Efficacy of a Nasogastric Tube Educational Intervention for Nursing Staff.

AIM: We performed a single-center teaching intervention with nursing providers on nasogastric tube (NG tube) clinical practice. The initial purpose of this study was the validation of whether the training was sufficient enough to be retained at a later time point. METHODS: We performed a prospective pre-post study examining participants' knowledge before, immediately after, and 4 weeks after training in NG tube management. Training was delivered in face-to-face classroom sessions. Knowledge was assessed using a multiple-choice test (pretest, posttest #1and #2). RESULTS: A total of 137 nursing providers participated in the training intervention. Immediately after training (posttest #1) and again 4 weeks later (posttest #2), participants overwhelmingly recalled and retained the knowledge of NG tube management as compared to pretest results. Paired t-tests showed each participant increased their test score from pretest to posttest #1, t (134) = 12.64, P = .0001. Similarly, participants who took posttest #2 significantly improved their scores from the pretest to posttest #2, t (71) = 10.629, P < .0001. Secondary analysis showed that the NG tube management comfort level and age of provider were not significant in predicting test results. However, years of professional experience and frequency of NG tube care were significant predictors for higher test scores. CONCLUSION: To minimize the risk of NG tubes for patients, it is critical to follow clinical guidelines. This study shows that teaching interventions for providers to increase knowledge on NG tubes are beneficial. In addition, the knowledge is retained at later time points.

Rovibrational energy transfer in Ne-Li2(A1Sigmau+,v=0): Comparison of experimental data and results from classical and quantum calculations.

Absolute rate constants for rotational and rovibrational energy transfer in the system Ne-Li2(A1Sigmau+) were measured by a dispersed fluorescence technique following excitation of the (v = 0,j = 18) initial level of Li2(A1Sigmau+). The rate coefficients for Deltav = 0 processes decline monotonically with increasing |Deltaj|. The Deltav = 1 rate coefficients are also peaked near Deltaj = 0 but show a broad shoulder extending to approximately Deltaj = 30. Classical trajectory calculations and accurate quantum mechanical close-coupled calculations were used to compute theoretical rate constants from an ab initio potential surface. The agreement between the classical and quantum calculations is very good. The calculations slightly overestimate the measured rate constants for Deltav = 0, Deltaj or= 20, implying that the anisotropy of the ab initio surface is too small at short range and too large at long range. For Deltav = 1 collisions, the calculations agree well with experiment for Deltaj 0 collisions, disagreeing with experiment by a factor of 2 for Deltaj approximately 20 but agreeing better at higher and lower Deltaj. Analysis of classical trajectories indicates that the vibrationally inelastic collisions fall into two groups corresponding to equatorial and near-end impacts; the former generally produce small Deltaj while the latter produce large Deltaj. Studies of a simple model potential show that this dual mechanism may be a general phenomenon not limited to the particular potential surface employed here. Criteria controlling the relative importance of the two vibrational excitation routes are enumerated.

Effect of a brief intervention on evidence-based medicine skills of pediatric residents.

BACKGROUND: While Evidence-Based Medicine (EBM) skills are increasingly being taught in medical schools, teaching quality has been insufficient, so that incoming pediatric residents lack adequate EBM skills required for patient care. The objective of this study was to evaluate the effectiveness of a brief teaching module developed to improve EBM skills of pediatric residents. METHODS: With-in subjects study design with pre- and post-test evaluation was performed in a large urban pediatric residency training program in Brooklyn, New York. We included PGY-1s during intern orientation, while second and third year pediatric residents were selected based on schedule availability. Sixty-nine residents were enrolled into the study, 60 (87%) completed the training. An EBM training module consisting of three or four weekly two-hour seminars was conducted. The module was designed to teach core EBM skills including (1) formulating answerable clinical questions, (2) searching the evidence, (3) critical appraisal skills including validity and applicability, and (4) understanding levels of evidence and quantitative results for therapy articles. A portion of the Fresno test of competence in EBM was used to assess EBM skills. The test presented a clinical scenario that was followed by nine short answer questions. One to three questions were used to assess EBM skills for each of the four core skills. The kappa co-efficient for inter-rater reliability was 0.74 (95% CI: 0.56-0.92). RESULTS: Prior to the training module, the residents achieved a mean score of 17% correct overall. Post intervention, the mean score increased to 63% with improvement in each EBM category. A mean of 4.08 more questions (out of 9) were answered correctly after the training (95% CI of 3.44-4.72). CONCLUSION: A brief training module was effective in improving EBM skills of pediatric residents.

Collaborating to enhance patient education and recovery.

