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At least 19 recordsLinked to original sources

Faculty and student perceptions of effective clinical teachers: an extension study.

This extension study was conducted to (1) identify which characteristics of the effective clinical teacher are deemed most important by nursing students and faculty; (2) determine whether previous findings remain valid (are transferable); and (3) investigate whether the perception of effective teaching behavior shifts as students advance toward graduation. The research tool, a two-part questionnaire developed by Brown, was circulated among students and instructors at a university college of nursing in southwestern Ohio. The first section listed 20 characteristics of teachers to be rated, using a Likert-type scale, from "of most importance" to "of no importance." The second section required subjects to select and rank in order the five most important characteristics from the list of 20. Descriptive analysis was applied to the data, and findings were compared with those of Brown. The study suggests that both faculty and students favor articulate, knowledgeable clinical instructors who are "objective and fair" in student evaluation. There is a high degree of similarity between the responses of faculty and students, but differences emerge. Both value skills involving the student-faculty relationship over skills centering on the professional or personal attributes of the instructor. However, faculty respondents appear to place a higher value on instructor interest in patients, and students are more concerned with communication-related attributes. Faculty members place a greater value on showing interest in patients than do students. The results, when compared with Brown's findings, appear largely transferable, but significant differences appear. For example, faculty members ranked characteristics dealing with the clinical instructor's relationship with students to be more important than those dealing with professional competence--the opposite of Brown's results. This study shows the need for nursing institutions to implement programs to foster and to promote uniformly identified effective clinical teaching characteristics. Given the special challenges of clinical nursing education, graduate programs should also seek to teach the skills identified as most effective, and persons with the skills perceived as effective should be urged to enter clinical instruction and should be rewarded for success in this important area.

Clinical Competence

Effect of long-term sepiapterin treatment on dietary phenylalanine tolerance in patients with phenylketonuria: Interim results from the phase 3 APHENITY Extension Study.

PURPOSE: To report interim results from the ongoing, open-label, phase 3 APHENITY Extension Study (NCT05166161), evaluating long-term treatment with sepiapterin in patients with phenylketonuria. METHODS: Participants received an age-based dose of oral sepiapterin daily; those with mean blood phenylalanine (Phe) levels <360 &#x3bc;mol/L (<5.95 mg/dL) after 2 weeks underwent a 26-week dietary Phe tolerance assessment, wherein dietary Phe intake was adjusted and blood Phe levels monitored. Other participants continued treatment with optional diet liberalization. Primary endpoints included change from baseline to week 26 in dietary Phe intake and treatment-emergent adverse events (TEAEs). RESULTS: As of September 2, 2024, 169 participants received sepiapterin (median [minimum, maximum] age: 14.0 [0.2, 55.0] years, median exposure: 72.9 weeks); 102 participants underwent dietary Phe tolerance assessments. Mean (SD) dietary Phe intake increased from 27.6 (18.0) mg/kg/day at baseline to 62.5 (41.5) mg/kg/day at week 26 (least-squares mean change [SE]: 36.4 [2.8] mg/kg/day from baseline) (P < .0001 from post hoc analysis). The incidence of treatment-related TEAEs was 29.0%; 3 participants (1.8%) discontinued treatment owing to treatment-related TEAEs. There were no treatment-related serious TEAEs or deaths. CONCLUSION: Interim results support the long-term safety of sepiapterin and demonstrate the potential for diet liberalization in adults and children with phenylketonuria. GOV IDENTIFIER: NCT05166161 (https://www. CLINICALTRIALS: gov/study/NCT05166161; date of registration, December 8, 2021).

Humans

The man-made mineral fiber European historical cohort study. Extension of the follow-up.

The study concentrated on 21,967 workers producing rock wool/slag wool, glass wool or continuous filament in 13 European factories. The expected deaths and incident cancer cases were derived from multiplying the accumulated person-years by national reference rates across sex, age, and calendar-year strata, correction factors for regional lung cancer mortality also being used. Exposure assessment was based on the results of a historical environmental investigation reported elsewhere. There were 189 deaths (151.2 expected), and for rock-wool/slag-wool and glass-wool workers the standardized mortality ratios for lung cancer showed a pattern of increasing mortality with time since first exposure but not duration of employment. There was an excess of lung cancer among rock-wool/slag-wool workers employed during an early technological phase before the introduction of dust-suppressing agents, and fiber exposure, either alone on in combination with other exposures, may have contributed to the elevated risk. No excess of the same magnitude was evident for glass-wool production, and the follow-up of the continuous filament cohort was too short to allow for an evaluation of possible long-term effects. There was no evidence of an increased risk for pleural tumors or nonmalignant respiratory diseases.

