An East Antarctic, sub-annual resolution water isotope record from the Mount Brown South Ice core.

We report high resolution measurements of the stable water isotope ratios (δO, δD) from the Mount Brown South ice core (MBS, 69.11 S 86.31 E).

Using Teaching Videos to Improve Nursing Students' Self-Efficacy in Managing Patient Aggression.

Background: Nursing students experience patient aggression due to their age and lack of experience. Academic institutions can implement strategies to prepare students to manage aggression.

Method: One-hundred forty-eight undergraduate nursing students in a baccalaureate nursing program participated in this quality improvement initiative.

A Clinical Nurse Specialist-Led Initiative to Reduce Catheter-Associated Urinary Tract Infection Rates Using a Best Practice Guideline.

Purpose: The purpose of this clinical nurse specialist-led initiative was to reduce catheter-associated urinary tract infection rates to less than 1 infection per 1000 catheter days, to reduce catheter device utilization, and to improve staff adherence to documentation requirements on a traumatic brain injury rehabilitation unit.

Description Of The Project: Catheter-associated urinary tract infections are costly hospital-acquired infections increasing length of stay and morbidity for patients. Following an education intervention, a best practice initiative was implemented.

A Comfort Measures Only Checklist for Critical Care Providers: Impact on Satisfaction and Symptom Management.

Purpose: This quality improvement project created a guide for critical care providers transitioning patients to comfort measures only encouraging communication, collaboration, and shared decision making; ensuring management of patients' end-of-life symptoms and needs; and enhancing provider satisfaction by improving structure and consistency when transitioning patients.

Description Of The Project: Interviews conducted with staff in intensive care units revealed opportunities to improve structure and processes of transitioning patients at the end of life. A subcommittee of experts designed a checklist to facilitate interdisciplinary conversations.

Neuroradiological emergency consultations during the first year of the COVID-19 pandemic.

Background: Measures taking aim at minimizing the risk of coronavirus transmission and fear of infection may affect decisions to seek care for other medical emergency conditions. The purpose of this analysis was to analyze intermediate-term effects of the COVID-19 pandemic on neuroradiological emergency consultations (NECs).

Methods: We conducted an ambispective study on NEC requests to a university hospital from a teleradiological network covering 13 hospitals in Germany.

Preparing ABSN students for early entry and success in the clinical setting: flipping both class and skills lab with the Socratic Method.

Objectives: Accelerated Second Degree BSN (ABSN) students have limited time to gain expertise. Reaching competency in skills takes weeks, delaying the application and mastery of skills in clinical practice. Our objective is to describe how our ABSN program fundamentals of nursing course enhances learning effectiveness and prepares students for successful entry into nursing.

Variability of acquisition phase of computed tomography angiography in acute ischemic stroke in a real-world scenario.

Objectives: The informative value of computed tomography angiography (CTA) depends on the contrast phase in the vessels which may differ depending on the level of local expertise.

Methods: We retrospectively measured vessel contrast density from CTA scans in patients presenting with acute ischemic stroke to a comprehensive stroke center (CSC) or to one of eight primary stroke centers (PSC). CTAs were classified into arterial or venous phases as well as into 1 of 5 phases (early arterial, peak arterial, equilibrium, peak venous, and late venous).

Preferred Teaching/Learning Strategies for Graduate Nursing Students in Web-Enhanced Courses.

Background: Advanced and continuing education is essential for maintaining competence. Graduate students have shown an increase in online course enrollment, and similar trends are anticipated among nurses with limited access to on-site education due to the current COVID-19 (coronavirus disease 2019) pandemic. Faculty must utilize preferred teaching/learning strategies to provide high-quality online education courses that engage learners and improve outcomes.

Variability of computed tomography angiography coverage of lung parenchyma in acute stroke.

Background: Computed tomography angiography (CTA) of the head and neck during acute ischemic stroke (AIS) usually includes visualization of lung apices. The possibility to evaluate for pulmonary changes, e.g.

Hypertension Management in Nursing Homes: Review of Evidence and Considerations for Care.

Purpose Of Review: We sought to summarize recent evidence regarding optimal blood pressure (BP) treatment targets and antihypertensive regimen intensity for nursing home (NH) residents and similar older, complex patients with hypertension.

Recent Findings: Recent trials have demonstrated cardiovascular benefits from more intensive BP targets among ambulatory, less complex older adults, but generalizability to NH residents is questionable. Other trials have demonstrated that de-intensifying antihypertensives in frail, older patients is feasible, with no or modest increases in BP, but most have not assessed effects on patient-centered outcomes.

Germline mutations detected in pediatric sequencing studies impact parents' evaluation and care.

