Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units.

BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. PURPOSE: The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). METHODOLOGY/APPROACH: A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. FINDINGS: Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. PRACTICE IMPLICATIONS: Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality

COVID-19 as a mass death event

As of the first week of February 2021, the COVID-19 pandemic has resulted in over two million people dead across the globe. This essay argues that in order to fully understand the politics arising from the COVID-19 pandemic, we need to focus on the individual and collective experiences of death, loss, and grief. While the emerging scholarly discourse on the pandemic, particularly in political science and international relations, typically considers death only in terms of its effects on formal state-level politics and as a policy objective for mitigation, we argue that focusing on the particularities of the experience of death resulting from COVID-19 can help us fully understand the ways in which the pandemic is reordering our worlds. Examining the ambiguous sociopolitical meaning of death by COVID-19 can provide broader analytical comparisons with other mass death events. Ultimately, the essay argues that centering the impact of the pandemic on the experience of death and loss directly poses the question of how politics should value human lives in the post-pandemic world, helping us better formulate the normative questions necessary for a more ethical future

Heat shock-induced phosphorylation of TAR DNA-binding protein 43 (TDP-43) by MAPK/ERK kinase regulates TDP-43 function

TAR DNA-binding protein (TDP-43) is a highly conserved and essential DNA- and RNA-binding protein that controls gene expression through RNA processing, in particular, regulation of splicing. Intracellular aggregation of TDP-43 is a hallmark of amyotrophic lateral sclerosis and ubiquitin-positive frontotemporal lobar degeneration. This TDP-43 pathology is also present in other types of neurodegeneration including Alzheimer's disease. We report here that TDP-43 is a substrate of MEK, a central kinase in the MAPK/ERK signaling pathway. TDP-43 dual phosphorylation by MEK, at threonine 153 and tyrosine 155 (p-T153/Y155), was dramatically increased by the heat shock response (HSR) in human cells. HSR promotes cell survival under proteotoxic conditions by maintaining protein homeostasis and preventing protein misfolding. MEK is activated by HSR and contributes to the regulation of proteome stability. Phosphorylated TDP-43 was not associated with TDP-43 aggregation, and p-T153/Y155 remained soluble under conditions that promote protein misfolding. We found that active MEK significantly alters TDP-43-regulated splicing and that phosphomimetic substitutions at these two residues reduce binding to GU-rich RNA. Cellular imaging using a phospho-specific p-T153/Y155 antibody showed that phosphorylated TDP-43 was specifically recruited to the nucleoli, suggesting that p-T153/Y155 regulates a previously unappreciated function of TDP-43 in the processing of nucleolar-associated RNA. These findings highlight a new mechanism that regulates TDP-43 function and homeostasis through phosphorylation and, therefore, may contribute to the development of strategies to prevent TDP-43 aggregation and to uncover previously unexplored roles of TDP-43 in cell metabolism

Britain avoids talking about COVID-19 deaths. that’s a mistake

How has the UK government acknowledged and talked about COVID-19 deaths? In an extract from their new report, Katharine M Millar, Yuna Han, Katharina Kuhn, Martin Bayly and Irene Morlino (LSE) warn that the current focus on ‘recovery’ and ‘inevitable’ deaths risks alienating sections of society, and suggest how it can do better. Pandemics present a ... Continue

Confronting the COVID-19 pandemic: grief, loss, and social order

This research addresses the challenge the 2019- 2020 COVID-19 pandemic (COVID-19) presents to social order as a result of mass grieving and loss. It places a particular emphasis on the UK response and lessons that can be learnt for further ‘waves’. A tendency for research to look at technocratic policy responses has led to the overlooking of the social impact that pandemics produce. This study, in contrast, employs a qualitative, comparative methodology to examine four key cases – the UK, Italy, South Korea, and Germany – from 1 January to 31 July 2020, as well as the UK during the 1918-19 influenza epidemic – to examine the politics of COVID-9 as a mass death event. Our research finds that the narrative framing of the pandemic as a particular type of crisis; the ways that deaths have been recorded and managed; and the manner in which loss has been mourned and commemorated vary across cases. This variance, the research suggests, has implications for the ways that societies may respond, particularly in the medium- and longterm. Recommendations are made for governments responding to future ‘waves’ of the virus in relation to communicating loss to the public, and commemorating deaths in a manner that supports social cohesion and prepares the public for future crises

