Search

The implementation of ethics review processes is an important first step for anticipating and mitigating the potential harms of AI research. Its long-term success, however, requires a coordinated community effort, to support experimentation with different ethics review processes, to study their effect, and to provide opportunities for diverse voices from the community to share insights and foster norms.

Serum magnesium is the most frequently used laboratory test for evaluating clinical magnesium status. Hypomagnesemia (low magnesium status), which is associated with many chronic diseases, is diagnosed using the serum magnesium reference range. Currently, no international consensus for a magnesemia normal range exists. Two independent groups designated 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L) as the low cut-off point defining hypomagnesemia. MaGNet discussions revealed differences in serum magnesium reference ranges used by members' hospitals and laboratories, presenting an urgent need for standardization.We gathered and compared serum magnesium reference range values from our institutions, hospitals, and colleagues worldwide.Serum magnesium levels designating "hypomagnesemia" differ widely. Of 43 collected values, only 2 met 0.85 mmol/L as the low cut-off point to define hypomagnesemia. The remainder had lower cut-off values, which may underestimate hypomagnesemia diagnosis in hospital, clinical, and research assessments. Current serum magnesium reference ranges stem from "normal" populations, which unknowingly include persons with chronic latent magnesium deficit (CLMD). Serum magnesium levels of patients with CLMD fall within widely used "normal" ranges, but their magnesium status is too low for long-term health. The lower serum magnesium reference (0.85 mmol/L) proposed specifically prevents the inclusion of patients with CLMD.Widely varying serum magnesium reference ranges render our use of this important medical tool imprecise, minimizing impacts of low magnesium status or hypomagnesemia as a marker of disease risk. To appropriately diagnose, increase awareness of, and manage magnesium status, it is critical to standardize lower reference values for serum magnesium at 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L).

Knowledge from past disasters can inform and support recovery, yet these insights are not always readily accessible to recovery practitioners. To bridge this gap, effective collaboration is needed to produce practical, evidence-based resources. This was the focus of the Recovery Capitals (ReCap) project, a collaboration between researchers and practitioners across Australia and Aotearoa New Zealand.

Introduction Workplace violence is prevalent in the emergency department, putting patients and staff at risk for harm. An ED-specific standardized tool is needed to promote a consistent assessment process to strengthen documentation of escalating patient behaviors, give justification for de-escalating interventions, and reduce restraints. The purpose of this project was to design, implement, and evaluate feasibility of an ED-specific tool to help nurses proactively identify and intervene with patients’ escalating behaviors, capture better documentation of aggressive/violent patient events, and reduce restraint usage. Methods A quality improvement design was used. The Emergent Documentation Aggression Rating Tool was constructed by combining evidence-based behavioral cues for potential aggression/violence with observed behaviors and successfully implemented interventions in patients. Nurses were trained on how to use the tool to rate patients’ behaviors and take necessary action. Chart data were collected from August 2018 to December 2019 at a Midwestern suburban hospital emergency department. Chart audits and just-in-time education were conducted after implementation. Survey data were collected to evaluate nurses’ perception of the tool's usefulness. Results Use of the novel Emergent Documentation Aggression Rating Tool increased over time (67.36% in Quarter 3 2018 to 97.55% in Quarter 4 2019). After Emergent Documentation Aggression Rating Tool implementation, visual inspection of the time series indicated a decrease in percent restraints, and there was an overall increase in documented escalations de-escalations over time. The patients that escalated most frequently had diagnoses of alcohol use, suicidal ideations, pain-related complaints, or mental health issues. Conclusion The Emergent Documentation Aggression Rating Tool was feasible for emergency nurses to proactively identify and intervene with patients at risk for aggression/violence.

