Spatiotemporal relationships of coyotes and free-ranging domestic cats as indicators of conflict in Culver City, California.

As habitat generalists, urban coyote (Canis latrans) populations often utilize an abundance of diverse food sources in cities. Within southern California, domestic cats (Felis catus) comprise a higher proportion of coyote diets than in other studied urban areas throughout the United States. However, it is unclear which ecological factors contribute to higher rates of cat depredation by coyotes in this region. While previous research suggests that coyote presence may have a negative effect on free-ranging domestic cat distributions, few studies have determined whether urban green spaces affect coyote or free-ranging domestic cat occurrence and activity within a predominantly urbanized landscape. We placed 20 remote wildlife cameras across a range of green spaces and residential sites in Culver City, California, an area of Los Angeles County experiencing pronounced coyote-domestic cat conflict. Using data collected across 6 months from 2019-2020, we assessed the influence of green space and prey species (i.e., cottontail rabbits (Sylvilagus spp.) and domestic cats) on coyote habitat use and activity. Coyotes exhibited a preference for sites with higher amounts of green space, while domestic cat habitat use was high throughout our study region. Although cottontail rabbit habitat use was also highly associated with urban green space, neither cottontails nor domestic cats appeared to temporally overlap significantly with coyotes. Unlike other cities where coyotes and domestic cats exhibit strong habitat partitioning across the landscape, domestic cats and coyotes spatially overlapped in green space fragments throughout Culver City. We suggest that this pattern of overlap may be responsible for the frequent cases of domestic cat depredation by coyotes in Culver City.

Experience of using a regional network of hospitals in the care of older inpatients with COVID-19 in spring 2020.

Introduction: Frail, older patients with COVID-19 have an increased risk of hospital admission and death. Methods: We studied a regional model of care used for older patients with COVID-19 in spring 2020 across three settings: an acute teaching hospital, a district general hospital and a temporary emergency hospital. We also studied demographic and outcome data for these patients. Results: Increasing bed capacity in non-acute sites freed up beds in acute hospitals. Strict admission criteria and multidisciplinary team involvement allowed for the safe delivery of care in step-down sites. Conclusion: This model of care allowed for patient flow out of acute sites following the acute stage of their illness allowing for an increase in bed capacity while providing a safe setting for ongoing management.

Clinical frailty as a key characteristic of the patient population of the NHS Nightingale North West COVID-19 temporary emergency field hospital: cohort study April to June 2020.

OBJECTIVES: COVID-19 temporary emergency 'field' hospitals have been established in the UK to support the surge capacity of the National Health Service while protecting the community from onward infection. We described the population of one such hospital and investigated the impact of frailty on clinical outcomes. DESIGN: Cohort study. SETTING: NHS Nightingale Hospital North West, April-June 2020. PARTICIPANTS: All in-patients with COVID-19. MAIN OUTCOME MEASURES: Mortality and duration of admission. METHODS: We analysed factors associated with mortality using logistic regression and admission duration using Cox's regression, and described trends in frailty prevalence over time using linear regression. RESULTS: A total of 104 COVID-19 patients were admitted, 74% with moderate-to-severe frailty (clinical frailty score, CFS > 5). A total of 84 were discharged, 14 transferred to other hospitals, and six died on site. High C-reactive protein (CRP) > 50 mg/dL predicted 30-day mortality (adjusted odds ratio 11.9, 95%CI 3.2-51.5, p < 0.001). Patients with CFS > 5 had a 10-day median admission, versus 7-day for CFS ≤ 5 and half the likelihood of discharge on a given day (adjusted hazard ratio 0.51, 95%CI 0.29-0.92, p = 0.024). CRP > 50 mg/dL and hospital-associated COVID-19 also predicted admission duration. As more frail patients had a lower rate of discharge, prevalence of CFS > 5 increased from 64% initially to 90% in the final week (non-zero slope p < 0.001). Conclusions: The NNW population was characterized by high levels of frailty, which increased over the course of the hospital's operation, with subsequent operational implications. Identifying and responding to the needs of this population, and acknowledging the risks of this unusual clinical context, helped the hospital to keep patients safe.

Trabecular architecture and joint loading of the proximal humerus in extant hominoids, Ateles, and Australopithecus africanus.

OBJECTIVES: Several studies have investigated potential functional signals in the trabecular structure of the primate proximal humerus but with varied success. Here, we apply for the first time a "whole-epiphyses" approach to analysing trabecular bone in the humeral head with the aim of providing a more holistic interpretation of trabecular variation in relation to habitual locomotor or manipulative behaviors in several extant primates and Australopithecus africanus. MATERIALS AND METHODS: We use a "whole-epiphysis" methodology in comparison to the traditional volume of interest (VOI) approach to investigate variation in trabecular structure and joint loading in the proximal humerus of extant hominoids, Ateles and A. africanus (StW 328). RESULTS: There are important differences in the quantification of trabecular parameters using a "whole-epiphysis" versus a VOI-based approach. Variation in trabecular structure across knuckle-walking African apes, suspensory taxa, and modern humans was generally consistent with predictions of load magnitude and inferred joint posture during habitual behaviors. Higher relative trabecular bone volume and more isotropic trabeculae in StW 328 suggest A. africanus may have still used its forelimbs for arboreal locomotion. DISCUSSION: A whole-epiphysis approach to analysing trabecular structure of the proximal humerus can help distinguish functional signals of joint loading across extant primates and can provide novel insight into habitual behaviors of fossil hominins.

