Utah Air Quality: PM 2.5

Particulate matter two-point-five (PM2.5) is a tiny suspended particle of air pollution that can penetrate deeply into our lungs and potentially enter the bloodstream. The 2.5 unit means that the particles are smaller than 2.5 micrometers (a micrometer is one millionth of a meter). In Cache Valley and along the Wasatch Front, these tiny particles form and accumulate to unhealthy levels when air is trapped in the bottom of the valley during cold winter days

Barriers and facilitators to family participation in the care of their hospitalized loved ones

This study’s objective was to better understand family members’ experiences in order to identify how healthcare organizations can facilitate their participation in the care of a hospitalized loved one. Eighteen individuals at the bedside of a hospitalized loved one were interviewed individually. Roles at the bedside and factors that facilitated their participation or represented barriers were examined. A qualitative analysis using a mixed inductive/deductive approach was performed. Reassurance and emotional support, as well as sharing information with the healthcare team emerged as main roles. Quality and timeliness of the information received about the patient’s condition, prognosis and changes in medical condition, as well as information on how to participate in their care, were the factors most frequently evoked as facilitating participation. On the other hand, the need to improve communication channels and access to doctors were highlighted. Most family members having no prior knowledge or exposure to healthcare environments reported feeling overwhelmed in this foreign environment. Among the suggestions on how to improve their experience, having a well-identified contact person who liaises with them and who can instruct them on how to participate in care during hospitalization and back at home was frequently suggested. Furthermore, many mentioned that recognizing the experiential knowledge they have of the patient allows for more holistic care and contributes to improve both patient and family experience. Families need to be adequately recognized and supported and have access to information in a timely manner so that their contribution to their loved one’s care is maximized and the burden associated with this stressful experience alleviated

Substrats artificiels structurés pour applications micro-ondes

Substrat diélectrique artificiel (SDA) -- Explication des diélectriques artificiels et revue historique -- Description de la structure proposée -- Paramètres équivalents en technologie microruban -- Extraction des paramètres constitutifs équivalents -- Miniaturisation de composants planaires sur SDA -- Circuits (1D et 2D) -- Antenne -- Ligne à retard dispersive sur SDA de type réflexion pour traitement du signal anlogique -- Revue historique des lignes à retard dispersives -- SDA non-uniforme et régime de Bragg -- SDA à sauts d'impédance et à périodicité uniforme -- SDA à sauts d'impédance, à périodicité non-uniforme à "CHIRP" linéaire et à réponse dispersive -- Discriminateur de fréquences et compensation de la dispersion -- Système à retard d'impulsion accordable -- Comparaison avec des lignes à retard dispersives microrubans à trace modulée -- Caractérisation de l'asymétrie en termes des pertes et du rayonnement -- Structure compacte champignon allogé à bande électromagnétique interdite (BEI) pour amélioration des performances d'un réseau d'antennes microrubans -- Explication, revue historique et applications des structures à BEI -- Description de la structure champignon allongé (CA) à BEI et sa motivation -- Prototype, design et diagramme de dispersion -- Comparaison avec la structure champignon conventionnel (CC) à BEI -- Réduction du couplage mutuel -- Antenne réseau avec la structure à BEI -- Impact de la réduction du couplage mutuel provenant de la structure à BEI dans les applications de traitement du réseau

Usefulness of a patient experience study to adjust psychosocial oncology and spiritual care services according to patients’ needs

Little is known about how cancer patients experience psychosocial and spiritual care services and about what services they feel should be offered in order to help them meet their actual needs. This study’s main goal was to examine how cancer patients experienced the psychosocial oncology and spiritual care (POSC) services they received, in order to adjust the service offer according to their expressed needs and expectancies. A qualitative design approach was used. The study was conducted in two phases: (1) Collection of the patients’ perspective and divulgation of the results to the clinical team and managers; and (2) assessment of the impact of the patient experience study results on the clinical team’s services and managerial decisions. Suggestions for improvement were gathered mainly around the themes of service delivery and information about services. Contrary to what was expected, delays to access service responded to patients’ needs and expectations. According to clinical managers, patients’ perspectives on their services legitimized the maintenance of certain services, and were levers that helped make coherent and targeted changes. They felt the changes they made were patient-driven instead of being driven by staff’s perception of patients’ needs. The fact that results emerged from a fairly large and structured patient experience evaluation had an impact on the motivation of stakeholders to initiate changes. These results suggest that collecting patients’ perspective will likely help clinicians and managers tailor service delivery to meet patients’ needs and expectations and may contribute to set more informative standards regarding access to care delays