Objective: Delivery of a safe cystectomy service is a multidisciplinary exercise. In this article, we detail the measures implemented at our institution to deliver a cystectomy service for bladder cancer patients during coronavirus disease 2019 (COVID-19). Methods: A ‘one-stop’ enhanced recovery clinic had been established at our hospital, consisting of an anaesthetist, an exercise testing service, urinary diversion nurses, clinical nurse specialists and surgeons. During COVID-19, we modified these processes in order to continue to provide urgent cystectomy safely for bladder cancer. We collected patients’ outcomes prospectively measuring demographic characteristics, oncological and perioperative outcomes, the presence of COVID-19 symptoms and confirmed COVID-19 test results. Results: From March to May 2020, 25 patients underwent radical cystectomy for bladder cancer. Twenty-four procedures were performed with robotic assistance and one open as part of a research trial. We instituted modifications at various multidisciplinary steps, including patient selection, preoperative optimisation, enhanced recovery protocols, patient counselling and perioperative protocols. Thirty-day mortality was 0%. The 30-day rate of Clavien ⩾3 complications was 8%. Postoperatively, none of the patients developed COVID-19 based on World Health Organization criteria and testing. Conclusion: We safely delivered a complex cystectomy service during the peak of the COVID-19 pandemic without any COVID-19-related morbidity or mortality. Level of evidence: Level 2b.

Assembly of RAS molecules into complexes at the cell membrane is critical for RAS signaling. We previously showed that oncogenic KRAS codon 61 mutations increase its affinity for RAF, raising the possibility that KRASQ61H, the most common KRAS mutation at codon 61, upregulates RAS signaling through mechanisms at the level of RAS assemblies. We show here that KRASQ61H exhibits preferential binding to RAF relative to PI3K in cells, leading to enhanced MAPK signaling in in vitro models and human NSCLC tumors. X-ray crystallography of KRASQ61H:GTP revealed that a hyperdynamic switch 2 allows for a more stable interaction with switch 1, suggesting that enhanced RAF activity arises from a combination of absent intrinsic GTP hydrolysis activity and increased affinity for RAF. Disruption of KRASQ61H assemblies by the RAS oligomer–disrupting D154Q mutation impaired RAF dimerization and altered MAPK signaling but had little effect on PI3K signaling. However, KRASQ61H oligomers but not KRASG12D oligomers were disrupted by RAF mutations that disrupt RAF–RAF interactions. KRASQ61H cells show enhanced sensitivity to RAF and MEK inhibitors individually, whereas combined treatment elicited synergistic growth inhibition. Furthermore, KRASQ61H tumors in mice exhibited high vulnerability to MEK inhibitor, consistent with cooperativity between KRASQ61H and RAF oligomerization and dependence on MAPK signaling. These findings support the notion that KRASQ61H and functionally similar mutations may serve as predictive biomarkers for targeted therapies against the MAPK pathway. Significance: These findings show that oncogenic KRASQ61H forms a cooperative RAS–RAF ternary complex, which renders RAS-driven tumors vulnerable to MEKi and RAFi, thus establishing a framework for evaluating RAS biomarker-driven targeted therapies.

Many older settlements appear to restrict the class of children and issue who may benefit to those who are legitimate. Whether this is the full story and what trustees can do about it, given the impact of the issue on family harmony, was considered by Chief Master Marsh in the recent case of PQ v RS. The case is of particular interest on the point of the use of powers of appointment (rather than powers of advancement) to benefit non-objects.

Developing multifunctional nanostructures that promote bone repair while fighting infection is highly desirable in bone regenerative therapies. Previous efforts have focused on achieving one property or another by altering the chemical makeup of nanostructures or using growth factors or antibiotics. We present nanostructures with several simultaneous functional attributes including positive effects of strontium on bone formation and prevention of osteoclast differentiation along with incorporation of antimicrobial peptides (AMP) to prevent infection. To form these multifunctional nanostructures, mesoporous calcium silicate (CaMSN) was modified with high levels of strontium. For this, CaMSNs were either partially substituted (20 wt% Ca) or completely replaced with strontium (Sr) to form Sr-CaMSN or SrMSN. The mesoporous nature of these bioactive silicate nanostructures rendered a configuration for substantial AMP loading as well as their effective delivery. The physico-chemical and structural characterization of synthesized MSNs confirmed the mesoporous nature of the synthesized MSNs and their total surface area, pore size, pore volume and SBF-mediated bioactivity remained unaltered with the incorporation of Sr. However, biological evaluation confirmed that synthesized SrMSN upregulated osteogenic differentiation of mesenchymal stromal cells and significantly downregulated osteoclast differentiation. Also, the AMP-loaded MSNs prevented formation and growth of methicillin resistant Staphylococcus aureus (MRSA) biofilms. Thus, high Sr-containing AMP-loaded SrMSNs may combat MRSA-associated infection while promoting bone regeneration. The controlled availability of therapeutic Sr and AMP release as SrMSN degrade enables its potential application in bone tissue regeneration.

