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PubMed2006

Using clinical skills laboratories to promote theory-practice integration during first practice placement: an Irish perspective.

AIMS AND OBJECTIVES: This aim of this study was designed to investigate how a select cohort of nursing students experienced their first practice placement in a large Irish teaching hospital. The objectives of this study were to investigate whom do students learn from, what skills they learnt during their first practice placement and to identify if the use of clinical skills laboratories before their first practice placement helped students relate theory to practice during their first practice placement. The aim of this paper is to discuss if the sessions taught in the clinical skills laboratory prior to the first placement helped students integrate theory to practice during their first practice placement. BACKGROUND: The debate regarding theory-practice integration has been ongoing in nursing for decades. Many studies across Europe have consistently demonstrated that the use of clinical skills laboratories have helped students integrate theory to practice during practice placements. Others have identified the difficulty students have relating theory to practice. However, as there appears to be a gap in current literature, from an Irish perspective, it is essential to highlight if Irish students can integrate theory to practice during their first practice placement. DESIGN: A qualitative method incorporating the Heideggarian approach of phenomenology was utilized. METHODS: A purposeful sampling technique was used to select six participants from all first year students. Interviews were conducted using a semi-structured interview schedule. Data were analysed using the Giorgi method of analysing phenomenological data. RESULTS: The participants identified that sessions taught in the clinical skills laboratory before the first practice placement, which they identified as 'basic nursing skills such as taking and recording vital signs and hygiene needs of patients were useful and helped them to integrate theory to practice during their first practice placement. These results are relevant to this paper as they identify the use of teaching sessions in the clinical skills laboratories, enabling students to link theory to practice during practice placements. CONCLUSIONS: Nursing students must be adequately prepared to carry out clinical skills competently and efficiently. Educators and practitioners must display the knowledge and skills required to promote theory-practice integration, to enhance nursing students education, which in turn will optimize high standards of patient care. Relevance to clinical practice. Clinical skills laboratories are essential to help students develop the collaborative skills required for a profession like nursing. It is essential that students are adequately prepared to carry out clinical skills during their first practice placement, and have the ability to link theory to practice.

Attitude of Health Personnel↗
PubMed2006

The struggle for social integration in the community--the experiences of people with mental health problems.

The goal of social integration is part of the ideological motivation behind the transition from institutionalized to decentralized psychiatry. Modern community mental health care considers social integration as vital for improving mental health. However, reports suggest that efforts to socially integrate people who suffer from mental health problems have not been as successful as anticipated. The aim of this study was to explore how people with mental health problems experience their ability to integrate socially into a community in central Norway. Three multistage focus groups, consisting of 17 people with mental health problems, were set up in two counties of different sizes. In this explorative study, data were analysed using a qualitative content analysis method. The participants experienced shame and fear of exclusion in their struggle to become integrated in the community. They had a sense of loneliness, had to struggle for equality and experienced being neglected. The days passed very slowly and they reported a lack of financial resources. They wanted to work or take part in other daytime activities and sought reciprocal relationships. In conclusion, those working in community mental health care need to ensure that people suffering from mental health problems experience a sense of belonging in the community, thus enabling them to develop a network and achieve social integration.

Adult↗
PubMed1989

Construction, transfer and properties of a novel temperature-sensitive integrable plasmid for genomic analysis of Staphylococcus aureus.

As an alternative approach to genetic transfer and analysis, a novel integrable plasmid system was developed that should prove useful for mapping and cloning various genes in Staphylococcus aureus and other Gram-positive bacteria. The use of a restriction-deficient recipient strain and an improved protocol for protoplast plasmid transformation facilitated direct cloning of a recombinant plasmid (pPQ126) in S. aureus NCTC 8325-4. Plasmid pPQ126 (13.6 kb) is a novel, temperature-sensitive integrable plasmid containing genes encoding resistance to erythromycin and chloramphenicol (from plasmid pTV1ts), and resistance to gentamicin (from transposon Tn4001). When introduced into an appropriate recipient strain at the permissive temperature (30 degrees C), pPQ126 replicates autonomously. Integration of pPQ126 is directed into homologous chromosomal target sequences (chromosomal insertions of Tn551 or Tn4001) by growing a population of cells containing autonomous pPQ126 in the presence of gentamicin, erythromycin, and chloramphenicol at 39 degrees C (nonpermissive temperature). Elevated temperature both selects for and maintains pPQ126 as an integrated replicon. Integration of pPQ126 occurs at significantly reduced frequency in a recombination-deficient host, and does not occur in the absence of host chromosomal homology. Integrated pPQ126 excises from the chromosome under permissive conditions (30 degrees C), and excision results in derivatives of pPQ126 that harbour DNA of chromosomal origin.

