Revealing Your Sources: The Case for Non-Anonymous Gamete Donation

This article argues that both legislating the end of anonymous gamete donation and allowing current children of anonymous gamete donation the ability to access identifying information about their donors is in the best interests of all parties involved in the donation process. Recipient-parents and donor-conceived children will benefit from having increased access to their donor\u27s health information. Records access, including access to a donor\u27s identifying information, will help donor-conceived children avoid potential incest and what is sometimes termed in adoption cases genealogical bewilderment. Finally, banning anonymous donation will give potential gamete donors the ability to make a truly informed decision before donating, because, as evidenced by the teenager and his DNA kit, it is nearly impossible for anonymity contracts to truly guarantee that anonymity

An Evidence-based Framework for Reporting Student Nurse Medication Incidents: Errors, Near Misses and Discovered Errors

Purpose: To share an evidence-based framework for reporting and analysing three types of medication incidents in an undergraduate nursing program. Incident types include errors, near misses and discovered errors. Background: Medication errors are underreported. Published studies on errors by nursing students indicate that although errors occur during clinical placements, there is a lack of consensus on how the factors that contributed to the errors are reported and analyzed. This limits our understanding of the factors that impact safe medication administration and reduces our ability to apply this knowledge to education and practice. Method: Quality improvement project. Results: Our reporting framework quantifies system factors that are supported by the literature as contributing to errors but not usually captured in incident reporting. Contributing factors for errors and near misses varied. This finding has not been documented in the literature. Conclusion: Nursing schools should prepare nursing students with a strong commitment to report all incidents and provide them with the competencies and a reporting system that allows them to report efficiently and effectively. As these graduates enter the workforce, they can influence the reporting practices of seasoned nurses. The ten factor framework provides nursing schools with the ability to quantify the individual and system factors that influence the safety of the student nurse medication administration process and the opportunity to implement strategies to reduce and/or prevent these incidents from occurring. Objectif : Présenter un cadre fondé sur des résultats probants pour signaler et analyser trois types d’incidents liés aux médicaments dans un programme de premier cycle en sciences infirmières, soit les erreurs, les quasi-incidents et les erreurs découvertes. Contexte : Les erreurs de médication ne sont pas toutes signalées. Les études publiées portant sur les erreurs causées par des étudiantes infirmières indiquent que, même si les erreurs se produisent durant les stages cliniques, la manière de signaler et d’analyser les facteurs contributifs ne fait pas consensus. Cela limite notre compréhension des facteurs influant sur l’administration sécuritaire des médicaments et réduit notre capacité à mettre en application ces connaissances en formation et en pratique. Méthode : Projet d’amélioration de la qualité. Résultats : Notre cadre de signalements quantifie les facteurs systémiques qui, selon la littérature sur le sujet, contribuent à des erreurs, mais ne figurent pas normalement dans les déclarations d’incident. Les facteurs ayant contribué à des erreurs et quasi-incidents étaient variables. Ce résultat n’a pas été rapporté dans la littérature. Conclusion : Les écoles de sciences infirmières devraient enseigner aux étudiantes infirmières l’importance de signaler l’ensemble des incidents tout en leur fournissant les habiletés et un système de déclaration qui leur permet de les déclarer de façon efficace et efficiente. Lorsque les diplômées intègreront le marché du travail, elles pourront influencer les pratiques des infirmières chevronnées en matière de signalement. Le cadre composé de dix facteurs permet aux écoles de sciences infirmières de quantifier les facteurs individuels et systémiques ayant un impact sur la sécurité du processus d’administration des médicaments par des étudiantes infirmières; il leur permet aussi de mettre en œuvre des stratégies de réduction ou de prévention de tels incidents

Participant retention practices in longitudinal clinical research studies with high retention rates

Abstract Background There is a need for improving cohort retention in longitudinal studies. Our objective was to identify cohort retention strategies and implementation approaches used in studies with high retention rates. Methods Longitudinal studies with ≥200 participants, ≥80% retention rates over ≥1 year of follow-up were queried from an Institutional Review Board database at a large research-intensive U.S. university; additional studies were identified through networking. Nineteen (86%) of 22 eligible studies agreed to participate. Through in-depth semi-structured interviews, participants provided retention strategies based on themes identified from previous literature reviews. Synthesis of data was completed by a multidisciplinary team. Results The most commonly used retention strategies were: study reminders, study visit characteristics, emphasizing study benefits, and contact/scheduling strategies. The research teams were well-functioning, organized, and persistent. Additionally, teams tailored their strategies to their participants, often adapting and innovating their approaches. Conclusions These studies included specialized and persistent teams and utilized tailored strategies specific to their cohort and individual participants. Studies’ written protocols and published manuscripts often did not reflect the varied strategies employed and adapted through the duration of study. Appropriate retention strategy use requires cultural sensitivity and more research is needed to identify how strategy use varies globally

