The Community Nurse in Australia. Who are they? A rapid systematic review.

AimTo profile the community nurse in Australia.BackgroundThe need for nurses in the community health care sector is increasing in response to shorter hospital stays, an ageing population and chronic disease. The increase in demand has not been followed by appropriate workforce planning, leading to structural issues and lack of qualified nursing workforce in the community sector.EvaluationMEDLINE and ProQuest Public Health and grey literature were searched for records published between 2010-2020 relative to the profile of the community nurse in Australia. Twenty-five records (21 publications, two databases and two reports) were included in the review. Abstracted data followed the principles of workforce planning, and included demographics, qualifications and roles.Key issuesInconsistent definitions, self-reported data and a focus on practice nurses have contributed to data irregularities. Little is known about the specific aspects of community nursing work.ConclusionA lack of concrete data has over-shadowed a community nursing workforce crisis with implications for patients' health and safety across the lifespan.Implications for nursing managementThere is urgent need for nurse managers globally to refocus nursing recruitment to the community sector to maintain quality and ensure sustainability of the nursing workforce

Minimal breast milk transfer of rituximab, a monoclonal antibody used in neurological conditions.

ObjectiveTo determine the transfer of rituximab, an anti-CD20 monoclonal antibody widely used for neurologic conditions, into mature breast milk.MethodsBreast milk samples were collected from 9 women with MS who received rituximab 500 or 1,000 mg intravenous once or twice while breastfeeding from November 2017 to April 2019. Serial breast milk samples were collected before infusion and at 8 hours, 24 hours, 7 days, and 18-21 days after rituximab infusion in 4 patients. Five additional patients provided 1-2 samples at various times after rituximab infusion.ResultsThe median average rituximab concentration in mature breast milk was low at 0.063 μg/mL (range 0.046-0.097) in the 4 patients with serial breast milk collection, with an estimated median absolute infant dose of 0.0094 mg/kg/d and a relative infant dose (RID) of 0.08% (range 0.06%-0.10%). Most patients had a maximum concentration at 1-7 days after infusion. The maximum concentration occurred in a woman with a single breast milk sample and was 0.29 μg/mL at 11 days postinfusion, which corresponds with an estimated RID of 0.33%. Rituximab concentration in milk was virtually undetectable by 90 days postinfusion.ConclusionsWe determined minimal transfer of rituximab into mature breast milk. The RID for rituximab was less than 0.4% and well below theoretically acceptable levels of less than 10%. Low oral bioavailability would probably also limit the absorption of rituximab by the newborn. In women with serious autoimmune neurologic conditions, monoclonal antibody therapy may afford an acceptable benefit to risk ratio, supporting both maternal treatment and breastfeeding

Comparative Study of 3-Dimensional Woven Joint Architectures for Composite Spacecraft Structures

The National Aeronautics and Space Administration (NASA) Exploration Systems Mission Directorate initiated an Advanced Composite Technology (ACT) Project through the Exploration Technology Development Program in order to support the polymer composite needs for future heavy lift launch architectures. As an example, the large composite structural applications on Ares V inspired the evaluation of advanced joining technologies, specifically 3D woven composite joints, which could be applied to segmented barrel structures needed for autoclave cured barrel segments due to autoclave size constraints. Implementation of these 3D woven joint technologies may offer enhancements in damage tolerance without sacrificing weight. However, baseline mechanical performance data is needed to properly analyze the joint stresses and subsequently design/down-select a preform architecture. Six different configurations were designed and prepared for this study; each consisting of a different combination of warp/fill fiber volume ratio and preform interlocking method (Z-fiber, fully interlocked, or hybrid). Tensile testing was performed for this study with the enhancement of a dual camera Digital Image Correlation (DIC) system which provides the capability to measure full-field strains and three dimensional displacements of objects under load. As expected, the ratio of warp/fill fiber has a direct influence on strength and modulus, with higher values measured in the direction of higher fiber volume bias. When comparing the Z-fiber weave to a fully interlocked weave with comparable fiber bias, the Z-fiber weave demonstrated the best performance in two different comparisons. We report the measured tensile strengths and moduli for test coupons from the 6 different weave configurations under study