Chromosomes↗
PubMed2005

Cell wall integrity is dependent on the PKC1 signal transduction pathway in Cryptococcus neoformans.

Cell wall biogenesis and integrity are crucial for fungal growth, pathogenesis and survival, and are attractive targets for antifungal therapy. In this study, we identify, delete and analyse mutant strains for 10 genes involved in the PKC1 signal transduction pathway and its regulation in Cryptococcus neoformans. The kinases Bck1 and Mkk2 are critical for maintaining integrity, and deletion of each of these causes severe phenotypes different from each other. In stark contrast to results seen in Saccharomyces cerevisiae, a deletion in LRG1 has severe repercussions for the cell, and one in ROM2 has little effect. Also surprisingly, the phosphatase Ppg1 is crucial for cell integrity. These data indicate that the mechanisms of maintaining cell integrity differ between the two fungi. Deletions in SSD1 and PUF4, potential alternative regulators of cell integrity, also exhibit phenotypes. This is the first comprehensive analysis examining genes involved the maintenance of cell integrity in C. neoformans and sets the foundation for future biochemical and virulence studies.

Animals↗
PubMed1987

Integration of porin synthesized in vitro into outer mitochondrial membranes.

Porin, an intrinsic protein of outer mitochondrial membranes of rat liver, was synthesized in vitro in a cell-free in a cell-free translation system with rat liver RNA. The apparent molecular mass of porin synthesized in vitro was the same as that of its mature form (34 kDa). This porin was post-translationally integrated into the outer membrane of rat liver mitochondria when the cell-free translation products were incubated with mitochondria at 30 degrees C even in the presence of a protonophore (carbonyl cyanide m-chlorophenylhydrazone). Therefore, the integration of porin seemed to proceed energy-independently as reported by Freitag et al. [(1982) Eur. J. Biochem. 126, 197-202]. Its integration seemed, however, to require the participation of the inner membrane, since porin was not integrated when isolated outer mitochondrial membranes alone were incubated with the translation products. Porin in the cell-free translation products bound to the outside of the outer mitochondrial membrane when incubated with intact mitochondria at 0 degrees C for 5 min. When the incubation period at 0 degrees C was prolonged to 60 min, this porin was found in the inner membrane fraction, which contained monoamine oxidase, suggesting that porin might bind to a specific site on the outer membrane in contact or fused with the inner membrane (a so-called OM-IM site). This porin bound to the OM-IM site was integrated into the outer membrane when the membrane fraction was incubated at 30 degrees C for 60 min. These observations suggest that porin bound to the outside of the outer mitochondrial membrane is integrated into the outer membrane at the OM-IM site by some temperature-dependent process(es).

Animals↗
PubMed2005

Scanning ion conductance microscopy reveals how a functional renal epithelial monolayer maintains its integrity.

BACKGROUND: To function as a transport barrier a renal tubule epithelial monolayer needs to maintain its integrity when, sudden hypertonic stress causes cell shrinkage, new cells are added, or cells in the monolayer die. However, the mechanism used to achieve this is largely unknown. Scanning ion conductance microscopy (SICM) has been shown to be suitable for imaging the surface of live renal cells with high topographic resolution, and can be used to elucidate how a functional renal epithelial monolayer maintains its integrity. METHODS: SICM was used for high spatial resolution topographic imaging of Xenopuslaevis renal epithelial A6 cells cultured on membrane filter inserts. RESULTS: The SICM images of A6 cells showed that the epithelial monolayer maintains its integrity under hypertonic stress, and during cell division and death. Sequential SICM topographic images revealed detailed structural changes and their time course for these protective processes, which involve highly cooperative cell movement. Some "balloon-like" structures were observed at susceptible tight junction regions, which were proposed to help cell maintaining the monolayer permeability integrity. CONCLUSION: SICM is a powerful tool for research on living renal epithelial cells, and has been used to elucidate how a functional epithelial monolayer maintains its integrity. Using this technique we have observed that during hypertonic stress and regeneration, an organized sequence of events protect the loss of integrity of monolayer so that tight junctions and cell-cell contact are maintained and disruption to the function of whole monolayer is prevented.

