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Caroline Gibbons,1 Pamela Durepos,2 Natasha Taylor,3 Lisa Keeping-Burke,3 Matt W Rogers,4 Karen E Furlong,3 Rose M McCloskey3 1School of Nursing, Université de Moncton, Moncton, NB, Canada; 2Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada; 3Department of Nursing & Health Sciences, University of New Brunswick, Saint John, NB, Canada; 4Faculty of Education, University of New Brunswick, Fredericton, NB, CanadaCorrespondence: Caroline Gibbons, School of Nursing, 18 Antonine-Maillet Ave, Université de Moncton, Moncton, NB, E1A 3E9, Canada, Email caroline.gibbons@umoncton.caPurpose: This mixed methods study aimed to assess the knowledge and skills related to infection prevention and control amongst visitors to long-term care homes following the removal of visiting restrictions during the Covid-19 pandemic.Methods: Forty visitors to residents in long-term care homes were recruited. Participants’ knowledge of the Covid-19, infection prevention and control practices, and self-reported use of protective behaviours were assessed through questionnaires. Handwashing skills, donning and doffing of personal protective equipment and decision-making surrounding hand hygiene moments were assessed through laboratory simulation using observation checklists.Results: Participants’ level of knowledge and perceived use of protective behaviours were high. However, no one accurately performed the handwashing steps, few (5.0%) performed all hand hygiene moments recommended, 35.0% donned personal protective equipment and only 12.5% doffed correctly. This is concerning because 90.0% of participants reported receiving infection prevention and control training.Conclusion: These findings suggest educational interventions, resources and policies are needed to strengthen infection prevention and control training for visitors’ to long-term care.Keywords: long-term care, handwashing utilization, personal protective equipment utilization, simulation

Susan D Mathias,1 Laurie Burke,2 Hilary H Colwell,1 George Mensing,3 Will Savage,3 Hetanshi Naik4 1Health Outcomes Solutions, Palm Beach Gardens, FL, USA; 2LORA Group, Normal, IL, USA; 3Disc Medicine, Watertown, MA, USA; 4Department of Genetics, Stanford University School of Medicine, Palo Alto, CA, USACorrespondence: Hetanshi Naik, Department of Genetics, Stanford University School of Medicine, Palo Alto, CA, USA, Email naikh@stanford.eduPurpose: Erythropoietic protoporphyria (EPP), a rare inherited disorder, presents in early childhood with severe, painful phototoxicity, with significant impacts on health-related quality of life (HRQoL). Previous studies have not captured all concepts important to patients. Therefore, this study sought to develop a novel, comprehensive, and content valid patient-reported outcome (PRO) measure to assess the efficacy of new therapies.Patients and Methods: Qualitative interviews were conducted with EPP participants and clinical experts to obtain views on concepts relevant to patients. Results informed the development of novel PROs, which were debriefed during subsequent combined concept elicitation and cognitive debriefing interviews.Results: Twenty-three interviews were conducted with 17 adults and 6 adolescents with EPP. Concept elicitation revealed that participants experienced many symptoms with significant variability. The most common were burning, pain, swelling, and tingling. Tingling was the most common prodromal symptom, while burning was the most bothersome, and pain was the worst full reaction symptom. Participants reported being negatively impacted in their ability to do daily activities, and social and emotional functioning. Many reported impacted ability to work and be productive at their job. Participants reviewed and completed the newly developed PRO measures assessing full reactions and ability to do activities, as well as items to assess severity and change in severity of prodromal symptoms, full reactions, and EPP overall. All measures were found to be comprehensive, clear, and relevant.Conclusion: PRO measures are needed to assess important aspects of HRQoL and evaluate therapeutic response. These PRO measures are unique in assessing overall severity and change in EPP.Plain Language Summary: Erythropoietic protoporphyria (EPP) is a rare but severe condition; people with it experience painful reactions on their skin after exposure to sun and in some cases, artificial light. Measuring how EPP affects individual’s lives is critical to properly understanding the disorder. However, current questionnaires do not capture all the issues important to individuals with EPP. Therefore, we conducted interviews with individuals with EPP and doctors who are experts in EPP to create and evaluate a questionnaire that addresses these gaps. The interviews showed that people with EPP experience many symptoms with lots of variability, and that EPP impacts their ability to work and be productive at their job. This information was used to create a questionnaire that measures individual’s full EPP reactions and ability to do activities (EPP Impact Questionnaire), and how bad early warning symptoms, full reactions, and EPP overall are, as well as how they change (Patient Global Impression of Severity and Change). The questionnaire was found to be clear and relevant. This is important in being able to measure how patients feel and function and whether treatments work for people with EPP.Keywords: erythropoietic protoporphyria, porphyria, patient-reported outcome development, qualitative interviews, rare disease

