Leadership by point-of-care and senior managers is increasingly recognized as critical to the acceptance and use of research evidence in practice. The purpose of this systematic review was to ...identify the leadership behaviours of managers that are associated with research use by clinical staff in nursing and allied health professionals.
A mixed methods systematic review was performed. Eight electronic bibliographic databases were searched. Studies examining the association between leadership behaviours and nurses and allied health professionals' use of research were eligible for inclusion. Studies were excluded if leadership could not be clearly attributed to someone in a management position. Two reviewers independently screened abstracts, reviewed full-text articles, extracted data and performed quality assessments. Narrative synthesis was conducted.
The search yielded 7019 unique titles and abstracts after duplicates were removed. Three hundred five full-text articles were reviewed, and 31 studies reported in 34 articles were included. Methods used were qualitative (n = 19), cross-sectional survey (n = 9), and mixed methods (n = 3). All studies included nurses, and six also included allied health professionals. Twelve leadership behaviours were extracted from the data for point-of-care managers and ten for senior managers. Findings indicated that managers performed a diverse range of leadership behaviours that encompassed change-oriented, relation-oriented and task-oriented behaviours. The most commonly described behavior was support for the change, which involved demonstrating conceptual and operational commitment to research-based practices.
This systematic review adds to the growing body of evidence that indicates that manager-staff dyads are influential in translating research evidence into action. Findings also reveal that leadership for research use involves change and task-oriented behaviours that influence the environmental milieu and the organisational infrastructure that supports clinical care. While findings explain how managers enact leadership for research use, we now require robust methodological studies to determine which behaviours are effective in enabling research use with nurses and allied health professionals for high-quality evidence-based care.
PROSPERO CRD42014007660.
Changes in phenology in response to ongoing climate change have been observed in numerous taxa around the world. Differing rates of phenological shifts across trophic levels have led to concerns that ...ecological interactions may become increasingly decoupled in time, with potential negative consequences for populations. Despite widespread evidence of phenological change and a broad body of supporting theory, large-scale multitaxa evidence for demographic consequences of phenological asynchrony remains elusive. Using data from a continental-scale bird-banding program, we assess the impact of phenological dynamics on avian breeding productivity in 41 species of migratory and resident North American birds breeding in and around forested areas. We find strong evidence for a phenological optimum where breeding productivity decreases in years with both particularly early or late phenology and when breeding occurs early or late relative to local vegetation phenology. Moreover, we demonstrate that landbird breeding phenology did not keep pace with shifts in the timing of vegetation green-up over a recent 18-y period, even though avian breeding phenology has tracked green-up with greater sensitivity than arrival for migratory species. Species whose breeding phenology more closely tracked green-up tend to migrate shorter distances (or are resident over the entire year) and breed earlier in the season. These results showcase the broadest-scale evidence yet of the demographic impacts of phenological change. Future climate change-associated phenological shifts will likely result in a decrease in breeding productivity for most species, given that bird breeding phenology is failing to keep pace with climate change.
Abstract
Chiral spin textures such as skyrmions are of interest to the field of spintronics for their potential use in future computing devices. Hall effect measurements are a simple and powerful ...method to probe the electronic and magnetic properties of materials. The topological Hall effect, which appears as anomalies in Hall resistance versus magnetic field measurements compared to magnetic measurements, has frequently been used to establish the occurrence of chiral spin textures. However, in addition to experimental issues, intrinsic electronic mechanisms combined with inhomogeneity in materials and at interfaces can lead to an inhomogeneous anomalous Hall effect which could be mistaken for a topological Hall signal. This review covers recent research using Hall effect measurements to probe chiral spin textures, focusing on SrRuO
3
as a model system. The ambiguity between Hall effects due to topological sources has led to disagreement in the interpretation of experimental results and casts doubts on the effectiveness of these techniques for investigating chiral spin textures.
Tuberculosis is out of control in developing countries, where it is killing millions of people every year. In these areas, the present vaccine - Mycobacterium bovis bacillus Calmette-Guérin (BCG) - ...is failing. Progressive tuberculosis occurs because the potentially protective T helper 1 (T(H)1)-cell response is converted to an immunopathological response that fails to eliminate the bacteria. Here, we discuss the data indicating that the problem in developing countries is not a lack of adequate T(H)1-cell responses but, instead, an exaggerated tendency to switch to immunopathological responses. We propose that a successful vaccine needs to block this immunopathology, because it is not the quantity of T(H)1-cell activity that matters but, rather, its context.
STUDY QUESTION
To what extent do the management of endometriosis and the symptoms that remain after treatment affect the quality of life in women with the disease?
SUMMARY ANSWER
Many women with ...endometriosis had impaired quality of life and continued to suffer from endometriosis-associated symptoms even though their endometriosis has been managed in tertiary care centres.
WHAT IS KNOWN ALREADY
The existing literature indicates that quality of life and work productivity is reduced in women with endometriosis. However, most studies have small sample sizes, are treatment related or examine newly diagnosed patients only.
