Teacher Competencies Related to Family Engagement: The Impact on Families

Although there is a large body of research that addresses the essential elements of family engagement, little information was available on the impact that a family engagement program had on teacher evaluation and familial self-efficacy. The purpose of this qualitative case study was to assess teacher competencies and family self-efficacy in a large urban district in West Texas. The research was conducted by gathering baseline data using questionnaires derived from the Measure of School, Family, and Community Partnerships survey and the 2015 Equitable Parent-School Collaboration Research Project University of Washington. In-depth interviews followed with both teachers and parents. Findings indicated that cognition, connection, communication, capabilities, and confidence were critical to the success of the teacher, and can impact their yearly evaluation. For teachers, this study implies that campus leaders should strive to purposefully embed intentional professional learning that provides background information and best practices on engaging families in order to build their knowledge and confidence to use family engagement as a strategy to support teachers as well as children. Moreover, the willingness of the teacher to use family engagement as a support strategy surfaced as well. Additional findings indicated that a campus environment that was developmental, collaborative, and relational supported building confidence and self-efficacy within the family. For parents, this study suggested that through a connection with the school campus, they were able to increase their knowledge and work together with the school campus to support their children’s learning. Ultimately, it is the principal and faculty who must extend themselves to families in order for the families to view themselves as equal partners in the education journey

Improving Patient Outcomes by Preventing Airway Injuries Associated with Video Laryngoscopes

Video laryngoscopy poses a higher risk of airway injury than direct laryngoscopy when used for difficult intubations in the operating room. Education related to manufacturer guidelines, in addition to, routine simulation practice are vital to improving efficacy and patient safety when using video laryngoscopes. The purpose of this project was to provide education to anesthesia providers regarding the potential risk of airway injury through a presentation and mid-fidelity simulation experience. An in-person PowerPoint presentation was delivered to anesthesia providers, along with a simulation experience using an intubation trainer manikin to demonstrate the proper technique when using the GlideScope and McGRATH MAC Video Laryngoscope. A pocket reference tool was also created and distributed to all participants after the presentation. The participants completed a 10-question pre-test before the presentation and a 10-question post-test immediately following the presentation and simulation experience. The results from both tests were evaluated to determine the overall impact and effectiveness of the presentation and simulation experience. A post-implementation survey was also utilized, which consisted of an 11-question Likert Scale Survey with two open-ended questions. This was used to collect participant perceptions on how well the material was presented and the usefulness of the educational tools provided. The results of this quality improvement project implied there was an immediate impact on the participants’ level of knowledge related to the proper use of video laryngoscopes to avoid injury to the patient. The survey results suggested that the participants had an increase in confidence of video laryngoscope use when presented with a difficult intubation, along with the reinforcement of accurate use according to manufacturer guidelines. Recommendations of this project would be to continue to provide awareness to anesthesia providers of the potential airway injury risk associated with video laryngoscopy with further education and simulation experiences

Phenolic metabolites of anthocyanins following a dietary intervention study in post-menopausal women

Scope Numerous studies feeding anthocyanin-rich foods report limited bioavailability of the parent anthocyanins. The present study explores the identity and concentration of the phenolic metabolites of anthocyanins in humans. Methods and results Anthocyanin metabolites were quantified in samples collected from a previously conducted 12-wk elderberry intervention study in healthy post-menopausal women. Individual 1-, 2- and 3-h post-bolus urine samples and pooled plasma samples following acute (single bolus) and chronic (12-wk supplementation) anthocyanin consumption (500 mg/day) were analysed using HPLC-ESI-MS/MS. Twenty-eight anthocyanin metabolites were identified in urine and 21 in plasma (including sulfates of vanillic, protocatechuic and benzoic acid). Phenolic metabolites reached peak concentrations of 1237 nM in plasma, while anthocyanin conjugates only reached concentrations of 34 nM. Similarly, in urine, phenolic metabolites were detected at concentrations of 33 185 ± 2549 nM/mM creatinine, while anthocyanin conjugates reached concentrations of 548 ± 219 nM/mM creatinine. There was no evidence that chronic exposure had any impact on either the profile or quantity of metabolites recovered relative to acute exposure. Conclusion An extensive range of phenolic metabolites of anthocyanin was identified following elderberry consumption in humans, including 11 novel metabolites, which were identified at much higher concentrations than their parent compounds

Human metabolism and elimination of the anthocyanin, cyanidin-3-glucoside: a 13C-tracer study

