University-State Child Welfare Training Partnerships: The Challenge of Matching Dollar Contributions

Universities are uniquely positioned to provide the very best training opportunities to public child welfare workers. However, university–child welfare agency training partnerships require a significant commitment of time and resources by university personnel at a time of extensive state cuts to public higher education. This national survey of university partnership administrators found significant differences among university respondents involving length of the contractual relationship, matching dollar requirements, and overall satisfaction with the training partnership

Telehealth Education In Nursing Curricula Enhances Nursing

The recent COVID-19 pandemic has drastically increased the use of telehealth in nursing practice. Many practicing nurses used telehealth with little to no formal training. Did the pre-licensure registered nurse (RN) programs prepare the nurses to provide the best possible client-centered care when using telehealth? When pre-licensure RN programs are looking at meeting the American Association of College of Nursing (AACN) Essentials, adding telehealth education to the curriculum is an expected element of developing a strong academic program. The Essentials outline the necessary curriculum content and expected competencies of graduates from baccalaureate, master’s, and Doctor of Nursing Practice programs, as well as the clinical support needed for the full spectrum of academic nursing. Health care agencies anticipate that nurses will use telehealth as an additional client interfacing tool when entering the workforce. A variety of research data bases resulted that telehealth training is necessary to improve the confidence and comfort level of graduate students in their curricula. Additionally, this research can translate well for pre-licensure RN programs. A review of articles pertaining to undergraduate programs revealed evidence to match the need of telehealth education. Nursing students improved their confidence, comfort, and adaptability with the use of technology after a telehealth experience (Lister et al., 2018). Academic institutions can control and bridge the knowledge gap by incorporating telehealth education in all nursing programs, which would ultimately enhance nursing practice delivery methods that improve client-centered access to optimal care

Cryo-electron microscopy of HPV16 pseudovirions reveal changes in capsid conformation upon furin cleavage

Persistent infection by oncogenic human papillomavirus (HPV) is the primary cause of cervical cancer, a leading cause of cancer deaths in women worldwide. There are no treatments for HPV infection, and although prophylactic vaccines are effective and safe, they are HPV type specific, provide little therapeutic benefit and developing countries often have limited access to these. Therefore, additional measures against HPV infection are urgently needed. Preventing HPV entry into host cells is an attractive option for therapeutic intervention. The HPV capsid is icosahedral and consists of two proteins, L1 and L2, which participate in entry and infection of host cells. During entry, the virus capsid attaches to the cell surface via binding to heparan sulphate proteoglycans (HSPGs). Cleavage of L2 by a host protease, furin, is necessary for infection and is thought to facilitate a conformational change in the virus capsid. Furin cleavage may affect the ability of HPV to bind to sulphated glycoproteins and a HSPG substitute, heparin. Understanding these proposed structural changes may aid in the development of therapeutics targeting virus entry. Here, we directly visualize the conformation changes to HPV16 pseudovirions (HPV16 PsVs) resulting from cleavage of L2 by exogenous furin using cryoelectron microscopy (cryo-EM). At 5 Å resolution, we observed that furin-cleaved HPV16 PsVs capsids display widespread changes in the arrangement of capsomeres relative to uncleaved control virions. This structural change is relevant because heparin has previously been observed to bind to the HPV16 capsid in the canyon surrounding the capsomere at the five-fold icosahedral symmetry axis, but not in other canyons between capsomeres, related by pseudo-symmetry. This suggests that differences in the relative orientations of the surrounding capsomeres to each other either prevent or allow heparin binding. We observed a narrowing of the putative heparin binding site by 0.4 Å after furin cleavage and propose that this change may be responsible for the transfer of HPV from cell-surface HSPGs to the unknown entry receptor(s) by a yet unidentified mechanism

Vancomycin minimum inhibitory concentration is not a substitute for clinical judgment: Response to healthcare-associated ventriculitis and meningitis

To the Editor—We read with interest the new clinical practice guideline for healthcare-associated ventriculitis and meningitis published in Clinical Infectious Diseases [1]. The guideline recommends consideration of alternative therapies for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) meningitis and ventriculitis for isolates with a vancomycin minimum in-hibitory concentration (MIC) ≥1μg/mL. We believe this recommendation places inappropriate emphasis on a single determinant of antimicrobial therapy that has uncertain clinical relevance and variable accuracy depending on the antimicrobial susceptibility testing (AST) method used. This may lead clinicians to use less well-evidenced strategies in cases likely to respond to vancomycin

Perceptions of Disabilities Among Native Americans Within the State of Utah

Currently, little research exists on disabilities among Native American communities and no research exists on how Native Americans perceive disabilities, services currently available, and unmet needs. Understanding these key areas is essential to providing efficacious and culturally relevant care. To address this gap in the literature, we used Indigenous research methodology through sharing circles throughout the state of Utah to listen and amplify the voices of the Native communities. Participants shared how they conceptualize disability, what they thought of current services, and how they thought the needs of Native persons with disabilities should be addressed. Four major themes emerged in the data: a culturally-based conceptualization of disability, barriers to services, belonging, and needed actions. These themes highlight the cultural strengths among Native communities surrounding disabilities and bring attention to systematic change needed to better address the needs of Native Americans with disabilities

Credit Access and Technical Efficiency of Cavendish Banana Growers in Santo Tomas, Davao del Norte, Southern Philippines

