Consolation Management Aesthetics Within Holistic Nursing.

The aim of this article is to elaborate on consolation management aesthetics in terms of literature, art, and music. This article will be centered on holistic nurses who come in daily contact with vulnerable patients in need of both medical treatment and consolation, as they continue their journey toward one or another outcome. Consolation management aesthetics enables the patients to shift their attention from something that appears intractable to something that motivates, bolsters existential resilience, and offers hope and optimism for the future. Holistic nursing aesthetics, involving psychological healing through literature, art, and music, can help anxious, troubled patients to once again find beauty and balance in their lives.

Spiritual Self-Care Management for Nursing Professionals: A Holistic Approach.

Among all the groups and occupations that have been affected by the global pandemic, nursing professionals stand out as having been particularly hard-pressed due to the dramatic increase in the need for their services. Given the rising tide of coronavirus disease 2019 patients who require specialized medical treatment as well as the millions of others that are lining up for vaccinations, it can be assumed that many nursing professionals have had to endure such things as longer working hours, tighter schedules, and the intensity of a work environment in which failure of care and multiple deaths are the daily fare. This article proposes that nurses can avoid such severe consequences by taking up a regime of enhanced self-care management that enables them to achieve psychophysical balance and wellness. Three practices are highlighted in this regard: prayer, meditative walking, and the mindfulness practice of body scanning. Our suggestion is that these coping strategies will be both beneficial and healthful for nursing professionals in terms of enhancing their spiritual/existential resilience and meeting their own need for consolation as they navigate in an extremely difficult and demanding work environment.

The similarity-updating model of probability judgment and belief revision.

People often take nondiagnostic information into account when revising their beliefs. A probability judgment decreases due to nondiagnostic information represents the well-established "dilution effect" observed in many domains. Surprisingly, the opposite of the dilution effect called the "confirmation effect" has also been observed frequently. The present work provides a unified cognitive model that allows both effects to be explained simultaneously. The suggested similarity-updating model incorporates two psychological components: first, a similarity-based judgment inspired by categorization research, and second, a weighting-and-adding process with an adjustment following a similarity-based confirmation mechanism. Four experimental studies demonstrate the model's predictive accuracy for probability judgments and belief revision. The participants received a sample of information from one of two options and had to judge from which option the information came. The similarity-updating model predicts that the probability judgment is a function of the similarity of the sample to the options. When one is presented with a new sample, the previous probability judgment is updated with a second probability judgment by taking a weighted average of the two and adjusting the result according to a similarity-based confirmation. The model describes people's probability judgments well and outcompetes a Bayesian cognitive model and an alternative probability-theory-plus-noise model. The similarity-updating model accounts for several qualitative findings, namely, dilution effects, confirmation effects, order effects, and the finding that probability judgments are invariant to sample size. In sum, the similarity-updating model provides a plausible account of human probability judgment and belief revision. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Longterm Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis: 17 Years of Followup of a Nordic Juvenile Idiopathic Arthritis Cohort.

OBJECTIVE: To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset. METHODS: Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997 to 2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The followup visit included demographic data, a standardized clinical orofacial examination, and full-face cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used. RESULTS: Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 ± 4.2 yrs) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least 1 orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Further, among participants reporting complaints, the number of symptoms was also higher in JIA. The mean maximal incisal opening was lower in the JIA group (p < 0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective. CONCLUSION: This study of the longterm consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary followup of JIA patients also in adulthood.

Five-coordinate MnIV intermediate in the activation of nature's water splitting cofactor.

Nature's water splitting cofactor passes through a series of catalytic intermediates (S0-S4) before O-O bond formation and O2 release. In the second last transition (S2 to S3) cofactor oxidation is coupled to water molecule binding to Mn1. It is this activated, water-enriched all MnIV form of the cofactor that goes on to form the O-O bond, after the next light-induced oxidation to S4 How cofactor activation proceeds remains an open question. Here, we report a so far not described intermediate (S3') in which cofactor oxidation has occurred without water insertion. This intermediate can be trapped in a significant fraction of centers (>50%) in (i) chemical-modified cofactors in which Ca2+ is exchanged with Sr2+; the Mn4O5Sr cofactor remains active, but the S2-S3 and S3-S0 transitions are slower than for the Mn4O5Ca cofactor; and (ii) upon addition of 3% vol/vol methanol; methanol is thought to act as a substrate water analog. The S3' electron paramagnetic resonance (EPR) signal is significantly broader than the untreated S3 signal (2.5 T vs. 1.5 T), indicating the cofactor still contains a 5-coordinate Mn ion, as seen in the preceding S2 state. Magnetic double resonance data extend these findings revealing the electronic connectivity of the S3' cofactor is similar to the high spin form of the preceding S2 state, which contains a cuboidal Mn3O4Ca unit tethered to an external, 5-coordinate Mn ion (Mn4). These results demonstrate that cofactor oxidation regulates water molecule insertion via binding to Mn4. The interaction of ammonia with the cofactor is also discussed.

