Mothers\u27 Experiences in the Nurse-Family Partnership Program: A Qualitative Case Study

BACKGROUND:Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers\u27 experiences participating in the Nurse-Family Partnership (NFP) Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant\u27s first birthday.METHODS:A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently.RESULTS:The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent.CONCLUSIONS:Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers\u27 perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers\u27 unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation

Prescription Of analgesia in Emergency Medicine (POEM): a multicentre observational survey of pain relief in patients presenting with an isolated limb fracture and/or dislocation

Background: Acute pain is one of the most commonly cited reasons for attendance to the emergency department (ED), and the Royal College of Emergency Medicine (RCEM) Best Practice Guideline (2014) acknowledged that the current management of acute pain in UK EDs is inadequate and has a poor evidence base. Methods: The Prescription Of analgesia in Emergency Medicine (POEM) survey is a cross-sectional observational survey of consecutive patients presenting to 12 National Health Service (NHS) EDs with limb fracture and/or dislocation in England and Scotland and was carried out between 2015 and 2017. The primary outcome was to assess the adequacy of pain management in the ED against the recommendations in the RCEM Best Practice Guidelines. Results: In all, 8346 patients were identified as attending the ED with a limb fracture and/or dislocation but adherence to RCEM guidelines could only be evaluated for the 4160 (49.8%) patients with a recorded pain score. Of these, 2409/4160 (57.9%) patients received appropriate pain relief, but only 1347 patients were also assessed within 20 minutes of their arrival in the ED. Therefore, according to the RCEM guidelines, only 16.1% (1347/8346) of all patients were assessed and had satisfactory pain management in the ED. Conclusions: The POEM survey has identified that pain relief for patients with an isolated limb fracture remains inadequate when strictly compared to the RCEM Best Practice Guidelines. However, we have found that some patients receive analgesia despite having no pain score recorded, while other analgesic modalities are provided that are not currently encompassed by the Best Practice Guidelines. Future iterations of these guidelines may wish to encompass the breadth of available modalities of pain relief and the whole patient journey. In addition, more work is needed to improve timely and repeated assessment of pain and its recording, which has been better achieved in some EDs than others

British Columbia Healthy Connections Project Process Evaluation: A Mixed Methods Protocol to Describe the Implementation and Delivery of the Nurse-Family Partnership in Canada

Background The Nurse-Family Partnership is a home visitation program for first-time, socially and economically disadvantaged mothers. The effectiveness of this public health intervention has been well established in the United States; however, whether the same beneficial outcomes will be obtained within the Canadian context is unknown. As part of the British Columbia Healthy Connections Project, which includes a trial comparing Nurse-Family Partnership’s effectiveness with existing services in British Columbia, we are conducting a process evaluation to describe and explain how the intervention is implemented and delivered across five regional Health Authorities. Methods A convergent parallel mixed methods research design will be used to address the process evaluation objectives. The principles of interpretive description will guide all sampling, data collection and analytic decisions in the qualitative component of the study. The full population of public health nurses and supervisors (n = 71) will discuss their experiences of implementing and delivering the program in interviews (or focus groups). Managers (n  = 5–15) responsible for this portfolio will also be interviewed annually. Fidelity reports with quantitative data on the reach and the dose of the intervention will be collected and analyzed. Summaries of team meetings and supervisory sessions will be analyzed. Data will be used to compare, corroborate and explain results and variances across the five regional Health Authorities. Discussion The process evaluation results will be of immediate instrumental use to the program implementers to inform intervention delivery. Findings will contribute to the emerging body of evidence surrounding: 1) professional nurse home visitation practice issues; 2) best practices for meeting the needs of families living in rural and remote communities; 3) a deeper understanding of how health and social issues such as mental health problems including substance misuse and exposure to intimate partner violence affect a young mother’s capacity to parent; and 4) strategies to support professionals from the primary care, public health and child welfare sectors to work collaboratively to meet the needs of children and families who are at risk or experiencing maltreatment

Prescription Of analgesia in Emergency Medicine (POEM) secondary analysis: an observational multicentre comparison of pain relief provided to adults and children with an isolated limb fracture and/or dislocation

