Mobile translators for non-English-speaking women accessing maternity services.

noIt is becoming increasingly common for midwives to care for women who do not speak English, and UK interpreting services are often inadequate and underused. Persistent language barriers have been found to contribute to maternal and perinatal mortality thus it is essential that these barriers are overcome to provide safe maternity care. This article reports on a two-stage study undertaken to address this. The study aimed to: • Identify difficulties midwives experience when communicating with non-English-speaking women. Through undertaking a group interview with 11 senior students, four themes emerged: accessing interpreters, working with interpreters, cultural barriers and strategies to address persistent language barriers • Explore the feasibility of using mobile devices with a translation application to communicate in clinical practice. Google Translate was tested in a simulated clinical environment with multi-lingual service users. Google Translate was not adequately developed to be safely used in maternity services. However, a maternity-specific mobile application could be built to help midwives and women communicate in the presence of a persistent language barrier

Controlling The pH Of Cultures Of Penicillium Notatum Through Its Carbon And Nitrogen Nutrition

A survey of published material reveals relatively little information concerning the nutritional physiology of Penicillium notatum Westl. on synthetic media. Metabolism studies of P. notatum on various media have appeared to be incidental to the more pressing problem of producing penicillin quickly and in quantity. Fleming (1929) originally used a nutrient broth non-synthetic in nature. The Oxford group (Abraham et al., 1941) then adopted a modification of the so-called Czapek-Dox synthetic medium which supplies nitrogen as sodium nitrate and glucose as carbohydrate. Hobby, Meyer, and Chaffee (1942) suggested that brown sugar be substituted for glucose in this nutrient, with resultant higher yields and decreased time for maximum production of penicillin. Apparently a variety of carbon and nitrogen sources have been employed in liquid nutrients (Foster, 1943; Foster, Woodruff and McDaniel, 1943; McKee and Rake, 1942; Kocholaty, 1942; Waksman and Horning, 1943); but specific data have not been offered. At the present time corn steep liquor appears to be an important component of the medium used

B837: New Approaches to Chemical Control of White Pine Weevil Damage

There has been little recent research on control of damage by the white pine weevil, and available insecticides have been few and have become obsolete. Tests in Canada suggested that the insect growth-regulating chemical diflubenzeron was effective, and we have successfully repeated those tests in Maine using several formulations of Dimilin and several ground application systems. Aerial trials have not succeeded; the probable reasons for their failure are discussed. We present a general description of the weevil and its damage, approaches to control of damage, and specific recommendations for use of ground applications of Dimilin, which has recently become registered for this use.https://digitalcommons.library.umaine.edu/aes_bulletin/1010/thumbnail.jp

Factors that Affect the Surgical Decision-making Process among Women with Breast Cancer

There are multiple factors that influence surgical treatment decision making at the time of diagnosis for women with breast cancer. The purpose of this study is to identify these factors that may be related to the surgical choice made in the treatment of breast cancer by women. Gaps in the existing research literature revealed a lack of prospective (pre-surgical) studies. The proposed study addresses this gap by focusing on pre-surgical decision making regarding the various factors that impact why women choose mastectomy when the stage of and type of their cancer allows breast conserving surgery as an option. This prospective, mixed mode design was conducted in a mid-Michigan oncology private practice setting. The purposive sample included a total of 10 participants, 3 scheduled for modified radical mastectomy (MRM) surgery and the other 7 scheduled for breast conserving surgery (BCS). A Factor List developed by Ward and colleagues (1989) was adapted to use in content analysis of narrative data from an open-ended question for participants' thoughts and feelings about their surgical treatment decisions. Results revealed most participants were ≤60 years of age, Caucasian, married, employed, and had full coverage health insurance. The following content analysis findings were consistent with previous post-op findings. Among the 10 participants, 90% stated that their physician's opinion was an impact in surgical treatment choice. Fear of side effects from chemo and radiation, length of recovery, and fear of recurrence were also discovered as influences regarding type of surgical treatment chosen. In addition, 10 new factors/themes emerged including fear (nonspecified) (60%), involved support system (60%), information given (40%), personal decision (30%) and strong faith/spirituality beliefs (30%). Other factors/themes (10-20%) were previous experience with someone with breast cancer, guidance from the nurse navigator, trust (nonspecified), age, and fear of subsequent surgeries. Fisher's Exact test revealed no significant relationship between type of surgery (MRM, BCS) and actual breast satisfaction ratings by participants. There was no significant relationship between demographic variables and breast satisfaction. Findings are beneficial to nurse practitioners and other health care providers who can enhance their understanding about the experience women go through during this difficult time, and may ultimately facilitate the surgical treatment decision making process for patients with breast cancer.Master'sSchool of Health Professions and Studies: NursingUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/117696/1/Dimond.pd