Calcium Compounds

Long-term safety and efficacy of ponesimod, an oral S1P1 receptor modulator, in relapsing-remitting multiple sclerosis (RRMS): Results from randomized phase 2b core and extension studies spanning up to 13 years.

BACKGROUND: Ponesimod demonstrated efficacy and safety in relapsing-remitting multiple sclerosis (RRMS) in 24-week phase-2 core study, further confirmed by an interim combined analysis of the core and open-label long-term extension (LTE) studies (NCT01093326; up to 8 years). Current study evaluated safety and efficacy of ponesimod using combined core and LTE studies data for up to 13 years. METHODS: Of 393 participants completing the core study, 353 (90%) entered LTE, having 3 treatment periods (TP). In TP1 (&#x223c;1.85 years), participants continued core treatment (ponesimod: 10, 20, or 40&#x202f;mg QD) whereas placebo-treated participants were re-randomized (1:1:1) to respective ponesimod doses. In TP2 (TP2 and TP3 combined duration: &#x223c;10.4 years), participants on 40&#x202f;mg were re-randomized (1:1) to 10/20&#x202f;mg, while others continued same dose; in TP3 all participants received 20&#x202f;mg. Study outcomes included safety and efficacy (ARR, time-to 24-week confirmed-disability-accumulation [24-week CDA], total T1-weighted Gadolinium-enhanced (T1 Gd+) lesions, new/enlarging T2 lesions and Combined Unique Active Lesions [CUALs]). RESULTS: For 20&#x202f;mg dose, total 92.4% participants experienced &#x2265;1 TEAEs (73.1% mild/moderate severity) and 19 (13%) participants discontinued study. Mean (95% CI) ARR=0.14 (0.10-0.20); Kaplan-Meier estimate (95% CI) of confirmed relapse and 24-week CDA=52.5% (42.3-63.5) and 31.3% (22.6-42.3). Mean [SD] T1 Gd+ lesions decreased from ponesimod baseline (2.62 [7.06]) to 12.4 years (0.26 [1.48]), mean (95% CI) CUALs per participant/year=3.97 (2.75-5.73). CONCLUSION: Ponesimod treatment for up to 13 years was not associated with new safety concerns. Participants continued to experience low levels of disease activity consistently across clinical and MRI outcomes.

Humans

Primer extension studies on alpha-amylase mRNAs in barley aleurone. I. Characterization and quantification of the transcripts.

Primer extension was used to characterize alpha-amylase mRNAs from aleurone tissue of barley (Hordeum vulgare L. cv. Himalaya) grains. Two synthetic oligonucleotides, specific for the low-pI and high-pI alpha-amylase groups, were used as primers for synthesis of cDNA from total RNA preparations. Between them, these two oligonucleotides appear to account for all major alpha-amylase mRNAs as judged by hybrid-arrested translation of alpha-amylase mRNAs in a cell-free system. Reconstruction experiments indicated that the levels of extended primers (determined by scintillation counting) were directly proportional to the level of input mRNA over a wide range. This indicates that the technique is suitable for quantification of relative levels of individual alpha-amylase from approximately 2% to 100% of maximal levels. The nucleotide sequences of extended primers defined two different alpha-amylase mRNAs in each of the low-pI and high-pI groups, and possibly a third mRNA in the high-pI group.

Base Sequence

Primer extension studies on alpha-amylase mRNAs in barley aleurone. II. Hormonal regulation of expression.

Relative levels of different alpha-amylase mRNAs were assessed by primer extension experiments using RNA prepared from aleurone of barley (Hordeum vulgare L. cv. Himalaya). Three different aleurone systems were studied: protoplasts prepared from aleurone layers, isolated aleurone layers, and aleurone from germinated grain. Oligonucleotide primers specific for the low-pI and high-pI alpha-amylase groups allowed the levels of different alpha-amylase mRNAs to be assessed both within and between the two groups. In all aleurone systems the same set of alpha-amylase mRNAs was produced in response to either applied gibberellic acid (aleurone protoplasts, isolated aleurone layers) or, presumably, native gibberellin(s) (germinated grain). This result indicates that the same set of genes is being expressed in each case. Differences were observed between the different aleurone systems in regulation of levels of alpha-amylase mRNAs. In particular, the regulation of alpha-amylase mRNA levels in aleurone of germinated grain has unique features which are not adequately explained by the response of isolated aleurone layers to gibberellic acid.