Deformation of dorsal root ganglion due to pressure transients of venous blood and cerebrospinal fluid in the cervical vertebral canal.

The dorsal root ganglion (DRG) that is embedded in the foramen of the cervical vertebra can be injured during a whiplash motion. A potential cause is that whilst the neck bends in the whiplash motion, the changes of spinal canal volume induce impulsive pressure transients in the venous blood outside the dura mater (DM) and in the cerebrospinal fluid (CSF) inside the DM. The fluids can dynamically interact with the DRG and DM, which are deformable. In this work, the interaction is investigated numerically using a strong-coupling partitioned method that synchronize the computations of the fluid and structure. It is found that the interaction includes two basic processes, i.e., the pulling and pressing processes. In the pulling process, the DRG is stretched towards the spinal canal, and the venous blood is driven into the canal via the foramen. This process results from negative pressure in the fluids. In contrast, the pressing process is caused by positive pressure that leads to compression of the DRG and the outflow of the venous blood from the canal. The largest pressure gradient is observed at the foramen, where the DRG is located at. The DRG is subject to prominent von Mises stress near its end, which is fixed without motions. The negative internal pressure is more efficient to deform the DRG than the positive internal pressure. This indicates that the most hazardous condition for the DRG is the pulling process.

SBS symptoms in relation to dampness and ventilation in inspected single-family houses in Sweden.

PURPOSE: To investigate the relationships between symptoms compatible with the sick building syndrome (SBS) in adults and building dampness and ventilation in single-family houses. METHODS: Within the Swedish BETSI study, a national sample of single-family houses were inspected by professional building experts, and adults living in the houses answered a questionnaire on SBS. Relationships between building factors and SBS were analysed using logistic regression. RESULTS: Of the respondents, 23% reported having had weekly SBS symptoms during the last three months. A large proportion of houses exhibited building or construction problems. In total, 40% of houses had dampness problems in the foundation, and this was related to a higher prevalence of both mucous and dermal symptoms, and any SBS symptoms. Furthermore, high air humidity was related to more symptoms, with the relationship with absolute humidity being stronger than that with relative humidity or moisture load. Symptoms were also more prevalent in houses with a high U value, reflecting a poor thermal insulation. Compared to natural ventilation, living in a house with mechanical supply and exhaust ventilation was related to a lower prevalence of general symptoms and any SBS symptoms, but there were only weak associations between measured air exchange rate and symptoms. CONCLUSIONS: A large proportion of single-family houses have dampness problems in the foundation, and pollutants may enter the living space of the house and affect the health of the occupants. Furthermore, absolute air humidity should be measured more often in indoor air studies.

Air bubbles are released by thoracic endograft deployment: An in vitro experimental study.

PURPOSE: Embolic stroke is a dreaded complication of thoracic endovascular aortic repair. The prevailing theory about its cause is that particulate debris from atherosclerotic lesions in the aortic wall are dislodged by endovascular instruments and embolize to the brain. An alternative source of embolism might be air trapped in the endograft delivery system. The aim of this experimental study was to determine whether air is released during deployment of a thoracic endograft. METHODS: In an experimental benchtop study, eight thoracic endografts (five Medtronic Valiant Thoracic and three Gore TAG) were deployed in a water-filled transparent container drained from air. Endografts were prepared and deployed according to their instructions for use. Deployment was filmed and the volume of air released was collected and measured in a calibrated syringe. RESULTS: Air was released from all the endografts examined. Air volumes ranged from 0.1 to 0.3 mL for Medtronic Valiant Thoracic and from <0.025 to 0.04 mL for Gore TAG. The largest bubbles had a diameter of approximately 3 mm and came from the proximal end of the Medtronic Valiant device. CONCLUSION: Air bubbles are released from thoracic endografts during deployment. Air embolism may be an alternative cause of stroke during thoracic endovascular aortic repair.

