Aerospace Section

The Aerospace Section of the Engineering Division encourages communication and cooperation among information professionals concerned with aerospace, aeronautical and related technologies. In addition, it fosters dialog with entities such as NASA, the AIAA and other important sources of technical data and bibliographical services

Dynamic Transformations of Genome-wide Epigenetic Marking and Transcriptional Control Establish T Cell Identity

T cell development comprises a stepwise process of commitment from a multipotent precursor. To define molecular mechanisms controlling this progression, we probed five stages spanning the commitment process using RNA-seq and ChIP-seq to track genome-wide shifts in transcription, cohorts of active transcription factor genes, histone modifications at diverse classes of cis-regulatory elements, and binding repertoire of GATA-3 and PU.1, transcription factors with complementary roles in T cell development. The results highlight potential promoter-distal cis-regulatory elements in play and reveal both activation sites and diverse mechanisms of repression that silence genes used in alternative lineages. Histone marking is dynamic and reversible, and though permissive marks anticipate, repressive marks often lag behind changes in transcription. In vivo binding of PU.1 and GATA-3 relative to epigenetic marking reveals distinctive factor-specific rules for recruitment of these crucial transcription factors to different subsets of their potential sites, dependent on dose and developmental context

Prevention of mother-to-child transmission of HIV guidelines: Nurses’ views at four primary healthcare facilities in the Limpopo Province

Background: When new guidelines for existing programmes are introduced, it is often the clinicians tasked with the execution of the guidelines who bear the brunt of the changes. Frequently their opinions are not sought. In this study, the researcher interviewed registered nurses working in the field of the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) to gain an understanding of their perspectives on the changes introduced to the guidelines. The guideline changes in 2014 were to move from the World Health Organization (WHO) Option B to Option B + which prescribes lifelong antiretroviral therapy (ART) for all HIV-positive pregnant women regardless of CD4 cell count.Objective: To determine what the registered nurses’ perspectives are on the PMTCT programme as implemented at four PHC facilities in the Limpopo Province.Method: For this qualitative investigation, a descriptive research design was implemented. The data were collected during semi-structured interviews with nurses from four primary healthcare facilities in the Limpopo Province of South Africa. Data were analysed using thematic analysis.Results: Challenges preventing effective implementation (e.g. increased workloads, viz. staff shortages; poor planning of training; equipment and medication shortages and long lead times; poor patient education) were identified.Conclusion: In spite of the successes of the PMTCT programme, considerable challenges still prevail; lack of patient education, poor facilities management and staff shortages could potentially influence the implementation of the PMTCT guidelines negatively

Nutrition process improvements for adult inpatients with inborn errors of metabolism using the i-PARIHS framework

This project aimed to implement consensus recommendations and innovations that improve dietetic services to promote timely referral to optimise nutritional management for adult inpatients with inborn errors of metabolism (IEM).The i-PARIHS framework was used to identify service gaps, implement innovations and evaluate the innovations within this single-site study. The constructs of this framework are: (i) review of the evidence; (ii) recognising patients and staff knowledge and attitudes; (iii) acknowledging the local context; and (iv) the facilitators role. This included a literature review and metabolic centre service comparisons to investigate dietetic referral and foodservice processes to inform the innovation. A 12-month chart audit (6 months retrospective and prospective of implemented innovation, respectively) to evaluate newly established dietetic referral and IEM nutrition provision procedures was also completed.The innovations implemented encompassed a clinical alert triggering urgent referral, nutrition sick day plans and metabolic diet and formula prescription via an 'alert' tab in electronic records. Eleven metabolic protein-restricted diets and nine formula recipes were introduced. Prior to the innovations, only 53% (n = 19/36) of inpatients with IEM were assessed by the dietitian and received appropriate nutrition within 24 hours. Following implementation of the innovations, 100% (n = 11/11) of inpatients with IEM received timely dietetic assessment and therapeutic nutrition.Implementation of innovations developed using the i-PARIHS framework is effective in timely notification of the metabolic dietitian of referrals. This ensures optimal nutritional management during admissions which is required in this group of high-risk patients

Consensual Qualitative Research: An Update

The authors reviewed the application of consensual qualitative research (CQR) in 27 studies published since the method’s introduction to the field in 1997 by C. E. Hill, B. J. Thompson, and E. N. Williams (1997). After first describing the core components and the philosophical underpinnings of CQR, the authors examined how it has been applied in terms of the consensus process, biases, research teams, data collection, data analysis, and writing up the results and discussion sections of articles. On the basis of problems that have arisen in each of these areas, the authors made recommendations for modifications of the method. The authors concluded that CQR is a viable qualitative method and suggest several ideas for research on the method itself

