Interprofessional rhetoric and operational realities: an ethnographic study of rounds in four intensive care units.

Morning interprofessional rounds (MIRs) are used in critical care medicine to improve team-based care and patient outcomes. Given existing evidence of conflict between and dissatisfaction among rounds participants, this study sought to better understand how the operational realities of care delivery in the intensive care unit (ICU) impact the success of MIRs. We conducted a year-long comparative ethnographic study of interprofessional collaboration and patient and family involvement in four ICUs in tertiary academic hospitals in two American cities.

T Cells Target Pancreatic Tumors.

Researchers have generated engineered T cells that home in on mesothelin, a protein produced in large amounts by pancreatic tumors. In mice, the T cells entered pancreatic tumors and destroyed cancer cells. Repeated infusions of the T cells nearly doubled survival times in the animals.

The employment concerns of Americans with multiple sclerosis: Perspectives from a national sample.

Background: The recent rehabilitation literature does not include a thorough assessment of the employment concerns of people with MS.

Objective: This article presents descriptive findings from a national survey of the employment concerns of Americans with multiple sclerosis (MS; N = 1,924), representing nine chapters of the National Multiple Sclerosis Society.

Methods: Respondents were asked to evaluate 38 employment concerns items on two dimensions, importance and satisfaction, for the purpose of identifying strengths and weaknesses in the employment policies and practices affecting the labor force participation of people with MS.

Motorcycle Helmets: The Economic Burden of an Incomplete Helmet Law to Medical Care in the State of Connecticut.

The lack of a mandatory motorcycle helmet law leads to increased injury severity and increased health care costs. This study presents a financial model to estimate how the lack of a mandatory helmet law impacts the cost of health care in the state of Connecticut. The average cost to treat a helmeted rider and a nonhelmeted rider was $3,112 and $5,746 respectively (cost adjusted for year 2014).

Patterns in workplace accommodations for people with multiple sclerosis to overcome cognitive and other disease-related limitations.

Background: Cognitive symptoms and other functional limitations associated with multiple sclerosis (MS) have a significant negative impact on employment status. Work accommodations positively impact the ability of a person with MS to obtain and retain employment, however, current understanding of the role of accommodations in the careers of adults with MS is limited.

Objective: To analyze the percentage of American workers with MS who utilize workplace accommodations as per Title I of the ADA, the types of accommodations most frequently required, and differences in disease variables, job-related factors, and quality of life between workers using and not using work accommodations.

The Evolution of Individual Maternity Care Providers to Delayed Cord Clamping: Is It the Evidence?

Introduction: Studies of organizational strategies to incorporate evidence into practice and change provider behavior have shown limited success. The majority of existing research centers on influencing participants to change practice versus understanding what occurs when providers have successfully shifted to an evidence-based practice on their own. This study sought to explore the dynamics involved when individual midwives and physicians transitioned from a practice less based on the evidence to one with more scientific support.

How important are autonomy and work setting to nurse practitioners' job satisfaction?

Purpose: Nurse practitioners (NPs) have reported aspects of their jobs that they are more and less satisfied with. However, few studies have examined the factors that predict overall job satisfaction. This study uses a large national sample to examine the extent to which autonomy and work setting predict job satisfaction.

A review of the effect of omega-3 polyunsaturated fatty acids on blood triacylglycerol levels in normolipidemic and borderline hyperlipidemic individuals.

Circulating levels of triacylglycerol (TG) is a recognized risk factor for developing cardiovascular disease, a leading cause of death worldwide. The Institute of Medicine and the American Heart Association both recommend the consumption of n-3 polyunsaturated fatty acids (PUFA), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), to reduce serum TG in hyperlipidemic individuals. Additionally, a number of systematic reviews have shown that individuals with any degree of dyslipidemia, elevated serum TG and/or cholesterol, may benefit from a 20-30% reduction in serum TG after consuming n-3 PUFA derived from marine sources.

Supportive text messages to reduce mood symptoms and problem drinking in patients with primary depression or alcohol use disorder: protocol for an implementation research study.

Background: Depression and Alcohol Use Disorders (AUDs) are two leading causes of disability worldwide and are associated with significant treatment challenges requiring new, innovative, cost-effective and technologically-based therapies including the use of supportive text messages.

