Nurses’ Insights on Students’ Performance in Administering Intramuscular Injection at Tobruk Medical Center

The research is a quantitative non-experimental research with purposive sampling using nurses at Tobruk Medical Center as respondent with the students doing their hospital duty as subject. Questionnaire method was used for data collection with the aim of finding the nurses insights on students’ performance in administering intramuscular injection at the hospital based on their observation. A total of 30 nurses were used in the study. Performance were computed based on assessment, planning and implementation of the students’. The result shows that the students’ performance as perceived by the nurses has an overall weighted mean of 3.24 and standard deviation of 0.56 equivalent to good performance. When grouped according to profile, it appears that there is no significant difference in terms of gender (T-stat=0.06882656, p-value=0.945616854), age (F-stat=1.193781718, p value=0.318568251) and years of experience (F-stat=1.042539568, p-value=0.390283827). No relationship was establish based on the statistical result

Characteristics of children with the best and poorest first- and second-year growth during rhGH therapy: data from 25 years of the Genentech national cooperative growth study (NCGS)

Background Models assessing characteristics contributing to response to recombinant human growth hormone (rhGH) response rarely address growth extremes in both years 1 and 2 or examine how children track from year to year. Using National Cooperative Growth Study (NCGS) data, we determined characteristics contributing to responsiveness to rhGH and the pattern of change from years 1 to 2. Patients and methods Height velocity standard deviation score (HV SDS) for 2 years for prepubertal children with idiopathic GH deficiency (IGHD) (n = 1899) and idiopathic short stature (ISS) (n = 1186) treated with similar doses for two years were computed. Group 1 = HV SDS \u3c −1; 2 = HV SDS −1 to +1; 3 = HV SDS \u3e +1. Results For IGHD, mean age was 7.5 years and similar in all groups. Year 1 HV SDS was associated with greater body mass index (BMI) SDS, lower pre-treatment HV, baseline height SDS, greater target height SDS minus height SDS, and lower maximum stimulated GH (P \u3c0.0001). Year 2, 172/271 (73%) in group 1 moved to either group 2 (n = 156) or 3 (n = 16). Year 2 HV SDS was associated with greater year 1 HV SDS (r = 0.045, P \u3c0.0001), greater BMI SDS, taller parents and lower peak GH. For ISS, year 1 HV SDS was associated with greater BMI SDS and lower pre-treatment HV (P≤0.0001). 109/169 (64%) in group 1 moved to group 2 (n = 90) or group 3 (n = 19). Greater year 2 HV SDS was related to year 1 HV SDS (r = 0.27, P \u3c0.0001). Conclusion For IGHD, multiple characteristics contributed to best first-year response but for ISS, best first-year HV SDS was associated only with BMI SDS and inversely with pre-treatment HV. For both GHD and ISS, year 1 HV SDS was not a strong enough predictor of year 2 HV SDS to use first-year HV alone to determine GH continuation

What Should a Psychiatrist Know About Genetics? Review and Recommendations From the Residency Education Committee of the International Society of Psychiatric Genetics.

The International Society of Psychiatric Genetics (ISPG) created a Residency Education Committee with the purpose of identifying key genetic knowledge that should be taught in psychiatric training programs. Thirteen committee members were appointed by the ISPG Board of Directors, based on varied training, expertise, gender, and national origin. The Committee has met quarterly for the past 2 years, with periodic reports to the Board and to the members of the Society. The information summarized includes the existing literature in the field of psychiatric genetics and the output of ongoing large genomics consortia. An outline of clinically relevant areas of genetic knowledge was developed, circulated, and approved. This document was expanded and annotated with appropriate references, and the manuscript was developed. Specific information regarding the contribution of common and rare genetic variants to major psychiatric disorders and treatment response is now available. Current challenges include the following: (1) Genetic testing is recommended in the evaluation of autism and intellectual disability, but its use is limited in current clinical practice. (2) Commercial pharmacogenomic testing is widely available, but its utility has not yet been clearly established. (3) Other methods, such as whole exome and whole genome sequencing, will soon be clinically applicable. The need for informed genetic counseling in psychiatry is greater than ever before, knowledge in the field is rapidly growing, and genetic education should become an integral part of psychiatric training

