Protocol for the microinjection of free fatty acids and triacylglycerol in zebrafish embryos.

During development, the zebrafish embryo relies on its yolk sac as a nutrient source. Here, we present a protocol for modifying the free fatty acid (FFA) and triacylglycerol (TAG) content of the zebrafish yolk sac by microinjection. We describe steps for needle and injection mold preparation, FFA and TAG solution preparation, and microinjection. This protocol can elucidate how excesses of FFA and TAG affect development and modify the transcriptome of zebrafish embryos. For complete details on the use and execution of this protocol, please refer to Konadu et al. 1.

Blocking endogenous retinoic acid degradation induces oral tooth formation in zebrafish.

According to Dollo's Law of irreversibility in evolution, a lost structure is usually considered to be unable to reappear in evolution due to the accumulation over time of mutations in the genes required for its formation. Cypriniform fish are a classic model of evolutionary loss because, while they form fully operational teeth in the ventral posterior pharynx, unlike other teleosts, they do not possess oral teeth. Paleontological data show that Cypriniforms, a clade of teleost fish that includes the zebrafish, lost their oral teeth 50 to 100 Mya. In order to attempt to reverse oral tooth loss in zebrafish, we block the degradation of endogenous levels of retinoic acid (RA) using a specific inhibitor of the Cyp26 RA degrading enzymes. We demonstrate the inhibition of endogenous RA degradation is sufficient to restore oral tooth induction as marked by the re-appearance of expression of early dental mesenchyme and epithelium genes such as dlx2b and sp7 in the oral cavity. Furthermore, we show that these exogenously induced oral tooth germs are able to be at least partly calcified. Taken together, our data show that modifications of signaling pathways can have a significant effect on the reemergence of once-lost structures leading to experimentally induced reversibility of evolutionary tooth loss in cypriniforms.

Wearable Technology: A Wellbeing Option for Serving Police Officers and Staff? A Comparison of Results of a Pilot Study with Firearms Officers and a Group of Mixed Officers and Staff.

The high-stress nature of policing contributes to deterioration of officer health and wellbeing as well as high levels of absenteeism and attrition. Wearable technology (WT) has been identified as a potential tool that can help in improving officer health and wellbeing. This pilot study aimed to give initial insight into acceptability and engagement with WT amongst officers. The study also aimed to uncover any notable areas for exploration in future research within the domain of officer health and wellbeing. Two groups were observed, firearms officers and a mixed group of officers. Participants wore the WT for an extended period, completed a variety of health and wellbeing questionnaires and discussed their experience in focus groups. Firearms officers and mixed group officers displayed similar sleep efficiency, but firearms officers have worse sleep consistency and sleep performance. Firearms officers appear to have higher HRV and a slightly lower resting heart rate. Both groups display reasonable acceptance of the use of WT, speaking favorably during the focus groups of how monitoring the data had improved their quality of life in terms of their understanding of sleep, wellbeing and how they had consequently completed lifestyle modification. WT offers some promise in managing officer health and wellbeing; studies with larger sample sizes are needed to confirm this.

Evaluation of a Disaster Preparedness Curriculum and Medical Students' Views on Preparedness Education Requirements for Health Professionals.

OBJECTIVE: In general, medical students perceive themselves as inadequately prepared to assist in disasters. This study evaluated the impact of a disaster preparedness curriculum and medical students' views toward required preparedness education for health care professionals. METHODS: A comprehensive disaster preparedness curriculum was evaluated on its effect on medical students' views on preparedness education requirements, preparedness, and prior disaster training using self-report survey methodology. RESULTS: Results provide evidence to support curricular effectiveness in significantly increasing initial participant views of health professionals' education requirements, perceived preparedness for integrating professional roles into the emergency response system, and confidence in exposure risk assessment and triage skills. Most participants possessed limited recent prior disaster training and drill experience. Most interestingly, the majority consistently believed throughout the study that disaster preparedness training should be a medical license mandate. CONCLUSIONS: For those instructing current medical students in disaster preparedness, it is suggested that a curriculum be chosen that can create participant initial anticipation, awareness, and belief in the importance of and need for disaster preparedness training. Further investigation is recommended into the relationship between students' perceived training importance and any future curriculum delivery efforts on behalf of required or mandatory preparedness offerings in continuing professional development.

