A Pilot Study for Enhancing Postpartum Discharge Instructions for Incision Care: Assessment of Comprehension

Literacy and Health Care • 14.5% of United States is illiterate 1 • Reading level of most medical forms is 10th grade 2 Improving Outcomes with a Visual Aid • Cesarean Surgical Site Infection (SSI) rate is 5% 3 • A patient with a SSI can be 2 times as expensive 4 • Visual aids improve information recall 8 and confidence in wound care 5 Study Objectives 1. To evaluate the readability of the cesarean wound care discharge instructions relative to the patient population’s reading level 2. To conduct a pilot Randomized Control Trial (RCT) to evaluate the effectiveness of a visual aid on improving comprehension of the cesarean wound care instructionshttps://jdc.jefferson.edu/cwicposters/1034/thumbnail.jp

Alterations in the lipid profile and liver enzymes of rats treated with monosodium glutamate

This study was carried out to evaluate the effects of monosodium glutamate on the liver and lipid profile of eighteen adult male Wistar rats as measured by biochemical parameters. The rats received monosodium glutamate at dose rate of 0, 0.5 and 1.0g per day for 28 days. There was significant increase (P<0.05) in aminotransferases i.e. alanine and aspartate aminotransferases as well as increase in total plasma cholesterol and low density lipoprotein cholesterol most obvious at higher dose of 1.0g of monosodium glutamate. Though there was decrease in plasma protein concentration, triglyceride and high density lipoprotein cholesterol which was not statistically significant, therefore monosodium glutamate has both hepatotoxic and dyslipidaemia effects due to its alterations in both aminotransferase activities and lipid profile, hence monosodium glutamate though a flavor enhancer food additive but it must be carefully used in food preparation due to it alterations in both the liver enzymes and the lipid profile.Keywords: Adult rats, dyslipidaemia, flavor enhancer, hepatotoxic, monosodium glutamat

Is There a Causal Association between Genotoxicity and the Imposex Effect?

There is a growing body of evidence that indicates common environmental pollutants are capable of disrupting reproductive and developmental processes by interfering with the actions of endogenous hormones. Many reports of endocrine disruption describe changes in the normal development of organs and tissues that are consistent with genetic damage, and recent studies confirm that many chemicals classified to have hormone-modulating effects also possess carcinogenic and mutagenic potential. To date, however, there have been no conclusive examples linking genetic damage with perturbation of endocrine function and adverse effects in vivo. Here, we provide the first evidence of DNA damage associated with the development of imposex (the masculinization of female gastropods considered to be the result of alterations to endocrine-mediated pathways) in the dog-whelk Nucella lapillus. Animals (n = 257) that displayed various stages of tributyltin (TBT)-induced imposex were collected from sites in southwest England, and their imposex status was determined by physical examination. Linear regression analysis revealed a very strong relationship (correlation coefficient of 0.935, p < 0.0001) between the degree of imposex and the extent of DNA damage (micronucleus formation) in hemocytes. Moreover, histological examination of a larger number of dog-whelks collected from sites throughout Europe confirmed the presence of hyperplastic growths, primarily on the vas deferens and penis in both TBT-exposed male snails and in females that exhibited imposex. A strong association was found between TBT body burden and the prevalence of abnormal growths, thereby providing compelling evidence to support the hypothesis that environmental chemicals that affect reproductive processes do so partly through DNA damage pathways

Diversity, floristic composition, and structure of the woody vegetation of the Cerrado in the Cerrado–Amazon transition zone in Mato Grosso, Brazil

