Identifying systems barriers that may prevent bereavement service access to bereaved carers: A report from an Australian specialist palliative care service

Background: Bereavement follow up is an integral element of palliative care. However, little is known about the systems that link bereavement services with bereaved carers. Aim: To map how effectively a specialist palliative care service linked bereavement service to bereaved carers. Methodology: A retrospective medical audit, using process mapping was undertaken within one Australian specialist palliative care service to identify the systems that linked bereavement services to a consecutive cohort of palliative care decedents (n=60) next of kin. Results: Bereavement records were located for 80% of decedents. Nearly all (98%) had a nominated next of kin, with just over half (54%) of those nominated contacted by bereavement services. Incomplete or missing contact details was the main reason (75%) that the bereavement service was unable to contact the decedents’ next of kin. Conclusion: Having access to a designated bereavement service can ensure that bereaved next of kin are contract routinely and in a timely way. However the effectiveness of this type of service is dependent upon the bereavement service having access to all relevant contact information. There are numerous opportunities to refine and strengthen the recording of palliative care next of kin details to optimize follow up

The VOICE Study: Valuing Opinions, Individual Communication and Experience: Building the evidence base for undertaking patient-centred family meetings in palliative care - a mixed methods study

Background: Despite family meetings being widely used to facilitate discussion among patients, families, and clinicians in palliative care, there is limited evidence to support their use. This study aims to assess the acceptability and feasibility of Patient-Centred Family Meetings in specialist inpatient palliative care units for patients, families, and clinicians and determine the suitability and feasibility of validated outcome measures from the patient and family perspectives. Methods: The study is a mixed-methods quasi-experimental design with pre-planned Patient-Centred Family Meetings at the intervention site. The patient will set the meeting agenda a priori allowing an opportunity for their issues to be prioritised and addressed. At the control site, usual care will be maintained which may include a family meeting. Each site will recruit 20 dyads comprising a terminally ill inpatient and their nominated family member. Pre- and post-test administration of the Distress Thermometer, QUAL-EC, QUAL-E, and Patient Health Questionnaire-4 will assess patient and family distress and satisfaction with quality of life. Patient, family, and clinician interviews post-meeting will provide insights into the meeting feasibility and outcome measures. Recruitment percentages and outcome measure completion will also inform feasibility. Descriptive statistics will summarise pre- and post-meeting data generated by the outcome measures. SPSS will analyse the quantitative data. Grounded theory will guide the qualitative data analysis. Discussion: This study will determine whether planned Patient-Centred Family Meetings are feasible and acceptable and assess the suitability and feasibility of the outcome measures. It will inform a future phase III randomised controlled trial. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12616001083482 on 11 August 201

Conducting Publishable Research From Special Populations: Studying Children and Non-Human Primates with Undergraduate Research Assistants

Collecting publishable data with only undergraduate research assistants (RAs) is difficult; conducting research with young children or non-human primates (NHPs) adds a layer of difficulty, yet we have been able to successfully sustain and grow research programs in Developmental Psychology and primate Behavioral Neuroscience at Trinity University (TU), a primarily undergraduate institution (PUI) in San Antonio. We each have been conducting research for over 25 years, with most of that time at this type of institution, and have developed effective strategies for publishing articles with undergraduates in this environment

NASA Kennedy Space Center: Contributions to Sea Turtle Science and Conservation

The National Aeronautics and Space Administration (NASA) is a United States (US) federal agency that oversees US space exploration and aeronautical research. NASA's primary launch site, Kennedy Space Center (KSC) is located along the east coast of Florida, on Cape Canaveral and the western Atlantic Ocean. The natural environment within KSC's large land boundaries, not only functions as an extensive safety buffer-area, it performs simultaneously as a wildlife refuge and a national seashore. In the early 1960s, NASA was developing KSC for rocket launches and the US was establishing an awareness of, and commitment to protecting the environment. The US began creating regulations that required the consideration of the environment when taking action on federal land or with federal funds. The timing of the US Endangered Species Act (1973), the US National Environmental Policy Act (1972), coincided with the planning and implementation of the US Space Shuttle Program. This resulted in the first efforts to evaluate the impacts of space launch operation operations on waterways, air quality, habitats, and wildlife. The first KSC fauna and flora baseline studies were predominantly performed by University of Central Florida (then Florida Technological University). Numerous species of relative importance were observed and sea turtles were receiving regulatory review and protection as surveys by Dr. L Ehrhart (UCF) from 1973-1978 described turtles nesting along the KSC beaches and foraging in the KSC lagoon systems. These data were used in the first NASA Environmental Impact Statement for the Space Transportation System (shuttle program) in 1980. In 1982, NASA began a long term ecological monitoring program with contracted scientists on site. This included efforts to track sea turtle status and trends at KSC and maintain protective measures for these species. Many studies and collaborations have occurred on KSC over these last 45 years with agencies (USFWS, NOAA, NAVY), students, and universities (UCF, University of Toronto, Texas A&M, UF). This presentation will review the various studies and collaborations on sea turtles at KSC that include: nest distributions and success, stranding network development, aerial survey testing for nest counts, predator control assessments, the earliest baseline blood chemistry health determinations on nesting females, stress hormones in nesting females, multi-year study of hatchling sex ratios, genetics, species composition, abundance and distribution of in-water juveniles, turtle cold stun response, exterior lighting impacts and control, and satellite tag tracking of post-nesting turtles in the vicinity of near shore shoals and sand mining sites. Through these studies, monitoring, and recommendations, KSC has provided excellent stewardship and protection of the local environment. While conducting its space program mission, KSC has also made significant contributions of information for agencies charged with the conservation and management of these specie

