A pilot randomised controlled trial using prophylactic dressings to minimise sacral pressure injuries in high risk hospitalised patients

This pilot randomised controlled trial examined the effect of prophylactic dressings to minimise sacral pressure injuries in high-risk hospitalised patients and assessed feasibility criteria to inform a larger study. Eighty patients were recruited at admission points (the Emergency Department and Surgical Care Unit) or directly from participating wards in the general medical surgical setting following assessment of high risk for sacral pressure injury. Participants were randomised into either the routine care or routine care and silicone foam border dressing group. Outcome assessment comprised digital photographs of each participant’s sacrum every 72 hours for evaluation by a blind-to-intervention assessor. Sixty-seven participants had at least one sacral photograph taken and assessed by a blind-to-intervention assessor. Three participants were assessed as having a Stage I pressure injury. While the use of photography was effective, feasibility criteria identified challenges related to bias, blinding, weight assessment, preparation of nursing staff and sample size estimation

Exploring ethical issues associated with using online surveys in educational research

Online surveys are increasingly used in educational research, yet little attention has focused on ethical issues associated with their use in educational settings. Here, we draw on the broader literature to discuss 5 key ethical issues in the context of educational survey research: dual teacher/researcher roles; informed consent; use of incentives; privacy, anonymity, and confidentiality; and data quality. We illustrate methods of addressing these issues with our experiences conducing online surveys in educational contexts. Moving beyond the procedural ethics approach commonly adopted in quantitative educational research, we recommend adopting a situated/process ethics approach to identify and respond to ethical issues that may arise during the conduct, analysis, and reporting of online survey research. The benefits of online surveying in comparison to traditional survey methods are highlighted, including the potential for online surveys to provide ethically defensible methods of conducting research that would not be feasible in offline education research settings

Prophylactic Melatonin for Delirium in Intensive Care (Pro-MEDIC): Study protocol for a randomised controlled trial

Background: Delirium is an acute state of brain dysfunction characterised by fluctuating inattention and cognitive disturbances, usually due to illness. It occurs commonly in the intensive care unit (ICU), and it is associated with greater morbidity and mortality. It is likely that disturbances of sleep and of the day-night cycle play a significant role. Melatonin is a naturally occurring, safe and cheap hormone that can be administered to improve sleep. The main aim of this trial will be to determine whether prophylactic melatonin administered to critically ill adults, when compared with placebo, decreases the rate of delirium. Methods: This trial will be a multi-centre, randomised, placebo-controlled study conducted in closed ICUs in Australia. Our aim is to enrol 850 adult patients with an expected ICU length of stay (LOS) of 72h or more. Eligible patients for whom there is consent will be randomised to receive melatonin 4mg enterally or placebo in a 1:1 ratio according to a computer-generated randomisation list, stratified by site. The study drug will be indistinguishable from placebo. Patients, doctors, nurses, investigators and statisticians will be blinded. Melatonin or placebo will be administered once per day at 21:00 until ICU discharge or 14days after enrolment, whichever occurs first. Trained staff will assess patients twice daily to determine the presence or absence of delirium using the Confusion Assessment Method for the ICU score. Data will also be collected on demographics, the overall prevalence of delirium, duration and severity of delirium, sleep quality, participation in physiotherapy sessions, ICU and hospital LOS, morbidity and mortality, and healthcare costs. A subgroup of 100 patients will undergo polysomnographic testing to further evaluate the quality of sleep. Discussion: Delirium is a significant issue in ICU because of its frequency and associated poorer outcomes. This trial will be the largest evaluation of melatonin as a prophylactic agent to prevent delirium in the critically ill population. This study will also provide one of the largest series of polysomnographic testing done in ICU. Trial registration: Australian New Zealand Clinical Trial Registry (ANZCTR) number: ACTRN12616000436471. Registered on 20 December 2015

Bird-Like Anatomy, Posture, and Behavior Revealed by an Early Jurassic Theropod Dinosaur Resting Trace

