Nurses’ knowledge and practice in relation to peripheral intravenous catheter care

Peripheral Intravenous Catheters (PIC) are widely used. Nurses are required to possess appropriate knowledge and practice. The present study aimed to determine nurses' knowledge and practice towards care of PIC. A cross-sectional descriptive study was conducted and 84 respondents participated in the study. A 26-item questionnaire comprising 11 items on knowledge and 15 items related to nursing practice was adapted and modified. The findings reported higher mean score from specialty unit respondents, with knowledge (M = 49.19, SD = 3.44) and practice (M = 66.38, SD = 5.15), compared to medical surgical wards with knowledge (M = 46.25, SD = 4.68) and practice (M = 63.17, SD = 4.63) towards the care of PIC, which was significant (p value = 0.010 and p value = 0.009, respectively). The study indicated a higher mean score of charge nurse respondents as compared with registered nurse with knowledge (M = 49.68, SD = 3.23); (M = 46.20, SD = 4.62) and practice (M = 67.11, SD = 4.84); (M = 63.06, SD = 4.61), which was significant (p value = 0.003 and p value = 0.001, respectively). There were no significant differences between respondents’ education qualification towards care of PIC with p > 0.05. However, the findings reported that respondents who possessed Bachelor of Nursing were deemed to score slightly higher in their knowledge and practice towards the care of PIC. In conclusion, the specialty unit and charge nurse respondents were deemed to possess better knowledge and practice towards the care of PIC in the hospital

Needs of family members of critically ill patients in a Critical Care Unit at Universiti Kebangsaan Malaysia Medical Centre

Fulfillment of the family needs for the critically ill patient in Critical Care Unit should be met by healthcare providers to improve patient’s quality of life. The purpose of this study was to identify the needs of family members of critically ill patients in a Critical Care Unit. A cross-sectional study was conducted on 109 family members of patient hospitalized at the Intensive Care Unit and Coronary Care Units of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The modified Critical Care Family Needs Inventory (CCFNI) comprised of 5 domains of family member’s needs: Information, Proximity, Assurance, Comfort and Support. The findings showed that assurance and information needs were the highest with (3.77 ± 0.306); (3.62 ± 0.379), proximity need (3.60 ± 0.415), support need (3.57 ± 0.477) and comfort need (3.55 ± 0.586), respectively. There was significant relationship between respondent’s relationship with family needs of proximity (p = 0.013). This study indicated that there were significant association between respondent’s monthly income and family needs of comfort and support, (p = 0.033) and (p = 0.004). There was also significant association between the gender with comfort need (p = 0.013). In this study, it was observed that information, proximity, assurance, comfort and support were opinioned as their requirements during hospitalization. Hence, it assists in coping while being admitted to Intensive Care Unit and Coronary Care Unit of UKMMC. An educational package and updating patient’s information should be emphasized to enhance the family needs of critically ill patient in the critical care settings

A novel transcript of oil palm (Elaeis guineensis Jacq.), Eg707, is specifically upregulated in tissues related to totipotency

In this study, we report the molecular characterization of clone Eg707 isolated from cell suspension culture of the oil palm. The deduced polypeptide of clone Eg707 is highly similar to an unknown protein from Arabidopsis thaliana. The presence of an Ald-Xan-dh-C2 superfamily domain in the deduced protein sequence suggested that Eg707 protein might be involved in abscisic acid biosynthesis. Eg707 might be present as a single copy gene in the oil palm genome. This gene is highly expressed in tissue cultured materials compared to vegetative and reproductive tissues, suggesting a role of this gene during oil palm somatic embryogenesis or at the early stages of embryo development. Expression analysis of Eg707 by RNA in situ hybridization showed that Eg707 transcripts were present throughout somatic embryo development starting from proembryo formation at the embryogenic callus stages till the maturing embryo stages. Since proembryo formation within the embryogenic callus is one of the first key factors in oil palm somatic embryo development, it is suggested that Eg707 could be used as a reliable molecular marker for detecting early stage of oil palm somatic embryogenesis

RNA from fresh frozen cryosections of oil palm inflorescences is superior to FFPE sections

Formalin-fixed, paraffin-embedded (FFPE) and fresh frozen (FF) tissue sections are valuable sources for histology and molecular studies. However, FFPE tissue sections usually provide poor quality RNA that is unsuitable for most downstream molecular applications. In this study, tissue preparation for cryosectioning and RNA extraction protocols were optimised for FF oil palm inflorescences. FF tissue treated with sucrose offered good cellular image resolution and more importantly, good RNA quality. Higher RNA quality with good RIN values (>6) was obtained from FF sections compared to the fragmented RNA from FFPE tissue sections. However, FFPE sections provided better resolution in terms of cellular morphology. The quality of cellular morphology of the FF sections was moderate, but was sufficient to distinguish the different cell types. Hence, FF oil palm inflorescences is a better choice for downstream transcriptomics studies that require tissue sections without compromising the cytological details

The default mode network is disrupted in Parkinson's disease with visual hallucinations.