A Year of Hijacking of Budgets by the Elite, Bypassing Public Welfare: End of Year Notes and Reflections by SEKNAS FITRA on Budget Year 2011

2011 was a year of budget hijacking by Indonesia's political and bureaucratic elite to the detriment of public welfare. An important factor at play in this situation was increasing “budget mafia” activity, evident in corruption cases within the Ministries of Youth & Sport and Labor & Transmigration; and in confirmation of charges against members of the Budget Committee (Banggar) of the House of Representatives (DPR) as accomplices in those cases. This turn of events confirms that Banggar has become a springboard for budget mafia activity. And, this year, hijacking of budgets has taken place in broad daylight with funds from the public purse being openly squandered on activities of benefit to political and bureaucratic leaders. Proposed construction of a new DPR building has a bad smell about it; purchase of a Presidential aircraft makes no sense; burdens of debt weigh more heavily on citizens; and official travel votes have become like feeding troughs for bureaucrats. All of this has amounted to nothing less than a hijacking of the State budget acted out in full public view. Hijacking of Indonesia's budgets continues because of Indonesia's weak law enforcement regime and because budget processes remain closed. Thus, in comparison to the amount spent on corruption eradication, the value of embezzled assets returned to the public purse is modest. The overall situation was made worse by the predilection of public institutions—especially ministries, agencies and political parties—not to be open about budgetary information. This derailing of budgetary funds has had implications for expenditure on education and health—both of which continued to be ineffective. Although government has managed to spend 20% of budgetary resources on education, education budgets have, at the same time, become a dumping ground for all sorts of activities. Moreover, at the central level, education funding is dispersed across 19 ministries and agencies and almost half of it is being appropriated for payment of salaries. Government is also not meeting its legal obligation to spend 5% of budgetary resources on health. It is no surprise, therefore, that Indonesia's Human Development Index (HDI)—which encompasses education and health—declined in 2011. The elite's hijacking of budgets has also led to neglect of public welfare in regions. A principal cause of this has been distortions of the system for fiscal transfers from the central government to regions (known as dana perimbangan). Those distortions have impacted badly on regional budgetary processes. Indeed, it is the fiscal transfers system itself that is acting as a catalyst for increased civil service spending in regions and for promotion of even more fiscal imbalance among regions. Around half of Indonesia's sub-national (regional) governments are appropriating more than 50% of their budgets to fund civil service costs. This situation was made worse by increased levels of misappropriation of regional funds—evident from national Audit Board reports. FITRA's projections and recommendations for 2012 reflect the assessment that budgets for 2012 are unlikely to be very different to those of 2011. Budget processes are still on a business-as-usual footing. Hijacking of budgets by the elite and neglect of public welfare will continue unless government completely revamps current pro-“rent-seeking” budgetary processes. And, as the next general election approaches, budget mafias will peddle their wares even more actively as they become players in political contests. According to FITRA's projections, State budget funding of civil service costs will continue to blow out in 2012 without any improvement of service provided or any diminution in the level of misappropriated funds. 2012 State funding for education will continue to resemble a dumping ground for sundry activities. The legal requirement to spend 5% of budgetary resources on health will, yet again, not be met. And national Audit Board reporting will continue to be little more than an annual ritual that cannot be counted on to improve the quality of budgetary spending. To put a stop to budget mafia operations, budget processes need to be totally revamped. Above all else, budgetary processes need to be open. To achieve that, the Law on State Finances needs to be revised to ensure in particular that it contains specific provisions fleshing out the Constitutional mandate that State budgets “shall be implemented in an open and accountable manner in order to best attain the prosperity of the people”. In addition, corruption eradication efforts should focus on the return of State assets to the public purse by those found guilty of embezzling them. Both the President and the DPR should become agents for change—to make budgets more efficient—and should refrain from deriving personal benefit from State-financed facilities. Revision of the regional fiscal transfers system must also be a priority. That system should squarely focus on realizing fundamental civic rights by reducing per capita fiscal inequalities among regions. The system's policy framework should therefore facilitate more efficient spending on regional civil services and promote greater prosperity for the people

An essential role for a mammalian SWI/SNF chromatin-remodeling complex during male meiosis

