Exploring Parents' Intentions to Monitor and Mediate Adolescent Social Media Use and Implications for School Nurses.

Social media may promote health and social connectedness, but its misuse and frequency of use may pose risks. Social media use during adolescence requires parental monitoring and mediation to mitigate potentially harmful effects such as depression, anxiety, and risk-taking behaviors. While parents and health care professionals convey concern surrounding exposure to inappropriate content, prolonged screen time, and cyberbullying, appropriate social media monitoring remains challenging. The purpose of this study was to explore parental monitoring and mediation of social media use in adolescents. Online recruitment yielded a nationwide sample (n = 836) of parents of adolescents. The results of the online survey indicated that parents are concerned about adolescent social media use and endorse positive attitudes toward monitoring. Yet parents perceived little control over monitoring. Findings from this study support the school nurse in promoting healthy social media use, media literacy among parents and adolescents, and the use of screening tools.

The Impact of Transition Readiness and Stress on Patient-Centered Outcomes in Young Adults With Inflammatory Bowel Disease.

Young adults, 18-35 years of age, account for nearly half of all inflammatory bowel disease emergency department visits annually, costing millions of healthcare dollars and signifying undue pain and suffering. To mitigate this sequela, the study aimed to characterize the relationships between transition readiness (self-management ability), stress, and patient-centered outcomes. Outcomes were defined as disease activity and inflammatory bowel disease-related healthcare utilization (emergency department visits and inpatient hospitalization). This was a descriptive, correlational design via online survey of young adults with inflammatory bowel disease. Participants (n = 284) utilized an estimated 2.77 million healthcare dollars in 12 months. Transition readiness decreased the odds of having consistently active disease and healthcare utilization, with adjusted odds ratio ranging from 6.4 to 10.9 (p < .05). Higher stress levels increased the odds of having consistently active disease and healthcare utilization, with adjusted odds ratio ranging from 9.5 to 10.5 (p < .0001). Twenty-five percent (24.7%) of the variation in transition readiness was explained by changes in stress (p < .0001). Transition readiness and stress impacted all patient-centered outcomes. Stress negatively impacted transition readiness. These results are powerful reminders for healthcare providers to assess and treat stress and support transition readiness in young adults with inflammatory bowel disease. The potential to decrease pain, suffering, and healthcare cost is enormous.

Lipoxin A4 augments host defense in sepsis and reduces Pseudomonas aeruginosa virulence through quorum sensing inhibition.

Bacterial infections can quickly turn into sepsis, with its attendant clinical sequelae of inflammation, tissue injury, and organ failure. Paradoxically, sustained inflammation in sepsis may lead to immune suppression, because of which the host is unable to clear the existing infection. Use of agents that suppress the inflammatory response may accelerate host immune suppression, whereas use of traditional antibiotics does not significantly affect inflammation. In this study, we investigated whether lipoxin A4 (LXA4), a specialized, proresolution lipid mediator, could increase neutrophil phagocytic activity as well as reduce bacterial virulence. Using the mouse cecal ligation and puncture (CLP) model of sepsis, the administration of LXA4 (7 µg/kg i.v.) 1 h after surgery increased neutrophil phagocytic ability and Fcγ receptor I (CD64) expression. Ex vivo studies have confirmed that the direct addition of LXA4 to CLP neutrophils increased phagocytic ability but not CD64 expression. LXA4 did not affect neutrophils taken from control mice in which CD64 expression was minimal. Taken together with in vivo data, these results suggest that LXA4 directly augments CD64-mediated neutrophil phagocytic ability but does not directly increase neutrophil CD64 expression. Bacterial communication and virulence is regulated by quorum sensing inducers. In Pseudomonas aeruginosa, virulence is induced with release of various virulence factors, by N-3-oxododecanolyl homoserine lactone binding to the quorum sensing receptor, LasR. We show that LXA4 is an inhibitor of LasR in P. aeruginosa and that it decreases the release of pyocyanin exotoxin. These results suggest that LXA4 has the novel dual properties of increasing host defense and decreasing pathogen virulence by inhibiting quorum sensing.-Wu, B., Capilato, J., Pham, M. P., Walker, J., Spur, B., Rodriguez, A., Perez, L. J., Yin, K. Lipoxin A4 augments host defense in sepsis and reduces Pseudomonas aeruginosa virulence through quorum sensing inhibition.

