Annual Report: 2010-2011 Storm Season Sampling For NON-DRY DOCK STORMWATER MONITORING FOR PUGET SOUND NAVAL SHIPYARD, BREMERTON, WA

This interim report summarizes the stormwater monitoring conducted for non-dry dock outfalls in both the confined industrial area and the residential areas of Naval Base Kitsap within the Puget Sound Naval Shipyard (referred to as the Shipyard). This includes the collection, analyses, and descriptive statistics for stormwater sampling conducted from November 2010 through April 2011. Seven stormwater basins within the Shipyard were sampled during at least three storm events to characterize non-dry dock stormwater discharges at selected stormwater drains located within the facility. This serves as the Phase I component of the project and Phase II is planned for the 2011-2012 storm season. These data will assist the Navy, USEPA, Ecology and other stakeholders in understanding the nature and condition of stormwater discharges from the Shipyard and inform the permitting process for new outfall discharges. The data from Phase I was compiled with current stormwater data available from the Shipyard, Sinclair/Dyes Inlet watershed, and Puget Sound in order to support technical investigations for the Draft NPDES permit. The permit would require storm event sampling at selected stormwater drains located within the Shipyard. However, the data must be considered on multiple scales to truly understand potential impairments to beneficial uses within Sinclair and Dyes Inlets

Prevalence and causes of prescribing errors: the prescribing outcomes for trainee doctors engaged in clinical training (PROTECT) study

Objectives Study objectives were to investigate the prevalence and causes of prescribing errors amongst foundation doctors (i.e. junior doctors in their first (F1) or second (F2) year of post-graduate training), describe their knowledge and experience of prescribing errors, and explore their self-efficacy (i.e. confidence) in prescribing. Method A three-part mixed-methods design was used, comprising: prospective observational study; semi-structured interviews and cross-sectional survey. All doctors prescribing in eight purposively selected hospitals in Scotland participated. All foundation doctors throughout Scotland participated in the survey. The number of prescribing errors per patient, doctor, ward and hospital, perceived causes of errors and a measure of doctors' self-efficacy were established. Results 4710 patient charts and 44,726 prescribed medicines were reviewed. There were 3364 errors, affecting 1700 (36.1%) charts (overall error rate: 7.5%; F1:7.4%; F2:8.6%; consultants:6.3%). Higher error rates were associated with : teaching hospitals (p&#60;0.001), surgical (p = &#60;0.001) or mixed wards (0.008) rather thanmedical ward, higher patient turnover wards (p&#60;0.001), a greater number of prescribed medicines (p&#60;0.001) and the months December and June (p&#60;0.001). One hundred errors were discussed in 40 interviews. Error causation was multi-factorial; work environment and team factors were particularly noted. Of 548 completed questionnaires (national response rate of 35.4%), 508 (92.7% of respondents) reported errors, most of which (328 (64.6%) did not reach the patient. Pressure from other staff, workload and interruptions were cited as the main causes of errors. Foundation year 2 doctors reported greater confidence than year 1 doctors in deciding the most appropriate medication regimen. Conclusions Prescribing errors are frequent and of complex causation. Foundation doctors made more errors than other doctors, but undertook the majority of prescribing, making them a key target for intervention. Contributing causes included work environment, team, task, individual and patient factors. Further work is needed to develop and assess interventions that address these.</p

Participation in physical play and leisure : developing a theory- and evidence-based intervention for children with motor impairments

Peer reviewedPublisher PD

From consensus to action: Knowledge transfer, education and influencing policy on sports concussion

ABSTRACT Objective To: (1) provide a review of knowledge transfer (KT) and related concepts; (2) look at the impact of traditional and emerging KT strategies on concussion knowledge and education; (3) discuss the value and impact of KT to organisations and concussion-related decision making and (4) make recommendations for the future of concussion education. Design Qualitative literature review of KT and concussion education literature. Intervention PubMed, Medline and Sport Discus databases were reviewed and an internet search was conducted. The literature search was restricted to articles published in the English language, but not restricted to any particular years. Altogether, 67 journal articles, 21 websites, 1 book and 1 report were reviewed. Results The value of KT as part of concussion education is increasingly becoming recognised. Target audiences benefit from specific learning strategies. Concussion tools exist, but their effectiveness and impact require further evaluation. The media is valuable in drawing attention to concussion, but efforts need to ensure that the public is aware of the right information. Social media as a concussion education tool is becoming more prominent. Implementation of KT models is one approach which organisations can use to assess knowledge gaps; identify, develop and evaluate education strategies and use the outcomes to facilitate decision-making. Conclusions Implementing KT strategies requires a defined plan. Identifying the needs, learning styles and preferred learning strategies of target audiences, coupled with evaluation, should be a piece of the overall concussion education puzzle to have an impact on enhancing knowledge and awareness