Structure of photosystem II and substrate binding at room temperature.

Light-induced oxidation of water by photosystem II (PS II) in plants, algae and cyanobacteria has generated most of the dioxygen in the atmosphere. PS II, a membrane-bound multi-subunit pigment protein complex, couples the one-electron photochemistry at the reaction centre with the four-electron redox chemistry of water oxidation at the Mn4CaO5 cluster in the oxygen-evolving complex (OEC). Under illumination, the OEC cycles through five intermediate S-states (S0 to S4), in which S1 is the dark-stable state and S3 is the last semi-stable state before O-O bond formation and O2 evolution. A detailed understanding of the O-O bond formation mechanism remains a challenge, and will require elucidation of both the structures of the OEC in the different S-states and the binding of the two substrate waters to the catalytic site. Here we report the use of femtosecond pulses from an X-ray free electron laser (XFEL) to obtain damage-free, room temperature structures of dark-adapted (S1), two-flash illuminated (2F; S3-enriched), and ammonia-bound two-flash illuminated (2F-NH3; S3-enriched) PS II. Although the recent 1.95 Å resolution structure of PS II at cryogenic temperature using an XFEL provided a damage-free view of the S1 state, measurements at room temperature are required to study the structural landscape of proteins under functional conditions, and also for in situ advancement of the S-states. To investigate the water-binding site(s), ammonia, a water analogue, has been used as a marker, as it binds to the Mn4CaO5 cluster in the S2 and S3 states. Since the ammonia-bound OEC is active, the ammonia-binding Mn site is not a substrate water site. This approach, together with a comparison of the native dark and 2F states, is used to discriminate between proposed O-O bond formation mechanisms.

Transient pressure changes in the vertebral canal during whiplash motion--A hydrodynamic modeling approach.

In vehicle collisions, the occupant's torso is accelerated in a given direction while the unsupported head tends to lag behind. This mechanism results in whiplash motion to the neck. In whiplash experiments conducted for animals, pressure transients have been recorded in the spinal canal. It was hypothesized that the transients caused dorsal root ganglion dysfunction. Neck motion introduces volume changes inside the vertebral canal. The changes require an adaptation which is likely achieved by redistribution of blood volume in the internal vertebral venous plexus (IVVP). Pressure transients then arise from the rapid redistribution. The present study aimed to explore the hypothesis theoretically and analytically. Further, the objectives were to quantify the effect of the neck motion on the pressure generation and to identify the physical factors involved. We developed a hydrodynamic system of tubes that represent the IVVP and its lateral intervertebral vein connections. An analytical model was developed for an anatomical geometrical relation that the venous blood volume changes with respect to the vertebral angular displacement. This model was adopted in the hydrodynamic tube system so that the system can predict the pressure transients on the basis of the neck vertebral motion data from a whiplash experiment. The predicted pressure transients were in good agreement with the earlier experimental data. A parametric study was conducted and showed that the system can be used to assess the influences of anatomical geometrical properties and vehicle collision severity on the pressure generation.

Estimation of the driving force for dioxygen formation in photosynthesis.

Photosynthetic water oxidation to molecular oxygen is carried out by photosystem II (PSII) over a reaction cycle involving four photochemical steps that drive the oxygen-evolving complex through five redox states Si (i = 0,…, 4). For understanding the catalytic strategy of biological water oxidation it is important to elucidate the energetic landscape of PSII and in particular that of the final S4 → S0 transition. In this short-lived chemical step the four oxidizing equivalents accumulated in the preceding photochemical events are used up to form molecular oxygen, two protons are released and at least one substrate water molecule binds to the Mn4CaO5 cluster. In this study we probed the probability to form S4 from S0 and O2 by incubating YD-less PSII in the S0 state for 2­3 days in the presence of (18)O2 and H2(16)O. The absence of any measurable (16,18)O2 formation by water-exchange in the S4 state suggests that the S4 state is hardly ever populated. On the basis of a detailed analysis we determined that the equilibrium constant K of the S4 → S0 transition is larger than 1.0 × 10(7) so that this step is highly exergonic. We argue that this finding is consistent with current knowledge of the energetics of the S0 to S4 reactions, and that the high exergonicity is required for the kinetic efficiency of PSII.

Heuristics can produce surprisingly rational probability estimates: Comment on Costello and Watts (2014).

