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For over 30 years, the assessment of the clinical competence of student nurses has been the subject of much theoretical debate, yet the definition of criteria based on observable indicators of competence remains problematic. In practice, however, different assessors will judge and agree, relatively quickly, whether a student is competent or not; whether they have got ‘it’. Articulating what ‘it’ is, is difficult; although ‘it’ appears to be collectively, yet tacitly, understood. These judgements provide the key to the definition of competence. This research solves the dilemma of revealing and investigating these tacit understandings through the video analysis of students in simulated practice. The findings of four initial exploratory studies confirmed that competence is an example of tacitly understood behaviour and identified the limitations of traditional research methods in this context. The practical challenges of analysing video were highlighted, leading to the development of Video-View-Point to solve these problems and to reveal the tacitly understood behaviours. This innovative hybrid research method combines analysis of multiple ‘Think Aloud’ commentaries with the ability to ‘point’ at the subject of interest. The analysis is presented as a time-stamped multimedia dialectic, a visually simple yet sophisticated collage of data which reveals relevant behaviours, including those which are tacitly understood. A bespoke software tool (BigSister) was designed to facilitate the data collection, and was tested against the most similar commercially available technology, an eye tracker. The test of Video-View-Point successfully revealed four tacitly understood indicators of competence: communication, processing clinical information, being in the right place, and being proactive. Video-View-Point offers huge potential for behavioural analysis in other domains.

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abstract: In the United States, two-thirds of adults are considered hypertensive orprehypertensive. In addition, chronic illness, such as hypertension, cardiovascular disease, and type II diabetes, results in $3.5 trillion in annual healthcare cost and is the primary cause of disability and death. As a result, many individuals seek cheaper and simpler alternatives to combat their conditions. In this exploratory analysis, a study assessing nitrate intake and its effects on vascular function in 39 young adult males was investigated for underlying metabolic variations through a liquid chromatography – mass spectrometry-based large-scale targeted metabolomics approach. A two-way repeated measures ANOVA was used, and 18 significant metabolites were discovered across the time, treatment, and time & treatment groups, including prostaglandin E2 (p<0.001), stearic acid (p=0.002), caprylic acid (p=0.016), pentadecanoic acid (p=0.027), and heptadecanoic acid (p=0.005). In addition, log-transformed principal component analysis and orthogonal partial least squares – discriminant analysis models demonstrated distinct separation among the treatment, control, and time variables. Moreover, pathway and enrichment analyses validated the effect of nitrate intake on the metabolite sets and its possible function in fatty acid oxidation. This better understanding of altered metabolic pathways may help explicate the benefits of nitrate on vascular function and reveal any unknown mechanisms of its supplementation. / Dissertation/Thesis / Masters Thesis Nutrition 2020

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Previously, we demonstrated that exposure to morphine during gestation increases hypothalamic norepinephrine (NE) content and turnover rate in adult male rats and decreases these measures in adult females. To investigate the basis of these alterations, the present study examined the effects of prenatal exposure to morphine on tyrosine hydroxylase immunoreactivity (TH-IR) in the brains of adult male and female progeny. In male rats, prenatal morphine exposure significantly increased the density of TH-IR in cells and fibers in the caudal paraventricular nucleus of the hypothalamus (PVN) and locus coeruleus (LC), but had no effects in the lateral hypothalamus (LH). In female rats that were ovariectomized (OVX), prenatal morphine exposure significantly decreased the density of TH-IR in cells and fibers in the LC. Interestingly, an injection of estrogen in OVX control females reduced the mean optical density of TH-IR in the LC, but it was ineffective in drug-exposed females in the same brain region. Estrogen injections also reduced the mean optical density of TH-IR in the LH but not in the PVN of females, regardless of prenatal drug exposure. Thus, the present study suggests that prenatal morphine exposure induces long-term, sex-specific alterations in TH-IR in the PVN and LC of adult progeny.

