Overcoming language barriers using an information video on spinal anesthesia for cesarean section: implementation and impact on maternal anxiety

Background It is unknown whether the implementation of an information video on spinal anesthesia for caesarean section, narrated in a patient's first language, reduces anxiety, increases satisfaction, and improves doctor-patient communication if there is a language barrier. In South Africa most doctors speak English, and patients Xhosa, with educational and cultural disparities existing in many doctor-patient interactions. Methods One hundred and seventy-five Xhosa patients scheduled for elective cesarean section were enrolled in the study. The first 92 patients received “usual care” verbal explanations of the spinal anesthesia procedure (control group); the next 83 patients watched a spinal anesthesia information video (intervention group), narrated in Xhosa. Videos were displayed using smartphones. Maternal anxiety was assessed before and after spinal explanation, using a Numerical Visual Analog Anxiety Scale (NVAAS). A difference in post-explanation NVAAS score of 1.5 points between intervention and control groups was regarded as clinically significant. Patient satisfaction was assessed using the Maternal Satisfaction Scale for Cesarean Section (MSSCS). Results The mean (SD) age (31.5 (5.2) and 32.1 (5.4) years) and pre-explanation NVAAS score (4.2 (3.2) and 4.0 (3.0)) of the intervention and control groups respectively, showed no difference at baseline. The mean (SD) post-explanation decrease in NVAAS score was greater in the intervention- than in the control group (1.6 (3.5) versus .7 (2.3), P = .046, unadjusted mean difference .9 points (95% CI .02 to 1.8)). A linear regression model for the post-explanation NVAAS score showed that the intervention effect was significantly associated with the pre-explanation score (P = .002), adjusted for age and English fluency. Patients with pre-explanation NVAAS scores ³ 5 showed a statistically significant intervention effect. There was no significant difference in patient satisfaction between the intervention and control groups. The smartphone was an accessible and convenient display medium for the video. Ninety nine percent of patients exposed to the intervention would recommend watching the video prior to the procedure. Conclusion In this pilot study, lower NVAAS scores were observed in anxious patients, when a Xhosa information video was used to ameliorate challenges posed by a doctor-patient language barrier. It is easily implemented and demonstrates a novel use of mobile health technology. The study provides baseline data to inform sample size calculations for future studies. A high level of patient recommendation for the video suggests that this is an agreeable practice

Stars and Stakeholders: Leaders Linking School Climate to Sustainable Success

“Perception is reality.” This presentation will individually address each stakeholder group within the school and discuss how their experiences impact both the climate and culture of each school. These experiences and perceptions directly tie to a school’s Climate Star Rating and in turn, the CCRPI Score. As educators and administrators we highlight our strengths and strive to tackle any concerns or issues, but even the smallest problem can escalate quickly and impact student, teacher, parent and community perceptions of your school. This session is designed to showcase effective strategies implemented throughout the Glynn County School System that are targeted at sustaining positive school climate and perception. Real-world suggestions for utilizing social media, school events and community outreach will be shared to address areas for sustainability and to provide ideas for parents to implement within the home. Presenters will also describe how multiple data trends are analyzed to determine areas of focus. Attendees will be encouraged to share their own strategies with the group so that we can grow together towards our common goal of spreading the power of positive supports to the home, school and community

Endothelial HO-1 induction by model TG-rich lipoproteins is regulated through a NOX4-Nrf2 pathway

Circulating levels of chylomicron remnants (CMRs) increase postprandially and their composition directly reflects dietary lipid intake. These TG-rich lipoproteins likely contribute to the development of endothelial dysfunction, albeit via unknown mechanisms. Here, we investigated how the FA composition of CMRs influences their actions on human aortic endothelial cells (HAECs) by comparing the effects of model CMRs—artificial TG-rich CMR-like particles (A-CRLPs)—containing TGs extracted from fish, DHA-rich algal, corn, or palm oils. HAECs responded with distinct transcriptional programs according to A-CRLP TG content and oxidation status, with genes involved in antioxidant defense and cytoprotection most prominently affected by n-3 PUFA-containing A-CRLPs. These particles were significantly more efficacious inducers of heme oxygenase-1 (HO-1) than n-6 PUFA corn or saturated FA-rich palm CRLPs. Mechanistically, HO-1 induction by all CRLPs requires NADPH oxidase 4, with PUFA-containing particles additionally dependent upon mitochondrial reactive oxygen species. Activation of both p38 MAPK and PPARβ/δ culminates in increased nuclear factor erythroid 2-related factor 2 (Nrf2) expression/nuclear translocation and HO-1 induction. These studies define new molecular pathways coupling endothelial cell activation by model CMRs with adaptive regulation of Nrf2-dependent HO-1 expression and may represent key mechanisms through which dietary FAs differentially impact progression of endothelial dysfunction

