Reliability of Semiautomated Kinetic Perimetry (SKP) and Goldmann Kinetic Perimetry in Children and Adults With Retinal Dystrophies.

PurposeTo investigate the precision of visual fields (VFs) from semiautomated kinetic perimetry (SKP) on Octopus 900 perimeters, for children and adults with inherited retinal degenerations (IRDs). Goldmann manual kinetic perimetry has long been used in the diagnosis and follow-up of these patients, but SKP is becoming increasingly common. Octopus VFs (OVFs) and Goldmann VFs (GVFs) were both mapped on two occasions.MethodsNineteen females and 10 males with IRDs were tested on OVFs and GVFs, with two targets per test (V4e and one smaller target). Tests were performed in the same (randomized) order at two visits about 1 week apart. The VFs were digitized to derive isopter solid angles. Comparisons, within and between visits, were performed with paired t-tests and Bland-Altman plots.ResultsMedian age was 20 years (range, 7-70; 10 participants aged ≤17 years old). There were no significant differences in solid angles between OVFs and GVFs (P ≥ 0.06) or between the two visits' solid angles on either perimeter (P ≥ 0.30). Between-visit test-retest variability for GVFs and OVFs was similar (P ≥ 0.73), with median values of approximately 9% to 13%. Overall variability was lower for children than adults (medians of 7.5% and 12.8%, respectively).ConclusionsOctopus SKP and Goldmann perimetry produced VFs of similar size and variability.Translational relevanceOur study indicates that SKP provides a viable alternative to traditional Goldmann perimetry in clinical trials or care involving both children and adults with IRDs

A Review of Clinical Informatics Competencies in Nursing to Inform Best Practices in Education and Nurse Faculty Development

AIM The aim of this literature review was to determine the state of the science related to clinical informatics competencies of registered nurses and to determine best practices in educational strategies for both nursing students and faculty. BACKGROUND Continued emphasis on the provision of evidence-based patient care has implications for requisite informatics-focused competencies to be threaded throughout all levels of nursing educational programs. METHOD Whittemore and Knalf’s five-step integrative review process guided this research. An extensive search yielded 69 publications for critical appraisal. RESULTS Results suggest nursing educational programs do not adhere to standardized criteria for teaching nursing informatics competencies. Another identified literature gap was the scarcity of research related to informatics training requirements for nurse educators. CONCLUSION Findings support the need for continued research to provide clear direction about the expected clinical informatics competencies of graduate nurses and what training faculty need to facilitate student learning

Comparison of Post-injection Site Pain Between Technetium Sulfur Colloid and Technetium Tilmanocept in Breast Cancer Patients Undergoing Sentinel Lymph Node Biopsy.

BackgroundNo prior studies have examined injection pain associated with Technetium-99m Tilmanocept (TcTM).MethodsThis was a randomized, double-blinded study comparing postinjection site pain between filtered Technetium Sulfur Colloid (fTcSC) and TcTM in breast cancer lymphoscintigraphy. Pain was evaluated with a visual analogue scale (VAS) (0-100 mm) and the short-form McGill Pain Questionnaire (SF-MPQ). The primary endpoint was mean difference in VAS scores at 1-min postinjection between fTcSC and TcTM. Secondary endpoints included a comparison of SF-MPQ scores between the groups at 5 min postinjection and construction of a linear mixed effects model to evaluate the changes in pain during the 5-min postinjection period.ResultsFifty-two patients underwent injection (27-fTcSC, 25-TcTM). At 1-min postinjection, patients who received fTcSC experienced a mean change in pain of 16.8 mm (standard deviation (SD) 19.5) compared with 0.2 mm (SD 7.3) in TcTM (p = 0.0002). At 5 min postinjection, the mean total score on the SF-MPQ was 2.8 (SD 3.0) for fTcSC versus 2.1 (SD 2.5) for TcTM (p = 0.36). In the mixed effects model, injection agent (p < 0.001), time (p < 0.001) and their interaction (p < 0.001) were associated with change in pain during the 5-min postinjection period. The model found fTcSC resulted in significantly more pain of 15.2 mm (p < 0.001), 11.3 mm (p = 0.001), and 7.5 mm (p = 0.013) at 1, 2, and 3 min postinjection, respectively.ConclusionsInjection with fTcSC causes significantly more pain during the first 3 min postinjection compared with TcTM in women undergoing lymphoscintigraphy for breast cancer

Case 7 : What Do We Do About the Families?

