Fogharnold4386

BACKGROUND Per the Centers for Medicare and Medicaid Services (CMS) Code of Federal Regulations (CFR) 482.23(c) regarding medication administration, hospital policies and procedures must identify time-critical scheduled medications which must be administered within 30 minutes either before or after the scheduled dosing time, for a total administration window of 1 hour. OBJECTIVE The general objective of this analysis was to determine whether there was a difference in meeting medication administration goals when comparing time-critical to non-time-critical scheduled medication administration in both intensive care units (ICUs) and general medical floors at a large, academic medical center. METHODS Data were collected in 6 inpatient nursing units (3 general medical units and 3 ICUs) during the month of June 2017. Electronic medical record charge data for medications were used to evaluate timeliness of medication administration. RESULTS In total, 69,794 medication administrations were evaluated. find more Of 389 administrations of time-critical scheduled medications, 268 (69%) were administered on time. Of 69,405 administrations of non-time-critical scheduled medications, 58,099 (84%) were administered on time (P less then 0.001). ICUs had a higher percentage of on-time administrations than general medical units (89% vs 77%, P less then 0.001), and nurses had a higher percentage of on-time administrations than respiratory therapists (84% vs 63%, P less then 0.001). CONCLUSIONS Non-time-critical scheduled medications were more commonly administered on time compared with time-critical scheduled medications. Staff education and optimizations to the electronic health record (EHR) are interventions that may improve administration of time-critical scheduled medications.Bordetella pertussis, a strictly human re-emerging pathogen and the causative agent of whooping cough, exploits a broad variety of virulence factors to establish efficient infection. Here, we used RNA sequencing to analyse the changes in gene expression profiles of human THP-1 macrophages resulting from B. pertussis infection. In parallel, we attempted to determine the changes in intracellular B. pertussis-specific transcriptomic profiles resulting from interaction with macrophages. Our analysis revealed that global gene expression profiles in THP-1 macrophages are extensively rewired 6 h post-infection. Among the highly expressed genes, we identified those encoding cytokines, chemokines, and transcription regulators involved in the induction of the M1 and M2 macrophage polarization programmes. Notably, several host genes involved in the control of apoptosis and inflammation which are known to be hijacked by intracellular bacterial pathogens were overexpressed upon infection. Furthermore, in silico analyses identified large temporal changes in expression of specific gene subsets involved in signalling and metabolic pathways. Despite limited numbers of the bacterial reads, we observed reduced expression of majority of virulence factors and upregulation of several transcriptional regulators during infection suggesting that intracellular B. pertussis cells switch from virulent to avirulent phase and actively adapt to intracellular environment, respectively.RNA secondary structure elements in the mRNA 3'-untranslated regions (3'UTR) play important roles in post-transcriptional regulation. RNA structure elements in the viral RNA provide valuable model for studying diverse regulation mechanisms. Herpesvirus genomes are double-stranded DNA with GC-rich sequences, which can be transcribed into abundant GC-rich RNAs. It is valuable to explore the structures and function of those GC-rich RNAs. We identified a G2-quadruplex-forming sequence named PQS18-1 in the 3'UTR of the unique immediate early gene of Pseudorabies virus (PRV), an important member of Alphaherpesvirinae subfamily. The RNA PQS18-1 was folded into parallel G-quadruplex structure, enhancing gene expression. Both non-G-quadruplex mutant and G3-quadruplex mutant in the 3'UTR showed lower gene expression level than the wildtype G2-quadruplex. TMPyP4 destroyed PQS18-1 G2-quadruplex and suppressed gene expression, accordingly reducing PRV replication by one titre in the PK15 cells at 24 h post infection. Our findings indicated that the RNA G2-quadruplex in 3'UTR was essential for high expression of IE180 gene, and it could be a specific post-transcription regulation element in response to small molecules or other macromolecules. This study discovers a novel RNA G2-quadruplex in the 3'UTR of an immediate early gene of alphaherpesvirus and provides a new nucleic acid target for anti-virus drug design.Against the backdrop of an increase in reported hate crimes, we present the development of a U.K.-focussed instrument designed to evaluate the nature of public beliefs about hate crime, legislation, offenders and victims. In Study 1, 438 participants completed an Anglicized version of the Hate Crime Beliefs Scale (HCBS). Factor analyses revealed three subfactors Denial (high scores represent a denial of hate crime severity and need for legislation), Compassion (high score reflect compassion toward victims and affected communities) and Sentencing (higher scores reflect more punitive attitudes). In Study 2 (N = 134) we show that scores on Denial are positively associated with those on Right-Wing Authoritarianism (RWA) and Social Dominance Orientation (SDO), ideologies known to be associated with prejudice. Compassion was negatively associated with these ideologies. Mediation analyses showed that Big Five personality traits Openness to Experience and Conscientiousness predicted Denial and Compassion via RWA, whereas Agreeableness and Openness predicted scores via SDO, consistent with a dual-process motivation model of hate crime beliefs. Results are discussed in terms of the nature of hate crime beliefs and the importance of understanding public attitudes which may support undesirable social norms and influence jury decision making in trials of hate related offenses.This article offers tangible support for school nurses to understand, recognize, and integrate self-management promotion, anticipatory guidance, and advocacy into practice. The article utilizes the chronic condition of asthma as a case exemplar, but many of the recommendations apply to other aspects of chronic illness self-management promotion. School nurses are in an ideal position to advocate for students and families and to support evidence-based self-management promotion. In the school setting, gaps currently exist regarding best practices for the promotion of self-management and anticipatory guidance for children with chronic illnesses. Future interventions within school settings should focus on multisystem level collaboration with care coordination efforts between providers and social support systems, internal and external, to the school system. These policies and this resource development will ultimately support the promotion of self-management for children with chronic illness in the school environment and maximize health outcomes.