Because there are fewer tools available to probe the interactions therein, the effect of the fundamental chemistry of the organic diluent on solvent extraction equilibria has been under-cha...

We review 50 years of use of 2′,3′-O-trinitrophenyl (TNP)-ATP, a fluorescently tagged ATP analog. It has been extensively used to detect binding interactions of ATP to proteins and to measure parameters of those interactions such as the dissociation constant, Kd, or inhibitor dissociation constant, Ki. TNP-ATP has also found use in other applications, for example, as a fluorescence marker in microscopy, as a FRET pair, or as an antagonist (e.g., of P2X receptors). However, its use in protein binding studies has limitations because the TNP moiety often enhances binding affinity, and the fluorescence changes that occur with binding can be masked or mimicked in unexpected ways. The goal of this review is to provide a clear perspective of the pros and cons of using TNP-ATP to allow for better experimental design and less ambiguous data in future experiments using TNP-ATP and other TNP nucleotides.

The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend waiting 3 to 5 days between the introduction of new complementary foods (solid foods introduced to infants12 months of age), yet with advances in the understanding of infant food diversity, the guidance that pediatric practitioners are providing to parents is unclear.To characterize pediatric practitioner recommendations regarding complementary food introduction and waiting periods between introducing new foods.In this survey study, a 23-item electronic survey on complementary food introduction among infants was administered to pediatric health care professionals from February 1 to April 30, 2019. Responses were described among the total sample and compared among subgroups. Survey invitations were emailed to 2215 members of the Illinois Chapter of the American Academy of Pediatrics and the national American Academy of Pediatrics' Council on Early Childhood. Participants were required to be primary medical practitioners, such as physicians, resident physicians, or nurse practitioners, providing pediatric care to infants 12 months or younger.The main outcome measures were recommendations on age of complementary food introduction and waiting periods between the introduction of new foods. Categorical survey items were reported as numbers (percentages) and 95% CIs. Means (SDs) were used to describe continuous survey items.The survey was sent to 2215 practitioners and completed by 604 (response rate, 27.3%). Of these respondents, 41 were excluded because they did not provide care for infants or pediatric patients. The final analyses included responses from 563 surveys. Of these, 454 pediatricians (80.6%), 85 resident physicians (15.1%), and 20 nurse practitioners (3.6%) completed the survey. Only 217 practitioners (38.6%; 95% CI, 34.1%-44.6%) recommended waiting 3 days or longer between food introduction; 259 practitioners (66.3%; 95% CI, 61.4%-70.8%) recommended waiting that amount of time for infants at risk for food allergy development (P = .02). A total of 264 practitioners (46.9%; 95% CI, 42.8%-51.0%) recommended infant cereal as the first food, and 226 practitioners (40.1%; 95% CI, 36.1%-44.2%) did not recommend a specific order. A total of 268 practitioners (47.6%; 95% CI, 43.5%-51.7%) recommended food introduction at 6 months for exclusively breastfed (EBF) infants, and 193 (34.3%; 95% CI, 30.5%-38.3%) recommended food introduction at 6 months for non-EBF infants (P .001); 179 practitioners (31.8%; 95% CI, 28.1%-35.8%) recommended food introduction at 4 months for EBF infants, and 239 practitioners (42.5%; 95% CI, 38.4%-46.6%) recommended food introduction at 4 months for non-EBF infants (P .001). A need for additional training on complementary food introduction was reported by 310 practitioners (55.1%; 95% CI, 50.9%-59.1%).In this survey study, most pediatric practitioners did not counsel families to wait 3 days or longer between introducing foods unless infants were at risk for food allergy development. The findings suggest that the current recommendation limits infant food diversity and may delay early peanut introduction. Because the approach to food allergy prevention has changed, a reevaluation of published feeding guidelines may be necessary.

