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BACKGROUND: Nursery pigs undergo stressors in the post-weaning period that result in production and welfare challenges. These challenges disproportionately impact the offspring of primiparous sows compared to those of multiparous counterparts. Little is known regarding potential interactions between parity and feed additives in the post-weaning period and their effects on nursery pig microbiomes. Therefore, the objective of this study was to investigate the effects of maternal parity on sow and offspring microbiomes and the influence of sow parity on pig fecal microbiome and performance in response to a prebiotic post-weaning. At weaning, piglets were allotted into three treatment groups: a standard nursery diet including pharmacological doses of Zn and Cu (Con), a group fed a commercial prebiotic only (Preb) based on an Aspergillus oryzae fermentation extract, and a group fed the same prebiotic plus Zn and Cu (Preb + ZnCu). RESULTS: Although there were no differences in vaginal microbiome composition between primiparous and multiparous sows, fecal microbiome composition was different (R2 = 0.02, P = 0.03). The fecal microbiomes of primiparous offspring displayed significantly higher bacterial diversity compared to multiparous offspring at d 0 and d 21 postweaning (P < 0.01), with differences in community composition observed at d 21 (R2 = 0.03, P = 0.04). When analyzing the effects of maternal parity within each treatment, only the Preb diet triggered significant microbiome distinctions between primiparous and multiparous offspring (d 21: R2 = 0.13, P = 0.01; d 42: R2 = 0.19, P = 0.001). Compositional differences in pig fecal microbiomes between treatments were observed only at d 21 (R2 = 0.12, P = 0.001). Pigs in the Con group gained significantly more weight throughout the nursery period when compared to those in the Preb + ZnCu group. CONCLUSIONS: Nursery pig gut microbiome composition was influenced by supplementation with an Aspergillus oryzae fermentation extract, with varying effects on performance when combined with pharmacological levels of Zn and Cu or for offspring of different maternal parity groups. These results indicate that the development of nursery pig gut microbiomes is shaped by maternal parity and potential interactions with the effects of dietary feed additives.
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Senecavirus A (SVA) causes vesicular disease in swine and has been responsible for a rampant increase in the yearly number of foreign animal disease investigations conducted in the United States. Diagnostic investigations for SVA are typically performed by sampling animals individually, which is labor-intensive and stressful. Developing an alternative aggregate sampling method would facilitate the detection of this virus at the population level. In a preliminary study, SVA was detected in processing fluids (PF) collected in a breeding herd before and after outbreak detection. The objective of this study was to estimate the average number of weeks PF remain SVA-positive after an SVA outbreak. Ten farrow-to-wean breeding herds volunteered to participate in this studyby longitudinally collecting PF samples after an SVA outbreak was detected and submitting samples for RT-rtPCR testing. The PF samples from the 10 farms were SVA-positive for an average of 11.8 weeks after the outbreak. Here, we show that testing of PF may be a cost-effective method to detect SVA and help halt its spread in SVA-endemic regions.
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Senecavirus A (SVA) infection in pigs causes vesicular disease and results in a short viremia and transient shedding of the virus, mainly in oral fluids and feces. Here we describe the consistent prolonged shedding of SVA in the semen of 2 boars, and persistence of SVA within the tonsils and testes of 3 adult boars. Two SVA-infected boars that were identified on a Minnesota sow farm in 2017 shed SVA RNA in semen for >3 mo after an outbreak of vesicular disease had occurred on the farm. SVA was isolated from 1 semen sample collected 9 d after clinical disease began on the farm. The third SVA-infected boar was identified on an Indiana sow farm in 2020. All boars had SVA RNA detected in the testes and tonsils by RT-rtPCR, with lower Ct values obtained for the testes than from the tonsils. All boars had multifocal lymphocytic orchitis with segmental degeneration and atrophy of the germinal epithelium within the seminiferous tubules. One boar also had areas of seminiferous tubule collapse and interstitial fibrosis within the testes. In all boars, in situ hybridization demonstrated the presence of SVA mRNA within cells located basally in the seminiferous tubules of the testes, and within the basal surface epithelial cells, crypt epithelial cells, and subepithelial and parafollicular lymphocytes and histiocytes of the tonsil.
