Comparison of the effects of simulation training and problem-based scenarios on the improvement of graduating nursing students to speak up about medication errors: A quasi-experimental study.

BACKGROUND: Medication administration errors are common among new nurses. Nursing students might be less willing to speak up about errors because of a lack of knowledge and experience. OBJECTIVES: To examine the effects of simulation training and problem-based scenarios on speaking up about medication errors among graduating nursing students. DESIGN: Prospective, controlled experimental study design. SETTING: A university four-year nursing program in Taiwan. PARTICIPANTS: In total, 93 graduating nursing students in their last semester were recruited. Sixty-six students who received both a problem-based scenario and medication administration simulation training comprised the experimental group, while 27 students who received problem-based scenarios alone comprised the control group. METHODS: Experimental group students underwent 2 h of simulation training. This training class was designed based on Kolb's experiential learning theory for knowledge development and speaking up about errors. Students in both groups administered medications in problem-based scenarios with eight embedded errors. Students' performance in speaking up about medication errors was directly observed and graded using an objective structured checklist. The McNeamer Chi-squared test, paired t-test, Z test, t-test, and Hedges' g effect size were conducted. RESULTS: The number of times participants spoke up about medication errors significantly improved in both the experimental group (pre-test: 2.05 ± 1.12 and post-test 6.14 ± 1.25, t = 22.85, p<0.001) and control group (pretest: 2.04 ± 1.16 and post-test: 4.26 ± 1.63, t = 6.33, p<0.001). However, after the intervention, the mean number of times participants spoke up about medication errors in the experimental group was significantly higher than that in the control group (t = 5.99, p<0.001) in the post-test. CONCLUSIONS: Simulation training exhibited more-significant improvements than problem-based scenarios. Nursing schools and hospitals should incorporate simulation training or at least problem-based scenarios to improve medication safety.

Inhibitory and combinatorial effect of diphyllin, a v-ATPase blocker, on influenza viruses.

An influenza pandemic poses a serious threat to humans and animals. Conventional treatments against influenza include two classes of pathogen-targeting antivirals: M2 ion channel blockers (such as amantadine) and neuraminidase inhibitors (such as oseltamivir). Examination of the mechanism of influenza viral infection has shown that endosomal acidification plays a major role in facilitating the fusion between viral and endosomal membranes. This pathway has led to investigations on vacuolar ATPase (v-ATPase) activity, whose role as a regulating factor on influenza virus replication has been verified in extensive genome-wide screenings. Blocking v-ATPase activity thus presents the opportunity to interfere with influenza viral infection by preventing the pH-dependent membrane fusion between endosomes and virions. This study aims to apply diphyllin, a natural compound shown to be as a novel v-ATPase inhibitor, as a potential antiviral for various influenza virus strains using cell-based assays. The results show that diphyllin alters cellular susceptibility to influenza viruses through the inhibition of endosomal acidification, thus interfering with downstream virus replication, including that of known drug-resistant strains. In addition, combinatorial treatment of the host-targeting diphyllin with pathogen-targeting therapeutics (oseltamivir and amantadine) demonstrates enhanced antiviral effects and cell protection in vitro.

Frequency response and bandwidth enhancement in Ge/Si avalanche photodiodes with over 840 GHz gain-bandwidth-product.

In this work we report a separate-absorption-charge-multiplication Ge/Si avalanche photodiode with an enhanced gain-bandwidth-product of 845 GHz at a wavelength of 1310 nm. The corresponding gain value is 65 and the electrical bandwidth is 13 GHz at an optical input power of -30 dBm. The unconventional high gain-bandwidth-product is investigated using device physical simulation and optical pulse response measurement. The analysis of the electric field distribution, electron and hole concentration and drift velocities in the device shows that the enhanced gain-bandwidth-product at high bias voltages is due to a decrease of the transit time and avalanche build-up time limitation at high fields.

Biodegradable foam plastics based on castor oil.

In this work, a simple but effective approach was proposed for preparing biodegradable plastic foams with a high content of castor oil. First of all, castor oil reacted with maleic anhydride to produce maleated castor oil (MACO) without the aid of any catalyst. Then plastic foams were synthesized through free radical initiated copolymerization between MACO and diluent monomer styrene. With changes in MACO/St ratio and species of curing initiator, mechanical properties of MACO foams can be easily adjusted. In this way, biofoams with comparable compressive stress at 25% strain as commercial polyurethane (PU) foams were prepared, while the content of castor oil can be as high as 61 wt %. The soil burial tests further proved that the castor oil based foams kept the biodegradability of renewable resources despite the fact that some petrol-based components were introduced.

Determinants of inorganic arsenic methylation capability among residents of the Lanyang Basin, Taiwan: arsenic and selenium exposure and alcohol consumption.

The objective of this study was to assess individual variation in inorganic arsenic methylation capability and the association between selenium levels in urine and blood, and inorganic arsenic methylation capability among residents of the Lanyang Basin who drank groundwater and were exposed to high concentrations of inorganic arsenic. According to the arsenic concentration of their drinking water, they were equally and randomly classified into four groups of 252 persons. It turned out that the higher the concentration of arsenic in well water was and thus the cumulative arsenic exposure, the higher the total inorganic arsenic metabolites in urine (total As(i)) and the overall inorganic and organic arsenic in urine (overall As(i+o)) were. The percentage of inorganic arsenic significantly decreased and the DMA percentage significantly increased as the concentration of urinary selenium and serum alpha-tocopherol increased. It appeared that urinary selenium levels increased the metabolism by methylation of arsenic, a finding that requires further investigation.