Capturing patient mobility levels in the hospital: An examination of nursing charting and behavioural mapping.

AIMS: Our study aimed to (1) validate the accuracy of nursing mobility documentation and (2) identify the most effective timings for behavioural mapping. DESIGN: We monitored the mobility of 55 inpatients using behavioural mapping throughout a nursing day shift, comparing the observed mobility levels with the nursing charting in the electronic health record during the same period. RESULTS: Our results showed a high level of agreement between nursing records and observed mobility, with improved accuracy observed particularly when documentation was at 12 PM or later. Behavioural mapping observations revealed that the most effective timeframe to observe the highest levels of patient mobility was between 10 AM AND 2 PM. CONCLUSION: To truly understand patient mobility, comparing nursing charting with methods like behavioural mapping is beneficial. This comparison helps evaluate how well nursing records reflect actual patient mobility and offers insights into the best times for charting to capture peak mobility. While behavioural mapping is a valuable tool for auditing patient mobility, its high resource demands limit its regular use. Thus, determining the most effective times and durations for observations is key for practical implementation in hospital mobility audits. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE: Nurses are pivotal in ensuring patient mobility in hospitals, an essential element of quality care. Their role involves safely mobilizing patients and accurately charting their mobility levels during each shift. For nursing practice, this research underscores that nurse charting can accurately reflect patient mobility, and highlights that recording the patient's highest level of mobility later in the shift offers a more precise representation of their actual mobility. REPORTING METHOD: Strobe. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

"Value in diversity": School racial and ethnic composition, teacher diversity, and school punishment.

American schools have become increasingly punitive and characterized by racial and ethnic disparities in punishment outcomes. Scholarship on the causes and consequences of this shift has highlighted the potential salience of school context. The current study extends this work by exploring the potential effect of an underexplored factor, teacher diversity, on suspension disparities. To date, explorations of the role of teacher diversity have been limited to its impact on academic outcomes, teacher perceptions, and behavioral outcomes. The current study fills a void in the existing literature by examining (1) whether greater teacher diversity is associated with reductions in racial and ethnic suspension disparities and (2) whether greater teacher diversity interacts with the size of the racial and ethnic student population to influence suspension disparities. This study contributes to the existing literature by extending the "value in diversity" perspective to the school setting. Additionally, the findings suggest that racial and ethnic diversity in positions of authority in the school setting fosters a more equitable approach to the administration of student punishment.

EXPLAINING THE ASSOCIATION BETWEEN INCARCERATION AND DIVORCE.

Recent studies have suggested that incarceration dramatically increases the odds of divorce, but we know little about the mechanisms that explain the association. This study uses prospective longitudinal data from a subset of married young adults in the National Longitudinal Study of Adolescent Health (N = 1,919) to examine whether incarceration is associated with divorce indirectly via low marital love, economic strain, relationship violence, and extramarital sex. The findings confirmed that incarcerations occurring during, but not before, a marriage were associated with an increased hazard of divorce. Incarcerations occurring during marriage also were associated with less marital love, more relationship violence, more economic strain, and greater odds of extramarital sex. Above-average levels of economic strain were visible among respondents observed preincarceration, but only respondents observed postincarceration showed less marital love, more relationship violence, and higher odds of extramarital sex than did respondents who were not incarcerated during marriage. These relationship problems explained approximately 40 percent of the association between incarceration and marital dissolution. These findings are consistent with theoretical predictions that a spouse's incarceration alters the rewards and costs of the marriage and the relative attractiveness of alternative partners.

INCORPORATING ROUTINE ACTIVITIES, ACTIVITY SPACES, AND SITUATIONAL DEFINITIONS INTO THE SOCIAL SCHEMATIC THEORY OF CRIME.

Simons and Burt's (2011) social schematic theory (SST) of crime posits that adverse social factors are associated with offending because they promote a set of social schemas (i.e., a criminogenic knowledge structure) that elevates the probability of situational definitions favorable to crime. This study extends the SST model by incorporating the role of contexts for action. Furthermore, the study advances tests of the SST by incorporating a measure of criminogenic situational definitions to assess whether such definitions mediate the effects of schemas and contexts on crime. Structural equation models using 10 years of panel data from 582 African American youth provided strong support for the expanded theory. The results suggest that childhood and adolescent social adversity fosters a criminogenic knowledge structure as well as selection into criminogenic activity spaces and risky activities, all of which increase the likelihood of offending largely through situational definitions. Additionally, evidence shows that the criminogenic knowledge structure interacts with settings to amplify the likelihood of situational definitions favorable to crime.

