Study protocol for a randomized controlled trial: Integrating the 'Time-limited Trial' in the emergency department.

Introduction: Time-limited trial (TLT) is a structured approach between clinicians and seriously ill patients or their surrogates to discuss patients' values and preferences, prognosis, and shared decision-making to use specific therapies for a prespecified period of time in the face of prognostic uncertainty. Some evidence exists that this approach may lead to more patient-centered care in the intensive care unit; however, it has never been evaluated in the emergency department (ED). The study protocol aims to assess the feasibility and acceptability of TLTs initiated in the ED.

Pediatric screen time.

Background: Ease of access to technology by the pediatric individual has brought with it new challenges for parents and guardians as they grapple to understand and formulate healthy boundaries between their child and the media. This transition into a media-forward generation has triggered a new wave of research discussing the relationship between early media exposure and the developing pediatric mind; media and the parent-child relationship; and recommendations for healthy boundaries from the American Academy of Pediatrics (AAP) as well as the American Academy of Child and Adolescent Psychiatry (AACAP) and American Psychological Association (APA).

Objectives: This systematic review was written for the purposes of equipping physicians and nurse practitioners to be the bridge between research and their patients.

Phylogenomic analysis of the species of the Mycobacterium tuberculosis complex demonstrates that Mycobacterium africanum, Mycobacterium bovis, Mycobacterium caprae, Mycobacterium microti and Mycobacterium pinnipedii are later heterotypic synonyms of Mycobacterium tuberculosis.

The species within the Mycobacterium tuberculosis Complex (MTBC) have undergone numerous taxonomic and nomenclatural changes, leaving the true structure of the MTBC in doubt. We used next-generation sequencing (NGS), digital DNA-DNA hybridization (dDDH), and average nucleotide identity (ANI) to investigate the relationship between these species. The type strains of Mycobacterium africanum, Mycobacterium bovis, Mycobacterium caprae, Mycobacterium microti and Mycobacterium pinnipedii were sequenced via NGS.

The effect of respiratory rate and ingestion of hot and cold beverages on the accuracy of oral temperatures measured by electronic thermometers.

Researchers examined hot and cold beverage consumption, tachypnea, and bradypnea effects on oral electronic thermometer readings. Results indicate that waiting at least 30 minutes after drinking yields a more accurate reading. Outcomes also suggest that bradypnea may create false temperature elevations.

The challenge of acute rheumatic fever diagnosis in a high-incidence population: a prospective study and proposed guidelines for diagnosis in Australia's Northern Territory.

Background: Accurate diagnosis of acute rheumatic fever (ARF) remains problematic in high-incidence settings and especially in the Aboriginal population of Australia's Northern Territory. Previous investigators have demonstrated that strict application of the 1992 Updated Jones Criteria results in under-diagnosis. This study's objectives were to review use of the Jones Criteria (1992 Update) in diagnosing ARF in Australian Aboriginal patients presenting with suspected rheumatic fever, and formulate a locally relevant algorithm to improve diagnosis.

Actions of paracetamol on cyclooxygenases in tissue and cell homogenates of mouse and rabbit.

Background: Paracetamol is a potent analgesic and antipyretic drug, but has only weak anti-inflammatory activity. Unlike aspirin-like drugs, paracetamol does not damage the stomach mucosa or inhibit the aggregation of platelets. The analgesic action of paracetamol is on the central nervous system.

cis,cis- and trans,trans-ceratospongamide, new bioactive cyclic heptapeptides from the Indonesian red alga Ceratodictyon spongiosum and symbiotic sponge Sigmadocia symbiotica.

Chemical investigation of the marine red alga (Rhodophyta) Ceratodictyon spongiosum containing the symbiotic sponge Sigmadocia symbiotica collected from Biaro Island, Indonesia, yielded two isomers of a new and bioactive thiazole-containing cyclic heptapeptide, cis,cis-ceratospongamide (1) and trans, trans-ceratospongamide (2). Isolation of these peptides was assisted by bioassay-guided fractionation using a brine shrimp toxicity assay (Artemia salina). The structures of the ceratospongamides, which each consist of two L-phenylalanine residues, one (L-isoleucine)-L-methyloxazoline residue, one L-proline residue, and one (L-proline)thiazole residue, were established through extensive NMR spectroscopy, including (1)H-(13)C HMQC-TOCSY, and (1)H-(15)N HMBC experiments, as well as chemical degradation and chiral analysis.

Facilitating communication and collaboration across the continuum: a transportable plan of care.

As the healthcare system becomes more complex and the need for communication and collaboration more critical, knowledge of hospice and palliative care, coupled with an easy-to-use tool that communicates a patient's wishes, becomes invaluable in preserving the dying patient's rights and wishes. Through this project, a stronger commitment and awareness of end-of-life issues and rights has been realized by those patients, families, and healthcare communities involved. The recipient of a National Hospice Organization Award of Excellence, the Plan of Care project is a model that can and should be adapted and incorporated into all healthcare settings to enhance continuity of care across settings and help to preserve the rights and wishes of all patients.

Manipulation of distinct NFkappaB proteins alters interleukin-1beta-induced human rheumatoid synovial fibroblast prostaglandin E2 formation.

Interleukin 1beta (IL-1beta) up-regulates human rheumatoid synovial fibroblast (RSF) 85-kDa phospholipase A2 (PLA2) and mitogen-inducible cyclooxygenase (COX) II. Promoter regions for these genes contain a motif that closely resembles the "classic" NFkappaB consensus site. Immunoblot analysis identified NFkappaB1 (p50), RelA (p65), and c-Rel in RSF.

Communicating with staff nurses: support or hostility?

Communication researchers specializing in social support determine factors that influence and make up supportive encounters in the hospital environment. Effective communication strategies provide a vital dyad's link between nurse managers and staff nurses. Thus, supportive relationships are formed that can ease stressful situations and encourage innovative ideas.

A comparative analysis of several crutch-length-estimation techniques.

The purpose of this study was to determine which of several crutch-fitting techniques best predicts ideal crutch length. One hundred seven active-duty military volunteers were measured for crutches using each of the following methods: (1) axillary fold to heel in the supine position, (2) olecranon to opposite third fingertip, (3) olecranon to opposite fifth fingertip, (4) 77% of height, (5) height minus 16 in (40.6 cm), (6) 77% of arm span, and (7) arm span minus 16 in (40.

Assessing social support of people with AIDS.

Research indicates that social support has a direct effect on health, buffers the effects of physical and emotional stress, and mediates immune dysfunction. Although nurses frequently incorporate social support needs during patient assessment, it may not be specific or systematic. Assessment of social support for the person with AIDS is important because of the devastating psychosocial consequences of the disease.