Adaptation of clinical guidelines: literature review and proposition for a framework and procedure

Purpose. The development and updating of high-quality clinical practice guidelines require substantial resources. Many guideline programmes throughout the world are using similar strategies to achieve similar goals, resulting in many guidelines on the same topic. One method of using resources more efficiently and avoiding unnecessary duplication of effort would be to adapt existing guidelines. The aim was to review the literature on adaptation of guidelines and to propose a systematic approach for adaptation of guidelines. Data sources. We selected and reviewed reports describing the methods and results of adaptation of guidelines from those found by searching Medline, Internet, and reference lists of relevant papers. On the basis of this review and our experience in guideline development, we proposed a conceptual framework and procedure for adaptation of guidelines. Results. Adaptation of guidelines is performed either as an alternative to de novo guideline development or to improve guideline implementation through local tailoring of an international or national guideline. However, no validated process for the adaptation of guidelines produced in one cultural and organizational setting for use in another (i.e. trans-contextual adaptation) was found in the literature. The proposed procedure is a stepwise approach to trans-contextual adaptation, including searching for existing guidelines, quality appraisal, detailed analysis of the coherence between the evidence and the recommendations, and adaptation of the recommendations to the target context of use, taking into account the organization of the health care system and cultural context. Conclusions. Trans-contextual adaptation of guidelines is increasingly being considered as an alternative to de novo guideline development. The proposed approach should be validated and evaluated to determine if it can reduce duplication of effort and inefficient use of resources, although guaranteeing a high-quality product, compared with de novo developmen

Extramitochondrial OPA1 and adrenocortical function

We have previously described that silencing of the mitochondrial protein OPA1 enhances mitochondrial 27 Ca2+ signaling and aldosterone production in H295R adrenocortical cells. Since extramitochondrial OPA1 28 (emOPA1) was reported to facilitate cAMP-induced lipolysis, we hypothesized that emOPA1, via the 29 enhanced hydrolysis of cholesterol esters, augments aldosterone production in H295R cells. A few 30 OPA1 immunopositive spots were detected in �40% of the cells. In cell fractionation studies OPA1/COX 31 IV (mitochondrial marker) ratio in the post-mitochondrial fractions was an order of magnitude higher 32 than that in the mitochondrial fraction. The ratio of long to short OPA1 isoforms was lower in post-mito- 33 chondrial than in mitochondrial fractions. Knockdown of OPA1 failed to reduce db-cAMP-induced phos- 34 phorylation of hormone-sensitive lipase (HSL), Ca2+ signaling and aldosterone secretion. In conclusion, 35 OPA1 could be detected in the post-mitochondrial fractions, nevertheless, OPA1 did not interfere with 36 the cAMP – PKA – HSL mediated activation of aldosterone secretio

Rhomboid family member 2 regulates cytoskeletal stress-associated Keratin 16.

Keratin 16 (K16) is a cytoskeletal scaffolding protein highly expressed at pressure-bearing sites of the mammalian footpad. It can be induced in hyperproliferative states such as wound healing, inflammation and cancer. Here we show that the inactive rhomboid protease RHBDF2 (iRHOM2) regulates thickening of the footpad epidermis through its interaction with K16. K16 expression is absent in the thinned footpads of irhom2-/- mice compared with irhom2+/+mice, due to reduced keratinocyte proliferation. Gain-of-function mutations in iRHOM2 underlie Tylosis with oesophageal cancer (TOC), characterized by palmoplantar thickening, upregulate K16 with robust downregulation of its type II keratin binding partner, K6. By orchestrating the remodelling and turnover of K16, and uncoupling it from K6, iRHOM2 regulates the epithelial response to physical stress. These findings contribute to our understanding of the molecular mechanisms underlying hyperproliferation of the palmoplantar epidermis in both physiological and disease states, and how this 'stress' keratin is regulated

Cell wound repair in Drosophila occurs through three distinct phases of membrane and cytoskeletal remodeling

Single-cell wound repair in Drosophila involves mechanistically distinct expansion, contraction, and closure phases