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Canadian Community health nurses (CHNs) work in diverse urban, rural, and remote settings such as: public health units/departments, home health, community health facilities, family practices, and other community-based settings. Research into specific learning needs of practicing CHNs is sparsely reported. This paper examines Canadian CHNs learning needs in relation to the 2008 Canadian Community Health Nursing Standards of Practice (CCHN Standards). It answers: What are the learning needs ofdoi:10.1186/1472-6955-13-31 pmid:25349531 pmcid:PMC4209163 fatcat:x4dvkzrmw5dtznwkfnmrc6u4o4
more »... s in Canada in relation to the CCHN Standards? What are differences in CHNs' learning needs by: province and territory in Canada, work setting (home health, public health and other community health settings) and years of nursing practice? Methods: Between late 2008 and early 2009 a national survey was conducted to identify learning needs of CHNs based on the CCHN Standards using a validated tool. Results: Results indicated that CHNs had learning needs on 25 of 88 items (28.4%), suggesting CHNs have confidence in most CCHN Standards. Three items had the highest learning needs with mean scores > 0.60: two related to epidemiology (means 0.62 and 0.75); and one to informatics (application of information and communication technology) (mean = 0.73). Public health nurses had a greater need to know about "...evaluating population health promotion programs systematically" compared to home health nurses (mean 0.66 vs. 0.39, p <0.010). Nurses with under two years experience had a greater need to learn "... advocating for healthy public policy..." than their more experienced peers (p = 0.0029). Also, NPs had a greater need to learn about "...using community development principles when engaging the individual/community in a consultative process" compared to RNs (p = 0.05). Many nurses were unsure if they applied foundational theoretical frameworks (i.e., the Ottawa Charter of Health Promotion, the Jakarta Declaration, and the Population Health Promotion Model) in practice. Conclusions: CHN educators and practice leaders need to consider these results in determining where to strengthen content in graduate and undergraduate nursing programs, as well as professional development programs. For practicing CHNs educational content should be tailored based on learner's years of experience in the community and their employment sector.
, Eva, Levinson, & Wainman, 2007) , and simulation use in nursing education (Akhtar-Danesh, Baxter, Valaitis, Stanyon, & Sproul, 2009) . ... For a complete review of Q-methodology, readers are referred to Akhtar-Danesh et al. (2008) for practical guidance and to Brown (1980) for a theoretical account. ...doi:10.1177/0193945911408623 pmid:21576400 fatcat:pt4nlawzcbfwlpjqg7zislvgmi
Labeling, hybridization, and primary analyses were carried out according to the methods of Turton and colleagues (2001) and Akhtar et al., (2002) . ... lower level of changes were tested by Q-PCR, with Scamp3 (Secretory carrier membrane protein 3) used as a constitutive control, as it does not express circadian changes in any of the tissues examined by Akhtar ...doi:10.1081/cbi-200062353 pmid:16076647 fatcat:nwhz4r7iq5cozfqalll5iimcxa
JAMA Network Open
We have used these arrays for circadian analyses previously (Akhtar et al. 2002) . ... For all novel probes, both sense and anti-sense transcripts were tested for hybridisation signal as described previously (Akhtar et al. 2002 ). ...doi:10.1177/0748730409332029 pmid:19346449 pmcid:PMC3398136 fatcat:rzozxvsefrd6jdm6q2ryyzdmaa
Ending the hepatitis C virus (HCV) epidemic requires stopping transmission among networks of people who inject drugs (PWID). Identification of transmission networks through the application of genomic epidemiology may inform community response models that can quickly interrupt transmission. We retrospectively identified HCV RNA-positive specimens corresponding to 459 individuals tested in public health settings, including correctional facilities and syringe service programs, in Wisconsin fromdoi:10.1101/2020.06.19.20134148 fatcat:utmq6eux5rgpxfrsja5eo4mtdm
more »... 6-2017. Next-generation sequencing of HCV was conducted and analyzed for phylogenetic linkage using the CDC Global Hepatitis Outbreak Surveillance Technology platform. Transmission network analysis showed that 126 individuals were linked across 42 clusters (range: 2-11 individuals per cluster). Phylogenetic clustering was higher in rural communities and associated with female gender and younger age among rural residents. These data highlight that the increasing rurality of opioid injection use and HCV transmission among young PWID could be better supported by the expansion of molecular-based surveillance strategies to reduce transmission.
