Spiritual Coping in Children Diagnosed with Cancer

Children coping with chronic illnesses employ a variety of strategies to help them defend against their illness-related stressors. In a study of children diagnosed with asthma, Ezop (2002), using the Children’s Religious Coping Scale (CRC), found that the use of positive religious coping techniques led to a better adaptation to life and a more positive perspective on illnesses. The Ezop study also found that children and adolescents used positive religious coping moderately and made only limited use of negative religious coping. The present study analyzed the positive and negative coping skills of adolescents diagnosed with cancer. Specifically, in a prior study adolescents in a pediatric oncology clinic, who were newly diagnosed with cancer, were interviewed about how they understood their situations, including the coping strategies they utilized, their social support, and their views of God, among other topics. The archival transcripts from these structured interviews were recoded for presence of the 20 positive and 9 negative coping strategies on the CRC Scale (Ezop 2002). The findings of this study indicate that adolescent cancer patients used positive religious coping strategies more frequently than negative religious coping strategies. Both the frequency of occurrence and the number of words devoted to describing a coping strategy showed the same pattern of results. The most frequently occurring and extensively described positive strategy was “I think God will help me get through this,” followed by “I go to church/temple/synagogue” and “I think God gave me [my illness] for a reason.” The most frequently used and extensively described negative coping strategies were “I think God cannot help me” and “I just let God take care of me and I do nothing” These results provide evidence that Ezop’s religious coping strategies are ecologically valid and arise spontaneously in the same patterns as found on the CRC scale

De la compétence à l’empathie : évaluation de l’évolution de la perception qu’ont les étudiants en médecine des chirurgiens dans le cadre d’un programme associant le patient comme enseignant et la réflexion basée sur les arts

Introduction: The purpose of this study was to identify whether the incorporation of a combined Patient as teacher (PAT) and arts-based reflection (ABR) program during a surgical clerkship rotation could influence more humanistic perceptions of surgeons, using an innovative evaluation approach. Methods: A novel, single question evaluation tool was created. Third year medical-students were asked to “list the top 5 attributes of a surgeon, in order of perceived importance” both before and after their surgical clerkship rotations and participation in the PAT/ABR program. Attributes identified by students were coded as either “humanistic” or “non-humanistic,” which were then analyzed using generalized linear regression models under a Bayesian framework. Results: After participation in the PAT/ABR program, the predicted probability of students ranking a humanistic characteristic as the most important attribute of a surgeon had increased by 17%, and the predicted probability of students ranking a humanistic characteristic amongst their top three attributes for a surgeon had increased by 21%. Conclusion: This innovative evaluative method suggested the success of a combined PAT/ABR program in encouraging a humanistic perspective of surgery and this approach could potentially be explored to evaluate other humanistic education initiatives.Résumé Introduction : L’objectif de cette étude était de déterminer si l’introduction d’une nouvelle approche d’évaluation associant la participation de Patients comme enseignants (PCE) à une Réflexion basée sur les arts (RBA) dans un stage d’externat en chirurgie permettait de mieux percevoir les qualités humanistes chez les chirurgiens. Méthodes : Un nouvel outil d’évaluation à question unique a été créé. Des étudiants en troisième année de médecine ont été invités à ‘’énumérer les cinq principaux attributs d’un chirurgien, par ordre d’importance perçue’’, avant et après leur stage d’externat en chirurgie et le programme PCE/RBA. Les attributs identifiés par les étudiants ont été codés comme « humanistes » ou « non humanistes », puis analysés à l’aide de modèles de régression linéaire généralisée dans un cadre bayésien. Résultats : Après leur participation au programme PCE/RBA, la probabilité prédite moyenne que les étudiants classent un trait humaniste comme l’attribut le plus important d’un chirurgien a augmenté de 17 %, et la probabilité prédite que les étudiants classent un trait humaniste parmi les trois premiers attributs d’un chirurgien a augmenté de 21 %. Conclusion : Cette méthode d’évaluation innovante porte à croire que le programme PCE/RBA réussit en effet à favoriser une vision humaniste de la chirurgie. Cette approche peut être explorée pour évaluer d’autres activités de formation axées sur l’humanisme

Factors Affecting the Microbiome of \u3ci\u3eIxodes scapularis\u3c/i\u3e and \u3ci\u3eAmblyomma americanum\u3c/i\u3e

