During simulation-based education, simulators are subjected to procedures composed of a variety of tasks and processes. Simulators should functionally represent a patient in response to the physical ...action of these tasks. The aim of this work was to describe a method for determining whether a simulator does or does not have sufficient functional task alignment (FTA) to be used in a simulation.
Potential performance checklist items were gathered from published arthrocentesis guidelines and aggregated into a performance checklist using Lawshe's method. An expert panel used this performance checklist and an FTA analysis questionnaire to evaluate a simulator's ability to respond to the physical actions required by the performance checklist.
Thirteen items, from a pool of 39, were included on the performance checklist. Experts had mixed reviews of the simulator's FTA and its suitability for use in simulation. Unexpectedly, some positive FTA was found for several tasks where the simulator lacked functionality.
By developing a detailed list of specific tasks required to complete a clinical procedure, and surveying experts on the simulator's response to those actions, educators can gain insight into the simulator's clinical accuracy and suitability. Unexpected of positive FTA ratings of function deficits suggest that further revision of the survey method is required.
Objective:
The objective of this study was to quantify the organizational commitment of sonographers and determine factors influencing their connection or bond with their employer.
Materials and ...Methods:
One thousand nationally credentialed sonographers and vascular technologists in the mid-Atlantic region were surveyed using a systematic sampling model. Measurement tools included the Affective, Continuance, and Normative Commitment Scales. Descriptive and inferential statistics based on stepwise regression were used to define organizational commitment levels and the impact of sociodemographic characteristics on organizational commitment.
Results:
Of the 1000 surveys mailed, 110 usable surveys were returned (11% response rate). Affective, continuance, and normative commitment scores were 4.30, 4.62, and 3.46 out of 7, respectively. Results showed living in Pennsylvania, years at current organization, being a registered cardiac sonographer, and being unmarried had a statistically significant impact upon the variance in sonographers’ organizational commitment scores.
Conclusion:
Sonographers indicated feeling little obligation to remain with the employer but may do so because of the perceived costs of leaving. As a result, sonographers’ performance, work behavior, and attendance may be affected negatively. Factors such as locale, marital status, work tenure, and registration as a cardiac sonographer impact sonographers’ organizational commitment.
Excitotoxicity occurs in a number of pathogenic states including stroke and epilepsy. The adaptations of neuronal circuits in response to such insults may be expected to play an underlying role in ...pathogenesis. Synchronous neuronal firing can be induced in isolated hippocampal slices and involves all regions of this structure, thereby providing a measure of circuit activity. The effect of an excitotoxic insult (kainic acid, KA) on Mg2+-free-induced synchronized neuronal firing was tested in organotypic hippocampal culture by measuring extracellular field activity in CA1 and CA3.
Within 24 hrs of the insult regional specific changes in neuronal firing patterns were evident as: (i) a dramatic reduction in the ability of CA3 to generate firing; and (ii) a contrasting increase in the frequency and duration of synchronized neuronal firing events in CA1. Two distinct processes underlie the increased propensity of CA1 to generate synchronized burst firing; a lack of ability of the CA3 region to 'pace' CA1 resulting in an increased frequency of synchronized events; and a change in the 'intrinsic' properties limited to the CA1 region, which is responsible for increased event duration. Neuronal quantification using NeuN immunoflurescent staining and stereological confocal microscopy revealed no significant cell loss in hippocampal sub regions, suggesting that changes in the properties of neurons within this region were responsible for the KA-mediated excitability changes.
These results provide novel insight into adaptation of hippocampal circuits following excitotoxic injury. KA-mediated disruption of the interplay between CA3 and CA1 clearly increases the propensity to synchronized firing in CA1.