How can countries respond to the health and care workforce crisis? Insights from international evidence

Future global health security requires a health and care workforce (HCWF) that can respond effectively to health crises as well as to changing health needs with ageing populations, a rise in chronic conditions and growing inequality. COVID-19 has drawn attention to an impending HCWF crisis with a large projected shortfall in numbers against need. Addressing this requires countries to move beyond a focus on numbers of doctors, nurses and midwives to consider what kinds of healthcare workers can deliver the services needed; are more likely to stay in country, in rural and remote areas, and in health sector jobs; and what support they need to deliver high-quality services. In this paper, which draws on a Policy Brief prepared for the World Health Organization (WHO) Fifth Global Forum on Human Resources for Health, we review the global evidence on best practices in organising, training, deploying, and managing the HCWF to highlight areas for strategic investments. These include (1). Increasing HCWF diversity to improve the skill-mix and provide culturally competent care; (2). Introducing multidisciplinary teams in primary care; (3). Transforming health professional education with greater interprofessional education; (4). Re-thinking employment and deployment systems to address HCWF shortages; (5). Improving HCWF retention by supporting healthcare workers and addressing migration through destination country policies that limit draining resources from countries with greatest need. These approaches are departures from current norms and hold substantial potential for building a sustainable and responsive HCWF

Beyond Description: The Predictive Role of Affect, Memory, and Context in the Decision to Donate or Not Donate Blood

Research on the recruitment and retention of blood donors has typically drawn on a homogeneous set of descriptive theories, viewing the decision to become and remain a donor as the outcome of affectively cold, planned, and rational decision-making by the individual. While this approach provides insight into how our donors think about blood donation, it is limited and has not translated into a suite of effective interventions. In this review, we set out to explore how a broader consideration of the influences on donor decision-making, in terms of affect, memory, and the context in which donation takes place may yield benefit in the way we approach donor recruitment and retention. Drawing on emerging research, we argue for the importance of considering the implications of both the positive and negative emotions that donors experience and argue for the importance of directly targeting affect in interventions to recruit non-donors. Next, we focus on the reconstructed nature of memory and the factors that influence what we remember about an event. We discuss how these processes may impact the retention of donors and the potential to intervene to enhance donors’ recollections of their experiences. Finally, we discuss how our focus on the individual has led us to neglect the influence of the context in which donation takes place on donor behaviour. We argue that the amassing of comprehensive large data sets detailing both the characteristics of the individuals and the context of their giving will ultimately allow for the more effective deployment of resources to improve recruitment and retention. In suggesting these directions for future research, our want is to move beyond the ways we have traditionally described blood donation behaviour with the aim of improving our theorizing about donors while improving the translational value of our research

Transcription factor redundancy and tissue-specific regulation: Evidence from functional and physical network connectivity

Two major transcriptional regulators of Caenorhabditis elegans bodywall muscle (BWM) differentiation, hlh-1 and unc-120, are expressed in muscle where they are known to bind and regulate several well-studied muscle-specific genes. Simultaneously mutating both factors profoundly inhibits formation of contractile BWM. These observations were consistent with a simple network model in which the muscle regulatory factors drive tissue-specific transcription by binding selectively near muscle-specific targets to activate them. We tested this model by measuring the number, identity, and tissue-specificity of functional regulatory targets for each factor. Some joint regulatory targets (218) are BWM-specific and enriched for nearby HLH-1 binding. However, contrary to the simple model, the majority of genes regulated by one or both muscle factors are also expressed significantly in non-BWM tissues. We also mapped global factor occupancy by HLH-1, and created a genetic interaction map that identifies hlh-1 collaborating transcription factors. HLH-1 binding did not predict proximate regulatory action overall, despite enrichment for binding among BWM-specific positive regulatory targets of hlh-1. We conclude that these tissue-specific factors contribute much more broadly to the transcriptional output of muscle tissue than previously thought, offering a partial explanation for widespread HLH-1 occupancy. We also identify a novel regulatory connection between the BWM-specific hlh-1 network and the hlh-8/twist nonstriated muscle network. Finally, our results suggest a molecular basis for synthetic lethality in which hlh-1 and unc-120 mutant phenotypes are mutually buffered by joint additive regulation of essential target genes, with additional buffering suggested via newly identified hlh-1 interacting factors