Headlice: a precursor to Group A Streptococcal infection in remote Indigenous children

A child is brought to a remote area nursing clinic by his mother. He appears acutely unwell, is crying and scratching his head through matted hair – he has impetigo as a result of head lice. This case report describes the comprehensive wound management considerations to reduce the risk of rheumatic heart disease or renal disease secondary to infection with Group A beta-haemolytic streptococci (GAS). There is an extremely high incidence of impetigo secondary to scabies and head louse infestations in Northern Territory communities. Reducing the incidence of pyogenic skin disease and the more serious sequelae for children from remote Indigenous communities requires more than a course of antibiotics and educating the primary carers. It requires community wide action including promoting the importance of effective prevention and management of skin infections in infants and children and working with other sectors to address household overcrowding, a lack of health hardware, and a lack of ready access to affordable, effective topical head louse treatment

Making a case for telehealth: measuring the carbon cost of health-related travel

Background: Telehealth services are promoted to reduce the cost of travel for people living in rural areas. The previous Australian Government, through the national Digital Economy Strategy, invested heavily in telehealth service development, at the same time introducing a carbon pricing mechanism. In planning a range of new telehealth services to a rural community the authors sought to quantify the travel conducted by people from one rural area in Australia to access health care, and to calculate the associated carbon emissions.Methods: A population survey was conducted over a 1-week period of health-related travel events for the year 1 July 2011 to 30 June 2012 of all households on King Island, a community situated between the Australian mainland state of Victoria and the state of Tasmania. Validated emissions calculators were sourced from the Carbon Neutral website, including the vehicle and fuel use calculator and air travel carbon calculator, to calculate the total emissions associated with the fuel burned in tonnes of carbon dioxide equivalent (tCO2e).Results: Thirty nine percent of the population (625 participants) reported a total of 511 healthcare-related travel events. Participants travelled a total of 346 573 km and generated 0.22 tCO2e per capita. Participants paid the cost of their own travel more than 70% of the time.Conclusions: Dependence on fossil fuels for transport in a carbon economy has a significant impact on total healthcare carbon emissions. Alternative models of care, such as telehealth, need be developed for an environmentally sustainable healthcare system for rural and remote areas

Nursing Competencies Needed for Electronic Advance Care Planning in Community

Advance care planning implementation occurs acrossthe world using different legislative frameworks, differentlanguage to describe both the process and the outcome, anddifferent models to develop these plans. Many countries are inthe process of developing personally controlled electronic healthrecords. Including advance care plans as part of this record isproposed in Australia. The Electronic Advance Care Plan(eACP) in Community project aimed to develop a model that willengage community dwelling older adults with chronic lifelimitingillnesses in the process of advance care planning that isperson-centred, evidence-based and has a focus of dignity of life.A systematic review was conducted to identify models of advancecare planning information sharing and to examine the nurses’role. A realist review comprising a metasynthesis of 8 qualitativestudies and 9 quantitative studies was conducted. Nursingcompetencies need to be developed to include the medico-legalframework around advance care plan development, as well asinformation technology competencies and communicationcompetencies so that nurses around the world are betterinformed for end-of-life care planning and practice in a digitalworl

Amorphous determination in calcium sulfoaluminate materials by external and internal methods

Sitio Web de la revista: http://www.icevirtuallibrary.com/toc/jadcr/currentExternal standard methodology has been successfully applied to quantify the known amounts of amorphous component that are increasingly added to cement-related materials. The consistency and accuracy of the methodology were demonstrated by the R2 values of the least-square fits determined against weighed amorphous amounts, which were close to 1.0 in all the series. This method requires common laboratory X-ray powder diffractometers (knowing the equipment constant) and avoids the dilution/alteration of the sample. However, the obtained values may be biased due to poor particle statistics. On the other hand, internal standard analysis in transmission geometry is suitable to determine the absolute amorphous and crystalline non-quantified contents that are less biased owing to enhanced particle averaging statistics. This method is, however, experimentally tedious due to the addition of the internal standard and the sample loading in the X-ray diffraction sample holders which represent inherent drawbacks to follow amorphous evolutions