The final publication is available at Springer via http://dx.doi.org/10.1007/s40415-015-0186-2We compared the diversity and species composition and the structure of the vegetation of three distinct Cerrado phytophysiognomies (Cerradão, Dense Cerrado, and Typical Cerrado) in the Cerrado–Amazon transition, Mato Grosso (Brazil). Species richness (observed and estimated) in the Cerradão and Dense Cerrado was higher than that recorded in the Typical Cerrado. Species diversity, based on a Rényi profile, was highest in the Dense Cerrado, in comparison with the other phytophysiognomies. We recorded a higher number of exclusive species in the Cerradão and a greater similarity (Morisita and Sørensen indices) between this vegetation type and the Dense Cerrado. While individuals were tallest in the Cerradão and Dense Cerrado and lowest in the Typical Cerrado, there was no difference among phytophysiognomies in mean diameter. A gradient in decreasing species richness and diversity (hypothesis 1) and vegetation vertical structure (hypothesis 3) was expected for the Cerradão–Dense Cerrado–Typical Cerrado; however, neither hypothesis was supported by the results. The Cerradão and Dense Cerrado were most similar in species composition not confirming hypothesis 2, which predicted that the two savanna vegetation types (Dense Cerrado and Typical Cerrado) were more similar to one another than either is to the woodland (Cerradão). Overall, the similarities among the three study communities depended on the type of parameter analyzed. While the species richness and the vertical and structure of the vegetation of the Cerradão and Dense Cerrado are closely similar, the Cerradão and Typical Cerrado are more similar in their species diversity. With regard to the floristic composition, Dense Cerrado occupies an intermediate position between Cerradão and Typical Cerrado.UNEMAT Graduate Program in Ecology and ConservationBrazilian Higher Education Training Program (CAPES)“Tropical Biomes in Transition – TROBIT”CAPES/Science without Borders ProgramPELD/CNPq (Long-Term Ecological Studies)PROCAD UnB/UNEMA

High Treatment Success Rates When Switching to Once Daily Nevirapine Containing Antiretroviral Therapy

INTRODUCTION: Two recent studies have highlighted low rates of virological response to once daily nevirapine containing combination antiretroviral therapy (CART) in treatment naïve HIV-1 infected subjects. AIM: We assessed factors associated with treatment responses in a cohort of HIV-1 infected, therapy naïve individuals, commencing nevirapine CART with two nucleoside reverse transcriptase inhibitors (NRTI) containing either lamivudine or emtricitabine. RESULTS: Between January 2002 and 2006, 173 subjects (80 female) met the study inclusion criteria. All subjects initially commenced on twice daily nevirapine with six different NRTI backbones. Mean follow up was 802 days. 49 (28%) subjects switched to once daily nevirapine, 23 (13%) within the first year. After 48 weeks of therapy, HIV RNA was < 50 copies/mL in 154/173 subjects (89%). A trend was observed towards improved virological outcome (HIV RNA < 50 copies/mL) and switching to once daily nevirapine during the first year of therapy (p=0.051). CONCLUSION: Whilst awaiting the results of prospective studies assessing once daily nevirapine, our data describe high treatment success rates and good safety responses when switching to once daily nevirapine

Estimation of the Optimal Statistical Quality Control Sampling Time Intervals Using a Residual Risk Measure

Background: An open problem in clinical chemistry is the estimation of the optimal sampling time intervals for the application of statistical quality control (QC) procedures that are based on the measurement of control materials. This is a probabilistic risk assessment problem that requires reliability analysis of the analytical system, and the estimation of the risk caused by the measurement error. Methodology/Principal Findings: Assuming that the states of the analytical system are the reliability state, the maintenance state, the critical-failure modes and their combinations, we can define risk functions based on the mean time of the states, their measurement error and the medically acceptable measurement error. Consequently, a residual risk measure rr can be defined for each sampling time interval. The rr depends on the state probability vectors of the analytical system, the state transition probability matrices before and after each application of the QC procedure and the state mean time matrices. As optimal sampling time intervals can be defined those minimizing a QC related cost measure while the rr is acceptable. I developed an algorithm that estimates the rr for any QC sampling time interval of a QC procedure applied to analytical systems with an arbitrary number of critical-failure modes, assuming any failure time and measurement error probability density function for each mode. Furthermore, given the acceptable rr, it can estimate the optimal QC sampling time intervals

Lead exposure in adult males in urban Transvaal Province, South Africa during the apartheid era

Human exposure to lead is a substantial public health hazard worldwide and is particularly problematic in the Republic of South Africa given the country’s late cessation of leaded petrol. Lead exposure is associated with a number of serious health issues and diseases including developmental and cognitive deficiency, hypertension and heart disease. Understanding the distribution of lifetime lead burden within a given population is critical for reducing exposure rates. Femoral bone from 101 deceased adult males living in urban Transvaal Province (now Gauteng Province), South Africa between 1960 and 1998 were analyzed for lead concentration by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Of the 72 black and 29 white individuals sampled, chronic lead exposure was apparent in nearly all individuals. White males showed significantly higher median bone lead concentration (ME = 10.04 µg·g−1), than black males (ME = 3.80 µg·g−1) despite higher socioeconomic status. Bone lead concentration covaries significantly, though weakly, with individual age. There was no significant temporal trend in bone lead concentration. These results indicate that long-term low to moderate lead exposure is the historical norm among South African males. Unexpectedly, this research indicates that white males in the sample population were more highly exposed to lead

