Following live cells – A novel high content high throughput screening platform

The goal was to develop a light-microscope platform concept, which allows the structural and functional characterization of live cells in microtiterplates with a speed, sensitivity and versatility unattainable so far. The goal was achieved by combining several novel technological concepts:

• •using mineral-cast as body material, thus having a 14x better vibration damping than with conventional metal-materials;
• •employing a model-based digital control for a voice coil focus drive. The drive features an excursion of 10 mm with nanometer resolution and with minimal response times (1 ms for a 1 μm step and<500 ms for a 10 mm step);
• •applying galvanometer-scanning technology to follow a continuously moving sample during image acquisition, thus avoiding the usual stop & go;
• •implementing rapid (millisecond) switching of excitation wavelengths in the wavelength-range from 280 to 680 nm;
• •automated dual emission image registration and
• •easy integration of environmental control.

     

Utilizing Peplau's psychodynamic theory for stroke patient care

• • A theory which enables the recipient of care to identify health-care needs is paramount.
• • Hildegard Peplau's (1952) theory of psychodynamic nursing enables this process to occur in collaborative identification and resolution of need.
• • The psychodynamic approach can direct the user to focus on the psychosocial problems created by a stroke.
• • The advantages and limitations of the theory are still to be investigated with the continued application to varied clinical situations.
• • There is a need to generate an expanded research-based taxonomy of psycho-social interventions for this client group.

     

Research in intensive care nursing

• • The results of a questionnaire study about intensive care nursing in Finland indicate that the chief problems in intensive care nursing are concerned with staff coping resources, quality development and patient experiences.
• • Questions on staff stress and coping have been researched quite extensively. Earlier studies have described intensive care nursing as highly stressful and pointed to numerous problems related to coping.
• • It is clear that intensive care nursing warrants closer attention in research.

     

Angiogenèse: de la physiologie à la thérapeutique

• •- Vasculogenesis, angiongenesis and arteriogenesis

• •• Angiogenesis in embryonic development vasculogenesis
• •• Angiogenesis

• •- Vessel formation
• •- Mechanical hypothesis
• •- Biological hypothesis: role of the angiogenic growth factors FGF and VEGF
• •• Combined hypothesis: angiogenesis and vascular remodelling

• •- Therapeutic angiogenesis in cardiovascular diseases
• •• Critical limb ischemia
• •• Myocardial ischemia

• •- Gene therapy
• •- Angiogenic growth factor therapy
• •- Tumour angiogenesis
• •- Angiogenesis in healing wounds

     

Intoxication à la méthadone chez l'enfant

• •- Pharmacology of methadone
• •- Specific antagonist
• •- Toxicity of methadone in adults
• •- Therapeutic use in children
• •- Methadone poisoning in children

     

Rapid COVID-19 testing: Speed,quality and cost. Can you have all three?

Key Messages

• •Consider safety precautions and infection control processes, particularly in remote testing locations when using rapid SARS-CoV-2 devices.
• •Seek oversight and partnership with an accredited clinical laboratory for guidance on setting up a quality assurance framework.
• •Rapid-testing for SARS-CoV-2 requires method verification prior to clinical implementation.

     

Capacity of People with Intellectual Disabilities to Consent to Take Part in a Research Study

Background Within the context of current legislation relating to mental capacity in adults, the capacity of people with intellectual disabilities to consent to take part in research studies and the impact of different forms of information provision was experimentally investigated. Materials and methods A questionnaire measure of ability to consent to take part in this research study was administered individually to participants. A total of 102 participants with intellectual disabilities were recruited from three day services for adults with intellectual disabilities. Consent information appertaining to taking part in an actual research project was presented to participants and their capacity assessed using a questionnaire. Three experimental conditions were used:

• • Control (n = 34) – consent information was presented followed by the questionnaire.
• • Section (n = 34) – consent information was broken into sections and the appropriate questions were asked following each section.
• • Photograph (n = 34) – consent information was accompanied by six colour photographs, followed by the questionnaire.

