Leinhard School of Nursing

Objective: To determine the effects of graded dietary restriction of tryptophan on food intake, energy expenditure, body composition, gut hormones, and select fecal bacterial populations in obesity-prone rats. Methods: Obesity-prone rats were randomized to isocaloric diets with varying degrees of tryptophan restriction: control (100% requirements), 70% tryptophan (70TRP), 40% tryptophan (40TRP), or 10% tryptophan (10TRP) for 21 days. The sympathetic system was challenged with a subcutaneous injection of propranolol on days 15 to 17. Measurements included food intake, energy expenditure, body composition, metabolic hormones, and fecal concentrations of select bacteria. Results: Moderate tryptophan restriction (70TRP) induced thermogenesis without altering body composition, whereas severe degrees of restriction (40TRP, 10TRP) produced profound hypophagia and decreased energy expenditure and body weight. The thermogenic effects of moderate tryptophan restriction were sympathetically mediated. Severe tryptophan restriction decreased fasting circulating concentrations of glucose, insulin, C-peptide, and leptin, but increased glucagon, pancreatic polypeptide, and glucagon-like peptide-1. Severe tryptophan restriction decreased fecal concentrations of Enterobacteriaceae, Lactobacillus, Bacteroides, and Clostridium coccoides while increasing Roseburia groups. Conclusions: Our findings demonstrate that dietary tryptophan restriction dose-dependently modulates energy balance, with severe restriction causing hypophagia and weight loss and moderate restriction promoting sympathetically driven thermogenesis as well as concurrent changes in gut microbiota and hormones.

Objective: To determine the effects of graded dietary restriction of tryptophan on food intake, energy expenditure, body composition, gut hormones, and select fecal bacterial populations in obesity-prone rats. Methods: Obesity-prone rats were randomized to isocaloric diets with varying degrees of tryptophan restriction: control (100% requirements), 70% tryptophan (70TRP), 40% tryptophan (40TRP), or 10% tryptophan (10TRP) for 21 days. The sympathetic system was challenged with a subcutaneous injection of propranolol on days 15 to 17. Measurements included food intake, energy expenditure, body composition, metabolic hormones, and fecal concentrations of select bacteria. Results: Moderate tryptophan restriction (70TRP) induced thermogenesis without altering body composition, whereas severe degrees of restriction (40TRP, 10TRP) produced profound hypophagia and decreased energy expenditure and body weight. The thermogenic effects of moderate tryptophan restriction were sympathetically mediated. Severe tryptophan restriction decreased fasting circulating concentrations of glucose, insulin, C-peptide, and leptin, but increased glucagon, pancreatic polypeptide, and glucagon-like peptide-1. Severe tryptophan restriction decreased fecal concentrations of Enterobacteriaceae, Lactobacillus, Bacteroides, and Clostridium coccoides while increasing Roseburia groups. Conclusions: Our findings demonstrate that dietary tryptophan restriction dose-dependently modulates energy balance, with severe restriction causing hypophagia and weight loss and moderate restriction promoting sympathetically driven thermogenesis as well as concurrent changes in gut microbiota and hormones.

Mental illnesses are common worldwide, and nurses' attitudes toward mental illness have an impact on the care they deliver. This integrative literature review focused on nurses' attitudes toward mental illness. Four databases were searched between January 1, 1995 to October 31, 2015 selecting studies, which met the following inclusion criteria: 1) English language; and 2) Research in which the measured outcome was nurses' attitudes toward mental illness. Fourteen studies conducted across 20 countries that 4282 participants met the inclusion criteria. No study was conducted in the United States (U.S.). Studies reported that nurses had mixed attitudes toward mental illness, which were comparable to those of the general public. More negative attitudes were directed toward persons with schizophrenia. Results indicate the need for further research to determine whether attitudes among nurses in the U.S. differ from those reported from other countries and to examine potential g...

Mental illnesses are common worldwide, and nurses' attitudes toward mental illness have an impact on the care they deliver. This integrative literature review focused on nurses' attitudes toward mental illness. Four databases were searched between January 1, 1995 to October 31, 2015 selecting studies, which met the following inclusion criteria: 1) English language; and 2) Research in which the measured outcome was nurses' attitudes toward mental illness. Fourteen studies conducted across 20 countries that 4282 participants met the inclusion criteria. No study was conducted in the United States (U.S.). Studies reported that nurses had mixed attitudes toward mental illness, which were comparable to those of the general public. More negative attitudes were directed toward persons with schizophrenia. Results indicate the need for further research to determine whether attitudes among nurses in the U.S. differ from those reported from other countries and to examine potential g...

Abstract Over 43 million Americans are diagnosed with a mental illness. Various factors, including health professionals’ attitudes, prevent patients from seeking care. Previous evidence fails to identify nursing staff attitudes toward patients with mental illness. This cross-sectional study investigated attitudes toward mental illness of 146 registered nurses and mental health technicians in a psychiatric hospital. The study was guided by the Modified Labeling Theory. Respondents expressed stereotyping beliefs that people with mental illness would be devaluated and discriminated, and endorsed stigmatizing attitudes expressing stronger desire for social distance from a person with schizophrenia than depression or diabetes. Implications for future research, nursing education and practice are discussed.