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Picornaviridae , Doenças dos Suínos , Animais , Feminino , Masculino , Picornaviridae/genética , RNA , Suínos , Doenças dos Suínos/epidemiologia , Viremia/veterináriaRESUMO
We report an ongoing regional outbreak of an emerging porcine reproductive and respiratory syndrome virus (PRRSV2) variant within Lineage 1C affecting 154 breeding and grow-finishing sites in the Midwestern U.S. Transmission seemed to have occurred in two waves, with the first peak of weekly cases occurring between October and December 2020 and the second starting in April 2021. Most of cases occurred within a 120 km radius. Both orf5 and whole genome sequencing results suggest that this represents the emergence of a new variant within Lineage 1C distinct from what has been previously circulating. A case-control study was conducted with 50 cases (sites affected with the newly emerged variant) and 58 controls (sites affected with other PRRSV variants) between October and December 2020. Sites that had a market vehicle that was not exclusive to the production system had 0.04 times the odds of being a case than a control. A spatial cluster (81.42 km radius) with 1.68 times higher the number of cases than controls was found. The average finishing mortality within the first 4 weeks after detection was higher amongst cases (4.50%) than controls (0.01%). The transmission of a highly similar virus between different farms carrying on trough spring rises concerns for the next high transmission season of PRRS.
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Processing fluid (PF) is a sample type composed of fluids obtained from testicles and tails as the product of piglet processing. Mycoplasma hyopneumoniae is a bacterium that colonises the respiratory tract of pigs and has rarely been detected in tissues outside the respiratory system. No data exist in the literature regarding detection of M hyopneumoniae in PF or its use for herd monitoring of this pathogen. The main goal of this study was to evaluate the feasibility of detecting M hyopneumoniae in PF. Testicles and tails of 21 conveniently selected litters from a commercial sow farm were collected, by litter, and tested for M hyopneumoniae by real time-PCR. Daily aggregated processing tissues were collected for a two-month period to assess the detection of M hyopneumoniae in PF. The comparison in the percentage of positive samples in fluids from testicles (38 per cent, 8/21) or tails (4.8 per cent, 1/21) was significantly different (P=0.023). The percentage of daily aggregated PF with cycle threshold values up to 37 was 52.9 per cent (9/17) and 26.7 per cent (4/15) for December and January, respectively. Overall, these data show detection of M hyopneumoniae in PF for the first time and points at the potential use of this sample for monitoring of this bacterium in breeding farms.
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Exsudatos e Transudatos/microbiologia , Mycoplasma hyopneumoniae/isolamento & purificação , Suínos/microbiologia , Animais , Estudos de Viabilidade , Reação em Cadeia da Polimerase em Tempo Real/veterináriaRESUMO
INTRODUCTION: Given the rising prevalence of obesity in the United States, innovative methods are needed to increase physical activity (PA) in community settings. Evidence suggests that individuals are more likely to engage in PA if they are given a choice of activities and have support from others (for encouragement, motivation, and accountability). The objective of this study was to describe the use of the online Walk Georgia PA tracking platform according to whether the user was an individual user or group user. METHODS: Walk Georgia is a free, interactive online tracking platform that enables users to log PA by duration, activity, and perceived difficulty, and then converts these data into points based on metabolic equivalents. Users join individually or in groups and are encouraged to set weekly PA goals. Data were examined for 6,639 users (65.8% were group users) over 28 months. We used independent sample t tests and Mann-Whitney U tests to compare means between individual and group users. Two linear regression models were fitted to identify factors associated with activity logging. RESULTS: Users logged 218,766 activities (15,119,249 minutes of PA spanning 592,714 miles [41,858,446 points]). On average, group users had created accounts more recently than individual users (P < .001); however, group users logged more activities (P < .001). On average, group users logged more minutes of PA (P < .001) and earned more points (P < .001). Being in a group was associated with a larger proportion of weeks in which 150 minutes or more of weekly PA was logged (B = 20.47, P < .001). CONCLUSION: Use of Walk Georgia was significantly higher among group users than among individual users. To expand use and dissemination of online tracking of PA, programs should target naturally occurring groups (eg, workplaces, schools, faith-based groups).
