Attitudes about work engagement of different generations-A cross-sectional study with nurses and supervisors.

AIM: This study investigated whether generation Y nurses (1981-1995) adopt a different attitude about work than generation X caregivers (1966-1980) and baby boomers (1956-1965). BACKGROUND: Employees' positive attitude to work engagement is a competitive factor for clinics. In age-diverse team structures, possible different attitudes can lead to conflicts. METHODS: As part of a quantitative, descriptive, cross-sectional study with the survey instrument AVEM-44, health and nursing staff, as well as nursing directors and ward administrators, were interviewed. RESULTS: A total of N = 992 individuals (n = 312 nursing directors, n = 259 ward administrators and n = 421 nurses) were included in the study. Nurses and executives viewed generation Y as being less willing to give oneself out and as attaching less importance to work than generation X and the baby boomers. On the other hand, professional ambition was more important to generation Y than the older generations. CONCLUSIONS: Transformational leadership behaviour represents an approach to guide employees of different generations individually and to harmonize different attitudes. IMPLICATIONS FOR NURSE MANAGEMENT: To lead employees transformationally, it is necessary to know generation-specific differences concerning attitudes towards work.

Tricuspid Annular Geometry and Strain After Suture Annuloplasty in Acute Ovine Right Heart Failure.

BACKGROUND: Tricuspid valve repair using suture annuloplasty is thought to be more physiologic, but the effect of annular reduction on annular geometry and motion is unknown. We set out to investigate the effect of DeVega suture annuloplasty (DV) on tricuspid annular geometry and dynamics during acute right heart failure (RHF). METHODS: Ten adult sheep underwent implantation of sonomicrometry crystals around the tricuspid annulus and on the right ventricle; pressure transducers were placed in right ventricle, left ventricle, and right atrium. RHF was induced by a combination of 500 mL volume infusion, posterior descending artery occlusion, and pulmonary artery constriction. Hemodynamic, echocardiographic, and sonomicrometry data were acquired at baseline, with RHF, and after two progressive (8 to 10 mm) DV suture cinches (DV-1, DV-2) during RHF. Annular size, geometry, and dynamics were determined from crystal coordinates. RESULTS: Combination of volume infusion, ischemia, and pulmonary hypertension resulted in acute RHF and significant functional tricuspid regurgitation grade (0.5 ± 0.5 versus 2.7 ± 0.8, p < 0.001). Annular area increased with RHF from 700 ± 98 mm2 to 801 ± 128 mm2 (p < 0.001). DV-1 and DV-2 reduced annular area to 342 ± 88 mm2 and 180 ± 57 mm2 while reducing regurgitation grade to 1.2 ± 0.4 and 0.4 ± 0.5, respectively (all p < 0.001 versus RHF). Tricuspid annular area contraction was 12% ± 7%, 10% ± 6%, and 12% ± 6% for RHF, DV-1, and DV-2, respectively (p = 0.25) and annular height was 4.9 ± 2.0 mm, 5.6 ± 1.4 mm, and 5.5 ± 1.7 mm (p = 0.43). Mean transvalvular gradient was 1.3 ± 0.7 mm Hg and 2.0 ± 1.0 mm Hg with DV-1 and DV-2, respectively. CONCLUSIONS: During acute ovine RHF, DeVega annuloplasty successfully treated tricuspid regurgitation and preserved normal tricuspid annular dynamics and geometry. These data may lead to more physiologic tricuspid reparative techniques.

[Values of generation Y nurses compared to generation X and baby boomers - A cross-sectional study]. / Generationsspezifische Unterschiede in den Werthaltungen von Gesundheits- und Krankenpfleger / -innen ­ Eine Querschnittstudie.