Participants also completed measures of memory ability, verbal ability and non‐verbal problem‐solving ability. Results Seventeen participants withdrew from the study at some point. Of the remaining 85 participants, no significant differences in ability to consent scores were found between the experimental conditions. Using this measure, only five participants (5.9%) were deemed able to consent, i.e. scored the minimum required on each aspect of consent. Conclusions The validity and usefulness of the current dichotomous concept of consent is challenged as only a small proportion of participants were deemed able to consent.     

The role of the mental health nursing leadership

holm a.l. & severinsson e. (2010) Journal of Nursing Management 18, 463–471
The role of the mental health nursing leadership Aim The aim of the present study was to illuminate what the mental health nursing (MHN) leader needs in order to develop her/his leadership role. Background MHN leadership has tended to focus on the nature of the care provided rather than the development of the role. Method This literature review (1998–2008) examines papers from the past decade by means of a synthesis of empirical studies. Results Three themes emerged:

• • clarifying role expectations and areas for development at the same time as increasing the influence on patients with mental health problems;
• • using evidence-based practice to implement improvements and organizational change in mental health; and
• • employing communication skills as well as supporting, nurturing and empowering others.

Conclusion This review provided evidence that the MHN leader needs various skills in order to make enlightened changes that can meet the needs of both patients and staff. Implications for nursing management The MHN leader needs to explore the range of tasks involved in leadership in order to define role expectations and areas for development. These areas include enhancing patient care; reliance on team work; and attending to the personal life of the staff; increasing collaboration within the organization as well as with the community; utilizing the best available evidence; and communicating in order to improve the organization.     

Audit for IV fluid requirement in preterm babies in Sunderland Royal Hospital (SRH)

BackgroundPreterm infants are particularly vulnerable to the effects of fluid mismanagement due to shifts between intracellular, extracellular and vascular compartments; inappropriate fluid administration may lead to electrolyte imbalances, with the potential for serious morbidity.AimTo determine whether preterm babies are receiving the volume of IV fluid prescribed by a doctor, as indicated in the neonatal guidelines.Methods

• •A retrospective study of hospital notes was carried out using a pro forma to collect data.
• •The study sample (n = 35) consisted of all preterm babies <32 weeks admitted to ITU between July and December 2013.
• •Mean fluid intake, including and excluding lipids, was calculated and compared to volume prescribed. It was categorised as correct (±1.0 ml/kg/24 h prescribed volume), too much or too little.

Results

• •27/37 notes were available for analysis; 23 were suitable for the audit.
• •On average 22% (n = 5) babies received the correct volume of fluid, 22% (n = 5) received too much, 56% (n = 13) received too little (mean deficit: 3.89 ml/kg/24 h).
• •21 babies received lipids; with lipid inclusion 4% (n = 1) received the correct volume, 86% (n = 18) received too much (mean excess 5.51 ml/kg/24 h), 10% (n = 2) received too little.
• •There was no correlation between fluid accuracy and age of baby.

ConclusionMost babies receive total daily fluids within 6 ml of the volume prescribed yet few receive the correct volume to the nearest ml/kg/24 h. The inclusion of lipids in daily totals shifted the trend from under to over administration of fluid; clarification is required on whether this is significant enough to require lipid inclusion in daily totals.     

Against all odds: a retrospective case-controlled study of women who experienced extraordinary breastfeeding problems

Aims. The study investigated factors empowering women to continue breastfeeding despite experiencing extraordinary difficulties. The study documented the experiences and characteristics of women who continued to breastfeed (continuing cohort) and those who weaned (non-continuing cohort) despite extraordinary difficulties. Design. Retrospective case control. Methods. The study was undertaken in south-east Queensland, Australia in 2004. Forty women (20 in each cohort) were recruited over six months. Both quantitative (breastfeeding knowledge questionnaire) and qualitative (semi-structured interviews) data were collected. This paper describes the qualitative data. Results. Women from both cohorts expressed idealistic expectations about breastfeeding and experienced psychological distress due to their breastfeeding problems. Those who continued breastfeeding used coping strategies and exhibited personal qualities that assisted them to overcome the difficulties experienced. Women who continued to breastfeed were more likely to report relying on a health professional they could trust for support. This latter cohort were also more likely to report having peers with which they shared their experiences. Non-continuing women expressed feelings of guilt and inadequacy following weaning and were more likely to feel isolated. Conclusions. This study has highlighted the methods women use to deal with breastfeeding problems. It has also revealed modificable factors that can improve breastfeeding duration. Relevance to clinical practice. The findings indicate that clinicians should:

• • Provide information which accurately reflects the breastfeeding experience;
• • Ensure systems are in place so that effective postnatal support for breastfeeding difficulties is available;
• • Consider screening to ascertain levels of psychological distress, sadness and disillusionment among breastfeeding women;
• • Design educational interventions with elements of cognitive skills, problem-solving and self-efficacy training to equip women with the skills to overcome any experienced difficulties.

     

Vasomotricité pulmonaire (2e partie): contrôle neurohumoral

• •- Neurologic control of lung vascular tone
  • ◦• Cholinergic system:
    • -- mediators
    • -- muscarinic receptors
    • -- mechanisms of action
  • ◦• Non-adrenergic non-cholinergic system:
    • -- definition
    • -- mediators
  • ◦• Reflex mechanisms
  • ◦• Interactions between endothelium and neural mechanisms

• •- Humoral control of lung vascular tone
  • ◦• Atrial natriuretic peptide
  • ◦• Vasopressin
  • ◦• Angiotensin-II
  • ◦• Kinins
  • ◦• Histamine
  • ◦• Serotonin
  • ◦• Free radicals:
    • -- hydrogen peroxide
    • -- superoxide anion
    • -- peroxinitrite

     

Effect of omega-3 fatty acids supplementation on anthropometric indices in children and adolescents: A systematic review and meta-analysis of randomized controlled trials

• •Background Childhood obesity is a major public health problem with a global prevalence greater than 23 %. Omega-3 polyunsaturated fatty acids (omega-3 FAs) supplementation may improve anthropometric indices by increased energy expenditure, attenuated appetite, elevated adiponectin levels, though current evidence is still inconclusive.
• •Objective The aim of this systematic review was to conduct the first comprehensive meta-analysis of randomized controlled trials on the association between omega-3 FAs supplementation and anthropometric indices in children and adolescents.
• •Methods We performed an extensive online database search of the published literature using the SCOPUS, Web of Science, PubMed, EMBASE, and Cochrane library databases from the index date through April 2019. Six studies met inclusion criteria. Changes in anthropometric indices (weight, BMI and waist circumference) were extracted from each article. Statistical heterogeneity was assessed by calculating the I² statistic. We used the standardized mean difference (SMD) with 95 % confidence interval. The meta-analysis was performed based on a random effects model.
• •Results This meta-analysis demonstrated that omega-3 FAs supplementation had no effect on reducing body weight (SMD = -0.00, 95 % CI -0.26 to 0.25), BMI (SMD = -0.07, 95 % CI -0.32 to 0.17) and waist circumference (SMD = -0.16, 95 % CI -0.51 to 0.19).
• •Conclusions Omega-3 FAs supplementation did not change anthropometric indices in children and adolescents. Further large-scale studies with larger sample sizes in children and adolescents are needed to clarify the effects of omega-3 FAs.

     

Work-related barriers and resources of migrant and autochthonous homecare nurses in Germany: A qualitative comparative study