State-dependent alteration of respiration in a rat model of Parkinson's disease.

Parkinson's disease (PD) is the second most frequent neurodegenerative disorder. Besides major deficits in motor coordination, patients may also display sensory and cognitive impairments, which are often overlooked despite being inherently part of the PD symptomatology. Amongst those symptoms, respiration, a key mechanism involved in the regulation of multiple physiological and neuronal processes, appears to be altered. Importantly, breathing patterns are highly correlated with the animal's behavioral states. This raises the question of the potential impact of behavioral state on respiration deficits in PD. To answer this question, we first characterized the respiratory parameters in a neurotoxin-induced rat model of PD (6-OHDA) across three different vigilance states: sleep, quiet waking and exploration. We noted a significantly higher respiratory frequency in 6-OHDA rats during quiet waking compared to Sham rats. A higher respiratory amplitude was also observed in 6-OHDA rats during both quiet waking and exploration. No effect of the treatment was noted during sleep. Given the relation between respiration and olfaction and the presence of olfactory deficits in PD patients, we then investigated the odor-evoked sniffing response in PD rats, using an odor habituation/cross-habituation paradigm. No substantial differences were observed in olfactory abilities between the two groups, as assessed through sniffing frequency. These results corroborate the hypothesis that respiratory impairments in 6-OHDA rats are vigilance-dependent. Our results also shed light on the importance of considering the behavioral state as an impacting factor when analyzing respiration.

Resolvin D2 induces anti-microbial mechanisms in a model of infectious peritonitis and secondary lung infection.

In severe bacterial infections, there is a pro-inflammatory response to promote bacterial clearance but this response can cause tissue injury. Later, the immune system becomes dysregulated and the host is unable to clear a secondary or a pre-existing infection. Specialized Pro-resolving Mediators (SPMs) such as resolvin D2 (RvD2) have been shown to be beneficial for inflammation/infection resolution in animal models of sepsis but in vivo mechanisms by which RvD2 may promote bacterial clearance and/or attenuate deleterious effects of a secondary infection have not been fully established. In this study, we used the 2-hit model of cecal ligation and puncture (CLP) induced infectious peritonitis and secondary lung infection with Pseudomonas aeruginosa to find possible antimicrobial and immunomodulatory mechanisms of RvD2. We show that RvD2 given as late as 48h after CLP surgery reduced blood bacterial load without altering plasma cytokines compared to mice given saline vehicle. RvD2 increased splenic neutrophil accumulation as well as average reactive oxygen species (ROS) production. There was also an increase in an immature leukocyte population the myeloid derived suppressor cells (MDSCs) in the spleen of RvD2 treated mice. RvD2 reduced lung lavage bacterial load 24h after P. aeruginosa administration and significantly decreased lung lavage levels of IL-23, a cytokine essential in the Th-17 inflammatory response. In addition, we show that RvD2 increased the number of non-inflammatory alveolar macrophages after P. aeruginosa administration compared to saline treated mice. The study uncovered an antimicrobial mechanism of RvD2 where RvD2 increases mature neutrophil and MDSC accumulation into the spleen to promote blood bacterial clearance. The study showed that in this 2-hit model, RvD2 promotes lung bacterial clearance, increased non-inflammatory alveolar macrophage number and inhibits an adaptive immune pathway providing evidence of its resolution mechanism in secondary pulmonary infection.

Effects of student participation in hand hygiene monitoring on knowledge and perception of infection control practices.

Studies report that students in health care professions do not retain knowledge of infection control and demonstrate poor hand hygiene compliance. This study describes the effect of a multifaceted approach (education, skills training, and monitoring) on nursing students' knowledge of infection control principles, opinions, hand hygiene practices, and value of nursing research in evidence-based practice. Students participated in hand hygiene monitoring of health care workers with 900 observations. Students demonstrated strong knowledge of hand hygiene principles: 63% reported that hand hygiene monitoring positively influenced their own compliance. Although posters have been identified as effective prompts, students did not perceive poster reminders as effective in prompting handwashing. Students reported that hand hygiene activities helped them value the role of the nurse in research and evidence-based practice. This study may help educators clarify misconceptions that result in student noncompliance in hand hygiene practices.