Excess glucose or fat differentially affects metabolism and appetite-related gene expression during zebrafish embryogenesis.

Zebrafish embryos use their yolk sac reserve as the sole nutrient source during embryogenesis. The two main forms of energy fuel can be found in the form of glucose or fat. Zebrafish embryos were exposed to glucose or injected with free fatty acid/Triacylglycerol (FFA/TAG) into the yolk sac at 24 hpf. At 72 hpf, glucose exposed or FFA/TAG injected had differential effects on gene expression in embryos, with fat activating lipolysis and ß-oxidation and glucose activating the insulin pathway. Bulk RNA-seq revealed that more gene expression was affected by glucose exposure compared to FFA/TAGs injection. Appetite-controlling genes were also differently affected by glucose exposure or FFA/TAG injections. Because the embryo did not yet feed itself at the time of our analysis, gene expression changes occurred in absence of actual hunger and revealed how the embryo manages its nutrient intake before active feeding.

Electronic assistive technology use and supported employment.

BACKGROUND: Level of electronic assistive technology use by people with intellectual disabilities is lower than for other disability groups. METHODS: In this mixed-methods exploratory study during the pandemic, staff (online survey) and executive administration (focus group) from a regional supported employment service provider in the Midwest US were surveyed about use of and barriers to use of electronic assistive technology for their clients with intellectual disabilities. RESULTS: Forty percent of staff reported 'not' using any of the assistive technologies with their clients. Executive administration perceived that they should be providing technology resources to clients and staff. Both groups rated expense, access, and complexity as barriers to assistive technology use at the client's worksite. CONCLUSIONS: Identifying the types of assistive technologies that can be most easily accessed and most cost-effective, including lower-cost consumer market devices, as employment supports for people with intellectual disabilities may be a first step in helping to overcome perceived barriers to use.

Undergraduate health professions students' perceptions of athletic training students before and after an interprofessional case study program.

Students pursuing careers in health professions may initially approach their training with preconceived ideas and perceptions of those who practice different health-related careers. Little research has been conducted on athletic training students and professional stereotypes or athletic training students and interprofessional education in general. Because interprofessional education may provide some positive effects on stereotypes, the goal of this study was to measure undergraduate health professions student stereotypes of athletic training students before and after an interprofessional case study program. Undergraduate nursing and public health interprofessional case study program participants assessed various relational and intrapersonal capabilities for their own professions and the athletic training profession, pre-post-program. For nursing student participants with athletic training students on their team, perceptions of their own profession and the athletic training profession significantly (p <.05) increased as compared to those with no athletic training student on their team. For public health student participants, although scores increased, no significant differences were found. Interprofessional collaborative experiences may decrease negative stereotypes of other professions, including athletic training.

Pharmacological Transection of Brain-Spinal Cord Communication Blocks Pain-Induced Hemorrhage and Locomotor Deficits after Spinal Cord Injury in Rats.

Spinal cord injury (SCI) is often accompanied by additional tissue damage (polytrauma), which engages pain (nociceptive) fibers. Prior research has shown that nociceptive input can increase cell death, expand the area of hemorrhage, and impair long-term recovery. The current study shows that these adverse effects can be blocked by the sodium channel blocker lidocaine applied rostral to a contusion injury. Rats received a lower thoracic (T12) contusion injury, and noxious electrical stimulation (shock) was applied to the tail 24 h later. Immediately before shock treatment, a pharmacological transection was performed by slowly infusing lidocaine at T2. Long-term locomotor recovery was assessed over the next 21 days. Noxious electrical stimulation impaired locomotor recovery, and this effect was blocked by rostral lidocaine. Next, the acute effect of lidocaine was assessed. Tissue was collected 3 h after noxious stimulation, and the extent of hemorrhage was evaluated by assessing hemoglobin content using Western blotting. Nociceptive stimulation increased the extent of hemorrhage. Lidocaine applied at T2 before, but not immediately after, stimulation blocked this effect. A similar pattern of results was observed when lidocaine was applied at the site of injury by means of a lumbar puncture. The results show that a pharmacological transection blocks nociception-induced hemorrhage and exacerbation of locomotor deficits.

