Nurse Practitioners’ Attitudes and Knowledge about Influenza Immunization

Influenza remains a leading cause of death nationally and internationally. Annual influenza immunization for healthcare workers has been recommended since 1984. Despite this, many healthcare workers do not receive the immunization. Nurse practitioners (NPs) are key primary care providers in the U.S. healthcare system. The purpose of this study was to assess the knowledge and personal beliefs of NPs as a step toward understanding the reasons for the participation or non-participation in the influenza vaccine of this professional group. A quantitative cross-sectional survey of knowledge, attitudes, NP demographics, and patient factors was carried out. Most of the 174 participants had received the vaccine. Vaccine status was not correlated with the assessed risk level of patients. Available and mandatory vaccine in the workplace was correlated with vaccination status of the NP. Vaccine status of the NP was correlated with patient counseling to receive influenza immunization. Not all NPs agree with or adhere to federal vaccine recommendations. It is critically important for healthcare providers to base decisions affecting the health of themselves and their patients on evidence-based research

Neural mechanisms of temporal resolution of attention

The dynamic nature of the world requires that our visual representations are continuously updated. These representations are more precise if there is a narrow time window over which information is averaged. We assess the neural processes of visual updating by testing patients with lesions including inferior parietal cortex, control patients and healthy adults on a continuous visual monitoring task. In Experiment 1, observers kept track of the changing spatial period of a luminance grating and identified the final spatial period after the stimulus disappeared. Healthy older adults and neurological controls were able to perform better than simulated guesses, but only 3 of 11 patients with damage including parietal cortex were able to reach performance that differed from simulated guesses. The effects were unrelated to lesion size. Poor performance on this task is consistent with an inability to selectively attend to the final moment at which the stimulus was seen. To investigate the temporal limits of attention, we varied the rate of stimulus change in Experiment 2. Performance remained poor for some patients even with slow 2.5 Hz change rates. The performance of 4 patients with parietal damage displayed poor temporal precision, namely recovery of performance with slower rates of change

Reimagining the Digital Monograph: Design Thinking to Build New Tools for Researchers, A JSTOR Labs Report

Scholarly books are increasingly available in digital form, but the online interfaces for using these books often allow only for the browsing of PDF files. JSTOR Labs, an experimental product-development group within the not-for-profit digital library JSTOR, undertook an ideation and design process to develop new and different ways of showing scholarly books online, with the goal that this new viewing interface should be relatively simple and inexpensive to implement for any scholarly book that is already available in PDF form. This paper documents that design process, including the recommendations of a working group of scholars, publishers, and librarians convened by JSTOR Labs and the Columbia University Libraries in October 2016. The prototype monograph viewer developed through this process—called “Topicgraph”—is described herein and is freely available online at https://labs.jstor.org/topicgraph

D8.4 – Second RAGE Evaluation Report

This document presents the results of the summative evaluation and validation studies carried out in WP8 of the RAGE project. Summative evaluation by definition represents evaluation at the end of the development process and aims at collecting information on the outcomes of the implementation. Correspondingly, the summative evaluations in RAGE aimed at obtaining a concluding statement and evidence on the quality and effects of the final versions of (a) the RAGE components, (b) the Ecosystem portal, and (c) the games at the end of the project. Overall, the summative evaluation studies have demonstrated the usefulness and potential benefits of the technologies and methodologies developed in the project for applied game development and for educational application, and argue for the usefulness and significance of the RAGE approach. In addition, valuable suggestions for further improvement or enrichment of the games, game components, and Ecosystem portal could be collected and, thus meaningful information and inspiration for future work beyond the RAGE project lifetime could be obtained

Time for a quick word? The striking benefits of training speed and accuracy of word retrieval in post-stroke aphasia