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Exercício Físico , Internet , Motivação , Sistemas On-Line , Adulto , Georgia , Humanos , Comportamento Social , CaminhadaRESUMO
As access to healthy food (or lack thereof) could be considered a social justice issue, social workers should be concerned about this issue and willing to collaborate with colleagues of various disciplines to address it. This study was a formative evaluation conducted to understand best practices, recommendations, and feasibility of a social-marketing-based nutrition education program tailored to the needs of adults with limited income. The authors report findings from focus groups conducted with Cooperative Extension Agents (CEAs) and region coordinators (n = 45) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) (n = 69) eligible participants to inform the development of a social marketing nutrition intervention for SNAP-Ed in Georgia. Barriers to healthy eating included cultural preferences, costs of healthy food, lack of time, and lack of availability. Social marketing has a potential to deliver effective and efficient SNAP-Ed targeted to large, limited-resource Georgians. Segmenting the low-income population based on geographical location as well as best methods for outreach can allow tailored messages to meet identified needs, lifestyles, and other variables that make these individuals most likely to respond to the program. Food security and nutrition education are topics of concern for all health care professionals interested in addressing complex health issues of many low-income adults.
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Dieta Saudável , Educação em Saúde/métodos , Pobreza , Marketing Social , Adulto , Características Culturais , Dieta Saudável/economia , Feminino , Grupos Focais , Assistência Alimentar , Georgia , Humanos , Masculino , Pesquisa QualitativaRESUMO
CONTEXT: The burden of cardiovascular disease (CVD) continues to be a public health concern. Workplace interventions that focus on modifying lifestyle habits may reduce CVD risk factors in people at risk. OBJECTIVE: To determine the effectiveness of a comprehensive lifestyle intervention program that integrated dietary modification, physical activity, stress management, and behavior modification counseling to reduce the risk of CVD in at-risk adults. METHODS: Twelve 1-year cohorts who participated in a comprehensive employer-sponsored lifestyle intervention program targeting diet, exercise, behavior modification, and stress management between 2006 and 2010 at a rural university in Appalachian Ohio were studied. Body composition, fasting glucose and lipid levels, and maximal oxygen consumption were measured at baseline, after 100 days, and at 1 year. Repeated-measures analyses of variance were conducted to compare measures at baseline with measures at 100 days and at 1 year. RESULTS: Seventy-four participants (57 women [77.1%], 17 men [22.9%]) of 97 completed the program (76.3% completion rate). Body weight (P<.001); percentage of body fat (P<.001); fat mass (P<.001); body mass index (P<.001); waist circumference (P<.001); blood levels of high-density lipoprotein (P=.035), low-density lipoprotein (P=.011), and glucose (P=.008); serum triglyceride levels (P=.019); blood pressure (systolic P=.028; diastolic, P=.001); and maximal oxygen consumption (P<.001) improved from baseline to 1 year after the intervention. Lean body mass (P=.111) and total cholesterol (P=.053) did not improve. CONCLUSIONS: This employer-based lifestyle intervention program was effective in reducing CVD risk factors after 1 year of treatment. Future studies should examine the effects of the intervention at 2 and 5 years to further assess long-term adoption of the lifestyle changes and maintenance of health promoted by this program.
