Lung sickness in Murri kids : a cohort study in urban Indigenous children

QLD, 4Murri Health Group, Caboolture, QLD Introduction Respiratory illnesses with cough as a symptom are predominant causes of morbidity in young Australian Indigenous children. With the exception of ear disease, there are limited studies that have addressed burden and outcome. Also, there are no studies that are specific to urban Indigenous children. Aim: We aim to comprehensively investigate the incidence, aetiology, risk factors for and outcomes of acute respiratory illnesses (ARIs) in this population. Methods A cohort study of Indigenous children aged less than 5 years registered with an urban Indigenous primary health care service. Comprehensive baseline data are collected and children are followed monthly for 12 months to capture ARI events. ARI events are subsequently followed weekly for 4 weeks to determine cough outcomes, with review by a paediatric respiratory physician if cough has not resolved within 28 days. Results To date, 58 children (57% female) have been enrolled and 46 ARIs have been captured over 907 child weeks of observation (5.1 events per 100 child weeks, 95%CI 3.7–6.8). 13 ARIs (28.3%) have resulted in persistent cough for >28 days following onset. Conclusion Our early findings suggest an excess incidence of ARI in this population. The proportion of ARIs resulting in persistent cough for more than 4 weeks is the highest yet reported. Key Words: Indigenous, acute respiratory illness, paediatric.

Pt(II) bipyridyl complexes bearing substituted fluorenyl motif on the bipyridyl and acetylide ligands : synthesis, photophysics, and reverse saturable absorption

A series of Pt(II) diimine complexes bearing benzothiazolylfluorenyl (BTZ-F8), diphenylaminofluorenyl (NPh2- F8), or naphthalimidylfluorenyl (NI-F8) motifs on the bipyridyl or acetylide ligands (Pt-4−Pt-8), (i.e., {4,4′-bis[7-R1-F8-(≡)n-]bpy}Pt(7- R2-F8- ≡ -)2, where F8 = 9,9′-di(2-ethylhexyl)fluorene, bpy = 2,2′- bipyridine, Pt-4: R1 = R2 = BTZ, n = 0; Pt-5: R1 = BTZ, R2 = NI, n = 0; Pt-6: R1 = R2 = BTZ, n = 1; Pt-7: R1 = BTZ, R2 = NPh2, n = 1; Pt- 8: R1 = NPh2, R2 = BTZ, n = 1) were synthesized. Their ground-state and excited-state properties and reverse saturable absorption performances were systematically investigated. The influence of these motifs on the photophysics of the complexes was investigated by spectroscopic methods and simulated by time-dependent density functional theory (TDDFT). The intense absorption bands below 410 nm for these complexes is assigned to predominantly 1π,π* transitions localized on either the bipyridine or the acetylide ligands; while the broad low-energy absorption bands between 420 and 575 nm are attributed to essentially 1MLCT (metal-to-ligand charge transfer)/ 1LLCT (ligand-to-ligand charge transfer) transitions, likely mixed with some 1ILCT (intraligand charge transfer) transition for Pt-4−Pt-7, and predominantly 1ILCT transition admixing with minor 1MLCT/1LLCT characters for Pt-8. The different substituents on the acetylide and bipyridyl ligands, and the degrees of π-conjugation in the bipyridyl ligand influence both the 1π,π* and charge transfer transitions pronouncedly. All complexes are emissive at room temperature. Upon excitation at their respective absorption band maxima, Pt-4, Pt-6, and Pt-8 exhibit acetylide ligand localized 1π,π* fluorescence and 3MLCT/3LLCT phosphorescence in CH2Cl2, while Pt-5 manifests 1ILCT fluorescence and 3ILCT phosphorescence. However, only 1LLCT fluorescence was observed for Pt-7 at room temperature. The nanosecond transient absorption study was carried out for Pt-4−Pt-8 in CH3CN. Except for Pt-7 that contains NPh2 at the acetylide ligands, Pt-4−Pt-6 and Pt-8 all exhibit weak to moderate excited-state absorption in the visible spectral region. Reverse saturable absorption (RSA) of these complexes was demonstrated at 532 nm using 4.1 ns laser pulses in a 2 mm cuvette. The strength of RSA follows this trend: Pt-4 > Pt-5 > Pt-7 > Pt-6 > Pt-8. Incorporation of electron-donating substituent NPh2 on the bipyridyl ligand significantly decreases the RSA, while shorter π-conjugation in the bipyridyl ligand increases the RSA. Therefore, the substituent at either the acetylide ligands or the bipyridyl ligand could affect the singlet and triplet excited-state characteristics significantly, which strongly influences the RSA efficiency.

