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Når et sted skal utvikles, er kunnskap om lokalbefolkningens ønsker, innspill og behov avgjørende for både god planlegging og gjennomføring. I økende grad ser vi at kommunale myndigheter, planleggere, urbanister og arkitekter er opptatt av å få tak i folks stemmer utover den lovpålagte medvirkningen. Samtidig mangler viktige aktører både kompetanse og metoder for å kunne nyttiggjøre seg av medvirkningsinnspill. Hvordan kan folks personlige historier og refleksjoner bli en viktig del av kunnskapsgrunnlaget for en stedsutviklingsprosess og hvordan får vi tak i folks mangfoldige erfaringer og meningsverden på en effektiv og ivaretagende måte? Vi har gjennom flere år med aksjonsforskning på barn og unges medvirkning i by- og stedsutviklingsprosesser, utviklet en kombinert tegneøvelse, dialogverktøy og læringsintervensjon vi kaller «splotting». Her tar vi utgangspunkt i det enkle spørsmålet: Hvor har du det godt? Metoden er testet og utviklet i samarbeid med blant andre lokal ungdom i Oslo og landskapsarkitektstudenter fra NMBU, og gir innsikt i steders betydning for de menneskene det angår uten bruk av forutbestemte kategorier og såkalte «forbildefeller». Splotting er spesielt egnet som verktøy i dialogbaserte medvirkningsprosesser innenfor by- og stedsutvikling med fokus på utforming av det offentlige rom som sosial arena, blant annet innenfor fag som arkitektur, design og sosialantropologi. Utfordringen har vært å sikre systematisk dokumentasjon og oversetting av folks refleksjoner til plantegning og formgivning. Metoden har slik store utviklingsmuligheter, og kan også brukes transdisiplinært i samarbeid med fagfelt som kunst og kultur, folkehelse og innenfor organisasjonsutvikling i offentlig sektor. Norges Forskningsråd, Stiftelsen Dam og Redd Barna har finansiert og støttet prosjektene hvor forfatterne har utviklet denne metodikken, Alternative byrom: Unges medvirkning (2015-2019) og Et sted å være ung: Metoder og rammeverk for innovativ medvirkning ved utvikling og etablering av ungdomssteder (2018-2021).

Clinical placement for nurse practitioner (NP) students is difficult due to an increase in demand for clinical sites and qualified preceptors, and the nursing faculty shortage. The American Association of Colleges of Nursing supports the use of simulation with standardized patients as an adjunct to traditional clinical placement for NPs. In this article, we describe an innovative standardized patient simulation experience implemented in a family NP master's of science program. The purposes of this experience were to provide alternative clinical opportunities and formative feedback for NP students and to identify gaps in students' diagnostic reasoning. Lessons learned through this experience are included.

Readiness for practice (RFP) is essential as new nurses will practice in a nursing shortage climate, with high acuity patients and complex technology. Nurse educators are challenged to foster readiness for practice. Aim The aim of this integrative review was to explore the impact of simulation and senior practicum on graduating senior nursing students' readiness for practice. Background Readiness for practice has been a point of concern for healthcare for quite some time. This has led to a need for better understanding for what RFP means including their perceptions of various stakeholders. Further, it is important to address what teaching and learning strategies can be implemented to assist in ensuring the graduating senior nursing student is ready for practice on graduation and for their first professional practice. Readiness for practice is defined as the ability to safely and competently care for patients by synthesizing theory, skills, attitudes and values in applying clinical reasoning in practice settings. Method An integrative review identified 48 published papers on simulation and senior practicum that met the inclusion criteria. Results Themes identified from the senior practicum/preceptor literature included clinical reasoning, skills, barriers to the senior practicum and transition. Themes identified regarding simulation as a strategy included preparation, competence development, clinical reasoning and the number of human patient simulators used. Conclusion Although the evidence is not conclusive, simulation and senior practicums have the promise of preparing graduating nursing students for their first professional practice. However, nurse educators must ensure simulations are well-organized with clear objectives and that preceptors are supported in teaching and assessing students.