IMPORTANCE There are no medical interventions for the orphan disease CYLD cutaneous syndrome (CCS). Transcriptomic profiling of CCS skin tumors previously highlighted tropomyosin receptor kinases (TRKs) as candidate therapeutic targets. OBJECTIVE To investigate if topical targeting of TRK with an existing topical TRK inhibitor, pegcantratinib, 0.5% (wt/wt), is safe and efficacious in CCS. DESIGN, SETTING, AND PARTICIPANTS A phase 1b open-label safety study, followed by a phase 2a within-patientdoi:10.1001/jamadermatol.2018.1610 pmid:29955768 pmcid:PMC6128505 fatcat:fzhz6kj3pje5xd5z4i26vixagm
more »... randomized (by tumor), double-blind, placebo-controlled trial (the Tropomyosin Receptor Antagonism in Cylindromatosis [TRAC] trial). The setting was a single-center trial based at a tertiary dermatogenetics referral center for CCS (Royal Victoria Infirmary, Newcastle, United Kingdom). Patients who had germline mutations in CYLD or who satisfied clinical diagnostic criteria for CCS were recruited between March 1, 2015, and July 1, 2016. INTERVENTIONS In phase 1b, patients with CCS applied pegcantratinib for 4 weeks to a single skin tumor. In phase 2a, allocation of tumors was to either receive active treatment on the right side and placebo on the left side (arm A) or active treatment on the left side and placebo on the right side (arm B). Patients were eligible if they had 10 small skin tumors, with 5 matched lesions on each body side; patients were randomized to receive active treatment (pegcantratinib) to one body side and placebo to the other side once daily for 12 weeks. MAIN OUTCOMES AND MEASURES The primary outcome measure was the number of tumors meeting the criteria for response in a prespecified critical number of pegcantratinib-treated tumors. Secondary clinical outcome measures included an assessment for safety of application, pain in early tumors, and compliance with the trial protocol. RESULTS In phase 1b, 8 female patients with a median age of 60 years (age range, 41-80 years) were recruited and completed the study. None of the participants experienced any adverse treatment site reactions. Three patients reported reduced pain in treated tumors. In phase 2a (15 patients [13 female; median age, 51 years], with 150 tumors), 2 tumors treated with pegcantratinib achieved the primary outcome measure of response compared with 6 tumors treated with placebo. The primary prespecified number of responses was not met. The incidence of adverse events was low. CONCLUSIONS AND RELEVANCE In this study, pegcantratinib, 0.5% (wt/wt), applied once daily appeared to be well tolerated and to penetrate the tumor tissue; however, the low tumor drug concentrations demonstrated are likely to account for the lack of response. Dose-escalation studies to assess the maximal tolerated dose may be beneficial in future studies of CCS.
Climate change and variability affect virtually everyone and every region of the world but the effects are nowhere more prominent than in mountain regions and people living therein. The Hindu Kush Himalayan (HKH) region is a vast expanse encompassing 18% of the world's mountainous area. Sprawling over 4.3 million km2, the HKH region occupies areas of eight countries namely Nepal, Bhutan, Afghanistan, Bangladesh, China, India, Myanmar, and Pakistan. The HKH region is warming at a rate higherdoi:10.3389/fphys.2021.651189 fatcat:w64gjwmm5jfqrh3d3lmyocrdem
more »... the global average and precipitation has also increased significantly over the last 6 decades along with increased frequency and intensity of some extreme events. Changes in temperature and precipitation have affected and will like to affect the climate-dependent sectors such as hydrology, agriculture, biodiversity, and human health. This paper aims to document how climate change has impacted and will impact, health and well-being of the people in the HKH region and offers adaptation and mitigation measures to reduce the impacts of climate change on health and well-being of the people. In the HKH region, climate change boosts infectious diseases, non-communicable diseases (NCDs), malnutrition, and injuries. Hence, climate change adaptation and mitigation measures are needed urgently to safeguard vulnerable populations residing in the HKH region.