Intercomparison of Satellite-Derived Snow-Cover Maps

In anticipation of the launch of the Earth Observing System (EOS) Terra, and the PM-1 spacecraft in 1999 and 2000, respectively, efforts are ongoing to determine errors of satellite-derived snow-cover maps. EOS Moderate Resolution Imaging Spectroradiometer (MODIS) and Advanced Microwave Scanning Radiometer-E (AMSR-E) snow-cover products will be produced. For this study we compare snow maps covering the same study area acquired from different sensors using different snow- mapping algorithms. Four locations are studied: 1) southern Saskatchewan; 2) a part of New England (New Hampshire, Vermont and Massachusetts) and eastern New York; 3) central Idaho and western Montana; and 4) parts of North and South Dakota. Snow maps were produced using a prototype MODIS snow-mapping algorithm used on Landsat Thematic Mapper (TM) scenes of each study area at 30-m and when the TM data were degraded to 1 -km resolution. National Operational Hydrologic Remote Sensing Center (NOHRSC) 1 -km resolution snow maps were also used, as were snow maps derived from 1/2 deg. x 1/2 deg. resolution Special Sensor Microwave Imager (SSM/1) data. A land-cover map derived from the International Geosphere-Biosphere Program (IGBP) land-cover map of North America was also registered to the scenes. The TM, NOHRSC and SSM/I snow maps, and land-cover maps were compared digitally. In most cases, TM-derived maps show less snow cover than the NOHRSC and SSM/I maps because areas of incomplete snow cover in forests (e.g., tree canopies, branches and trunks) are seen in the TM data, but not in the coarser-resolution maps. The snow maps generally agree with respect to the spatial variability of the snow cover. The 30-m resolution TM data provide the most accurate snow maps, and are thus used as the baseline for comparison with the other maps. Comparisons show that the percent change in amount of snow cover relative to the 3 0-m resolution TM maps is lowest using the TM I -km resolution maps, ranging from 0 to 40%. The highest percent change (less than 100%) is found in the New England study area, probably due to the presence of patchy snow cover. A scene with patchy snow cover is more difficult to map accurately than is a scene with a well-defined snowline such as is found on the North and South Dakota scene where the percent change ranged from 0 to 40%. There are also some important differences in the amount of snow mapped using the two different SSM/I algorithms because they utilize different channels

Mitochondrial Overload and Incomplete Fatty Acid Oxidation Contribute to Skeletal Muscle Insulin Resistance

SummaryPrevious studies have suggested that insulin resistance develops secondary to diminished fat oxidation and resultant accumulation of cytosolic lipid molecules that impair insulin signaling. Contrary to this model, the present study used targeted metabolomics to find that obesity-related insulin resistance in skeletal muscle is characterized by excessive β-oxidation, impaired switching to carbohydrate substrate during the fasted-to-fed transition, and coincident depletion of organic acid intermediates of the tricarboxylic acid cycle. In cultured myotubes, lipid-induced insulin resistance was prevented by manipulations that restrict fatty acid uptake into mitochondria. These results were recapitulated in mice lacking malonyl-CoA decarboxylase (MCD), an enzyme that promotes mitochondrial β-oxidation by relieving malonyl-CoA-mediated inhibition of carnitine palmitoyltransferase 1. Thus, mcd−/− mice exhibit reduced rates of fat catabolism and resist diet-induced glucose intolerance despite high intramuscular levels of long-chain acyl-CoAs. These findings reveal a strong connection between skeletal muscle insulin resistance and lipid-induced mitochondrial stress

A Blended Global Snow Product using Visible, Passive Microwave and Scatterometer Satellite Data