STUDY DESIGN, SIZE, DURATION
A cross-sectional questionnaire-based survey among 931 women with endometriosis treated in 12 tertiary care centres in 10 countries.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Women diagnosed with endometriosis who had at least one contact related to endometriosis-associated symptoms during 2008 with a participating centre were enrolled into the study. The study investigated the effect of endometriosis on education, work and social wellbeing, endometriosis-associated symptoms and health-related quality of life, by using questions obtained from the World Endometriosis Research Foundation (WERF) GSWH instrument (designed and validated for the WERF Global Study on Women's Health) and the Short Form 36 version 2 (SF-36v2).
MAIN RESULTS AND THE ROLE OF CHANCE
Of 3216 women invited to participate in the study, 1450 (45%) provided informed consent and out of these, 931 (931/3216 = 29%) returned the questionnaires. Endometriosis had affected work in 51% of the women and affected relationships in 50% of the women at some time during their life. Dysmenorrhoea was reported by 59%, dyspareunia by 56% and chronic pelvic pain by 60% of women. Quality of life was decreased in all eight dimensions of the SF-36v2 compared with norm-based scores from a general US population (all P < 0.01). Multivariate regression analysis showed that number of co-morbidities, chronic pain and dyspareunia had an independent negative effect on both the physical and mental component of the SF-36v2.
LIMITATIONS, REASONS FOR CAUTION
The fact that women were enrolled in tertiary care centres could lead to a possible over-representation of women with moderate-to-severe endometriosis, because the participating centres typically treat more complex and referred cases of endometriosis. The response rate was relatively low. Since there was no Institute Review Board approval to do a non-responder investigation on basic characteristics, some uncertainty remains regarding the representativeness of the investigated population.
WIDER IMPLICATIONS OF THE FINDINGS
This international multicentre survey represents a large group of women with endometriosis, in all phases of the disease, which increases the generalizability of the data. Women still suffer from frequent symptoms, despite tertiary care management, in particular chronic pain and dyspareunia. As a result their quality of life is significantly decreased. A patient-centred approach with extensive collaboration across disciplines, such as pain specialists, psychologists, sexologists and social workers, may be a valuable strategy to improve the long-term care of women with endometriosis.
STUDY FUNDING/COMPETING INTEREST(S)
The WERF EndoCost study is funded by the World Endometriosis Research Foundation (WERF) through grants received from Bayer Schering Pharma AG, Takeda Italia Farmaceutici SpA, Pfizer Ltd and the European Society of Human Reproduction and Embryology. The sponsors did not have a role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript. L.H. is the chief executive and T.D. was a board member of WERF at the time of funding. T.D. holds the Merck-Serono Chair in Reproductive Medicine and Surgery, and the Ferring Chair in Reproductive Medicine at the Katholieke Universiteit Leuven in Belgium and has served as consultant/research collaborator for Merck-Serono, Schering-Plough, Astellas and Arresto.
Can we vaccinate against depression? Rook, Graham A.W.; Raison, Charles L.; Lowry, Christopher A.
Drug discovery today,
05/2012, Letnik:
17, Številka:
9-10
Journal Article
Recenzirano
► Microorganisms and microbiota with which we coevolved are essential for the induction of immunoregulation. ► Depletion of these organisms by modern life is leading to increased chronic inflammatory ...disorders. ► Depression is strongly associated with inflammation and with chronic inflammatory disorders. ► Auto-reactive regulatory cells are important for central nervous system (CNS) function. ► Vaccination with immunoregulation-inducing organisms might combat depression.
Major depression is common in the context of autoimmune and inflammatory diseases and is frequently associated with persistently raised levels of proinflammatory cytokines and other markers of inflammation, even in the absence of another diagnosable immune pathology to account for these findings. Therefore immunoregulation-inducing vaccines or manipulations of the gut microbiota might prevent or treat depression. These strategies are already undergoing clinical trials for chronic inflammatory disorders, such as allergies, autoimmunity and inflammatory bowel disease. In this article, we summarize data suggesting that this approach might be effective in depression and encourage the initiation of clinical vaccination trials in this disorder.
Scaling relations between supermassive black hole mass, M
BH, and host galaxy properties are a powerful instrument for studying their co-evolution. A complete picture involving all of the black hole ...scaling relations, in which each relation is consistent with the others, is necessary to fully understand the black hole-galaxy connection. The relation between M
BH and the central light concentration of the surrounding bulge, quantified by the Sérsic index n, may be one of the simplest and strongest such relations, requiring only uncalibrated galaxy images. We have conducted a census of literature Sérsic index measurements for a sample of 54 local galaxies with directly measured M
BH values. We find a clear M
BH-n relation, despite an appreciable level of scatter due to the heterogeneity of the data. Given the current M
BH-L
sph and the L
sph-n relations, we have additionally derived the expected
M
BH-n relations, which are marginally consistent at the 2σ level with the observed relations. Elliptical galaxies and the bulges of disc galaxies are each expected to follow two distinct bent
M
BH-n relations due to the Sérsic/core-Sérsic divide. For the same central light concentration, we predict that M
BH in the Sérsic bulges of disc galaxies are an order magnitude higher than in Sérsic elliptical galaxies if they follow the same M
BH-L
sph relation.