Background: Registered nurses are increasingly becoming embedded in primary care teams yet there is a wide variability in nursing roles and responsibilities across organizations. Policy makers are calling for a closer look at how to best utilize registered nurses in primary care teams. Lack of knowledge about effective primary care nursing roles and responsibilities challenges policy makers' abilities to develop recommendations to effectively deploy registered nurses in primary care needed to assure efficient, evidence-based, and quality health care. Objective: To synthesize international evidence about primary care RN roles and responsibilities to make recommendations for maximizing the contributions of RNs in team-based primary care models. Design: Systematic review. Data sources: The Meta-Analysis and Systematic Reviews of Observational Studies framework guided the conduct of this review. Five electronic databases (OVID Medline, CINAHL, EMBASE, PubMed and Cochrane Library) were searched using MeSH terms: primary care, roles, and responsibilities. The term "nurs*" was truncated to identify all literature relevant to nursing. Review methods: The initial search yielded 2243. Abstracts and titles were screened for relevance and seventyone full text reviews were completed by two researchers. Inclusion criteria included: (1) registered nurses practicing in interprofessional teams; (2) description of registered nursing roles and responsibilities; (3) primary care setting. All eligible studies underwent quality appraisal using the Integrative Quality Criteria for Review of Multiple Study Designs tool. Results: Eighteen studies met eligibility across six countries: Australia, United States, Spain, Canada, New Zealand, and South Africa. Registered nurses play a large role in chronic disease management, patient education, medication management, and often can shift between clinical and administrative responsibilities. There are a limited number of registered nurses that participate in primary care policy making and research. Conclusion: Integrating registered nurses into primary care has the potential to increase patient access to a primary care provider because registered nurses can supplement some of the provider workload: they renew prescriptions, address patient questions, and provide patient education. Clear practice protocols and nursing policy should be written by registered nurses to ensure safe, and effective nursing care. The use of a medical assistant or nurse's aide to perform non-nursing tasks allows registered nurses to take on more complex patient care. Future research should expand on emerging payment models for nurse-specific tasks. What is already known about the topic? • A current global healthcare professional shortage requires the best utilization of the existing primary care workforce, including registered nurses, that are needed to meet the demand for effective primary care services. • RNs are increasingly being embedded into primary care teams and policy makers and administrators are seeking evidence to optimally utilize registered nurses in these teams. What this paper adds • This review demonstrates that nurses play a vital role in chronic disease management, care coordination, pharmaceutical management, and contributions to pediatric and women's health care delivery. • The use of clearly delineated protocols and standardized responsibilities increase the number of tasks that nurses can perform without provider oversight, subsequently reducing primary care provider

PURPOSE Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physicians and specialists. Because nurse practitioners are increasingly managing patient care as independent clinicians, our study objective was to propose a model of nurse practitioner-physician comanagement. METHODS We conducted a literature search using the following key words: comanagement; primary care; nurse practitioner OR advanced practice nurse. From 156 studies, we extracted information about nurse practitioner-physician comanagement antecedents, attributes, and consequences. A systematic review of the findings helped determine effects of nurse practitioner-physician comanagement on patient care. Then, we performed 26 interviews with nurse practitioners and physicians to obtain their perspectives on nurse practitioner-physician comanagement. Results were compiled to create our conceptual nurse practitioner-physician comanagement model. RESULTS Our model of nurse practitioner-physician comanagement has 3 elements: effective communication; mutual respect and trust; and clinical alignment/ shared philosophy of care. Interviews indicated that successful comanagement can alleviate individual workload, prevent burnout, improve patient care quality, and lead to increased patient access to care. Legal and organizational barriers, however, inhibit the ability of nurse practitioners to practice autonomously or with equal care management resources as primary care physicians. CONCLUSIONS Future research should focus on developing instruments to measure and further assess nurse practitioner-physician comanagement in the primary care practice setting.

Nurses’ Attitudes Toward Mental Illness Krystyna de Jacq This dissertation consists of three studies to assess nurses’ attitudes toward persons with mental illness. The first study was an integrative review of literature which revealed that surveyed nurses across 20 countries and three continents had mixed attitudes toward people with mental illness. While those attitudes mirrored attitudes of the general public and health providers in the United States, none of the identified studies explored nurses’ attitudes toward people with mental illness in the United States and none included a theoretical framework, showing several gaps in knowledge. Therefore, in the second paper of this dissertation two leading theories regarding stigma were analyzed and compared in order to select the best theoretical framework to guide a survey of psychiatric nurses’ attitudes toward the mentally ill, which comprises the third study of this dissertation. The Modified Labeling Theory (MLT) and the Cogniti...