Different Concentrations of Lactobacillus acidophilus Cell Free Filtrate Have Differing Anti-Biofilm and Immunomodulatory Effects.

Probiotics such as various strains of Lactobacillaceae have been shown to have antimicrobial and immunomodulatory activity. In vitro studies have shown that Lactobacilli can decrease bacterial biofilm formation. Effects on immune cells have been unclear with most studies showing anti-inflammatory activity. The mechanism of effects has not been clearly elucidated. In these studies, we used different concentrations of live Lactobacillus acidophilus as well as cell free filtrate (CFF) derived from different concentrations of bacteria. Use of CFF is advantageous as a therapeutic because in vivo it can directly contact immune cells and its concentration is fixed. Both live cells and CFF inhibited Pseudomonas aeruginosa biofilm formation. Importantly, we show that high concentration CFF destroyed mature biofilm. This activity was not due to a lowered pH per se, as pH matched HCl did not remove mature biofilm. High concentration CFF totally inhibited P. aeruginosa growth and was bactericidal (>99.99%), but low concentration CFF was not bactericidal. To examine the immunomodulatory effects of L. acidophilus, we incubated THP-1 monocytes and derived macrophages with CFF and measured TNFα production. CFF did not significantly increase TNFα production in THP-1 monocytes. When cells were prestimulated with LPS, high concentration CFF increased TNFα production even further. In macrophages, high concentration CFF alone increased TNFα production but did not affect LPS prestimulated cells. In contrast, low concentration CFF decreased TNFα production in LPS prestimulated cells. To elucidate the possible mechanisms for these effects, we repeated the experiments using a NF-κB reporter THP-1 cell line. High concentration CFF increased NF-κB activity in monocytes and macrophages. In LPS prestimulated macrophages, only low concentration CFF reduced NF-κB activity. These results suggest that high concentration CFF alone induced NF-κB expression which could account partially for an increase in TNFα production. On the other hand, in macrophages, the lower non-bactericidal concentration of CFF reduced NF-κB expression and decreased TNFα production after LPS prestimulation. Taken together, the results provide evidence that different concentrations of L. acidophilus CFF possess varying bactericidal, anti-biofilm and immunomodulatory effects. This is important in vivo to evaluate the possible use of L. acidophilus CFF in different conditions.

Preventative interventions, protocols or guidelines for trauma patients at risk of cervical collar-related pressure ulcers: a scoping review.

OBJECTIVE: The objective of this scoping review was to explore the existing literature related to preventative interventions, protocols or guidelines for trauma patients at risk of cervical collar-related pressure ulcers to examine and conceptually map the evidence, and to identify any gaps in the literature. INTRODUCTION: Cervical collars are necessary to stabilize cervical spine injuries in trauma patients; however, pressure ulcers are a major complication of prolonged cervical collar use. The longer a patient wears a cervical collar, the more likely the patient will develop a pressure ulcer that will worsen as wear time increases. INCLUSION CRITERIA: This review considered both experimental and quasi-experimental study designs, analytical observational studies, case-control studies, analytical cross-sectional studies, descriptive observational studies, qualitative studies, and text and opinion papers. Trauma patients of all ages who presented to the emergency department or intensive care unit with an extrication or field collar in place were included in this study. Extrication collars included but were not limited to Stifneck, Philadelphia and Miami J. METHODS: The JBI scoping review methodology was used for this review. The database searches included MEDLINE (PubMed), CINAHL, Embase, Scopus, JBI Database of Systematic Reviews and Implementation Reports, NHS Research Register, National Institute of Health Clinical Trial Databases, Cochrane Database of Sytematic Reviews, MedNar, WorldWideScience, PsycEXTRA, OAIster, OpenGrey, and ProQuest Dissertations and Theses. The data were extracted using a charting table, which was developed to record key information from sources relevant to the review questions. The findings were descriptively presented, with tables and figures to support the data, when appropriate. Only studies in English from 1965 to December 2018 were included. RESULTS: Preventative interventions found in the seven studies included in the review were: removal of the extrication collar, cervical spine clearance, nursing education, routine nursing care, use of products such as air mattresses, and a multidisciplinary approach to care. Additionally, six of the seven studies identified 28 risk factors associated with the development of cervical collar-related pressure ulcers. Two studies reported elimination of cervical collar-related pressure ulcers while three studies reported reduced incidence in cervical collar-related pressure ulcers. Another study reported a reduction in cervical collar wear time from 14 days to 7.7 days. CONCLUSIONS: Protocols with a multidisciplinary approach are available in the literature to serve as guidance for proper treatment and care of trauma patients' wearing of cervical collars. Standardized cervical collar protocols should highlight the importance of early identification of trauma patients who may be at risk. Risk factors identified in this review should be assessed and addressed to halt cervical collar-related pressure ulcers from ever developing in trauma patients who are immediately identified as at risk. Preventative interventions identified in the protocols in this scoping review can be used to create a standardized approach to care for patients in cervical collars.

