High Voltage: The Molecular Properties of Redox-Active Dissolved Organic Matter in Northern High-Latitude Lakes.

Redox-active functional groups in dissolved organic matter (DOM) are crucial for microbial electron transfer and methane emissions. However, the extent of aquatic DOM redox properties across northern high-latitude lakes and their relationships with DOM composition have not been thoroughly described. We quantified electron donating capacity (EDC) and electron accepting capacity (EAC) in lake DOM from Canada to Alaska and assessed their relationships with parameters from absorbance, fluorescence, and ultrahigh resolution mass spectrometry (FT-ICR MS) analyses. EDC and EAC are strongly tied to aromaticity and negatively related to aliphaticity and protein-like content. Redox-active formulae spanned a range of aromaticity, including highly unsaturated phenolic formulae, and correlated negatively with many aliphatic N and S-containing formulae. This distribution illustrates the compositional diversity of redox-sensitive functional groups and their sensitivity to ecosystem properties such as local hydrology and residence time. Finally, we developed a reducing index (RI) to predict EDC in aquatic DOM from FT-ICR MS spectra and assessed its robustness using riverine DOM. As the hydrology of the northern high-latitudes continues to change, we expect differences in the quantity and partitioning of EDC and EAC within these lakes, which have implications for local water quality and methane emissions.

eHealth Education and Support for Pediatric Hearing Aid Management: Parent Goals, Questions, and Challenges.

PURPOSE: The purpose of this study was to investigate parent goals, questions, and challenges that emerged during coaching phone calls in an eHealth program designed to provide education and support for hearing aid management. METHOD: Coaching phone calls were audio-recorded, transcribed, and qualitatively analyzed for emergent themes within the categories of goals, questions, and challenges. RESULTS: Emergent themes revealed that parent goals were focused on self-efficacy, routines, device care, and child development. Emergent themes for questions revealed that parents asked questions related to the device care, audiology appointments, confirmation of learning, and child development. For challenges, emergent themes revealed parents' own struggles (e.g., with emotions), issues related to working with their audiologist, child factors, and anticipated challenges. CONCLUSIONS: The eHealth intervention allowed parents to raise questions and discuss their challenges in a supportive environment. Supportive accountability helped participants identify and address barriers to hearing aid management based on their priorities and current challenges. Providing supplemental learning support, in addition to routine audiology visits, can help parents develop more effective hearing aid management routines.

Applied tele-audiology research in clinical practice during the past decade: a scoping review.

OBJECTIVE: The purpose of this scoping review was two-fold, (1) to provide information about the characteristics, type of service delivery, participant information and outcomes related to tele-audiology in clinical popluations, and (2) to describe documented facilitators and barriers to tele-audiology delivery from the perspectives of practitioners and service recipients. Knowledge of these findings can assist audiologists in considering remote service delivery options for their practices. DESIGN: A scoping review was conducted in November 2019 to identify English-language peer-reviewed journal articles published from 1 January 2010 to 30 October 2019 related to remote clinical service delivery in audiology. RESULTS: Thirty-six published research articles were included. Research studies were classified into four broad areas with some articles including more than one area within the scope of their article: Screening (n = 5), Diagnostic (n = 5), Intervention (n = 18), and Perspectives (n = 22). CONCLUSION: Hearing healthcare service delivery is expanding with the changing technological landscape, providing greater opportunities and flexibility for audiologists and patients. There are clear opportunities for interdisciplinary collaboration and for collaboration with on-site local facilitators. Local facilitators, with training, can assist in connecting individuals to follow-up care, provide educational support, and needed hands-on assistance for specialised testing.

Two types of disengagement during couples' conflicts: withdrawal and passive immobility.

A series of 3 studies using nonclinical samples investigated validity associated with the Conflict Disengagement Inventory (CDI), a questionnaire developed to measure passive immobility and withdrawal as context-specific forms of disengagement in couples' conflicts. In the first study, 2,588 married participants completed the CDI, and an expected 2-dimensional factor structure was confirmed. Additionally, results demonstrated measurement invariance across racial/ethnic and gender groups. In the second study, 223 adults in committed romantic relationships completed the CDI along with measures of attachment, emotion, underlying concerns, withdrawal, relationship expectations, relationship satisfaction, and communication behavior. Although the disengagement scales were moderately correlated, the results provided consistent evidence of convergent and divergent validity. In the third study, a sample of 135 undergraduate students in romantic relationships completed the CDI and measures of emotion on up to 5 separate assessment sessions, with sessions spaced at least 2 weeks apart. Analyses of within-person effects using hierarchical linear modeling provide evidence that the CDI captures meaningful variance at the context-specific level. There was substantial variance within persons across different episodes of conflict and within-person changes in disengagement predicted corresponding within-person changes in emotion.