Seasonal Stability of a Flexible Algal-Cnidarian Symbiosis in a Highly Variable Temperate Environment

We evaluated the seasonal stability of two algal symbiont populations in the temperate intertidal sea anemone Anthopleura elegantissima on San Juan Island, Washington, where the relatively thermally tolerant dinoflagellate Symbiodinium muscatinei coexists with the less thermally tolerant chlorophyte Elliptochloris marina. Random collection of anemones along repeatedly sampled transects over four seasons and three shore heights revealed S. muscatinei to be the dominant symbiont, with E. marina mostly limited to anemones in the lower intertidal zone. At the lowest shore height sampled (+0.2 m), the proportion of E. marina was between 40% and 50% of the total symbiont population throughout the year. Symbiont distribution patterns persisted despite considerable seasonal variation in aerial exposure, temperature, irradiance, nutrients, and phytoplankton concentration, as well as a high potential for symbiont shuffling, with mixed-symbiont assemblages occurring in 51% of all anemones sampled. Symbiont density in anemones also changed little despite three- to fourfold-higher division frequencies of both symbionts during July and November. Although the intertidal zonation of these symbionts was stable over an annual period, we predict that their spatial distributions will be responsive to longer-term environmental change, and anticipate that this anemone symbiosis will be a useful and highly tractable barometer for future climate change, with this study serving as a baseline

B819: The Spruce Budworm Outbreak in Maine in the 1970\u27s–Assessment and Directions for the Future

This report was initiated by the Maine Forest Service (MFS) in response to concerns that a serious effort was needed to capture the experiences and lessons learned during the 1970-85 spruce budworm outbreak in Maine. The report synthesizes the observations and experiences of land managers, as well as the principal results of recent scientific research on spruce budworm in Maine. This report briefly reviews budworm population dynamics and interactions with the forest, then describes the budworm\u27s impacts in detail. It then reviews the three principal responses: survey and detection; spraying; and silviculture and salvage. It then offers an overview of the outbreak\u27s effects and provides a summary of conclusions and recommendations for the future.https://digitalcommons.library.umaine.edu/aes_bulletin/1044/thumbnail.jp

Predictive genetic testing for Huntington's disease: Exploring participant experiences of uncertainty and ambivalence between clinic appointments

Ambivalence and uncertainty are key themes throughout the psychology of healthcare literature. This is especially so for individuals at risk of Huntington's disease (HD) deliberating the decision to undergo genetic testing because there is currently no treatment that modifies disease progression. A better understanding of the experience of making a decision about genetic prediction will help practitioners support and guide individuals through this process. Our aim was to capture participants' experiences of uncertainty and ambivalence in between their genetic counseling appointments. We explored these issues through the experiences of nine participants who were referred for predictive HD testing at four regional genetics services in England and Wales. Data consisted of recordings of clinic consultations, diaries, and an in‐depth interview conducted at the end of the testing process. Data were analyzed thematically. Four themes were identified representing four possible futures, each future dependent on the decision to undergo testing and the result of that test. Our results showed that participants, as well as attending more to a future that represents their current situation of not having undergone predictive testing, also attended more to a distant future where a positive predictive result is received and symptoms have started. Participants attended less to the two futures that were more immediate once testing was undertaken (a future where a positive result is received and symptoms have not started and a future where a negative result is received). The use of diaries gave us a unique insight into these participants' experiences of ambivalence and uncertainty, psychological distress, and the emotional burden experienced. These findings help inform discussions within the clinic appointment as well as encourage researchers to consider diary use as a method of exploring what happens for individuals outside of clinical encounters

Interpopulation hybridization results in widespread viability selection across the genome in Tigriopus californicus