Families are involved in the support of many people with mental health conditions. Support ranges from financial, housing, help with ADL (activities of daily living) etc. Families can also be useful sources of clinical information/history during inpatient treatment. Families generally want to be more involved in the care of their loved ones while they are in hospital. Mental health literacy includes knowledge and information on access and evaluation related to mental health pathology/issues. This includes being able to assess and identify mental health pathology and symptoms. Increasing mental health literacy (and health literacy) among family members can lead to improved health outcomes in patients. It can also lead to better health among family members. Families who support loved ones with mental health conditions can face caregiver burden. This can be related to the amount of physical and emotional resources required to deal with their loved ones. CAMH tries to address issues involving caregiver burden via peer support initiatives and training/workshops. Peer support is a model that includes building relationships based on shared experiences. The peer support model includes ‘self-help’ initiatives and peer support groups. The above issues faced by families should be brought together in a way that facilitates the families advocating for changes that involve them and their loved ones. Families need to be consulted to gather information on how to best address their needs, but their role should also be more participatory in nature

Spinning Interdisciplinary Service-Learning Webs: A Secondary Education Approach

Springboards: The ideas presented are not meant to be comprehensive. Placing this much information on one page restrains the number of ideas that can be given. They are meant to spark creative minds. Each teacher knows his/her students, community. and curriculum best. Making connections: Each and every curricular area does not need to participate for successful interdisciplinary learning to occur. Choosing your action: We have presented an example of each type of action: (direct, indirect, and advocacy). Only one type of action is required to make this a service-learning project along with preparation and reflection All School activities: When reading the Aging and Hunger and Homelessness webs it becomes obvious that an all school project is the focus. In the Aging web , references to holding a Senior Prom is a theme throughout. The same is true of the Hunger and Homelessness web where holding a Hunger Banquet becomes a school wide project. MSPAP and Service-learning: Service-learning and MSPAP are natural fit. Both incorporate real-life learning, problem-solving, critical thinking, and the opportunity to apply skills. Goals of this project: It is hoped that these webs accomplish 2 goals: 1- to increase understanding of service learning and its contributions to application of knowledge.2- to encourage curricular webbing that helps increase overall learning and understanding

Systematic review of patients’ and healthcare professionals’ views on patient‐initiated follow‐up in treated cancer patients

Background: Current follow‐up models in cancer are seen to be unsustainable and inflexible, and there is growing interest in alternative models, such as patient‐initiated follow‐up (PIFU). It is therefore important to understand whether PIFU is acceptable to patients and healthcare professionals (HCPs). Methods: Standard systematic review methodology aimed at limiting bias was used for study identification (to January 2022), selection and data extraction. Thematic synthesis was undertaken for qualitative data, and survey findings were tabulated and described. Results: Nine qualitative studies and 22 surveys were included, mainly in breast and endometrial cancer. Women treated for breast or endometrial cancer and HCPs were mostly supportive of PIFU. Facilitators for PIFU included convenience, control over own health and avoidance of anxiety‐inducing clinic appointments. Barriers included loss of reassurance from scheduled visits and lack of confidence in self‐management. HCPs were supportive of PIFU but concerned about resistance to change, unsuitability of PIFU for some patients and costs. Conclusion: PIFU is viewed mostly positively by women treated for breast or endometrial cancer, and by HCPs, but further evidence is needed from a wider range of cancers, men, and more representative samples. A protocol was registered with PROSPERO (CRD42020181412)

