\u3cem\u3eFlared Skirt\u3c/em\u3e and \u3cem\u3eThe Healds\u3c/em\u3e by Arai Takako

Translated from the Japanese by Carol Hayes and Rina Kikuchi

Enhancing Nursing Students’ Understanding of Oral Health: An Educational Intervention with an Interprofessional Component

Oral health is integral to general health and essential for well-being, and therefore, should be prioritized in pediatric nursing education. The purpose of this pilot study was to examine if an oral health education intervention with an Interprofessional Education (IPE) component delivered to third-year baccalaureate nursing students would improve their knowledge of pediatric oral health care. Nursing students (n=99) from a Bachelor of Nursing program in a mid-Western Canadian university completed a survey before and after receiving the educational intervention which included a two-hour lecture from a Dentistry faculty member and a one-hour clinical lab in which nursing students learned how to conduct a comprehensive oral health assessment in practice. Paired-sample t-tests were conducted to compare pre-and post-intervention survey scores. Findings indicate a statistically significant (p \u3c .001) increase in knowledge from pre-test (67%) to post-test (86%) and contribute to a new understanding of the importance of pediatric oral health care in nursing education. The outcome of this intervention is that registered nurses can be prepared with the knowledge necessary to address the disparate oral health challenges experienced by children globally. These findings will provide the foundation for the refinement and implementation of the educational intervention on an international, multi-site scale. Résumé La santé buccodentaire, essentielle au bien-être, fait partie intégrante de la santé générale. Elle devrait donc constituer une priorité dans la formation infirmière en soins pédiatriques. Cette étude pilote vise à évaluer si une intervention pédagogique appuyée d’un volet interprofessionnel, donnée à des étudiantes de troisième année au baccalauréat en sciences infirmières, améliorerait leurs connaissances au sujet des soins pédiatriques relatifs à la santé buccodentaire. Les étudiantes (n = 99) au baccalauréat en sciences infirmières d’une université du Centre-Ouest du Canada ont rempli un sondage avant et après avoir suivi une intervention pédagogique qui comprenait une conférence de deux heures présentée par un membre de la Faculté de médecine dentaire, ainsi qu’un laboratoire clinique d’une heure où elles ont appris à effectuer une évaluation complète de la santé buccodentaire en situation de pratique. Des tests t pour échantillons appariés ont été réalisés pour comparer les résultats du sondage avant et après l’intervention. Les résultats démontrent une augmentation statistiquement significative (p \u3c 0,001) des connaissances de l’examen préintervention (67 %) à l’examen postintervention (86 %), et offrent une nouvelle compréhension de l’importance des soins pédiatriques relatifs à la santé buccodentaire dans la formation infirmière. Cette intervention procure ainsi le savoir nécessaire aux infirmières autorisées pour régler les différents problèmes de santé buccodentaire touchant les enfants du monde. Ces résultats permettront de perfectionner l’intervention pédagogique et de la mettre en œuvre à l’échelle internationale, en plusieurs endroits

Exploring Front Line Ambulance Staff Perspectives of the Hospital Transfer Pathway

Guidance from the National Institute for Health and Care Excellence in the UK was introduced in 2015 to improve the quality of the care pathway of transfers of care home residents to hospital when needed. The Red Bag scheme was developed by Sutton Clinical Commissioning Group in 2016 as a means of improving communication between organisations involved in the process by ensuring residents’ notes and other personal belongings were easily identifiable and kept in one place. The Red Bag was implemented in the North East of England in 2018. The aim of this study was to understand the knowledge of and experiences of front line ambulance staff who had potential to be involved with the transfer of care home residents to hospital. A mixed methods approach was used for the study. Participants were recruited by two research paramedics working in the North East ambulance service and approached to take part in a confidential, on-line survey using Survey Monkey®. Data was analysed through descriptive statistics and a constant comparative analytic framework to develop into concepts found in the free text comments, which were constructed into themes. Two hundred and fifty eight participants were recruited to the study. Six themes were identified in the data that represented the knowledge and experiences of the participants. Findings showed there was variance in the implementation, interpretation and use of the Red Bag in practice. Where effective communication took place, handovers worked well, however perceived organisational processes and avoidable delays prevented the optimal transfer of care. Improved communication between organisations is recommended, along with building capacity and capability within and between professional disciplines working at the front line of patient care were identified as fundamental mechanisms of streamlining handover processes for the vulnerable and older adults who live in residential care settings

