Kristensenfinn6514
The second article in this series will examine how critical thinking aids in the diagnosis of blood disorders.Sam Dorney-Smith, Nursing Fellow, Pathway, and Specialist Advisor, Homeless Health Programme, Queen's Nursing Institute, London (samantha.dorney-smith@nhs.net), runner-up in the Nurse of the Year category of the BJN Awards 2021.Observed structured clinical examinations (OSCEs) are a common method of assessment within higher education to prepare for the advanced nurse practitioner (ANP) role. This article reviews a wide range of literature relating to OSCE assessment in the healthcare arena, from an ANP, interprofessional and advanced clinical practice perspective. Theories underpinning OSCE and advanced nursing roles are explored, with relevant supporting literature indicating how established OSCEs can become integrated with other methods to improve outcomes for this level of practice. Alternative assessments are explored with specific reference to the context of the education delivered, and the suitability for higher education today.
To explore the service provision for compression therapy for inpatients with leg ulcers in UK hospitals.
An online survey was carried out to explore the service provision in hospital settings. It was distributed to Wounds UK National Conference delegates and to wound care specialist groups using social media.
The authors received 101 responses from health professionals in the UK. Of these, 67.3% reported there was no dedicated service for inpatients with leg ulceration and only 32% said compression therapy was provided in their hospitals.
This survey confirmed there is a significant shortfall in care provision for patients with leg ulcers in secondary care and highlighted the wide variations in service delivery in hospitals. Further research is needed to understand the reasons for these variations.
This survey confirmed there is a significant shortfall in care provision for patients with leg ulcers in secondary care and highlighted the wide variations in service delivery in hospitals. Further research is needed to understand the reasons for these variations.Surgical site infection (SSI) increases length of treatment, delays wound healing, increases antibiotic use and causes patient death in severe cases. This case was a boy aged 38 weeks and 4 days with a birthweight of 2100 g, a height of 42 cm and a head circumference of 32 cm. Twelve days after birth, he was admitted to hospital where a surgeon removed a sacrococcygeal teratoma. LDC195943 DNA inhibitor The surgical site became infected, and the infection failed to improve despite him receiving routine normal saline dressings twice a day and intravenous antibiotic therapy. The authors started treatment using an antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month. The infant's SSI was wholly healed after 3 months, and he was discharged from the wound treatment team in good general condition. This case shows that SSIs can be treated with honey-containing antibacterial wound gel, especially in infants who have weaker immune systems.
This study aimed to explore the psychological cognitive factors of weight management during pregnancy based on protective motivation theory (PMT).
Cross-sectional study.
Participants were recruited at the Maternal and Child Health Hospital of Changzhou City, Jiangsu Province, China.
A sample of 533 pregnant women was enrolled in the study.
Measures was a self-design questionnaire, comprising of demographics, cognition of weight management during pregnancy, and weight management behavior during pregnancy.
Structural equation modeling was used to examine the weight management's cognitive factors, path relationships, and the influence of maternal characteristics.
Self-efficacy cognition could promote gestational weight management behavior (b = .22,
< .001), but response cost cognition hindered gestational weight management (b = -.21,
< .001). Parity moderated pregnant women's self-efficacy cognition (diff b = .24,
< .01), where the self-efficacy of nullipara promoted weight management behaviors, but the self-efficacy of multipara had no significant effect. Also, the response cost factors stably existed in primipara and multipara groups, with multipara, being positively affected by response efficacy (
= .15,
< .05).
Findings highlight the need for psychological and cognitive interventions. Intervention strategies that focus on enabling women to correctly understand response cost and make an active response, improve self-efficacy cognition especially among primipara, and strengthening multipara's response efficacy among pregnant are required.
Findings highlight the need for psychological and cognitive interventions. Intervention strategies that focus on enabling women to correctly understand response cost and make an active response, improve self-efficacy cognition especially among primipara, and strengthening multipara's response efficacy among pregnant are required.
Changes in vascular trauma care and trainee exposure to vascular surgery have raised questions regarding who should take care of vascular trauma patients. This study aimed to determine nationwide trends and perceptions regarding the management of vascular trauma amongst vascular and trauma surgeons.
Online surveys were administered to trauma surgeons through the American Association for the Surgery of Trauma (AAST) and to vascular surgeons through the Vascular and Endovascular Surgery Society (VESS) and Western Vascular Society (WVS) in February 2021. Demographics, practice-related information, and interest in, experience and comfort level with vascular trauma were queried. Trainees and those practicing outside the United States were excluded. Results were analyzed using Stata/BE v16.1.
247 surgeons were included in the final study population, of which 163 (66%) were trauma surgeons (T) and 84 (34%) were vascular surgeons (V). Vascular surgeons were younger (46 v 51y,
< .001) and had fewer years in practice (10 v 17y,
< .001). Vascular surgeons had greater experience and comfort with managing vascular trauma, but less interest in both vascular and endovascular trauma care when compared to trauma surgeons. Inability to maintain skillset (27%) and unfamiliarity with techniques (32%) were the most common barriers to practicing vascular trauma cited by trauma surgeons.