Background: Acute pain is a common reason for emergency department (ED) attendance. Royal College of Emergency Medicine (RCEM) pain management audits have shown national variation and room for improvement. Previous evidence suggests that children receive less satisfactory pain management than adults. Methods: Prescription of analgesia in emergency medicine is a cross-sectional observational study of consecutive patients presenting to 12 National Health Service EDs with an isolated long bone fracture and/ or dislocation, and was carried out between 2015 and 2017. Using the recommendations in the RCEM Best Practice Guidelines, pain management in ED was assessed for differences of age (adults vs children) and hospital type (children’s vs all patients). Results: From the total 8346 patients, 38% were children (median age 8 years). There was better adherence to the RCEM guidance for children than adults (24% (766/3196) vs 11% (579/5123)) for the combined outcome of timely assessment, pain score and appropriate analgesia. In addition, children were significantly more likely than adults to receive analgesia appropriate to the pain score (of those with a recorded pain score 67% (1168/1744) vs 52% (1238/2361)). Children’s hospitals performed much better across all reported outcomes compared with general hospitals. Conclusions: In contrast to previous studies, children with a limb fracture/dislocation are more likely than adults to have a pain score documented and to receive appropriate analgesia. Unexpectedly, children’s EDs performed better than general EDs in relation to timely and appropriate analgesia but the reasons for this are not apparent from the present study

LI-Detector:a Method for Curating Ordered Gene-Replacement Libraries

In recent years the availability of genome sequence information has grown logarithmically resulting in the identification of a plethora of uncharacterized genes. To address this gap in functional annotation, many high-throughput screens have been devised to uncover novel gene functions. Gene-replacement libraries are one such tool that can be screened in a high-throughput way to link genotype and phenotype and are key community resources. However, for a phenotype to be attributed to a specific gene, there needs to be confidence in the genotype. Construction of large libraries can be laborious and occasionally errors will arise. Here, we present a rapid and accurate method for the validation of any ordered library where a gene has been replaced or disrupted by a uniform linear insertion (LI). We applied our method (LI-detector) to the well-known Keio library of Escherichia coli gene-deletion mutants. Our method identified 3,718 constructed mutants out of a total of 3,728 confirmed isolates, with a success rate of 99.7% for identifying the correct kanamycin cassette position. This data set provides a benchmark for the purity of the Keio mutants and a screening method for mapping the position of any linear insertion, such as an antibiotic resistance cassette in any ordered library. IMPORTANCE The construction of ordered gene replacement libraries requires significant investment of time and resources to create a valuable community resource. During construction, technical errors may result in a limited number of incorrect mutants being made. Such mutants may confound the output of subsequent experiments. Here, using the remarkable E. coli Keio knockout library, we describe a method to rapidly validate the construction of every mutant.</p

Contribution to Research with Regard to the Activities of Ruđer Josip Bošković as a Surveyor and Cartographer

U radu je dan pregled života i rada Ruđera Boškovica, a posebno je istaknut njegov rad kao geodeta i kartografa. Boškovic je dao velik doprinos ondašnjoj geodeziji i izmjeri svojim inovacijama koje je potom prvi upotrijebio za postizanje veće točnosti mjerenja. Zaključio je da ondašnje postojeće karte ne zadovoljavaju potrebe zaključivanja u stručnim ekspertizama. Kao rezultat mjerenja i računanja na putovanjima koja je proveo, izradio je kartu Crkvene države i često davao mišljenje uz kritički osvrt prema drugim ekspertizama i stručnjacima.This paper presents an overview of the work of Ruler Josip Boškovic, emphasising his activities as a cartographer and surveyor. Boškovic made a great contribution to the geodesy and surveying of his time through innovations which he initially used to achieve better accuracy of measurement. He concluded that existing maps did not meet the needs of professional and expert use. As a result of his surveying and travels, he made a Map of the Ecclesiastical State, often appending his opinions and criticisms of other experts

The NAD+-dependent protein deacetylase activity of SIRT1 is regulated by its oligomeric status