Microglia-mediated neuroinflammation is widely associated with seizures and epilepsy. Although microglial cells are professional phagocytes, less is known about the status of this phenotype in epilepsy. Recent evidence supports that phagocytosis-associated molecules from the classical complement (C1q-C3) play novel roles in microglia-mediated synaptic pruning. Interestingly, in human and experimental epilepsy, altered mRNA levels of complement molecules were reported. Therefore, to identify a potential role for complement and microglia in the synaptodendritic pathology of epilepsy, we determined the protein levels of classical complement proteins (C1q-C3) along with other phagocytosis signaling molecules in human epilepsy. Cortical brain samples surgically resected from patients with refractory epilepsy (RE) and non-epileptic lesions (NE) were examined. Western blotting was used to determine the levels of phagocytosis signaling proteins such as the complements C1q and C3, MerTK, Trem2, and Pros1 along with cleaved-caspase 3. In addition, immunostaining was used to determine the distribution of C1q and co-localization to microglia and dendrites. We found that the RE samples had significantly increased protein levels of C1q (p=0.034) along with those of its downstream activation product iC3b (p=0.027), and decreased levels of Trem2 (p=0.045) and Pros1 (p=0.005) when compared to the NE group. Protein levels of cleaved-caspase 3 were not different between the groups (p=0.695). In parallel, we found C1q localization to microglia and dendrites in both NE and RE samples, and also observed substantial microglia-dendritic interactions in the RE tissue. These data suggest that aberrant phagocytic signaling occurs in human refractory epilepsy. It is likely that alteration of phagocytic pathways may contribute to unwanted elimination of cells/synapses and/or impaired clearance of dead cells. Future studies will investigate whether altered complement signaling contributes to the hyperexcitability that result in epilepsy.

Traumatic brain injury (TBI) causes cortical dysfunction and can lead to post-traumatic epilepsy. Multiple studies demonstrate that GABAergic inhibitory network function is compromised following TBI, which may contribute to hyperexcitability and motor, behavioral, and cognitive deficits. Preserving the function of GABAergic interneurons, therefore, is a rational therapeutic strategy to preserve cortical function after TBI and prevent long-term clinical complications. Here, we explored an approach based on the ketogenic diet, a neuroprotective and anticonvulsant dietary therapy which results in reduced glycolysis and increased ketosis. Utilizing a pharmacologic inhibitor of glycolysis (2-deoxyglucose, or 2-DG), we found that acute in vitro application of 2-DG decreased the excitability of excitatory neurons, but not inhibitory interneurons, in cortical slices from naïve mice. Employing the controlled cortical impact (CCI) model of TBI in mice, we found that in vitro 2-DG treatment rapidly attenuated epileptiform activity seen in acute cortical slices 3 to 5 weeks after TBI. One week of in vivo 2-DG treatment immediately after TBI prevented the development of epileptiform activity, restored excitatory and inhibitory synaptic activity, and attenuated the loss of parvalbumin-expressing inhibitory interneurons. In summary, 2-DG may have therapeutic potential to restore network function following TBI.

Traumatic brain injury (TBI) causes cortical dysfunction and can lead to post-traumatic epilepsy. Multiple studies demonstrate that GABAergic inhibitory network function is compromised following TBI, which may contribute to hyperexcitability and motor, behavioral, and cognitive deficits. Preserving the function of GABAergic interneurons, therefore, is a rational therapeutic strategy to preserve cortical function after TBI and prevent long-term clinical complications. Here, we explored an approach based on the ketogenic diet, a neuroprotective and anticonvulsant dietary therapy which results in reduced glycolysis and increased ketosis. Utilizing a pharmacologic inhibitor of glycolysis (2-deoxyglucose, or 2-DG), we found that acute in vitro glycolytic inhibition decreased the excitability of excitatory neurons, but not inhibitory interneurons, in cortical slices from naïve mice. Employing the controlled cortical impact (CCI) model of TBI in mice, we found that in vitro 2-DG treatment rapidly attenuated epileptiform activity seen in acute cortical slices 3-5 weeks after TBI. One week of in vivo 2-DG treatment immediately after TBI prevented the development of epileptiform activity, restored excitatory and inhibitory synaptic activity, and attenuated loss of parvalbumin-positive inhibitory interneurons. In summary, inhibition of glycolysis with 2-DG may have therapeutic potential to restore network function following TBI.One Sentence SummaryFollowing traumatic brain injury in mice, in vivo treatment with the glycolytic inhibitor 2-deoxyglucose prevented cortical network pathology including cortical hyperexcitability, changes in synaptic activity, and loss of parvalbumin-expressing GABAergic interneurons.