Epitope mapping of antibodies induced with a conserved rhinovirus protein generating protective anti-rhinovirus immunity

Human rhinovirus (RV) infections are the principle cause of common colds and precipitate asthma and chronic obstructive pulmonary disease (COPD) exacerbations. Currently there is no vaccine for RV which is largely due to the existence of ~160 serotypes/strains. We demonstrated previously that immunising mice with highly conserved VP4 and VP2 regions of the RV polyprotein (RV-A16 VP0) generated cross-reactive immunity to RV in vivo. The current study investigated and mapped the epitopes of RV-A16 VP0 that are targets for antibodies in serum samples from VP0 immunisation and RV challenge studies in mice. Recombinant capsid proteins, peptide pools and individual peptides spanning the immunogen sequence (RV-A16 VP0) were assessed for IgG binding sites to identify epitopes. We found that peptide pools covering the C-terminus of VP4, the N-terminus of VP2 and the neutralising NIm-II site within VP2 were bound by serum IgG from immunised mice. The NIm-II site peptide pool blocked IgG binding to the immunogen RV-A16 VP0 and individual peptides within the pool binding IgG were further mapped. Thus, we have identified immunodominant epitopes of RV vaccine candidate RV-A16 VP0, noting that strong IgG binding antibodies were observed that target a key neutralising epitope that is highly variable amongst RV serotypes

Annual Report: 2011-2012 Storm Season Sampling, Non-Dry Dock Stormwater Monitoring for Puget Sound Naval Shipyard, Bremerton, WA

Annual PSNS non-dry dock storm water monitoring results for 2011-2012 storm season. Included are a brief description of the sampling procedures, storm event information, laboratory methods and data collection, a results and discussion section, and the conclusions and recommendations

Annual Report: 2011-2012 Storm Season Sampling, Non-Dry Dock Stormwater Monitoring for Puget Sound Naval Shipyard, Bremerton, WA

Annual PSNS non-dry dock storm water monitoring results for 2011-2012 storm season. Included are a brief description of the sampling procedures, storm event information, laboratory methods and data collection, a results and discussion section, and the conclusions and recommendations

HER2 and ESR1 mRNA expression levels and response to neoadjuvant trastuzumab plus chemotherapy in patients with primary breast cancer

Introduction: Recent data suggest that benefit from trastuzumab and chemotherapy might be related to expression of HER2 and estrogen receptor (ESR1). Therefore, we investigated HER2 and ESR1 mRNA levels in core biopsies of HER2-positive breast carcinomas from patients treated within the neoadjuvant GeparQuattro trial. Methods: HER2 levels were centrally analyzed by immunohistochemistry (IHC), silver in-situ hybridization (SISH) and qRT-PCR in 217 pretherapeutic formalin-fixed, paraffin-embedded (FFPE) core biopsies. All tumors had been HER2-positive by local pathology and had been treated with neoadjuvant trastuzumab/ chemotherapy in GeparQuattro. Results: Only 73% of the tumors (158 of 217) were centrally HER2-positive (cHER2-positive) by IHC/SISH, with cHER2-positive tumors showing a significantly higher pCR rate (46.8% vs. 20.3%, p<0.0005). HER2 status by qRT-PCR showed a concordance of 88.5% with the central IHC/SISH status, with a low pCR rate in those tumors that were HER2-negative by mRNA analysis (21.1% vs. 49.6%, p<0.0005). The level of HER2 mRNA expression was linked to response rate in ESR1-positive tumors, but not in ESR1-negative tumors. HER2 mRNA expression was significantly associated with pCR in the HER2-positive/ESR1-positive tumors (p=0.004), but not in HER2-positive/ESR1-negative tumors. Conclusions: Only patients with cHER2-positive tumors - irrespective of the method used - have an increased pCR rate with trastuzumab plus chemotherapy. In patients with cHER2-negative tumors the pCR rate is comparable to the pCR rate in the non-trastuzumab treated HER-negative population. Response to trastuzumab is correlated to HER2 mRNA levels only in ESR1-positive tumors. This study adds further evidence to the different biology of both subsets within the HER2-positive group