Values of generation Y nurses compared to generation X and baby boomers - A cross-sectional study Abstract. BACKGROUND: Several studies point to special behaviours of generation Y employees. RESEARCH QUESTION: Starting from the assumption that there is an effect on the attitudes and behaviour of values, the study deals with the question of differences in the values between generation Y (1981 - 1995) and generations X (1966 - 1980) and the baby boomers (1956 - 1965). METHOD: Values are identified by nurses (n = 421) in the self-assessment as well as by stranger estimations of station leads (n = 259) and nursing directors (n = 312) in a quantitative cross-sectional study based on the PVQ-21 questionnaire was laid. RESULTS: While the values of self-centredness, stimulation, and hedonism are of high importance to generation Y in both self-assessment and outside consideration, tradition, conformity, and safety are considered less important. Likewise, for some values of generation Y, differences in self and other views can be determined. CONCLUSIONS: In the sense of a transformational understanding of leadership, operative and strategic nursing management must consider generation-specific differences in dealing with nursing staff.

Tricuspid valvular dynamics and 3-dimensional geometry in awake and anesthetized sheep.

OBJECTIVES: Clinical and experimental tricuspid valve physiology data are derived predominantly from anesthetized subjects, but normal tricuspid valve geometry and dynamics may be altered by general anesthesia and mechanical ventilation. We set out to investigate 3-dimensional geometry and dynamics of the tricuspid valve complex in awake and anesthetized sheep. METHODS: While on cardiopulmonary bypass and with the heart beating, 6 adult sheep (50 ± 8 kg) underwent implantation of 6 sonomicrometry crystals around the tricuspid annulus. One crystal was implanted on the anterior, posterior, and septal papillary muscle tips, 4 on the right ventricular free wall and 1 on its apex. Pressure transducers were placed in both ventricles. Sonomicrometry and pressure transducer cables were externalized to subcutaneous buttons. After 7 days of recovery, hemodynamic and sonomicrometry data were recorded with animals awake and anesthetized. RESULTS: Hemodynamic parameters did not differ between groups. Tricuspid annular area contraction decreased with anesthesia (16.4% ± 4.2% vs 11.2% ± 3.2%, P = .047) as did tricuspid annular perimeter contraction (8.1% ± 2.2% vs 5.4% ± 1.7%, P = .050), predominantly due to reduced contraction of the septal annulus (10.5% ± 2.9% vs 7.5% ± 3.5%, P = .019). Tricuspid annular height did not differ between groups. Minimal distance from anterior, posterior, and septal papillary muscle tips to the annular plane did not change with anesthesia. Regional right ventricle free wall contraction was depressed under anesthesia in anterior (16.3% ± 3.1% vs 12.3% ± 2.2%, P = .027) and lateral (14.9% ± 1.3% vs 11.5% ± 2.8%, P = .016) segments, whereas the posterior remained unchanged. CONCLUSIONS: General anesthesia did not alter tricuspid annular or subvalvular 3-dimensional geometry but reduced right ventricular contraction and tricuspid annular dynamics.

Large animal model of acute right ventricular failure with functional tricuspid regurgitation.

BACKGROUND: Functional tricuspid regurgitation (FTR) commonly arises secondary to conditions affecting the left heart and is associated with right ventricular dysfunction and tricuspid annular dilatation. We set out to establish an animal model of acute RV failure (RVF) with FTR resembling the clinical features. METHODS: Ten adult sheep had pressure sensors placed in the LV, RV, and right atrium while sonomicrometry crystals were implanted around tricuspid annulus and on the RV. Animals were studied open-chest to assess for RV function and FTR after: (1) volume infusion, (2) pulmonary artery constriction, (3) 5 min posterior descending artery occlusion, and (4) combination of all interventions. Hemodynamic, echocardiographic, and sonomicrometry data were collected at baseline and after every intervention. RV dimensions, RV strain, and annular area, perimeter, and size were calculated from crystal coordinates. The model was validated in six additional sheep studied only before and after combined interventions. RESULTS: Neither volume infusion, pulmonary hypertension, nor ischemia were associated with RVF or clinically significant TR when applied separately but combined resulted in RVF and greater than moderate FTR. In the validation group, maximal RV volume increased (62 ±â€¯14 vs 70 ±â€¯16 ml, p = 0.006), contractility decreased (20 ±â€¯6 vs 12 ±â€¯2%, p = 0.02), and strain increased. FTR increased from 0.4 ±â€¯0.5 to 2.5 ±â€¯0.8 (p < 0.001) and annular area from 652 ±â€¯87 mm2 to 739 ±â€¯87 mm2 (p = 0.005). CONCLUSIONS: The developed ovine model of acute RVF was associated with significant annular and RV enlargement and FTR. This novel and clinically pertinent research platform offers insight into the acute RVF pathophysiology and can be utilized to evaluate treatment interventions.

