Trust of inpatient physicians among parents of children with medical complexity: a qualitative study.

Background: Trust is a foundation of the therapeutic relationship and is associated with important patient outcomes. Building trust between parents of children with medical complexity (CMC) and physicians during inpatient care is complicated by lack of relational continuity, cumulative (sometimes negative) parent experiences and the need to adjust roles and expectations to accommodate parental expertise. This study's objective was to describe how parents of CMC conceptualize trust with physicians within the pediatric inpatient setting and to provide recommendations for building trust in these relationships.

Exploration of trust between pediatric nurses and children with a medical diagnosis and their caregivers on inpatient care units: A scoping review.

Problem: Trust is central to the development of nurse-patient relationships. Pediatric nurses encounter difficulties developing trust with children and their caregivers. The purpose of this scoping review was to identify, examine, and summarize available evidence on the concept of trust among nurses and children/caregivers when admitted to hospital inpatient care units.

A Cluster Randomised Controlled Trial of a Targeted Distributed Toothpaste and Toothbrushing Programme.

Introduction: The aim was to assess the effectiveness of a distributed, targeted toothbrush and toothpaste programme on referrals for tooth extraction under Dental General Anaesthetic (DGA), in children of high-risk families compared to usual care.

Methods: A recruiter and assessor-blinded, clustered parallel randomised control trial (RCT). Families with one or more children aged between 3 and 10 years having undergone a DGA operation for extraction of carious teeth, were approached within hospitals in the North West of England.

Evaluation of the diagnostic accuracy of exome sequencing and its impact on diagnostic thinking for patients with rare disease in a publicly funded health care system: A prospective cohort study.

Purpose: To evaluate the diagnostic utility of publicly funded clinical exome sequencing (ES) for patients with suspected rare genetic diseases.

Methods: We prospectively enrolled 297 probands who met eligibility criteria and received ES across 5 sites in Ontario, Canada, and extracted data from medical records and clinician surveys. Using the Fryback and Thornbury Efficacy Framework, we assessed diagnostic accuracy by examining laboratory interpretation of results and assessed diagnostic thinking by examining the clinical interpretation of results and whether clinical-molecular diagnoses would have been achieved via alternative hypothetical molecular tests.

How Do Anxiety and Relationship Factors Influence the Application of Childbirth Education Strategies During Labor and Birth: A Bowen Family Systems Perspective.

The effectiveness of childbirth education (CBE) has long been debated with studies showing contradictory outcomes for mothers and babies. Understanding how what is learned in CBE is translated into practice during labor and birth is an area that requires investigation as this may be a mediating factor in its effectiveness. Bowen family system theory's concept of differentiation of self, the ability to be guided by and to act from one's beliefs and values, is an organizing principle that may affect how relational factors affect the use and application of CBE at the time of birth.

Impact of the COVID-19 Pandemic on Canadian Social Connections: A Thematic Analysis.

Background: On March 11, 2020, the World Health Organization declared COVID-19 a worldwide pandemic. Responses to the pandemic response disrupted Canadian social connections in complex ways; because social connections are determinants of health and well-being, their disruption could adversely affect health and well-being. Moreover, understanding how pandemics and public health responses affect social connections could inform pandemic recovery strategy and public health approaches designed for future pandemics.

Preprinting is positively associated with early career researcher status in ecology and evolution.

The usage of preprint servers in ecology and evolution is increasing, allowing research to be rapidly disseminated and available through open access at no cost. Early Career Researchers (ECRs) often have limited experience with the peer review process, which can be challenging when trying to build publication records and demonstrate research ability for funding opportunities, scholarships, grants, or faculty positions. ECRs face different challenges relative to researchers with permanent positions and established research programs.

Effects of phytase supplementation and increased nutrient density on growth performance, carcass characteristics, and hypothalamic appetitive hormone expression and catecholamine concentrations in broilers from 1 to 43 days of age.