Assembly of RAS molecules into complexes at the cell membrane is critical for RAS signaling. We previously showed that oncogenic KRAS codon 61 mutations increase its affinity for RAF, raising the possibility that KRAS

Supervisors are responsible for protecting client welfare and for promoting counselor development. In order for counselor growth and development to occur, the supervisee must feel safe bein...

Objectif : Les intervenants de première ligne sont en position idéale pour fournir des services de repérage, détection, interventions brèves et orientation (RDIBO) aux patients ayant un problème de dépendance. Par contre, la mise en oeuvre du RDIBO dans la pratique clinique présente de nombreux défis et son adoption généralisée s’avère lente. L’objectif global de cette recherche a été d’examiner les expériences vécues par les intervenants de première ligne ayant suivi les ateliers de formation du ministère de la Santé et des Services sociaux (MSSS) afin de mettre en oeuvre le programme-services Dépendances et, ensuite, d’étudier la relation entre cette formation et l’intégration des savoirs acquis à la pratique.Méthodes : Deux groupes de discussion focalisée ont eu lieu avec un total de 10 intervenants de première ligne et, dans une seconde phase, 69 questionnaires ont été distribués à d’autres intervenants, dont 22 avaient eu l’occasion de suivre la formation du MSSS. Tous les intervenants provenaient d’un centre de santé et de services sociaux (CSSS) qui était dans le processus de mise en place des services de première ligne en dépendance, tel qu’exigé par le programme-services Dépendances du MSSS.Résultats : Bien que la formation ait contribué à accroître la connaissance des participants sur la dépendance, les participants ont dit faire peu usage des outils de formation et avoir apporté peu de changements concrets à leur pratique clinique postatelier. En outre, les participants ont eu le sentiment que la formation dispensée ne les a pas suffisamment outillés pour adopter et mettre en oeuvre le RDIBO, car trop théorique et déconnectée du stade de mise en oeuvre dans leur propre organisme.Conclusion : La tenue d’ateliers est une approche fréquemment utilisée pour encourager l’adoption de nouvelles pratiques dans les milieux de soins de santé. Cependant, ils sont peu susceptibles de conduire à des changements de pratique significatifs à long terme. Les résultats sont discutés dans l’optique d’une réflexion sur le processus de transfert de connaissances., Objective: Substance abuse is a public health concern worldwide. Frontline health care professionals (HCP) are well placed to provide screening, brief intervention and referral to treatment (SBIR) for patients with substance abuse. There are many challenges to implementation of SBIR in clinical practice and widespread adoption has been slow. The objective of this research was to explore the experience of frontline HCPs in training workshops mandated by the Ministry of Health and Social Services in Quebec, and to explore the gap between training and implementation into practice.Methods: Two focus groups with ten frontline HCPs who had attended the mandated workshops were conducted and, in a second phase, 69 questionnaires were completed by HCP, among which 22 had attended the workshop. The study was conducted in Health and Social Service Centres that were in the process of implementing frontline services for substance abuse in response to government mandates.Results: Participants felt that the training provided did not adequately equip them to adopt or implement SBIR. The training was perceived as too theoretical, and disconnected from their organization’s stage of implementation. While some reported that the training was helpful in increasing knowledge, participants reported minimal use of the training tools and few concrete changes in clinical practice post-workshop.Conclusion: Workshops are a commonly used approach for promoting the uptake of new practices in health care settings ; however, they are unlikely to lead to significant long-term changes in practice. The results are discussed in the context of issues related to knowledge translation and the best practices for training., Objetivo: Quienes intervienen en primera línea están en posición ideal para proporcionar servicios de identificación, detección, intervenciones breves y orientación (IDIBO) a los pacientes que presentan un problema de dependencia. Por el contrario, la puesta en marcha del servicio IDIBO en la práctica clínica plantea numerosos desafíos y su adopción generalizada resulta lenta. El objetivo general de esta investigación es el de analizar las experiencias vividas por los intervinientes de primera línea que han seguido los talleres de formación del Ministerio de Salud y Servicios Sociales (MSSS) para poner en marcha el programa de servicios a las dependencias y, a continuación, estudiar la relación entre esta formación y la integración de los conocimientos adquiridos en la práctica.Métodos: se realizó una discusión focalizada en dos grupos con un total de 10 intervinientes de primera línea y, en una segunda etapa, se distribuyeron 69 cuestionarios a otros intervinientes, 22 de los cuales tuvieron la ocasión de seguir la formación del Ministerio. Todos los intervinientes provenían de un Centro de Salud y Servicios Sociales (CSSS) que estaba en proceso de instaurar los servicios de primera línea sobre dependencias, tal como lo exige el programa de servicios en materia de dependencia del MSSS.Resultados: si bien la formación a contribuido a aumentar el conocimiento de los participantes sobre la dependencia, los mismos manifestaron haber utilizado poco las herramientas de formación y haber aportado pocos cambios concretos a su práctica clínica con posterioridad al taller. Además, los participantes consideran que la formación dispensada no les ha proporcionado suficientes herramientas para adoptar y poner en práctica el servicio IDIBO, considerándolo demasiado teórico y desconectado del estadio de la puesta en marcha en su propio organismo.Conclusión: la realización de talleres es un enfoque utilizado con frecuencia para alentar la adopción de nuevas prácticas en los medios de atención de la salud. Sin embargo, estos talleres son poco susceptibles de producir cambios de práctica significativos a largo plazo. Los resultados se discuten en la óptica de una reflexión sobre el proceso de transferencia de conocimientos.