[Competency requirements for executives in healthcare and social services organizations: Results of a Delphi study]. / Kompetenzanforderungen an Führungskräfte in Organisationen des Gesundheits- und Sozialwesens: Ergebnisse einer Delphi-Studie.

BACKGROUND: Leadership in social services and healthcare organizations is marked by high levels of complexity and contradiction, which cannot be fully explained by politically, economically, and socially induced changes. Rather, it is the particularities of service provision in healthcare and social services that confront executives with specific demands. OBJECTIVE: This study aimed to capture and prioritize required leadership competencies in healthcare and social services organizations. METHODS: A three-step Delphi study was conducted with executives and managerial staff, who are job holders and thus experts on their occupation. For the first step, an explorative qualitative approach was chosen to record general opinion without prior assumptions. The following two steps weighted and selected the competency requirements in step one using rating- and ranking procedures. RESULTS: Results of the Delphi inquiry imply high relevance of social and personal competencies. Approximately 66 % of the competencies assessed in round three were social and personal competencies. 12 out of the 15 highest rated competencies in Delphi step three can be assigned to these two competency categories. In contrast, the importance of professional as well as methodical competencies was rated as less important. Only two methodical competencies and one professional competency were rated as very important by the panel. Nevertheless, the importance of executive professional and methodical competencies in healthcare and social services organizations is emphasized by high ratings of the competencies "Sector-specific expertise" and "Analytical skills". The methodical competency "Analytical skills" was identified by the Delphi respondents as the most important competency requirement. CONCLUSION: Social and personal requirements are of primary importance for leadership in healthcare and social services organizations. These results mostly correspond to leadership requirements posited in the literature on leadership skills. Emphasis should be on the specific relevance of professionalism, which can be traced back to the high proportion of professional activities in everyday working practices, the self-conception of executive staff based on professional qualifications and profession as well as the organizational form as expert organization. Healthcare and social services organizations are expert organizations with a strong emphasis on professional expertise. Professional knowledge is the most important means of production of expert organizations and imperative to leadership in healthcare and social services organization, given the high integration of executives into the professional system. Despite the dominance of social and personal competency requirements, the most important competency requirement is "Analytical skills", which can be described as the basis of every action.

Large animal model of functional tricuspid regurgitation in pacing induced end-stage heart failure.

OBJECTIVES: Functional tricuspid regurgitation (FTR) is common in patients with advanced heart failure and frequently complicates left ventricular assist device implantation yet remains poorly understood. We set out to establish large animal model of FTR that could serve as a research platform to investigate the pathogenesis of FTR associated with end-stage heart failure. METHODS: : Through right thoracotomy, ten adult sheep underwent implantation of pacemaker with epicardial LV lead, five sonomicrometry crystals on the right ventricle, and left and right ventricular telemetry pressure sensors during a beating heart off-pump procedure. After 5 ± 1 days of recovery, baseline haemodynamic, echocardiographic and sonomicrometry data were collected. Animals were paced thereafter at a rate of 220-240 beats/min until the development of heart failure and concomitant tricuspid regurgitation. RESULTS: : Three animals died during early recovery period and one during the pacing phase. Six surviving animals were paced for a mean of 14 ± 5 days. Cardiac function was significantly depressed compared to baseline, with LV ejection fraction falling from 69 ± 2% to 22 ± 4% ( P < 0.001) and RV fractional area change from 52 ± 11% to 25 ± 9% ( P = 0.005). All animals developed significant enlargement of tricuspid annulus (from 29.5 ± 1.6 to 36.5 ± 4.5 mm; P = 0.01) and right ventricle (from 21.9 ± 0.2 to 30.3 ± 0.6 mm; P = 0.03). Sonomicrometry derived contractility of RV free wall was depressed and at least moderate tricuspid insufficiency developed in all animals. CONCLUSIONS: : Biventricular dysfunction, tricuspid annular dilatation and significant FTR were observed in our model of ovine tachycardia induced cardiomyopathy. This animal model reflects the clinical situation of end-stage heart failure patients presenting for mechanical support.