The microbial community composition of disease vectors can impact pathogen establishment and transmission as well as on vector behavior and fitness. While data on vector microbiota are accumulating quickly, determinants of the variation in disease vector microbial communities are incompletely understood. We explored the microbiome of two human-biting tick species abundant in eastern North America (Amblyomma americanum and Ixodes scapularis) to identify the relative contribution of tick species, tick life stage, tick sex, environmental context and vertical transmission to the richness, diversity, and species composition of the tick microbiome. We sampled 89 adult and nymphal Ixodes scapularis (N = 49) and Amblyomma americanum (N = 40) from two field sites and characterized the microbiome of each individual using the v3-v4 hypervariable region of the 16S rRNA gene. We identified significant variation in microbial community composition due to tick species and life stage with lesser impact of sampling site. Compared to unfed nymphs and males, the microbiome of engorged adult female I. scapularis, as well as the egg masses they produced, were low in bacterial richness and diversity and were dominated by Rickettsia, suggesting strong vertical transmission of this genus. Likewise, microbiota of A. americanum nymphs and males were more diverse than those of adult females. Among bacteria of public health importance, we detected several different Rickettsia sequence types, several of which were distinct from known species. Borrelia was relatively common in I. scapularis but did not show the same level of sequence variation as Rickettsia. Several bacterial genera were significantly over-represented in Borrelia-infected I. scapularis, suggesting a potential interaction of facilitative relationship between these taxa; no OTUs were under-represented in Borrelia-infected ticks. The systematic sampling we conducted for this study allowed us to partition the variation in tick microbial composition as a function of tick- and environmentally-related factors. Upon more complete understanding of the forces that shape the tick microbiome it will be possible to design targeted experimental studies to test the impacts of individual taxa and suites of microbes on vector-borne pathogen transmission and on vector biology

Patient Compliance With Follow-Up After Open Reduction and Internal Fixation for Treating Malleolar Ankle Fractures: A Retrospective Review

Background: Compliance with follow-up after orthopaedic procedures is variable and does not always occur as recommended. Various factors such as medical, financial, cultural, and logistical reasons may contribute to this lack of compliance. The purpose of this study was to determine follow-up compliance of patients who had undergone open reduction and internal fixation (ORIF) for treating closed malleolar ankle fractures. Methods: Medical records of patients who underwent ORIF for treating closed malleolar ankle fractures by the senior author (RAM) were reviewed to evaluate compliance with postoperative follow-up (n = 267). Inclusion criteria were patients with isolated, acute, closed fractures (n = 229). Patients were considered to have followed up appropriately if they returned to clinic after a removable cast boot was issued at 4 to 8 weeks postoperatively. A 2-tailed t test was performed to analyze age and visual analogue scale score at the time of obtaining the removable cast boot. Chi-square testing was performed to analyze the other variables studied. Results: Of the 229 patients included, a total of 183 complied with follow-up whereas 46 did not. Younger age, male sex, and living greater than 160.9 km (100 mi) from the hospital were statistically significant variables associated with decreased compliance with follow-up. Conclusions: In our patient population, 80% of patients followed up in clinic as scheduled. The remaining 20% did not adhere with scheduled followup either before or after obtaining a removable cast boot. Younger age, male sex, and living greater than 100 miles from the hospital were associated with decreased compliance. Consideration should be paid to these factors when treating patients with ankle fractures

Keeping patients with epilepsy safe: a surmountable challenge?

This quality improvement project was inspired as an answer to a problem that intellectual disability teams have been struggling to manage whilst caring for people with epilepsy (PWE). The issue was that despite guidance to discuss the possibility of sudden unexpected death in epilepsy (SUDEP) be discussed with a newly diagnosed PWE this is rarely done. Additionally when, how, and what to discuss about SUDEP and reduce its risk is arbitrary, non-person centred, and with no structured evidence. Prior to initiating changes a discussion of SUDEP was recorded in just 10% of PWE. We introduced a check-list to help identify risk factors for SUDEP. We then modified the check-list, and then used it via telehealth, a way of contacting patients and their carers over the phone using the check-list approach. Following interventions, discussions of SUDEP are now recorded in 80% of PWE. Feedback from patients, carers and primary and secondary care professionals has been positive. We are now developing an app so that patients and carers can monitor their own risk factors, thus empowering them and increasing their knowledge and awareness of SUDEP

The Next Frontier: Making Research More Reproducible

Science and engineering rest on the concept of reproducibility. An important question for any study is: are the results reproducible? Can the results be recreated independently by other researchers or professionals? Research results need to be independently reproduced and validated before they are accepted as fact or theory. Across numerous fields like psychology, computer systems, and water resources there are problems to reproduce research results (Aarts et al. 2015; Collberg et al. 2014; Hutton et al. 2016; Stagge et al. 2019; Stodden et al. 2018). This editorial examines the challenges to reproduce research results and suggests community practices to overcome these challenges. Coordination is needed among the authors, journals, funders and institutions that produce, publish, and report research. Making research more reproducible will allow researchers, professionals, and students to more quickly understand and apply research in follow-on efforts and advance the field

Studying Venom Toxin Variation Using Accurate Masses from Liquid Chromatography–Mass Spectrometry Coupled with Bioinformatic Tools