Gibberellins

Inpatient Memory Impairment Scale: a cross-validation and extension study.

The psychometric properties of the Inpatient Memory Impairment Scale (IMIS), a 10-item behavioural rating scale for assessing hospitalized amnesiacs, were investigated using matched groups of 18 amnesiacs, 20 chronic alcoholics, and 20 psychiatric patients. The scale was found to have a high degree of internal consistency and interrater reliability when two raters are used and to correlate significantly with a range of memory tasks. The IMIS was found to discriminate amnesiacs from chronic alcoholics and amnesiacs from psychiatric patients, which extends the findings of previous studies that used this scale. It is concluded that the IMIS has encouraging psychometric properties that have been replicated in this study and that the development of ecologically valid behavioral measures of cognitive deficit represents a promising direction for future research.

Adult

Stability of the head in pitch (neck flexion-extension): studies in normal subjects and patients with axial rigidity.

The dynamic stability of the head in pitch during normal upright posture has been studied in normal subjects and patients with neurological disease affecting neck muscle tone by examining angular head acceleration responses to unpredictable linear motion of the trunk in the direction of surge. Within the frequency range of natural head movements the transfer function between head and trunk for both normal subjects and patients approximated a second-order linear differential equation involving inertia and coefficients of viscosity and elasticity. The degree of neck rigidity was determined by the damping ratio (viscosity:elasticity), which averaged .35 for normal subjects and ranged from 0.6 to 0.96 for patients with rigid syndromes. A patient with absent labyrinthine function and a "floppy" head had a damping ratio 0.18. The technique gives a numerical measurement of neck rigidity, which could be of value in characterising severity of disorder and response to therapy.

Adult

Extensive study of DRB, DQA, and DQB gene polymorphism in 23 DR2-positive, insulin-dependent diabetes mellitus patients.

To gain insight into the HLA subregions involved in protection against insulin-dependent diabetes mellitus (IDDM) we investigated the polymorphism of HLA-DR and -DQ genes in 23 DR2 IDDM patients. Results show the following. (1) Fourteen patients (61%) possess the DRB1, DRB5, and DQB1 alleles found in DRw16/DQw5 healthy people. These data contrast with the 5% of DRw16 normally found in DR2 populations and are in agreement with former observations supporting that the DRw16 haplotype is not protective. (2) Nine DR2 patients, i.e., 39% versus 95% in published DR2 controls, possess the DRB alleles found in DRw15 unaffected people. Among them, six patients have also DQA1 and DQB1 alleles identical to those found in DRw15/DQw6 healthy individuals. These data confirm that the DRw15/DQw6 haplotype is protective but indicate that none of the DR or DQ alleles, alone or in association, confers an absolute protection. (3) Our most striking results concern the very high frequency of recombinant haplotypes among the DRw15 patients: 3 of 9. In these three patients recombinations led to the elimination of both DQB1 and DQA1 alleles usually associated with DRw15. This strongly suggests that the occurrence of IDDM in these DRw15 patients is due to the absence of the usual DQ product and thus reinforces the assumption that DQ rather than DR region is involved in the protection conferred by the DRw15/DQw6 haplotype. Finally, analysis of the non-DRw15 haplotypes in heterozygous patients showed that IDDM can occur in the absence of any DQ alpha beta heterodimer of susceptibility.

DNA Probes, HLA

Prognostic factors in mesangial IgA glomerulonephritis: an extensive study with univariate and multivariate analyses.

To clarify the risk factors for chronic renal failure in idiopathic IgA glomerulonephritis (IgA-GN), we performed a dual study on 282 patients using both standard univariate statistical methods and the multivariate regression model of Cox. During a follow-up ranging from 1 to 36 years, with a mean of 8 years, 18% of the patients (50/282) had gone into chronic renal failure (CRF), with 18 of them in end-stage renal disease (ESRD) (6%). The univariate comparison of patients with CRF versus patients without CRF showed multiple risk factors: mainly arterial hypertension, an amount of proteinuria, nephrotic syndrome, a high level of serum IgA, presence of HLA-B35 antigen, and the intensity of most pathological lesions on light microscopy. The actuarial survival rate for a normal renal function (serum creatinine less than 135 mumol/L [1.5 mg/dL]) was 84% at 10 years and 64% at 20 years. The multivariate study allowed the isolation of only four risk factors with a significant effect on survival rate. These were the amount of proteinuria, the global optical score on first renal biopsy, the presence of an initial hypertension, and the presence of the HLA-B35 antigen. From these results, the probability of renal survival for individual patients may be calculated and a high-risk subgroup defined. Our data confirm the greater usefulness of multivariate over univariate statistical analyses in finding risk factors for CRF in IgA-GN.

