Wound Related Pain Management in a Community Healthcare Setting

Chronic wounds affect millions of individuals in the United States with a large percentage of these individuals experiencing wound-related pain. Dressing removal has been reported to be the most painful procedure related to wound care. Pain is typically well controlled in the hospital setting, but once the patient leaves, pain control becomes more difficult in the community setting. It is not clear why pain management is more difficult for community-dwelling individuals. The purpose of this program evaluation is to evaluate pain management strategies in a community-dwelling population. The setting for this program evaluation is an outpatient wound healing clinic in rural eastern North Carolina which serves between 50-60 individuals/day. Clients of all ages receive wound care for diabetic ulcers, pressure ulcers, trauma wounds, and burns. In collaboration with a wound care Registered Nurse, a chart audit tool was developed to evaluate factors such as demographic profile, wound type, dressing type, pain management strategy, pain scale during wound care, and dressing change frequency. The audit tool will also look at if the patient’s reported pain is controlled or uncontrolled, and if a change in the management plan was documented for those with uncontrolled pain. These factors will be compared to the most recent evidence-based practices for wound management

Goo - Goo Land

https://digitalcommons.library.umaine.edu/mmb-vp/5276/thumbnail.jp

Goo - Goo Land

https://digitalcommons.library.umaine.edu/mmb-vp/5277/thumbnail.jp

Choosing The Right Path: Analysis Of Axon Guidance In Peripheral Nerve Regeneration

After injury, axons of the peripheral nervous system (PNS) regenerate, and yet functional recovery from peripheral nerve injury is rare. This is because PNS axons regrow slowly and often toward inappropriate targets. Peripheral nerves are composed of bundles of axons that exit the spinal cord via a shared path and then diverge toward different targets forming a complex meshwork of nerve branches. These branched bundles of axons are encased in layers of glia, endothelial cells, and associated extracellular matrix (ECM). After nerve injury, severed axons degenerate and are cleared away, but the encasing cells and ECM beyond the injury site remain as branched tube-like structures that lead to nerve targets. To reconnect with their pre-injury targets, regenerating axons must navigate through these nerve tubes. Importantly, at points where nerve tubes diverge into multiple branches (branch-points), regenerating axons must select the branch that leads to their pre-injury target. Despite important implications for functional recovery, the mechanisms that guide regenerating axons at nerve branch-points are poorly understood. To probe the cellular and molecular mechanisms that guide regenerating axons, we exploit the simple architecture of spinal motor nerves in larval zebrafish, which are composed of two axonal populations that initially share a common path but diverge at a stereotyped branch-point to innervate dorsal or ventral muscles. After laser nerve transection, axons regenerate along their original nerve branch \u3e80% of the time. Using genetic mutants and in vivo time-lapse imaging, we demonstrate that the repulsive axon guidance receptor robo2 is necessary and sufficient to promote axon regeneration along the dorsal branch. During regeneration, a small subset of glia at the nerve branch-point upregulate the Robo-ligand slit1a and the ECM component col4a5. We demonstrate that robo2 functions in a common molecular pathway with col4a5 to guide regenerating axons dorsally, and that the spatiotemporal restriction of col4a5 to the nerve branch-point during regeneration is required to guide regenerating dorsal axons. Our results provide the first cell-autonomous mechanism by which regenerating axons select between nerve branches during regeneration and provide a molecular pathway by which glia at a nerve branch-point guide regenerating axons via local ECM modifications

The Berardenga Antependium and the Passio Ymaginis Office

Table S1. Signatures summary. A summary of 33 signatures about the platforms derived from, the subtypes used for, the gene number included, and the function terms involved. Table S8. The number of function terms in each signature. (PDF 82 kb

Evaluation of fecal contamination by seagulls in an urban estuarine environment using microbiological and molecular approaches