Evaluating the successful implementation of evidence into practice using the PARiHS framework : theoretical and practical challenges

Background The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified. Discussion This being the case, the paper provides an integrated summary of our conceptual and theoretical thinking so far and introduces a typology (derived from social policy analysis) used to distinguish between the terms conceptual framework, theory and model – important definitional and conceptual issues in trying to refine theoretical and methodological approaches to knowledge translation. Secondly, the paper describes the next phase of our work, in particular concentrating on the conceptual thinking and mapping that has led to the generation of the hypothesis that the PARiHS framework is best utilised as a two-stage process: as a preliminary (diagnostic and evaluative) measure of the elements and sub-elements of evidence (E) and context (C), and then using the aggregated data from these measures to determine the most appropriate facilitation method. The exact nature of the intervention is thus determined by the specific actors in the specific context at a specific time and place. In the process of refining this next phase of our work, we have had to consider the wider issues around the use of theories to inform and shape our research activity; the ongoing challenges of developing robust and sensitive measures; facilitation as an intervention for getting research into practice; and finally to note how the current debates around evidence into practice are adopting wider notions that fit innovations more generally. Summary The paper concludes by suggesting that the future direction of the work on the PARiHS framework is to develop a two-stage diagnostic and evaluative approach, where the intervention is shaped and moulded by the information gathered about the specific situation and from participating stakeholders. In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches. We also recommend further refinement of the definitions around conceptual framework, theory, and model, suggesting a wider discussion that embraces multiple epistemological and ontological perspectives

The Waiting Time for Inter-Country Spread of Pandemic Influenza

BACKGROUND: The time delay between the start of an influenza pandemic and its subsequent initiation in other countries is highly relevant to preparedness planning. We quantify the distribution of this random time in terms of the separate components of this delay, and assess how the delay may be extended by non-pharmaceutical interventions. METHODS AND FINDINGS: The model constructed for this time delay accounts for: (i) epidemic growth in the source region, (ii) the delay until an infected individual from the source region seeks to travel to an at-risk country, (iii) the chance that infected travelers are detected by screening at exit and entry borders, (iv) the possibility of in-flight transmission, (v) the chance that an infected arrival might not initiate an epidemic, and (vi) the delay until infection in the at-risk country gathers momentum. Efforts that reduce the disease reproduction number in the source region below two and severe travel restrictions are most effective for delaying a local epidemic, and under favourable circumstances, could add several months to the delay. On the other hand, the model predicts that border screening for symptomatic infection, wearing a protective mask during travel, promoting early presentation of cases arising among arriving passengers and moderate reduction in travel volumes increase the delay only by a matter of days or weeks. Elevated in-flight transmission reduces the delay only minimally. CONCLUSIONS: The delay until an epidemic of pandemic strain influenza is imported into an at-risk country is largely determined by the course of the epidemic in the source region and the number of travelers attempting to enter the at-risk country, and is little affected by non-pharmaceutical interventions targeting these travelers. Short of preventing international travel altogether, eradicating a nascent pandemic in the source region appears to be the only reliable method of preventing country-to-country spread of a pandemic strain of influenza

Simulating plant produced material in the laboratory to replicate rheological and fatigue properties

As part of an effort by agencies and industry to move towards performance-based design to evaluate mixtures in the laboratory at a smaller scale before moving to full scale operation, laboratory protocols exist to simulate the aging that occurs as a material is produced. However, recent research has shown that these existing protocols may not accurately represent the changes a material experiences in a plant. Moreover, due to the focus of previous studies on the ability of the current method to replicate mixture characteristics and performance in an undamaged state, there is a lack of information as it relates to the damaged state. This paper presents a concise description of a study undertaken on a particular mixture to evaluate the differences in the behaviour of a standard asphalt concrete mixture produced in the laboratory and in the plant to assess the anticipated field performance at the mixture design stage. The results, in terms of the rheological properties of binders extracted and recovered from laboratory and plant produced mixtures as well as rheological, repeated cyclic fatigue, and cracking performance evaluation of the asphalt mixtures, have shown the ability of a short-term oven aging protocol to replicate plant produced material in the laboratory