RESUMEN
Lateral inhibition mediates alternative cell fate decision and produces regular cell fate patterns with fate symmetry breaking (SB) relying on the amplification of small stochastic differences in Notch activity via an intercellular negative feedback loop. Here, we used quantitative live imaging of endogenous Scute (Sc), a proneural factor, and of a Notch activity reporter to study the emergence of Sensory Organ Precursor cells (SOPs) in the pupal abdomen of Drosophila. SB was observed at low Sc levels and was not preceded by a phase of intermediate Sc expression and Notch activity. Thus, mutual inhibition may only be transient in this context. In support of the intercellular feedback loop model, cell-to-cell variations in Sc levels promoted fate divergence. The size of the apical area of competing cells did not detectably bias this fate choice. Surprisingly, cells that were in direct contact at the time of SB could adopt the SOP fate, albeit at low frequency (10%). These lateral inhibition defects were corrected by cellular rearrangements, not cell fate change, highlighting the role of cell-cell intercalation in pattern refinement.
RESUMEN
Implementing person-centred care is often considered difficult in congested emergency rooms. The purpose of this study was to understand person-centred care experienced by emergency room nurses in depth and examine the essence of emergency room nurses' lived experience of the person- centred care. Eight nurses working in the emergency room of a large hospital in South Korea and who had over six months of experience were surveyed via semi-structured interviews in February 2019. The data were transcribed and analysed using Colaizzi's framework. The major findings related to person-centred care experiences among emergency room nurses were: (1) feeling distanced from patients; (2) guilt and frustration; (3) accepting patients' symptoms and emotions as they are; (4) person-centred care as a domain of nursing that cannot be replaced by machines; and (5) nursing as an art wherein the minutest details make a difference. Providing person-centred practice in the emergency room is difficult, but it will not only improve the quality of patient care but also increase the job satisfaction of nurses. Based on an in-depth understanding of person-centred care experienced by emergency nurses, it will contribute to enhancing the quality of nursing care in the emergency room.
RESUMEN
PURPOSE: This study aimed to evaluate the usefulness of a behavioral cue checklist (BCC) containing 17 items developed by Wilkes et al. (2010) for identifying potentially violent patients in emergency departments. METHODS: This was a prospective observational study to evaluate the usefulness of the Korean version of a BCC (K-BCC) as an assessment tool for predicting patient violence in emergency departments, and was conducted over 4 weeks in a regional emergency medical center located in B City. A total of 1,324 patients were finally analyzed. RESULTS: Logistic regression analysis was performed to investigate whether each item of the K-BCC predicts violence, and a parsimonious set of 8 statistically significant items was selected for the tool. Receiver operating characteristic analysis of the BCC showed that the area under the curve was .97 (95% confidence interval: .94~1.0). The sensitivity, specificity, positive predictive value, and negative predictive value at the cut-off score of 2 were 75.6%, 98.9%, 68.2%, and 99.2%, respectively. CONCLUSION: The K-BCC was found to be useful in predicting patient violence toward emergency department staff. This tool is simple, and fast to use and can play a significantly role identifying potentially violent patients. Owing to this advance identification, this tool can be helpful in preventing the potential for violence from manifesting as violent behaviors.