Effect of a rapid e-learning module and brief interprofessional simulation event on medical and nursing student collaborative attitudes and behaviors.

Objectives Undergraduate nursing and first-year medical students participated in a brief, scenario-based, interprofessional event. The experimental group only was provided an innovative, rapid e-learning instructional module focused on interprofessional roles/responsibilities and communication prior to the event. Methods Pre-post attitudes toward physician-nurse collaboration were surveyed, and collaborative behaviors were observed during the event. Results For the experimental group, a statistically significant (p<0.05) attitude improvement was found between pre-post e-learning module scores as well as pre-e-learning module and post-simulation event scores. For the control group, a statistically significant (p=0.001) attitude improvement was found between pre-post simulation event scores. No statistically significant differences in team collaborative behaviors were observed between experimental and control. Conclusions The combination of module and simulation event was not a more effective option than the event alone. As both interventions present unique challenges in regards to technology and facility requirements, having multiple effective intervention options will be of benefit to educational institutions.

The Omnipresence of Cancer: Two Perspectives.

This article aimed at describing the development of a theory of the experience of living with cancer. Secondary analysis of data from a series of studies yielded the concepts and propositions of the theory of the omnipresence of cancer. Theory construction was guided by Heidegger's ontology of dasein, whereas Newman's grand theory of health as expanding consciousness guided theory evolution. The theory includes 4 concepts-influencing factors, toward authentic dasein, mapping out the future, and living with cancer-each of which has several dimensions. Based on this theory, nursing interventions can be developed and tested to support persons with cancer.

Work motivation perceptions of students with intellectual disabilities before and after participation in a short-term vocational rehabilitation summer programme: An exploratory study.

BACKGROUND: A small group of transition-aged students with intellectual disabilities participated in a short-term summer work experience programme under the mentorship of a job coach. METHODS: Dyadic interview technique was used to identify student and mentor participants' perceptions of student participant work motivation pre- and post-programme. Themes were identified and interpreted. RESULTS: Student participants reported becoming more intrinsically motivated and future-focused by programme completion. They noted a broader outlook about the meaning of employment; moving from a narrow, financial-focused, short-term perception to a longer-term, more holistic view of work. Although student participants reported high confidence levels for obtaining and keeping employment by programme completion, mentors voiced concerns about realism of their goals due to employment barriers for people with disabilities. CONCLUSIONS: Work motivation has been previously associated with positive employment participation. Findings provide some support for assessment of work motivation in school-to-work transition planning.

Rapid E-Learning for professional development in school-based diabetes management.

The number of school aged youth in the United States requiring assistance in the management of diabetes has reached over 200,000. School nurses are often charged with the training of personnel and provision of assistance to children with this chronic disease. The need for quick, efficient, and accessible training methods is necessary to ensure school nurses have the most current information necessary to perform their duties. The purpose of this study was to assess the effectiveness of a rapid e-learning module for school nurse professional development in school-based diabetes management. A sample (N = 1977, n = 1127) of school nurses was asked to complete a module addressing current and/or changing information on diabetes management, the training of staff charged with assisting students, and the associated pre- and post-tests for the module. A total of 678 nurses completed the pre-test, while 449 nurses completed the post-test. T-test results for independent samples indicated a significant increase (p < 0.001) in knowledge at post-test. Results support the contention that e-modules are a convenient and effective way to provide professional development opportunities and improve nurses' knowledge.

Exploring Public Health and Nursing Students' Perceptions of Each Other's Professional Roles.