The glyoxal budget and its contribution to organic aerosol for Los Angeles, California, during CalNex 2010

Recent laboratory and field studies have indicated that glyoxal is a potentially large contributor to secondary organic aerosol mass. We present in situ glyoxal measurements acquired with a recently developed, high sensitivity spectroscopic instrument during the CalNex 2010 field campaign in Pasadena, California. We use three methods to quantify the production and loss of glyoxal in Los Angeles and its contribution to organic aerosol. First, we calculate the difference between steady state sources and sinks of glyoxal at the Pasadena site, assuming that the remainder is available for aerosol uptake. Second, we use the Master Chemical Mechanism to construct a two-dimensional model for gas-phase glyoxal chemistry in Los Angeles, assuming that the difference between the modeled and measured glyoxal concentration is available for aerosol uptake. Third, we examine the nighttime loss of glyoxal in the absence of its photochemical sources and sinks. Using these methods we constrain the glyoxal loss to aerosol to be 0-5 × 10-5 s-1 during clear days and (1 ± 0.3) × 10-5 s-1 at night. Between 07:00-15:00 local time, the diurnally averaged secondary organic aerosol mass increases from 3.2 μg m-3 to a maximum of 8.8 μg m -3. The constraints on the glyoxal budget from this analysis indicate that it contributes 0-0.2 μg m-3 or 0-4% of the secondary organic aerosol mass. Copyright 2011 by the American Geophysical Union

Abstract - INMM Annual Meeting 1998 Status of Underground Testing Program

This report is about the INMM Annual Meeting 1998 Status of Underground Testing Program

Genome-Wide Analysis of the Effects of Heat Shock on a Saccharomyces cerevisiae Mutant With a Constitutively Activated cAMP-Dependent Pathway

We have used DNA microarray technology and 2-D gel electrophoresis combined with mass spectrometry to investigate the effects of a drastic heat shock from 30℃ to 50℃ on a genome-wide scale. This experimental condition is used to differentiate between wild-type cells and those with a constitutively active cAMP-dependent pathway in Saccharomyces cerevisiae. Whilst more than 50% of the former survive this shock, almost all of the latter lose viability. We compared the transcriptomes of the wildtype and a mutant strain deleted for the gene PDE2, encoding the high-affinity cAMP phosphodiesterase before and after heat shock treatment. We also compared the two heat-shocked samples with one another, allowing us to determine the changes that occur in the pde2Δ mutant which cause such a dramatic loss of viability after heat shock. Several genes involved in ergosterol biosynthesis and carbon source utilization had altered expression levels, suggesting that these processes might be potential factors in heat shock survival. These predictions and also the effect of the different phases of the cell cycle were confirmed by biochemical and phenotypic analyses. 146 genes of previously unknown function were identified amongst the genes with altered expression levels and deletion mutants in 13 of these genes were found to be highly sensitive to heat shock. Differences in response to heat shock were also observed at the level of the proteome, with a higher level of protein degradation in the mutant, as revealed by comparing 2-D gels of wild-type and mutant heat-shocked samples and mass spectrometry analysis of the differentially produced proteins

Genetic variation in the HLA region is associated with susceptibility to herpes zoster.