BACKGROUND: Fossil tracks made by non-avian theropod dinosaurs commonly reflect the habitual bipedal stance retained in living birds. Only rarely-captured behaviors, such as crouching, might create impressions made by the hands. Such tracks provide valuable information concerning the often poorly understood functional morphology of the early theropod forelimb. METHODOLOGY/PRINCIPAL FINDINGS: Here we describe a well-preserved theropod trackway in a Lower Jurassic ( approximately 198 million-year-old) lacustrine beach sandstone in the Whitmore Point Member of the Moenave Formation in southwestern Utah. The trackway consists of prints of typical morphology, intermittent tail drags and, unusually, traces made by the animal resting on the substrate in a posture very similar to modern birds. The resting trace includes symmetrical pes impressions and well-defined impressions made by both hands, the tail, and the ischial callosity. CONCLUSIONS/SIGNIFICANCE: The manus impressions corroborate that early theropods, like later birds, held their palms facing medially, in contrast to manus prints previously attributed to theropods that have forward-pointing digits. Both the symmetrical resting posture and the medially-facing palms therefore evolved by the Early Jurassic, much earlier in the theropod lineage than previously recognized, and may characterize all theropods

Azo Dyes, Their Environmental Effects, and Defining a Strategy for Their Biodegradation and Detoxification

Intenzivan industrijski razvoj popraćen je sve većom kompleksnošću sastava otpadnih voda, što u smislu učinkovite zaštite okoliša i održivog razvoja nalaže potrebu pospješivanja kvalitete postojećih te uvođenjem novih postupaka obrade otpadnih voda, kao iznimno važnog čimbenika u interakciji čovjeka i okoliša. Posebnu znanstveno-tehnološku pozornost zahtijevaju novosintetizirani ksenobiotici, poput azo-boja, koji su u prirodi veoma teško razgradivi. Azo-boje podložne su bioakumulaciji, a zbog alergijskih, kancerogenih, mutagenih i teratogenih svojstava nerijetko su prijetnja zdravlju ljudi i očuvanju okoliša. Primjenu fi zikalnokemijskih metoda za uklanjanje azo-boja iz otpadnih voda često ograničavaju visoke cijene, potrebe za odlaganjem nastalog štetnog mulja ili nastanak toksičnih sastojaka razgradnje. Biotehnološki postupci su, zbog mogućnosti ekonomične provedbe i postizanja potpune biorazgradnje, a time i detoksifi kacije, sve zastupljeniji u obradi svih vrsta otpadnih voda, pa tako i onih koje sadržavaju azo-boje.Intense industrial development has been accompanied by the production of wastewaters of very complex content, which pose a serious hazard to the environment, put at risk sustainable development, and call for new treatment technologies that would more effectively address the issue. One particular challenge in terms of science and technology is how to biodegrade xenobiotics such as azo dyes, which practically do not degrade under natural environmental conditions. These compounds tend to bioaccumulate in the environment, and have allergenic, carcinogenic, mutagenic, and teratogenic properties for humans. Removal of azo dyes from effl uents is mostly based on physical-chemical methods. These methods are often very costly and limited, as they accumulate concentrated sludge, which also poses a significant secondary disposal problem, or produce toxic end-products. Biotechnological approach may offer alternative, lowcost biological treatment systems that can completely biodegrade and detoxify even the hard-to-biodegrade azo dyes

Operational Field Evaluation of a Plastic Bulb Reservoir as a Tranquilizer Trap Device for Delivering Propiopromazine Hydrochloride to Feral Dogs, Coyotes, and Gray Wolves

We evaluated a polyethylene bulb reservoir fabricated at the Pocatello Supply Depot, Pocatello, Idaho, as a potential cost savings replacement for the McBride lubber device that is used as a tranquilizer trap device (TTD). The polyethylene devices, also called pipette TTDs, were formulated with 0.6 g of propiopromazine hydrochloride (PPZH) and 0.4 g of ascorbic acid, an antioxidant. The pipette bulb was secured to a 1.6 mm-diameter cable and the cable was attached to the trap jaw. TTD testing was conducted during routine operational control under an Investigational New Animal Drug application (INAD 9528) from the U.S. Food and Drug Administration. The targeted animals were feral dogs in Guam, coyotes in Utah and Idaho, and gray wolves in Minnesota. Various degrees of tranquilization ranging from quietness and lack of attention to sleepiness, were observed in the animals. Percent of tranquilization effects observed in feral dogs, coyotes, and wolves were 67%, 90%, and 67%, respectively. Evidence of reduced struggling and reduced injuries to feet and legs was observed. Tranquilization effects were also observed in non-target animals such as badgers, skunks, and raccoons. A mortality that was probably related to beat stress was recorded in one juvenile wolf. A major drawback of the pipette TTD was leakage at the stem attached to the trap jaw. Degradation of PPZH was also observed but was reduced compared to formulations without ascorbic acid

Reviews: Unsettling Questions: Palestine, Israel, the Holy Land and Zion

Reviews: Unsettling Questions: Palestine, Israel, the Holy Land and Zio