Background: Genetic interactions within hybrids influence their overall fitness. Understanding the details of these interactions can improve our understanding of speciation. One experimental approach is to investigate deviations from Mendelian expectations (segregation distortion) in the inheritance of mapped genetic markers. In this study, we used the copepod Tigriopus californicus, a species which exhibits high genetic divergence between populations and a general pattern of reduced fitness in F2 interpopulation hybrids. Previous studies have implicated both nuclear-cytoplasmic and nuclear-nuclear interactions in causing this fitness reduction. We identified and mapped population-diagnostic single nucleotide polymorphisms (SNPs) and used these to examine segregation distortion across the genome within F2 hybrids.Results: We generated a linkage map which included 45 newly elucidated SNPs and 8 population-diagnostic microsatellites used in previous studies. The map, the first available for the Copepoda, was estimated to cover 75% of the genome and included markers on all 12 T. californicus chromosomes. We observed little segregation distortion in newly hatched F2 hybrid larvae (fewer than 10% of markers at p < 0.05), but strikingly higher distortion in F2 hybrid adult males (45% of markers at p < 0.05). Hence, segregation distortion was primarily caused by selection against particular genetic combinations which acted between hatching and maturity. Distorted markers were not distributed randomly across the genome but clustered on particular chromosomes. In contrast to other studies in this species we found little evidence for cytonuclear coadaptation. Instead, different linkage groups exhibited markedly different patterns of distortion, which appear to have been influenced by nuclear-nuclear epistatic interactions and may also reflect genetic load carried within the parental lines.Conclusion: Adult male F2 hybrids between two populations of T. californius exhibit dramatic segregation distortion across the genome. Distorted loci are clustered within specific linkage groups, and the direction of distortion differs between chromosomes. This segregation distortion is due to selection acting between hatching and adulthood

The role of the smartphone in the transition from medical student to foundation trainee: a qualitative interview and focus group study

Background The transition from medical student to junior doctor is one of the most challenging in medicine, affecting both doctor and patient health. Opportunities to support this transition have arisen from advances in mobile technology and increased smartphone ownership. Methods This qualitative study consisted of six in-depth interviews and two focus groups with Foundation Year 1 Trainees (intern doctors) and final year medical students within the same NHS Trust. A convenience sample of 14 participants was recruited using chain sampling. Interviews and focus groups were recorded, transcribed verbatim, analysed in accordance with thematic analysis and presented below in keeping with the standards for reporting qualitative research. Results Participants represented both high and low intensity users. They used their smartphones to support their prescribing practices, especially antimicrobials through the MicroGuide™ app. Instant messaging, via WhatsApp, contributed to the existing bleep system, allowing coordination of both work and learning opportunities across place and time. Clinical photographs were recognised as being against regulations but there had still been occasions of use despite this. Concerns about public and colleague perceptions were important to both students and doctors, with participants describing various tactics employed to successfully integrate phone use into their practices. Conclusion This study suggests that both final year medical students and foundation trainees use smartphones in everyday practice. Medical schools and healthcare institutions should seek to integrate such use into core curricula/training to enable safe and effective use and further ease the transition to foundation training. We recommend juniors are reminded of the potential risks to patient confidentiality associated with smartphone use

Symbiont presence and identity influence life history strategies of a temperate sea anemone

Along the North American Pacific coast, the common intertidal sea anemone Anthopleura elegantissima engages in facultative, flexible symbioses with Symbiodinium muscatinei (a dinoflagellate) and Elliptochloris marina (a chloro- phyte). Determining how symbiotic state affects host fitness is essential to understanding the ecological significance of engaging in such flexible relationships with diverse symbionts. Fitness consequences of hosting S. muscatinei, E. marina or negligible numbers of either symbiont (aposymbiosis) were investigated by measuring growth, cloning by fission and gonad development after 8.5 – 11 months of sustained exposure to high, moderate or low irradiance under seasonal environmental conditions. Both symbiotic state and irradiance affected host fitness, leading to divergent life-history strategies. Moderate and high irradiances led to a greater level of gonad development in individuals hosting E. marina, while high irradiance and high summer temperature promoted cloning in individuals hosting S. muscatinei and reduced fitness of aposymbiotic anemones. Associating with S. muscatinei may contribute to the success of A. elegantissima as a spatial competitor on the high shore: (i) by offsetting the costs of living under high temperature and irradiance conditions, and (ii) by promoting a high fission rate and clonal expansion. Our results suggest that basic life-history characteristics of a clonal cnidarian can be affected by the identity of the endosymbionts it hosts