An orally bioavailable positive allosteric modulator of the mGlu4 receptor with efficacy in an animal model of motor dysfunction.

A high-throughput screening campaign identified 4-((E)-styryl)-pyrimidin-2-ylamine (11) as a positive allosteric modulator of the metabotropic glutamate (mGlu) receptor subtype 4. An evaluation of the structure-activity relationships (SAR) of 11 is described and the efficacy of this compound in a haloperidol-induced catalepsy rat model following oral administration is presented.

Development of a high-throughput AlphaScreen assay measuring full-length LRRK2(G2019S) kinase activity using moesin protein substrate.

Mutations within the LRRK2 (leucine-rich repeat kinase 2) gene predispose humans to develop late-onset Parkinson's disease (PD). The most prevalent of these mutations, G2019S, has been shown to increase LRRK2 kinase activity. Therefore, the discovery of small molecule inhibitors of LRRK2(G2019S) through high-throughput screening (HTS) may provide a novel therapeutic strategy for treating PD. Current biochemical assays monitoring the activity of LRRK2(G2019S) either are radioactive or use short peptidic substrates. Here we describe the development and optimization of a novel HTS AlphaScreen assay for measuring the catalytic activity of full-length LRRK2(G2019S) using its putative physiological protein substrate moesin. The high sensitivity of this optimized 384-well assay allowed the use of enzyme concentrations as low as 0.75nM. The estimated apparent K(m) value for adenosine triphosphate (6 microM) using the glutathione S-transferase-moesin substrate was much lower than the one previously reported using LRRKtide, a synthetic peptide derived from moesin. Testing of nonselective kinase inhibitors (staurosporine, H-1152, and Y-27632) generated potencies consistent with published data. Finally, robotic validation of the assay yielded an average Z' factor of 0.80. Overall, these results indicate that the present HTS AlphaScreen assay might provide a more relevant biochemical approach for the discovery of novel LRRK2(G2019S) inhibitors.

Skin diseases in workers at a perfume factory.

The aim of this study is to find out the causes of skin diseases in one-third of the staff of a perfume factory, in which 10 different perfume sprays were being manufactured. Site inspection, dermatological examination and patch testing of all 26 persons at risk with 4 perfume oils and 30 ingredients of them. The results showed 6 bottlers were found suffering from allergic contact dermatitis, 2 from irritant contact dermatitis, 12 workers showed different strong reactions to various fragrances. The main causes of allergic contact dermatitis were 2 perfume oils (12 cases) and their ingredients geraniol (12 cases), benzaldehyde(9), cinnamic aldehyde (6), linalool, neroli oil, terpenes of lemon oil and orange oil (4 each). Nobody was tested positive to balsam of Peru. Job changes for office workers, packers or printers to other rooms, where they had no longer contact with fragrances, led to a settling. To conclude, automation and replacement of glass bottles by cartridges from non-fragile materials and using gloves may minimize the risk.

[Quality criteria that are important to residents of elders' homes and their relatives--a literature analysis]. / Qualitätskriterien, die Altenpflegeheim- bewohnern und Angehörigen wichtig sind--Eine Literaturanalyse.

This literature analysis attempts to identify quality criteria which are important for residents of nursing homes and their relatives. To this end, 13 research articles published in international scientific journals were analysed. For the residents themselves, the ability to manage their daily lives autonomously as well as their ability to structure social contacts and relationships appears to be of special importance. In contrast, relatives emphasise criteria that refer to the quality of the care provided and the structure quality of the institutional setting. For them it is of specific importance to know that residents feel at home in the facility.

Peptide protein binding assay using ImageFlashPlates or Imaging Beads.

