Best Practice for Post-Operative Surgical Site Infection Prevention

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? The project was completed at a community hospital in Northern Indiana. There was a total of 26 participants, comprised mostly of males aged 49-88 years old. The surgical wounds were assessed for SSIs utilizing the National Healthcare Safety Network/Centers for Disease Control (NHSN/CDC) assessment tool. A Pearson Chi-Square test was used to compare data between two surgical groups to analyze if there was a difference between participants who had received a post-operative care bundle and those who had not. Data between the groups were analyzed and found there was not a statistical relationship between the two groups and whether an SSI was present after the intervention (p= 0.443). Findings from this project may help guide future post-operative care standards in the cardiothoracic and vascular surgical population

Influence of a Palliative Care Protocol on Nurses\u27 Perceived Barriers to Palliative Care and Moral Distress

The World Health Organization (2013) states palliative care for children should begin at diagnosis which may even occur prenatally. Neonatal palliative care is variable due to the high technological, curative environment in the newborn intensive care unit, and the uncertain prognoses of infants born at the edge of viability. The purpose of this EBP project was to determine the influence of establishing a neonatal palliative care protocol on nurses’ perceived barriers to palliative care and moral distress. Corley’s Moral Distress theory and Stetler’s Model were used as guides for the framework of the project. The protocol, based on guidelines supported by the American Academy of Pediatrics and the National Association of Neonatal Nurses, included forming a care team for the infant and family and educational sessions for the nurse based on the End of Life Nursing Education Curriculum. Pre-invention and post-invention surveys were administered which measured perceived barriers and moral distress. The pre intervention and the post-intervention groups differed by gender (X2(1) = 4.483, p\u3c0.05) and formal education (X2(2) = 6.357, p\u3c0.05). A significant decrease in perceived barriers were found in (a) medical staff support palliative care (t (42) = 2.031, p\u3c0.05), (b) physical environment for palliative care (t (43) = 3.216, p\u3c0.01), (c) policies/guidelines are present for palliative care (t (41) = 2.634, p\u3c0.05), (d) palliative care options are given to families (t (42) = 2.075, p\u3c0.05), and (e) team member express opinions, values, and beliefs (t (43) = 2.951, p\u3c0.01). A significant decrease in moral distress was noted in the concepts of witnessing providers giving false hope to families (t (43) = 2.321, p\u3c0.05) and working with unsafe providers (t (41) = 2.300, p\u3c0.05). A significant increase was noted, though, in the concept of working with incompetent providers (t (41) = -2.152, p\u3c0.05). The neonatal palliative care protocol has been adopted by the clinical agenc

Optimized primers and other critical conditions for efficient fusion PCR to generate knockout vectors in filamentous fungi.

Methods to streamline functional studies of large numbers of genes are essential to fully utilize the significant genomic resources now available for fungi. Fusion PCR is often used to join pieces of DNA together, particularly in the construction of DNA fragments for gene replacement in fungi. Here we present high-efficiency primers which reliably direct fusion and amplification to generate constructs for gene knockouts. Addendum: The authors communicated this omission post publication: We inadvertently left out the 3HS sequence with which we had such great success. The 5HS sequence, as seen in Figure 2D, is 5\u27-AGTCGACGACAACTACCATCGATCTGACG. The 3HS sequence which was missing from the original paper is 5\u27-ACACTGGTGACGGCTAACCAGAACTGTCA

Risk factors, predictive markers and prevention strategies for intrauterine fetal death. An integrative review

According to World Health Organization (WHO), fetal death is defined as the death of the fetus prior to its complete expulsion, independent of the duration of pregnancy, thus only ascribing the term stillbirth to fetal deaths in the case of pregnancies after 28 weeks of gestation. The great progress of perinatology care is reflected in a significant reduction in the rate of stillbirths, especially in well-developed countries, with approximately 98% of stillbirth cases now occurring in poor and developing countries. Stillbirth powerfully impacts both the patient and the practitioner. Because nearly half of stillbirth cases result from apparently uncomplicated pregnancies, we considered it critical to review the known predictive markers for intrauterine fetal death. In both preterm and term infants, perinatal mortality is increased in fetuses small for their gestational age, and this risk grows proportionally with the severity of the fetal growth restriction. A protracted first stage of labor has not been associated with an increased risk of perinatal mortality and morbidity, but a prolonged second stage of labor has been associated with mortality and neonatal morbidity characterized by sepsis, seizures, and hypoxic-ischemic encephalopathy. Ultrasound examination of the placenta and the umbilical cord is essential for appropriate pregnancy monitoring. Various findings from ultrasound examination have been related to variable adverse perinatal outcomes, including intrauterine fetal death. After reviewing the evidence for predictors of intrauterine fetal death, we offer a general strategy for reducing the likelihood of stillbirths

Reproductive and endocrine parameters of fat versus moderately conditioned mares following parturition