Animals↗
PubMed2003

Solving the hypersingular boundary integral equation in three-dimensional acoustics using a regularization relationship.

Regularization of the hypersingular integral in the normal derivative of the conventional Helmholtz integral equation through a double surface integral method or regularization relationship has been studied. By introducing the new concept of discretized operator matrix, evaluation of the double surface integrals is reduced to calculate the product of two discretized operator matrices. Such a treatment greatly improves the computational efficiency. As the number of frequencies to be computed increases, the computational cost of solving the composite Helmholtz integral equation is comparable to that of solving the conventional Helmholtz integral equation. In this paper, the detailed formulation of the proposed regularization method is presented. The computational efficiency and accuracy of the regularization method are demonstrated for a general class of acoustic radiation and scattering problems. The radiation of a pulsating sphere, an oscillating sphere, and a rigid sphere insonified by a plane acoustic wave are solved using the new method with curvilinear quadrilateral isoparametric elements. It is found that the numerical results rapidly converge to the corresponding analytical solutions as finer meshes are applied.

Journal Article↗
PubMed2005

An analysis of the impact of auditory-nerve adaptation on behavioral measures of temporal integration in cochlear implant recipients.

The objective of this study was to determine the impact that auditory-nerve adaptation has on behavioral measures of temporal integration in Nucleus 24 cochlear implant recipients. It was expected that, because the auditory nerve serves as the input to central temporal integrator, a large degree of auditory-nerve adaptation would reduce the amount of temporal integration. Neural adaptation was measured by tracking amplitude changes of the electrically evoked compound action potential (ECAP) in response to 1000-pps biphasic pulse trains of varying durations. Temporal integration was measured at both suprathreshold and threshold levels by an adaptive procedure. Although varying degrees of neural adaptation and temporal integration were observed across individuals, results of this investigation revealed no correlation between the degree of neural adaptation and psychophysical measures of temporal integration.

Acoustic Stimulation↗
PubMed1983

Integration of spectral and temporal cues in discrimination of nonspeech sounds: a psychoacoustic analysis.

This study presents a psychoacoustic analysis of the integration of spectral and temporal cues in the discrimination of simple nonspeech sounds. The experimental task was a same-different discrimination between a standard and a comparison pair of tones. Each pair consists of two 80-ms, 1500-Hz tone bursts separated by a 60-ms interval. The just-discriminable (d' = 2.0) increment in duration delta t, of one of the bursts was measured as a function of increments in the frequency delta f, of the other burst. A trade off between the values of delta t and delta f required to perform at d' = 2.0 was observed, which suggests that listeners integrate the evidence from the two dimensions. Integration occurred with both sub- and supra-threshold values of delta t or delta f, regardless of the order in which the cues were presented. The performance associated to the integration of cues was found to be determined by the discriminability of delta t plus that of delta f, and thus, it is within the psychophysical limits of auditory processing. To a first approximation the results agreed with the prediction of orthogonal vector summation of evidence stemming from signal detection theory. It is proposed that the ability to integrate spectral and temporal cues is in the repertoire of auditory processing capabilities. This integration does not appear to depend on perceiving sounds as members of phonetic classes.

Adolescent↗
PubMed1991

Temporal integration and multiple looks.

The decrease in detection and discrimination thresholds with increases in signal duration has often been taken to indicate that a process of relatively long-term temporal integration occurs in hearing. Two experiments are reported that suggest that no such process occurs. The first experiment is similar to the two-pulse experiment reported by Zwislocki [J. Zwislocki, J. Acoust. Soc. Am. 32, 1046-1059 (1960)] in which the threshold in quiet for a pair of brief pulses is measured as a function of the temporal separation between them. Our data indicate that power integration occurs only for separations less than approximately 5 ms. For separations larger than 5-10 ms, thresholds do not change with separation and the pulses appear to be processed independently. In the second experiment, brief 1-kHz tone pulses separated by 100 ms are presented during gaps in a wideband noise. The threshold for a pair of pulses is lower than that for either pulse presented alone, indicating that some type of "integration" occurs. However, the threshold for the pulse pair is not affected by changes in the level of the noise during the interval between the pulses. These data are inconsistent with the classical view of temporal integration that involves long-term integration. They are consistent with the notion that the input is sampled at a fairly high rate and that these samples or "looks" are stored in memory and can be accessed and processed selectively. This multiple-look model can account for the data from the present experiment and also can account for the data on temporal integration for tones and noise.(ABSTRACT TRUNCATED AT 250 WORDS)