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Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Comportamentos Relacionados com a Saúde , Estilo de Vida , Serviços de Saúde do Trabalhador , Comportamento de Redução do Risco , Adulto , Idoso , Estudos de Coortes , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
BACKGROUND: Online eLearning may be an innovative, efficient, and cost-effective method of providing nutrition education to a diverse low-income audience. AIMS: The intent of this project is to examine perceptions of nutrition educators regarding the feasibility of an eLearning nutrition education program tailored to low-income Georgians. METHOD: Semistructured individual interviews were conducted, guided by the constructivist theory. The interview guide focused on three themes: accessibility, literacy, and content. A prototype of the program also served as a talking point. Interviews were conducted in two urban Georgian counties in a location chosen by each participant. We recruited a convenience sample of Georgian nutrition educators ( n = 10, 100% female, 50% Black). Interviews were transcribed and analyzed using constant comparative method. RESULTS AND DISCUSSION: Motivation is considered the primary barrier to program feasibility. Neither access to the Internet nor literacy are considered significant barriers. Inclusion of skill-based, visual education methods such as cooking videos, recipes, and step-by-step teaching tools was highlighted. Nutrition educators perceived this program would be a feasible form of nutrition education for the priority audience. CONCLUSIONS: Findings from this study will inform the user-centered development of the program.
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Vitamin D has been a topic of much research interest and controversy, and evidence is mixed concerning its preventive effects and health benefits. The purpose of our study was to explore the decision-making strategies used by both primary care providers and community members surrounding vitamin D in relation to uncertainty management theory. We conducted semistructured interviews with primary care providers (n = 7) and focus groups with community members (n = 89), and transcribed and coded using the constant comparative method. Themes for providers included awareness, uncertainty, patient role, responsibility, skepticism, uncertainty management, and evolving perceptions. Community member focus group themes included uncertainty, information sources, awareness/knowledge, barriers, and patient-provider relationship. Both providers and community members expressed uncertainty about vitamin D but used conflicting strategies to manage uncertainty. Awareness of this disconnect might facilitate improved patient-provider communication.
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Tomada de Decisões , Conhecimentos, Atitudes e Prática em Saúde , Atenção Primária à Saúde , Relações Profissional-Paciente , Deficiência de Vitamina D/prevenção & controle , Adulto , Idoso , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , IncertezaRESUMO
OBJECTIVE: Tobacco use is the leading preventable cause of death, resulting in 443,000 US deaths per year. Rural adults have higher smoking prevalence and less access to tobacco dependence treatment than their urban counterparts. This study examined exposure to a culturally specific smoking cessation outreach intervention, assessing whether exposure was associated with cessation behaviors. DESIGN AND SAMPLE: Post-test only quasi-experimental study. Targeted adult smokers (N = 251) living in a rural, economically distressed southeastern US county for at least 6 months. MEASUREMENTS: Five outreach elements (brochures/pushcards, posters, print and radio advertisements, quilt made by local artisans) based on themes from focus groups with current and former smokers and paired with brief tobacco cessation counseling, and were delivered over 6 months in 2009-2010. Exposure and cessation behavior indicators were collected via cross-sectional random-digit dial survey. The total intervention exposure score was 4.8 (SD = 4.3, range 0-19). RESULTS: Intervention exposure was associated with having talked to a health care provider about quitting smoking in the past 6 months and planning to quit smoking in the next 6 months. CONCLUSIONS: Culturally specific outreach materials based on personal narratives are a promising population-based intervention to motivate rural smokers to consider cessation.
