The Primary Care Visit: What Else Could Be Happening?

The Institute of Medicine Report called for a greater role for nurses within the context of oral health in two recent publications, Advancing Oral Health in America (2011) and Improving Access to Oral Health Care for Vulnerable and Underserved Populations (2011). Nurses provide care for many vulnerable persons, including frail and functionally dependent older adults, persons with disabilities, and persons with intellectual and developmental disabilities. These persons are the least likely to receive necessary, health-sustaining dental care (which is distinct from mouth care). The mouth, or more accurately, plaque, serves as a reservoir for bacteria and pathogens. The link between mouth care, oral health, and systemic health is well-documented; infections such as pneumonia have been linked to poor oral health. Nurses, therefore, need to reframe mouth care as oral infection control and infection control more broadly. The can provide the preventive measure that are crucial to minimizing systemic infections. Nurses in all settings can potentially provide mouth care, conduct oral health assessments, educate patients about best mouth care practices, and make dental referrals. Yet, nurses are often hesitant to do anything beyond basic oral hygiene—and even in this area, often fail to provide mouth care based on best practices

Structural Conformers of (1,3-Dithiol-2-ylidene)ethanethioamides: The Balance Between Thioamide Rotation and Preservation of Classical Sulfur-Sulfur Hypervalent Bonds

The reaction of N-(2-phthalimidoethyl)-N-alkylisopropylamines and S2Cl2 gave 4-N-(2-phthalimidoethyl)-N-alkylamino-5-chloro-1,2-dithiol-3-thiones that quantitatively cycloadded to dimethyl or diethyl acetylenedicarboxylate to give stable thioacid chlorides, which in turn reacted with one equivalent of aniline or a thiole to give thioanilides or a dithioester. Several compounds of this series showed atropisomers that were studied by a combination of dynamic NMR, simulation of the signals, conformational analysis by DFT methods, and single crystal X-ray diffraction, showing a good correlation between the theoretical calculations, the experimental values of energies, and the preferred conformations in the solid state. The steric hindering of the crowded substitution at the central amine group was found to be the reason for the presence of permanent atropisomers in this series of compounds and the cause of a unique disposition of the thioxo group at close-to-right angles with respect to the plane defined by the 1,3-dithiole ring in the dithiafulvene derivatives, thus breaking the sulfur–sulfur hypervalent bond that is always found in this kind of compounds.Ministerio de Economıá y Competitividad, Spain (Project CTQ2012- 31611), Junta de Castilla y León, Consejería de Educación y Cultura y Fondo Social Europeo (Project BU246A12-1), and the European Commission, Seventh Framework Programme (Project SNIFFER FP7-SEC-2012-312411

Measuring infrastructure: A key step in program evaluation and planning

State tobacco prevention and control programs (TCPs) require a fully functioning infrastructure to respond effectively to the Surgeon General’s call for accelerating the national reduction in tobacco use. The literature describes common elements of infrastructure; however, a lack of valid and reliable measures has made it difficult for program planners to monitor relevant infrastructure indicators and address observed deficiencies, or for evaluators to determine the association among infrastructure, program efforts, and program outcomes. The Component Model of Infrastructure (CMI) is a comprehensive, evidence-based framework that facilitates TCP program planning efforts to develop and maintain their infrastructure. Measures of CMI components were needed to evaluate the model’s utility and predictive capability for assessing infrastructure. This paper describes the development of CMI measures and results of a pilot test with nine state TCP managers. Pilot test findings indicate that the tool has good face validity and is clear and easy to follow. The CMI tool yields data that can enhance public health efforts in a funding-constrained environment and provides insight into program sustainability. Ultimately, the CMI measurement tool could facilitate better evaluation and program planning across public health programs

Perinatal Loss in Low-Income African American Parents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74050/1/0884217505280000.pd