Attention↗
PubMed1999

Temporal integration of loudness in listeners with hearing losses of primarily cochlear origin.

To investigate how hearing loss of primarily cochlear origin affects the loudness of brief tones, loudness matches between 5- and 200-ms tones were obtained as a function of level for 15 listeners with cochlear impairments and for seven age-matched controls. Three frequencies, usually 0.5, 1, and 4 kHz, were tested in each listener using a two-interval, two--alternative forced--choice (2I, 2AFC) paradigm with a roving-level, up-down adaptive procedure. Results for the normal listeners generally were consistent with published data [e.g., Florentine et al., J. Acoust Soc. Am. 99, 1633-1644 (1996)]. The amount of temporal integration--defined as the level difference between equally loud short and long tones--varied nonmonotonically with level and was largest at moderate levels. No consistent effect of frequency was apparent. The impaired listeners varied widely, but most showed a clear effect of level on the amount of temporal integration. Overall, their results appear consistent with expectations based on knowledge of the general properties of their loudness-growth functions and the equal-loudness-ratio hypothesis, which states that the loudness ratio between equal-SPL long and brief tones is the same at all SPLs. The impaired listeners' amounts of temporal integration at high SPLs often were larger than normal, although it was reduced near threshold. When evaluated at equal SLs, the amount of temporal integration well above threshold usually was in the low end of the normal range. Two listeners with abrupt high-frequency hearing losses (slopes > 50 dB/octave) showed larger-than-normal maximal amounts of temporal integration (40 to 50 dB). This finding is consistent with the shallow loudness functions predicted by our excitation-pattern model for impaired listeners [Florentine et al., in Modeling Sensorineural Hearing Loss, edited by W. Jesteadt (Erlbaum, Mahwah, NJ, 1997), pp. 187-198]. Loudness functions derived from impaired listeners' temporal-integration functions indicate that restoration of loudness in listeners with cochlear hearing loss usually will require the same gain whether the sound is short or long.

Adult↗
PubMed2003

Evidence that nuclear factor-kappa B activation is critical in oxidant-induced disruption of the microtubule cytoskeleton and barrier integrity and that its inactivation is essential in epidermal growth factor-mediated protection of the monolayers of intestinal epithelia.

Using monolayers of intestinal (Caco-2) cells, we showed that oxidants disrupt the microtubule cytoskeleton and barrier integrity; epidermal growth factor (EGF) was protective via stabilization of the microtubules. Because proinflammatory conditions activate nuclear factor-kappaB (NF-kappaB), we hypothesized that oxidants disrupt barrier integrity through activation of NF-kappaB and that EGF protects by suppressing NF-kappaB. Parental cells were pretreated with EGF or NF-kappaB or inhibitory kappaBalpha (I-kappaBalpha) modulators. Other cells were stably transfected with varying levels of a dominant negative mutant for the NF-kappaB inhibitor I-kappaBalpha. Both types of cells were grown as monolayers and then exposed to oxidant (H2O2). We then monitored monolayer barrier integrity (permeability), stability of the microtubule cytoskeleton (confocal microscopy, immunoblotting), intracellular levels of the I-kappaBalpha (immunoblotting), translocation, and activity of NF-kappaB (immunoblotting, sensitive enzyme-linked immunosorbent assay). Monolayers were also fractionated and processed to assess alterations in 1) polymerized tubulin (S2; an index of cytoskeletal integrity) and 2) monomeric tubulin (S1; an index of disassembly) (polyacrylamide gel electrophoresis fractionation and immunoblotting). We found the following: 1) Oxidants caused I-kappaBalpha degradation, NF-kappaB translocation, NF-kappaB (p50 and p65 subunits) activation, tubulin disassembly ( upward arrow S1, downward arrow S2), microtubule architectural instability, and barrier disruption. I-kappaBalpha stabilizers and NF-kappaB inhibitors [e.g., carbobenzyloxy-leuleu-leucinol (MG-132), lactacystin] suppressed oxidants injurious effects. 2) EGF (10 ng/ml) stabilized I-kappaBalpha and prevented both NF-kappaB translocation and activation while protecting monolayers against oxidants. 3) In stably transfected cells, transfection-induced stabilization of I-kappaBalpha by itself led to EGF-like protective effects. In these mutant cells, protection was not potentiated by EGF (10 ng/ml). Conclusions are 1) oxidants induce disruption of the cytoskeleton and intestinal barrier integrity, in part, through I-kappaBalpha degradation and subsequent NF-kappaB activation, 2) I-kappaBalpha stabilization is by itself protective, mimicking EGF, and 3) EGF protects cell monolayers through I-kappaBalpha stabilization and NF-kappaB inactivation. To our knowledge, this is the first report that NF-kappaB can affect the dynamics of cytoskeletal assembly and intestinal barrier integrity.