Periodic Metallo-Dielectric Structures: Electromagnetic Absorption and its Related Developed Temperatures.

Multi-layer, metallo-dielectric structures (screens) have long been employed as electromagnetic band filters, either in transmission or in reflection modes. Here we study the radiation energy not transmitted or reflected by these structures (trapped radiation, which is denoted-absorption). The trapped radiation leads to hot surfaces. In these bi-layer screens, the top (front) screen is made of metallic hole-array and the bottom (back) screen is made of metallic disk-array. The gap between them is filled with an array of dielectric spheres. The spheres are embedded in a dielectric host material, which is made of either a heat-insulating (air, polyimide) or heat-conducting (MgO) layer. Electromagnetic intensity trapping of 97% is obtained when a 0.15 micron gap is filled with MgO and Si spheres, which are treated as pure dielectrics (namely, with no added absorption loss). Envisioned applications are anti-fogging surfaces, electromagnetic shields, and energy harvesting structures.

Preventative interventions, protocols or guidelines for trauma patients at risk for cervical collar-related pressure ulcers: a scoping review protocol.

REVIEW OBJECTIVE/QUESTION: The objective of this review is to explore the existing literature related to preventative interventions, protocols or guidelines for trauma patients at risk for cervical collar-related pressure ulcers, examine and conceptually map the evidence, and identify any gaps in the literature.Specifically the review questions are.

Preferences for teaching methods in a baccalaureate nursing program: how second-degree and traditional students differ.

Accelerated baccalaureate nursing programs are in great demand in the United States. Currently there are 197 such programs, but little research has been conducted on student characteristics and program outcomes. This quantitative study explores preferences of second-degree students and traditional generic students with regard to teaching methods and relationships with faculty. The results indicate that statistically significant differences exist between the two groups of students. Three areas of significance are ability for self-directed learning, expectations of faculty and classroom structure, and obtaining a grade that really matters.

Effectiveness of formal hand hygiene education and feedback on healthcare workers' hand hygiene compliance and hospital-associated infections in adult intensive care units: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this quantitative systematic review is to identify and synthesize evidence on the effectiveness of formal hand hygiene education with and without feedback on healthcare workers' hand hygiene compliance and healthcare-associated infections in adult intensive care units.

Generational (age) differences in nursing students' preferences for teaching methods.

A generational age transformation is occurring in nursing classrooms across the United States. Nurse educators need to prepare for the different values and expectations of students from Generation X and the newly emerging Generation Y in the educational environment. This quantitative, descriptive research begins to examine the preferences and expectations of these generations regarding teaching methods.

Pain assessment and management strategies for elderly patients.

Home healthcare nurses play a critical role in pain assessment and management in elderly patients. People 65 years of age and older are the largest consumers of prescription and nonprescription pain medications in the United States and are at increased risk for adverse reactions and inadequate pain management. This article seeks to explore strategies to assist hospice and home healthcare nurses in assessing and managing elderly patients' pain. The goal is to provide tools to assist nurses in streamlining elderly patient care and improving quality of life while decreasing mortality and morbidity for this patient population.