Two experiments were conducted to evaluate extra-phosphoric effects of phytase and nutrient density on growth performance, meat yield, and hypothalamic appetitive hormone expression and catecholamine concentrations of broilers. Experiment 1 determined differences of digestible amino acid concentrations and AME using 256 Yield Plus × Ross 708 broilers (32 cages, 8 birds/cage) fed diets without or with 4,500 phytase units (FTU)/kg inclusion (16 reps/treatment). In Experiment 2, 832 Yield Plus × Ross 708 broilers (32 pens; 26 birds/pen) were provided diets in a 2 × 2 factorial arrangement consisting of 2 nutrient contents (without or with increased density) and 2 phytase inclusions (0 or 4,500 FTU/kg).

Cross-Sectional Study Protocol for the COVID-19 Impact Survey of Mothers and Their 7-11 Year Old Children in Alberta, Canada.

Our aim is to understand the effect of the COVID-19 pandemic on families who have been followed longitudinally in two cohorts studied in Alberta, Canada. We will examine household infections during the COVID-19 pandemic, financial impact, domestic violence, substance use, child school and daily life and relationships in the home. We will identify risk and protective factors for maternal mental health outcomes using longitudinal data that can inform policy and government resource allocation in future disasters.

Inoculation Route and Serotype Alter Salmonella Recovery in the Broiler's Digestive Tract.

Salmonella enterica serotypes Enteritidis (SE) and Heidelberg (SH) are consistently linked to poultry-related foodborne outbreaks and can be isolated from broiler parts in processing facilities. In order to control this pathogen's establishment in the broiler, entryways at the farm that lead to colonization must be considered. The objective of these trials was to determine if the inoculation route of either SE or SH altered its recovery in a market-age broiler's digestive tract if chicks were dosed on day of hatch.

Deciphering the dynamics of lamellipodium in a fish keratocytes model.

Motile cells depend on an intricate network of feedback loops that are essential in driving cell movement. Integrin-based focal adhesions (FAs) along with actin are the two key factors that mediate such motile behaviour. Together, they generate excitable dynamics that are essential for forming protrusions at the leading edge of the cell and, in certain cases, traveling waves along the membrane.

Outcome of Hospitalization for COVID-19 in Patients with Interstitial Lung Disease. An International Multicenter Study.

The impact of coronavirus disease (COVID-19) on patients with interstitial lung disease (ILD) has not been established. To assess outcomes in patients with ILD hospitalized for COVID-19 versus those without ILD in a contemporaneous age-, sex-, and comorbidity-matched population. An international multicenter audit of patients with a prior diagnosis of ILD admitted to the hospital with COVID-19 between March 1 and May 1, 2020, was undertaken and compared with patients without ILD, obtained from the ISARIC4C (International Severe Acute Respiratory and Emerging Infection Consortium Coronavirus Clinical Characterisation Consortium) cohort, admitted with COVID-19 over the same period.

Parental Experiences Caring for Their Hospitalized Medically Fragile Infants: A Description of Grief, Stress, and Coping.

Background: Advances in care have increased survival and improved outcomes of infants with complex and chronic diseases. These medically fragile infants require long-term hospitalization and depend on technology for survival. Parents of these infants experience stress and difficulties adapting to their parental role.

Is point of care renal function testing reliable screening pre-IV contrast administration?

Purpose: Intravenous iodinated contrast is a commonly used diagnostic aid to improve image quality on computed tomography. There exists a small risk of post-contrast acute kidney injury in patients receiving IV contrast. One of the biggest risk factors for developing PC-AKI is the presence of pre-existing renal dysfunction, making it important to measure the renal function prior to contrast administration.

Moving Beyond the Rhetoric of Shared Decision-Making: Designing Personal Health Record Technology With Young Adults With Type 1 Diabetes.

Objectives: Engaging young adults with type 1 diabetes (T1D) in the self-management of daily tasks and decision-making provides opportunities for positive health outcomes. However, emerging adulthood and care transitions are associated with decreased clinic attendance and diabetes complications. Shared decision-making (SDM) is an optimal approach for health decisions; however, it has been difficult to implement in practice.

The bioenergetics of integrin-based adhesion, from single molecule dynamics to stability of macromolecular complexes.

The forces actively generated by motile cells must be transmitted to their environment in a spatiotemporally regulated manner, in order to produce directional cellular motion. This task is accomplished through integrin-based adhesions, large macromolecular complexes that link the actin-cytoskelton inside the cell to its external environment. Despite their relatively large size, adhesions exhibit rapid dynamics, switching between assembly and disassembly in response to chemical and mechanical cues exerted by cytoplasmic biochemical signals, and intracellular/extracellular forces, respectively.

