Student Nurse Perceptions of Effective Medication Administration Education

Nursing faculty strive to educate students in a manner that prevents errors, promoting quality, patient-centered care. This endeavor is dependent upon meaningful and effective education that incorporates educational experiences reflective of the service sector. Anecdotal reports from clinical faculty and student nurses suggest that academic medication administration education may not optimally prepare students for safe entry into clinical practice. The aim of this phenomenologic qualitative research is to understand student nurse perceptions regarding teaching strategies and learning activities that prepared them for safe medication administration in acute care clinical settings. Focus group interviews resulted in two broad themes that are identified as Effective Education and Gaps in Education. Within these broad themes, findings revealed that students value faculty demonstrations, peer-learning opportunities, and repetitive practice with timely feedback. Study findings also pointed to educational gaps. Students reported needing to learn communication and conflict resolution strategies that would help them manage real-world interruptions, distractions, and computer generated alerts. Study findings recommend implementing relevant decision-support technology within academic lab learning activities

Revisiting the association between candidal infection and carcinoma, particularly oral squamous cell carcinoma

Background: Tobacco and alcohol are risk factors associated with cancer of the upper aerodigestive tract, but increasingly the role of infection and chronic inflammation is recognized as being significant in cancer development. Bacteria, particularly Helicobacter pylori, and viruses such as members of the human papilloma virus family and hepatitis B and C are strongly implicated as etiological factors in certain cancers. There is less evidence for an association between fungi and cancer, although it has been recognized for many years that white patches on the oral mucosa, which are infected with Candida, have a greater likelihood of undergoing malignant transformation than those that are not infected. Objective: This article reviews the association between the development of oral squamous cell carcinoma in potentially malignant oral lesions with chronic candidal infection and describes mechanisms that may be involved in Candida-associated malignant transformation

Early diagnosis of fibrotic interstitial lung disease: challenges and opportunities.

Many patients with interstitial lung disease (ILD) develop pulmonary fibrosis, which can lead to reduced quality of life and early mortality. Patients with fibrotic ILD often have considerable diagnostic delay, and are exposed to unnecessary and costly diagnostic procedures, and ineffective and potentially harmful treatments. Non-specific and insidious presenting symptoms, along with scarce knowledge of fibrotic ILD among primary care physicians and non-ILD experts, are some of the main causes of diagnostic delay. Here, we outline and discuss the challenges facing both patients and physicians in making an early diagnosis of fibrotic ILD, and explore strategies to facilitate early identification of patients with fibrotic ILD, both in the general population and among individuals at highest risk of developing the disease. Finally, we discuss controversies and key uncertainties in screening programmes for fibrotic ILD. Timely identification and accurate diagnosis of patients with fibrotic ILD poses several substantial clinical challenges, but could potentially improve outcomes through early initiation of appropriate management

Resequencing Study Confirms That Host Defense and Cell Senescence Gene Variants Contribute to the Risk of Idiopathic Pulmonary Fibrosis

Rationale: Several common and rare genetic variants have been associated with idiopathic pulmonary fibrosis, a progressive fibrotic condition that is localized to the lung. Objectives: To develop an integrated understanding of the rare and common variants located in multiple loci that have been reported to contribute to the risk of disease. Methods: We performed deep targeted resequencing (3.69 Mb of DNA) in cases (n = 3,624) and control subjects (n = 4,442) across genes and regions previously associated with disease. We tested for associations between disease and 1) individual common variants via logistic regression and 2) groups of rare variants via sequence kernel association tests. Measurements and Main Results: Statistically significant common variant association signals occurred in all 10 of the regions chosen based on genome-wide association studies. The strongest risk variant is the MUC5B promoter variant rs35705950, with an odds ratio of 5.45 (95% confidence interval, 4.91-6.06) for one copy of the risk allele and 18.68 (95% confidence interval, 13.34-26.17) for two copies of the risk allele (P = 9.60 × 10-295). In addition to identifying for the first time that rare variation in FAM13A is associated with disease, we confirmed the role of rare variation in the TERT and RTEL1 gene regions in the risk of IPF, and found that the FAM13A and TERT regions have independent common and rare variant signals. Conclusions: A limited number of common and rare variants contribute to the risk of idiopathic pulmonary fibrosis in each of the resequencing regions, and these genetic variants focus on biological mechanisms of host defense and cell senescence

Flammer syndrome and autoimmune inflammatory conditions of the central nervous system: multifactorial interrelations

Multiple sclerosis (MS) is the most frequent autoimmune inflammatory and neurodegenerative central nervous system disorder that affects mostly young females and manifests with transient or irreversible neurologic dysfunction caused by demyelination and subsequent axonal transection and neuronal demise. Besides genetic susceptibility, environmental risk factors play a causative role. Although the exact immunopathogenesis has not been fully clarified, the condition is – albeit incurable – amenable to treatment with immunomodulatory drugs. Structural and functional changes in the brain and retinal vasculature in MS causing cerebral hypoperfusion may be a potential pathophysiological link with Flammer Syndrome (FS). However, only one study thus far has systematically investigated the co-occurrence of MS and FS and has shown that multiple symptoms and signs considered as characteristic of FS occur more often in MS patients than in unselected controls. While there is some overlap in symptomatology and clinical findings between the 2 conditions, this does not imply causality, but this preliminary observation should trigger more research on pathophysiological commonalities and clinical course of patients who are eventually diagnosed with both disorders. Susac Syndrome (SuS) is a very rare presumably immune mediated central nervous system disease that affects microvessels in the brain, the retina and the inner ear. This may cause secondary vascular dysregulation and thus signs and symptoms of FS, while it was also proposed that FS may predispose to SuS. However, as in MS assumptions on a potential association of SuS with FS are still poorly supported by rigorous data