Oxygen, pH, and labile organic carbon as possible mechanisms for algal stimulation of bacterial and fungal production in periphyton

Algal photosynthesis can stimulate production of associated microbial heterotrophs; however,the mechanisms for this stimulation remain unknown. I incubated submerged Typha domingensis leaf litter in greenhouse mesocosms under low- and high-nutrient regimes and conducted microbial production assays after 79/80 (week 11) or 128/129 (week 18) days of colonization. I manipulated environmental factors (oxygen, pH, and labile organic carbon) affected by algal photosynthesis to test the hypothesis that one or more of these factors stimulates heterotrophic microbial production. In the low-nutrient treatments, bacterial production was increased by glucose addition during week 11 (p \u3c 0.001) and by photosynthesis during week 18 (p \u3c 0.05). Fungal production was stimulated by photosynthesis in the high-nutrient treatments during weeks 11 (p \u3c 0.001) and 18 (p \u3c 0.01) and by glucose during week 11 (p \u3c 0.05). These results confirm that algal photosynthesis can increase heterotrophic microbial production and suggest that photosynthetic labile organic carbon (LOC) could be a stimulatory mechanism

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A quality initiative to improve primary care self-management education for Mexican American type 2 diabetes patients using a culturally-tailored protocol

Type 2 diabetes mellitus is the fifth leading cause of death among the Hispanic population in America. Current data estimates up to 50% of all Hispanics born in 2000 will develop diabetes within their lifetime. Factors leading to diabetes or diabetes related complications in Hispanic patients are low English proficiency, low literacy levels, and cultural influences. A vital component to diabetes treatment is self-care behaviors. Elements vital in providing effective diabetes education should incorporate services that are person-centered, culturally relevant, and responsive to the participants’ needs. The purpose of this quality improvement initiative was to increase clinical compliance with diabetes guidelines to provide timely and culturally competent diabetes self-management education and improve diabetes knowledge, self-management behaviors, and health outcomes in Mexican American patients with diabetes at a primary care clinic in East Texas, using an customized education protocol. The protocol addressed language and literacy barriers, as well as appealing to social norms with the assistance of bilingual translators, educational handouts, and telenovela diabetes educational videos created by the Agency for Healthcare Research and Quality. This quality initiative used a pre-test, post-test design to implement a change in practice instituting an improved protocol for delivering DSME to Mexican American patients with diabetes at project site over a 12-week period. The implementation of the DSME protocol at the project site resulted in a large and statistically significant increase in the frequency and quality of DSME provided by the clinic and improved patients’ knowledge of diabetes and reported management activities.Nursing PracticeCollege of Nursing and Health Science