Novel Psychoactive Substance Use and Psychological Trauma: A Multimethodological Analysis.

BACKGROUND: Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. METHOD: This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. RESULTS: Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). CONCLUSIONS: Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS.

Using PETTLEP imagery as a simulation technique in nursing: Research and guidelines.

One of the most valuable skill sets developed in nurse education is the ability to develop the clinical and practical skills learned. This can take various forms such as university-based practice, simulation and direct experience with patients. To this end imagery, a process where all of the senses are used to create or recreate an experience in the mind, could represent simulated practice of clinical skills. Research on imagery has indicated that the technique, when used to assist in the performance of skill based procedures carried out by nurses can be beneficial. However, guidelines are lacking in this area of simulated practice. In this article, we review current research on the topic of imagery in enhancing skilled performance and outline a model that can assist in conducting interventions. Furthermore, we consider how this could be implemented within a nursing environment to produce beneficial performance effects in both pre-registration and registered nurses.

Developing nurse match: A selection tool for evoking and scoring an applicant's nursing values and attributes.

AIM: To develop an instrument (Nurse Match: NM) for assessing a candidate's nursing values, their meaning, relative importance and emotional significance. Candidate's values to be scored against professionally preferred nursing values effectively and efficiently. DESIGN: A case study-based qualitative process with quantified output. Perception of self and others in relevant contexts using bi-polar value dimensions. METHODS: Respondents (N = 63) were first year nursing students completed the instrument and a feedback questionnaire. Data were analysed and scored by ipseus software using algorithm defined parameters. Statistical analysis: Minitab 17. RESULTS: The instrument discriminated effectively and efficiently between year one nurses in terms of the professional quality of their inherent nursing values and attributes;created suitability scores (STOT scores) for candidate screening purposes;suitability scores closely approximated normal distributions;was valid and reliable: robust in quantitative and qualitative terms;was administered, scored and interpreted in a standard manner;was easy to understand and complete and well received by participants. The NM instrument offers a standardized, effective, user friendly, screening process for values and attributes. Development work with a group of actual applicants is required. NM is complementary to other modes of assessment.

The nurse match instrument: Exploring professional nursing identity and professional nursing values for future nurse recruitment.

From April 1st 2015 it will be mandatory for Higher Education Institutions (HEI) in the United Kingdom (UK) providing pre-qualifying health care higher education to use a Values Based Recruitment (VBR) tool, to ensure only the candidates with the "right" personal identity and values commensurate with the Professional Identity of Nursing (PIN) are accepted for nurse education. "Nurse Match" instrument was developed to enhance the recruitment and selection of candidates for pre-qualifying nursing. Action Research into PIN commenced with voluntary, purposive, convenience samples of qualified nurses (n = 30), Service Users (N = 10), postgraduate diploma nurses in mental health (N = 25), third year mental health branch students (N = 20) and adult and child student nurses in years 2 and 3 (N = 20) in Focus Groups. Data collection and analysis occurred concomitantly between July 2013 and October 2014, aided by NVivo 10 software and revealed Key Quality Indicators (KQIs) of the social construction of PIN. Construct development included a literature review spanning the last fifteen years, which identified four main themes; 1. Nursing's ethics and values. 2. Nursing's professional identity and caring. 3. Nursing's emotional intelligence. 4. Nursing's professionalism. Nurse Match offers an evidence-based enhancement to VBR, for future nurse recruitment locally, nationally and internationally.

Evolutionary implications of C3 -C4 intermediates in the grass Alloteropsis semialata.