A Novel 3D Skin Explant Model to Study Anaerobic Bacterial Infection.

Skin infection studies are often limited by financial and ethical constraints, and alternatives, such as monolayer cell culture, do not reflect many cellular processes limiting their application. For a more functional replacement, 3D skin culture models offer many advantages such as the maintenance of the tissue structure and the cell types present in the host environment. A 3D skin culture model can be set up using tissues acquired from surgical procedures or post slaughter, making it a cost effective and attractive alternative to animal experimentation. The majority of 3D culture models have been established for aerobic pathogens, but currently there are no models for anaerobic skin infections. Footrot is an anaerobic bacterial infection which affects the ovine interdigital skin causing a substantial animal welfare and financial impact worldwide. Dichelobacter nodosus is a Gram-negative anaerobic bacterium and the causative agent of footrot. The mechanism of infection and host immune response to D. nodosus is poorly understood. Here we present a novel 3D skin ex vivo model to study anaerobic bacterial infections using ovine skin explants infected with D. nodosus. Our results demonstrate that D. nodosus can invade the skin explant, and that altered expression of key inflammatory markers could be quantified in the culture media. The viability of explants was assessed by tissue integrity (histopathological features) and cell death (DNA fragmentation) over 76 h showing the model was stable for 28 h. D. nodosus was quantified in all infected skin explants by qPCR and the bacterium was visualized invading the epidermis by Fluorescent in situ Hybridization. Measurement of pro-inflammatory cytokines/chemokines in the culture media revealed that the explants released IL1ß in response to bacteria. In contrast, levels of CXCL8 production were no different to mock-infected explants. The 3D skin model realistically simulates the interdigital skin and has demonstrated that D. nodosus invades the skin and triggered an early cellular inflammatory response to this bacterium. This novel model is the first of its kind for investigating an anaerobic bacterial infection.

"The five-minute check-in" intervention to ease the transition into professional education: A descriptive analysis.

BACKGROUND: Students can have problems transitioning into nursing education, and nursing instructors can have an impact on this transition by using an active coaching role. OBJECTIVES: The objective of this study was to evaluate how early an academic coaching intervention helped students progress during the beginning of their first nursing semester. Student perceptions of the intervention were also explored. DESIGN: This study followed a descriptive non-experimental design. A nonprobability convenience sample was used. SETTINGS: A four-year Bachelor's nursing program at a private college in central Pennsylvania. PARTICIPANTS: The sample included 22 first semester students enrolled in their first nursing course. METHOD: For the first five weeks of the semester students were asked to meet with their nursing course instructors for "five minute check-ins". Students were coached on time management, study skills, access to resources, stress management, upcoming assignments, and grades. An online survey was also sent to students regarding their check-in experience. RESULTS: The student coaching needs changed throughout the five week intervention. At first students heavily needed time management coaching. Study skill coaching was a steady need through the second through fifth week, and stress management coaching increased during the last week of data collection, which was along the same time as their first exams. Students who attended four to five of the weekly visits had higher first test scores and higher overall course grades. The majority of students reported benefits for attending check-in visits including organization, study skills, and feeling more connected to the instructor. CONCLUSIONS: Students reported an overall benefit to attending check-in visits. Course instructors were able to intervene early with students' academic problems, and help students gain access to resources. Although the check-ins were to be brief visits, there was an impact on instructors time during the check-in weeks.

Laying the Groundwork for NCLEX Success: An Exploration of Adaptive Quizzing as an Examination Preparation Method.

First-time NCLEX-RN pass rates are an important indicator of nursing school success and quality. Nursing schools use different methods to anticipate NCLEX outcomes and help prevent student failure and possible threat to accreditation. This study evaluated the impact of a shift in NCLEX preparation policy at a BSN program in the southeast United States. The policy shifted from the use of predictor score thresholds to determine graduation eligibility to a more proactive remediation strategy involving adaptive quizzing. A descriptive correlational design evaluated the impact of an adaptive quizzing system designed to give students ongoing active practice and feedback and explored the relationship between predictor examinations and NCLEX success. Data from student usage of the system as well as scores on predictor tests were collected for three student cohorts. Results revealed a positive correlation between adaptive quizzing system usage and content mastery. Two of the 69 students in the sample did not pass the NCLEX. With so few students failing the NCLEX, predictability of any course variables could not be determined. The power of predictor examinations to predict NCLEX failure could also not be supported. The most consistent factor among students, however, was their content mastery level within the adaptive quizzing system. Implications of these findings are discussed.

Comparative Analysis of Registered Nurses' and Nursing Students' Attitudes and Use of Nonpharmacologic Methods of Pain Management.