Service as Leadership

This Grants Collection for College Algebra was created under a Round Eleven ALG Textbook Transformation Grant. Affordable Learning Georgia Grants Collections are intended to provide faculty with the frameworks to quickly implement or revise the same materials as a Textbook Transformation Grants team, along with the aims and lessons learned from project teams during the implementation process. Documents are in .pdf format, with a separate .docx (Word) version available for download. Each collection contains the following materials: Linked Syllabus Initial Proposal Final Reporthttps://oer.galileo.usg.edu/business-collections/1008/thumbnail.jp

Behavioral and Psychological Aspects of Physical Education and Coaching

This Grants Collection for Behavioral and Psychological Aspects of Physical Education and Coaching was created under a Round Eleven ALG Textbook Transformation Grant. Affordable Learning Georgia Grants Collections are intended to provide faculty with the frameworks to quickly implement or revise the same materials as a Textbook Transformation Grants team, along with the aims and lessons learned from project teams during the implementation process. Documents are in .pdf format, with a separate .docx (Word) version available for download. Each collection contains the following materials: Linked Syllabus Initial Proposal Final Reporthttps://oer.galileo.usg.edu/education-collections/1009/thumbnail.jp

Programming and Problem Solving I

This Grants Collection for Programming and Problem Solving I was created under a Round Eleven ALG Textbook Transformation Grant. Affordable Learning Georgia Grants Collections are intended to provide faculty with the frameworks to quickly implement or revise the same materials as a Textbook Transformation Grants team, along with the aims and lessons learned from project teams during the implementation process. Documents are in .pdf format, with a separate .docx (Word) version available for download. Each collection contains the following materials: Linked Syllabus Initial Proposal Final Reporthttps://oer.galileo.usg.edu/compsci-collections/1020/thumbnail.jp

High-fat meals rich in EPA plus DHA compared with DHA only have differential effects on postprandial lipemia and plasma 8-isoprostane F-2 alpha concentrations relative to a control high-oleic acid meal: a randomized controlled trial

Background: Eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation has beneficial cardiovascular effects, but postprandial influences of these individual fatty acids are unclear. Objectives: The primary objective was to determine the vascular effects of EPA + DHA compared with DHA only during postprandial lipemia relative to control high–oleic acid meals; the secondary objective was to characterize the effects of linoleic acid–enriched high-fat meals relative to the control meal. Design: We conducted a randomized, controlled, double-blind crossover trial of 4 high-fat (75-g) meals containing 1) high–oleic acid sunflower oil (HOS; control), 2) HOS + fish oil (FO; 5 g EPA and DHA), 3) HOS + algal oil (AO; 5 g DHA), and 4) high–linoleic acid sunflower oil (HLS) in 16 healthy men (aged 35–70 y) with higher than optimal fasting triacylglycerol concentrations (mean ± SD triacylglycerol, 1.9 ± 0.5 mmol/L). Results: Elevations in triacylglycerol concentration relative to baseline were slightly reduced after FO and HLS compared with the HOS control (P < 0.05). The characteristic decrease from baseline in plasma nonesterified fatty acids after a mixed meal was inhibited after AO (Δ 0–3 h, P < 0.05). HLS increased the augmentation index compared with the other test meals (P < 0.05), although the digital volume pulse–reflection index was not significantly different. Plasma 8-isoprostane F(2α) analysis revealed opposing effects of FO (increased) and AO (reduced) compared with the control (P < 0.05). No differences in nitric oxide metabolites were observed. Conclusions: These data show differential postprandial 8-isoprostane F(2α) responses to high-fat meals containing EPA + DHA–rich fish oil compared with DHA-rich AO, but these differences were not associated with consistent effects on postprandial vascular function or lipemia. More detailed analyses of polyunsaturated fatty acid–derived lipid mediators are required to determine possible divergent functional effects of single meals rich in either DHA or EPA. This trial was registered at clinicaltrials.gov as NCT01618071

Divide and rule: Frontinus and Roman land-surveying

This paper aims to cast new light on one of our main sources for ancient science, Sextus Julius Frontinus; to cast new light on the science of the Graeco-Roman period; and to contribute ancient materials to present discussions on the relations between power and knowledge, and/or science and empire

A novel strategy for the targeted analysis of protein and peptide metabolites

The detection and quantitation of exogenously administered biological macromolecules (e.g. vaccines, peptide and protein therapeutics) and their metabolites is frequently complicated by the presence of a complex endogenous mixture of closely related compounds. We describe a method that incorporates stable isotope labeling of the compound of interest allowing the selective screening of the intact molecule and all metabolites using a modified precursor ion scan. This method involves monitoring the low molecular weight fragment ions produced during MS/MS that distinguish isotopically labelled material from related endogenous compounds. All isotopically labelled substances can be selected using this scanning technique for further analysis whilst other unlabelled and irrelevant substances are ignored. The potential for this technique to be used in metabolism and pharmacokinetic experiments is discussed with specific examples looking at the metabolism of &#x3b1;-synuclein in serum and the brain