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Relações Comunidade-Instituição , Características Culturais , População Rural , Abandono do Hábito de Fumar/métodos , Fumar/psicologia , Adulto , Idoso , Aconselhamento , Estudos Transversais , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Avaliação de Programas e Projetos de Saúde , População Rural/estatística & dados numéricos , Abandono do Hábito de Fumar/psicologia , Prevenção do Hábito de Fumar , Adulto JovemRESUMO
INTRODUCTION: The objective of this investigation is to evaluate the Mental Healthiness and Aging Initiative (MHAI) intervention. The MHAI was created to promote awareness and knowledge about mental health/substance (MH/SA) use and aging issues in rural Kentucky, USA, due to limitations in formal and informal mental health care and treatment resources as a result of multilevel barriers in rural regions and effects on health, wellbeing and quality of life. METHODS: This investigation took place between 2010 and 2011 in two rural counties in Kentucky. Participants from two counties were recruited through an email solicitation sent to Kentucky cooperative extension agents (university-affiliated community liaisons). Individuals participated in a two-hour intervention session covering facts and information, application exercises, and community tools for addressing late-life mental health and substance abuse. Effectiveness was evaluated by examining changes in attitudes and knowledge about MH/SA and aging from pre-test to post-test and again 3 months and 6 months later. The evaluation survey examined mental health and substance abuse awareness (six questions) and knowledge (13 questions) and was previously piloted and designed for the current study ensuring face validity. Seven individual linear mixed models were analyzed using each of the six awareness questions and an additional model using an aggregate score across the knowledge questions representing the total percent correct for knowledge questions. RESULTS: The participating sample (n=55) was 65.35 years of age on average, with the majority being female (85%), white (100%), married (69%), living with a spouse/partner only (68%), high school educated (57%) and having a total household income averaging US$44,199. The findings indicated sustained improvement in awareness and knowledge about MH/SA and aging. Results also indicated that there is a need to improve maintenance of knowledge regarding older adult alcohol consumption risk, clinical provider communication about mental health, identifying/recognizing mental health problems, and older adult retention of their mental abilities based on long-term retention rates. These indicators had below 90% correctness at 6 months, despite having 90%+ accuracy at post-assessment, immediately after the intervention administration. CONCLUSIONS: This study demonstrates that community interventions for MH/SA awareness and knowledge are effective within majority rural regions. As currently designed, implementing the MHAI intervention program is feasible. Evidence from the current study indicates that community residents (including rural individuals) can be recruited to participate in a program about MH/SA and aging, and as an outcome have increased awareness and knowledge about MH/SA and aging. Future research will need to explore how to utilize MHAI-type intervention programs to a point where the mental health of rural adults can be improved. Specifically, further investigation is needed to examine whether community mental health awareness interventions, such as the MHAI intervention program, can lead to earlier detection of MH/SA issues among older adults and increase treatment rates. If so, community mental health workers and facilities can expect such interventions to increase local residents' awareness of their services and likelihood of utilizing mental health services. Future research needs to enhance generalizability and ensure that improved knowledge and awareness translates into improved mental health in rural regions.
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Envelhecimento/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Idoso , Serviços de Saúde Comunitária , Feminino , Avaliação Geriátrica , Humanos , Kentucky , Masculino , Transtornos Mentais/prevenção & controle , Transtornos Mentais/terapia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
Non-gay identified (NGI) Black men who have sex with both men and women (MSMW) and who use substances are at risk of acquiring and transmitting HIV to their partners. Homophobic community norms can discourage such men from disclosing their risk behaviour to female partners and others, including service providers. It is important to understand the dynamics of risk in this vulnerable population, but research is challenged by the men's need for secrecy. In this paper we report on successful efforts to recruit 33 non-disclosing, NGI Black MSMW for in-depth interviews concerning substance use, HIV risk and attitudes toward disclosing their risk behaviour. We employed targeted and referral sampling, with initial contacts and/or key informants drawn from several types of settings in New York City, including known gay venues, community organisations, neighbourhood networks and the Internet. Key informant gatekeepers and the ability to establish rapport proved central to success. Perceived stigma is a source of social isolation, but men are willing to discuss their risk behaviour when they trust interviewers to protect their privacy and engage with them in a non-judgemental manner. Findings imply that the most effective prevention approaches for this population may be those that target risk behaviours without focusing on disclosure of sexual identities.
