High fidelity full sized human patient simulation manikins: Effects on decision making skills of nursing students

Background: The continued use of high fidelity full sized human patient simulation manikins (HF-HPSMs) for developing decision making skills of nursing students has led to growing research focusing its value on student learning and decision making skills. Methods: In October 2012, a cross-sectional survey using the 24-item Nurse Decision-Making Instrument was used to explore the decision making process of 232 pre-registration nursing students (age 22.0 + 5.4; 83.2% female) in Singapore. Results: The independent samples t-tests demonstrated three significant predictive indicators. These indicators include: prior experience in high fidelity simulation based on pre-enrolled nursing course (t = 70.6, p = .001), actual hands-on practice (t = 69.66, p < .005) and active participation in debrief (t = 70.11, p < .005). A complete experience based on role-playing followed by active discussion in debrief was a significant contributor to the decision making process (t = 73.6667, p < .005). However, the regression model indicated active participation in debrief as a significant variable which explained its development (t = 12.633, p < .005). Conclusions: This study demonstrated the usefulness of active participation in simulation learning for an analytic- intuitive approach to decision making, however active participation in debrief was a more important influencing element than role-playing. In situations where resources are limited for students to experience hands-on role-playing, peer reviewing and feedback on others’ experiences could benefit students, just as much. However, further study is warranted to determine the development of HF-HPSMs as a pedagogic tool for enhancing the decision making process of nursing students

Does linguistic input play the same role in language learning for children with and without early brain injury?

Children with unilateral pre- or perinatal brain injury (BI) show remarkable plasticity for language learning. Previous work highlights the important role that lesion characteristics play in explaining individual variation in plasticity in the language development of children with BI. The current study examines whether the linguistic input that children with BI receive from their caregivers also contributes to this early plasticity, and whether linguistic input plays a similar role in children with BI as it does in typically developing (TD) children. Growth in vocabulary and syntactic production is modeled for 80 children (53 TD, 27 BI) between 14 and 46 months. Findings indicate that caregiver input is an equally potent predictor of vocabulary growth in children with BI and in TD children. In contrast, input is a more potent predictor of syntactic growth for children with BI than for TD children. Controlling for input, lesion characteristics (lesion size, type, seizure history) also affect the language trajectories of children with BI. Thus, findings illustrate how both variability in the environment (linguistic input) and variability in the organism (lesion characteristics) work together to contribute to plasticity in language learning

Trauma histories among justice-involved youth: findings from the National Child Traumatic Stress Network.

BackgroundUp to 90% of justice-involved youth report exposure to some type of traumatic event. On average, 70% of youth meet criteria for a mental health disorder with approximately 30% of youth meeting criteria for post-traumatic stress disorder (PTSD). Justice-involved youth are also at risk for substance use and academic problems, and child welfare involvement. Yet, less is known about the details of their trauma histories, and associations among trauma details, mental health problems, and associated risk factors.ObjectiveThis study describes detailed trauma histories, mental health problems, and associated risk factors (i.e., academic problems, substance/alcohol use, and concurrent child welfare involvement) among adolescents with recent involvement in the juvenile justice system.MethodThe National Child Traumatic Stress Network Core Data Set (NCTSN-CDS) is used to address these aims, among which 658 adolescents report recent involvement in the juvenile justice system as indexed by being detained or under community supervision by the juvenile court.ResultsAge of onset of trauma exposure was within the first 5 years of life for 62% of youth and approximately one-third of youth report exposure to multiple or co-occurring trauma types each year into adolescence. Mental health problems are prevalent with 23.6% of youth meeting criteria for PTSD, 66.1% in the clinical range for externalizing problems, and 45.5% in the clinical range for internalizing problems. Early age of onset of trauma exposure was differentially associated with mental health problems and related risk factors among males and females.ConclusionsThe results indicate that justice-involved youth report high rates of trauma exposure and that this trauma typically begins early in life, is often in multiple contexts, and persists over time. Findings provide support for establishing trauma-informed juvenile justice systems that can respond to the needs of traumatized youth

Halting indigenous biodiversity decline: ambiguity, equity, and outcomes in RMA assessment of significance

In New Zealand, assessment of ‘significance’ is undertaken to give effect to a legal requirement for local authorities to provide for protection of significant sites under the Resource Management Act (1991). The ambiguity of the statute enables different interests to define significance according to their goals: vested interests (developers), local authorities, and non-vested interests in pursuit of protection of environmental public goods may advance different definitions. We examine two sets of criteria used for assessment of significance for biological diversity under the Act. Criteria adapted from the 1980s Protected Natural Areas Programme are inadequate to achieve the maintenance of biological diversity if ranking is used to identify only highest priority sites. Norton and Roper-Lindsay (2004) propose a narrow definition of significance and criteria that identify only a few high-quality sites as significant. Both sets are likely to serve the interests of developers and local authorities, but place the penalty of uncertainty on non-vested interests seeking to maintain biological diversity, and are likely to exacerbate the decline of biological diversity and the loss of landscape-scale processes required for its persistence. When adopting criteria for assessment of significance, we suggest local authorities should consider whose interests are served by different criteria sets, and who will bear the penalty of uncertainty regarding biological diversity outcomes. They should also ask whether significance criteria are adequate, and sufficiently robust to the uncertainty inherent in the assessment of natural values, to halt the decline of indigenous biological diversity