Biological Transport↗
PubMed1985

Deletion in chromosome 11p associated with a hepatitis B integration site in hepatocellular carcinoma.

Hepatitis B virus (HBV), a virus with known carcinogenic potential, integrates into cellular DNA during long-term persistent infection in man. Hepatocellular carcinomas isolated from viral carriers often contain clonally propagated viral DNA integrations. As small chromosomal deletions are associated with several types of carcinomas, the occurrence of chromosomal deletions in association with HBV integration in hepatocellular carcinoma was studied. HBV integration was accompanied by a deletion of at least 13.5 kilobases of cellular sequences in a human hepatocellular carcinoma. The viral DNA integration and deletion of cellular sequences occurred on the short arm of chromosome 11 at location 11p13-11p14. The cellular sequences that were deleted at the site of HBV integration were lost from the tumor cells, leaving only a single copy of the remaining cellular allele.

Animals↗
PubMed1990

Stability of Integrated Plasmids in the Chromosome of Lactococcus lactis.

Derivatives of plasmids pBR322, pUB110, pSC101, and pTB19, all containing an identical fragment of lactococcal chromosomal DNA, were integrated via a Campbell-like mechanism into the same chromosomal site of Lactococcus lactis MG1363, and the transformants were analyzed for the stability of the integrated plasmids. In all cases the erythromycin resistance gene of pE194 was used as a selectable marker. Transformants obtained by integration of the pBR322 derivatives contained a head-to-tail arrangement of several plasmid copies, which most likely was caused by integration of plasmid multimers. Single-copy integrations were obtained with the pSC101 and pTB19 derivatives. In all of these transformants no loss of the erythromycin gene was detected during growth for 100 generations in the absence of the antibiotic. In contrast, transformants containing integrated amplified plasmid copies of pUB110 derivatives were unstable under these conditions. Since pUB110 appeared to have replicative activity in L. lactis, we suggest that this activity destabilized the amplified structures in L. lactis.

Journal Article↗
PubMed1973

Integration efficiencies of spontaneous mutant alleles of amiA locus in pneumococcal transformation.

The distribution of integration efficiencies of independent mutations spontaneously occurring in the amiA locus was determined in two strains of pneumococcus. Strain Cl(3) integrates genetic markers with different efficiencies during transformation, whereas strain 401, isogenic with strain Cl(3), does not discriminate between markers and integrates all markers with the same high efficiency. The discriminating strain Cl(3) gives rise to spontaneous mutations in the locus amiA, which fall into four classes with respect to their individual integration efficiencies. Mutations with a low efficiency of integration are equal in number to mutations with a high efficiency. Mutations from the two other classes corresponding to intermediate and very high efficiencies are about five times less frequent. The same four classes were also found among amiA mutants spontaneously occurring in strain 401. However, the two distributions of integration efficiencies of amiA mutants arisen either in strain Cl(3) or strain 401 are significantly different. The number of spontaneous amiA mutants, estimated by two methods, was found to be higher in strain 401 than in strain Cl(3). The increase of the mutation rate in strain 401 could be accounted for by the excess of mutations falling in the two less-efficient classes observed in this strain. The discriminating process which acts during transformation presumably also intervenes in the appearance of spontaneous mutations.