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Bissexualidade/etnologia , Negro ou Afro-Americano , Infecções por HIV/prevenção & controle , Assunção de Riscos , Comportamento Sexual/etnologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adulto , Bissexualidade/psicologia , Estudos de Viabilidade , Identidade de Gênero , Infecções por HIV/transmissão , Humanos , Masculino , Cidade de Nova Iorque , Pesquisa Qualitativa , Autorrevelação , Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Revelação da VerdadeRESUMO
Primarily a disease affecting older adults, myelodysplastic syndromes (MDS) are a class of incurable myeloid malignancies with variable clinical presentation, treatment recommendations, and prognoses. Although effective communication between healthcare professionals and patients and their caregivers is a significant part of optimizing clinical outcomes, studies have shown that all three frequently have an incomplete understanding of MDS, its therapeutic options, and the fact that MDS is a malignancy. In addition, the advanced age of the patient population, high frequency of comorbidities, and variability of disease outcomes based on risk status require consistent communication across a wide number and type of healthcare providers as well as an individualized approach to patient and caregiver education. This article discusses these challenges and provides a number of resources designed to help educate healthcare professionals, patients, and caregivers.
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Comunicação , Recursos em Saúde/organização & administração , Disseminação de Informação/métodos , Síndromes Mielodisplásicas/enfermagem , Educação de Pacientes como Assunto/métodos , Relações Profissional-Família , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Grupos de Autoajuda , Apoio Social , Sociedades Médicas , Estados UnidosRESUMO
Little is known about the most effective strategies to motivate rural smokers to quit. This article describes the personal narratives of current and former smokers living in an economically distressed, rural area of Appalachian Kentucky. Three categories emerged: personal motivators to quit smoking, external influences, pride of place. Capturing personal narratives represents an evidence-based, data-rich strategy for development of culturally sensitive, population-based interventions for rural smokers. Such strategies may be effective in reaching rural smokers and motivating them to quit, thereby reducing tobacco-related disease and premature death in rural, economically distressed communities.
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Motivação , Avaliação das Necessidades , Saúde da População Rural , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Adulto , Idoso , Prática Clínica Baseada em Evidências , Feminino , Grupos Focais , Humanos , Kentucky , Masculino , Pessoa de Meia-Idade , Narração , Fumar/psicologia , Abandono do Hábito de Fumar/psicologia , Estados UnidosRESUMO
The objective of this study is to evaluate the Mental Healthiness Aging Initiative, designed to promote community awareness and knowledge about mental health and aging issues. This study occurred during 2007-2009 in 67 of 120 counties in Kentucky. A rural region (11 counties) received the intervention, consisting of focus groups, Extension Agent training, and television-based social marketing campaign. Partial-intervention counties (29 counties) received only the television-based social marketing campaign. The control counties (27 counties) received no intervention activities. Results indicated that the intervention counties agreed more with being able to assist elder adults with a potential mental illness. Also, the intervention counties understood the risk of consuming alcohol and medications better, but had a poorer recognition of drinking problems in elder adults. These findings need to be considered within study limitations, such as measurement error, degree of intervention exposure, and regional differences across intervention groups. The study demonstrates that community interventions on mental health awareness and knowledge are feasible within majority rural regions, with Extension Agents being gatekeepers, for promoting positive messages about mental health and aging issues.
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Envelhecimento/psicologia , Redes Comunitárias , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Saúde Mental , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Entrevistas como Assunto , Kentucky , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Providing emotional support both to children or young persons and to their parents or caregivers during pediatric burn dressing changes is a crucial aspect of nursing care in a burn unit; however, little research has examined perceptions of the effectiveness of typical interventions. Therefore, the aim of this research was to compare nurses' and parents' or caregivers' perceptions of support interventions provided before, during, and after pediatric burn dressing changes. This research was exploratory in nature and included the development of two differing questionnaires that focused on the perceptions of both parents or caregivers and nursing staff involved in dressing changes. Nurses and parents or caregivers involved in a total of 30 dressing changes completed surveys. Results were then analyzed using Microsoft Excel computer program, and a simple thematic analysis was performed on the responses to the open-ended survey questions. The survey results indicated that participants were generally favorable in their perceptions of the interventions used to support children during dressing changes; however, some gaps in the provision of care were identified. These included the need for clearer communication between the nurse and the parent or caregiver, poor pain assessment skills, and the need for debriefing for those involved in burn dressing procedures. Also highlighted were the difficulties nursing staff had in recognizing distress in parents or caregivers and when this occurred during the process. This research provided insights into coping strategies used by families and nurses and the value of support currently provided by the pediatric burn team. The results indicate that there is a need for improved communication with parents. The presence of a hospital play specialist, in addition to the parent or caregiver, was valuable. Also important was focusing on "comfort" positioning and use of distraction/alternative focus during dressing changes. The information gathered has provided additional strategies that can improve the care offered to children, young people, and families with burn injuries. Such strategies should be implemented in collaboration with the burn multidisciplinary team.