Adults with sickle cell disease: an interdisciplinary approach to home care and self-care management with a case study.

The complexity of caring for adults with sickle cell disease (SCD) strains the confines of a care-segregated medical system. As treatment protocols have dramatically improved since 1990, many patients with SCD are now living well beyond their 6th decade of life. This improved survival rate presents opportunities and challenges for the home healthcare nurse in the management of adult patients with SCD. The home healthcare nurse is essential in the coordination of interdisciplinary health team members to reduce pain episodes and the potentially catastrophic complications of renal failure, pulmonary disease, and cardiovascular events. In addition, the home healthcare nurse serves as patient advocate for the transition from acute care to home, as well as advocate for healthcare maintenance of vision, musculoskeletal involvement, and social and psychological support. This article seeks to provide a viable network for home healthcare nurses to establish self-care management and support of the adult patient with SCD.

Self-care management practices for the home health nurse: staying hale and hearty through enhanced self-care and ergonomics--with a case study.

Ergonomics provides a broad framework for home healthcare nurses to improve their individual physical, psychological, cognitive, and spiritual well-being through application of models for self-care planning. As the individual becomes stronger, more resilient and work hardy, the benefits to the individual, along with the work organization and ultimately the clients, grow exponentially. This article seeks to explore the relevant ergonomic domains and assist home healthcare nurses to develop self-care planning practices that lead to healthy lifestyles and improved quality of life.

Use of text messaging to audit early clinical outcome following vasectomy in primary care.

Fifty patients undergoing vasectomy at community-based day surgery clinics in Grampian were invited to participate in follow-up by text message. Forty-six (92%) of the patients responded, 14 reporting problems, generally of a minor nature, but severe enough to result in unscheduled time off work (n = 4) and oral antibiotic therapy (n = 5). Text messaging appears to be a useful form of communication for audit in this setting. The study findings have influenced the information provided by the authors at preoperative counselling.

Lipoxin a4 increases survival by decreasing systemic inflammation and bacterial load in sepsis.

Sepsis is characterized by systemic inflammation with release of a large amount of inflammatory mediators. If sustained, this inflammatory response can lead to multiple organ failure and/or immunoparalysis. In the latter condition, the host may be susceptible to opportunistic infections or be unable to clear existing infections. Therefore, it is potentially beneficial to resolve inflammation by reducing inflammation without compromising host defense. We examined the effect of lipoxin A4 (LXA4), a compound with inflammatory resolution properties, in the cecal ligation and puncture (CLP) model of sepsis. Cecal ligation and puncture rats were given either saline or LXA4 (40 µg/kg, i.p.) 5 h after surgery. Lipoxin A4 administration increased 8-day survival of CLP rats, which lived longer than 48 h, and attenuated tissue injury after 8 days. Therefore, we investigated the effects of LXA4 on systemic inflammation and bacterial load 48 h after CLP sepsis. Plasma IL-6, monocyte chemotactic protein 1, and IL-10 levels were reduced in LXA4-treated rats compared with CLP rats given saline vehicle. Lipoxin A4 reduced phosphorylation of the p65 subunit of nuclear factor κB (NF-κB) at serines 536 and 468 in peritoneal macrophages, suggesting that LXA4 reduced production of proinflammatory mediators through an NF-κB-mediated mechanism. Lipoxin A4 reduced blood bacterial load and increased peritoneal macrophage number without affecting phagocytic ability, suggesting that LXA4 reduced blood bacterial load by enhancing macrophage recruitment. It also suggests that LXA4 reduced systemic inflammation and NF-κB activation without compromising host defense. Increased macrophage recruitment was in part due to a direct effect of LXA4 as LXA4 increased peritoneal macrophage recruitment in sham controls and partly due to reduced production of IL-10 as LXA4 decreased macrophage IL-10 release (a known inhibitor of macrophage migration) after CLP. The results suggest that LXA4 increased survival in sepsis by simultaneously reducing systemic inflammation as well as bacterial spread.