Exploring Intensive Care Unit Nurses’ Decision Making in Alarm Management

Alarm fatigue, which occurs when the exposure to an increased amount of false or nonactionable alarms leads to alarm desensitization and reduced clinical response by the healthcare provider, can pose a significant risk to patient safety. With the increasing advances in technology and frequency of alarms in our healthcare system, alarm fatigue is an important and growing safety concern that needs to be addressed. Exploring alarm-related decision making is key to reducing alarm fatigue, as it is important to the development of alarm management related initiatives, education, and policies. To examine this, I used Interpretive Description methodology to explore factors that influence Intensive Care Unit nurses’ decision making regarding alarm management, specifically how they triage and respond to various alarms. This study included 12 participants, comprised of nurses with varying levels of experience, working at three different Intensive Care Units. The results of the interviews suggest that the nurses’ decision making consists of three steps that capture their alarm management response: awareness, triage, and response. Based on these results, a positive alarm management culture, standardized alarm-related education, and mentorship should be evaluated to implement an effective alarm management response and reduce alarm fatigue

Glavni proteini matične mliječi kao markeri izvornosti i kakvoće meda

Until now, the properties of honey have been defined based exclusively on the content of plant components in the nectar of given plant. We showed that apalbumin1, the major royal jelly (RJ) protein, is an authentic and regular component of honey. Apalbumin1 and other RJ proteins and peptides are responsible for the immunostimulatory properties and antibiotic activity of honey. For the quantification of apalbumin1, an enzyme-linked immunosorbent assay (ELISA) was developed using polyclonal anti-apalbumin1 antibody. The method is suitable for honey authenticity determination; moreover it is useful for detection of the honey, honeybee pollen and RJ in products of medicine, pharmacy, cosmetics, and food industry, where presences of these honeybee products are declared. Results from the analysis for presence and amount of apalbumin1 in honeys will be used for high-throughput screening of honey samples over the world. On the basis of our experiments which show that royal jelly proteins are regular and physiologically active components of honey we propose to change the definition of honey (according to the EU Honey Directive 2001/110/EC) as follows: Honey is a natural sweet substance produced by honey bees from nectar of plants or from secretions of plants, or excretions of plant sucking insects, which honey bees collect, transform by combining with major royal jelly proteins and other specific substances of their own, deposit, dehydrate, store and leave in the honey comb to ripen and mature.Do sada su svojstva meda bila definirana isključivo na temelju sadržaja komponenti nektara određene biljke. Mi smo pokazali da je apalbumin1, glavni protein matične mliječi, izvoran i uobičajeni sastojak meda. Apalbumin1, ostali proteini matične mliječi i peptidi odgovorni su za imunostimulatorna svojstva i antibiotsko djelovanje meda. Korištenjem poliklonalnog anti-apalbumin 1 protutijela osmišljen je imunoenzimski test (ELISA) za kvantifikaciju apalbumina 1. Metoda je ne samo prikladna za utvrđivanje izvornosti meda nego i korisna za detekciju meda, peluda i matične mliječi u medicinskim, farmaceutskim, kozmetičkim i prehrambenim proizvodima na kojima je naznačena prisutnost pčelinjih proizvoda. Rezultati analize prisutnosti i količine apalbumina 1 koristit će se za probir velike količine uzoraka meda diljem svijeta. Na temelju naših eksperimenata, koji pokazuju da su proteini matične mliječi uobičajene i fiziološki aktivne komponente meda, predlažemo izmjenu definicije meda (na temelju Direktive EU-a o medu 2001/110/EC): Med je prirodna slatka tvar koju pčele proizvode od nektara ili izlučevina biljaka ili izlučevina insekata koji sišu biljke. Nju pčele skupljaju, pretvaraju kombinacijom glavnih proteina matične mliječi i ostalih vlastitih specifičnih tvari, polažu, dehidriraju, pohranjuju i ostavljaju u saću da sazrije

Spatial differences in corneal electroretinogram potentials measured in rat with a contact lens electrode array

PURPOSE: It has been known for several decades that the magnitude of the corneal electroretinogram (ERG) varies with position on the eye surface, especially in the presence of focal or asymmetric stimuli or retinal lesions. However, this phenomenon has not been well-characterized using simultaneous measurements at multiple locations on the cornea. This work provides the first characterization of spatial differences in the ERG across the rat cornea. METHODS: A contact lens electrode array was employed to record ERG potentials at 25 corneal locations simultaneously following brief full-field flash stimuli in normally sighted Long-Evans rats. These multi-electrode electroretinogram (meERG) responses were analyzed for spatial differences in a-wave and b-wave amplitudes and implicit times. RESULTS: Spatially distinct ERG potentials could be recorded reliably. Comparing relative amplitudes across the corneal locations suggested a slight non-uniform distribution when using full-field, near-saturating stimuli. Amplitudes of a- and b-waves were approximately 3 % lower in the inferior quadrant than in the superior quadrant of the cornea. CONCLUSIONS: The present results comprise the start of the first normative meERG database for rat eyes and provide a basis for comparison of results from eyes with functional deficit. Robust measures of spatial differences in corneal potentials will also support optimization and validation of computational source models of the ERG. To fully utilize the information contained in the meERG data, a detailed understanding of the roles of the many determinants of local corneal potentials will eventually be required

Development of a Multi-Electrode Electroretinography System and Characterization of meERG Signals in Rat