Validation of a Single Inertial Sensor for Measuring Running Kinematics Overground During a Prolonged Run

This article is made available in accordance with the publisher's statement on Open access.Introduction: The purpose of this study was to validate acceleration data from a single inertial sensor containinga tri-axial accelerometer, whilst running overground during a prolonged run against a motion analysis system. Methods: An inertial sensor was placed on the low back of 10 runners who performed an 8 km run on a treadmill.To provide validation of the sensor, data were collected as runners ran along a runway through a motion analysis system at the beginning and throughout the run.Results: High levels of agreement between the two systems were found in the craniocaudal and mediolateral acceleration, with antero posterior having the least agreement with greatest Typical Error of the Estimate (0.66 sample points). Very high to extremely high correlations across all testing times were found in all three directions of accelerations (r=0.75 to 0.95). Heel strike and toe off events were identified in anteroposterior and craniocaudal acceleration, with high levels of agreement and extremely high correlations (r=0.99) between the two systems.Minimal variation and change in agreement and correlation between the data at each testing time were found. Discussion: This study provides evidence that a single inertial sensor placed on the low back is valid for measuring three-dimensional acceleration in overground running during a prolonged run. Further analysis identified specific events of heel strike and toe off and were comparable between the two systems. The minimal variation and change in agreement between the two systems during the run indicates the adherence method of the inertial sensor was suitable. Conclusions: The results of this study indicate that data collected from a single inertial sensor is highly correlated with simultaneous data collected using a motion analysis system, and has the capability to identify heelstrike and toe off events in overground running throughout a prolonged fatiguing run

Antibody-Based Ticagrelor Reversal Agent in Healthy Volunteers.

BACKGROUND: Ticagrelor is an oral P2Y12 inhibitor that is used with aspirin to reduce the risk of ischemic events among patients with acute coronary syndromes or previous myocardial infarction. Spontaneous major bleeding and bleeding associated with urgent invasive procedures are concerns with ticagrelor, as with other antiplatelet drugs. The antiplatelet effects of ticagrelor cannot be reversed with platelet transfusion. A rapid-acting reversal agent would be useful. METHODS: In this randomized, double-blind, placebo-controlled, phase 1 trial, we evaluated intravenous PB2452, a monoclonal antibody fragment that binds ticagrelor with high affinity, as a ticagrelor reversal agent. We assessed platelet function in healthy volunteers before and after 48 hours of ticagrelor pretreatment and again after the administration of PB2452 or placebo. Platelet function was assessed with the use of light transmission aggregometry, a point-of-care P2Y12 platelet-reactivity test, and a vasodilator-stimulated phosphoprotein assay. RESULTS: Of the 64 volunteers who underwent randomization, 48 were assigned to receive PB2452 and 16 to receive placebo. After 48 hours of ticagrelor pretreatment, platelet aggregation was suppressed by approximately 80%. PB2452 administered as an initial intravenous bolus followed by a prolonged infusion (8, 12, or 16 hours) was associated with a significantly greater increase in platelet function than placebo, as measured by multiple assays. Ticagrelor reversal occurred within 5 minutes after the initiation of PB2452 and was sustained for more than 20 hours (P\u3c0.001 after Bonferroni adjustment across all time points for all assays). There was no evidence of a rebound in platelet activity after drug cessation. Adverse events related to the trial drug were limited mainly to issues involving the infusion site. CONCLUSIONS: In healthy volunteers, the administration of PB2452, a specific reversal agent for ticagrelor, provided immediate and sustained reversal of the antiplatelet effects of ticagrelor, as measured by multiple assays. (Funded by PhaseBio Pharmaceuticals; ClinicalTrials.gov number, NCT03492385.)

The effect of sewage on uptake of inorganic nitrogen and carbon by natural populations of marine phytoplankton

The short-term effect of sewage effluent on nitrogen and carbon productivity of natural marine phytoplankton obtained near two California outfalls has been studied. Uptake of ammonium was shown to be inhibited at much lower effluent concentrations than was carbon uptake. Since the populations studied were shown to exhibit Michaelis-Menten kinetics for ammonium uptake, a precise measurement of inhibition could be obtained. The results have immediate application since the phytoplankton populations of the area studied have been shown previously to be nitrogen limited

Anatomic brain asymmetry in vervet monkeys.

Asymmetry is a prominent feature of human brains with important functional consequences. Many asymmetric traits show population bias, but little is known about the genetic and environmental sources contributing to inter-individual variance. Anatomic asymmetry has been observed in Old World monkeys, but the evidence for the direction and extent of asymmetry is equivocal and only one study has estimated the genetic contributions to inter-individual variance. In this study we characterize a range of qualitative and quantitative asymmetry measures in structural brain MRIs acquired from an extended pedigree of Old World vervet monkeys (n = 357), and implement variance component methods to estimate the proportion of trait variance attributable to genetic and environmental sources. Four of six asymmetry measures show pedigree-level bias and one of the traits has a significant heritability estimate of about 30%. We also found that environmental variables more significantly influence the width of the right compared to the left prefrontal lobe