Novel synthesis of porous aluminium and its application in hydrogen storage

A novel approach for confining LiBH4 within a porous aluminium scaffold was applied in order to enhance its hydrogen storage properties, relative to conventional techniques for confining complex hydrides. The porous aluminium scaffold was fabricated by sintering NaAlH4, which was in the form of a dense pellet, under dynamic vacuum. The final product was a porous aluminium scaffold with the Na and H2 having been removed from the initial pellet. This technique contributed to achieving highly dispersed LiBH4 particles that were also destabilised by the presence of the aluminium scaffold. In this study, the effectiveness of this novel fabrication method of confined/destabilised LiBH4 was extensively investigated, which aimed to simultaneously improve the hydrogen release at lower temperature and the kinetics of the system. These properties were compared with the properties of other confined LiBH4 samples found in the literature. As-synthesised samples were characterised using Scanning Electron Microscopy (SEM), X-ray Diffraction (XRD) and Nitrogen Adsorption measurements. The hydrogen storage capacity of all samples was analysed using temperature programmed desorption in order to provide a comprehensive survey of their hydrogen desorption properties. The porous aluminium scaffold has a wide pore size distribution with most of the porosity due to pores larger than 50 nm. Despite this the onset hydrogen desorption temperature (Tdes) of the LiBH4 infiltrated into the porous aluminium scaffold was 200 °C lower than that of bulk LiBH4 and 100 °C lower than that of nanosized LiBH4. Partial cycling could be achieved below the melting point of LiBH4 but the kinetics of hydrogen release decreased with cycle number

The community nurse in Australia. Who are they? : a rapid systematic review

Aim: This study aimed to profile the community nurse in Australia. Background: The need for nurses in the community health care sector is increasing in response to shorter hospital stays, an aging population and chronic disease. The increase in demand has not been followed by appropriate workforce planning, leading to structural issues and lack of qualified nursing workforce in the community sector. Evaluation: MEDLINE and ProQuest Public Health and grey literature were searched for records published between 2010 and 2020 relative to the profile of the community nurse in Australia. Twenty-five records (21 publications, 2 databases and 2 reports) were included in the review. Abstracted data followed the principles of workforce planning and included demographics, qualifications and roles. Key Issues: Inconsistent definitions, self-reported data and a focus on practice nurses have contributed to data irregularities. Little is known about the specific aspects of community nursing work. Conclusion: A lack of concrete data has overshadowed a community nursing workforce crisis with implications for patients' health and safety across the lifespan. Implications for Nursing Management: There is urgent need for nurse managers globally to refocus nursing recruitment to the community sector to maintain quality and ensure sustainability of the nursing workforce

Extended H? emission line sources from UWISH2

We present the extended source catalogue for the UKIRT Wide Field Infrared Survey for H2 (UWISH2). The survey is unbiased along the inner Galactic Plane from l ? 357° to l ? 65° and |b| ? 1.5° and covers 209 deg2. A further 42.0 and 35.5 deg2 of high dust column density regions have been targeted in Cygnus and Auriga. We have identified 33 200 individual extended H2 features. They have been classified to be associated with about 700 groups of jets and outflows, 284 individual (candidate) planetary nebulae, 30 supernova remnants and about 1300 photodissociation regions. We find a clear decline of star formation activity (traced by H2 emission from jets and photodissociation regions) with increasing distance from the Galactic Centre. About 60 per cent of the detected candidate planetary nebulae have no known counterpart and 25 per cent of all supernova remnants have detectable H2 emission associated with them

High site-fidelity in common bottlenose dolphins despite low salinity exposure and associated indicators of compromised health

Funding for this work was provided by the National Fish and Wildlife Foundation Gulf Environmental Benefit Fund (https://www.nfwf.org/gulf-environmental-benefit-fund; contract number 57223) to CS under subcontracts to Abt Associates Inc.More than 2,000 common bottlenose dolphins (Tursiops truncatus) inhabit the Barataria Bay Estuarine System in Louisiana, USA, a highly productive estuary with variable salinity driven by natural and man-made processes. It was unclear whether dolphins that are long-term residents to specific areas within the basin move in response to fluctuations in salinity, which at times can decline to 0 parts per thousand in portions of the basin. In June 2017, we conducted health assessments and deployed satellite telemetry tags on dolphins in the northern portions of the Barataria Bay Estuarine System Stock area (9 females; 4 males). We analyzed their fine-scale movements relative to modeled salinity trends compared to dolphins tagged near the barrier islands (higher salinity environments) from 2011 to 2017 (37 females; 21 males). Even though we observed different movement patterns among individual dolphins, we found no evidence that tagged dolphins moved coincident with changes in salinity. One tagged dolphin spent at least 35 consecutive days, and 75 days in total, in salinity under 5 parts per thousand. Health assessments took place early in a seasonal period of decreased salinity. Nonetheless, we found an increased prevalence of skin lesions, as well as abnormalities in serum biochemical markers and urine:serum osmolality ratios for dolphins sampled in lower salinity areas. This study provides essential information on the likely behavioral responses of dolphins to changes in salinity (e.g., severe storms or from the proposed Mid-Barataria Sediment Diversion project) and on physiological markers to inform the timing and severity of impacts from low salinity exposure.Publisher PDFPeer reviewe