Objective: To determine the feasibility and effectiveness of supportive text messages in long-term follow-up to reduce mood symptoms and problem drinking in patients with Depression or AUD respectively and to explore the usefulness of self-reports of health services utilization as an outcomes measure.

Methods: This will be a longitudinal, prospective, parallel-design, two-arm, placebo-controlled single-rater-blinded randomized clinical trial with a recruitment period of 6 months and an observation period of 12 months for each participant, with two strata based on primary diagnosis of Major Depressive Disorder or AUD.

Does Prior RN Clinical Experience Predict Academic Success in Graduate Nurse Practitioner Programs?

Background: There is limited evidence on whether prior RN clinical experience is predictive of academic success in graduate nurse practitioner (NP) programs. The purpose of this study was to explore whether the frequently held assumption that more prior clinical experience is associated with better academic success in The George Washington University online NP programs.

Method: Applications (n = 106) for clinical NP students entering from 2008-2010 were examined along with data on academic performance.

The Economic Impact of Helmet Use on Motorcycle Accidents: A Systematic Review and Meta-analysis of the Literature from the Past 20 Years.

Objective: The incidence and cost of motorcycle accidents are projected to increase. Motorcycle helmets are accepted as an effective strategy for reducing the morbidity and therefore the cost of motorcycle accidents. Despite this, states have continued to repeal helmet laws in the past 20 years.

Perspectives on implementing delayed cord clamping.

Expanding evidence supports delayed cord clamping (DCC) for both term and preterm infants. This article explores issues that may be keeping early cord clamping (ECC) in place as usual practice. Professional organizations almost universally recommend DCC for preterm infants, but some reserve recommending it for term infants only in resource-poor settings.

Loss of Arabidopsis thaliana Dynamin-Related Protein 2B reveals separation of innate immune signaling pathways.

Vesicular trafficking has emerged as an important means by which eukaryotes modulate responses to microbial pathogens, likely by contributing to the correct localization and levels of host components necessary for effective immunity. However, considering the complexity of membrane trafficking in plants, relatively few vesicular trafficking components with functions in plant immunity are known. Here we demonstrate that Arabidopsis thaliana Dynamin-Related Protein 2B (DRP2B), which has been previously implicated in constitutive clathrin-mediated endocytosis (CME), functions in responses to flg22 (the active peptide derivative of bacterial flagellin) and immunity against flagellated bacteria Pseudomonas syringae pv.

The world's most isolated and distinct whale population? Humpback whales of the Arabian Sea.

A clear understanding of population structure is essential for assessing conservation status and implementing management strategies. A small, non-migratory population of humpback whales in the Arabian Sea is classified as "Endangered" on the IUCN Red List of Threatened Species, an assessment constrained by a lack of data, including limited understanding of its relationship to other populations. We analysed 11 microsatellite markers and mitochondrial DNA sequences extracted from 67 Arabian Sea humpback whale tissue samples and compared them to equivalent datasets from the Southern Hemisphere and North Pacific.

Escherichia coli persister cells suppress translation by selectively disassembling and degrading their ribosomes.

Bacterial persisters are rare, phenotypically distinct cells that survive exposure to multiple antibiotics. Previous studies indicated that formation and maintenance of the persister phenotype are regulated by suppressing translation. To examine the mechanism of this translational suppression, we developed novel methodology to rapidly purify ribosome complexes from persister cells.

Haptic biofeedback for improving compliance with lower-extremity partial weight bearing.

After lower-extremity orthopedic trauma and surgery, patients are often advised to restrict weight bearing on the affected limb. Conventional training methods are not effective at enabling patients to comply with recommendations for partial weight bearing. The current study assessed a novel method of using real-time haptic (vibratory/vibrotactile) biofeedback to improve compliance with instructions for partial weight bearing.

Preoperative factors and early complications associated with hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures.

Displaced femoral neck fractures are common injuries in the elderly individuals. There is controversy about the best treatment with regard to total hip arthroplasty (THA) versus hemiarthroplasty. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to evaluate the preoperative risk factors associated with the decision to perform THA over hemiarthroplasty.