A joint U.S. Air Force/NASA blended, global snow product that utilizes Earth Observation System (EOS) Moderate Resolution Imaging Spectroradiometer (MODIS), Advanced Microwave Scanning Radiometer for EOS (AMSR-E) and QuikSCAT (Quick Scatterometer) (QSCAT) data has been developed. Existing snow products derived from these sensors have been blended into a single, global, daily, user-friendly product by employing a newly-developed Air Force Weather Agency (AFWA)/National Aeronautics and Space Administration (NASA) Snow Algorithm (ANSA). This initial blended-snow product uses minimal modeling to expeditiously yield improved snow products, which include snow cover extent, fractional snow cover, snow water equivalent (SWE), onset of snowmelt, and identification of actively melting snow cover. The blended snow products are currently 25-km resolution. These products are validated with data from the lower Great Lakes region of the U.S., from Colorado during the Cold Lands Processes Experiment (CLPX), and from Finland. The AMSR-E product is especially useful in detecting snow through clouds; however, passive microwave data miss snow in those regions where the snow cover is thin, along the margins of the continental snowline, and on the lee side of the Rocky Mountains, for instance. In these regions, the MODIS product can map shallow snow cover under cloud-free conditions. The confidence for mapping snow cover extent is greater with the MODIS product than with the microwave product when cloud-free MODIS observations are available. Therefore, the MODIS product is used as the default for detecting snow cover. The passive microwave product is used as the default only in those areas where MODIS data are not applicable due to the presence of clouds and darkness. The AMSR-E snow product is used in association with the difference between ascending and descending satellite passes or Diurnal Amplitude Variations (DAV) to detect the onset of melt, and a QSCAT product will be used to map areas of snow that are actively melting

Familial Aggregation of High Tumor Necrosis Factor Alpha Levels in Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) patients frequently have high circulating tumor necrosis factor alpha (TNF-α) levels. We explored circulating TNF-α levels in SLE families to determine whether high levels of TNF-α were clustered in a heritable pattern. We measured TNF-α in 242 SLE patients, 361 unaffected family members, 23 unaffected spouses of SLE patients, and 62 unrelated healthy controls. Familial correlations and relative recurrence risk rates for the high TNF-α trait were assessed. SLE-affected individuals had the highest TNF-α levels, and TNF-α was significantly higher in unaffected first degree relatives than healthy unrelated subjects (P=0.0025). No Mendelian patterns were observed, but 28.4% of unaffected first degree relatives of SLE patients had high TNF-α levels, resulting in a first degree relative recurrence risk of 4.48 (P=2.9×10-5). Interestingly, the median TNF-α value in spouses was similar to that of the first degree relatives. Concordance of the TNF-α trait (high versus low) in SLE patients and their spouses was strikingly high at 78.2%. These data support a role for TNF-α in SLE pathogenesis, and TNF-α levels may relate with heritable factors. The high degree of concordance in SLE patients and their spouses suggests that environmental factors may also play a role in the observed familial aggregation

HRAS1 and LASS1 with APOE are associated with human longevity and healthy aging

The search for longevity-determining genes in human has largely neglected the operation of genetic interactions. We have identified a novel combination of common variants of three genes that has a marked association with human lifespan and healthy aging. Subjects were recruited and stratified according to their genetically inferred ethnic affiliation to account for population structure. Haplotype analysis was performed in three candidate genes, and the haplotype combinations were tested for association with exceptional longevity. An HRAS1 haplotype enhanced the effect of an APOE haplotype on exceptional survival, and a LASS1 haplotype further augmented its magnitude. These results were replicated in a second population. A profile of healthy aging was developed using a deficit accumulation index, which showed that this combination of gene variants is associated with healthy aging. The variation in LASS1 is functional, causing enhanced expression of the gene, and it contributes to healthy aging and greater survival in the tenth decade of life. Thus, rare gene variants need not be invoked to explain complex traits such as aging; instead rare congruence of common gene variants readily fulfills this role. The interaction between the three genes described here suggests new models for cellular and molecular mechanisms underlying exceptional survival and healthy aging that involve lipotoxicity. © 2010 The Authors Aging Cell © 2010 Blackwell Publishing Ltd/Anatomical Society of Great Britain and Ireland