How the Space Environment Affects Seed Germination and Growth

Understanding observed space environment effects on biological organisms such seeds are important in design of long duration space missions, such as to those planned for Mars, where appropriate storage and growth of food resources is essential. Evaluation of the effects of the real and simulated space environment on seed germination and growth in space is the purpose of this research. Preliminary tests of germination rate and growth of radish seeds in a controlled environment have identified statistically significant differences between control samples and seeds flown for 30 days in low earth orbit on the Bion M-1 launch capsule Russian research flight in 2013. Most significantly, average germination of space exposed radish seeds was 2 days less than the 6 days observed for the control seed group. Seed coats of the control group, space-exposed, and vibration-exposed seed were also inspected by LHS and USU students for physical changes. Observed changes in both the space-exposed and vibration-exposed seeds coats included the production of proteins presumably related to defense of the embryo from soil pathogens during seed germination. Previous research by others has shown production of anti-fungal proteins in radish seed coats is initiated by disturbance. Effects to germination rate from ionizing radiation up to 1 kGy were studied. Radiation exposure occurred with a custom biological exposure test chamber designed by Tsukuba students for the USU Materials Physics Group Space Survivability Test (SST) chamber, which is designed to mimic low-earth and geosynchronous orbital environments. * USU STARS! GEAR UP partnership # Partially funded by Japan Student Services Organization (JASSO), and University of Tsukub

Severe Histoplasmosis in Travelers to Nicaragua

We investigated an outbreak of unexpectedly severe histoplasmosis among 14 healthy adventure travelers from the United States who visited a bat-infested cave in Nicaragua. Although histoplasmosis has rarely been reported to cause serious illness among travelers, this outbreak demonstrates that cases may be severe among travelers, even young, healthy persons

2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

[Extract] Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease 1. The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life. 2. A team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions. 3. Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin. In addition, assessing for other risk-enhancing factors can help guide decisions about preventive interventions in select individuals, as can coronary artery calcium scanning. 4. All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss. 5. Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity. 6. For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist. 7. All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit. 8. Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit. 9. Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion. 10. Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg

Effective dementia education and training for the health and social care workforce: A systematic review of the literature

Ensuring an informed and effective dementia workforce is of international concern, however there remains limited understanding of how this can be achieved. This systematic review aimed to identify factors associated with effective dementia educational programmes. Critical Interpretive Synthesis underpinned by Kirkpatrick’s return on investment model for evaluation of education was applied. One hundred and fifty-two papers of variable quality were included in the review. Common features of more efficacious educational programmes included the need for educational programmes to: be relevant to participants’ role and experience; involve active face-to-face participation; underpin practice-based learning with theory; be delivered by an experienced facilitator; have a total duration of at least eight hours with individual sessions of 90 minutes or more; support application of learning in practice; and provide a structured tool or practice guideline to underpin care practice. Further robust research is required to develop the evidence base; however, the findings of this review have relevance for all working in workforce education

Exome-wide analysis of rare coding variation identifies novel associations with COPD and airflow limitation in MOCS3, IFIT3 and SERPINA12.

Several regions of the genome have shown to be associated with COPD in genome-wide association studies of common variants.To determine rare and potentially functional single nucleotide polymorphisms (SNPs) associated with the risk of COPD and severity of airflow limitation.3226 current or former smokers of European ancestry with lung function measures indicative of Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2 COPD or worse were genotyped using an exome array. An analysis of risk of COPD was carried out using ever smoking controls (n=4784). Associations with %predicted FEV1 were tested in cases. We followed-up signals of interest (p<10(-5)) in independent samples from a subset of the UK Biobank population and also undertook a more powerful discovery study by meta-analysing the exome array data and UK Biobank data for variants represented on both arrays.Among the associated variants were two in regions previously unreported for COPD; a low frequency non-synonymous SNP in MOCS3 (rs7269297, pdiscovery=3.08×10(-6), preplication=0.019) and a rare SNP in IFIT3, which emerged in the meta-analysis (rs140549288, pmeta=8.56×10(-6)). In the meta-analysis of % predicted FEV1 in cases, the strongest association was shown for a splice variant in a previously unreported region, SERPINA12 (rs140198372, pmeta=5.72×10(-6)). We also confirmed previously reported associations with COPD risk at MMP12, HHIP, GPR126 and CHRNA5. No associations in novel regions reached a stringent exome-wide significance threshold (p<3.7×10(-7)).This study identified several associations with the risk of COPD and severity of airflow limitation, including novel regions MOCS3, IFIT3 and SERPINA12, which warrant further study

Identification of sumoylation targets, combined with inactivation of SMT3, reveals the impact of sumoylation upon growth, morphology, and stress resistance in the pathogen Candida albicans

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