Costello and Watts (2014) present a model assuming that people's knowledge of probabilities adheres to probability theory, but that their probability judgments are perturbed by a random noise in the retrieval from memory. Predictions for the relationships between probability judgments for constituent events and their disjunctions and conjunctions, as well as for sums of such judgments were derived from probability theory. Costello and Watts (2014) report behavioral data showing that subjective probability judgments accord with these predictions. Based on the finding that subjective probability judgments follow probability theory, Costello and Watts (2014) conclude that the results imply that people's probability judgments embody the rules of probability theory and thereby refute theories of heuristic processing. Here, we demonstrate the invalidity of this conclusion by showing that all of the tested predictions follow straightforwardly from an account assuming heuristic probability integration (Nilsson, Winman, Juslin, & Hansson, 2009). We end with a discussion of a number of previous findings that harmonize very poorly with the predictions by the model suggested by Costello and Watts (2014).

Light-dependent production of dioxygen in photosynthesis.

Oxygen, that supports all aerobic life, is abundant in the atmosphere because of its constant regeneration by photosynthetic water oxidation, which is catalyzed by a Mn4CaO5 cluster in photosystem II (PS II), a multi subunit membrane protein complex. X-ray and other spectroscopy studies of the electronic and geometric structure of the Mn4CaO5 cluster as it advances through the intermediate states have been important for understanding the mechanism of water oxidation. The results and interpretations, especially from X-ray spectroscopy studies, regarding the geometric and electronic structure and the changes as the system proceeds through the catalytic cycle will be summarized in this review. This review will also include newer methodologies in time-resolved X-ray diffraction and spectroscopy that have become available since the commissioning of the X-ray free electron laser (XFEL) and are being applied to study the oxygen-evolving complex (OEC). The femtosecond X-ray pulses of the XFEL allows us to outrun X-ray damage at room temperature, and the time-evolution of the photo-induced reaction can be probed using a visible laser-pump followed by the X-ray-probe pulse. XFELs can be used to simultaneously determine the light-induced protein dynamics using crystallography and the local chemistry that occurs at the catalytic center using X-ray spectroscopy under functional conditions. Membrane inlet mass spectrometry has been important for providing direct information about the exchange of substrate water molecules, which has a direct bearing on the mechanism of water oxidation. Moreover, it has been indispensable for the time-resolved X-ray diffraction and spectroscopy studies and will be briefly reviewed in this chapter. Given the role of PS II in maintaining life in the biosphere and the future vision of a renewable energy economy, understanding the structure and mechanism of the photosynthetic water oxidation catalyst is an important goal for the future.

Mindful Sustainable Aging: Advancing a Comprehensive Approach to the Challenges and Opportunities of Old Age.

The primary aim of this article is to present a new concept called mindful sustainable aging (MSA), which is informed by mindfulness practices that support the physical, the mental, and especially, the social and the existential dimensions of old life. The concept of MSA is discussed and compared with four influential psychosocial theories in the field of gerontology, i.e., activity theory, disengagement theory, successful aging theory and gerotranscendence theory. The article ends with reviewing research on how mindfulness practice can help to manage, diminish and/or improve a number of serious physical conditions that are common among older people. The potential of mindfulness when it comes to facilitating for older adults in their quest for spiritual and existential meaning is discussed extensively throughout the article.

The role of ANS acuity and numeracy for the calibration and the coherence of subjective probability judgments.

The purpose of the study was to investigate how numeracy and acuity of the approximate number system (ANS) relate to the calibration and coherence of probability judgments. Based on the literature on number cognition, a first hypothesis was that those with lower numeracy would maintain a less linear use of the probability scale, contributing to overconfidence and nonlinear calibration curves. A second hypothesis was that also poorer acuity of the ANS would be associated with overconfidence and non-linearity. A third hypothesis, in line with dual-systems theory (e.g., Kahneman and Frederick, 2002) was that people higher in numeracy should have better access to the normative probability rules, allowing them to decrease the rate of conjunction fallacies. Data from 213 participants sampled from the Swedish population showed that: (i) in line with the first hypothesis, overconfidence and the linearity of the calibration curves were related to numeracy, where people higher in numeracy were well calibrated with zero overconfidence. (ii) ANS was not associated with overconfidence and non-linearity, disconfirming the second hypothesis. (iii) The rate of conjunction fallacies was slightly, but to a statistically significant degree decreased by numeracy, but still high at all numeracy levels. An unexpected finding was that participants with better ANS acuity gave more realistic estimates of their performance relative to others.