Imaging devices used for the measurement of radioligand-receptor binding assays are typically based on charge-coupled device (CCD) cameras, which are more sensitive for red-shifted scintillation. In the past, red-shifted scintillants had only been integrated into microspheres, referred to as scintillation proximity assay (SPA) Imaging Beads. More recently, ImageFlashPlates have been developed that emit light at 615 nm when exposed to beta-radiation. In this article, we report the establishment of peptide-protein binding assays using either streptavidin-coated ImageFlashPlates or Imaging Beads in a low volume 384-well format. In these assays, we employed a biotinylated peptide X and a [33P]-phosphorylated protein Y as the binding partner. The FlashPlates required a washing step, the bead-filled microtiter plates (MTPs) needed a centrifugation step for optimal performance in the scintillation measurements. Both the peptide X-loaded FlashPlates and the beads displayed saturable binding of [33P]-phosphorylated protein Y with a similar scintillation efficiency. A KD value of about 30 nmol/l was measured using the bead-based assay. Due to the washing step in the FlashPlate experiment, approximately two-thirds of the [33P]-phosphorylated protein Y were withdrawn from equilibrium binding. This resulted in correspondingly lower scintillation signals for the FlashPlate experiment. For this reason, the FlashPlate produced a Z' value of 0.64 that was lower than the Z' value of 0.87 for the beads. Using a reference inhibitor in a competition assay produced similar IC50 values for the bead-based assay as for the FlashPlate. Depending on the local automation environment either the centrifugation step for the beads or the washing step for the FlashPlates may be considered more or less of a challenge. Low volume 384-well high-throughput screening (HTS) applicable assay formats are achievable using either the ImageFlashPlates or the Imaging Beads.

Pharmacokinetics and pharmacodynamics of terbogrel, a combined thromboxane A2 receptor and synthase inhibitor, in healthy subjects.

AIMS: To characterize the pharmacokinetics of terbogrel, a new combined thromboxane A2 (TxA2) receptor and synthase inhibitor, in healthy human subjects after single or multiple oral administration. METHODS: Forty-eight healthy male subjects received a single oral dose (10, 25, 50, 100, 150 or 200 mg) of terbogrel or placebo and 32 different subjects received one of the following treatments twice daily for 7 days: 50, 100 or 150 mg terbogrel, placebo, or once-a-day 330 mg acetylsalicylic acid. RESULTS: Terbogrel was well tolerated without obvious adverse effects following either a single oral dose or administration over 7 days. Plasma drug concentrations were dose-linear and there was no accumulation over 7 days. There was a dose-dependent blockade of TxA2 receptors and of inhibition of thromboxane synthase activity with values for IC50 of 12 ng ml(-1) and 6.7 ng ml(-1), respectively. At the highest dose tested (150 mg) there was almost complete inhibition of thomboxane synthase and thromboxane receptor occupancy. Even at trough concentrations, receptor occupancy remained above 80% and thromboxane synthase was still completely inhibited. These two activities were associated with a dose-dependent inhibition of platelet aggregation (>80% at the 150 mg dose of terbogrel) and enhanced prostacyclin production. CONCLUSIONS: Terbogrel is a potent agent having two distinct, complimentary pharmacodynamic actions, namely inhibition of thromboxane synthase and antagonism of the TxA2 receptor. The antithrombotic effect of terbogrel was dose-dependent and was associated with enhanced prostacyclin production. Terbogrel is an attractive candidate for long-term antithrombotic therapy.

Automated high throughput screening for serine kinase inhibitors using a LEADseeker scintillation proximity assay in the 1536-well format.

High-throughput screening in the 1536-well format has been largely restricted to solution-based and cell-based screens. In this article, we show the feasibility of a completely automated, robust scintillation proximity assay in the 1536-well format that is suitable to identify inhibitors for a serine/threonine kinase from a compound library. The introduction of [(33)P]phosphate into a biotinylated peptide substrate mirrors the activity of the kinase. The peptide is immobilized on streptavidin-coated LEADseeker imaging beads and [(33)P]phosphate incorporation is detected with the LEADseeker imaging system of Amersham Pharmacia Biotech. To improve the liquid handling procedures for imaging bead suspensions in the low microliter range, we developed a novel trough with an integrated stirring function. A comparison of the 1536-well assay to a 384-well assay revealed a comparable assay quality with Z' factors of about 0.7 for the 384-well format and 0.6 for the 1536-well format. In an automated screen of a random compound collection, 94.4% of the inhibitory compounds could be identified with both assay formats. Dose-response curves were performed for a selection of identified kinase inhibitors and revealed similar IC(50) values for both assay formats.