C4 photosynthesis is a complex trait resulting from a series of anatomical and biochemical modifications to the ancestral C3 pathway. It is thought to evolve in a stepwise manner, creating intermediates with different combinations of C4 -like components. Determining the adaptive value of these components is key to understanding how C4 photosynthesis can gradually assemble through natural selection. Here, we decompose the photosynthetic phenotypes of numerous individuals of the grass Alloteropsis semialata, the only species known to include both C3 and C4 genotypes. Analyses of δ(13) C, physiology and leaf anatomy demonstrate for the first time the existence of physiological C3 -C4 intermediate individuals in the species. Based on previous phylogenetic analyses, the C3 -C4 individuals are not hybrids between the C3 and C4 genotypes analysed, but instead belong to a distinct genetic lineage, and might have given rise to C4 descendants. C3 A. semialata, present in colder climates, likely represents a reversal from a C3 -C4 intermediate state, indicating that, unlike C4 photosynthesis, evolution of the C3 -C4 phenotype is not irreversible.

Ecology of grazing lawns in Africa.

Grazing lawns are a distinct grassland community type, characterised by short-stature and with their persistence and spread promoted by grazing. In Africa, they reveal a long co-evolutionary history of grasses and large mammal grazers. The attractiveness to grazers of a low-biomass sward lies in the relatively high quality of forage, largely due to the low proportion of stem material in the sward; this encourages repeat grazing that concomitantly suppresses tall-grass growth forms that would otherwise outcompete lawn species for light. Regular grazing that prevents shading and maintains sward quality is thus the cornerstone of grazing lawn dynamics. The strong interplay between abiotic conditions and disturbance factors, which are central to grazing lawn existence, can also cause these systems to be highly dynamic. Here we identify differences in growth form among grazing lawn grass species, and assess how compositional differences among lawn types, as well as environmental variables, influence their maintenance requirements (i.e. grazing frequency) and vulnerability to degradation. We also make a clear distinction between the processes of lawn establishment and lawn maintenance. Rainfall, soil nutrient status, grazer community composition and fire regime have strong and interactive influences on both processes. However, factors that concentrate grazing pressure (e.g. nutrient hotspots and sodic sites) have more bearing on where lawns establish. Similarly, we discuss the relevance of enhanced rates of nitrogen cycling and of sodium levels to lawn maintenance. Grazer community composition and density has considerable significance to grazing lawn dynamics; not all grazers are adapted to foraging on short-grass swards, and differences in body size and relative mouth dimensions determine which species are able to convert tall-grass swards into grazing lawns under different conditions. Hence, we evaluate the roles of different grazers in lawn dynamics, as well as the benefits that grazer populations derive from having access to grazing lawns. The effects of grazing lawns can extend well beyond their borders, due to their influence on grazer densities, behaviour and movements as well as fire spread, intensity and frequency. Variation in the area and proportion of a landscape that is grazing lawn can thus have a profound impact on system dynamics. We provide a conceptual model that summarises grazing lawn dynamics, and identify a rainfall range where we predict grazing lawns to be most prevalent. We also examine the biodiversity associated with grazing lawn systems, and consider their functional contribution to the conservation of this biodiversity. Finally, we assess the utility of grazing lawns as a resource in a rangeland context.

Resettlement of individuals with learning disabilities into community care: a risk audit.

This article describes a risk audit carried out on the support provided for 36 people with profound learning disabilities who had been resettled from hospital care to supported housing. The risks were those factors identified in the literature as associated with deleterious effects on quality of life. The audit was carried out with a specially designed tool that covered 24 possible risks and involved a support worker familiar with the service user choosing the most appropriate statement regarding each risk. Their judgements were verified by care managers and social needs assessors. Whilst one or more risks were identified for 32 of the 36 service users, the overall result showed relatively low risks for the group as a whole with 62 incidences (7%) from a possible 864, which nevertheless highlighted several areas that needed attention. The results of the audit have led to action plans for the provision and for the individual service users for whom risks were identified.

Producer survey of herd-level risk factors for nursing beef calf respiratory disease.