Tale of Two Courthouses

This article reviews the assumptions that underpin the commonly implemented Chronic Disease Self-Management models. Namely that there are a clear set of instructions for patients to comply with, that all health care providers agree with; and that the health care provider and the patient agree with the chronic disease self-management plan that was developed as part of a consultation. These assumptions are evaluated for their validity in the remote health care context, particularly for Aboriginal people. These assumptions have been found to lack validity in this context, therefore an alternative model to enhance chronic disease care is proposed

Characterization of the Tomato ARF Gene Family Uncovers a Multi-Levels Post-Transcriptional Regulation Including Alternative Splicing

Background: The phytohormone auxin is involved in a wide range of developmental processes and auxin signaling is known to modulate the expression of target genes via two types of transcriptional regulators, namely, Aux/IAA and Auxin Response Factors (ARF). ARFs play a major role in transcriptional activation or repression through direct binding to the promoter of auxin-responsive genes. The present study aims at gaining better insight on distinctive structural and functional features among ARF proteins. Results: Building on the most updated tomato (Solanum lycopersicon) reference genome sequence, a comprehensive set of ARF genes was identified, extending the total number of family members to 22. Upon correction of structural annotation inconsistencies, renaming the tomato ARF family members provided a consensus nomenclature for all ARF genes across plant species. In silico search predicted the presence of putative target site for small interfering RNAs within twelve Sl-ARFs while sequence analysis of the 59-leader sequences revealed the presence of potential small uORF regulatory elements. Functional characterization carried out by transactivation assay partitioned tomato ARFs into repressors and activators of auxin-dependent gene transcription. Expression studies identified tomato ARFs potentially involved in the fruit set process. Genome-wide expression profiling using RNA-seq revealed that at least one third of the gene family members display alternative splicing mode of regulation during the flower to fruit transition. Moreover, the regulation of several tomato ARF genes by both ethylene and auxin, suggests their potential contribution to the convergence mechanism between the signaling pathways of these two hormones. Conclusion: All together, the data bring new insight on the complexity of the expression control of Sl-ARF genes at the transcriptional and post-transcriptional levels supporting the hypothesis that these transcriptional mediators might represent one of the main components that enable auxin to regulate a wide range of physiological processes in a highly specific and coordinated manner

Predictors of response rates of safety culture questionnaires in healthcare : a systematic review and analysis

Objectives: Safety culture questionnaires are widely used in healthcare to understand how staff feel at work, their attitudes and views, and the influence this has on safe and high-quality patient care. A known challenge of safety culture questionnaires is achieving high response rates to enhance reliability and validity. This review examines predictors of response rates, explores reasons provided for low response rates and identifies strategies to improve those rates. Methods: Four bibliometric databases were searched for studies assessing safety culture in hospitals from January 2008 to May 2022. Data were extracted from 893 studies that included a safety culture questionnaire conducted in the hospital setting. Regression was used to predict response rate based on recruitment and data collection methods (incentives, reminders, method of survey administration) and country income classification. Reasons for low response were thematically analysed and used to identify strategies to improve response rates. Results: Of the 893 studies that used a questionnaire to assess safety culture in hospitals, 75.6% reported a response rate. Response rates varied from 4.2% to 100%, with a mean response rate of 66.5% (SD=21.0). Regression analyses showed that safety culture questionnaires conducted in low-income and middle-income countries were significantly more likely to yield a higher response rate compared with high-income countries. Mode of administration, questionnaire length and timing of administration were identified as key factors. Remote methods of questionnaire data collection (electronic and by post) were significantly less likely to result in a higher response rate. Reasons provided for low response included: survey fatigue, time constraints, and lack of resources. Conclusion: This review presents strategies for researchers and hospital staff to implement when conducting safety culture questionnaires: principally, distribute questionnaires in-person, during meetings or team training sessions; use a local champion; and consider the appropriate time of distribution to manage survey fatigue

