Technology: A metaparadigm concept of nursing

Undoubtedly, technology continues to permeate the world at an unprecedented pace. The discipline of nursing is not alien to this phenomenon as nurses continue to employ various technological objects and applications in clinical practice, education, administration and research. Despite the centrality of technology in nursing, it has not been recognised as a metaparadigm domain of interest in the discipline of nursing. Thus, this paper sought to examine if technology truly reflected a metaparadigm domain using the four requirements posited by Fawcett. Using these requirements, we examined the onto-epistemology of technology in relation to nursing and conclude that technology potentially represents a distinct domain that intersects with nursing (particularly, from the humanities perspective). Also, technology encompasses some phenomena of interest to the discipline of nursing, demonstrates perspective-neutrality, and is international in scope and substance albeit with some nuances which do not fit well with nursing onto-epistemology. Put together, it is highlighted that technology intersects with the existing metaparadigm domains (person, health, environment and nursing) which positions it as a potential phenomenon of interest to the discipline of nursing requiring further work to articulate its position and role.     

Changing epidemiology of human enteroviruses (HEV) in a hand,foot and mouth disease outbreak in Vellore,south India

PurposeHand Foot and mouth disease (HFMD) is a major childhood exanthematous disease causing outbreaks that have become a major public health threat in recent years. In Vellore district of Tamil Nadu, south India, occasional outbreaks are common among the paediatric age group, most commonly in those under 5years of age (U5s). CoxsackieA6, A4, A5, A9, A10, B2 and B5 are the common serotypes causing outbreaks. This study aimed to identify the molecular serotype of the causative agent, co-circulating in this region.MethodsAdapting the WHO case definition, cases during an HFMD outbreak between October and December 2017, were identified by a clinical criterion of fever, mouth ulcers and rash in the extremities. Vesicle fluid from these lesions were collected in viral transport medium and transported cold to the Clinical Virology laboratory of a tertiary care hospital in Vellore. Identification of the causative agent was undertaken by two real time PCRs (EV1 and EV2) followed by sequencing the VP1–2C region and constructing a phylogenetic tree.ResultsAmong the 31 HFMD patients included in this study, 23 (74.2%) were U5s, 3 (9.7%) were between 6 and 15 years and the remaining 5 (16.1%) were adolescents (>15 ?yrs). The outbreak ran a mild clinical course, with 22(71%) patients having fever as a prodromal symptom. Papulovesicular lesions characteristic of HFMD were present on all 31 (100%) patients’ palms and soles, buttocks of 19 (61.3%), oral mucosa of 12 (38.7%), and all over the body in 4 (12.9%) patients. Coxsackie A6(75%) and Coxsackie A16(25%) were the pathogens associated with this outbreak.ConclusionsChanging epidemiology of HFMD was seen in this outbreak since; other serotypes apart from the classical Coxsackievirus serotypes causing HFMD outbreak were also found co-circulating. EV1 PCR was a better screening assay than EV2 PCR in this region. Continued surveillance and molecular serotyping are necessary for HFMD outbreaks in any region.     

Association between root taper and root proximity of single-rooted teeth with periodontitis: a cone-beam computed tomography based study

Odontology - This study aimed to determine the association between the root taper and proximity of single-rooted teeth with periodontitis using cone-beam computed tomography (CBCT). CBCT images of...     

The frequency of low-risk morbilliform drug eruptions observed in patients treated with different classes of antibiotics

Antibiotics are among the most commonly prescribed medications worldwide but can lead to numerous cutaneous adverse events. Cutaneous adverse drug reactions can range from a common and low-risk morbilliform eruption to severe cutaneous adverse reactions (SCARs) such as toxic epidermal necrolysis. In the hospital setting, patients often start a myriad of new drugs and may be on multiple antibiotics when the dermatologist is consulted. With the current lack of commercially available testing for delayed-type hypersensitivity reactions, etiologic confirmation is challenging. While the Naranjo and other standardized assessment criteria are available, complete scoring is often impossible in hospitalized patients. Further, multiple drugs may have been initiated at the same time point. Therefore, the prevalence of antibiotic-associated drug eruptions often is required to facilitate causality assessments. This review summarizes the prevalence of morbilliform eruptions for the most frequently prescribed antibiotics based upon systematic reviews, retrospective, and prospective analyses, with case series and reports providing other salient details.     

Brief Report: Gender Identity Differences in Autistic Adults: Associations with Perceptual and Socio-cognitive Profiles

Prior research has shown an elevation in autism traits and diagnoses in individuals seen for gender related consultation and in participants self-identifying as transgender. To investigate this relationship between autism and gender identity from a new angle, we compared the self-reported autism traits and sensory differences between participants with autism who did or did not identify with their assigned sex (i.e. cisgender or trans and non-binary, respectively). We found broad elevation of most cognitive autism traits in the trans and non-binary group (those who identified with a gender other than their assigned gender), and lower visual and auditory hypersensitivity. We contrast these data to existing hypotheses and propose a role for autistic resistance to social conditioning.