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Atitude do Pessoal de Saúde , Bandagens , Queimaduras/enfermagem , Cuidadores , Pediatria , Percepção , Adolescente , Fatores Etários , Unidades de Queimados , Queimaduras/epidemiologia , Queimaduras/terapia , Criança , Pré-Escolar , Competência Clínica , Intervalos de Confiança , Emoções , Feminino , Pesquisas sobre Atenção à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Tempo de Internação , Masculino , Nova Zelândia/epidemiologia , Autoadministração , Inquéritos e Questionários , Resultado do TratamentoRESUMO
African American males are regularly cast as deadbeat dads and non-contributors to family life. However, a growing literature has been documenting that African American males do contribute in many ways, including as custodial fathers. 5% of African American children live in single-parent father-only households. This paper presents B.K.'s story which describes his overcoming drug abuse and his becoming a custodial father. His story illustrates the powerful contribution African American males can make in their families and thereby in their communities. His story also describes how social outreach sustained him during his most troubled periods and supported his path to responsibility.
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A preparation of thiophilic agarose-based paramagnetic particles (T-Gel) has been developed with physical characteristics (particle size and particle density) that facilitate its use as a batch separation medium suitable for the large-scale purification and isolation of immunoglobulins. The medium was used to extract immunoglobulins from a wide range of starting materials, including sera, ascites fluid, tissue culture medium, and whole blood. None of these starting materials required pretreatment such as clarification by centrifugation or filtration prior to antibody extraction. The antibody purity obtained using T-Gel compared well with that obtained using protein A agarose column chromatography. Yields were approximately 30 mg of immunoglobulins per milliliter of T-Gel, and little was required in the way of specialist equipment. The method is uncomplicated and involves a roll mix extraction overnight, followed by magnetic separation to facilitate supernatant removal and subsequent washing of the particles. Elution of bound antibodies was carried out at neutral pH to yield a concentration of immunoglobulins that was approximately 7 mg/ml. The method was found to be applicable to antibody purification from the blood serum of seven different mammalian species and for all immunoglobulin classes.
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Imunoglobulinas/isolamento & purificação , Animais , Líquido Ascítico/imunologia , Géis/química , Humanos , Imunoglobulinas/sangue , Imunoglobulinas/química , Magnetismo , Mercaptoetanol/química , Sulfonas/químicaRESUMO
AIM: To assess the level of understanding of pulse oximetry in a hospital setting and identify training needs. METHODS: Twenty nine nurses and 34 doctors anonymously completed a questionnaire survey previously used by researchers in Exeter, UK. Respondents were required to explain the basic principles of pulse oximetry and demonstrate an understanding of the physiological factors limiting its accuracy. They were asked to apply their knowledge in different clinical scenarios. RESULTS: A higher proportion of nurses than doctors demonstrated an awareness of the physiological limitations of pulse oximetry. The majority of respondents correctly identified normal ranges for adult patients. Twenty nine per cent of respondents did not know how a pulse oximeter worked. Respondents failed to recognise the clinical implications of low oxygen saturations in many of the hypothetical scenarios. Only 16% of respondents had received any formal training in the use of pulse oximetry, with 65% identifying a need for more training. CONCLUSIONS: Medical and nursing staff at Christchurch Hospital have a good understanding of pulse oximetry. A higher proportion of participants were aware of checking vital signs when the oximeter reading was unreliable, than in the original UK study cohort. A need was identified for further education in this core technique. Staff training may increase the clinical value of pulse oximetry.