Substrate-water exchange in photosystem II is arrested before dioxygen formation.

Light-driven oxidation of water into dioxygen, catalysed by the oxygen-evolving complex (OEC) in photosystem II, is essential for life on Earth and provides the blueprint for devices for producing fuel from sunlight. Although the structure of the OEC is known at atomic level for its dark-stable state, the mechanism by which water is oxidized remains unsettled. Important mechanistic information was gained in the past two decades by mass spectrometric studies of the H2(18)O/H2(16)O substrate-water exchange in the four (semi) stable redox states of the OEC. However, until now such data were not attainable in the transient states formed immediately before the O-O bond formation. Using modified photosystem II complexes displaying up to 40-fold slower O2 production rates, we show here that in the transient S3YZ state the substrate-water exchange is dramatically slowed as compared with the earlier S states. This further constrains the possible sites for substrate-water binding in photosystem II.

Substrate water exchange in photosystem II core complexes of the extremophilic red alga Cyanidioschyzon merolae.

The binding affinity of the two substrate-water molecules to the water-oxidizing Mn4CaO5 catalyst in photosystem II core complexes of the extremophilic red alga Cyanidioschyzon merolae was studied in the S2 and S3 states by the exchange of bound ¹6O-substrate against ¹8O-labeled water. The rate of this exchange was detected via the membrane-inlet mass spectrometric analysis of flash-induced oxygen evolution. For both redox states a fast and slow phase of water-exchange was resolved at the mixed labeled m/z 34 mass peak: kf=52 ± 8s⁻¹ and ks=1.9 ± 0.3s⁻¹ in the S2 state, and kf=42 ± 2s⁻¹ and kslow=1.2 ± 0.3s⁻¹ in S3, respectively. Overall these exchange rates are similar to those observed previously with preparations of other organisms. The most remarkable finding is a significantly slower exchange at the fast substrate-water site in the S2 state, which confirms beyond doubt that both substrate-water molecules are already bound in the S2 state. This leads to a very small change of the affinity for both the fast and the slowly exchanging substrates during the S2→S3 transition. Implications for recent models for water-oxidation are briefly discussed.

Inferring conjunctive probabilities from noisy samples: evidence for the configural weighted average model.

Judging whether multiple events will co-occur is an important aspect of everyday decision making. The underlying probabilities of occurrence are usually unknown and have to be inferred from experience. Using a rigorous, quantitative model comparison, we investigate how people judge the conjunctive probabilities of multiple events to co-occur. In 2 experiments, participants had to repeatedly choose between pairs of 2 conjunctive events (represented as 2 gambles). To estimate the probability that both events occur, they had access to a small sample of information. The 1st experiment consisted of a balanced set of gambles, whereas in the 2nd experiment, the gambles were constructed such that the models maximally differed in their predictions. A hierarchical Bayesian approach used for estimating the models' parameters and for testing the models against each other showed that the majority of participants were best described by the configural weighted average model. This model performed best in predicting people's choices, and it assumes that constituent probabilities are ranked by importance, weighted accordingly, and added up. The cognitive modeling approach provides an understanding of the cognitive processes underlying people's conjunctive probability judgments.

Experiences by patients and health professionals of a multidisciplinary intervention for long-term orofacial pain.

The aim of the present study was to describe patients' and health professionals' experiences of a multidisciplinary stress-focused clinical evaluation with prolonged engagement as an intervention for patients with long-term orofacial pain. Data in the patient part of this study were collected by free-text questionnaires using open-ended questions. Data were collected by group interview in the part of the study concerning health professionals. All data were analyzed according to qualitative content analysis. Data from patients revealed three categories for the intervention, ie, "helpful for most and crucial for some", "being listened to, respected and validated", and "gives important coping strategies". The results showed that a vast majority of patients described themselves as having been helped by the intervention. Some patients reported that meeting with the orofacial pain consultant team was crucial to the future course of their lives. Most patients described still having residual pain and symptoms, and only a few described their pain as being fully remitted. However, because of the intervention, the patients reported being able to adopt more constructive coping strategies. They also described their perception of the pain as being different, in that it was not so frightening once they had been given a model with which to understand it. Data from the health professionals revealed similar categories. Concordance between the patients' and health professionals' experiences was striking. In their descriptions, the health professionals and patients underscored the same components as being effective, with understanding, respect, and validation being the most important. The multidisciplinary approach was highlighted as being key to success by both the patients and health professionals.