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Summary Background Middle East respiratory syndrome (MERS) coronavirus causes a highly fatal lower-respiratory tract infection. There are as yet no licensed MERS vaccines or therapeutics. This study (WRAIR-2274) assessed the safety, tolerability, and immunogenicity of the GLS-5300 MERS coronavirus DNA vaccine in healthy adults. Methods This study was a phase 1, open-label, single-arm, dose-escalation study of GLS-5300 done at the Walter Reed Army Institute for Research Clinical Trials Center (Silver Spring, MD, USA). We enrolled healthy adults aged 18–50 years; exclusion criteria included previous infection or treatment of MERS. Eligible participants were enrolled sequentially using a dose-escalation protocol to receive 0·67 mg, 2 mg, or 6 mg GLS-5300 administered by trained clinical site staff via a single intramuscular 1 mL injection at each vaccination at baseline, week 4, and week 12 followed immediately by co-localised intramuscular electroporation. Enrolment into the higher dose groups occurred after a safety monitoring committee reviewed the data following vaccination of the first five participants at the previous lower dose in each group. The primary outcome of the study was safety, assessed in all participants who received at least one study treatment and for whom post-dose study data were available, during the vaccination period with follow-up through to 48 weeks after dose 3. Safety was measured by the incidence of adverse events; administration site reactions and pain; and changes in safety laboratory parameters. The secondary outcome was immunogenicity. This trial is registered at ClinicalTrials.gov (number NCT02670187) and is completed. Findings Between Feb 17 and July 22, 2016, we enrolled 75 individuals and allocated 25 each to 0·67 mg, 2 mg, or 6 mg GLS-5300. No vaccine-associated serious adverse events were reported. The most common adverse events were injection-site reactions, reported in 70 participants (93%) of 75. Overall, 73 participants (97%) of 75 reported at least one solicited adverse event; the most common systemic symptoms were headache (five [20%] with 0·67 mg, 11 [44%] with 2 mg, and seven [28%] with 6 mg), and malaise or fatigue (five [20%] with 0·67 mg, seven [28%] with 2 mg, and two [8%] with 6 mg). The most common local solicited symptoms were administration site pain (23 [92%] with all three doses) and tenderness (21 [84%] with all three doses). Most solicited symptoms were reported as mild (19 [76%] with 0·67 mg, 20 [80%] with 2 mg, and 17 [68%] with 6 mg) and were self-limiting. Unsolicited symptoms were reported for 56 participants (75%) of 75 and were deemed treatment-related for 26 (35%). The most common unsolicited adverse events were infections, occurring in 27 participants (36%); six (8%) were deemed possibly related to study treatment. There were no laboratory abnormalities of grade 3 or higher that were related to study treatment; laboratory abnormalities were uncommon, except for 15 increases in creatine phosphokinase in 14 participants (three participants in the 0·67 mg group, three in the 2 mg group, and seven in the 6 mg group). Of these 15 increases, five (33%) were deemed possibly related to study treatment (one in the 2 mg group and four in the 6 mg group). Seroconversion measured by S1-ELISA occurred in 59 (86%) of 69 participants and 61 (94%) of 65 participants after two and three vaccinations, respectively. Neutralising antibodies were detected in 34 (50%) of 68 participants. T-cell responses were detected in 47 (71%) of 66 participants after two vaccinations and in 44 (76%) of 58 participants after three vaccinations. There were no differences in immune responses between dose groups after 6 weeks. At week 60, vaccine-induced humoral and cellular responses were detected in 51 (77%) of 66 participants and 42 (64%) of 66, respectively. Interpretation The GLS-5300 MERS coronavirus vaccine was well tolerated with no vaccine-associated serious adverse events. Immune responses were dose-independent, detected in more than 85% of participants after two vaccinations, and durable through 1 year of follow-up. The data support further development of the GLS-5300 vaccine, including additional studies to test the efficacy of GLS-5300 in a region endemic for MERS coronavirus. Funding US Department of the Army and GeneOne Life Science.

© Sara Santarossa, Deborah Kane, Charlene Y Senn, Sarah J Woodruff. The growth of the digital environment provides tremendous opportunities to revolutionize health behavior change efforts. This paper explores the use of Web-based, mobile, and social media health behavior change interventions and determines whether there is a need for a face-to-face or an in-person component. It is further argued that that although in-person components can be beneficial for online interventions, a digital person-to-person component can foster similar results while dealing with challenges faced by traditional intervention approaches. Using a digital person-to-person component is rooted in social and behavioral theories such as the theory of reasoned action, and the social cognitive theory, and further justified by the human support constructs of the model of supportive accountability. Overall, face-to-face and online behavior change interventions have their respective advantages and disadvantages and functions, yet both serve important roles. It appears that it is in fact human support that is the most important component in the effectiveness and adherence of both face-to-face and online behavior change interventions, and thoughtfully introducing a digital person-to-person component, to replace face-to-face interactions, can provide the needed human support while diminishing the barriers of in-person meetings. The digital person-to-person component must create accountability, generate opportunities for tailored feedback, and create social support to successfully create health behavior change. As the popularity of the online world grows, and the interest in using the digital environment for health behavior change interventions continues to be embraced, further research into not only the use of online interventions, but the use of a digital person-to-person component, must be explored.