The review focuses on exposure values, biological availability, toxic effects, and risks caused by nanoparticles of TiO 2 under their oral introduction into a body as a food coloring agent or E171 food additive, or as a significant component in its structure. According to toxicological assessment performed by JECFA in 1969, TiO 2 is considered to be insignificantly hazardous. However, at present experts employed by several foreign and international organizations that deal with food safety believe that the assessment should be reviewed as there are new scientific data on adverse effects produced by nano-sized TiO 2 on a human body. Overall intake of TiO 2 by people with food products, cosmetics (tooth pastes) and medications can vary from 0.5 to 5 mg a day; children aged 3-9 and teenagers aged 10-17 are the most exposed population groups. Despite insignificant intestinal absorption of TiO 2 nano-and micro-sized particles, a lot of scientific works revealed their overall toxic effects produced on a body under oral and intragastric introduction. Detected effects produced by TiO 2 include organotoxic (mostly hepatotoxic) ones, genotoxicity, immune toxicity, reproductive toxicity, and neurotoxicity. Still, there haven't been any data on carcinogenic effects produced by TiO 2 when it is introduced into the gastrointestinal tract. Presumably, some effects produced by TiO 2 nanoparticles are mediated by their local impacts on the lymphoid tissue associated with an intestinal mucosa as well as on the structure and activity of intestinal microbiocenosis, and nanoparticles are not necessarily absorbed in the intestines in the process. We performed meta-analysis of 64 articles (published over 2007-2019) which complied with criteria related to scientific authenticity and completeness; the meta-analysis revealed that a probable NOAEL for nano-sized TiO 2 amounted to less than 10 mg/kg of body weight a day, and a daily reference safe dose of the substance is estimated as being equal to 0.1 mg/kg of body weight. Given all the above-mentioned, a risk caused by TiO 2 intake as E171 food additive depends on nanoparticles fracture in its composition and it can be unacceptably high if this fracture exceeds 10 % of the overall TiO 2 mass. Therefore, it is necessary to control and regulate TiO 2 nanoparticles contents in the structure of E171 food additive that is applied in food industry.

at Chicago, is a recipient of the Kranichsteiner Musikpreis at the Darmstadt Festival for New Music, and founding member of contemporary chamber orchestra Ensemble Dal Niente in Chicago.-Bio and photograph alejandroacierto.com, 2016 Interview Transcript: Madeline Bolton: If you could just tell me a little bit about yourself? I read your bio, and I saw that you grew up in Chicago, so what was that like, and were you born there as well, or did you grow up in the city or the suburbs? Just tell me a little bit about that. Alejandro T. Acierto: I grew up in Chicago on the north side, sort of right off the Irving Park brown line stop, in an area called North Center. I grew up calling it Northwest Lakeview or Ravenswood sort of depending on what day it was. I went to public school until I went to college and I had the fortune of going to Whitney Young High School, which sort of opened up a lot of doors creatively and also intellectually and then I ended up in DePaul with a major in Music. Let's see, what else. Growing up in Chicago, is there anything specific about growing up in Chicago that you're interested in? MB: I mean, I just wanted to know specifically about where you grew up and then how all your schooling contributed to your evolution as an artist. I guess you kind of answered that. What was the high school you said again? ATA: Oh, I went to Whitney Young. Also the high school Michelle Obama went to. MB: Oh cool! ATA: But she was there before I was of course. MB: (Laughing) ATA: I also, wellso a lot of the work that I ended up doing, well this is maybe jumping around a little bit, but a lot of the work that I made in undergrad and then again in grad school, when I was at UIC, related to the experiences that I had as a young human, sort of negotiating the space on the playground and also sort of grappling with identity and identification as I continued my studies and workcreative work. So a lot of what I was doing, mostly what I was doing at DePaul creatively and outside of performing (in regard to making things like writing musical

Novel trisubstituted ethylenes, alkoxy ring-substituted isopropyl 2-cyano-3-phenyl-2-propenoates, RPhCH = C(CN)CO 2 CH(CH 3) 2 (where R is 2-methoxy, 3-methoxy, 4-methoxy, 2-ethoxy, 3ethoxy, 4-ethoxy, 4-propoxy, 4-butoxy, 4-hexyloxy) were prepared and copolymerized with styrene. The ethylenes were synthesized by the piperidine catalyzed Knoevenagel condensation of ring-substituted benzaldehydes and isopropyl cyanoacetate, and characterized by CHN analysis, FTIR, 1 H and 13 C NMR. All the ethylenes were copolymerized with styrene in solution with radical initiation (ABCN) at 70°C. The compositions of the copolymers were calculated from nitrogen analysis and the structures were analyzed by FTIR, 1 H and 13 C NMR. Decomposition of the copolymers in nitrogen occurred in two steps, first in the 250-500ºC range with residue (2.6-3.9% wt.), which then decomposed in the 500-800ºC range.