Biological Consequences of Tightly Bent DNA: The Other Life of a Macromolecular Celebrity

The mechanical properties of DNA play a critical role in many biological functions. For example, DNA packing in viruses involves confining the viral genome in a volume (the viral capsid) with dimensions that are comparable to the DNA persistence length. Similarly, eukaryotic DNA is packed in DNA-protein complexes (nucleosomes) in which DNA is tightly bent around protein spools. DNA is also tightly bent by many proteins that regulate transcription, resulting in a variation in gene expression that is amenable to quantitative analysis. In these cases, DNA loops are formed with lengths that are comparable to or smaller than the DNA persistence length. The aim of this review is to describe the physical forces associated with tightly bent DNA in all of these settings and to explore the biological consequences of such bending, as increasingly accessible by single-molecule techniques.Comment: 24 pages, 9 figure

Factors Associated With Becoming Edentulous in the US Health and Retirement Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153121/1/jgs16079.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153121/2/jgs16079_am.pd

Conducting Publishable Research From Special Populations: Studying Children and Non-human Primates With Undergraduate Research Assistants

Collecting publishable data with only undergraduate research assistants (RAs) is difficult; conducting research with young children or non-human primates (NHPs) adds a layer of difficulty, yet we have been able to successfully sustain and grow research programs in Developmental Psychology and primate Behavioral Neuroscience at Trinity University (TU), a primarily undergraduate institution (PUI) in San Antonio. We each have been conducting research for over 25 years, with most of that time at this type of institution, and have developed effective strategies for publishing articles with undergraduates in this environment

\u27Through the eyes of the dying\u27 - Identifying who may benefit from bereavement follow-up: A qualitative study

Introduction: Bereavement support is an integral element of palliative care. Emerging evidence stipulates that bereavement support should be reserved for those most at risk of poor outcomes. While this evidence makes identifying those at risk of experiencing a complex bereavement a necessary first step, it has been difficult to arrive at a consensus as to whom that should be. Aim: To explore whether palliative care in-patients with advanced disease are concerned about the bereavement needs of others and, if so, is it their next-of-kin. Design: A qualitative study using semi-structured interviews, and thematic analysis using a constant comparative method. Setting/participants: Patients identified by their physicians as being aware of their limited prognosis (n = 19) in a specialist palliative care service in Sydney, Australia. Findings: Three key themes emerged: 1) Families considered close and supportive may not require bereavement follow-up; 2) Families with previous significant losses or who have more complex lives are perceived by patients as having greater risk; and 3) Asking palliative care patients about whom they are most concerned in their network after their death is difficult but possible. Conclusions: There are potentially people in the palliative patients’ networks who may be in need of bereavement support, but who are unlikely to be informed about available bereavement services. New strategies are needed to identify people who may benefit from bereavement support

Selective Complexation and Reactivity of Metallic Nitride and Oxometallic Fullerenes with Lewis Acids and Use as an Effective Purification Method

Metallic nitride fullerenes (MNFs) and oxometallic fullerenes (OMFs) react quickly with an array of Lewis acids. Empty-cage fullerenes are largely unreactive under conditions used in this study. The reactivity order is Sc4O2@Ih-C80 \u3e Sc3N@C78 \u3e Sc3N@C68 \u3e Sc3N@D5h-C80 \u3e Sc3N@Ih-C80. Manipulations of Lewis acids, molar ratios, and kinetic differences within the family of OMF and MNF metallofullerenes are demonstrated in a selective precipitation scheme, which can be used either alone for purifying Sc3N@Ih-C80 or combined with a final high-performance liquid chromatography pass for Sc4O2@Ih-C80, Sc3N@D5h-C80, Sc3N@C68, or Sc3N@C78. The purification process is scalable. Analysis of the experimental rate constants versus electrochemical band gap explains the order of reactivity among the OMFs and MNFs

Accurate PCR detection of influenza A/B and respiratory syncytial viruses by use of Cepheid Xpert Flu+RSV Xpress Assay in point-of-care settings: Comparison to Prodesse ProFlu+

ABSTRACT The Xpert Flu+RSV Xpress Assay is a fast, automated in vitro diagnostic test for qualitative detection and differentiation of influenza A and B viruses and respiratory syncytial virus (RSV) performed on the Cepheid GeneXpert Xpress System. The objective of this study was to establish performance characteristics of the Xpert Flu+RSV Xpress Assay compared to those of the Prodesse ProFlu+ real-time reverse transcription-PCR (RT-PCR) assay (ProFlu+) for the detection of influenza A and B viruses as well as RSV in a Clinical Laboratory Improvement Amendments (CLIA)-waived (CW) setting. Overall, the assay, using fresh and frozen nasopharyngeal (NP) swabs, demonstrated high concordance with results of the ProFlu+ assay in the combined CW and non-CW settings with positive percent agreements (PPA) (100%, 100%, and 97.1%) and negative percent agreements (NPA) (95.2%, 99.5%, and 99.6%) for influenza A and B viruses and RSV, respectively. In conclusion, this multicenter study using the Cepheid Xpert Flu+RSV Xpress Assay demonstrated high sensitivities and specificities for influenza A and B viruses and RSV in ∼60 min for use at the point-of-care in the CW setting. </jats:p