Population-Based Imaging and Radiomics: Rationale and Perspective of the German National Cohort MRI Study.

UNLABELLED: The MRI study within the German National Cohort, a large-scale, population-based, longitudinal study in Germany, comprises comprehensive characterization and phenotyping of a total of 30 000 participants using 3-Tesla whole-body MR imaging. A multi-centric study design was established together with dedicated core facilities for e. g. managing incidental findings or providing quality assurance. As such, the study represents a unique opportunity to substantially impact imaging-based risk stratification leading to personalized and precision medicine. Supported by the developments in the field of computational science, the newly developing scientific field of radiomics has large potential for the future. In the present article we provide an overview on population-based imaging and Radiomics and conceptualize the rationale and design of the MRI study within the German National Cohort. KEY POINTS: • Population-based imaging and Radiomics constitute two emerging fields with great oppertunities and challenges for Radiology.• As part of the MRI-study of the NAKO approximately 30 000 subjects will undergo 3 Tesla whole-body MRI.• MR Imaging data is publicly accessable and will provide important insights into the natural history of disease processes and personalized risk profiles of the general population. Citation Format: • Schlett CL, Hendel T, Weckbach S et al. Population-Based Imaging and Radiomics: Rationale and Perspective of the German National Cohort MRI Study. Fortschr Röntgenstr 2016; 188: 652 - 661.

Visual learning in individually assayed Drosophila larvae.

An understanding of associative learning is facilitated if it can be analyzed in a simple animal like the fruit fly Drosophila. Here, we introduce the first visual associative learning paradigm for larval Drosophila; this is remarkable as larvae have an order of magnitude fewer neurons than adult flies. Larvae were subjected to either of two reciprocal training regimes: Light+/Dark- or Light-/Dark+. Subsequently, all larvae were individually tested for their preference between Light versus Dark. The difference between training regimes was therefore exclusively which visual situation was associated with which reinforcer; differences observed during the test thus reflected exclusively associative learning. For positive reinforcement (+) we used fructose (FRU), and for negative reinforcement (-) either quinine or sodium chloride (QUI, NaCl). Under these conditions, associative learning could be reproducibly observed in both wild-type strains tested. We then compared the effectiveness of training using differential conditioning, with both positive and negative reinforcement, to that using only positive or only negative reinforcement. We found that FRU only, but neither QUI nor NaCl, was in itself effective as a reinforcer. This is the first demonstration of appetitive learning in larval Drosophila. It is now possible to investigate the behavioral and neuronal organization of appetitive visual learning in this simple and genetically easy-to-manipulate experimental system.

Ethics in pediatric nursing: an international perspective.

The goal of this survey was to compare similarities and differences between two groups of pediatric nurses, a group from developing countries and a group from Israel, in confronting ethical issues and in the use of resources for support. Findings indicate similarities between the two groups in a majority of ethical situations that concern them in their work despite differences in cultural backgrounds.

Strategies used by hospital nurses to cope with a national crisis: a manager's perspective.

This article explores the anxiety level of, and coping strategies used by, hospital nurses, during a national state of emergency. The study was guided by a stress and coping framework, developed by Lazarus & Folkman, and was conducted at a large teaching hospital, located in the centre of Israel, during the Iraqi crisis in January and February, 1998. Data were collected from a sample of 100 female nurses, and a descriptive correlational design was used. The findings indicated that approximately 33% of the nurses expressed feelings of stress, tension and a sense of discomfort. The dominant coping strategy used by the nurses was direct-active, which was found to be the most effective strategy. As they were unable to remove or control the stressor, stress management intervention by nursing managers focused mainly on communicating with staff and providing social support - informational and emotional--to buffer the stressful experience. Providing support and help in finding practical solutions is important for maintaining emotional stability of staff, thereby helping them to improve their nursing interventions in assisting people to cope with stressful situations.

Israeli student nurses' attitudes about physical restraints in acute care settings.

A total of 147 nursing students from an academic school of nursing in Israel, affiliated with the Nursing Department at Tel Aviv University, were studied to determine their attitudes toward the use of physical restraints, their knowledge of patient restraint protocol, related reasons, alternatives, follow-up, and reporting. Data were analyzed according to the student's year of learning and experience in restraining. Significant results showed that most students displayed negative attitudes toward restraining. Most were quite knowledgeable of patient restraint protocol, but they acted according to accepted practice in the hospital wards. These findings suggest that nursing educators must play an important role in reinforcing knowledge and improving the practicum of nursing students in the clinical area concerning restraints. This goal will be achieved by various educational strategies.