Alleles↗
PubMed1982

Suppression of Escherichia coli dnaA46 mutations by integration of plasmid R100.1. derivatives: constraints imposed by the replication terminus.

We have studies the phenotypic suppression of a dnaA46 mutation by plasmid integration at preselected chromosomal sites after introducing homologous sequences (Mu prophages) onto both the chromosomes and the suppressive plasmid. The plasmids used were all derived from plasmid R100.1. We found that the conditions required to get viable suppressive integration varied as the plasmid integration site moved from the origin to the terminus of chromosome replication. Two constraints were observed. Both appeared to be linked to the new characteristics acquired by chromosome replication from the integrated plasmid. One constraint was that strains with integrative suppression near the terminus terC were viable only in minimal medium. The rich medium sensitivity of these strains was correlated with a loss of regulation of initiation. The other constraint was a requirement for a specific orientation in certain regions of the chromosome. The two branches defined by normally initiated replication, between oriC and terC, were also symmetrical with respect to these plasmid orientation constraints. In studying the possible reasons for a plasmid orientation constraint, we found that, of the two forks initiated in bidirectional replication from the integrated plasmid, one was capable of moving across the terC region with a higher movability than the other.

Chromosomes, Bacterial↗
PubMed1983

Conditionally replicating plasmid vectors that can integrate into the Klebsiella pneumoniae chromosome via bacteriophage P4 site-specific recombination.

P4 is a satellite phage of P2 and is dependent on phage P2 gene products for virion assembly and cell lysis. Previously, we showed that a virulent mutant of phage P4 (P4 vir1) could be used as a multicopy, autonomously replicating plasmid vector in Escherichia coli and Klebsiella pneumoniae in the absence of the P2 helper. In addition to establishing lysogeny as a self-replicating plasmid, it has been shown that P4 can also lysogenize E. coli via site-specific integration into the host chromosome. In this study, we show that P4 also integrates into the K. pneumoniae chromosome at a specific site. In contrast to that in E. coli, however, site-specific integration in K. pneumoniae does not require the int gene of P4. We utilized the alternative modes of P4 lysogenization (plasmid replication or integration) to construct cloning vectors derived from P4 vir1 that could exist in either lysogenic mode, depending on the host strain used. These vectors carry an amber mutation in the DNA primase gene alpha, which blocks DNA replication in an Su- host and allows the selection of lysogenic strains with integrated prophages. In contrast, these vectors can be propagated as plasmids in an Su+ host where replication is allowed. To demonstrate the utility of this type of vector, we show that certain nitrogen fixation (nif) genes of K. pneumoniae, which otherwise inhibit nif gene expression when present on multicopy plasmids, do not exhibit inhibitory effects when introduced as merodiploids via P4 site-specific integration.

Bacteriophages↗
PubMed1986

Integration of photosensory signals in Halobacterium halobium.

Stimulation of Halobacterium halobium through its sensory photosystems, PS 370 and PS 565, leads either to a prolonged or to a shortened interval between two reversals of the swimming direction of the cell, the attractant or repellent response. Stimuli are integrated to yield the same response regardless through which photosystem they are given. Simultaneously elicited attractant and repellent signals cancel each other at any time during a reversal interval, even in the period of refractoriness shortly after a reversal, when the cell is insensitive to repellent stimuli. Successively applied stimuli are less completely integrated. The net response depends on the moment of stimulation during the interval, on the sequence of stimuli, and on the delay between them. Integration of successively applied effective stimuli (after refractoriness) is to a great extent explained in terms of a cellular oscillator (A. Schimz and E. Hildebrand, Nature [London] 317:641-643, 1985) which is changed in opposite directions by attractant and repellent signals. Some conclusions on the shape of the oscillator after its disturbance by a stimulus can be made. Integration of signals during refractoriness leads us to postulate an additional step before the oscillator in the sensory pathway. Cancelling of simultaneous opposite signals is thought to proceed at this integrator. It also takes part in the integration of successively evoked signals. At this step signals rapidly decline within 10 ms, and the total life time (at least of repellent signals) does not exceed 1.2 s.

Flagella↗