OBJECTIVE: To identify herd-level risk factors for bovine respiratory disease (BRD) in nursing beef calves. DESIGN: Population-based cross-sectional survey. SAMPLE: 2,600 US cow-calf producers in 3 Eastern and 3 Plains states. PROCEDURES: The associations of herd characteristics with BRD detection in calves and cumulative BRD treatment incidence were determined. RESULTS: 459 (177%) surveys were returned and met the inclusion criteria; 48% and 52% of these surveys were completed by producers in Plains and Eastern states, respectively. Mean (95% confidence interval) number of animals in herds in Plains and Eastern states were 102 (77 to 126) and 48 (40 to 56), respectively. Bovine respiratory disease had been detected in ≥ 1 calf in 21% of operations; ≥ 1 calf was treated for BRD and ≥ 1 calf died because of BRD in 89.2% and 46.4% of operations in which calf BRD was detected, respectively. Detection of BRD in calves was significantly associated with large herd size, detection of BRD in cows, and diarrhea in calves. Calving season length was associated with BRD in calves in Plains states but not Eastern states. Cumulative incidence of BRD treatment was negatively associated with large herd size and examination of cows to detect pregnancy and positively associated with calving during the winter, introduction of calves from an outside source, offering supplemental feed to calves, and use of an estrous cycle synchronization program for cows. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study indicated factors associated with calf BRD risk; modification of these factors could potentially decrease the incidence of BRD in nursing calves.

Effect of calf age and administration route of initial multivalent modified-live virus vaccine on humoral and cell-mediated immune responses following subsequent administration of a booster vaccination at weaning in beef calves.

OBJECTIVE: To compare immune responses following modified-live virus (MLV) vaccination at weaning after intranasal or SC administration of an MLV vaccine to beef calves at 2 or 70 days of age. ANIMALS: 184 calves. PROCEDURES: Calves were allocated to 1 of 5 groups. The IN2 (n = 37) and IN70 (37) groups received an MLV vaccine containing bovine herpesvirus 1 (BHV1), bovine viral diarrhea virus (BVDV) types 1 and 2, bovine respiratory syncytial virus (BRSV), and parainfluenza 3 virus intranasally and a Mannheimia haemolytica and Pasteurella multocida bacterin SC at median ages of 2 and 70 days, respectively. The SC2 (n = 36) and SC70 (37) groups received a 7-way MLV vaccine containing BHV1, BVDV1, BVDV2, BRSV, parainfluenza 3 virus, M haemolytica, and P multocida SC at median ages of 2 and 70 days, respectively; the control group (37) remained unvaccinated until weaning. All calves received the 7-way MLV vaccine SC at median ages of 217 (weaning) and 231 days. Serum neutralizing antibody (SNA) titers against BHV1, BVDV1, and BRSV and intranasal IgA concentrations were determined at median ages of 2, 70, 140, 217, and 262 days. Cell-mediated immunity (CMI) against BHV1, BRSV, BVDV1, and P multocida was determined for 16 calves/group. RESULTS: At median ages of 140 and 217 days, BVDV1 SNA titers were significantly higher for the SC70 group than those for the other groups. Intranasal IgA concentrations and CMI increased over time for all groups. Vaccination at weaning increased SNA titers and CMI in all groups. CONCLUSIONS AND CLINICAL RELEVANCE: SC administration of an MLV vaccine to 70-day-old calves significantly increased BVDV1 antibody titers before weaning.

Evaluating quality of life in adults with profound learning difficulties resettled from hospital to supported living in the community.

This article describes a longitudinal evaluation of the quality of life of service users with profound learning difficulties who were resettled from hospital accommodation to supported housing in the community. The Trident approach was used for the design of the evaluation with data gathered regarding outcomes, process and stakeholder perspectives. Using a specially designed tool, quality of life was measured in seven domains for 39 service users in the hospital as a base line and at six months, twelve months and eighteen months in supported housing. A statistically significant improvement in quality of life overall and in each of the seven domains was found. Questionnaire surveys of parents/next of kin and support staff confirmed these findings as did a number of qualitative case studies.

An evaluation of a managed clinical network for personality disorder: breaking new ground or top dressing?