Merger management: a challenge to nursing leadership.

AIM: The article reviews the merger process of two obstetric divisions. BACKGROUND: Mergers of acute care facilities are becoming common due to the need to move towards a market orientation. There is a growing emphasis on corporations, competition, and profit and cost control. Nursing leadership in managing merger processes is crucial. METHODS: Information originated from administrative decisions, feelings expressed by the staff, author observations, and statistical data. Data was analysed by illustrating the merger phases, compared to the literature and research studies. KEY ISSUES: Issues related to planning and preparing the process, the management of human resources, the development of organizational culture, and the physical changes, are vital. CONCLUSIONS: Planning ahead, involving all partners from the early stages, extensive dialogue among colleagues and strong nursing leadership are key elements for a smooth transition.

Integrating ongoing evaluation process for international pediatric nursing courses.

Two international pediatric courses for nurses from developing countries were planned and implemented in Israel during the past 2 years. The courses consisted of 53 RNs from 29 countries. The purpose of this article is to describe the ongoing evaluation and follow-up process of these courses. Findings indicated that the majority of nurses expressed: a) high satisfaction with the course and felt it enhanced their professional capacity and practice, and benefited their colleagues and superiors; b) high motivation and enthusiasm to improve nursing practices in their home countries; c) changes in attitudes and beliefs relating to pediatric nursing.

PIP: A total of 53 nurses from 29 developing countries participated in two 8-week pediatric nursing courses held in Israel in 1993 and 1994 under the auspices of the Center for International Cooperation of the Ministry of Foreign Affairs, Kupat Holim (Israel's largest health insurance institution), and the Dina School of Nursing. The course objectives were to increase knowledge of child growth and development, enhance awareness of the special needs of children and their families, impart specific clinical skills, and instill a holistic, multicultural perspective. Continuous evaluation of the 320-hour course was achieved through structured individual interviews with participants, periodic class discussions, and a written midterm examination on the materials covered. Final course evaluation was achieved through a written examination, class discussion, and completion of a questionnaire devised by the Foreign Ministry. One year after completion of the second course, a questionnaire was mailed to all participants in both courses. Of the 30 nurses (57%) who responded, the majority felt the course enhanced their professional knowledge and practice and agreed their institution, colleagues, and supervisors benefited from their participation. Although 21 nurses (69%) stated the course increased their chances for professional advancement, only 9 (31%) reported it had any impact on their professional status. A particularly notable outcome of course enrollment was increased awareness of the importance of parental participation in the care of hospitalized children.

Promoting perioperative nursing through international cooperation.

Adequate development of human resources is a challenge facing all societies and nations, especially those in transition from one development stage to another. Through international cooperation programs, perioperative nurses can share and exchange knowledge, experience, and expertise. They also can expand their clinical horizons, fostering collegiality and friendships and further advancing nursing professionalism internationally. In Israel, we developed and implemented a special, short-term course for perioperative nurses from developing countries. Planners and participants found this course to be an outstanding experience.

Staff development through international cooperation. The Kenya experience.

International cooperation in nursing enables nurses to share, exchange, and develop knowledge and experience, increase tolerance and sensitivity, expand horizons, make new friends, and contribute to the advancement of professionalism. International cooperation exists in many fields and is carried out through governments, international organizations, public and academic institutions, and professional associations. The authors were sent by the Center for International Cooperation of Israel's Ministry of Foreign Affairs to teach a course entitled "The Nurse Educator Role: Aspects in Nursing Education and Management." The learners were senior nurses in Kenyatta National Hospital, Nairobi, Kenya. The course was designed to meet two main objectives: (1) to emphasize the educational role as an essential dimension of the professional nursing practice, and (2) to expand the knowledge base and skills to enable participants to improve their function as educators.

The moderating effects of structural characteristics of wards in general hospitals on the relationship between professional management and quality of care.

The present research examined the moderating effects of three structural characteristics of wards: ward type (surgical vs medical), size, and hospital size on the relationship between professional management and quality of nursing care (QNC) on the ward. The sample consisted of 119 wards situated in general hospitals in Israel. The results of the three regression analyses show that only hospital size, had a moderating effect. Further analysis of the interaction showed that the effect of professional ward management on QNC was greater in large than in small or medium-sized hospitals. In addition, ward size was found to have a great effect, i.e. larger wards had lower QNC. Finally, in all three analyses professional management achieved significance, that is, better management is associated with higher QNC.