X-ray nanotomography is a powerful tool for the characterization of nanoscale materials and structures, but it is difficult to implement due to the competing requirements of X-ray flux and spot size. Due to this constraint, state-of-the-art nanotomography is predominantly performed at large synchrotron facilities. We present a laboratory-scale nanotomography instrument that achieves nanoscale spatial resolution while addressing the limitations of conventional tomography tools. The instrument combines the electron beam of a scanning electron microscope (SEM) with the precise, broadband X-ray detection of a superconducting transition-edge sensor (TES) microcalorimeter. The electron beam generates a highly focused X-ray spot on a metal target held micrometers away from the sample of interest, while the TES spectrometer isolates target photons with a high signal-to-noise ratio. This combination of a focused X-ray spot, energy-resolved X-ray detection, and unique system geometry enables nanoscale, element-specific X-ray imaging in a compact footprint. The proof of concept for this approach to X-ray nanotomography is demonstrated by imaging 160 nm features in three dimensions in six layers of a Cu-SiO2 integrated circuit, and a path toward finer resolution and enhanced imaging capabilities is discussed.

X-ray nanotomography is a powerful tool for the characterization of nanoscale materials and structures, but it is difficult to implement due to the competing requirements of X-ray flux and spot size. Due to this constraint, state-of-the-art nanotomography is predominantly performed at large synchrotron facilities. We present a laboratory-scale nanotomography instrument that achieves nanoscale spatial resolution while addressing the limitations of conventional tomography tools. The instrument combines the electron beam of a scanning electron microscope (SEM) with the precise, broadband X-ray detection of a superconducting transition-edge sensor (TES) microcalorimeter. The electron beam generates a highly focused X-ray spot on a metal target held micrometers away from the sample of interest, while the TES spectrometer isolates target photons with a high signal-to-noise ratio. This combination of a focused X-ray spot, energy-resolved X-ray detection, and unique system geometry enables nanoscale, element-specific X-ray imaging in a compact footprint. The proof of concept for this approach to X-ray nanotomography is demonstrated by imaging 160 nm features in three dimensions in six layers of a Cu-SiO2 integrated circuit, and a path toward finer resolution and enhanced imaging capabilities is discussed. [ABSTRACT FROM AUTHOR]

In 2008 there were 87,339 people enrolled on foundation degrees (FDs) in the UK (Foundation Degree Forward, 2009), and educational institutions in the UK offered 1700 different foundation degrees in over 25 subjects, with nearly 900 more in development (Action on Access, 2010). In addition, student views are seen to be of importance, as demonstrated by the National Student Survey and the notion of the student as consumer. This paper reports on a study of the views of students undertaking FDs in one university. A mixed-methods evaluation approach was used. Data were collected from students through questionnaires, interviews and focus groups. This was an ambitious project that yielded a vast amount and range of qualitative and quantitative data across multiple cohorts of seven different foundation degrees. Overall, students' perceptions are positive, although some findings vary from one foundation degree to another. Across all subjects, students were agreed on their positive rating on five of the key elements of FDs. There was also agreement that employers did not, on the whole, value the foundation degree qualification. This paper presents the findings of this study and conclusions are drawn that add to the literature about FDs that will be of relevance to those involved in the development and delivery of FDs. (Contains 9 tables.)

Introduction Despite advances in diagnosis and management, the outcomes for both lung cancer and idiopathic pulmonary fibrosis (IPF) are still unfavourable. The pathophysiology and outcomes for patients with concomitant lung cancer and IPF remains unclear. Methodology A retrospective analysis was performed of all patients presenting with concomitant IPF and lung cancer to our centre over a 3-year period. Patients with connective tissue disease, asbestos exposure, sarcoidosis, previous thoracic radiation, radiological evidence of fibrosis but no histological confirmation of lung cancer, or the use of medications known to cause pulmonary fibrosis were excluded. We describe clinical, radiological and pathological characteristics of this group. We also report the response to standardized lung cancer therapy in this cohort. Results Of 637 lung cancer patients, 34 were identified with concomitant IPF (5.3%) and all were smokers. 85% had non-small cell lung cancer, 41% were squamous cell cancers. The majority of tumours were located in the lower lobes, peripheral and present in an area of honeycombing. Despite the fact that approximately 2/3rds of the patients had localised or locally advanced lung cancer, the outcome of therapy for lung cancer was extremely poor regardless of tumour stage or severity of IPF. Conclusions At our centre, 1/20 patients with lung cancer have concomitant IPF. The majority of these tumours are small in size, peripheral in location and squamous cell carcinoma; in an area of honey combing. The outcome for concomitant lung cancer and IPF regardless of stage or therapy is poor. Keywords Lung cancer * Pulmonary fibrosis * Radiological characteristics * Histological features * Outcome, Introduction Although cigarette smoking is clearly established as the major risk factor for lung cancer, a link between pulmonary fibrosis and lung cancer has been suggested as early as 1965 [...]