Trichinella surveillance in wildlife relies on muscle digestion of large samples which are logistically difficult to store and transport in remote and tropical regions as well as labour-intensive to ...process. Serological methods such as enzyme-linked immunosorbent assays (ELISAs) offer rapid, cost-effective alternatives for surveillance but should be paired with additional tests because of the high false-positive rates encountered in wildlife. We investigated the utility of ELISAs coupled with Western blot (WB) in providing evidence of Trichinella exposure or infection in wild boar. Serum samples were collected from 673 wild boar from a high- and low-risk region for Trichinella introduction within mainland Australia, which is considered Trichinella-free. Sera were examined using both an 'in-house' and a commercially available indirect-ELISA that used excretory-secretory (E/S) antigens. Cut-off values for positive results were determined using sera from the low-risk population. All wild boar from the high-risk region (352) and 139/321 (43.3%) of the wild boar from the low-risk region were tested by artificial digestion. Testing by Western blot using E/S antigens, and a Trichinella-specific real-time PCR was also carried out on all ELISA-positive samples. The two ELISAs correctly classified all positive controls as well as one naturally infected wild boar from Gabba Island in the Torres Strait. In both the high- and low-risk populations, the ELISA results showed substantial agreement (k-value=0.66) that increased to very good (k-value=0.82) when WB-positive only samples were compared. The results of testing sera collected from the Australian mainland showed the Trichinella seroprevalence was 3.5% (95% C.I. 0.0-8.0) and 2.3% (95% C.I. 0.0-5.6) using the in-house and commercial ELISA coupled with WB respectively. These estimates were significantly higher (P<0.05) than the artificial digestion estimate of 0.0% (95% C.I. 0.0-1.1). Real-time PCR testing of muscle from seropositive animals did not detect Trichinella DNA in any mainland animals, but did reveal the presence of a second larvae-positive wild boar on Gabba Island, supporting its utility as an alternative, highly sensitive method in muscle examination. The serology results suggest Australian wildlife may have been exposed to Trichinella parasites. However, because of the possibility of non-specific reactions with other parasitic infections, more work using well-defined cohorts of positive and negative samples is required. Even if the specificity of the ELISAs is proven to be low, their ability to correctly classify the small number of true positive sera in this study indicates utility in screening wild boar populations for reactive sera which can be followed up with additional testing.
Little is known of the prevalence and life-cycle of trypanosomes in mammals native to Australia. Native Australian trypanosomes have previously been identified in marsupials in the eastern states of ...Australia, with one recent report in brush-tailed bettongs (Bettongia penicillata), or woylie in Western Australia in 2008. This study reports a novel Trypanosoma sp. identified in blood smears, from 7 critically endangered Gilbert's potoroos (Potorous gilbertii) and 3 quokkas (Setonix brachyurus) in Western Australia. Trypanosomes were successfully cultured in vitro and showed morphological characteristics similar to members of the subgenus Herpetosoma. Phylogenetic analysis of 18S rRNA gene sequences identified 2 different novel genotypes A and B that are closely related to trypanosomes previously isolated from a common wombat (Vombatus ursinus) in Victoria, Australia. The new species is proposed to be named Trypanosoma copemani n. sp.
In this paper, we argue that Indigenous data sovereignty (IDS) is vital for addressing threats to ecosystems, as well as for Indigenous Peoples re-establishing and maintaining sovereignty over their ...territories. Indigenous knowledge-holders face pressure from non-Indigenous scientists to collaborate to address environmental problems, while the open data movement is pressuring them to make their data public. We examine the role of IDS in the context of cumulative effects and climate change that threaten salmon-bearing ecosystems in British Columbia, guided by content from an online workshop in June 2022 and attended exclusively by a Tier-1 audience (First Nations knowledge-holders and/or technical staff working for Nations). Attention to data is required for fruitful collaborations between Indigenous communities and non-Indigenous researchers to address the impacts of climate change and the cumulative effects affecting salmon-bearing watersheds in BC. In addition, we provide steps that Indigenous governments can take to assert sovereignty over data, recommendations that external researchers can use to ensure they respect IDS, and questions that external researchers and Indigenous partners can discuss to guide decision-making about data management. Finally, we reflect on what we learned during the process of co-creating materials.
