Evidence for a glycerol pathway through aquaporin 1 (CHIP28) channels

Permeabilities to glycerol and small non-electrolytes of three Aquaporin 1 CHIP (AQP1) water channels were measured in AQP1 cRNA-injected Xenopus laevis oocytes and in human AQP1 channels reconstituted in proteoliposomes. By an osmotic swelling assay, significant increases of ethylene glycol, glycerol and 1,3-propanediol apparent permeability coefficients (P_solutes) were found in oocytes expressing human, rat and frog AQP1. p-Chloromercuribenzene sulphonate (PCMBS) and CuSO₄ inhibited, by 95% and 58% respectively, apparent glycerol permeability (P _gly) in oocytes expressing human AQP1. pCMBS inhibition was reversed by -mercaptoethanol and CuSO₄ inhibition was partly reversed by the Cu²⁺-binding peptide Gly-Gly-His. Tritiated glycerol uptakes confirmed the augmented P _gly value of AQP1 cRNA-injected oocytes. In contrast, no increases of urea, meso-erythritol, D- or L-threitol, xylitol and mannitol uptakes were detected. Stopped-flow light scattering experiments performed with human AQP1 proteoliposomes also revealed a much greater increase of P _gly than did those with protein-free liposomes; the initial rate of proteoliposomes also swelling was inhibited by 96.2% with HgCl₂ and by 72.5% with CuSO₄. In AQP1 cRNA-injected oocytes and in proteoliposomes, the value of the glycerol reflection coefficient was 0.74–0.80, indicating that water and glycerol share the same pathway. All these results provide strong evidence that water and certain small solutes permeate the AQP1 channels expressed at the surface of X. laevis oocytes or reconstituted in proteoliposomes. The urea exclusion suggests that the selectivity of the AQP1 channels not only depends on the size of the solutes but probably also on their flexibility and their ability to form H-bonds.     

Enhancing the clinical reflective capacities of nursing students

The purpose of clinical practicums is to help nursing students learn from real clinical experiences. In clinical settings, nursing instructors set-aside time at the end of each clinical day for reflective, debriefing discussions that are designed to draw the students' attention to relevant information and help them understand their beliefs and experiences. The students' competence and decision-making skills are enhanced when they are able to reflect on critical incidents or everyday practice events. It is sometimes difficult, however, for instructors to engage students meaningfully in discussions and promote reflection when students are fatigued. In this article, I argue that it is possible to refresh, support, and inspire undergraduate nursing students by engaging them in an activity designed to distract them and occupy their conscious attention, so that their more divergent and less accessible ideas are allowed to surface. Less accessible ideas are associated with the default network; regions in the brain that are most active when the brain is allowed to rest and wander. Congruent with the middle range theory of comfort, a distracting activity will provide comfort to students who are fatigued and/or distressed, and at the same time, will enhance their reflective capacities. A distracting activity that is enjoyable, not too demanding, and can be sustained for more than just a few minutes works best for idea generation and reflection.     

Gaining awareness: Cultivating clinical reflection in nursing students

Earlier this year, in an article published in Nurse Education in Practice, a nurse educator in our school of nursing described an activity designed to refresh and inspire undergraduate nursing students who feel fatigued at the end of the day, and/or anxious, pressured, or overwhelmed during their clinical practice experiences (Andersen, 2016). We are some of those students who participated in this activity during some of our therapeutic debriefing and reflective discussions and we would like to respond by describing our experiences.     

Six habits to enhance MET performance under stress: A discussion paper reviewing team mechanisms for improved patient outcomes

Effective team decision making has the potential to improve the quality of health care outcomes. Medical Emergency Teams (METs), a specific type of team led by either critical care nurses or physicians, must respond to and improve the outcomes of deteriorating patients. METs routinely make decisions under conditions of uncertainty and suboptimal care outcomes still occur. In response, the development and use of Shared Mental Models (SMMs), which have been shown to promote higher team performance under stress, may enhance patient outcomes. This discussion paper specifically focuses on the development and use of SMMs in the context of METs. Within this process, the psychological mechanisms promoting enhanced team performance are examined and the utility of this model is discussed through the narrative of six habits applied to MET interactions.A two stage, reciprocal model of both nonanalytic decision making within the acute care environment and analytic decision making during reflective action learning was developed. These habits are explored within the context of a MET, illustrating how applying SMMs and action learning processes may enhance team-based problem solving under stress. Based on this model, we make recommendations to enhance MET decision making under stress. It is suggested that the corresponding habits embedded within this model could be imparted to MET members and tested by health care researchers to assess the efficacy of this integrated decision making approach in respect to enhanced team performance and patient outcomes.     