A highly sensitive and rapid method for the analysis of isradipine in human plasma using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) was developed. The procedure involves a simple liquid-liquid extraction of isradipine and amlodipine (IS, internal standard) with methyl-t-butyl ether after alkaline treatment and separation by RP-HPLC. Detection was performed by positive ion electrospray ionization (ESI) in multiple reaction monitoring (MRM) mode, monitoring the transitions m/z 372.1 → m/z 312.2 and m/z 408.8 → m/z 237.9, for quantification of isradipine and IS, respectively. The standard calibration curves showed good linearity within the range of 10 to 5000 pg/mL (r2 ≥ 0.9998). The lower limit of quantitation (LLOQ) was 10 pg/mL. The retention times of isradipine (0.81 min) and IS (0.65 min) suggested the potential for high throughput of the proposed method. In addition, no significant metabolic compounds were found to interfere with the analysis. This method offered good precision and accuracy and was successfully applied for the pharmacokinetic and bioequivalence studies of 5 mg of sustained-release isradipine in 24 healthy Korean volunteers.

Widespread sedentary lifestyle and unhealthy eating habits in the last few decades have resulted in a dramatic increase of the number of people affected by obesity, type 2 diabetes, and cardiovascular diseases. The study of these pathological conditions revealed that impaired metabolism often causes these disorders. Lipid metabolism research has contributed significantly to determining mechanisms underlying metabolic disorders. Omega-3 fatty acids are an interesting target for lipidomics studies because they were shown to lower risk of cardiovascular diseases and are hypothesized to regulate lipid metabolism. In this work, I optimized lipid extraction and chemical modification methods for analysis of fatty acids profile of tissue samples and biofluids using comprehensive two-dimensional gas chromatography coupled to mass spectrometry (GCxGC-MS). At first, I evaluated the relative amount of omega-3 fatty acids in red blood cells (Omega-3 index) of people living in Czech Republic in either the capital city (n=476) or the rural region (n=388). For this large-scale project, I extracted phospholipids from red blood cell (RBC) membranes, transesterified them into fatty acid methyl esters (FAMEs), and measured their profile by GCxGC-MS. The mean Omega-3 index was 3.56 mol % and I detected no significant...

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The detection and quantification of hormones are important to assess the reproductive and stress status of experimental models and for the diagnosis of diseases in human and veterinary clinics. The peptide secretoneurin (SN) has been proposed as a new sex hormone, but effective quantification methods are challenging. Traditional methods require the use of antibodies with either radioactive or non-radioactive tracers. There are difficulties with these methods in terms of sensitivity, specificity, and inter-laboratory repeatability. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) can circumvent many of these challenges. Another source of variation is the extraction of lipophilic steroidal compounds, which is incompatible with the extraction of hydrophilic peptide hormones. I have developed efficient extraction and sensitive detection methods of SN with numerous other peptide and steroid hormones in the same tissue sample in mice and zebrafish. The extraction efficiency for both peptide and steroid analytes is over 85%. The standard deviation for extraction and LC-MS/MS analysis for each compound varies between 5-10%. The steroid hormones can be quantified in the low to medium fmol/µL range. We quantified peptide hormones in the high fmol/µL to low pmol/µL range. Mouse SN levels were measured and compared against the levels of GnRH 1, oxytocin, vasopressin, E2, and P4 in multiple tissues at 3 important periods through the estrous cycle. In addition, SN levels were found to be moderately related to GnRH 1 levels in the hypothalamus in the estrous cycle. This is important because it is GnRH 1 that stimulates the luteinizing hormone surge in the pituitary that regulates ovulation in all vertebrate species. I also determined that SNa and SNb were both within the 2-8 pmol/µL range in the brain or pituitary harvested from a single female zebrafish. This makes it feasible for the first time to study the correlation between the SNs and other peptides and steroid hormones by quantifying them simultaneously in very small tissue samples. Untargeted peptidomics determined that the SN peptides in zebrafish can be further processed into smaller discrete fragments. This implies not only active synthesis and selective peptide processing but suggests that the are unknown functions of the SN peptide fragments that await discovery. This cost-effective package was used for the detailed assessment of hypothalamic-pituitary-gonadal function in mice and zebrafish and may be adaptable to many other hormones across species.