Investigating the Origin of Epimerization Attenuation during Pd-Catalyzed Cross-Coupling Reactions

Palladium-catalyzed cross-couplings remain among the most robust methodologies to form carbon–carbon and carbon-heteroatom bonds. In particular, carbon–nitrogen (C–N) couplings (Buchwald–Hartwig aminations) find widespread use in fine chemicals industries. The use of base in these reactions is critical for catalyst activation and proton sequestration. Base selection also plays an important role in process design, as strongly basic conditions can impact sensitive stereocenters and result in erosion of stereochemical purity. Herein we investigate the role of a Pd catalyst in suppressing base-mediated epimerization of a sultam stereocenter during a C–N cross-coupling reaction to access the RORγ inhibitor GDC-0022. Online high-performance liquid chromatography-mass spectrometry (HPLC-MS) was employed to acquire reaction time course profiles and to delineate epimerization behavior, identify decomposition pathways, and monitor Pd-containing species. Our ability to monitor organopalladium complexes in real time by HPLC-MS provided strong evidence that the degree of epimerization was correlated to the Pd speciation in solution. Specifically, Pd(II) complexes were associated with mitigating epimerization of six-membered sultams. Additional studies showed that the suppression of epimerization in the presence of Pd(II) can impact Pd-catalyzed reactions of other substrates such as enolizable ketones, thus providing practical insight on the execution and optimization of such processes.publishedVersio

Neuropathic Pain Phenotype Does Not Involve the NLRP3 Inflammasome and Its End Product Interleukin-1β in the Mice Spared Nerve Injury Model.

The NACHT, LRR and PYD domains-containing protein 3 (NLRP3) inflammasome is one of the main sources of interleukin-1β (IL-1β) and is involved in several inflammatory-related pathologies. To date, its relationship with pain has not been studied in depth. The aim of our study was to elucidate the role of NLRP3 inflammasome and IL-1β production on neuropathic pain. Results showed that basal pain sensitivity is unaltered in NLRP3-/- mice as well as responses to formalin test. Spared nerve injury (SNI) surgery induced the development of mechanical allodynia and thermal hyperalgesia in a similar way in both genotypes and did not modify mRNA levels of the NLRP3 inflammasome components in the spinal cord. Intrathecal lipopolysaccharide (LPS) injection increases apoptosis-associated speck like protein (ASC), caspase-1 and IL-1β expression in both wildtype and NLRP3-/- mice. Those data suggest that NLRP3 is not involved in neuropathic pain and also that other sources of IL-1β are implicated in neuroinflammatory responses induced by LPS

Functional mechanisms underlying pleiotropic risk alleles at the 19p13.1 breast-ovarian cancer susceptibility locus

A locus at 19p13 is associated with breast cancer (BC) and ovarian cancer (OC) risk. Here we analyse 438 SNPs in this region in 46,451 BC and 15,438 OC cases, 15,252 BRCA1 mutation carriers and 73,444 controls and identify 13 candidate causal SNPs associated with serous OC (P=9.2 × 10-20), ER-negative BC (P=1.1 × 10-13), BRCA1-associated BC (P=7.7 × 10-16) and triple negative BC (P-diff=2 × 10-5). Genotype-gene expression associations are identified for candidate target genes ANKLE1 (P=2 × 10-3) and ABHD8 (P<2 × 10-3). Chromosome conformation capture identifies interactions between four candidate SNPs and ABHD8, and luciferase assays indicate six risk alleles increased transactivation of the ADHD8 promoter. Targeted deletion of a region containing risk SNP rs56069439 in a putative enhancer induces ANKLE1 downregulation; and mRNA stability assays indicate functional effects for an ANKLE1 3′-UTR SNP. Altogether, these data suggest that multiple SNPs at 19p13 regulate ABHD8 and perhaps ANKLE1 expression, and indicate common mechanisms underlying breast and ovarian cancer risk