Germ cell development and gametogenesis require genome-wide transitions in epigenetic modifications and chromatin structure. These changes include covalent modifications to the DNA and histones as well as remodeling activities. Here, we explore the role of the mammalian SWI/SNF chromatin-remodeling complex during spermatogenesis using a conditional allele of the ATPase subunit, brahma-related gene 1 (Brg1, or Smarca4). Not only do BRG1 levels peak during the early stages of meiosis, genetic ablation of Brg1 in murine embryonic gonocytes results in arrest during prophase of meiosis I. Coincident with the timing of meiotic arrest, mutant spermatocytes accumulate unrepaired DNA and fail to complete synapsis. Furthermore, mutant spermatocytes show global alterations to histone modifications and chromatin structure indicative of a more heterochromatic genome. Together, these data demonstrate a requirement for BRG1 activity in spermatogenesis, and suggest a role for the mammalian SWI/SNF complex in programmed recombination and repair events that take place during meiosis

Behind the Glitz of the 2010 Budget

At the end of every year, it is important to reflect upon and evaluate the quality of national budget policies. The National Secretariat of the Indonesian Forum for Budget Transparency (Seknas FITRA), together with its network of budget advocacy units across Indonesia, has consistently provided annual reports on budget performance. Such reports are an important part of its budget transparency work program and its effort to realize popular sovereignty over national budgets 2010 was the first year of President Susilo Bambang Yudoyono (SBY)'s second term of office following his re-election in 2009. In this second term, SBY should be able to be more resolute in his espousal of good budget policies and should not accord any priority to maintaining his political image. The principal emphases in the 2010 State budget (APBN 2010) were that it should promote “national economic recovery and boost community welfare”. But all that turned out to be mere rhetoric. The reality was that the budget was further removed than ever from the mandate of Article 23 of the Consititution that national budgets “shall be implemented in an open and accountable manner in order to best attain the prosperity of the people”. Instead of being used to promote the public interest, 40.7% of the 2010 APBN was consumed by routine expenditure on the bureaucracy and top echelons of the civil service. Furthermore, Rp 162.6 trillion of that 40.7% was spent on civil service costs, Rp 19.5 trillion on official travel and Rp 153.6 trillion on payment of interest on loans or loan repayments

Eksperimen Strategi Pembelajaran Kooperatif Tipe Group Investigation Dan Think Pair Share Ditinjau Dari Komunikasi Matematik Siswa Kelas VIII SMP Muhammadiyah 5 Surakarta

This research aims to examine (1) the influence of cooperative learning strategy Types Group Investigation (GI) and Think Pair Share (TPS) against the results of the learning of mathematics, (2) influences the level of mathematical communication students toward outcome studied mathematics, (3) the interaction of learning strategies and mathematical communication students toward outcome studied mathematics. Types of quantitative research with experimental design. Population penelitin the entire grade VIII Junior High School Muhammadiyah Surakarta with 5 sample research VIII grade-C and VIII-D. The technique of collecting data by the method of test and question form. Data analysis techniques using variansi analysis of two way cells do not match. Research results with α = 5% is (1) there was significant influence between the use of cooperative learning strategies Group-type Investigation and Think Pair Share against results of learning math students with FA = 4,256 > F0,05:1;63 = 3,99; (2) there was significant influence between the mathematical communication against the results of the study of mathematics students with FB = 4,317 > F0.05:2:63 = 3,14; and (3) there is no interaction between the mathematical communication and learning strategies of students toward outcome studied mathematics students with FAB = 0.966 > F0.05:2:63 = 3,1. Keywords: Group Investigation, Think Pair Share, Mathematical Communication, Mathematical Study Result

Key mediators of somatic ATR signaling localize to unpaired chromosomes in spermatocytes

Meiotic silencing of unpaired chromatin (MSUC) occurs during the first meiotic prophase, as chromosomes that fail to pair are sequestered into a transcriptionally repressive nuclear domain. This phenomenon is exemplified by the heterologous sex chromosomes of male mammals, where the ATR DNA damage response kinase is crucial for this silencing event. However, the mechanisms underlying the initiation of MSUC remain unknown. Here, we show that essential components of ATR signaling in murine somatic cells are spatially confined to unpaired chromosomes in spermatocytes, including the ATR-dependent phosphorylation of the single-stranded DNA (ssDNA)-binding complex replication protein A (RPA) and the checkpoint kinase CHK1. These observations support a model in which ssDNA plays a central role in the recruitment of ATR during MSUC, and provide a link to meiotic progression through activation of CHK1