Adolescent

Synthesis and biological evaluation of 14-alkoxymorphinans. 3. Extensive study on cyprodime-related compounds.

A series of cyprodime-related compounds (2, 4-12, and 26) has been synthesized and evaluated for opioid agonist and antagonist activity with the mouse vas deferens and guinea pig ileum preparations. None of the changes to cyprodime, including the introduction of a 3-OMe group, increasing and decreasing the size of or completely removing the substituent in position 4, replacing the N-cyclopropylmethyl group with an N-allyl group, or replacing the 14-OMe with an 14-OEt substituent, resulted in an improved mu antagonist profile and most were detrimental either in terms of mu selectivity and potency or increased agonist activity. Increasing the length of the substituent in position 4 resulted in a compound (6a) with a very similar profile to that of cyprodime.

Animals

Learning needs of patients with angina: an extension study.

This study compares the learning needs of patients diagnosed with coronary artery disease who experience angina with ratings by the patients themselves and the nurses who care for them. Also compared are the rankings done on categories of select learning needs with rankings done on categories of actual or intended adherence to prescribed medical regimens, using data obtained from the patients. Samples consisted of 15 telemetry unit nurses, 15 inpatients with angina, and 15 postdischarge patients with angina. All participants responded to the Cardiac Patient Learning Need Inventory and a demographic data sheet. Patients also responded to the Educator Preference Tool and either the Health Intention or Health Behavior Scale. Data analysis indicated that similarities and differences existed between patients and nurses in what they believed is important for patients to learn. Patients expressed a greater preference for physicians, rather than nurses, to teach them cardiac information. The findings indicate that what patients believe is most important to learn, as indicated by select learning needs categories, is related to what they most intend to do or actually adhere to regarding their medical regimen.

Adult

Epidemiology of nocturnal enuresis in a part of Khartoum, Sudan. I. The extensive study.

An epidemiological study was made of 8,462 children aged 3-15 living in the suburban area Hag Yousif, Khartoum, Sudan. The prevalence of enuresis was higher in boys than in girls. Eighty-eight per cent wetted their beds at least several times per week. Up to the age of 9 both sexes showed prevalences which were significantly higher than comparable age/sex groups discussed in different European studies. Only 5% of the children above 7 years of age had secondary enuresis.

Adolescent

Smoking behavior in nine year old children: a replication and extension study.

This study replicates and extends the results of our earlier findings which showed that 35% of children at age 9 had experimented with cigarettes for various reasons. Seven hundred eighty-seven children from the earlier sample and 361 children from the current sample participated in this study. Forty-one percent of the current sample had puffed a cigarette, 18% had tried it in the last year, 6% in the last 4 weeks and 3.5% in the last week. The study also showed that children who had puffed a cigarette had a significantly positive attitude towards smoking when compared with children who had not experimented with cigarettes. The puffers believed smoking is good, wise and fun.

Attitude

[My practice of thrombolysis in the acute phase of myocardial infarction in the light of extensive studies].

Hospital mortality due to myocardial infarction has decreased markedly since the 1970's. Intravenous thrombolysis is certainly one of the reasons for this decrease but its precise role cannot be defined. In practice, major therapeutic trials enable definition of the broad lines. It is nevertheless essential to combine our personal experience with their analysis. It is not yet possible at present to say which is the best thrombolytic. Use of the association streptokinase-rtPA has the advantages of both agents and the same risks at a lower cost than that of rtPA alone.

Drug Therapy, Combination

Alternate explanations of loneliness in adolescents: a replication and extension study.

Alternate explanations of loneliness proposed by Weiss (1973)--the situational theory and the characterological theory--were tested in samples of early (N = 113), middle (N = 106), and late (N = 106) adolescents. In addition to completing the Revised UCLA Loneliness Scale, participants completed instruments linked to either the situational or characterological explanation of loneliness. Data were analyzed using hierarchical analysis of sets. For early adolescents, the results indicated that the characterological set of variables explained somewhat more variance in loneliness than did the situational set of variables. These findings did not replicate those of the original study (Mahon & Yarcheski, 1988). For middle and late adolescents, the results indicated that the situational set of variables explained more variance in loneliness than did the characterological set.

Adaptation, Psychological