Strategies for teaching evidence-based practice to undergraduate health students: A systematic review protocol

Review question/objective The objective of this review is to find, critically appraise and synthesize the available quantitative evidence on the effectiveness of interventions that promote successful teaching of the evidence-based practice process in undergraduate health students, in preparation for them to become professional evidence-based practitioners. More specifically, the question that this review seeks to answer is: What is the effectiveness of teaching strategies for evidence-based practice for undergraduate health students? Inclusion criteria Types of participants This review will consider studies that include undergraduate health students from any undergraduate health discipline, including but not limited to medicine, nursing and allied health. Post graduate and post-registration students will not be included. Types of interventions This review will consider studies that evaluate strategies or interventions aimed at teaching any or all of the five steps of evidence-based practice, namely asking a structured clinical question; collecting the best evidence available; critically appraising the evidence to ensure validity, relevance and applicability; applying or integrating the results into clinical practice, and evaluating outcomes. The strategy may take place solely within a tertiary education environment or may be combined with a clinical setting. Types of outcomes This review will consider studies that include the following outcome measures: evidence-based practice behavior, knowledge, skills, attitudes, self-efficacy (or self-confidence), beliefs, values, intention to use evidence-based practice (future use) and confidence levels. Tools used to measure these outcomes will be assessed for reported validity, reliability and generalizability. Outcomes will be measured during the student’s education period up to graduation. If studies are conducted across different year levels this will be taken into account during analysis and reported accordingly.

Tactics for teaching evidence-based practice : improving self-efficacy in finding and appraising evidence in a master's evidence-based practice unit

Universal application of evidence-based practice (EBP) is far from a reality with many clinicians feeling ill equipped to adopt this approach in their clinical practice (Melnyk Fineout- Overholt, Feinstein, Sadler, & Green-Hernandez, 2008; Sherriff, Wallis, & Chaboyer, 2007) and, thus, to be an intelligent consumer of evidence (Ciliska, 2005). While recognizing the benefit of EBP, many health professionals have low confidence in their skills for using evidence in clinical settings (Nagy, Lumby, McKinley, &Macfarlane, 2001). Educational initiatives are often recommended for promoting adoption of EBP with much of the focus being on providing knowledge of associated processes. Levin, Melnyk, Fineout-Overholt, Barnes, and Vetter (2011) demonstrated that providing knowledge of EBP process alone does not increase clinicians’ confidence in their ability to apply EBP to their practice...

Managing peripheral intravenous devices in the adults' general surgical setting: a best practice implementation report

AIM The aim of this evidence-based practice (EBP) project was to promote adherence to the current best practice in monitoring and optimal replacement of peripheral intravenous device (PIVD). METHODS This EBP project took place in a 30-bed acute general surgical ward. Twenty in-patients with PIVD in situ for 4 days or more were recruited. There were five stages in the project: identification of EBP topic, criteria, sample and setting; baseline; dissemination of baseline audit results and identification of best practice barriers; identification of barriers to EBP and implementation of strategies promoting EBP; and postimplementation audit. RESULTS There were eight criteria in this project. The first audit showed moderate compliance in PIVD monitoring and optimal replacement. The project identified three barriers: lack of awareness of the current evidence-based guidelines, hospital policy not being aligned with current guidelines and no standard form of documentation. In order to overcome these barriers the following strategies were used: audit and feedback, interactive educational meetings, reminders and hospital policy change. The second audit showed minor improvements in each criterion. Compliance with documentation remained a challenge, possibly because of the lack of standardised documentation. DISCUSSION Although the project did not render us the results we aimed for, it was successful because it highlighted the current EBP in PIVD management. The major challenges of the project were time and the lack of opinion leaders in our project team. We felt that more time was needed to adapt to the practice change and standardised documentation could not be developed in such a short time period. Further, the role of the opinion leader proved to be vital in this project. We felt that had we recruited more than one opinion leader, the results would have been different.