An increase in time to ovulation following parturition could result in economic loss if the mare cannot successfully conceive within a short time after foaling. To evaluate if a difference exists in reproductive efficiency of fat- (body condition score of 7 to 8) versus moderately-conditioned (body condition score of 5 to 6), 24 mares were allotted to and maintained in their respective group from late gestation until pregnancy was confirmed following breeding on the second post-partum estrus. Days to ovulation, interovulatory intervals, conception rates, and endocrine profiles were analyzed. Serum concentrations of thyroxine (T4), insulin-like growth factor-1 (IGF-1) and leptin were assayed in order to characterize normal circulating blood concentrations. There were no differences (P>0.05) in mean interval from parturition to first ovulation (14.41 ± 1.07 and 16.18 ± 1.06 d), first to second postpartum ovulation (22.91 ± 1.07 and 24.33 ± 0.93 d), or in conception rates (91.67% and 83.33%) between the 2 groups. However, mares in moderate conditioning did lose a greater percentage of body fat upon foaling as compared to fleshier mares (0.82% versus 0.35%). Leptin concentrations were not different between the groups (P>0.05). Nevertheless, serum concentrations of T4 were higher (P<0.01) and IGF-1 concentrations lower (P<0.01) in moderate- as compared to fat-conditioned mares during times of ovulation and the interovulatory period. Results indicate that mares maintained in a fleshy body condition are not prone to reproductive dysfunction or lowered levels of fertility. The significance of the current results is important as it reassures the breeder that mares in a fatter body condition score (BCS of 7-8) should not demonstrate sub-fertility related to level of body fat. Additionally, results indicate that mares may need to be kept in a BCS of 6 in order to avoid losing enough weight upon parturition and early lactation to bring the BCS below 5. It suggests that varying amounts of circulating T4 and IGF-1 do not affect reproductive capabilities of mares in a BCS of greater than 5 following parturition

Psychological and Physical Benefits of Interactions with Horses

Although much research exists concerning how horses can benefit people with specific debilitating impairments, relatively few studies have pursued what benefit horses offer people in the way of stress relief and improved quality of life. Study participants interacted with horses by grooming them and leading them through an obstacle course. Data were gathered through pre- and postinteraction surveys. Results suggest that interaction with horses offers a variety of benefits that may improve quality of life, such as increased confidence, lower stress, and an increase in caloric output. Implications exist for Extension programming

Characterization of the Tetraspan Junctional Complex (4JC) superfamily

Connexins or innexins form gap junctions, while claudins and occludins form tight junctions. In this study, statistical data, derived using novel software, indicate that these four junctional protein families and eleven other families of channel and channel auxiliary proteins are related by common descent and comprise the Tetraspan (4 TMS) Junctional Complex (4JC) Superfamily. These proteins all share similar 4 transmembrane α-helical (TMS) topologies. Evidence is presented that they arose via an intragenic duplication event, whereby a 2 TMS-encoding genetic element duplicated tandemly to give 4 TMS proteins. In cases where high resolution structural data were available, the conclusion of homology was supported by conducting structural comparisons. Phylogenetic trees reveal the probable relationships of these 15 families to each other. Long homologues containing fusions to other recognizable domains as well as internally duplicated or fused domains are reported. Large “fusion” proteins containing 4JC domains proved to fall predominantly into family-specific patterns as follows: (1) the 4JC domain was N-terminal; (2) the 4JC domain was C-terminal; (3) the 4JC domain was duplicated or occasionally triplicated and (4) mixed fusion types were present. Our observations provide insight into the evolutionary origins and subfunctions of these proteins as well as guides concerning their structural and functional relationships

Cracking the Silence of Modern Slavery in Public Education

[Abstract] Slavery is a more rapid and technical “game” than ever before in the world’s history. Coming in many different forms, human trafficking is the most popular form of slavery today and “generates as much as $150 billion in profits every year, more than one-third of which is generated in developed countries” (Hodal). Christine Caine has founded A21, a nonprofit organization that works with free slaves to disrupt the demand and is in hope that human beings everywhere will be rescued from bondage and completely restored, she states: “When a lot of people do a little, it adds up and makes a difference.” With this in mind, my research paper is advocates educating all age groups on the effects and devastation human trafficking has created for millions and millions of families around the world. Starting within the United States, the Polaris Project, another anti-slavery organization, “analyzed data from nearly 10 years of operating the National Human Trafficking Hotline, to show that human trafficking in the US consists of 25 distinct business models” (Polaris 4). Another key piece of present evidence of human trafficking is that there are still countries that have not outlawed owning another human being. Beginning with education and the advocation of lawmakers and the United Nations, there can be a difference made against modern slavery

Cracking the Silence of Modern Slavery in Public Education

[Abstract] Slavery is a more rapid and technical “game” than ever before in the world’s history. Coming in many different forms, human trafficking is the most popular form of slavery today and “generates as much as $150 billion in profits every year, more than one-third of which is generated in developed countries” (Hodal). Christine Caine has founded A21, a nonprofit organization that works with free slaves to disrupt the demand and is in hope that human beings everywhere will be rescued from bondage and completely restored, she states: “When a lot of people do a little, it adds up and makes a difference.” With this in mind, my research paper is advocates educating all age groups on the effects and devastation human trafficking has created for millions and millions of families around the world. Starting within the United States, the Polaris Project, another anti-slavery organization, “analyzed data from nearly 10 years of operating the National Human Trafficking Hotline, to show that human trafficking in the US consists of 25 distinct business models” (Polaris 4). Another key piece of present evidence of human trafficking is that there are still countries that have not outlawed owning another human being. Beginning with education and the advocation of lawmakers and the United Nations, there can be a difference made against modern slavery