BACKGROUND: Evidence suggests that the consumption of anthocyanin-rich foods beneficially affects cardiovascular health; however, the absorption, distribution, metabolism, and elimination (ADME) of anthocyanin-rich foods are relatively unknown. OBJECTIVE: We investigated the ADME of a (13)C5-labeled anthocyanin in humans. DESIGN: Eight male participants consumed 500 mg isotopically labeled cyanidin-3-glucoside (6,8,10,3',5'-(13)C5-C3G). Biological samples were collected over 48 h, and (13)C and (13)C-labeled metabolite concentrations were measured by using isotope-ratio mass spectrometry and liquid chromatography-tandem mass spectrometry. RESULTS: The mean +/- SE percentage of (13)C recovered in urine, breath, and feces was 43.9 +/- 25.9% (range: 15.1-99.3% across participants). The relative bioavailability was 12.38 +/- 1.38% (5.37 +/- 0.67% excreted in urine and 6.91 +/- 1.59% in breath). Maximum rates of (13)C elimination were achieved 30 min after ingestion (32.53 +/- 14.24 mug(13)C/h), whereas (13)C-labeled metabolites peaked (maximum serum concentration: 5.97 +/- 2.14 mumol/L) at 10.25 +/- 4.14 h. The half-life for (13)C-labeled metabolites ranged between 12.44 +/- 4.22 and 51.62 +/- 22.55 h. (13)C elimination was greatest between 0 and 1 h for urine (90.30 +/- 15.28 mug/h), at 6 h for breath (132.87 +/- 32.23 mug/h), and between 6 and 24 h for feces (557.28 +/- 247.88 mug/h), whereas the highest concentrations of (13)C-labeled metabolites were identified in urine (10.77 +/- 4.52 mumol/L) and fecal samples (43.16 +/- 18.00 mumol/L) collected between 6 and 24 h. Metabolites were identified as degradation products, phenolic, hippuric, phenylacetic, and phenylpropenoic acids. CONCLUSION: Anthocyanins are more bioavailable than previously perceived, and their metabolites are present in the circulation fo

The pharmacokinetics of anthocyanins and their metabolites in humans

Background and Purpose: Anthocyanins are phytochemicals with reported vasoactive bioactivity. However, given their instability at neutral pH, they are presumed to undergo significant degradation and subsequent biotransformation. The aim of the present study was to establish the pharmacokinetics of the metabolites of cyanidin-3-glucoside (C3G), a widely consumed dietary phytochemical with potential cardioprotective properties. Experimental Approach: A 500 mg oral bolus dose of 6,8,10,3′,5′-13C5-C3G was fed to eight healthy male participants, followed by a 48 h collection (0, 0.5, 1, 2, 4, 6, 24, 48 h) of blood, urine and faecal samples. Samples were analysed by HPLC-ESI-MS/MS with elimination kinetics established using non-compartmental pharmacokinetic modelling. Key Results: Seventeen 13C-labelled compounds were identified in the serum, including 13C5-C3G, its degradation products, protocatechuic acid (PCA) and phloroglucinaldehyde (PGA), 13 metabolites of PCA and 1 metabolite derived from PGA. The maximal concentrations of the phenolic metabolites (Cmax) ranged from 10 to 2000 nM, between 2 and 30 h (tmax) post-consumption, with half-lives of elimination observed between 0.5 and 96 h. The major phenolic metabolites identified were hippuric acid and ferulic acid, which peaked in the serum at approximately 16 and 8 h respectively. Conclusions and Implications: Anthocyanins are metabolized to a structurally diverse range of metabolites that exhibit dynamic kinetic profiles. Understanding the elimination kinetics of these metabolites is key to the design of future studies examining their utility in dietary interventions or as therapeutics for disease risk reduction

Applying best practice to feasibility assessment and strategic planning for great ape translocation: a case study of Grauer's gorilla (Gorilla beringei graueri)

We outline the feasibility and risk assessments that are essential prerequisites to conservation translocation of great apes, while upholding the precautionary principle to avoid harms to conspecifics, sympatric taxa and ecosystems. As part of a strategic planning process, we addressed key questions on the costs and benefits of a translocation of Grauer's gorillas in Democratic Republic of Congo. We reviewed published and gray literature to compile data on Grauer's gorilla ecology and potential release sites in the subspecies' geographic range. Taking into account ecological dimensions of the habitats, impacts on conspecifics, sympatric great apes and other wildlife, and existing threats, we formulated recommendations on whether and where translocation could benefit conservation of this taxon. We concluded that one site assessed is compatible with key IUCN criteria. At Mt. Tshiaberimu in Virunga National Park, the resident Grauer's gorilla population is non-viable, no sympatric great ape species is present and the site is actively protected against poaching and habitat encroachment. Conservation translocations are widely used for species recovery; however, detailed accounts of the analyses and planning required to adhere to IUCN best practice are rare. Our approach enabled evidence-based determination of feasibility despite some initial information gaps. The process is widely applicable and could encourage improved compliance with IUCN guidelines when risks to wild conspecifics might be high, yet ecological knowledge of the target population is limited. The Grauer's Gorilla Conservation and Reinforcement Project is a partnership between the Gorilla Rehabilitation and Conservation Education Center, Virunga National Park and Re:wild

The Clinical Frailty Scale can be used retrospectively to assess the frailty of patients with hip fracture:a validation study