Despite the benefits that nonpharmacologic methods of pain management have to offer, nurses cite barriers that inhibit their use in practice. The purpose of this research study was to compare the perceptions of prelicensed student nurses (SNs) and registered nurses (RNs) toward nonpharmacologic methods of pain management. A sample size of 64 students and 49 RNs was recruited. Each participant completed a questionnaire about their use and perceptions nonpharmacologic pain control methods. Sixty-nine percent of RNs reported a stronger belief that nonpharmacologic methods gave relief to their patients compared with 59% of SNs (p = .028). Seventy-five percent of student nurses felt they had adequate education about nonpharmacologic pain modalities compared with 51% of RN who felt less than adequately educated (p = .016). These findings highlight the need for education about nonpharmacologic approaches to pain management. Applications of these findings may decrease barriers to the use of nonpharmacologic methods of pain management.

A proven pathway for stoma care: the value of stoma care services.

The role of the stoma nurse is often misunderstood by those who have little or no understanding of the complexities of their role. Stoma nurses face challenges when communicating the valuable role they provide in relation to quality, value and cost. The implementation of an accredited pathway designed specifically for stoma patients would not only promote excellence in nursing practice, but would also assist the stoma nurse in building the profile of the specialty. The accredited pathway should outline the sequence and timings of actions necessary to achieve expected patient outcomes and organisational goals regarding quality of care, costs, patient experience and efficiency.

Differential expression of Toll-like receptors and inflammatory cytokines in ovine interdigital dermatitis and footrot.

Footrot is a common inflammatory bacterial disease affecting the health and welfare of sheep worldwide. The pathogenesis of footrot is complex and multifactorial. The primary causal pathogen is the anaerobic bacterium Dichelobacter nodosus, with Fusobacterium necrophorum also shown to play a key role in disease. Since immune-mediated pathology is implicated, the aim of this research was to investigate the role of the host response in interdigital dermatitis (ID) and footrot. We compared the expression of Toll-like receptors (TLRs) and pro-inflammatory cytokines and the histological appearance of clinically normal in comparison to ID and footrot affected tissues. Severe ID and footrot were characterised by significantly increased transcript levels of pro-inflammatory cytokines TNFα and IL1ß and the pattern recognition receptors TLR2 and TLR4 in the interdigital skin. This was reflected in the histopathological appearance, with ID and footrot presenting progressive chronic-active pododermatitis with a mixed lymphocytic and neutrophilic infiltration, gradually increasing from a mild form in clinically normal feet, to moderate in ID and to a focally severe form with frequent areas of purulence in footrot. Stimulation with F. necrophorum and/or D. nodosus extracts demonstrated that dermal fibroblasts, the resident cell type of the dermis, also contribute to the inflammatory response to footrot bacteria by increased expression of TNFα, IL1ß and TLR2. Overall, ID and footrot lead to a local inflammatory response given that expression levels of TLRs and IL1ß were dependent on the disease state of the foot not the animal.

A grounded theory of faculty's use of humanization to create online course climate.

The purpose of this research was to study the way faculty establish course social presence in an online course. The community of inquiry model by Garrison, Anderson, and Archer distinguished the area of social presence as an important component of online learning, and this study sought to understand how faculty perceive and create social presence in their online classroom. By employing a grounded theory approach, a substantive theory was developed to explain the way in which faculty create and maintain an online course climate. The sample consisted of 10 nursing faculty teaching various master's in nursing courses. Through a rigorous qualitative process using nursing faculty interviews and online course analysis, humanization was found to be the core category in setting online course climate. Faculty's efforts to humanize the climate lead each member of the community to view the other members as real, thereby enabling the establishment of online social presence.

Matching the skin barrier to the skin type.

Peristomal skin problems are thought to be common (Herlufsson et al, 2006; Williams et al, 2010), and can interfere with the security of stoma products. Stoma patients are reliant on the integrity of their peristomal skin to maintain a normal lifestyle. Bekkers et al (1996) highlighted that, if the peristomal skin becomes damaged, it not only affects the person physically, but also psychologically, ultimately prolonging rehabilitation and adaptation to the stoma. Therefore, it can be concluded that maintaining skin integrity is a basic and essential skill in ensuring good stoma management. This article explores the assessment of four stoma patients, highlighting the importance of matching their skin type with their skin barrier for optimum skin protection. The patients have kindly agreed for their case studies to be published as a means of informing others. All names have been changed in line with Nursing and Midwifery Council (2010) guidelines to maintain patient confidentiality. This article was originally presented at the World Council of Enterostomal Therapists' (WCET) annual conference in 2010, receiving first prize at poster presentations.

A new modern drainable appliance for people with ileostomies.

Finding the right drainable pouch can be difficult for the person with an ileostomy. There is an extensive range of appliances available on prescription that offer a variety of features and benefits. Welland Medical has introduced a new one-piece drainable pouch that has a secure integral locking device on the outlet. This new pouch also incorporates a unique Dual-Carb filter which combines modified and unmodified carbon to help fight the various odour types that an ileostomy can produce.