Angiogenesis is an essential component of tumour growth and, consequently, an important target both therapeutically and diagnostically. The cell adhesion molecule α v β 3 integrin is a specific marker of angiogenic vessels and the most prevalent vascular integrin that binds the amino acid sequence arginine-glycine-aspartic acid (RGD). Previous studies using RGD-targeted nanoparticles (20-50 nm diameter) of iron oxide (NPIO) for magnetic resonance imaging (MRI) of tumour angiogenesis, havedoi:10.7150/thno.10319 pmid:25767618 pmcid:PMC4350013 fatcat:nhcybppei5g7fh5oxyehqmnb3i
more »... fied a number of limitations, including non-specific extravasation, long blood half-life (reducing specific contrast) and low targeting valency. The aim of this study, therefore, was to determine whether conjugation of a cyclic RGD variant [c(RGDyK)], with enhanced affinity for α v β 3 , to microparticles of iron oxide (MPIO) would provide a more sensitive contrast agent for imaging of angiogenic tumour vessels. Cyclic RGD [c(RGDyK)] and RAD [c(RADyK)] based peptides were coupled to 2.8 μm MPIO, and binding efficacy tested both in vitro and in vivo. Significantly greater specific binding of c(RGDyK)-MPIO to S-nitroso-n-acetylpenicillamine (SNAP)-stimulated human umbilical vein endothelial cells in vitro than PBS-treated cells was demonstrated under both static (14-fold increase; P < 0.001) and flow (44-fold increase; P < 0.001) conditions. Subsequently, mice bearing subcutaneous colorectal (MC38) or melanoma (B16F10) derived tumours underwent in vivo MRI pre-and post-intravenous administration of c(RGDyK)-MPIO or c(RADyK)-MPIO. A significantly greater volume of MPIO-induced hypointensities were found in c(RGDyK)-MPIO injected compared to c(RADyK)-MPIO injected mice, in both tumour models (P < 0.05). Similarly, administration of c(RGDyK)-MPIO induced a greater reduction in mean tumour T 2 * relaxation times than the control agent in both tumour models (melanoma P < 0.001; colorectal P < 0.0001). Correspondingly, MPIO density per tumour volume assessed immunohistochemically was significantly greater for c(RGDyK)-MPIO than c(RADyK)-MPIO injected animals, in both melanoma (P < 0.05) and colorectal (P < 0.0005) tumours. In both cases, binding of c(RGDyK)-MPIO co-localised with α v β 3 expression. Comparison of RGD-targeted and dynamic contrast enhanced (DCE) MRI assessment of tumour perfusion indicated sensitivity to different vascular features. This study demonstrates specific binding of c(RGDyK)-MPIO to α v β 3 expressing neo-vessels, with marked and quantifiable contrast and rapid Ivyspring International Publisher Theranostics 2015, Vol. 5, Issue 5 http://www.thno.org 516 clearance of unbound particles from the blood circulation compared to NPIO. Combination of this molecular MRI approach with conventional DCE MRI will enable integrated molecular, anatomical and perfusion tumour imaging.
Ending the hepatitis C virus (HCV) epidemic requires stopping transmission among networks of persons who inject drugs. Identifying transmission networks by using genomic epidemiology may inform community responses that can quickly interrupt transmission. We retrospectively identified HCV RNA-positive specimens corresponding to 459 persons in settings that use the state laboratory, including correctional facilities and syringe services programs, in Wisconsin, USA, during 2016-2017. We conducteddoi:10.3201/eid2702.202957 pmid:33496239 fatcat:xxvuyqocxvblrajb4fov6m2tiy
more »... ext-generation sequencing of HCV and analyzed it for phylogenetic linkage by using the Centers for Disease Control and Prevention Global Hepatitis Outbreak Surveillance Technology platform. Analysis showed that 126 persons were linked across 42 clusters. Phylogenetic clustering was higher in rural communities and associated with female sex and younger age among rural residents. These data highlight that HCV transmission could be reduced by expanding molecular-based surveillance strategies to rural communities affected by the opioid crisis.