Herpes zoster, commonly referred to as shingles, is caused by the varicella zoster virus (VZV). VZV initially manifests as chicken pox, most commonly in childhood, can remain asymptomatically latent in nerve tissues for many years and often re-emerges as shingles. Although reactivation may be related to immune suppression, aging and female sex, most inter-individual variability in re-emergence risk has not been explained to date. We performed a genome-wide association analyses in 22,981 participants (2280 shingles cases) from the electronic Medical Records and Genomics Network. Using Cox survival and logistic regression, we identified a genomic region in the combined and European ancestry groups that has an age of onset effect reaching genome-wide significance (P>1.0 × 10(-8)). This region tags the non-coding gene HCP5 (HLA Complex P5) in the major histocompatibility complex. This gene is an endogenous retrovirus and likely influences viral activity through regulatory functions. Variants in this genetic region are known to be associated with delay in development of AIDS in people infected by HIV. Our study provides further suggestion that this region may have a critical role in viral suppression and could potentially harbor a clinically actionable variant for the shingles vaccine

Insulin versus oral agents in the management of Cystic Fibrosis Related Diabetes: a case based study

BACKGROUND: Insulin is the recommend therapeutic agent of choice for the management of Cystic Fibrosis Related Diabetes (CFRD), despite only sub-optimal reductions in glycemic control and increased morbidity and mortality reported by centers using this agent. The newer insulin sensitizing agents demonstrated to have anti-inflammatory mechanisms may provide an alternative management option for CFRD. METHODS: A prospective case based therapeutic comparison between insulin, sulfonylurea, metformin and thiazolidinedione was observed over one decade with 20 CFRD patients diagnosed using American Diabetes Association guideline standards. Patients entering the study elected treatment based on risk and benefit information provided for treatment options. Patients receiving organ transplant or requiring combination diabetic medications were excluded from the study. RESULTS: No statistical advantage was achieved regarding overall glycemic control for oral agents over insulin. Additional outcome measures including changes in weight, liver function testing and FEV(1 )were not statistically significant. CONCLUSION: Insulin alone may not be the only therapeutic option in managing CFRD. Oral hypoglycemic agents were equally effective in treating CFRD and may provide an alternative class of agents for patients reluctant in using insulin

The ACUTE (Ambulance CPAP: Use, Treatment effect and economics) feasibility study: a pilot randomised controlled trial of prehospital CPAP for acute respiratory failure

Background: Acute respiratory failure (ARF) is a common and life-threatening medical emergency. Standard prehospital management involves controlled oxygen therapy and disease-specific ancillary treatments. Continuous positive airway pressure (CPAP) is a potentially beneficial alternative treatment that could be delivered by emergency medical services. However, it is uncertain whether this treatment could work effectively in United Kingdom National Health Service (NHS) ambulance services and if it represents value for money. Methods: An individual patient randomised controlled external pilot trial will be conducted comparing prehospital CPAP to standard oxygen therapy for ARF. Adults presenting to ambulance service clinicians will be eligible if they have respiratory distress with peripheral oxygen saturation below British Thoracic Society (BTS) target levels, despite titrated supplemental oxygen. Enrolled patients will be allocated (1:1 simple randomisation) to prehospital CPAP (O_two system) or standard oxygen therapy using identical sealed boxes. Feasibility outcomes will include incidence of recruited eligible patients, number of erroneously recruited patients and proportion of cases adhering to allocation schedule and treatment, followed up at 30 days and with complete data collection. Effectiveness outcomes will comprise survival at 30 days (definitive trial primary end point), endotracheal intubation, admission to critical care, length of hospital stay, visual analogue scale (VAS) dyspnoea score, EQ-5D-5L and health care resource use at 30 days. The cost-effectiveness of CPAP, and of conducting a definitive trial, will be evaluated by updating an existing economic model. The trial aims to recruit 120 patients over 12 months from four regional ambulance hubs within the West Midlands Ambulance Service (WMAS). This sample size will allow estimation of feasibility outcomes with a precision of < 5%. Feasibility and effectiveness outcomes will be reported descriptively for the whole trial population, and each trial arm, together with their 95% confidence intervals. Discussion: This study will determine if it is feasible, acceptable and cost-effective to undertake a full-scale trial comparing CPAP and standard oxygen treatment, delivered by ambulance service clinicians for ARF. This will inform NHS practice and prevent inappropriate prehospital CPAP adoption on the basis of limited evidence and at a potentially substantial cost. Trial registration: ISRCTN12048261. Registered on 30 August 2017. http://www.isrctn.com/ISRCTN1204826