SIRT1, a NAD+-dependent protein deacetylase, is an important regulator in cellular stress response and energy metabolism. While the list of SIRT1 substrates is growing, how the activity of SIRT1 is regulated remains unclear. We have previously reported that SIRT1 is activated by phosphorylation at a conserved Thr522 residue in response to environmental stress. Here we demonstrate that phosphorylation of Thr522 activates SIRT1 through modulation of its oligomeric status. We provide evidence that nonphosphorylated SIRT1 protein is aggregation-prone in vitro and in cultured cells. Conversely, phosphorylated SIRT1 protein is largely in the monomeric state and more active. Our findings reveal a novel mechanism for environmental regulation of SIRT1 activity, which may have important implications in understanding the molecular mechanism of stress response, cell survival, and aging

Measuring health-relevant businesses over 21 years: refining the National Establishment Time-Series (NETS), a dynamic longitudinal data set

Background The densities of food retailers, alcohol outlets, physical activity facilities, and medical facilities have been associated with diet, physical activity, and management of medical conditions. Most of the research, however, has relied on cross-sectional studies. In this paper, we assess methodological issues raised by a data source that is increasingly used to characterize change in the local business environment: the National Establishment Time Series (NETS) dataset. Discussion Longitudinal data, such as NETS, offer opportunities to assess how differential access to resources impacts population health, to consider correlations among multiple environmental influences across the life course, and to gain a better understanding of their interactions and cumulative health effects. Longitudinal data also introduce new data management, geoprocessing, and business categorization challenges. Examining geocoding accuracy and categorization over 21 years of data in 23 counties surrounding New York City (NY, USA), we find that health-related business environments change considerably over time. We note that re-geocoding data may improve spatial precision, particularly in early years. Our intent with this paper is to make future public health applications of NETS data more efficient, since the size and complexity of the data can be difficult to exploit fully within its 2-year data-licensing period. Further, standardized approaches to NETS and other “big data” will facilitate the veracity and comparability of results across studies

シンカリキュラム ニ ムケテ ノ ダンカイテキ トリクミ : シズオカ ブンカ ゲイジュツ ダイガク ニ オケル エイゴ キョウイク カイカク ニ カンスル ホウコク

本稿は静岡文化芸術大学における英語教育改革の多面的な取り組みについて報告するものである。現カリキュラムおける取り組みを振り返ることは、2015年からはじまる新カリキュラムの開発とって意義があると考える。ここ数年でなされてきたカリキュラムレベルにおける改革は、教育方針、実践方法、などである。具体的には、授業内容(文政学部とデザイン学部の共同授業、共通テキスト使用など)や共通課題(オンラインTOEIC 練習、多読、e-learning)を充実するなど段階的な改革を行っている。さらには、カリキュラムを補完するものとして、課外活動の充実も図っている。授業外で英語を向上させる諸活動(ESS、スピーチコンテストや討論への参加、インターナショナルフォーラム開催)について紹介する。また、これらをシステマティクに動かしていくためのコーディネーション、ミーティング、役割の明確化などについても報告する。This paper reports on the multifaceted steps taken to improve English language education at Shizuoka University of Art and Culture(SUAC). This report is a reflection on the progress made in the current program. By taking stock of what is presently being done, theauthors will subsequently be able to develop plans for the next English curriculum in 2015. The improvements, implemented overa number of years, include changes at the curricular level in educational policies and practices such as the use of an online TOEICsystem, the implementation of an Extensive Reading program, a subscription to an E-learning system, the use of common textbooks,and an English course collaboration between the Design and Cultural Policy and Management Faculties. Furthermore, to complementthese additions that have strengthened SUAC\u27s English courses, a number of extracurricular activities such as the founding of anEnglish Speaking Society, hosting of an English speech contest, participation in an English Model United Nations, and the organizationof International Community Forums have been carried out on campus. After explaining the steps taken to improve English courses,coursework, assignments, and teaching materials, information will be given about the opportunities provided to students to continueimproving English outside of the classroom. To make these improvements happen, systematic coordination including English meetingsand the delegation of roles and responsibilities has taken place and will continue to be refined