Issues emerging from the first 10 pilot sites implementing the Nurse-Family Partnership home-visiting programme in England

"Issues emerging from the first 10 pilot sites implementing the FNP home-visiting programme in England" builds on those previously published, and identifies national and local system contributions to effective delivery of FNP, the emerging expertise of FNP practitioners and the influence of FNP practice on universal service provision

The Mechanical Unfolding of Fibronectin Using Atomic Force Microscopy and Its Relevance to Biocompatibility Studies

Protein adsorption to surfaces has hindered advancements made in biocompatible implants and drug delivery. Once a protein adsorbs, it can undergo conformational changes and unfold to expose buried cryptic sites of the protein. These sites are often critical for signaling additional proteins and cells to adsorb to the surface which can eventually lead to an implant's failure or the destruction of drug delivering devices. To improve the biocompatibility of these implants, an understanding of how a surface affects a protein's conformation and stability is required. In this work, an atomic force microscope (AFM) is used to quantify the stability of fibronectin (FN), an adhesion promoting protein, on mica, gold, poly(ethylene glycol), and -CH3, -OH, and -COOH terminated alkanethiol self-assembled monolayers. The thermodynamic parameters associated with this mechanically induced denaturation are presented as a function of surface type and amount of adsorbed protein using two different models. Results indicate greater stabilization of FN in densely deposited films while greater surface denaturation occurs as the proteins become more isolated on the substrate. Additional information about the protein's binding state was also obtained. Proteins aggregated on a hydrophobic surface adopted more rigid conformations apparently as a result of increased surface denaturation and tighter binding while looser conformations were observed on more hydrophilic surfaces. Finally, the force spectroscopy experiments were examined for any biocompatibility correlation by seeding substrates with human umbilical vascular endothelial cells (HUVEC). As predicted from the models used in this work, surfaces with aggregated FN promoted cellular deposition while surfaces with proteins sparsely populated hindered cellular deposition and growth. The AFM's use as a means for projecting cell deposition and perhaps biocompatibility does look promising

Management of RFID Systems in Hospital Transfusion Services

Radio Frequency Identification Devices (RFID) technology is used by hospital supply chains to track various medical products and monitor inventories. To improve overall operations, hospitals have implemented RFID as part of their supply chain processes. Hospitals have also have begun incorporating RFID technology as part of their transfusion services processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion services departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 51 sources referenced. RFID technology is being used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. Through RFID, transfusion departments and hospital supply chains have been able to manage blood samples and components to facilitate identification and transfusion of blood products to the correct patient. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-reduction times and error reduction. A pilot study in one Iowa hospital system yielded a 3%-10% reduction in misidentification of patients and/or blood products during transfusion. A cost-benefit assessment reported showed a 5-year ROI of 2%, with an approximate pay-back period of four years. Cost of RFID tags can be 10-15 times more expensive than barcode systems. There are also risks of this technology involving privacy and the security of patient information. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security and privacy appeared as principal barriers of adoption

Benefits and Barriers of Implementation and Utilization of Radio-Frequency Identification (RFID) Systems in Transfusion Medicine

Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-time reduction and error reduction. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security, and privacy appear to be the principal barriers to adoption

Diagnosis of Partial Body Radiation Exposure in Mice Using Peripheral Blood Gene Expression Profiles

In the event of a terrorist-mediated attack in the United States using radiological or improvised nuclear weapons, it is expected that hundreds of thousands of people could be exposed to life-threatening levels of ionizing radiation. We have recently shown that genome-wide expression analysis of the peripheral blood (PB) can generate gene expression profiles that can predict radiation exposure and distinguish the dose level of exposure following total body irradiation (TBI). However, in the event a radiation-mass casualty scenario, many victims will have heterogeneous exposure due to partial shielding and it is unknown whether PB gene expression profiles would be useful in predicting the status of partially irradiated individuals. Here, we identified gene expression profiles in the PB that were characteristic of anterior hemibody-, posterior hemibody- and single limb-irradiation at 0.5 Gy, 2 Gy and 10 Gy in C57Bl6 mice. These PB signatures predicted the radiation status of partially irradiated mice with a high level of accuracy (range 79–100%) compared to non-irradiated mice. Interestingly, PB signatures of partial body irradiation were poorly predictive of radiation status by site of injury (range 16–43%), suggesting that the PB molecular response to partial body irradiation was anatomic site specific. Importantly, PB gene signatures generated from TBI-treated mice failed completely to predict the radiation status of partially irradiated animals or non-irradiated controls. These data demonstrate that partial body irradiation, even to a single limb, generates a characteristic PB signature of radiation injury and thus may necessitate the use of multiple signatures, both partial body and total body, to accurately assess the status of an individual exposed to radiation

On the mechanisms governing gas penetration into a tokamak plasma during a massive gas injection

A new 1D radial fluid code, IMAGINE, is used to simulate the penetration of gas into a tokamak plasma during a massive gas injection (MGI). The main result is that the gas is in general strongly braked as it reaches the plasma, due to mechanisms related to charge exchange and (to a smaller extent) recombination. As a result, only a fraction of the gas penetrates into the plasma. Also, a shock wave is created in the gas which propagates away from the plasma, braking and compressing the incoming gas. Simulation results are quantitatively consistent, at least in terms of orders of magnitude, with experimental data for a D 2 MGI into a JET Ohmic plasma. Simulations of MGI into the background plasma surrounding a runaway electron beam show that if the background electron density is too high, the gas may not penetrate, suggesting a possible explanation for the recent results of Reux et al in JET (2015 Nucl. Fusion 55 093013)