Quantifying injury to common bottlenose dolphins from the Deepwater Horizon oil spill using an age-, sex- and class-structured population model

Field studies documented increased mortality, adverse health effects, and reproductive failure in common bottlenose dolphins Tursiops truncatus following the Deepwater Horizon (DWH) oil spill. In order to determine the appropriate type and amount of restoration needed to compensate for losses, the overall extent of injuries to dolphins had to be quantified. Simply counting dead individuals does not consider long-term impacts to populations, such as the loss of future reproductive potential from mortality of females, or the chronic health effects that continue to compromise survival long after acute effects subside. Therefore, we constructed a sex- and agestructured model of population growth and included additional class structure to represent dolphins exposed and unexposed to DWH oil. The model was applied for multiple stocks to predict injured population trajectories using estimates of post-spill survival and reproductive rates. Injured trajectories were compared to baseline trajectories that were expected had the DWH incident not occurred. Two principal measures of injury were computed: (1) lost cetacean years (LCY); the difference between baseline and injured population size, summed over the modeled time period, and (2) time to recovery; the number of years for the stock to recover to within 95% of baseline. For the dolphin stock in Barataria Bay, Louisiana, the estimated LCY was substantial: 30 347 LCY (95% CI: 11 511 to 89 746). Estimated time to recovery was 39 yr (95% CI: 24 to 80). Similar recovery timelines were predicted for stocks in the Mississippi River Delta, Mississippi Sound, Mobile Bay and the Northern Coastal Stock.Publisher PDFPeer reviewe

Individual-Based Model Framework to Assess Population Consequences of Polychlorinated Biphenyl Exposure in Bottlenose Dolphins

Marine mammals are susceptible to the effects of anthropogenic contaminants. Here we examine the effect of different polychlorinated biphenyl (PCB) accumulation scenarios on potential population growth rates using, as an example, data obtained for the population of bottlenose dolphins from Sarasota Bay, Florida. To achieve this goal, we developed an individual-based model framework that simulates the accumulation of PCBs in the population and modifies first-year calf survival based on maternal blubber PCB levels. In our example the current estimated annual PCB accumulation rate for the Sarasota Bay dolphin population might be depressing the potential population growth rate. However, our predictions are limited both by model naivety and parameter uncertainty. We emphasize the need for more data collection on the relationship between maternal blubber PCB levels and calf survivorship, the annual accumulation of PCBs in the blubber of females, and the transfer of PCBs to the calf through the placenta and during lactation. Such data require continued efforts directed toward long-term studies of known individuals in wild and semi-wild populations

Amylin and beta amyloid proteins interact to form amorphous heterocomplexes with enhanced toxicity in neuronal cells

Human pancreatic islet amyloid polypeptide (hIAPP) and beta amyloid (Aβ) can accumulate in Type 2 diabetes (T2D) and Alzheimer’s disease (AD) brains and evidence suggests that interaction between the two amyloidogenic proteins can lead to the formation of heterocomplex aggregates. However, the structure and consequences of the formation of these complexes remains to be determined. The main objective of this study was to characterise the different types and morphology of Aβ-hIAPP heterocomplexes and determine if formation of such complexes exacerbate neurotoxicity. We demonstrate that hIAPP promotes Aβ oligomerization and formation of small oligomer and large aggregate heterocomplexes. Co-oligomerized Aβ42-hIAPP mixtures displayed distinct amorphous structures and a 3-fold increase in neuronal cell death as compared to Aβ and hIAPP alone. However, in contrast to hIAPP, non-amyloidogenic rat amylin (rIAPP) reduced oligomer Aβ-mediated neuronal cell death. rIAPP exhibited reductions in Aβ induced neuronal cell death that was independent of its ability to interact with Aβ and form heterocomplexes; suggesting mediation by other pathways. Our findings reveal distinct effects of IAPP peptides in modulating Aβ aggregation and toxicity and provide new insight into the potential pathogenic effects of Aβ-IAPP hetero-oligomerization and development of IAPP based therapies for AD and T2D