The effectiveness of psychosocial interventions for cognitive dysfunction in cancer patients who have received chemotherapy : a systematic review

Background: Chemotherapy-related cognitive dysfunction (CRCD) refers to problems with memory,attention span, or concentration, experienced by patients with cancer who have had chemotherapy. CRCD can have a significant negative effect on a patient’s quality of life. The exact cause of CRCD is unknown but is presumed to be multifactorial. Objective: To conduct a systematic review of the effectiveness of psychosocial interventions designed to treat CRCD. Methods: Participants of interest to the review were over 18 years of age, diagnosed with cancer, and receiving chemotherapy or had received chemotherapy in the past. Interventions of interest were methods to improve cognitive function. Included study designs were randomized controlled trials, quasi-experimental trials, and quantitative observational studies. The primary outcome of interest was level of cognitive function. A three-step search strategy was utilized to identify studies published from 1985 to 2011 from a wide range of databases. Joanna Briggs Institute systematic review methods were used but findings were analyzed using the Cochrane Collaboration Review Manager 5.1 program.Weightedmean differences with 95% confidence intervals were calculated from the continuous data. Results: Searching identified 3,109 potentially relevant articles and 120 full-text articles were retrieved. Two further papers were sourced from reference lists of retrieved articles. From 122 papers, six were suitable for critical appraisal and six were included in the analysis. Meta-analysis was conducted on two cognitive behavioral therapy (CBT) trials for the outcome of inability to concentrate. Significant effect was seen for one CBT intervention at 20 weeks (p = .004). Significant effect from CBT on quality of life was seen at 6-month follow-up (p < .05). Conclusions: Despite some evidence of an effect, there is insufficient evidence at this stage to strongly recommend any of the interventions to assist in decreasing the effects of CRCD, except in terms of improving quality of life.

Toward making inroads in reducing the disparity of lung health in Australian Indigenous and New Zealand Maori children

Globally, Indigenous populations, which include Aboriginal and Torres Strait islanders in Australia and Māori people in New Zealand (NZ), have poorer health than their non-Indigenous counterparts. Indigenous peoples worldwide face substantial challenges in poverty, education, employment, housing and disconnection from ancestral lands. While addressing social determinants of health is a priority, solving clinical issues is equally important. Indeed, ignoring the latter until social issues improve risks further disparity as this may take generations. A systematic overview of interventions addressing social determinants of health found a striking lack of reliable evaluations.Where evidence was available, health improvement associated with interventions was modest or uncertain. 10 Thus advances in healthcare remain essential and these require the best evidence available in 11 preventing and managing common illnesses, including respiratory illnesses.

Inhaled corticosteroids for sub-acute cough in children (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the efficacy of inhaled corticosteroids in reducing the severity of cough in children with sub-acute cough (defined as cough duration of two to four weeks).

Corner detection in images under different noise levels

Corner detection has shown its great importance in many computer vision tasks. However, in real-world applications, noise in the image strongly affects the performance of corner detectors. Few corner detectors have been designed to be robust to heavy noise by now, partly because the noise could be reduced by a denoising procedure. In this paper, we present a corner detector that could find discriminative corners in images contaminated by noise of different levels, without any denoising procedure. Candidate corners (i.e., features) are firstly detected by a modified SUSAN approach, and then false corners in noise are rejected based on their local characteristics. Features in flat regions are removed based on their intensity centroid, and features on edge structures are removed using the Harris response. The detector is self-adaptive to noise since the image signal-to-noise ratio (SNR) is automatically estimated to choose an appropriate threshold for refining features. Experimental results show that our detector has better performance at locating discriminative corners in images with strong noise than other widely used corner or keypoint detectors.

