT205), postweaning gain (PG), ultrasonic backfat thickness (FAT) and predicted milk yield (MILK) data were collected in two herds of Hereford cattle located at Plymouth and Raleigh, North Carolina. Cytoplasmic lines were determined based on the foundation female in the maternal lineage of each animal. An animal model was used to account for all nuclear genetic variation among animals within herds. Direct breeding values were estimated for all animals with records and their parents for all traits. For MILK, permanent environmental effects were estimated for animals with multiple records. For preweaning traits, maternal breeding values and permanent maternal environmental effects also were estimated. In all analyses, F-tests for cytoplasmic effects were not significant. Probability values approached significance (P = .15 to P = .10) only for PG and FAT at Plymouth. Assumptions regarding the ratios of genetic and environmental variances and covariances had no effect on F-tests. Results contrast with earlier analyses of the same data in which nuclear genetic effects were accounted for by including sire and maternal grandsire in the statistical model. This study failed to show that cytoplasmic genetic effects were important sources of variation in performance; residual additive genetic effects were confounded with cytoplasmic lines for these herds. Because cytoplasmic sources may be regarded as founder effects, further research is needed in other populations.

Animals↗
PubMed2026

A Patient-Derived Xenograft Repository Capturing Clinical and Molecular Heterogeneity of Large B-cell Lymphoma.

UNLABELLED: Large B-cell lymphomas (LBCL) are a clinically and molecularly diverse group of malignancies with a rapidly evolving therapeutic landscape that has introduced new areas of clinical need, such as post-CD19 chimeric antigen receptor T (CART19) progression. Patient-derived xenograft (PDX) models are an important tool for mechanistic studies and preclinical evaluation of new therapies and can be generated from a variety of clinical contexts that capture tumor-intrinsic resistance mechanisms. We therefore undertook a comprehensive effort to generate PDX models that encompass the molecular landscape of LBCLs and include important clinical scenarios for new drug development. Here, we describe the first 48 models within this publicly available repository, capturing the transcriptional and genetic subsets of LBCL. These models also include 23 generated from post-CART19 progression patient biopsies, which reproduce patterns of progression driven by CD19 mutation or expression loss, as well as tumor cell-intrinsic CART19 resistance that we validated in vivo. SIGNIFICANCE: Here, we describe X-LYMPH (Xenografts of Lymphoma), a publicly available and molecularly annotated PDX repository that captures the heterogeneity of LBCL. X-LYMPH includes models of CAR T-cell resistance, providing a shared foundation for mechanistic research and therapeutic development for lymphomas. See related commentary by Evgin and Steidl, p. 655.

Humans↗
PubMedDate not supplied

Academic and clinical dissonance in nursing education: are we guilty of failure to rescue?

The experience of cognitive dissonance in novice clinical nursing students is examined. These students often confront an incongruity between the rule-bound academic ideal of nursing with which they have been prepared and the more flexible, intuition-driven clinical reality they encounter. Without insightful guidance from clinical faculty, the students' response to this dissonance could include disillusionment with clinical nursing practice or devaluation of the academic ideal of nursing. Cognitive Dissonance Theory, the Novice to Expert Model, and the Neuman Systems Model provide insight into this phenomenon and serve as a theoretical foundation for recommended strategies and interventions for optimal response to dissonance between academic ideal and clinical reality in nursing students.

Attitude of Health Personnel↗
PubMed1994

Case management in the acute care setting. A model for health care reform.

Case management, as a model for delivering health care, has a long history. Since its inception, the scope and goals of case management have changed and matured. Contemporary approaches to case management represent a dynamic, integrated, and multidisciplinary model of health care delivery. Case management incorporates interdependent and collaborative arrangements between the client and health care provider to ensure cost-effective, quality care. Because of its foundation in cost and quality control, case management is likely to be the delivery model that will play a major role in health care reform over the next decade, both in the acute care setting and in community-based, long-term care programs.

Acute Disease↗
PubMed1976

Foreign intervention in medical education: a case study of the Rockefeller Foundation's involvement in a Thai medical school.

A case study of the process of foreign intervention in medical education in the developing world is presented. Material collected from the Rockefeller Foundation Archives on a Foundation program in Thailand is used to analyze the conditions under which foreign agencies and their personnel intervene in the development of medical professionals in the Third World and to study the problems that may occur as a result of such intervention. The importance of value consensus and the competitive advantage foreigners have in the marketing of professional models are highlighted as reasons for the diffusion of Western models of medical education throughout the developing world.

Community Health Services↗
PubMed1981

Reevaluating the theoretical model underlying the neurodevelopmental theory. A literature review.

The purpose of this paper is to evaluate the foundations of prevalent physical therapy technique based on the current research on motor control. The conceptual framework of the neurodevelopmental theory, as described in the writings of the Bobaths, is presented. Their explanations of central nervous system disorders and recommendations for intervention are based upon a unidirectional model of the nervous system in which postural and voluntary motion become two separate and distinct entities. Systems theory is an alternative model of nervous system structure. In systems theory, the organism is a circular network of interacting yet autonomous subsystems, rather than a vertical structure of descending controls. Relevant research that supports the systems viewpoint is discussed and applied to the theories in the neurodevelopmental approach. Thus, another model is offered for understanding the functioning of the central nervous system when it is intact and when it is in a pathological state.

