We have been investigating the effects of preventing oxidative stress on pathogenesis and complications of type 1 diabetes in the NOD mouse model. Our studies have shown that damage caused by oxidative stress is higher in islets and vascular tissue of NOD mice than in nonautoimmune controls or a diabetes-resistant NOD mouse. In addition, phagocytic function and cytokine production by macrophages are aberrant in the NOD. We have demonstrated that treatment of prediabetic NOD mice for 2 weeks with a metalloporphyrin superoxide dismutase (SOD) mimetic results in marked reduction of oxidative stress in islets and vascular tissue and a reversal of macrophage defects.
In addition to Se status, atopy, gender and age all appear to influence GSH-Px activity, although the relative importance of these factors may differ in asthmatic and non-asthmatic populations. It seems likely that the reduced activity of this enzyme in platelets and blood may reflect mechanisms associated with the pathogenesis and severity of asthma.
Purpose The purposes of this study were to (a) describe nurse manager (NM) leadership behaviors for evidence‐based practice, NM evidence‐based practice competencies, and unit climates for evidence‐based practice implementation in acute care, and (b) test for differences in NMs’ and staff nurses’ (RNs’) perceptions. Design A multisite cross‐sectional design was used to collect data from a sample of 24 NMs and 553 RNs from 24 adult medical‐surgical units in seven U.S. community hospitals. Methods Responses were collected using electronic questionnaires, inclusive of the Nurse Manager Evidence‐Based Practice Competency Scale (NM only), Implementation Leadership Scale, and Implementation Climate Scale. E‐mail reminders and gift card lottery drawings encouraged response. Descriptive statistics described total and subscale scores by role. Differences in perceptions were evaluated using independent t‐tests with Bonferroni correction (α = .05). Findings 23 NMs and 287 RNs responded (95.8% and 51.9% response rates, respectively). NMs reported they were “somewhat competent” in evidence‐based practice (M = 1.62 [SD = 0.5]; 0–3 scale). NMs and RNs perceived leadership behaviors (NM: M = 2.73 [SD = 0.46]; RN: M = 2.88 [SD = 0.78]; 0–4 scale) and unit climates for evidence‐based practice implementation (NM: M = 2.16 [SD = 0.67]; RN: M = 2.24 [SD = 0.74]; 0–4 scale) as evident to a “moderate extent.” RN and NM perceptions differed significantly on the Proactive (p = .01) and Knowledgeable (p < .001) leadership subscales. Conclusions Evidence‐based practice competencies and leadership behaviors of NMs, and unit climates for evidence‐based practice were modest at best and interventions are needed. To close the research to practice gap, future studies should investigate the interplay between social dynamic context factors and implementation strategies to promote uptake of evidence‐based practices. Clinical Relevance Critical attention is needed to build organizational capacity for evidence‐based practices through development of unit leadership and climate for evidence‐based practice to accelerate routine use of evidence‐based practices for improving care delivery and patient outcomes. The three instruments described herein provide a foundation for nurse leaders to assess these dynamic context factors and design interventions or programs where there is opportunity for improvement.
Background MRI is the imaging modality of choice for diagnosis and intervention assessment in neurological disease. Its full potential has not been realized due in part to challenges in harmonizing advanced techniques across multiple sites. Purpose To develop a method for the assessment of reliability and repeatability of advanced multisite‐multisession neuroimaging studies and specifically to assess the reliability of an advanced MRI protocol, including multiband fMRI and diffusion tensor MRI, in a multisite setting. Study Type Prospective. Population Twice repeated measurement of a single subject with stable relapsing‐remitting multiple sclerosis (MS) at seven institutions. Field Strength/Sequence A 3 T MRI protocol included higher spatial resolution anatomical scans, a variable flip‐angle longitudinal relaxation rate constant (R1 ≡ 1/T1) measurement, quantitative magnetization transfer imaging, diffusion tensor imaging, and a resting‐state fMRI (rsFMRI) series. Assessment Multiple methods of assessing intrasite repeatability and intersite reliability were evaluated for imaging metrics derived from each sequence. Statistical Tests Student's t‐test, Pearson's r, and intraclass correlation coefficient (ICC) (2,1) were employed to assess repeatability and reliability. Two new statistical metrics are introduced that frame reliability and repeatability in the respective units of the measurements themselves. Results Intrasite repeatability was excellent for quantitative R1, magnetization transfer ratio (MTR), and diffusion‐weighted imaging (DWI) based metrics (r > 0.95). rsFMRI metrics were less repeatable (r = 0.8). Intersite reliability was excellent for R1, MTR, and DWI (ICC >0.9), and moderate for rsFMRI metrics (ICC∼0.4). Data Conclusion From most reliable to least, using a new reliability metric introduced here, MTR > R1 > DWI > rsFMRI; for repeatability, MTR > DWI > R1 > rsFMRI. A graphical method for at‐a‐glance assessment of reliability and repeatability, effect sizes, and outlier identification in multisite‐multisession neuroimaging studies is introduced. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:878–888.
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