Luminal threonine concentration acutely affects intestinal mucosal protein and mucin synthesis in piglets.

Intestinal mucin synthesis is sensitive to dietary threonine supply, which suggests that the gut's requirement for threonine may comprise a significant proportion of the whole body requirement. We used a continuously perfused gut loop model and intraluminal flooding dose technique in 6 young pigs to study the acute effects of varying luminal availability of threonine on intestinal protein and mucin syntheses. A complete amino acid mixture containing 0, 21, or 56 mg threonine/g total amino acids (whole body requirement ratio is approximately 28 mg/g) was continuously perfused in isolated loops for 120 min, including a 30-min (3)H-phenylalanine flooding dose. We measured fractional synthesis rates of total mucosal protein and mucin by analyzing (3)H-phenylalanine incorporation. Fractional rates of total mucosal protein synthesis were higher in loops perfused with solutions containing threonine at 56 mg/g (66 +/- 4%/d) compared with 0 mg/g (42 +/- 9%/d) and 21 mg/g (53 +/- 6%/d) (P < 0.05). For mucin, fractional rates of synthesis differed between 0 mg/g (323 +/- 72%/d), 21 mg/g (347 +/- 49%/d), and 56 mg/g (414 +/- 31%/d) (P < 0.05). In addition, total proline and threonine concentrations in the protein hydrolysates increased with luminal threonine concentration (P < 0.05), indicating an increase in threonine- and proline-rich proteins. De novo synthesis of mucosal and mucin proteins is acutely sensitive to luminal threonine concentration, which demonstrates the importance of dietary amino acid supply to gut protein metabolism.

A commentary on access to cardiovascular services: nursing roles and initiatives.

The Canadian Council of Cardiovascular Nurses (CCCN) applauds the work done by the Canadian Cardiovascular Society in setting benchmarks for wait times. The Canadian Cardiovascular Society is to be commended for developing the benchmark documents, as well as for establishing strategies for systematic dissemination to increase awareness, advocacy and implementation of the benchmarks across Canada. Quality nursing care, as defined within the CCCN framework, includes working with health teams to ensure that patients have timely access to specialized personnel, tests and procedures as required to prevent disease, promote health, address acute and episodic interventions, and to provide rehabilitative and palliative services, depending on patient need. To extend the access to care discussion, the CCCN suggests that further engagement of all stakeholders, especially clients/patients, is needed to find solutions to wait times and define benchmarks. In addition, preventing heart disease and promoting 'health care' should be recognized and acted on as central to reducing wait times for cardiovascular care. Finally, access to cardiovascular services will be more efficient when the first point of care is broadened to include nurses and other health care professionals. Nurses occupy creative, cost-effective roles directly aimed at reducing wait times and improving care while patients wait. The expanded role of interprofessional education and health care teams, as well as the inclusion of patients and families in program improvement, are solutions that the CCCN suggests may contribute to improved access to cardiovascular care and a sustainable health care system in Canada.

NURSE: Nitroglycerin Use: Revisiting Strategies for Efficacy.

Sublingual nitroglycerin (SLN) is front-line therapy for the treatment of episodic stable angina discomfort. Anecdotal evidence gathered by advanced practice nurses in a cardiac pre-assessment clinic suggested that SLN was often overlooked by health care professionals as an integral component of angina self-management. A brief questionnaire exploring patients' knowledge and use of SLN was subsequently administered to 300 patients. Information gathered from the questionnaire indicated that patients are not consistently prescribed SLN for suspected or confirmed coronary artery disease. Knowledge deficits were evident concerning the proper dosage and administration of SLN, even in patients with a longstanding history of angina. Many were unaware of SLN prophylaxis and the concomitant use of topical nitrates. This paper will discuss practice implications for optimizing SLN therapy in angina self-management.

Clinical practice guidelines for the management of dyslipidemia.

The causal relationship between dyslipidemia and atherosclerosis is well-documented. Screening and appropriate management of dyslipidemia by health care providers is imperative in both primary and secondary prevention of coronary artery disease, peripheral vascular disease, and stroke. In response to the release of new research data, clinical practice guidelines for the management of dyslipidemia in Canada have recently been updated. This article will provide an overview of the recommendations for screening, risk assessment, and target lipid values. Dietary and lifestyle interventions will be discussed in addition to pharmacotherapy as management strategies for achieving therapeutic lipid targets.