This study provides a new methodology for the rapid analysis of numerous venom samples in an automated fashion. Here, we use LC-MS (Liquid Chromatography–Mass Spectrometry) for venom separation and toxin analysis at the accurate mass level combined with new in-house written bioinformatic scripts to obtain high-throughput results. This analytical methodology was validated using 31 venoms from all members of a monophyletic clade of Australian elapids: brown snakes (Pseudonaja spp.) and taipans (Oxyuranus spp.). In a previous study, we revealed extensive venom variation within this clade, but the data was manually processed and MS peaks were integrated into a time-consuming and labour-intensive approach. By comparing the manual approach to our new automated approach, we now present a faster and more efficient pipeline for analysing venom variation. Pooled venom separations with post-column toxin fractionations were performed for subsequent high-throughput venomics to obtain toxin IDs correlating to accurate masses for all fractionated toxins. This workflow adds another dimension to the field of venom analysis by providing opportunities to rapidly perform in-depth studies on venom variation. Our pipeline opens new possibilities for studying animal venoms as evolutionary model systems and investigating venom variation to aid in the development of better antivenoms

Relationship between photonic band structure and emission characteristics of a polymer distributed feedback laser

G. A. Turnbull, P. Andrew, M. J. Jory, William L. Barnes, and I. D. W. Samuel, Physical Review B, Vol. 64, article 125122 (2001). "Copyright © 2001 by the American Physical Society."We present an experimental study of the emission characteristics and photonic band structure of a distributed feedback polymer laser, based on the material poly[2-methoxy-5-(2′-ethylhexyloxy)-1,4-phenylene vinylene]. We use measurements of the photonic band dispersion to explain how the substrate microstructure modifies both spontaneous and stimulated emission. The lasing structure exhibits a one-dimensional photonic band gap around 610 nm, with lasing occurring at one of the two associated band edges. The band edge (frequency) selection mechanism is found to be a difference in the level of output coupling of the modes associated with the two band edges. This is a feature of the second-order distributed feedback mechanism we have employed and is clearly evident in the measured photonic band structur

Highly Evolvable: Investigating Interspecific and Intraspecific Venom Variation in Taipans (Oxyuranus spp.) and Brown Snakes (Pseudonaja spp.)

Snake venoms are complex mixtures of toxins that differ on interspecific (between species) and intraspecific (within species) levels. Whether venom variation within a group of closely related species is explained by the presence, absence and/or relative abundances of venom toxins remains largely unknown. Taipans (Oxyuranus spp.) and brown snakes (Pseudonaja spp.) represent medically relevant species of snakes across the Australasian region and provide an excellent model clade for studying interspecific and intraspecific venom variation. Using liquid chromatography with ultraviolet and mass spectrometry detection, we analyzed a total of 31 venoms covering all species of this monophyletic clade, including widespread localities. Our results reveal major interspecific and intraspecific venom variation in Oxyuranus and Pseudonaja species, partially corresponding with their geographical regions and phylogenetic relationships. This extensive venom variability is generated by a combination of the absence/presence and differential abundance of venom toxins. Our study highlights that venom systems can be highly dynamical on the interspecific and intraspecific levels and underscores that the rapid toxin evolvability potentially causes major impacts on neglected tropical snakebites

Distinct regulatory networks control toxin gene expression in elapid and viperid snakes

Background Venom systems are ideal models to study genetic regulatory mechanisms that underpin evolutionary novelty. Snake venom glands are thought to share a common origin, but there are major distinctions between venom toxins from the medically significant snake families Elapidae and Viperidae, and toxin gene regulatory investigations in elapid snakes have been limited. Here, we used high-throughput RNA-sequencing to profile gene expression and microRNAs between active (milked) and resting (unmilked) venom glands in an elapid (Eastern Brown Snake, Pseudonaja textilis), in addition to comparative genomics, to identify cis- and trans-acting regulation of venom production in an elapid in comparison to viperids (Crotalus viridis and C. tigris). Results Although there is conservation in high-level mechanistic pathways regulating venom production (unfolded protein response, Notch signaling and cholesterol homeostasis), there are differences in the regulation of histone methylation enzymes, transcription factors, and microRNAs in venom glands from these two snake families. Histone methyltransferases and transcription factor (TF) specificity protein 1 (Sp1) were highly upregulated in the milked elapid venom gland in comparison to the viperids, whereas nuclear factor I (NFI) TFs were upregulated after viperid venom milking. Sp1 and NFI cis-regulatory elements were common to toxin gene promoter regions, but many unique elements were also present between elapid and viperid toxins. The presence of Sp1 binding sites across multiple elapid toxin gene promoter regions that have been experimentally determined to regulate expression, in addition to upregulation of Sp1 after venom milking, suggests this transcription factor is involved in elapid toxin expression. microRNA profiles were distinctive between milked and unmilked venom glands for both snake families, and microRNAs were predicted to target a diversity of toxin transcripts in the elapid P. textilis venom gland, but only snake venom metalloproteinase transcripts in the viperid C. viridis venom gland. These results suggest differences in toxin gene posttranscriptional regulation between the elapid P. textilis and viperid C. viridis. Conclusions Our comparative transcriptomic and genomic analyses between toxin genes and isoforms in elapid and viperid snakes suggests independent toxin regulation between these two snake families, demonstrating multiple different regulatory mechanisms underpin a venomous phenotype