RATIONALE, AIMS AND OBJECTIVES: This article describes an evaluation of an innovative managed clinical network in the UK. The purpose of the network was to establish a better-coordinated service for those with personality disorder. The network was evaluated with regard to the extent it met its stated and implied outcomes; the process whereby it was established and operated; and the views of the various stakeholders involved. Managed clinical networks are briefly reviewed. METHODS: Methods to gather evaluation data included documentary analysis, the use of specially devised tools to assess partnership, staff development needs and record keeping, and interviews. RESULTS: While the network had achieved its objectives to establish new operational structures and communication networks and staff showed a high level of commitment, it was unclear whether the network had maintained or improved the clinical service. Record keeping for assessment and clinical intervention was at an early stage and there was a need for more systematic use of assessment instruments and data management systems. The creation of a new category of staff - the Network coordinator - raised problems of delivery and staff development. CONCLUSIONS: On the basis of this evaluation and at this stage of one network's development it is concluded that the benefits of a managed clinical network remain theoretical rather than proven.

Effect of PETTLEP imagery training on performance of nursing skills: pilot study.

AIM: This article is a report of a study to evaluate the effect of PETTLEP-based imagery training on nursing skill performance. BACKGROUND: Imagery structuring has been demonstrated to facilitate the development of psychomotor skills in sporting performance. A form of imagery structuring known as PETTLEP was employed in this study. PETTLEP (an acronym for its procedures) involves preparation through focussing on physical characteristics, the environment, the task itself, timing, learning, emotion and perspective. METHODS: A pilot study was conducted, using experimental design, and the data were collected in 2005. Participants in the experiment were 56 pre-registration students from one university in the United Kingdom. Half of the students received training for two basic nursing skills using PETTLEP procedures, and scores were compared for two objective structured clinical examinations. RESULTS: Students who received PETTLEP training for blood pressure measurement performed statistically significantly better than those who did not (F = 4.62 P = <0.05). The training did not have a statistically significant effect for aseptic techniques. We suggest that the psychomotor element in aseptic techniques was not as important as that involved in blood pressure measurement. CONCLUSION: PETTLEP imagery should be explored further as a method to help nursing students acquire skills that have a psychomotor component.

Urinary incontinence in nulliparous women.

Linda Birch and colleagues review the evidence associated with various demographic and behavioural risk factors for the development of urinary incontinence in nulliparous, pre-menopausal women.

Evaluation and communication: using a communication audit to evaluate organizational communication.

This article identifies a surprising dearth of studies that explicitly link communication and evaluation at substantive, theoretical, and methodological levels. A three-fold typology of evaluation studies referring to communication is proposed and examples given. The importance of organizational communication in program delivery is stressed and illustrative studies reviewed. It is proposed that organizational communication should be considered in all program evaluations and that this should be approached through communication audit. Communication audits are described with particular reference to established survey questionnaire instruments. Two case studies exemplify the use of such instruments in the evaluation of educational and social programs.

Using a communication audit to improve communication on clinical placement in pre-registration nursing.

This article describes a novel communication audit conducted with those concerned with the practice placements of pre-registration Nursing students. The study, uniquely, addressed all who were involved in communication concerning placement in what is described as an organisational analysis. The aim of the audit was to identify levels of satisfaction and dissatisfaction with present communication processes and to identify points for improvement. The audit used the Hogard-Barker Communication Audit of Practice a customized version of a well established tool, devised to cover issues relevant to practice placements. A key feature of the tool is the opportunity for participants to identify the amount of communication they are receiving on particular topics and issues against the amount they would like to receive. Participants in the audit included students, assessor mentors, ward managers, clinical facilitators and link tutors. Overall there was considerable dissatisfaction with what was perceived to be the insufficient amount of communication received on a number of topics including allocations, the curriculum, students' learning outcomes and commitments in terms of college work. In addition to identifying points for improvement the audit provides a baseline against which progress can be assessed through a future audit.