OBJECTIVE: The paper describes a collaborative project between librarians and health care staff to enhance patient recovery by distributing educational videos and evaluating the acceptability of this "information intervention." BACKGROUND: On inpatient units, nurses experience decreased time to teach patients. Text handouts do not include multimedia information, and reading levels may limit comprehension. Because the postoperative period is not the optimal time for patient instruction, another format and opportunity for postsurgical instruction was needed. METHODS: Nurses, therapists, educators, and librarians partnered to select a video designed for home viewing by discharged patients. It was added to the existing text-based educational program for coronary patients. An evaluation component was incorporated into this collaboration. RESULTS: The library's role extended to all aspects of the program's implementation and management. The library's circulation system was used to coordinate borrowing with minimal loss. Ongoing preparation of the video materials for distribution and return remained a library function, and the evaluation component showed patients' positive reception of the video. DISCUSSION: Patients received a greater amount of information to enhance self-care during the recovery period without consuming more nursing time. Video circulation and reuse enhanced cost effectiveness of the program, and patients benefited from the library's resources.

An effective system to produce smoke solutions from dried plant tissue for seed germination studies.

PREMISE OF THE STUDY: An efficient and inexpensive system was developed to produce smoke solutions from plant material to research the influence of water-soluble compounds from smoke on seed germination. • METHODS AND RESULTS: Smoke solutions (300 mL per batch) were produced by burning small quantities (100-200 g) of dried plant material from a range of species in a bee smoker attached by a heater hose to a side-arm flask. The flask was attached to a vacuum water aspirator, to pull the smoke through the water. The entire apparatus was operated in a laboratory fume hood. • CONCLUSIONS: Compared with other smoke solution preparation systems, the system described is easy to assemble and operate, inexpensive to build, and effective at producing smoke solutions from desired species in a small indoor space. Quantitative measurements can be made when using this system, allowing for replication of the process.

Araneoid egg case silk: a fibroin with novel ensemble repeat units from the black widow spider, Latrodectus hesperus.

Araneoid spiders use specialized abdominal glands to manufacture up to seven different protein-based silks/glues that have diverse physical properties. The fibroin sequences that encode egg case fibers (cover silk for the egg case sac) and the secondary structure of these threads have not been previously determined. In this study, MALDI tandem TOF mass spectrometry (MS/MS) and reverse genetics were used to isolate the first egg case fibroin, named tubuliform spidroin 1 (TuSp1), from the black widow spider, Latrodectus hesperus. Real-time quantitative PCR analysis demonstrates TuSp1 is selectively expressed in the tubuliform gland. Analysis of the amino acid composition of raw egg case silk closely aligns with the predicted amino acid composition from the primary sequence of TuSp1, which supports the assertion that TuSp1 represents a major component of egg case fibers. TuSp1 is composed of highly homogeneous repeats that are 184 amino acids in length. The long stretches of polyalanine and glycine-alanine subrepeats, which account for the crystalline regions of minor ampullate and major ampullate fibers, are very poorly represented in TuSp1. However, polyserine blocks and short polyalanine stretches were highly iterated within the primary sequence, and (13)C NMR spectroscopy demonstrated that the majority of alanine was found in a beta-sheet structure in post-spun egg case silk. The TuSp1 repeat unit does not display substantial sequence similarity to any previously described fibroin genes or proteins, suggesting that TuSp1 is a highly divergent member of the spider silk gene family.

Supporting ward staff in acute care areas: the past, the present and the future?

Clinical education for acute ward staff caring for critically ill patients has continued to be a strong focus for practice development. Adopting a work-based learning approach to empower ward staff has led to the development of a five-day competency-based high dependency skills course. Developing leadership potential and enhancing networking opportunities for nurses from within critical care and ward areas is essential for the realisation of the aims of Comprehensive Critical Care.

Molecular and mechanical properties of major ampullate silk of the black widow spider, Latrodectus hesperus.

Molecular and material properties of major ampullate silk were studied for the cobweb-building black widow spider Latrodectus hesperus. Material properties were measured by stretching the silk to breaking. The strength was 1.0 +/- 0.2 GPa, and the extensibility was 34 +/- 8%. The secondary structure of the major ampullate silk protein was studied using carbon-13 NMR spectroscopy. Alanine undergoes a transition from a coiled structure in pre-spun silk to a beta sheet structure in post-spun silk. We have also isolated two distinct cDNAs (both about 500 bp) which encode proteins similar to major ampullate spidroin 1 and 2 (MaSp1 and MaSp2). The MaSp1-like silk contains polyalanine runs of 5-10 residues as well as GA and GGX motifs. The MaSp2-like silk contains polyalanine runs of varying length as well as GPG(X)(n) motifs. L. hesperus major ampullate silk is more like major ampullate silk from other species than other L. hesperus silks.