Dynamics of Mechanosensitive Nascent Adhesion Formation.

Cellular migration is a tightly regulated process that involves actin cytoskeleton, adaptor proteins, and integrin receptors. Forces are transmitted extracellularly through protein complexes of these molecules, called adhesions. Adhesions anchor the cell to its substrate, allowing it to migrate.

A comparison of dental fluorosis in adult populations with and without lifetime exposure to water fluoridation.

Objectives: There is a lack of evidence on the proportion and severity of fluorosis in adult populations exposed and not exposed to fluoridated water over their lifetimes. The aim of this study was to compare the proportion and severity of fluorosis in adults with lifetime exposure to water fluoridation with a nonexposed sample. A secondary aim was to report the gradient of fluorosis severity by age.

Prevalence and severity of dental fluorosis in four English cities.

Objective: To assess the prevalence and severity of dental fluorosis in four city-based populations using a robust photographic method with TF index reporting; and to record the aesthetic satisfaction scores of children in all four cities.

Basic Research Design: Cross sectional epidemiological survey (surveillance).

Participants: 1,904 children aged 11-14 years, in four English cities.

Shared decision-making using personal health record technology: a scoping review at the crossroads.

Objective: This scoping review aims to determine the size and scope of the published literature on shared decision-making (SDM) using personal health record (PHR) technology and to map the literature in terms of system design and outcomes.

Materials And Methods: Literature from Medline, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Engineering Village, and Web of Science (2005-2015) using the search terms "personal health records," "shared decision making," "patient-provider communication," "decision aid," and "decision support" was included. Articles ( n  = 38) addressed the efficacy or effectiveness of PHRs for SDM in engaging patients in self-care and decision-making or ways patients can be supported in SDM via PHR.

Development of Semiempirical Models for Proton Transfer Reactions in Water.

This letter presents a method for the parametrization of semiempirical models for proton transfer reactions in water clusters. Two new models are developed: AM1-W, which is a reparameterization of the classic AM1 model, and AM1PG-W, which is a modified AM1-like model including a pairwise correction to the core repulsion function. Both models show good performance on hydrogen-bonding energies and on proton transfer energy profiles, which are of great importance for proton transfer reactions in large water clusters and in proteins.

Perspective: Entering uncharted waters: navigating the transition from trainee to career for the nonphysician clinician-scientist.

The transition from trainee to career clinician-scientist can be a stressful and challenging time, particularly for those entering the less established role of nonphysician clinician-scientist. These individuals are typically PhD-prepared clinicians in the allied health professions, who have either a formal or informal joint appointment between a clinical institution and an academic or research institution. The often poorly defined boundaries and expectations of these developing roles can pose additional challenges for the trainee-to-career transition.

Exploring family-centered care among pediatric oncology nurses.

Family-centered care (FCC) is important within pediatric oncology nursing. However, pediatric oncology nurses often face challenges and barriers when attempting to provide FCC. The purpose of this study was to understand the experiences of pediatric oncology nurses in relation to FCC; identify how pediatric oncology nurses implemented FCC into their practice; identify what facilitated and enabled pediatric oncology nurses to implement FCC; and discern the barriers and challenges that were present in their setting when implementing FCC.

The use of a clinical resource nurse for newly graduated nurses in a pediatric oncology setting.

The pediatric oncology nursing unit at the Alberta Children's Hospital experienced a large influx of new staff nurses between May 2008 and November 2008. There were 16 in total, and only a few had previous experience, whereas the majority was newly graduated nurses. As a solution to the high numbers of new staff nurses, the role of a Resource Nurse was developed as a temporary position to assist new staff nurses with their patient assignment, prioritize their day, and deal with complex patient procedures/treatments.

Relationship between body image and stimulant use among Canadian adolescents.

This study investigated the relationship between body image, dieting, disordered eating behaviors, and stimulant use in a sample of more than 30,000 British Columbian students. For both males and females, significant associations were found between stimulant use and body satisfaction, binging and purging, and efforts to lose weight.