Promoting Shared Decision Making Through Patient Education of Labor Inductions

The induction of labor is medically indicated for many conditions in which delivering the baby outweighs the risk of continuing the pregnancy. Patients admitted for the induction of labor require adequate information to actively participate in decision making that affects their plan of care. The purpose of this quality improvement project was to improve the quality of healthcare delivery and promote patient engagement by providing consistent education using a teaching tool. The project question addressed the impact of a labor-induction teaching tool on improving patient education, participation, and overall satisfaction. The Plan-Do-Study-Act (PDSA) model was used to plan, implement, and evaluate the labor-induction teaching tool in a 9-room labor and delivery unit that averages approximately 1,500 births per year. The teaching tool content was obtained from existing patient education information from the organization\u27s resource library. The nurses piloted the teaching tool for all patients admitted for the induction of labor for 3 weeks. Patient comments supported the use of the teaching tool to improve knowledge, increase participation in decision making, and enhance overall satisfaction. The nurses voluntarily completed an online survey that indicated the teaching tool was easy to use, positively impacted workflow, and supported informed choice. Patient charts were audited and showed a 94% compliance with documentation of education. The success of the teaching tool in improving patient education and decision-making capacity supports the development of other teaching tools, encourages patient and family-centered care, and improves the delivery of quality care

Exploring potential germline associated roles of the TRIM-NHL protein NHL-2 through RNAi screening

TRIM-NHL proteins are highly conserved regulators of developmental pathways in vertebrates and invertebrates. The TRIM-NHL family member NHL-2 in Caenorhabditis elegans functions as a miRNA cofactor to regulate developmental timing. Similar regulatory roles have been reported in other model systems, with the mammalian ortholog in mice, TRIM32, contributing to muscle and neuronal cell proliferation via miRNA activity. Given the interest associated with TRIM-NHL family proteins, we aimed to further investigate the role of NHL-2 in C. elegans development by using a synthetic RNAi screening approach. Using the ORFeome library, we knocked down 11,942 genes in wild-type animals and nhl-2 null mutants. In total, we identified 42 genes that produced strong reproductive synthetic phenotypes when knocked down in nhl-2 null mutants, with little or no change when knocked down in wild-type animals. These included genes associated with transcriptional processes, chromosomal integrity, and key cofactors of the germline small 22G RNA pathway.Gregory M. Davis, Wai Y. Low, Joshua W.T. Anderson and Peter R. Boa

Extension of the sum rule for the transition rates between multiplets to the multiphoton case

The sum rule for the transition rates between the components of two multiplets, known for the one-photon transitions, is extended to the multiphoton transitions in hydrogen and hydrogen-like ions. As an example the transitions 3p-2p, 4p-3p and 4d-3d are considered. The numerical results are compared with previous calculations.Comment: 10 pages, 4 table

A Phenomenological Analysis of Gluon Mass Effects in Inclusive Radiative Decays of the J/ψ\rm{J/\psi} and $\Upsilon

The shapes of the inclusive photon spectra in the processes \Jp \to \gamma X and \Up \to \gamma X have been analysed using all available experimental data. Relativistic, higher order QCD and gluon mass corrections were taken into account in the fitted functions. Only on including the gluon mass corrections, were consistent and acceptable fits obtained. Values of $0.721^{+0.016}_{-0.068}$ GeV and $1.18^{+0.09}_{-0.29}$ GeV were found for the effective gluon masses (corresponding to Born level diagrams) for the \Jp and \Up respectively. The width ratios \Gamma(V \to {\rm hadrons})/\Gamma(V \to \gamma+ {\rm hadrons}) V=\Jp, \Up were used to determine $\alpha_s(1.5 {\rm GeV})$ and $\alpha_s(4.9 {\rm GeV})$. Values consistent with the current world average $\alpha_s$ were obtained only when gluon mass correction factors, calculated using the fitted values of the effective gluon mass, were applied. A gluon mass $\simeq 1$ GeV, as suggested with these results, is consistent with previous analytical theoretical calculations and independent phenomenological estimates, as well as with a recent, more accurate, lattice calculation of the gluon propagator in the infra-red region.Comment: 50 pages, 11 figures, 15 table

Performance of the CMS Level-1 trigger in proton-proton collisions at √s = 13 TeV

At the start of Run 2 in 2015, the LHC delivered proton-proton collisions at a center-of-mass energy of 13\TeV. During Run 2 (years 2015–2018) the LHC eventually reached a luminosity of 2.1× 10$^{34}$ cm$^{-2}$s$^{-1}$, almost three times that reached during Run 1 (2009–2013) and a factor of two larger than the LHC design value, leading to events with up to a mean of about 50 simultaneous inelastic proton-proton collisions per bunch crossing (pileup). The CMS Level-1 trigger was upgraded prior to 2016 to improve the selection of physics events in the challenging conditions posed by the second run of the LHC. This paper describes the performance of the CMS Level-1 trigger upgrade during the data taking period of 2016–2018. The upgraded trigger implements pattern recognition and boosted decision tree regression techniques for muon reconstruction, includes pileup subtraction for jets and energy sums, and incorporates pileup-dependent isolation requirements for electrons and tau leptons. In addition, the new trigger calculates high-level quantities such as the invariant mass of pairs of reconstructed particles. The upgrade reduces the trigger rate from background processes and improves the trigger efficiency for a wide variety of physics signals

The role of general practitioners in the management of erectile dysfunction - a qualitative study

The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED ( active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background