UNSTRUCTURED The growth of the digital environment provides tremendous opportunities to revolutionize health behavior change efforts. This paper explores the use of Web-based, mobile, and social media health behavior change interventions and determines whether there is a need for a face-to-face or an in-person component. It is further argued that that although in-person components can be beneficial for online interventions, a digital person-to-person component can foster similar results while dealing with challenges faced by traditional intervention approaches. Using a digital person-to-person component is rooted in social and behavioral theories such as the theory of reasoned action, and the social cognitive theory, and further justified by the human support constructs of the model of supportive accountability. Overall, face-to-face and online behavior change interventions have their respective advantages and disadvantages and functions, yet both serve important roles. It appears that it is in fact human support that is the most important component in the effectiveness and adherence of both face-to-face and online behavior change interventions, and thoughtfully introducing a digital person-to-person component, to replace face-to-face interactions, can provide the needed human support while diminishing the barriers of in-person meetings. The digital person-to-person component must create accountability, generate opportunities for tailored feedback, and create social support to successfully create health behavior change. As the popularity of the online world grows, and the interest in using the digital environment for health behavior change interventions continues to be embraced, further research into not only the use of online interventions, but the use of a digital person-to-person component, must be explored.

Background and Purpose. Men are underrepresented in nursing, accounting for less than 6% of Canadian nurses. This research explores issues surrounding recruitment, retention, and work life satisfaction for men who are nurses working in acute care settings Method and Findings. Purposive and snowball sampling was used in this descriptive, qualitative study. Sixteen men participated in four focus groups conducted in three communities in southwestern Ontario. The participants revealed that work stress, lack of full-time opportunities, and gender-based stereotypes contributed to job dissatisfaction. Providing care to patients and making a difference were personal rewards that influenced their desire to stay in the profession. To promote nursing as a viable profession, unrestricted by gender, the participants recommended that recruitment strategies begin at an earlier age. Discussion and Conclusion. Findings are discussed in relation to recruitment and retention issues with implications for education, practice, and management.

Although a limited number of studies have focused on bullying in nursing education to date, all of those studies demonstrate the existence of bullying in clinical settings, where nursing students undertake a significant amount of their nursing education. The purpose of this study was to examine the state of bullying in clinical nursing education among Canadian undergraduate nursing students ( N = 674) in all 4 years of their nursing program. Results suggest that nursing students experience and witness bullying behaviors at various frequencies, most notably by clinical instructors and staff nurses. Third-year and fourth-year students experience more bullying behaviors than first-year and second-year students. Implications for practice include ensuring that clinical instructors are well prepared for their role as educators. Policies must be developed that address the issue of bullying within nursing programs and within health care facilities where nursing students undertake their clinical nursing education.

Men are underrepresented in nursing, accounting for less than 6% of Canadian nurses. This research explores issues surrounding recruitment, retention, and work life satisfaction for men who are nurses working in acute care settings.Purposive and snowball sampling was used in this descriptive, qualitative study. Sixteen men participated in four focus groups conducted in three communities in southwestern Ontario. The participants revealed that work stress, lack of full-time opportunities, and gender-based stereotypes contributed to job dissatisfaction. Providing care to patients and making a difference were personal rewards that influenced their desire to stay in the profession. To promote nursing as a viable profession, unrestricted by gender, the participants recommended that recruitment strategies begin at an earlier age.Findings are discussed in relation to recruitment and retention issues with implications for education, practice, and management.

Quantum cascade laser based breath sensor platform for medical applications employing a quartz-enhanced photoacoustic spectroscopy technique is reported. The detection sensitivity for exhaled ammonia is at ≪10 ppbv level with 1 s time resolution.

This article uses a set of strategies designed by Abigail Stewart to guide the generation of knowledge about women and gender to revisit the relationship between nursing and feminism. It is important that nurses be aware of the valuable feminist contributions made by their predecessors in order to uncover the hidden links that exist between nursing and feminism. As long as the relationship between nursing and feminism remains invisible, the gender, problems in nursing that are systemic to a woman's occupation in a male-dominated society will continue.

Several states now require that all children attending day care, nursery schools, and kindergarten have evidence of a blood lead screening. Obtaining the requisite blood sample can be difficult because of inherent problems with pediatric clients. The purpose of this research was to explore if the application of heat to promote vasodilation affected finger stick collection time in pediatric clients. Subjects, ages 2 through 6 years, were randomly assigned to a control or intervention group (N = 63). For the intervention group, heat was applied for 1 min by placement of an infant heel warmer on the hand selected for the finger stick. A stopwatch was used to measure the time of blood collection in both the control and intervention groups. A two-tailed t test revealed statistical significance between the two groups (p = .008). Findings suggest the application of heat to promote vasodilation does reduce collection time in pediatric clients. Nurse practitioners may use this intervention to facilitate collection of blood samples in pediatric clients.

The study of psychological anthropology represents the interworkings of the theories, concepts, empirical findings, and methodologies of psychology and anthropology. This discussion of resources is written from the point of view of an anthropologist, not a psychologist. The psychologists have a related, though not identical, discipline called cross‐cultural psychology. As no scholar nor group of scholars can afford to live in a void, we find the works of members of both disciplines appearing in the same publications. This fact will be evident in the description of resources to follow.

Summary form only given. Statistically extreme events, that is to say, the events which have L-shaped probability distribution function (PDF, or in other words L-statistics) and, in particular, the rogue wave (RW) events, constitute a special family of natural phenomena. Curiously, this kind of events is more common than it is believed. It was observed that the behavior of the systems which obey L-shaped statistics is clustered. Periods of high predictability and low volatility are followed by periods of drastic changes and high volatility, for example, RWs [1], earthquakes, epileptic seizures etc. Permutation entropy (PE) is an indicator of dynamical predictability of the system [2, 3] which allows quantization of the predictability or volatility. We report an investigation of using it to characterize the uncertainty period which was observed during pulse-pulse interaction in a long ring laser resonator without a saturable absorber. These resonators, in particular, the resonator built using Er3+ doped fiber (Fig.1), have polarization dependent instability near the lasing threshold [4] which leads to the generation of pulses propagating with different speed, either randomly or regularly. Using this property, an investigator can observe the mechanism of the pulse-pulse interaction in detail