BACKGROUND: Visual hallucinations (VH) are one of the most striking nonmotor symptoms in Parkinson's disease (PD), and predict dementia and mortality. Aberrant default mode network (DMN) is associated with other psychoses. Here, we tested the hypothesis that DMN dysfunction contributes to VH in PD. METHODS: Resting state functional data was acquired from individuals with PD with VH (PDVH) and without VH (PDnonVH), matched for levodopa drug equivalent dose, and a healthy control group (HC). Independent component analysis was used to investigate group differences in functional connectivity within the DMN. In addition, we investigated whether the functional changes associated with hallucinations were accompanied by differences in cortical thickness. RESULTS: There were no group differences in cortical thickness but functional coactivation within components of the DMN was significantly lower in both PDVH and PDnonVH groups compared to HC. Functional coactivation within the DMN was found to be greater in PDVH group relative to PDnonVH group. CONCLUSION: Our study demonstrates, for the first time that, within a functionally abnormal DMN in PD, relatively higher "connectivity" is associated with VH. We postulate that aberrant connectivity in a large scale network affects sensory information processing and perception, and contributes to "positive" symptom generation in PD.Contract grant sponsor: Research Grant Council of Hong Kong (General Research Fund awarded to Chua and McAlonan); Infrastructural support: National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and [Institute of Psychiatry] King's College London (McAlonan); Wellcome Trust; Contract grant number: 088324 (Rowe); National Institute for Health Research Cambridge Biomedical Research Centre (Suckling).This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1002/hbm.2257

Maritime threat response

This report was prepared by Systems Engineering and Analysis Cohort Nine (SEA-9) Maritime Threat Response, (MTR) team members.Background: The 2006 Naval Postgraduate School (NPS) Cross-Campus Integrated Study, titled “Maritime Threat Response” involved the combined effort of 7 NPS Systems Engineering students, 7 Singaporean Temasek Defense Systems Institute (TDSI) students, 12 students from the Total Ship Systems Engineering (TSSE) curriculum, and numerous NPS faculty members from different NPS departments. After receiving tasking provided by the Wayne E. Meyer Institute of Systems Engineering at NPS in support of the Office of the Assistant Secretary of Defense for Homeland Defense, the study examined ways to validate intelligence and respond to maritime terrorist attacks against United States coastal harbors and ports. Through assessment of likely harbors and waterways to base the study upon, the San Francisco Bay was selected as a representative test-bed for the integrated study. The NPS Systems Engineering and Analysis Cohort 9 (SEA-9) Maritime Threat Response (MTR) team, in conjunction with the TDSI students, used the Systems Engineering Lifecycle Process (SELP) [shown in Figure ES-1, p. xxiii ] as a systems engineering framework to conduct the multi-disciplinary study. While not actually fabricating any hardware, such a process was well-suited for tailoring to the team’s research efforts and project focus. The SELP was an iterative process used to bound and scope the MTR problem, determine needs, requirements, functions, and to design architecture alternatives to satisfy stakeholder needs and desires. The SoS approach taken [shown in Figure ES-2, p. xxiv ]enabled the team to apply a systematic approach to problem definition, needs analysis, requirements, analysis, functional analysis, and then architecture development and assessment.In the twenty-first century, the threat of asymmetric warfare in the form of terrorism is one of the most likely direct threats to the United States homeland. It has been recognized that perhaps the key element in protecting the continental United States from terrorist threats is obtaining intelligence of impending attacks in advance. Enormous amounts of resources are currently allocated to obtaining and parsing such intelligence. However, it remains a difficult problem to deal with such attacks once intelligence is obtained. In this context, the Maritime Threat Response Project has applied Systems Engineering processes to propose different cost-effective System of Systems (SoS) architecture solutions to surface-based terrorist threats emanating from the maritime domain. The project applied a five-year time horizon to provide near-term solutions to the prospective decision makers and take maximum advantage of commercial off-the-shelf (COTS) solutions and emphasize new Concepts of Operations (CONOPS) for existing systems. Results provided insight into requirements for interagency interactions in support of Maritime Security and demonstrated the criticality of timely and accurate intelligence in support of counterterror operations.This report was prepared for the Office of the Assistant Secretary of Defense for Homeland DefenseApproved for public release; distribution is unlimited