High Variability of Mesenchymal Stem Cells Obtained via Bone Marrow Aspirate Concentrate Compared With Traditional Bone Marrow Aspiration Technique

Background: Bone marrow aspirate (BMA) is a common source for harvesting mesenchymal stem cells (MSCs), other progenitor cells, and associated cytokines and growth factors to be used in the biologic treatment of various orthopaedic pathologies. The aspirate is commonly centrifuged into a concentrated volume that can be immediately administered to a patient using commercially available kits. However, the handling and efficacy of BMA concentrate (BMAC) are still controversial. Purpose: To characterize BMA versus BMAC for MSC quantity, potency, and cytokine profile. Study Design: Controlled laboratory study. Methods: From 8 participants (age, 17-68 years), 30 mL of bone marrow was aspirated by a single surgeon from either the proximal humerus or distal femur and was separated into 2 equal samples. One sample was kept as BMA, and the other half was centrifuged into BMAC. The 2 samples then underwent flow cytometry for detection of MSCs, cell analysis for colony-forming units (CFUs), and cytokine profiling. A 2-tailed t test was used to detect differences between MSCs, CFUs, and cytokine density concentrations between BMA and BMAC. Results: The average concentration of MSCs in both BMA and BMAC was 0.001%. Average MSC events detected by flow cytometry were significantly higher in BMA versus BMAC (15.1 and 8.1, respectively; P < .045). Expanded MSCs demonstrated similar phenotypes, but CFUs were significantly increased in BMA compared with BMAC (104 vs 68 CFUs, respectively; P < .001). Total protein concentration and cytokine profiling demonstrated great variability between BMA and BMAC and between patients. Most importantly, BMAC failed to concentrate MSCs in 6 of 8 samples. Conclusion: There is great variability in MSC concentration, total protein concentration, and cytokine profile between BMA and BMAC. Clinical Relevance: When studying the clinical efficacy of BMAC, one must also evaluate the sample itself to determine the presence, concentration, and potency of MSCs if this is to be considered a cell-based therapy. Further standard operating procedures need to be investigated to ensure reproducible results and appropriate treatments

MAGNETO: Mapping the Earth’s Magnetic Field at 300 km using COTS Sensors

In the nearly two decades that CubeSats have been in significant use, over 800 have been launched, and many more are under construction. They have gained popularity in the industry and are often the choice for most first-time small-satellite missions. The University of Southern California’s (USC) Space Engineering Research Center (SERC) has developed a 1.5U student-built science mission called Magneto. Magneto is USC’s fourth CubeSat mission, and it has the goal of mapping the Earth’s magnetic field in Low-Earth Orbit (LEO) using Commercial Off-The-Shelf (COTS) hardware, to determine the viability of using COTS sensors to decrease the mission cost by a hundred-fold from similar missions using dedicated science instruments, while offering similar levels of precision. The spacecraft, built in partnership with Omega Engineering, will utilize COTS sensors provided by Omega to measure the Earth’s magnetosphere. These will be deployed on carbon-fiber booms to minimize the spacecraft’s effect on the magnetic field measurements throughout the mission. To collect accurate magnetosphere measurements without the use of GPS or a star tracker, the team at SERC developed a novel method to acquire attitude updates using a single sun sensor. This new GNC methodology is able to obtain the spacecraft’s attitude while operating under an unknown rotation rate. The spacecraft obtains its position from the USC ground-station by finding the time of closest approach using the Doppler effect. Combining this data over multiple passes and using statistical analysis, the space craft position can be determined to within a few kilometers. The Magneto spacecraft was scheduled on the manifest for the inaugural launch of the Firefly Alpha vehicle as part of Firefly’s DREAM program, a STEM outreach effort to offer University and High School students a free launch opportunity to LEO. Due to the Covid-19 delays Magento’s delivery was moved to alternative opportunities in Fall of 2020 or Spring of 2021. This paper will describe the design of the CubeSat, its unique mechanisms that enable compacts to wage and deployment of antennas and magnetometers, and the novel GNC approach used to determine attitude and position throughout the orbit