Traumatic brain injury (TBI) is a significant cause of disability worldwide and can lead to post-traumatic epilepsy. Multiple molecular, cellular, and network pathologies occur following injury which may contribute to epileptogenesis. Efforts to identify mechanisms of disease progression and biomarkers which predict clinical outcomes have focused heavily on metabolic changes. Advances in imaging approaches, combined with well-established biochemical methodologies, have revealed a complex landscape of metabolic changes that occur acutely after TBI and then evolve in the days to weeks after. Based on this rich clinical and preclinical data, combined with the success of metabolic therapies like the ketogenic diet in treating epilepsy, interest has grown in determining whether manipulating metabolic activity following TBI may have therapeutic value to prevent post-traumatic epileptogenesis. Here, we focus on changes in glucose utilization and glycolytic activity in the brain following TBI and during seizures. We review relevant literature and outline potential paths forward to utilize glycolytic inhibitors as a disease-modifying therapy for post-traumatic epilepsy.

The handloom product is a transformation of the yarn into exquisite fabrics by the ingenuity of the weavers. It is a combination of the yarn and the skill of the weaver. The final product is the outcome of the creativity and expertise of the weavers. Thenzawl handloom cluster in the state of Mizoram has become an important centre of weaving providing livelihood to a significant number of households. The looms at Thenzawl weave rich and colourful varieties of handloom products. This paper has attempted to examine the product policies of the handloom enterprises in the cluster based mainly on primary data collected from 175 respondents out of 325 entrepreneurs operating their enterprises in the cluster. Though Thenzawl cluster has demonstrated its sustainability and growth, there is an urgent need to provide support to the enterprises with regard to product development, improvisation of designs, building strong brands and creating networks with NIFT and NID to explore and enhance the markets for their products from merely local to national and international markets.

Peripheral artery disease (PAD) is a broad disorder encompassing multiple forms of arterial disease outside of the heart. As such, PAD development is a multifactorial process with a variety of manifestations. For example, aneurysms are pathological expansions of an artery that can lead to rupture, while ischemic atherosclerosis reduces blood flow, increasing the risk of claudication, poor wound healing, limb amputation, and stroke. Current PAD treatment is often ineffective or associated with serious risks, largely because these disorders are commonly undiagnosed or misdiagnosed. Active areas of research are focused on detecting and characterizing deleterious arterial changes at early stages using non-invasive imaging strategies, such as ultrasound, as well as emerging technologies like photoacoustic imaging. Earlier disease detection and characterization could improve interventional strategies, leading to better prognosis in PAD patients. While rodents are being used to investigate PAD pathophysiology, imaging of these animal models has been underutilized. This review focuses on structural and molecular information and disease progression revealed by recent imaging efforts of aortic, cerebral, and peripheral vascular disease models in mice, rats, and rabbits. Effective translation to humans involves better understanding of underlying PAD pathophysiology to develop novel therapeutics and apply non-invasive imaging techniques in the clinic.

An accumulation of factors over several years led faculty and administration at Auburn University School of Nursing to recognize the need to implement simulation across the curriculum. For many years the Nursing Resource Center (NRC) was underused, with basic fundamentals and assessment concepts practice being the only activities in the lab. Some faculty held a narrow view of the role, importance, and potential of traditional and nontraditional lab and simulation experiences. The belief that students learned best from traditional clinical experiences with human patients was dominant. At this point, the Institute of Medicine (2001, 2003), the Quality and Safety Education for Nurses faculty (Cronenwett et al., 2007), and the American Association of Colleges of Nursing (2008) called for an educational shift to emphasize patient safety and error reduction practices. Because of this shift in culture, clinical practice in a safe, controlled environment without potential harm to patients became a priority. As society demanded more professional nurses to meet its health care needs, enrollment increased in our school of nursing, along with other nursing programs. The combination of increasing competition for clinical sites on one hand and mandates from the Institute of Medicine, the Quality and Safety Education for Nurses faculty, and the American Association of Colleges of Nursing on the other made it apparent that a strong clinical lab and simulation program was needed.