Scale adaptive tracking using mean shift and efficient feature matching

The mean shift tracker has achieved great success in visual object tracking due to its efficiency being nonparametric. However, it is still difficult for the tracker to handle scale changes of the object. In this paper, we associate a scale adaptive approach with the mean shift tracker. Firstly, the target in the current frame is located by the mean shift tracker. Then, a feature point matching procedure is employed to get the matched pairs of the feature point between target regions in the current frame and the previous frame. We employ FAST-9 corner detector and HOG descriptor for the feature matching. Finally, with the acquired matched pairs of the feature point, the affine transformation between target regions in the two frames is solved to obtain the current scale of the target. Experimental results show that the proposed tracker gives satisfying results when the scale of the target changes, with a good performance of efficiency.

Thiophene–tetrafluorophenyl–thiophene : a promising building block for ambipolar organic field effect transistors

A thiophene–tetrafluorophenyl–thiophene donor–acceptor–donor building block was used in combination with a furan-substituted diketopyrrolopyrrole for synthesizing the polymer semiconductor, PDPPF-TFPT. Due to the balance of tetrafluorophenylene/diketopyrrolopyrrole electron-withdrawing and furan/thiophene electron-donating moieties in the backbone, PDPPF-TFPT exhibits ambipolar behaviour in organic thin-film transistors, with hole and electron mobilities as high as 0.40 cm2 V−1 s−1 and 0.12 cm2 V−1 s−1.

Stimulation of osteogenesis and angiogenesis of hBMSCs by delivering Si ions and functional drug from mesoporous silica nanospheres

Multifunctional bioactive materials with the ability to stimulate osteogenesis and angiogenesis of stem cells play an important role in the regeneration of bone defects. However, how to develop such biomaterials remains a significant challenge. In this study, we prepared mesoporous silica nanospheres (MSNs) with uniform sphere size (∼90 nm) and mesopores (∼2.7 nm), which could release silicon ions (Si) to stimulate the osteogenic differentiation of human bone marrow stromal cells (hBMSCs) via activating their ALP activity, bone-related gene and protein (OCN, RUNX2 and OPN) expression. Hypoxia-inducing therapeutic drug, dimethyloxaloylglycine (DMOG), was effectively loaded in the mesopores of MSNs (D-MSNs). The sustained release of DMOG from D-MSNs could stabilize HIF-1α and further stimulated the angiogenic differentiation of hBMSCs as indicated by the enhanced VEGF secretion and protein expression. Our study revealed that D-MSNs could combine the stimulatory effect on both osteogenic and angiogenic activity of hBMSCs. The potential mechanism of D-MSN-stimulated osteogenesis and angiogenesis was further elucidated by the supplementation of cell culture medium with pure Si ions and DMOG. Considering the easy handling characteristics of nanospheres, the prepared D-MSNs may be applied in the forms of injectable spheres for minimally invasive surgery, or MSNs/polymer composite scaffolds for bone defect repair. The concept of delivering both stimulatory ions and functional drugs may offer a new strategy to construct a multifunctional biomaterial system for bone tissue regeneration.

Testing and modifying a tool to measure nurses’ beliefs about aromatherapy

Aromatherapy has been found to have some effectiveness in treating conditions such as postoperative nausea and vomiting, however unless clinicians are aware of and convinced by this evidence, it is unlikely they will choose to use it with their patients. The aim of this study was to test and modify an existing tool, Martin and Furnham’s Beliefs About Aromatherapy Scale in order to make it relevant and meaningful for use with a population of nurses and midwives working in an acute hospital setting. A Delphi process was used to modify the tool and then it was tested in a population of nurses and midwives, then exploratory factor analysis was conducted. The modified tool is reliable and valid for measuring beliefs about aromatherapy in this population.