The oscillatory rhythms underlying many physiological and pathological states, including absence seizures, require both the thalamus and cortices for full expression. A co-culture preparation ...combining cortical and thalamic explants provides a unique model for investigating how such oscillations initiate and spread. Here we investigated the dynamics of synchronized thalamocortical activity by simultaneous measurement of field-potential recordings and rapid imaging of Ca2+ transients by fluorescence methods. Spontaneous sustained hypersynchronized “seizure-like” oscillations required reciprocal cortico-thalamocortical connections. Isolated cortical explants can independently develop brief discharges, while thalamic explants alone were unable to do so. Rapid imaging of Ca2+ transients demonstrated deep-layer cortical initiation of oscillatory network activity in both connected and isolated explants. Further, cortical explants derived from a rat model of genetic absence epilepsy showed increased bursting duration consistent with an excitable cortex. We propose that thalamocortical oscillatory network activity initiates in deep layers of the cortex with reciprocal thalamic interconnections enabling sustained hyper-synchronization.
► Measuring network activity in a contained thalamocortical network supports a cortical focus for initiation of such activity ► In vivo preparations lack the ability to sample the whole network simultaneously—a disadvantage the current study overcomes ► Increased cortical excitability is seen in a genetic model of absence epilepsy—supporting this type of excitability as a driver of aberrant seizure activity ► In summary, this paper supports the cortical focus hypothesis of seizure generation in absence seizures.
Changes in the conductance of the hyperpolarization-activated, cyclic nucleotide-gated (HCN) channel that mediates I
h are proposed to contribute to increased network excitability. Synchronous ...neuronal burst activity is a good reflection of network excitability and can be generated in isolated hippocampal slice cultures by removing Mg
2+ from the extracellular fluid. We demonstrate that I
h contributes to this activity by increasing both the frequency and duration of bursting events. Changes in HCN channel function are also implicated in altered seizure susceptibility. Short-term application of kainic acid (KA) is known to initiate long lasting changes in neuronal networks that result in seizures, and in slice cultures was found to alter HCN mRNA levels in an isoform and hippocampal sub-region specific manner. These changes correlate with the ability of each sub-region to develop synchronous burst activity following KA that we have previously reported. Specifically, a loss of synchronous activity in the CA3 correlated with an increase in HCN2 mRNA levels that normalized concomitantly with the restoration of CA3 burst activity 7 days post insult. In contrast, in CA1 an increase in synchronous burst duration correlated with a reduction in HCN2 mRNA levels and both changes were still evident for 7 days post insult. Lamotrigine, known to increase I
h, reversed the impact of KA on burst duration in CA1 at both time-points linking a transcriptional reduction in HCN2 function to increased burst duration.
There are over 200 million reported cases of malaria each year, and most children living in endemic areas will experience multiple episodes of clinical disease before puberty. We set out to ...understand how frequent clinical malaria, which elicits a strong inflammatory response, affects the immune system and whether these modifications are observable in the absence of detectable parasitaemia.
We used a multi-dimensional approach comprising whole blood transcriptomic, cellular and plasma cytokine analyses on a cohort of children living with endemic malaria, but uninfected at sampling, who had been under active surveillance for malaria for 8 years. Children were categorised into two groups depending on the cumulative number of episodes experienced: high (≥ 8) or low (< 5).
We observe that multiple episodes of malaria are associated with modification of the immune system. Children who had experienced a large number of episodes demonstrated upregulation of interferon-inducible genes, a clear increase in circulating levels of the immunoregulatory cytokine IL-10 and enhanced activation of neutrophils, B cells and CD8
T cells.
Transcriptomic analysis together with cytokine and immune cell profiling of peripheral blood can robustly detect immune differences between children with different numbers of prior malaria episodes. Multiple episodes of malaria are associated with modification of the immune system in children. Such immune modifications may have implications for the initiation of subsequent immune responses and the induction of vaccine-mediated protection.
The Breast Surgery Gallery is a unique and innovative computer program of digital photographs depicting sequential images of oncoplastic and prophylactic breast surgery. Specialist breast nurse ...counselors developed the tool to provide education and assist in decision making for people facing oncoplastic and prophylactic breast surgery. This article presents a historical perspective of the development of the gallery and how it can be used during education and counseling. The authors discuss background validation, structure, and testing of the gallery, with case studies that illustrate its flexibility. Data from regular audits of the breast surgery gallery demonstrate the tool's value. The Breast Surgery Gallery is a user-friendly tool that enables patients to make informed decisions while providing realistic photographs of the postoperative recovery phase.
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