Cavendish banana substantially boosts the economy of the Philippines, which is one of the leading suppliers worldwide. However, production problems and constraints, such as the spread of diseases and challenging cost of production due to expensive inputs, hinder farmers to generate higher incomes. As such, access to credit becomes an important tool to afford better inputs, invest in equipment, and eventually improve production. Therefore, credit access could potentially increase farm efficiency. Employing data envelopment analysis, along with Tobit regression, this study aims to investigate the effect of credit access on technical efficiency level. Using 187 production data from Cavendish banana farmers in Santo Tomas in Davao del Norte, findings showed that growers with access to credit attained higher technical efficiency. Furthermore, farmers who borrowed from formal financial institutions reaped higher technical efficiency compared to farmers who sourced from informal financiers. The study concludes that farmers in a developing country like the Philippines lack capital and need available and accessible credit sources to purchase adequate volume of inputs necessary to maximize technical efficiency. Additionally, borrowing from banks and/or cooperative could give better efficiency. These results could guide government and other industry actors in designing future agricultural credit programs to aid farmers

Factors Affecting the Logistical Costs of Cavendish Banana Farmers in the Philippines and Its Implications to Profitability

Currently back in the second spot of the world’s top exporters of Cavendish banana, the Philippines has been giving this industry much regard since its rapid growth has been a significant source of national income and employment for the agricultural sector. Vis-à-vis its potential to improve the welfare of farmers, the industry also received a lot of contention due to issues on equity of returns gained by actors along its value chain, which is presumably dominated by multinational companies. For the farmers to enhance competitiveness, there is a need to increase farmers’ welfare by increasing their take-home pay. This can be done by improving access to markets with better prices, lowering costs, and enabling farmers to achieve efficiency, among others. This research would posit to look at the logistics aspect of the value chain in order to explore how this affects the profitability. More importantly, understanding the factors that significantly affect the logistical costs would also help farmers to strategize by minimizing costs incurred and consequentially increasing the level of profitability. Employing linear regression, factors such as banana farming experience, membership to cooperatives, choosing an ex-patio marketing arrangement, and access to gravel-type roads were seen to significantly decrease the logistical costs. Therefore, it is critical for the farmers to do their marketing through a cooperative and/ or allow buyers to assume transportation cost to transfer risk of losses. The need to improve road and infrastructure conditions is also recognized as one way to potentially increase farmers’ welfare

Association of neighborhood-level factors with hospitalization for community-associated methicillin-resistant Staphylococcus aureus, New York City, 2006: a multilevel observational study

Background: Hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection have increased in New York City, with substantial geographic variation across neighborhoods. While individual-level risk factors, such as age, sex, HIV infection, and diabetes have been described, the role of neighborhood-level factors (e.g., neighborhood HIV prevalence or income) has not been examined. Methods: To explore plausible neighborhood-level factors associated with CA-MRSA-related hospitalizations, a retrospective analysis was conducted using New York City hospital discharges from 2006 and New York City-specific survey and health department surveillance data. CA-MRSA-related hospitalizations were identified using diagnosis codes and admission information. Associations were determined by using sex-specific multilevel logistic regression. Results: The CA-MRSA hospitalization rate varied by more than six-fold across New York City neighborhoods. Females hospitalized with CA-MRSA had more than twice the odds of residing in neighborhoods in the highest quintile of HIV prevalence (adjusted odds ratio [AOR]Q5 vs. Q1 2.3, 95% CI: 1.2, 2.7). Both males and females hospitalized with CA-MRSA had nearly twice the odds of residing in neighborhoods with moderately high proportion of men who have sex with men (MSM) residing in the neighborhood (males: AORQ4 vs. Q1 1.7, 95% CI: 1.1, 2.7; females: AORQ4 vs. Q1 2.0, 95% CI: 1.1, 3.6); but this association did not hold for neighborhoods in the highest quintile (males: AORQ5 vs. Q1 1.2, 95% CI: 0.76, 1.8; females: AORQ5 vs. Q1 1.5, 95% CI: 0.82, 2.7). Conclusions: Neighborhood-level characteristics were associated with CA-MRSA hospitalization odds, independent of individual-level risk factors, and may contribute to the population-level burden of CA-MRSA infection

The Effects of Dietary Advanced Glycation End-Products on Neurocognitive and Mental Disorders

Advanced glycation end products (AGEs) are glycated proteins or lipids formed endogenously in the human body or consumed through diet. Ultra-processed foods and some culinary techniques, such as dry cooking methods, represent the main sources and drivers of dietary AGEs. Tissue accumulation of AGEs has been associated with cellular aging and implicated in various age-related diseases, including type-2 diabetes and cardiovascular disease. The current review summarizes the literature examining the associations between AGEs and neurocognitive and mental health disorders. Studies indicate that elevated circulating AGEs are cross-sectionally associated with poorer cognitive function and longitudinally increase the risk of developing dementia. Additionally, preliminary studies show that higher skin AGE accumulation may be associated with mental disorders, particularly depression and schizophrenia. Potential mechanisms underpinning the effects of AGEs include elevated oxidative stress and neuroinflammation, which are both key pathogenetic mechanisms underlying neurodegeneration and mental disorders. Decreasing dietary intake of AGEs may improve neurological and mental disorder outcomes. However, more sophisticated prospective studies and analytical approaches are required to verify directionality and the extent to which AGEs represent a mediator linking unhealthy dietary patterns with cognitive and mental disorders