Public health education specialists and nurses often work interprofessionally in the public health setting. Using a mixed-methods design, this exploratory study evaluated the effect of an online interprofessional case study activity on nursing and public health education students' perceptions of each other's professional role. For the public health experimental group only, a statistically significant change (p < .05) was found in their perceptions of the professional roles of nurses including large changes in six specific domains. Recommendations for implementing interprofessional education programs include more emphasis on education about professional scopes of practice and roles/responsibilities of the health professions.

Desire for Continued Pessary Use Among Women of Hispanic and Non-Hispanic Ethnic Backgrounds for Pelvic Floor Disorders.

OBJECTIVE: This study aimed to describe the association between patient ethnicity/race and desire to continue using a pessary for the treatment of pelvic floor disorders. METHODS: We performed a secondary analysis of a randomized trial among women presenting for pessary fitting. The primary outcome was the desire to continue using a pessary at 3 months. Bacterial vaginosis by Nugent score and vaginal symptoms (discharge, itching, pain, sores) were also evaluated. Logistic or multiple linear regression was performed with correction for body mass index, education level, parity, Charlson Comorbidity Index, and randomization to TrimoSan gel. RESULTS: One hundred fourteen women (41 Hispanic and 73 non-Hispanic) were eligible for this analysis. Women self-identified as white (65/114; 57%), Hispanic (41/114, 36%), Asian (3/114; 2.6%), Native American (4/114; 3.5%), and "other" (1/114, 0.9%) race, with no self-identified African American women (0/114) meeting the inclusion criteria. No significant difference in desire to continue pessary use was found between Hispanic and non-Hispanic women (58.5% vs 63%; P = 0.69; corrected odds ratio [cOR], 1.11; 95% confidence interval [CI], 0.43-2.90) or across races (P = 0.89). Hispanic women had significantly higher risk of bacterial vaginosis (34% vs 16%; P = 0.04; cOR, 2.91; 95% CI, 1.01-8.39), higher Nugent scores (5.4 ± 2.3 vs 4.3 ± 2.3; P = 0.02; corrected coefficient, 1.10; 95% CI, 0.10-2.10), and more vaginal pain (17.1% vs 2.8%; P = 0.01; cOR, 9.14; 95% CI, 1.37-61.17) at 3 months. CONCLUSIONS: Despite increased vaginal pain and vaginal microbiome disturbances in Hispanic women using a pessary, no significant differences in the desire to continue using the pessary existed.

Edutainment: A Creative Solution for School-Based Preventive Screening Orientation in Missouri.

School nurses provide routine formal vision and hearing health screenings to school children. However, time available during the school day for nurses to visit elementary classrooms and conduct pre-screening education and orientation is limited. A group of school nurses in Missouri needed an age-appropriate and time-saving method to introduce and orient children to the equipment, materials, and procedures that will be used on screening day. The school nurses collaborated with a health education specialist at a state university to develop two e-learning edutainment programs (one for vision screening and one for hearing screening) following best practices for educational design of e-learning programs. Edutainment is an e-learning technology that mixes education and entertainment using sound, video, and pictures. Edutainment is used to attract student attention through an enjoyable computer-based interaction to encourage focus on lesson content. The edutainment programs developed can be used by students at their own pace on their school-provided or personal devices, and/or the teacher can play the program module to the entire class as a group activity.

Fine needle aspiration biopsy cytology of phyllodes tumour and fibroadenoma: A cytomorphological study of 104 cases.

BACKGROUND: The cytomorphological features in the distinction between phyllodes tumour (PT) and fibroadenoma (FA) on fine needle aspiration biopsy (FNAB) remains challenging because of the biphasic nature of these lesions and the rarity of PT. METHODS: FNAB smears of histologically confirmed PT (N = 26) and FA (N = 78) cases were retrieved from a retrospective database interrogation from the Department of Cytology/Tissue Pathology, ICPMR Pathology West (Cerner Millennium) in Westmead Hospital. For each case, two smears were selected, de-identified and independently reviewed by four observers comprising two cytologists and two cytopathologists. Cytological parameters examined included detailed evaluation of smear cellularity, epithelial and stromal components as well as the smear background. RESULTS: The cytological features of moderate to marked stromal cellularity and stromal nuclear atypia were more evident in PT than in FA, identified by three out of four observers. The epithelial characteristics, presence of macrophages, multinucleated giant cells and blood vessels showed no statistically significant differences in the distinction between the two lesions. CONCLUSION: The results of this study indicate that in all of the cytological features assessed for PT and FA, no single cytological feature was found to be statistically significant in identifying PT across all observers. This reflects the overlap of cytological features seen in these lesions. FNAB cytology cannot reliably distinguish FA and PT.