Sharon Kaasalainen, RN, PhD1,2; Abigail Wickson-Griffiths, RN, PhD3; Noori Akhtar-Danesh1,4; Kevin 4 Brazil, PhD4,5; Faith Donald, RN(EC), PhD6; Ruth Martin-Misener, RN-NP, PhD7; Alba DiCenso, RN, 5 PhD1,4 ... ., & Akhtar-Danesh, N. (2009). Nurse 37 practitioner and physician collaboration in long-term care homes: Survey results. ... ., 33 Akhtar-Danesh, N., & DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice 34 nurses in long-term care. ...doi:10.1016/j.ijnurstu.2016.07.022 pmid:27490328 fatcat:lh5quntuv5b27gw77xazckkjqe
structure across the brain and peripheral organs via neural and endocrine outputs. Disruption of this tempo-University of Leicester Leicester LE1 7RH ral programming of physiology and behavior, as occurs during rotational shift work, jet lag, and old age, carries 2 Neurobiology Division MRC Laboratory of Molecular Biology major costs for human health [3, 4, 5]. An important goal, therefore, is to identify the physiological basis of Hills Road Cambridge CB2 2QH circadian rhythmicity indoi:10.1016/s0960-9822(02)00759-5 pmid:11937022 fatcat:wcx5xhaokzch7gmeu62oenmjkq
more »... tissues and its relationship to the SCN. In invertebrates and lower verte-3 Department of Anatomy University of Cambridge brates, circadian rhythms in the periphery are driven by tissue-autonomous circadian oscillators, often light Cambridge CB2 3DY 4 MRC Toxicology Unit sensitive, and synchronized to but not dependent on central pacemakers [6, 7]. Recent studies using trans-University of Leicester Leicester LE1 9HN genic rodents and fibroblast cell lines indicate that peripheral tissues of mammals may also have a limited United Kingdom autonomous capacity for circadian gene expression [8, 9], but the relationship with the central pacemaker of the SCN is not yet defined. Summary Analysis of central and peripheral clock mechanisms has received an enormous impetus from the recent iden-Background: Genes encoding the circadian pacemaker tification of mammalian "clock genes" . Many have in the hypothalamic suprachiasmatic nuclei (SCN) of circadian rhythms of expression, and their products are mammals have recently been identified, but the molecuinvolved in complex autoregulatory feedback loops inlar basis of circadian timing in peripheral tissue is not volving both negative and positive controls . Cycling well understood. We used a custom-made cDNA mi-mRNAs are not, however, limited to the circadian oscillacroarray to identify mouse liver transcripts that show tor itself, and a number of rhythmically expressed clock circadian cycles of abundance under constant condioutput genes have been reported [1, 10, 11]. Systematic tions. attempts to identify genes that show circadian cycles of mRNA expression have been made in Neurospora, Drosophila, mouse, and cyanobacteria, using differen-Results: Using two independent tissue sampling and tial/subtractive screens or reporter gene insertions [12hybridization regimes, we show that %9ف of the 2122 15]. In Arabidopsis, high-density oligonucleotide and genes studied show robust circadian cycling in the liver. EST microarrays have been used to scan 0008ف genes These transcripts were categorized by their phase of and have revealed that 2%-6% undergo circadian cyabundance, defining clusters of day-and night-related cles of transcription [16, 17]. We employed a cDNA migenes, and also by the function of their products. Circacroarray, customized for the analysis of liver function, to dian regulation of genes was tissue specific, insofar as scan %5ف of the mouse genome in order to characterize novel rhythmic liver genes were not necessarily rhythmic circadian transcriptional cycling in the liver under conin the brain, even when expressed in the SCN. The rhythstant environmental conditions. We validated circadian mic transcriptome in the periphery is, nevertheless, deexpression patterns using in situ hybridization in both pendent on the SCN because surgical ablation of the liver and brain and tested their dependence on the cen-SCN severely dampened or destroyed completely the tral pacemaker by analyzing tissues from SCN-lesioned cyclical expression of both canonical circadian genes mice. and novel genes identified by microarray analysis. Results Conclusions: Temporally complex, circadian programming of the transcriptome in a peripheral organ is im-Microarray Analysis Reveals Circadian posed across a wide range of core cellular functions Transcriptional Cycling in the Liver and is dependent on an interaction between intrinsic, Rhythmic genes were revealed by two independent tissue-specific factors and extrinsic regulation by the sampling and analysis strategies. An "anchored" com-SCN central pacemaker. parison considered the relative