PURPOSE: Frailty is a common clinical syndrome affecting hip fracture patients. Recognising and accurately assessing frailty status is important in clinical and research settings. The Rockwood Clinical Frailty Scale (CFS) is a commonly used instrument and demonstrates a strong correlation with mortality and length of hospital admission following hip fracture. What is not understood, however, is the validity of retrospectively assigned CFS scores in hip fracture patients. The aim of this study was to assess the validity of retrospective non-orthogeriatrician assigned CFS scores in hip fracture patients. METHODS: Hip fracture patients from a single major trauma centre were assessed and CFS scores were assigned prospectively by non-orthogeriatric clinicians (n = 57). A subset of these patients were also assigned a prospective CFS score by a specialist orthogeriatrician (n = 27). Two separate blinded observers (non-orthogeriatric clinicians) assigned CFS scores retrospectively using electronic patient records alone. Agreement and precision was examined using the Bland–Altman plot, accuracy was assessed using R(2) statistic and inter-rater reliability was assessed using quadratic weighted Cohen’s kappa. RESULTS: Seventy percent of the cohort were female with an average age of 83. Agreement was high between prospective non-orthogeriatrician assigned CFS scores and retrospective non-orthogeriatrician assigned CFS scores, with a low bias (0.046) and good accuracy (R(2) = 73%). Good agreement was also seen in comparisons between prospective orthogeriatrician assigned CFS scores versus retrospective non-orthogeriatrician assigned scores, with a low bias (0.23) and good accuracy (R(2) = 78%). Good inter-rater reliability was seen between blinded observers with a quadratic weighted Cohen’s kappa of 0.76. CONCLUSIONS: Retrospective CFS scores assigned by non-orthogeriatricians are a valid means of assessing frailty status in hip fracture patients. However, our results suggest a tendency for non-orthogeriatricians to marginally overestimate frailty status when assigning CFS scores retrospectively. LEVEL OF EVIDENCE: 3

Sunyaev-Zel'dovich clusters in millennium gas simulations

Large surveys using the Sunyaev–Zel’dovich (SZ) effect to find clusters of galaxies are now starting to yield large numbers of systems out to high redshift, many of which are new dis- coveries. In order to provide theoretical interpretation for the release of the full SZ cluster samples over the next few years, we have exploited the large-volume Millennium gas cosmo- logical N-body hydrodynamics simulations to study the SZ cluster population at low and high redshift, for three models with varying gas physics. We confirm previous results using smaller samplesthattheintrinsic(spherical)Y500–M500relationhasverylittlescatter(σlog10Y ≃0.04), is insensitive to cluster gas physics and evolves to redshift 1 in accordance with self-similar expectations. Our preheating and feedback models predict scaling relations that are in excel- lent agreement with the recent analysis from combined Planck and XMM–Newton data by the Planck Collaboration. This agreement is largely preserved when r500 and M500 are derived using thehydrostaticmassproxy,YX,500,albeitwithsignificantlyreducedscatter(σlog10Y ≃0.02),a result that is due to the tight correlation between Y500 and YX,500. Interestingly, this assumption also hides any bias in the relation due to dynamical activity. We also assess the importance of projection effects from large-scale structure along the line of sight, by extracting cluster Y500 values from 50 simulated 5 × 5-deg2 sky maps. Once the (model-dependent) mean signal is subtracted from the maps we find that the integrated SZ signal is unbiased with respect to the underlying clusters, although the scatter in the (cylindrical) Y500–M500 relation increases in the preheating case, where a significant amount of energy was injected into the intergalactic medium at high redshift. Finally, we study the hot gas pressure profiles to investigate the origin of the SZ signal and find that the largest contribution comes from radii close to r500 in all cases. The profiles themselves are well described by generalized Navarro, Frenk & White profiles but there is significant cluster-to-cluster scatter. In conclusion, our results support the notion that Y500 is a robust mass proxy for use in cosmological analyses with clusters

Evolution of the Hepatitis E virus hypervariable region

The presence of a hypervariable (HVR) region within the genome of hepatitis E virus (HEV) remains unexplained. Previous studies have described the HVR as a proline-rich spacer between flanking functional domains of the ORF1 polyprotein. Others have proposed that the region has no function, that it reflects a hypermutable region of the virus genome, that it is derived from the insertion and evolution of host sequences or that it is subject to positive selection. This study attempts to differentiate between these explanations by documenting the evolutionary processes occurring within the HVR. We have measured the diversity of HVR sequences within acutely infected individuals or amongst sequences derived from epidemiologically linked samples and, surprisingly, find relative homogeneity amongst these datasets. We found no evidence of positive selection for amino acid substitution in the HVR. Through an analysis of published sequences, we conclude that the range of HVR diversity observed within virus genotypes can be explained by the accumulation of substitutions and, to a much lesser extent, through deletions or duplications of this region. All published HVR amino acid sequences display a relative overabundance of proline and serine residues that cannot be explained by a local bias towards cytosine in this part of the genome. Although all published HVRs contain one or more SH3-binding PxxP motifs, this motif does not occur more frequently than would be expected from the proportion of proline residues in these sequences. Taken together, these observations are consistent with the hypothesis that the HVR has a structural role that is dependent upon length and amino acid composition, rather than a specific sequence