There has been no indication to test for in children (with the rare exception of Fanconi anemia) as screening begins in adult years and there is a potential to induce anxiety related to adult-onset cancers. However, in the setting of pediatric cancer, with increasing utility and frequency of companion tumor-normal sequencing without regard for phenotype and with included in tumor profiling panels, germline mutations in and other DNA damage repair genes have been found. When mutations in these genes are revealed, there are implications for immediate family members.

Educational and Psychosocial Support Needs in Lynch Syndrome: Implementation and Assessment of an Educational Workshop and Support Group.

Few reports of educational and counseling support resources exist for Lynch syndrome (LS), a disorder requiring multi-organ cancer screening and specialized medical care throughout adult life. Here we describe the development and efficacy of two resources designed to address this need, the Memorial Sloan Kettering Cancer Center Clinical Genetics Service annual Lynch Syndrome Educational Workshop (LSEW), and a quarterly Lynch Syndrome Patient Advocacy Network (LSPAN) support group. The LSEW and LSPAN were implemented beginning in 2012.

Analysis of genetic variants in never-smokers with lung cancer facilitated by an Internet-based blood collection protocol: a preliminary report.

Purpose: Germ line polymorphisms may confer susceptibility to lung cancer in never smokers, but studies in the United States have been limited by the low number of cases seen at single institutions. We hypothesized that we could use the Internet to bolster the accrual of appropriate patients.

Experimental Design: We established an Internet-based protocol to collect blood and information from patients throughout the United States.

The 6q22.33 locus and breast cancer susceptibility.

Recently, we identified a novel breast cancer susceptibility locus at 6q22.33 following a genome-wide association study in the Ashkenazi Jewish genetic isolate. To replicate these findings, we did a case-control association analysis on 6q22.

Identification of seven novel germline mutations in the human E-cadherin (CDH1) gene.

Hereditary diffuse gastric cancer (HDGC) is a cancer predisposition syndrome caused by germline mutation of the gene encoding the tumour-suppressor E-cadherin (CDH1). We describe the search for CDH1 mutations in 36 new diffuse gastric cancer families. All 16 CDH1 exons, neighbouring intronic sequence and an essential promoter region were screened by DNA sequencing.

Genetics and the young woman with breast cancer.

While many individual risk factors have been defined for breast cancer, a family history was recognized long ago as one of the most potent. Mutations within BRCA1 or BRCA2, both identified about 10 years ago, are responsible for the majority of inherited breast cancer. By virtue of her age alone, a young woman diagnosed with breast cancer has a greatly elevated probability to carry a BRCA mutation.

High-dose intravenous dalteparin can be monitored effectively using standard coagulation times.

The objective of this study was to examine the pharmacokinetics of intravenous dalteparin (Fragmin, Pharmacia-Upjohn, Peapack, NJ) and to assess the accuracy of standard coagulation-based monitoring techniques as an estimate of drug concentration with which to guide dosing. Knowledge of the kinetic behavior of low-molecular-weight heparins (LMWHs) and the possible utility of coagulation times for monitoring may aid in the development of safe and effective dosing algorithms for percutaneous coronary interventions. Twenty normal volunteers were treated at 2-week intervals with each of three intravenous dalteparin doses.

Use of the capture-recapture method to estimate severe traumatic brain injury rates.

Objective: This study assessed the applicability of using three different data sources (hospital discharge data, Traumatic Brain Injury Registry data, and death certificates) to identify high-risk groups for traumatic brain injuries (TBI). Reporting biases were also addressed.

Methods: Linkage of the data sources and log-linear modelling in conjunction with the capture-recapture method was used to estimate the number of missing TBI.

Accuracy of an automated blood pressure device in stable inpatients: optimum vs routine use.

Background: Despite widespread use of the automated blood pressure (BP) device (IVAC model 4200, IVAC Corporation, San Diego, Calif), there is little formal validation in the literature on its accuracy.

Objective: To assess the accuracy of the IVAC 4200 device, both under standardized conditions and as routinely used by ward staff, compared with the true indirect BP measured by mercury manometer (MM).

Methods: One hundred forty-five stable inpatients were randomly selected for BP measurements by 3 randomly ordered protocols: (1) MM performed by certified investigators, (2) IVAC 4200 BP performed by trained investigators (research automated [RA]), and (3) IVAC 4200 BP performed by ward personnel (ward automated [WA]).

Balloon mitral valvuloplasty: clinical experience at the Texas Heart Institute.

For treatment of symptomatic mitral valve stenosis, balloon valvuloplasty has emerged as an alternative to surgery. This report describes our initial clinical experience with balloon mitral valvuloplasty in 45 patients (37 women and 8 men; age range, 34 to 79 years) treated from December 1986 through March 1991. Thirty-nine of the 45 patients (87%) underwent a complete procedure (that is, they had at least 1 balloon inflation and did not require emergency surgery).