Sexual health reflects physical, emotional, mental, and social elements of sexual well-being. Researchers often position self-esteem (i.e., global or domain-specific evaluations of self) as a key correlate of sexual health. We present the first comprehensive meta-analysis of correlations between self-esteem and sexual health. Our synthesis includes 305 samples from 255 articles, containing 870 correlations from 191,161 unique participants. The overall correlation between self-esteem and sexual health was positive and small (

The purpose of this study was to examine oral health needs and dental care in individuals with trisomy 18 and trisomy 13 (full, mosaic, partial and other, mixed types). Primary feeding method was also examined. Data was collected from a parent-completed, mixed method survey (TRIS Survey). Mean age in months was 120.2 (range 38 to 394 months) and 133 (range 36 to 405 months), respectively, for trisomy 18 and trisomy 13 individuals. Results indicated the majority of individuals received routine dental care from their family dentist. Approximately 80% in both groups needed some form of specialized dental care. Close to 25% and 30% of trisomy 18 and trisomy 13 individuals, respectively, required hospital admission for specialized dental care. Responses indicated the presence of excessive plaque and tooth decay across the groups with a higher incidence for individuals with trisomy 13. Although not the primary form of intake, over half of the individuals received oral feedings. Implications for dental care and management are provided along with the need for additional research to confirm or disconfirm this study's findings.

Limited literature exists on children and adults diagnosed with the mosaic form of trisomy 9. Data from the Tracking Rare Incidence Syndromes (TRIS) project has provided physical characteristics and medical conditions for 14 individuals. This article provides TRIS Survey results of 25 additional cases at two data points (birth and survey completion) as well as developmental status. Results confirmed a number of phenotypic features and medical conditions. In addition, a number of cardiac anomalies were reported along with feeding and respiratory difficulties in the immediate postnatal period. In addition, developmental status data indicated a range in functioning level up to skills in the 36 and 48-month range. Strengths were also noted across the sample in language and communication, fine motor and social-emotional development. Implications for professionals caring for children with this genetic condition are offered.

In this paper, we present a workflow to create Web3D interface that allows users to interact with video footage of outdoor scenery as a 3D reconstructed scene. Video clips of an outdoor scene are processed through a matchmoving and photogrammetry program, and solved for camera paths in a globally oriented coordinate frame. A three.js web app uses these paths to create a Web3D visualisation that projects objects added in the 3D scene on top of their locations in the original 2D video background. These objects move as the video frames are scrubbed, in accordance with their correct spatial locations within the visual scene. The visualisation script is a template that can be used to compile any visualisation through changing the camera paths and associated video clips. These camera paths can be obtained by using photogrammetry tools to process the desired set of videos.