Inflammation is a major factor in the progression of damage after stroke and in the clinic, current therapies treat the clot, not the resulting damage. We have developed a novel method of protein delivery that exploits the migration ability of leukocytes after ischemic stroke (transient middle cerebral artery occlusion; tMCAO). In our studies, ex vivo-derived dendritic cells (exDCs) migrate to the inflamed rat brain soon after tMCAO onset and the number of cells that remain in the brain after injection is significantly correlated with the amount of local inflammation at the injury site. In addition, exDCs transduced to overexpress soluble tumor necrosis factor (TNF) receptor1 (sTNFR1) produce functional cargo that is secreted and that blocks TNF-α bioavailability in vitro. When delivered at 6 hours post-tMCAO reperfusion, sTNFR1-exDC-treated rats show significantly smaller infarct size and decreased inflammation compared with animals treated with exDCs transduced with GFP lentivirus. These studies indicate that cell-mediated delivery of proteins may be a promising new approach to reduce brain damage after acute neurologic insult.

Cultural humility requires self-evaluation and the awareness that one's own culture is not the only or best one. Teaching health care providers to become culturally humble includes the development of critical thinking skills and the ability to reflect on practice. Journaling as a teaching strategy helps students develop these skills. This article describes the use of reflective journaling as students progressed through four semesters of a community clinical experience. This qualitative, descriptive study was based on the principles of naturalistic inquiry with person-centered written reflections. Two hundred journal entries from 50 students were reviewed, and 11 themes were identified. Cultural humility cannot be learned merely in the classroom with traditional teaching methods. Reflection on experiences over time leads to the development of cultural humility.

Purpose: The purpose of this study was to describe rural women’s knowledge of cardiovascular disease (CVD) and actual risk of CVD. The research question guiding this study was: “Are there relationships between demographic factors, women’s knowledge of CVD, and women’s CVD risk score?” Data sources: Demographic data were collected from a convenience sample of 112 women at a full-service, rural medical clinic in Alabama. Two questions assessed women’s knowledge of their risk factors for CVD. The Coronary Heart Disease Knowledge Test measured knowledge of coronary heart disease (CHD). Framingham CHD prediction scores were calculated to assess the actual heart disease risk of subjects. Conclusions: Knowledge of CVD in rural Alabama women is inadequate. The mean score for the knowledge test was 8.50 out of 20. This population of women has significant risk for CVD. Women recognized that smoking and obesity are issues, but are less aware of factors such as race, personality types, oral contraceptive use, hypertension, diabetes, age, hyperlipidemia, and family history. Implications for practice: The majority of women in the study could list only one or two CVD risk factors. New strategies for educating women about CVD should be explored by nurse practitioners (NPs). For example, NPs interested in CVD in women could organize and offer to teach in local schools, colleges, universities, churches, and at sites where women work. Collaboration with the local American Heart Association and Health Department in educating women may be appropriate. By increasing women’s knowledge, their actual risk may change and thus improve their chance to live free of CVD or have it later in life or to a lesser extent.

Nurse educators are challenged to prepare nursing students to practice in a changing environment. Pediatrics is a particularly challenging and important area to prepare nursing students for future nursing practice. Several factors emerged that suggested the current approach to teaching pediatrics was not adequate. This article describes the revision of the baccalaureate curriculum to address concerns related to pediatric nursing concepts. These revisions include the integration of pediatric concepts into three major theory and clinical courses and the implementation of an elective designed for those students with a special interest in pediatrics. A popular preceptorship program for nursing students who want to complete their cumulative final clinical experience in pediatrics was also developed.AUTHORSReceived: November 15, 2006Accepted: August 8, 2007Dr. Smith is Associate Professor, Department of Nursing, Columbus State University, Columbus, Georgia; and Dr. Hamner is Assistant Dean and Associate Professor, Auburn University School of Nursing, Auburn, Alabama.Address correspondence to Cheryl M. Smith, EdD, RN, FNP, Associate Professor, Department of Nursing, Columbus State University, 209 Illges Building, Columbus, GA 31907-5645; e-mail: Smith_cheryl6@colstate.edu.

Auburn University School of Nursing (AUSON) has been in a partnership with the Auburn Housing Authority (AHA), a low-income public housing provider, for several years by providing a weekly nursing care clinic. AUSON was convinced expansion of the clinics would be beneficial to all. This article describes the process and lessons learned in expanding the scope and depth of the partnership and how this service learning experience was integrated throughout the nursing curriculum. Journaling by students revealed that interactions with a different culture over time changed their perceptions. Residents have been empowered to take control of their health. A community partnership takes persistence, perseverance, and consistency. This partnership has been beneficial to residents, students, and faculty. The university's land-grant mission of service and access is demonstrated through a partnership that offers opportunities for students and faculty to address the community's needs.