Islet transplantation is an efficacious therapy for type 1 diabetes; however, islets from multiple donor pancreata are required, and a gradual attrition in transplant function is seen. Here, we ...manufactured human umbilical cord perivascular mesenchymal stromal cells (HUCPVCs) to Good Manufacturing Practice (GMP) standards. HUCPVCs showed a stable phenotype while undergoing rapid ex vivo expansion at passage 2 (p2) to passage 4 (p4) and produced proregenerative factors, strongly suppressing T cell responses in the resting state and in response to inflammation. Transplanting an islet equivalent (IEQ):HUCPVC ratio of 1:30 under the kidney capsule in diabetic NSG mice demonstrated the fastest return to normoglycemia by 3 days after transplant: Superior glycemic control was seen at both early (2.7 weeks) and later stages (7, 12, and 16 weeks) versus ratios of 1:0, 1:10, and 1:50, respectively. Syngeneic islet transplantation in immunocompetent mice using the clinically relevant hepatic portal route with a marginal islet mass showed that mice transplanted with an IEQ:HUCPVC ratio of 1:150 had superior glycemic control versus ratios of 1:0, 1:90, and 1:210 up to 6 weeks after transplant. Immunodeficient mice transplanted with human islets (IEQ:HUCPVC ratio of 1:150) exhibited better glycemic control for 7 weeks after transplant versus islet transplant alone, and islets transplanted via the hepatic portal vein in an allogeneic mouse model using a curative islet mass demonstrated delayed rejection of islets when cotransplanted with HUCPVCs (IEQ:HUCPVC ratio of 1:150). The immunosuppressive and proregenerative properties of HUCPVCs demonstrated long-term positive effects on graft function in vivo, indicating that they may improve long-term human islet allotransplantation outcomes.
Controls on floc growth in an energetic tidal channel Braithwaite, K. M.; Bowers, D. G.; Nimmo Smith, W. A. M. ...
Journal of Geophysical Research: Oceans,
February 2012, Letnik:
117, Številka:
C2
Journal Article
Recenzirano
Odprti dostop
Measurements of turbulence and suspended particle characteristics have been made continuously for 9 tidal cycles in a shallow, energetic tidal channel. Particle‐size spectra were measured with a ...LISST‐100 laser diffraction instrument placed on a frame on the seabed. A 1200 kHz ADCP in the same frame was used to measure vertical current profiles and from these the turbulent kinetic energy dissipation rate was determined using the structure function method. Median particle size is observed to change in a regular way by a factor of 3 or more over each tidal cycle, with the largest particles observed at slack tide and the smallest at times of maximum flood and ebb. The most likely explanation of this change is that particles are aggregating at times of low turbulence and breaking up during fast flows. A simple dynamical flocculation model that incorporates these processes gives good agreement with observations, particularly if tidal advection of a longitudinal gradient in particle size is allowed for. If particles have time to reach equilibrium with ambient conditions, the model predicts that the particle size will be proportional to the product of concentration and the Kolmogorov microscale. The observations support this prediction on most tidal cycles if a phase lag (of 30–60 min) is allowed between the measurements of particle size and Kolmogorov scale. This phase lag represents the adjustment time for flocs to respond to change in turbulence. The constant of proportionality between median particle size and Kolmogorov scale increases with particle volume.
Key Points
Observations of floc size and turbulence are presented
A dynamical model reproduces the observations
For some of the time, floc size is proportional to Kolmogorov scale, with a lag
In Arabidopsis thaliana, enzymes of glycolysis are present on the surface of mitochondria and free in the cytosol. The functional significance of this dual localization has now been established by ...demonstrating that the extent of mitochondrial association is dependent on respiration rate in both Arabidopsis cells and potato (Solanum tuberosum) tubers. Thus, inhibition of respiration with KCN led to a proportional decrease in the degree of association, whereas stimulation of respiration by uncoupling, tissue ageing, or overexpression of invertase led to increased mitochondrial association. In all treatments, the total activity of the glycolytic enzymes in the cell was unaltered, indicating that the existing pools of each enzyme repartitioned between the cytosol and the mitochondria. Isotope dilution experiments on isolated mitochondria, using ¹³C nuclear magnetic resonance spectroscopy to monitor the impact of unlabeled glycolytic intermediates on the production of downstream intermediates derived from ¹³C-labeled precursors, provided direct evidence for the occurrence of variable levels of substrate channeling. Pull-down experiments suggest that interaction with the outer mitochondrial membrane protein, VDAC, anchors glycolytic enzymes to the mitochondrial surface. It appears that glycolytic enzymes associate dynamically with mitochondria to support respiration and that substrate channeling restricts the use of intermediates by competing metabolic pathways.
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