Trisomy 13 (Patau syndrome), identified by Patau and colleagues [1960; Lancet 1: 790–793] is the third most common autosomal condition. Population studies indicate less than one in 10 children reaches their first birthday. In the face of mixed findings and recommendations for treatment, additional research is needed to further determine what contributes to longevity and implications for treatment for presenting medical conditions. The purpose of the present study is to report on presenting medical conditions and the presence or absence of the specific conditions (age at survey completion). Data on nine survivors (seven female, two male) with trisomy 13 indicated mean gestational age of approximately 36 weeks, birth weight ranging from 1100 to 3290 g and mean length of 45.3 cm. Length of hospital stay after birth varied. The majority of infants presented with well-known physical characteristics. Medical conditions and their treatment varied at birth and at survey completion. Notably, several infants' cardiac anomalies resolved without surgical intervention. Surgeries were provided for a range of conditions including gastrostomy tube placement to address feeding issues and removal of intestinal blockage. There were no reports of holoprosencephaly. Implications and recommendations are provided. © 2014 Wiley Periodicals, Inc.

The purpose of the study is to provide data about 22 survivors over the age of 1 year with full trisomy 18 (12-59 months). Mothers completed the online, mixed method Tracking Rare Incidence Syndrome (TRIS) Survey provides data on birth information (e.g., gestational age, birth weight) and medical conditions identified at birth and at the time of survey completion. Data indicate similar birth characteristics to other studies and presence of syndrome related medical conditions including cardiac conditions, use of a variety of feeding methods, apnea, respiratory difficulties, and kidney issues. Associated interventions, sometimes considered "aggressive" or "intensive" treatments including cardiac surgeries were noted in the sample. Implications for treatment are provided and the need for additional research with this clinical subgroup is needed.

In 2007, the Québec Ministry of Health issued a policy document that specifically mandated the development of addiction treatment services including screening, brief interventions and referral (SBIR) to be delivered by primary healthcare clinics throughout Québec. The current study examined the level of implementation of SBIR one year following the end of the mandate (2007-2012).Semi-structured interviews were conducted with 45 participants from 21 primary health and social service centres throughout the province. Qualitative analysis was used to evaluate the level of success each centre had in implementing SBIR and to identify organizational measures that contributed to successful implementation.The results show that Québec primary health and social service centres had limited success in their efforts to integrate SBIR into their services. A comparative analysis of the centres, categorized according to their level of implementation, revealed the presence of significant organizational- and staff-level factors, including the creation of formal action plans that were conducive to the successful implementation of SBIR in primary care.The findings highlight the importance of offering support and guidance, as well as a menu of specific practices that are likely to assist primary health and social services centres to implement SBIR. At the organizational level, the adoption of local action plans and formal service trajectories offers a framework that allows for horizontal and vertical integration of new practices.

This study examined morphological processing of inflected and derived words by children in Grades 4, 6, and 8. Participants were shown root forms and inflected, derived, and orthographic control items (e.g., harm, harmed, harmful, or harmony), followed by a fragment completion task (e.g., completing h a_ _). Participants were equally likely to complete the fragment with the target root (e.g., harm for h a_ _) following priming with inflected or derived forms. This reflected a morphological effect; priming scores were higher for the inflected and derived forms than for orthographic counterparts. These effects were consistent across the grades studied, suggesting that morphological processing of inflected and derived words has a similar time course across Grades 4, 6, and 8.

Little is known about the inheritance and influence of the fleece color gene Melanocortin 1 Receptor (MC1R). Melanocortin 1 Receptor (MC1R) is a well-known gene responsible for red versus black fleece pigmentation and is hypothesized to be a candidate gene for variation in alpaca coloration patterns. Inheritance of red versus black pigmentation in the context of genetic mutation is well understood in many domesticated mammals. We characterized the MC1R gene in a population of multi-colored alpacas in order to better understand its effect on coat color in the alpaca. Our characterization of the alpaca MC1R gene revealed 11 mutations. Of these one is a 4 bp deletion, four are silent mutations and six are single nucleotide polymorphisms (SNPs) that alter the amino acid sequence (T28V, M87V, S126G, T128I, S196F, R301C). No mutation correlated completely with fleece color in alpacas at the MC1R locus. This may be due to the epistatic relationship of MC1R with other coat color genes especially agouti signaling protein (ASIP).