Balanced transcription of cell division genes in Bacillus subtilis as revealed by single cell analysis.

Cell division in bacteria is carried out by a set of conserved proteins that all have to function at the correct place and time. A cell cycle-dependent transcriptional programme drives cell division in bacteria such as Caulobacter crescentus. Whether such a programme exists in the Gram-positive model organism Bacillus subtilis is unknown. Here, we investigate the role of gene transcription as a potential regulatory mechanism for control of division in B. subtilis. Transcriptional GFP fusions in combination with flow cytometry demonstrated a constitutive promoter activity, independent of growth rate, of nine tested cell division genes. These measurements were verified by quantitative real-time reverse-transcription PCR (qrtPCR). Time-lapse fluorescence microscopy was performed on a set of selected reporter strains to test transcriptional regulation during the cell cycle. Interestingly, although the average fluorescence remained constant during cell-cycle progression, individual cells demonstrated a roughly twofold higher promoter activity at the end of the cell cycle. This cell cycle-dependent increased promoter activity can be partly explained by the doubled promoter copy number after DNA replication. Our results indicate that the transcriptional activity of promoters for cell division genes remains constant regardless of growth rate and cell-cycle state, suggesting that regulation of cell division in B. subtilis predominantly takes place at the post-translational level.

THE CODE OF THE STREET AND INMATE VIOLENCE: INVESTIGATING THE SALIENCE OF IMPORTED BELIEF SYSTEMS.

Scholars have long argued that inmate behaviors stem in part from cultural belief systems that they "import" with them into incarcerative settings. Even so, few empirical assessments have tested this argument directly. Drawing on theoretical accounts of one such set of beliefs-the code of the street-and on importation theory, we hypothesize that individuals who adhere more strongly to the street code will be more likely, once incarcerated, to engage in violent behavior and that this effect will be amplified by such incarceration experiences as disciplinary sanctions and gang involvement, as well as the lack of educational programming, religious programming, and family support. We test these hypotheses using unique data that include measures of the street code belief system and incarceration experiences. The results support the argument that the code of the street belief system affects inmate violence and that the effect is more pronounced among inmates who lack family support, experience disciplinary sanctions, and are gang involved. Implications of these findings are discussed.

An interpenetrating-network theory of cytoplasm.

Under many physiological and pathological conditions such as division and migration, cells undergo dramatic deformations, under which their mechanical integrity is supported by cytoskeletal networks (i.e. intermediate filaments, F-actin, and microtubules). Recent observations of cytoplasmic microstructure indicate interpenetration among different cytoskeletal networks, and micromechanical experiments have shown evidence of complex characteristics in the mechanical response of the interpenetrating cytoplasmic networks of living cells, including viscoelastic, nonlinear stiffening, microdamage, and healing characteristics. However, a theoretical framework describing such a response is missing, and thus it is not clear how different cytoskeletal networks with distinct mechanical properties come together to build the overall complex mechanical features of cytoplasm. In this work, we address this gap by developing a finite-deformation continuum-mechanical theory with a multi-branch visco-hyperelastic constitutive relation coupled with phase-field damage and healing. The proposed interpenetrating-network model elucidates the coupling among interpenetrating cytoskeletal components, and the roles of finite elasticity, viscoelastic relaxation, damage, and healing in the experimentally-observed mechanical response of interpenetrating-network eukaryotic cytoplasm.

Identification of a growth factor required for culturing specific fastidious oral bacteria.