福岛核事故辐射与健康危害国际研讨会的总结和建议

主题为辐射与健康危害的国际专家研讨会于2011年9月11日至12日在日本福岛县举行.研讨会组织了来自日本以及其他国家的相关领域专家,目的旨在讨论日本福岛核事故造成的潜在公众健康危害.与会专家们广泛的国际经验有利于对事故后放射性物质对环境污染的评估,一致认为,后续的评估应充分借鉴国际经验.该会议提出了日本福岛核事故后的辐射与健康危害的相关建议和结论.     

Rumination,Social Problem Solving and Suicide Intent Among Egyptians With a Recent Suicide Attempt

The more complex influences of social problem-solving abilities and rumination—specifically brooding and reflection—on suicide intent is not well understood. We hypothesized that social problem solving would moderate the association between reflection and suicide intent, and mediate the influence of brooding on suicide intent. A convenience sample (N = 186) of individuals hospitalized for recent suicide attempt was interviewed, assessing suicide intent, social problem solving, brooding, reflection and depression. Brooding and reflection were positively associated with suicide intent. The mediating, but not the moderating, hypothesis was supported. Brooding was not significant (β = 0.15, t = 1.92, p = 0.06) with social problem solving controlled. Interventions to disengage rumination and improve social problem-solving skills are underscored.     

护生临床实践反思问卷的汉化及信效度检验

目的 汉化护生临床实践反思问卷,检验其在实习护生中的信度和效度。 方法 基于Brislin模型对英文版临床实践反思问卷进行翻译。采用一般资料调查表、中文版护生临床实践反思问卷和反思功能问卷对550名实习护生进行调查,以检验其信效度。 结果 中文版护生临床实践反思问卷包括专业能力、内部动机来源、基于反思的自我管理、具有挑战性的临床情境、动态的组织氛围和动态的职业发展6个维度,共36个条目。探索性因子分析共提取6个公因子,累计方差贡献率为70.099%;验证性因子分析结果显示,χ2/df=1.292,RMSEA=0.033,CFI=0.977,TLI=0.974。量表Cronbach′s α系数为0.961,各维度Cronbach′s α系数为0.870～0.949,量表水平的平均内容效度为0.983,折半信度为0.853,重测信度为0.934。 结论 中文版护生临床实践反思问卷具有较好的信度和效度,可用于评估我国实习护生在临床实践中的反思能力。     

The role of reflective practice in healthcare professions: Next steps for pharmacy education and practice

Reflective practice strategies can enable healthcare practitioners to draw on previous experiences to render more effective judgment in clinical situations. The central argument presented in this commentary is that education programs and structures for continuing professional development (CPD) and revalidation of professionals sharpen their focus regarding self-assessment to identify gaps in skills and attitudes rather than merely as a means of on-going monitoring. Pharmacy undergraduate and professional education need to promote reflective practice strategies that foster self-evaluation to promote pharmacists’ readiness for practice change and advance patient care within rapidly expanding roles and scope of practice.     

对医疗机构产权改革的思考

中国医疗机构的产权改革曾经是医疗改革的焦点问题，特别是围绕公立医疗机构产权的股份化，有各种截然不同的看法。但是，观察国外医疗机构的产权结构及其发展，我们看到产权并非造成医疗成本高或服务质量低等问题的根源，结果可能恰恰相反。关键问题在于国家是否有合适的医疗保障计划和与之相匹配的医疗服务供应体系。通过介绍国外医疗机构的产权状况，结合我国实际情况加以比较，使我们从中得到有益的启示。