change in mRNA abundance between CT0 and all other time points and when plotted yielded a conventional image of cyclical gene 5 Correspondence: email@example.com 6 These authors contributed equally to this work. expression ( Figures 1B and 1C, right-hand panels) . The were not randomly chosen but reflected the ongoing interests of CMHT, and many of the genes had duplicate copies on the slide, The authors are grateful to J. Bashford, I. Bolton, and A. Newman allowing further testing of the internal consistency of the hybridizafor their expert assistance in photomicrography and image analysis. tion. A number of clock genes and clock-controlled genes whose We also thank R. Davies for assistance with clone sequencing; and mRNAs cycle were present and served to validate our procedures. Michael Lush for help with bioinformatics. Finally, we thank G. Duf-All genes that gave cycling patterns of expression were resequenced field and J. Dunlap for sharing unpublished data. This work was to confirm their identity. supported by the Biotechnology and Biological Sciences Research Council (Project Grant to M.H.H. and C.P.K.) and the Human Fron-Hybridization to the Microarray tiers Science Programme (grant to C.P.K.). We used two different experimental paradigms utilizing the ratio of hybridization of Cy5 and Cy3 fluorophores. In the anchored compari-Received: December 24, 2001 son, 50 g of liver RNA from CT0 (Cy3, green) was compared with Revised: February 8, 2002 50 g of RNA harvested at 4 hr intervals between CT2 and 26 (Cy5, Accepted: February 8, 2002 red) (n ϭ 4 mice each). Our second, independent strategy used a Published: April 2, 2002 moving 12 hr window design in which mRNA pools from two different times, 12 hr apart, collected under the same DR conditions, were References compared (CT 2/14, 4/16, 6/18, 8/20, 10/22, 12/24, 14/26), again, using four livers per time point. This would be more useful for de-1. Dunlap, J.C. (1999). Molecular bases for circadian clocks. Cell tecting low-amplitude oscillations, as a peak and trough could be 96, 271-290. hit simultaneously, thereby providing a larger Cy5/Cy3 ratio than 2. Weaver, D.R. (1998). The suprachiasmatic nucleus: a 25-year the anchored method, which is dependent solely on CT0 mRNA retrospective. J. Biol. Rhythms 13, 100-112. levels for the overall pattern. In a final experiment, 12 SCN-lesioned 3. Costa, G. (1996). The impact of shift and night work on health. mice were sacrificed at CT0 and six each at CT6, CT12, and CT18, Appl. Ergonomics 27, 9-16. RNA prepared from their livers, labeled with the fluorophores, and 4. Hastings, M.H. (1998). The brain, circadian rhythms and clock CT0/CT6 and CT0/CT18 samples were hybridized to the arrays. CT6/ genes. BMJ 317, 1704-1707. 18 and CT0/12 moving window comparisons, harvested in the same
Aristolochia ringens Vahl. (Aristolochiaceae (AR); mǎ dōu líng) is used traditionally in Nigeria for the management of various disorders including oedema. Preliminary investigation revealed its modulatory effect on the cardiovascular system. This study was aimed at investigating the effect of the aqueous root extract of A. ringens (AR) on haemodynamic parameters of spontaneously hypertensive rats (SHRs). The effect of oral subacute (21 days) and intravenous acute exposure of SHRs to the extractdoi:10.1016/j.jtcme.2017.02.006 pmid:29321992 pmcid:PMC5755979 fatcat:mzc3bxaaznffjlran4bluvnuee
more »... were assessed using tail cuff and carotid artery canulation methods respectively. In the latter, the effect of chloroform, butanol and aqueous fractions of AR were also evaluated. The extract significantly reduced systolic and diastolic blood pressures in SHRs, with peak reductions of 20.3% and 26.7% respectively at 50 mg/kg by the 21st day of oral subacute exposure. Upon intravenous exposure, AR (50 mg/kg) reduced systolic and diastolic blood pressure by as much as 53.4 ± 2.2 and 49.2 ± 2.8 mmHg respectively. A dose-dependent reduction in heart rate, significant at 25 and 50 mg/kg was also observed. Hexamethonium (20 mg/kg) and atropine (1 mg/kg) inhibited the extract's reduction of systolic blood pressure, diastolic blood pressure and heart rate significantly. The extract's butanol fraction produced the greatest systolic and diastolic blood pressures reduction of 67.0 ± 3.8 and 68.4 mmHg respectively at 25 mg/kg and heart rate reduction of 40 ± 7 beats per minute at 50 mg/kg. HPLC analysis revealed the presence of 4-hydroxybenzoic acid and quercetin in AR. The extract's alterations of haemodynamic parameters in this study show that it has hypotensive effect on spontaneously hypertensive rats.
Canadian Journal of Nursing Leadership
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