Despite significant interest in practicing vascular trauma amongst trauma surgeons compared to vascular surgeons, most feel unprepared to do so. Collaboration between vascular and trauma surgeons could close the experience gap and appeal to the interests of both groups.
Despite significant interest in practicing vascular trauma amongst trauma surgeons compared to vascular surgeons, most feel unprepared to do so. Collaboration between vascular and trauma surgeons could close the experience gap and appeal to the interests of both groups.Diabetic patients always seek alternative treatments to lower their blood glucose level efficiently, because antidiabetic drugs produce adverse effects and many patients experience reduced response after a treatment period. Opium poppy (papaver somniferum) is frequently consumed by diabetic patients for reduction of blood glucose level. Scientific studies found controversial results in the investigation of the blood-glucose-lowering effects of opium poppy. In this regard, we explored the antidiabetic effect of opium poppy more closely. The antidiabetic or antihyperglycemic effect of papaver somniferum alkaloids were reviewed. Next, opioid receptors and their role in diabetes were explored. In the final part origins of interindividual variabilities in opioid receptors and metabolizing enzymes' functions including genetic and epigenetic factors were reviewed.Background Since December 2019, SARS-CoV-2 has continued to spread rapidly around the world. The effective drugs may provide a long-term strategy to combat this virus. The main protease (Mpro) and papain-like protease (PLpro) are two important targets for the inhibition of SARS-CoV-2 virus replication and proliferation. Materials & methods In this study, deep reinforcement learning, covalent docking and molecular dynamics simulations were used to identify novel compounds that have the potential to inhibit both Mpro and PLpro. Results & conclusion Three compounds were identified that can effectively occupy the Mpro protein cavity with the PLpro protein cavity and form high-frequency contacts with key amino acid residues (Mpro His41, Cys145, Glu166; PLpro Cys111). These three compounds can be further investigated as potential lead compounds for SARS-CoV-2 inhibitors.Coral trees (Viburnum odoratissimum), as a class of evergreen shrubs, are mainly planted in landscapes in numerous cities in China. During September 2020, the author investigated four major parks in Hefei (Bao Park, Hefei Botanical Garden, Luzhou Park and Peninsula Park) and the campus of Anhui Agricultural University (approximately 0.5 ha) (31°49'21.30″N, 117°13'18.25″E). The results showed that the incidence rate of leaf spot disease reached 60% among approximately 100,000 coral trees planted in these areas. Coral trees begin to show leaf spots in August. In early stages of coral trees infection, the symptoms appeared as small brown spots ranged in length from 2 to 3 millimeters on the leaves. After the disease patches expand and darken, the coral leaves eventually wither and fall, which seriously affects its viewing and admiring value. To identify the fungal pathogen, the five-point sampling method was used to take typical similar leaf samples from 5 regions, and 6 samples were taken from each site, so a t the maximum likelihood method, and the repeat value of bootstraps was 1000. A polygenic phylogenetic tree analysis based on multilocus alignment (ITS, EF1-alpha and TUB2) was constructed with some strains of Botryosphaeriaceae species. The results of the phylogenetic tree showed that MI1 and N. parvum clustered into a branch. To our knowledge, this is the first report of N. parvum causing leaf spot on V. odoratissimum in China.Protein nanoparticles (NPs) can be used as vaccine platforms for target antigen presentation. Aim To conduct a proof-of-concept study to demonstrate that an effective NP platform can be built based on a short self-assembling peptide (SAP) rather than a large self-assembling protein. Materials & methods SUMO-based protein fusions (SFs) containing an N-terminal SAP and a C-terminal antigen were designed, expressed in Escherichia coli and purified. The structure was investigated by electron microscopy. The antibody response was tested in mice after two adjuvant-free immunizations. Results Renatured SFs form fiber-like NPs with the antigen exposed on the surface and induce a significant antibody response with a remarkably high target-to-platform ratio. Conclusion The platform is effective and has considerable potential for modification toward various applications, including vaccine development.
High-energy Proton Beam Therapy (PBT) commenced in England in 2018 and NHS England commissions PBT for 1.5% of patients receiving radical radiotherapy. We sought expert opinion on the level of provision.
Invitations were sent to 41 colleagues working in PBT, most at one UK centre, to contribute by completing a spreadsheet. 39 responded 23 (59%) completed the spreadsheet; 16 (41%) declined, arguing that clinical outcome data are lacking, but joined six additional site-specialist oncologists for two consensus meetings. The spreadsheet was pre-populated with incidence data from Cancer Research UK and radiotherapy use data from the National Cancer Registration and Analysis Service. 'Mechanisms of Benefit' of reduced growth impairment, reduced toxicity, dose escalation and reduced second cancer risk were examined.
The most reliable figure for percentage of radical radiotherapy patients likely to benefit from PBT was that agreed by 95% of the 23 respondents at 4.3%, slightly larger than current provision. The median was 15% (range 4-92%) and consensus median 13%.