Multi-electrode electroretinography (meERG) is a new technique being developed in the Neural Engineering Vision Laboratory at UIC. The meERG is a simultaneous measure of potentials at several locations on the corneal surface in response to a photic stimulus. It is anticipated that analysis of these potentials will reveal spatial information about the health of the retina, and thus may prove useful in early diagnosis of eye diseases, such as glaucoma and diabetic retinopathy. While the meERG technique is being developed for clinical use, there is a great deal that can be learned in animal studies. In particular, the NEVL lab is working to characterize the sensitivity and specificity of the technique for detecting laser-induced retinal lesions in rats. The main goal of this thesis was to support this effort by improving the design of the stimulus source and the contact lens electrode array, and by doing the initial characterization of the meERG signals recorded from normally-sighted rats. With this in mind, the following aims were addressed. 1.2Specific Aims I.To optimize a full-field, spatially-homogenous light-flash stimulus source suitable for use with rats.   II.To improve the design and function of the rat-sized meERG Contact Lens Electrode Array (CLEAr Lens™), with the goals of increasing the yield of functional electrodes on each lens and improving the quality of the recorded signal. III.To record the meERG signal from normal rats and to characterize this relatively novel signal with regard to test-retest and inter animal variability and to quantify spatial differences in meERG potentials across the rat cornea Note: CLEAr Lens™ is a trademark of RetMap, Inc., a start-up company founded by NEVL alumni to facilitate development and distribution of meERG technology. A full-field light flash stimulus source for use in rats was optimized and characterized, and found suitable for the planned experiments (it is currently in routine use). The lens design, as well as the procedure for preparing the lens for recording, were both significantly improved; the lens preparation procedures developed here have been adopted for the human-version of the CLEAr Lens™ as well. The meERG responses were analyzed for spatial differences in amplitudes; the typical standard deviation of amplitudes across the corneal surface was 2-3% of the mean, indicating fairly uniform potnetials for normally-sighted rats. Inter-animal variability between a- and b-wave amplitudes was found to be high, but consistent with conventional ERG results. Regarding test-retest variability, a measure related to the spatial distribution of a-wave amplitudes was found to be significantly different in three of eight animals when comparing measurements made one week apart; this seems to indicate a degree of procedural variability inherent in this relatively new measurement

Effects of biocide treatments on the biofilm community in Domitilla's catacombs in Rome.

Different types of biofilms are widespread on lithic faces of the Catacombs of Domitilla (Rome, Italy) due to the favorable microclimatic conditions (temperature, high RH% and low irradiance). The biofilm, once established, becomes particularly dangerous due to the coverage of valuable surfaces causing spoilage, softening of materials and mineral precipitation. It is common practice to treat these surfaceswith biocides in order to eradicate the microorganisms present. The aim of the present research was to compare the changes occurring to the microbial community present in the biofilm in one site of the Catacombs of Domitilla (CD15) before and after a biocide treatment (a mixture of quaternary ammonium compounds and octylisothiazolone, OIT), applied for a one month period. A multistep approach was followed, based on microscopy, cultural methods and molecular techniques (f-ITS and 16S rDNA sequencing), for the phenotypic and genetic analysis of the culturable microbial population. Our results highlighted that the biocide treatments had little effect against cyanobacteria, while the bacterial population increased in numbers but changed drastically in terms of diversity. In fact, some bacteria proliferate at the expense of the organic matter released by dead microorganisms as demonstrated by laboratory tests. Further, our data describe howthe microbial interaction can have different responses depending on the favorable conditions for one kind of microorganism in respect to the others. This study exemplifies the real risks of applying biocide treatments on complex microbial communities and pinpoints the necessity of subjecting treatments to monitoring and reassessment. Moreover, the work showed the potential of bacteria isolated after the treatment for use, under controlled conditions, in combatting unwanted microbial growth in that they possess a positive tropismtoward stressed microorganisms and high hydrolytic enzymatic activity against cell components (e.g. cellulose, chitin and pectin). A tentative protocol is proposed

Complex bacterial diversity in the white biofilms of the Catacombs of St. Callixtus in Rome evidenced by different investigation strategies

Roman Catacombs are affected by different kinds of biofilms that were extensively investigated in the last 14 years. In particular, the areas far from the lamps are often covered by white biofilms of different extension, consistency and nature.The aim of this paper is to describe the profile of the microbial community present in two areas of the Ocean's Cubiculum (CSC13), characterized by similar alterations described as white biofilms, by using a multistep approach that included direct microscopy observations, culture-dependent and culture-independent methodologies through the extraction of DNA and RNA directly from the sampled areas. In addition to this, we extracted the DNA directly from the Petri dishes containing R2A and B4 media after incubation and growth of bacteria.Our results evidenced that a complex bacterial community (mainly constituted by filamentous Actinobacteria, as well as Firmicutes and Proteobacteria) colonizes the two different white biofilms and its detection, quantitative and qualitative, could be revealed only by different approaches, each method gave different information that only partially overlap

Complex bacterial diversity in the white biofilms of the Catacombs of St. Callixtus in Rome evidenced by different investigation strategies

Roman Catacombs are affected by different kinds of biofilms that were extensively investigated in the last 14 years. In particular, the areas far from the lamps are often covered by white biofilms of different extension, consistency and nature.The aim of this paper is to describe the profile of the microbial community present in two areas of the Ocean's Cubiculum (CSC13), characterized by similar alterations described as white biofilms, by using a multistep approach that included direct microscopy observations, culture-dependent and culture-independent methodologies through the extraction of DNA and RNA directly from the sampled areas. In addition to this, we extracted the DNA directly from the Petri dishes containing R2A and B4 media after incubation and growth of bacteria.Our results evidenced that a complex bacterial community (mainly constituted by filamentous Actinobacteria, as well as Firmicutes and Proteobacteria) colonizes the two different white biofilms and its detection, quantitative and qualitative, could be revealed only by different approaches, each method gave different information that only partially overlap