One-third of stroke survivors experience deficits in word retrieval as a core characteristic of their aphasia, which is frustrating, socially limiting and disabling for their professional and everyday lives. The, as yet, undiscovered ‘holy grail’ of clinical practice is to establish a treatment that not only improves item naming, but also generalizes to patients’ connected speech. Speech production in healthy participants is a remarkable feat of cognitive processing being both rapid (at least 120 words per minute) and accurate (∼one error per 1000 words). Accordingly, we tested the hypothesis that word-finding treatment will only be successful and generalize to connected speech if word retrieval is both accurate and quick. This study compared a novel combined speed- and accuracy-focused intervention—‘repeated, increasingly-speeded production’—to standard accuracy-focused treatment. Both treatments were evaluated for naming, connected speech outcomes, and related to participants’ neuropsychological and lesion profiles. Twenty participants with post-stroke chronic aphasia of varying severity and subtype took part in 12 computer-based treatment sessions over 6 weeks. Four carefully matched word sets were randomly allocated either to the speed- and accuracy-focused treatment, standard accuracy-only treatment, or untreated (two control sets). In the standard treatment, sound-based naming cues facilitated naming accuracy. The speed- and accuracy-focused treatment encouraged naming to become gradually quicker, aiming towards the naming time of age-matched controls. The novel treatment was significantly more effective in improving and maintaining picture naming accuracy and speed (reduced latencies). Generalization of treated vocabulary to connected speech was significantly increased for all items relative to the baseline. The speed- and accuracy-focused treatment generated substantial and significantly greater deployment of targeted items in connected speech. These gains were maintained at 1-month post-intervention. There was a significant negative correlation for the speed- and accuracy-focused treatment between the patients’ phonological scores and the magnitude of the therapy effect, which may have reflected the fact that the substantial beneficial effect of the novel treatment generated a ceiling effect in the milder patients. Maintenance of the speed- and accuracy-treatment effect correlated positively with executive skills. The neural correlate analyses revealed that participants with the greatest damage to the posterior superior temporal gyrus extending into the white matter of the inferior longitudinal fasciculus, showed the greatest speed- and accuracy treatment benefit. The novel treatment was well tolerated by participants across the range of severity and aphasia subtype, indicating that this type of intervention has considerable clinical utility and broad applicability

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Statistical upscaling of ecosystem CO2 fluxes across the terrestrial tundra and boreal domain: Regional patterns and uncertainties

The regional variability in tundra and boreal carbon dioxide (CO2) fluxes can be high, complicating efforts to quantify sink-source patterns across the entire region. Statistical models are increasingly used to predict (i.e., upscale) CO2 fluxes across large spatial domains, but the reliability of different modeling techniques, each with different specifications and assumptions, has not been assessed in detail. Here, we compile eddy covariance and chamber measurements of annual and growing season CO2 fluxes of gross primary productivity (GPP), ecosystem respiration (ER), and net ecosystem exchange (NEE) during 1990-2015 from 148 terrestrial high-latitude (i.e., tundra and boreal) sites to analyze the spatial patterns and drivers of CO2 fluxes and test the accuracy and uncertainty of different statistical models. CO2 fluxes were upscaled at relatively high spatial resolution (1 km(2)) across the high-latitude region using five commonly used statistical models and their ensemble, that is, the median of all five models, using climatic, vegetation, and soil predictors. We found the performance of machine learning and ensemble predictions to outperform traditional regression methods. We also found the predictive performance of NEE-focused models to be low, relative to models predicting GPP and ER. Our data compilation and ensemble predictions showed that CO2 sink strength was larger in the boreal biome (observed and predicted average annual NEE -46 and -29 g C m(-2) yr(-1), respectively) compared to tundra (average annual NEE +10 and -2 g C m(-2) yr(-1)). This pattern was associated with large spatial variability, reflecting local heterogeneity in soil organic carbon stocks, climate, and vegetation productivity. The terrestrial ecosystem CO2 budget, estimated using the annual NEE ensemble prediction, suggests the high-latitude region was on average an annual CO2 sink during 1990-2015, although uncertainty remains high

Submicroscopic Gametocytes and the Transmission of Antifolate-Resistant Plasmodium falciparum in Western Kenya

BACKGROUND: Single nucleotide polymorphisms (SNPs) in the dhfr and dhps genes are associated with sulphadoxine-pyrimethamine (SP) treatment failure and gametocyte carriage. This may result in enhanced transmission of mutant malaria parasites, as previously shown for chloroquine resistant parasites. In the present study, we determine the association between parasite mutations, submicroscopic P. falciparum gametocytemia and malaria transmission to mosquitoes. METHODOLOGY/PRINCIPAL FINDINGS: Samples from children treated with SP alone or in combination with artesunate (AS) or amodiaquine were genotyped for SNPs in the dhfr and dhps genes. Gametocytemia was determined by microscopy and Pfs25 RNA-based quantitative nucleic acid sequence-based amplification (Pfs25 QT-NASBA). Transmission was determined by membrane-feeding assays. We observed no wild type infections, 66.5% (127/191) of the infections expressed mutations at all three dhfr codons prior to treatment. The presence of all three mutations was not related to higher Pfs25 QT-NASBA gametocyte prevalence or density during follow-up, compared to double mutant infections. The proportion of infected mosquitoes or oocyst burden was also not related to the number of mutations. Addition of AS to SP reduced gametocytemia and malaria transmission during follow-up. CONCLUSIONS/SIGNIFICANCE: In our study population where all infections had at least a double mutation in the dhfr gene, additional mutations were not related to increased submicroscopic gametocytemia or enhanced malaria transmission. The absence of wild-type infections is likely to have reduced our power to detect differences. Our data further support the use of ACT to reduce the transmission of drug-resistant malaria parasites