Wild birds are important non-point sources of fecal contamination of surface waters, as they have been reported to excrete large amounts of fecal indicator bacteria and occasionally harbor enteric pathogens, such as Campylobacter and Salmonella. Hundreds of waterfowl frequent the sandflats within Talbert Marsh, a constructed wetland in Orange County, CA, on a daily basis for nesting and feeding purposes. The focus of this study was on the role of seagull fecal contamination as a potentially important contributor to the non-point sources of fecal contamination into Talbert Marsh waters, which eventually flow into the recreational surf-zone at Huntington Beach. Using traditional microbiological methods, Salmonella, Campylobacter, F+ coliphages, and bacterial indicators were isolated from Talbert Marsh seagull feces and/or estuarine waters. Genotypic methods, including PCR, RT-PCR, reverse line blot hybridization, PFGE, and nucleotide and amino acid sequencing, were employed on subsets of frozen suspensions of isolates for further characterization and to determine genetic relatedness. There is some limited evidence supporting the idea that seagull feces deposited on the sandflats of Talbert Marsh did impact the surrounding estuarine waters. A subset of isolates were relatively similar in both nucleotide and amino acid sequence and therefore may have come from the same population. Overall however, it is unlikely that pathogens from seagull feces in Talbert Marsh pose a significant health risk to swimmers in the ocean waters at Huntington Beach. Multiple adverse health outcomes have been linked to exposure to marine recreational water of poor microbiologic quality and identifying sources of fecal contamination as human or animal in origin is becoming a more important tool in decision making to manage fecal contamination of these waters

Novel application of synchrotron x-ray computed tomography for ex-vivo imaging of subcutaneously-injected polymeric microsphere suspension formulations

Purpose: Subcutaneously or intramuscularly administered biodegradable microsphere formulations have been successfully exploited in the management of chronic conditions for over two decades, yet mechanistic understanding of the impact of formulation attributes on in vivo absorption rate from such systems is still in its infancy. Methods: Suspension formulation physicochemical attributes may impact particulate deposition in subcutaneous (s.c.) tissue. Hence, the utility of synchrotron X-ray microcomputed tomography (μCT) for assessment of spatial distribution of suspension formulation components (PLG microspheres and vehicle) was evaluated in a porcine s.c. tissue model. Optical imaging of dyed vehicle and subsequent microscopic assessment of microsphere deposition was performed in parallel to compare the two approaches. Results: Our findings demonstrate that synchrotron μCT can be applied to the assessment of microsphere and vehicle distribution in s.c. tissue, and that microspheres can also be visualised in the absence of contrast agent using this approach. The technique was deemed superior to optical imaging of macrotomy for the characterisation of microsphere deposition owing to its non-invasive nature and relatively rapid data acquisition time. Conclusions: The μCT method outlined in this study provides a novel insight into the relative distribution of vehicle and suspended PLG microspheres following s.c. injection. A potential application for our findings is understanding the impact of injection, device and formulation variables on initial and temporal depot geometry in pre-clinical or ex-vivo models that can inform product design

Effectiveness of the ADEC as a level 2 screening test for young children with suspected autism spectrum disorders in a clinical setting

Background The Autism Detection in Early Childhood (ADEC) is a clinician-administered, Level 2 screening tool. A retrospective file audit was used to investigate its clinical effectiveness. Method Toddlers referred to an Australian child development service between 2008 and 2010 (N?=?53, M age?=?32.2 months) were screened with the ADEC. Their medical records were reviewed in 2013 when their mean age was 74.5 months, and the original ADEC screening results were compared with later diagnostic outcomes. Results The ADEC had good sensitivity (87.5%) and moderate specificity (62%). Three behaviours predicted autism spectrum disorders (ASDs): response to name, gaze switching, and gaze monitoring (p???.001). Conclusions The ADEC shows promise as a screening tool that can discriminate between young children with ASDs and those who have specific communication disorders or developmental delays that persist into middle childhood but who do not meet the criteria for ASDs