Hydrogels possess great potential in biofabrication because they allow cell encapsulation and proliferation in a highly hydrated three-dimensional environment, and they provide biologically relevant chemical and physical signals. However, development of hydrogel systems that mimic the complexity of natural extracellular matrix remains a challenge. In this study, we report the development of a binary hydrogel system containing a synthetic poly(amido amine) (PAMAM) dendrimer and a natural polymer, i.e., hyaluronic acid (HA), to form a fast cross-linking hydrogel. Live cell staining experiment and cell viability assay of bone marrow stem cells demonstrated that cells were viable and proliferating in the in situ formed PAMAM/HA hydrogel system. Furthermore, introduction of a Arginylglycylaspartic acid (RGD) peptide into the hydrogel system significantly improved the cell viability, proliferation, and attachment. Therefore, this PAMAM/HA hydrogel system could be a promising platform for various applications in biofabrication.

A distributive justice framework is used to examine how individuals make judgments about what is fair when making different types of health-care allocation decisions. The effects of 4 patient characteristics are assessed: (a) prognosis, (b) degree of responsibility for illness, (c) employment status, and (d) race. Results reveal that when the patient was defined as being more versus less responsible for his illness, respondents gave him a significantly lower priority score for obtaining health-care services, and they felt that he should be more responsible for paying for or soliciting funds to cover the costs of his health needs. Respondents also reacted with more negative emotion to the responsible patient and described him in more negative trait terms. Although patient's race produced no main effects, race did interact with employment status on several key variables. When the patient was described as being unemployed, the White patient compared to the Black patient was given a higher health-care priority score, he was resented less, and respondents were more willing to contribute money to pay for his health-care costs; but when the patient was described as being employed, the direction of differences between the races on these variables was reversed.

When she was asked to redraft the design technology programme for her chain of academies, experienced designer Emily Campbell went back to basics.

This paper summarizes the foci, activities, methods, and results of a three-year research project. Using a mixed methods approach, the Physician Order Entry Team has identified and categorized the unintended consequences of computerized physician order entry (CPOE). After analyzing 380 examples of unintended adverse consequences, the team described in detail nine major types and conducted a national survey in the U.S. to discover how hospitals recognize and deal with unintended consequences. With the assistance of a panel of experts, the team identified strategies for managing unintended adverse consequences and outlined contents of a toolkit for CPOE implementers for addressing them.

peer-reviewed Background: Substance abuse is a worldwide public health concern. Extensive scientific research has shown that screening and brief interventions for substance use disorders administered in primary care provide substantial benefit at relatively low cost. Frontline health clinicians are well placed to detect and treat patients with substance use disorders. Despite effectiveness shown in research, there are many factors that impact the implementation of these practices in real-world clinical practice. Recently, the Ministry of Health and Social Services in Quebec, Canada, issued two policy documents aimed at introducing screening and early intervention for substance abuse into frontline healthcare clinics in Quebec. The current research protocol was developed in order to study the process of implementation of evidence-based addiction treatment practices at three primary care clinics in Montreal (Phase 1). In addition, the research protocol was designed to examine the efficacy of overall policy implementation, including barriers and facilitators to addictions program development throughout Quebec (Phase 2). Methods/Design: Phase 1 will provide an in-depth case study of knowledge translation and implementation. The study protocol will utilize an integrated knowledge translation strategy to build collaborative mechanisms for knowledge exchange between researchers, addiction specialists, and frontline practitioners (guided by the principles of participatory-action research), and directly examine the process of knowledge uptake and barriers to transfer using both qualitative and quantitative methodologies. Evaluation will involve multiple measures, time points and domains; program uptake and effectiveness will be determined by changes in healthcare service delivery, sustainability and outcomes. In Phase 2, qualitative methods will be utilized to examine the contextual facilitators and barriers that frontline organizations face in implementing services for substance dependence. Phase 2 will provide the first study exploring the wide-scale implementation of frontline services for substance dependence in the province of Quebec and yield needed information about how to effectively implement mandated policies into clinical practice and impact public health. Discussion: Findings from this research program will contribute to the understanding of factors associated with implementation of frontline services for substance dependence and help to inform future policy and organizational support for the implementation of evidence-based practices.