The Core and Accessory Genomes of Burkholderia pseudomallei: Implications for Human Melioidosis

Natural isolates of Burkholderia pseudomallei (Bp), the causative agent of melioidosis, can exhibit significant ecological flexibility that is likely reflective of a dynamic genome. Using whole-genome Bp microarrays, we examined patterns of gene presence and absence across 94 South East Asian strains isolated from a variety of clinical, environmental, or animal sources. 86% of the Bp K96243 reference genome was common to all the strains representing the Bp “core genome”, comprising genes largely involved in essential functions (eg amino acid metabolism, protein translation). In contrast, 14% of the K96243 genome was variably present across the isolates. This Bp accessory genome encompassed multiple genomic islands (GIs), paralogous genes, and insertions/deletions, including three distinct lipopolysaccharide (LPS)-related gene clusters. Strikingly, strains recovered from cases of human melioidosis clustered on a tree based on accessory gene content, and were significantly more likely to harbor certain GIs compared to animal and environmental isolates. Consistent with the inference that the GIs may contribute to pathogenesis, experimental mutation of BPSS2053, a GI gene, reduced microbial adherence to human epithelial cells. Our results suggest that the Bp accessory genome is likely to play an important role in microbial adaptation and virulence

Targeted gene sanger sequencing should remain the first-tier genetic test for children suspected to have the five common X-linked inborn errors of immunity

DATA AVAILABILITY STATEMENT : The original contributions presented in the study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding author.To address inborn errors of immunity (IEI) which were underdiagnosed in resource-limited regions, our centre developed and offered free genetic testing for the most common IEI by Sanger sequencing (SS) since 2001. With the establishment of The Asian Primary Immunodeficiency (APID) Network in 2009, the awareness and definitive diagnosis of IEI were further improved with collaboration among centres caring for IEI patients from East and Southeast Asia. We also started to use whole exome sequencing (WES) for undiagnosed cases and further extended our collaboration with centres from South Asia and Africa. With the increased use of Next Generation Sequencing (NGS), we have shifted our diagnostic practice from SS to WES. However, SS was still one of the key diagnostic tools for IEI for the past two decades. Our centre has performed 2,024 IEI SS genetic tests, with in-house protocol designed specifically for 84 genes, in 1,376 patients with 744 identified to have disease-causing mutations (54.1%). The high diagnostic rate after just one round of targeted gene SS for each of the 5 common IEI (X-linked agammaglobulinemia (XLA) 77.4%, Wiskott–Aldrich syndrome (WAS) 69.2%, X-linked chronic granulomatous disease (XCGD) 59.5%, X-linked severe combined immunodeficiency (XSCID) 51.1%, and X-linked hyper-IgM syndrome (HIGM1) 58.1%) demonstrated targeted gene SS should remain the first-tier genetic test for the 5 common X-linked IEI.The Hong Kong Society for Relief of Disabled Children and Jeffrey Modell Foundation.http://www.frontiersin.org/Immunologyam2023Paediatrics and Child Healt

Recollections expressed by mechanically ventilated patients of Intensive Care Unit (ICU), Hospital Universiti Kebangsaan Malaysia (HUKM)

Ventilated patients who require intensive care unit (ICU) treatment may encounter unpleasant experiences. These experiences may include factual incidents and delusional memories of ICU such as dreams, hallucinations and frightening experiences. A cross sectional study using “Intensive Care Experience Questionnaire” consisted of four domains: awareness of surrounding, frightening experiences, recall of experience and satisfaction with nursing care. Forty five participants who fulfilled the inclusion criteria were recruited in this study. This study was conducted in ICU of HUKM from January to March 2006. Results showed that 20 respondents (44%) were aware of their surrounding and 31 respondents (69%) reported frightening experiences. Majority of respondents (43 respondents, 96%) reported satisfaction with the delivery of nursing care. There was positive correlation between awareness of surrounding and their abilities to recall their experiences (p<0.05). Patients’ awareness of surrounding achieved the strongest statistical significance as a contribution to the prediction of their abilities to recall their experiences with beta coefficient value of 0.353 and p<0.05. The finding of this study permits nurses to see the problems of mechanically ventilated patients through reports of unpleasant recollections by the patients themselves. Patients reported frustrations in their attempts to make their needs known. Although they are on sedation, they are aware of all unpleasant events occurring in the IC