Public Health and School Nurses' Perceptions of Barriers to HPV Vaccination in Missouri.

Human Papilloma Virus (HPV) is associated with various forms of cancer and is preventable with vaccination. Nurses are in a unique position to directly influence a person's decision to receive the HPV vaccine. A statewide sample of both school and public health nurses was used to assess knowledge and attitudes related to the HPV vaccine as well as nurse's behaviors and behavioral intentions toward educating parents and recommending the vaccine. Positive attitudes and adequate knowledge levels were found, however, the majority of school nurses did not provide information and resources to parents. Targeted health promotion programs for school nurses are recommended.

Translating interprofessional theory to interprofessional practice.

Although interprofessional collaborative activities for health professions students have demonstrated increased knowledge of professional roles, interprofessional attitudes and confidence, and team skills; traditional professional role patterns and lack of professional role understanding are still prevalent among health professions students and may continue into professional practice. Between 1 and 10years after they completed their undergraduate studies, practicing community/public health education professionals and registered nurses who participated in an interprofessional patient home-visiting curriculum as undergraduates were surveyed. Most reported current positive attitudes and perceived collaborative abilities regarding interprofessional collaboration. On their perceived interprofessional collaborative abilities, however, community/public health education participants scored significantly higher (t(143)=-2.53, p=0.01) than registered nurse participants. Although it is difficult to generalize the findings from this study to other interprofessional curriculum models, it seems that this curriculum that concentrated on teamwork behaviors and abilities may have contributed to participants' positive translation of interprofessional theory to interprofessional practice.

Effects of an Online Educational Module on School Nurses' Knowledge of HPV Vaccination.

BACKGROUND: Results of a previous state-wide survey revealed generally low knowledge levels about HPV vaccination among school nurses in Missouri. A short, online educational module targeted to address the specific low-scoring items was then created. METHOD: All 440 lead school nurses in Missouri were invited by e-mail to participate in an online HPV educational module and study. The e-mail contained a link to the module that included a consent form, a test, and a downloadable completion certificate. The test consisted of 12 multiple choice and true-or-false items based directly on the content contained in the module. An independent samples t test was used to determine pre-post differences in mean test scores. RESULTS: Scores improved significantly (p < .05) pre-post intervention; however, surveillance or epidemiology-related questions were still commonly missed. CONCLUSION: Using brief, targeted, online trainings to improve knowledge of specific health-related content may be a practical option for busy school nurses. J Contin Educ Nurs. 2017;48(9):431-436.

Practices and Attitudes of Missouri School Nurses Regarding Immunization Records and Select Immunizations of Graduating High School Seniors.

School nurses play a key role in maintaining a healthy student population, and one of their roles includes maintaining vaccination records. Further, they can play an important role in advocating for human papillomavirus (HPV) and meningococcal vaccination for students. All Missouri public high school nurses were sent an electronic survey addressing the knowledge, attitudes, and practices regarding immunization records and HPV and meningococcal vaccination of high school seniors. Approximately 75% of nurses reported their schools did not have or they did not know if the school had a written policy regarding the release of vaccination records. Approximately 1/2 and 1/3 of nurses do not communicate with parents/students about HPV or meningococcal vaccines, respectively. Although most favorable toward meningococcal, nurses had positive attitudes toward both vaccines. Recommendations include establishment of written policies regarding vaccination record release, and future research should focus on evaluating school nurses' communication methods regarding HPV and meningococcal vaccination.