BackgroundThere is substantial research about the occupational health of nurses worldwide. However, empirical evidence about the psychosocial health of migrant and minority nurses in outpatient settings in Germany in comparison to that of autochthonous nurses is lacking.ObjectivesThis study aims to identify work-related stressors, resources and the corresponding coping strategies of migrant and minority nurses in comparison to autochthonous nurses.Design24 migrant and 24 autochthonous nurses employed in the German homecare sector were interviewed in qualitative explorative manner while a distinction was made between non-commercial and private-commercial services.SettingsThe interviews took place in the nursing services' premises or in the nurses' private homes.ParticipantsServices were randomly chosen among all homecare providers in the second largest German federal city-state Hamburg. Nurses were invited for an interview, once their management agreed to participate in the study. Registered nurses and nursing assistants as well as those with a foreign certificate but validated or in process were eligible to participate.MethodsRelevant literature findings formed the base for the semi-structured interview guide. Key areas in the interview guide were barriers, resources and coping strategies in the collaboration with colleagues, superiors and clients as well as in the collaboration within a linguistically and culturally diverse team and clients. The conventional approach to qualitative content analysis by Hsieh and Shannon guided the analysis.ResultsRegardless of their origin or culture, nurses perceive time pressure, lifting patients, lack of appreciation or the client's personal fate as burdening. In the intercultural context, the divergent understanding of behavioral patterns as well as of nursing care and a non-functioning communication impede the collaboration within a diverse nursing workforce. Migrant and minority nurses suffer prejudices, verbal and sexual harassment proceeding from their clients. However they keep it to themselves and don't broach it to their supervisors or colleagues. The interaction with humans, the verbal exchange with colleagues and supervisors at eye level as well as the sensemaking of being a nurse helps nurses to cope with occupational stressors.ConclusionsDifferences in language is a main stressor which impedes a functioning team collaboration as well as a positive nurse-client relationship. Migrant and autochthonous nurses share similar coping strategies to master occupational burdens. A good collaboration within the team and having an appreciative supervisor are resources that support migrant and minority nurses as well as autochthonous nurses to face the stressors and to cope with those. Migrant nurses of different origin perceive their status as migrants as a sense of community by sharing commonalities.Contribution of the paperWhat is already known about the topic?

• •The growing demand for care due to the demographic change leads to an increasing trend to hire healthcare personnel such as nurses from abroad.
• •The nurses' workplace is characterized by physically and psychologically demanding tasks leading to musculoskeletal pain and job dissatisfaction.
• •Migrant healthcare workers experience additional stressors like discrimination practices as well acculturative stress.

What this paper adds:

• •Migrant and Autochthonous nurses share similar coping strategies to master occupational burdens
• •Differences in language is a main stressor, which impedes a functioning team collaboration as well as a working nurse-client relationship. More autochthonous than migrant and minority nurses report these differences as stressful.
• •Migrant nurses of different origin perceive their status as migrants as a sense of community by sharing the same destiny – this appears as an important resource for migrant and minority nurses.

     

A review on cardiovascular effects of newer hypoglycaemic medications

Cardiovascular disease (CVD) is the most prevalent cause of morbidity and mortality in diabetic patients. Improvement in cardiovascular complications with glycaemic control and managing cardiovascular risk factors is well established. However, the impact of hypoglycaemic medications on CVD is of increasing importance. In 2008, the U.S. Food and Drug Administration issued study regulations for hypoglycaemic agents after rosiglitazone was shown to increase the incidence of myocardial infarction, and the European Medicines Agency provided their own guidance in 2012. As a result, multiple studies have been published evaluating the cardiovascular safety of newer hypoglycaemic medications. Empagliflozin and liraglutide are among the newer agents that have shown cardiovascular benefit and are now recommended for patients with CVD or are at an increased risk of CVD per the 2017 American Diabetes Association Guidelines. Given the influx of new literature and other ongoing studies, it is important to understand the cardiovascular safety of newer hypoglycaemic medications. The purpose of this article is to provide a comprehensive review of clinical trials conducted evaluating cardiovascular outcomes of newer hypoglycaemic medications and their role within diabetic management.

• Key Messages

• With the prevalence of cardiovascular disease in diabetic patients, clinicians should develop a medication regimen that provides both sufficient efficacy for diabetes while also maintaining cardiovascular safety.

• Of the new diabetic classes, empagliflozin, a sodium-glucose co-transporter 2 inhibitor, and liraglutide, a glucagon-like peptide-1 receptor agonist, have shown cardiovascular benefit in diabetic patients with established cardiovascular disease and are now recommended in current guidelines for this population.

• Ongoing trials will give more insight to whether cardiovascular benefit is a class effect with sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide-1 receptor agonists and the cardiovascular safety of dipeptidyl peptidase-4 inhibitors.