Animals↗
PubMed2006

Is translational research compatible with preclinical publication strategies?

The term "translational research" is used to describe the transfer of basic biological knowledge into practical medicine, a process necessary for motivation of public spending. In the area of cancer therapeutics, it is becoming increasingly evident that results obtained in vitro and in animal models are difficult to translate into clinical medicine. We here argue that a number of factors contribute to making the translation process inefficient. These factors include the use of sensitive cell lines and fast growing experimental tumors as targets for novel therapies, and the use of unrealistic drug concentrations and radiation doses. We also argue that aggressive interpretation of data, successful in hypothesis-building biological research, does not form a solid base for development of clinically useful treatment modalities. We question whether "clean" results obtained in simplified models, expected for publication in high-impact journals, represent solid foundations for improved treatment of patients. Open-access journals such as Radiation Oncology have a large mission to fulfill by publishing relevant data to be used for making actual progress in translational cancer research.

Animals↗
PubMed2006

[Application of European Model of Quality in Oncology].

OBJECTIVES: To assess a Medical Oncology Service using a healthcare setting version of the European Foundation for Quality Management (EFQM). To use this tool as training, an opportunity for participation and the base for checking the strategic planning. MATERIAL AND METHODS: We use the EFQM Model adapted to healthcare centers EFQM as the evaluation instrument. It maintains scores and weights, only modifying vocabulary and simplifying that not relevant to the healthcare setting. Exercise was done with the "proform" system. Its advantage is that it uses standard formulas combined with open areas for discussion and presentation of ideas. It uses group sessions for agreement. STUDY PERIOD: 2001 Management. Evaluation was performed in the second term of 2002. RESULTS: 58 strengths and 37 areas of improvement were identified. These elements were used to create a strategic document, which served as the basis for future improvement. The score reached was used as an internal reference to monitor service quality evolution. CONCLUSIONS: The EFQM model is applicable in a Medical Oncology Service, although it would be desirable to have standardized quality indicators that permit a more objective and specific evaluation.

Europe↗
PubMed1990

Experimental autoimmune uveoretinitis in mice. Induction by a single eliciting event and dependence on quantitative parameters of immunization.

Experimental autoimmune uveoretinitis (EAU) in the mouse is a recently developed model of ocular autoimmunity. Dependence of disease induction on qualitative and quantitative parameters of immunization was studied in B10.A mice immunized with interphotoreceptor retinoid-binding protein (IRBP). It was found that use of Bordetella pertussis adjuvant as well as its mode of preparation was of critical importance for disease induction; no disease was induced if pertussis adjuvant was omitted. The minimal effective protocol for EAU induction when the vaccine form of B. pertussis adjuvant was used consisted of pretreatment with cyclophosphamide, two divided doses of IRBP in complete Freund's adjuvant (CFA), and two divided doses of B. pertussis vaccine. Any reduction in the immunization schedule resulted in reduced incidence of disease. In contrast, substituting purified B. pertussis toxin (PTX) for the vaccine allowed reduction of the immunization schedule to a single dose of IRBP in CFA and omission of the cyclophosphamide pretreatment. Severity and incidence of disease could be quantitatively controlled by varying the respective doses of IRBP and PTX. In addition, a chronic or an acute clinical course of EAU could be obtained by using either a low-dose or a high-dose immunization, respectively. Establishment of a single dose induction protocol and the quantitation of the immunopathogenic response as a function of the variables of immunization lay the foundation for the further development and utilization of this promising model of ocular autoimmunity.

Adjuvants, Immunologic↗
PubMed2007

From here to eternity: a unified kinetic model for the pathophysiology of atherosclerotic events.

Two operative pathophysiological models underlie the clinical management of ischemic heart disease: a physical model founded on the magnitude of vascular stenosis and a biochemical model founded on the inflammatory processes within the atherosclerotic plaque. Despite their complementary natures, these 2 models are implicitly competitive--the stenotic model supporting the primacy of aggressive interventional procedures and the inflammatory model supporting the primacy of conservative medical management. We unified these alternative perspectives through a kinetic model that characterizes the pathophysiology of cardiovascular events as a network of exponential transitions between the inflammatory and stenotic states. According to this model, the prevalence of the normative (nonstenotic and noninflammatory) state falls exponentially, while the prevalences of the inflammatory and stenotic states rise to a peak and then fall off exponentially. According to this model, event rate increases as a complex function of both myocardial ischemia and vascular inflammation. Although the model has yet to be prospectively validated, it provides a theoretical foundation for predicting the degree to which atherosclerotic events are due to inflammation versus stenosis and the degree to which they can thereby be prevented by treatment strategies directed at plaque stabilization or relief of ischemia.

Coronary Artery Disease↗