Aims: The aim of this research was to isolate oral bacteria that are dependent for growth on adjacent bacteria producing a required growth factor and to identify the chemical structure of the growth factor. Methods: Porphyromonas pasteri strain KLE1280, could be cultivated with Staphylococcus hominis and Escherichia coli as helper strains. A deletion mutant library of E. coli was screened to determine genes involved in production of the growth factor. Compounds produced by the growth factor's pathway were screened to see if they would stimulate growth of strain P. pasteri KLE1280. The genomes of species related to P. pasteri KLE1280 were screened for presence of the factor's synthetic pathway. Results: Analysis of the E. coli deletion mutant library and growth studies identified 1,2-dihydroxy-2-naphthoic acid (DHNA) and menaquinone-4 (MK4) as the growth factors. Strain P. pasteri KLE1280 was shown to lack five genes in the menaquinone synthesis pathway but to possess the two genes necessary to convert DHNA to menaquinone. Genome analysis found that 8 species in genera Porphyromonas and Tannerella lack five genes in the menaquinone synthesis pathway. Conclusions: Addition of DHNA to culture media allows isolation of strains of several oral species that are not recovered using standard media.

Underutilization of intravesical chemotherapy and immunotherapy for high grade non-muscle invasive bladder cancer in California between 2006-2018: Effect of race, age and socioeconomic status on treatment disparities.

OBJECTIVE: Among patients diagnosed with non-muscle invasive bladder cancer (NMIBC), those with high risk disease have the greatest risk of recurrence and disease progression. The underutilization of intravesical immunotherapy with Bacillus Calmette-Guérin (BCG) has been a longstanding concern in clinical practice. This study aimed to determine the disparities present in receipt of adjuvant intravesical chemotherapy and immunotherapy in treatment of patients with high grade NMIBC following initial transurethral resection of a bladder tumor (TURBT). METHODS: The California Cancer Registry data was used to identify 19,237 patients diagnosed with high grade NMIBC who underwent TURBT. Treatment variables include re-TURBT, re-TURBT and intravesical chemotherapy (IVC) and/or BCG. Independent variables include age, sex, race/ethnicity, neighborhood socioeconomic status (nSES), primary insurance payer and marital status at diagnosis. Multiple logistic regression and multinomial regression models were used to examine variation in the treatments received following TURBT. RESULTS: The proportion of patients receiving TURBT followed by BCG was similar across all racial and ethnic groups (28%-32%). BCG therapy was higher in patients belonging to the highest nSES quintile (37% for highest vs. 23%-26% for the 2 lowest quintiles). In multiple variable analyses, receipt of any intravesical therapy (IVT) was influenced by nSES, age, marital status, race/ethnicity, and insurance type. Patients in the lowest nSES quintile had a 45% less likelihood of receiving IVT compared to the highest nSES group (OR [95%CI]: 0.55[0.49, 0.61]). Race/ethnicity differences in receipt of any adjuvant therapy were noted in the middle to lowest nSES quintile for Hispanic and Asian/Pacific Islander patients when compared to non-Hispanic White patients. When comparing variation in treatment by insurance type at diagnosis, those with Medicare or other insurance were 24% and 30% less likely to receive BCG after TURBT compared to those with private insurance, (OR [95%CI]: 0.76 [0.70, 0.82] and 0.70[0.62, 0.79]) respectively. CONCLUSION: In patients with a diagnosis of high risk NMIBC, disparities in utilization of BCG are seen based on SES, age, and insurance type.

Growing unculturable bacteria.

The bacteria that can be grown in the laboratory are only a small fraction of the total diversity that exists in nature. At all levels of bacterial phylogeny, uncultured clades that do not grow on standard media are playing critical roles in cycling carbon, nitrogen, and other elements, synthesizing novel natural products, and impacting the surrounding organisms and environment. While molecular techniques, such as metagenomic sequencing, can provide some information independent of our ability to culture these organisms, it is essentially impossible to learn new gene and pathway functions from pure sequence data. A true understanding of the physiology of these bacteria and their roles in ecology, host health, and natural product production requires their cultivation in the laboratory. Recent advances in growing these species include coculture with other bacteria, recreating the environment in the laboratory, and combining these approaches with microcultivation technology to increase throughput and access rare species. These studies are unraveling the molecular mechanisms of unculturability and are identifying growth factors that promote the growth of previously unculturable organisms. This minireview summarizes the recent discoveries in this area and discusses the potential future of the field.