Effectiveness of physical and mental health interventions for young people with heart conditions: protocol for a systematic review and meta-analysis

INTRODUCTION

Cardiovascular disease is among the most common of non-communicable diseases, affecting 13.9 million children and young people (CYP) globally. Survival rates for CYP with heart conditions are rising, however, support for adjusting to life with a heart condition is lacking, as such it is unsurprising that one in three suffer from anxiety, depression or adjustment disorder. The proposed review aims to identify and assess the effectiveness of physical and mental health interventions across physical and mental health outcomes in young people with cardiac conditions using narrative synthesis and meta-analysis if appropriate.

METHODS AND ANALYSIS

Embase, Medline, PubMed, PsycINFO, Cochrane Databases, Web of Science and reference lists of relevant publications will be searched from 1980 to June 2022 for articles published in English or Italian. Screening, data extraction, intervention coding and risk of bias will be performed by two independent reviewers using an extraction checklist. Intervention content and features will be identified and reported using the Template for Intervention Description and Replication checklist. A narrative review of the included studies will be conducted. If possible and appropriate, a random-effects model meta-analysis will be conducted to calculate the pooled within-group and between-group effect sizes for the primary outcome measures. If sufficient data are available, a subgroup meta-analysis will investigate whether specific intervention types are associated with different levels of intervention effectiveness.

ETHICS AND DISSEMINATION

This systematic review does not directly involve the use of human beings, therefore, there is no requirement for ethical approval. Findings will be disseminated through peer-reviewed publication and in various media, such as conferences, congresses or symposia.

PROSPERO REGISTRATION NUMBER

CRD42022330582.

The importance of Antarctic krill in biogeochemical cycles

Antarctic krill (Euphausia superba) are swarming, oceanic crustaceans, up to two inches long, and best known as prey for whales and penguins - but they have another important role. With their large size, high biomass and daily vertical migrations they transport and transform essential nutrients, stimulate primary productivity and influence the carbon sink. Antarctic krill are also fished by the Southern Ocean's largest fishery. Yet how krill fishing impacts nutrient fertilisation and the carbon sink in the Southern Ocean is poorly understood. Our synthesis shows fishery management should consider the influential biogeochemical role of both adult and larval Antarctic krill.

It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis

Background

There is concern that blood pressure (BP) lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis. We assessed the effect of glyceryl trinitrate (GTN) in patients with carotid stenosis using data from the Efficacy of Nitric Oxide in Stroke (ENOS) Trial.

Methods

ENOS randomised 4011 patients with acute stroke and raised systolic BP (140-220 mm Hg) to transdermal GTN or no GTN within 48 hours of onset. Those on prestroke antihypertensives were also randomised to stop or continue their medication for 7 days. The primary outcome was the modified Rankin Scale (mRS) at day 90. Ipsilateral carotid stenosis was split: <30%; 30-<50%; 50-<70%; ≥70%. Data are ORs with 95% CIs adjusted for baseline prognostic factors.

Results

2023 (60.5%) ischaemic stroke participants had carotid imaging. As compared with <30%, ≥70% ipsilateral stenosis was associated with an unfavourable shift in mRS (worse outcome) at 90 days (OR 1.88, 95% CI 1.44 to 2.44, p<0.001). Those with ≥70% stenosis who received GTN versus no GTN had a favourable shift in mRS (OR 0.56, 95% CI 0.34 to 0.93, p=0.024). In those with 50-<70% stenosis, continuing versus stopping prestroke antihypertensives was associated with worse disability, mood, quality of life and cognition at 90 days. Clinical outcomes did not differ across bilateral stenosis groups.

Conclusions

Following ischaemic stroke, severe ipsilateral carotid stenosis is associated with worse functional outcome at 90 days. GTN appears safe in ipsilateral or bilateral carotid stenosis, and might improve outcome in severe ipsilateral carotid stenosis.

Krill faecal pellets drive hidden pulses of particulate organic carbon in the marginal ice zone

The biological carbon pump drives a flux of particulate organic carbon (POC) through the ocean and affects atmospheric levels of carbon dioxide. Short term, episodic flux events are hard to capture with current observational techniques and may thus be underrepresented in POC flux estimates. We model the potential hidden flux of POC originating from Antarctic krill, whose swarming behaviour could result in a major conduit of carbon to depth through their rapid exploitation of phytoplankton blooms and bulk egestion of rapidly sinking faecal pellets (FPs). Our model results suggest a seasonal krill FP export flux of 0.039 GT C across the Southern Ocean marginal ice zone, corresponding to 17-61% (mean 35%) of current satellite-derived export estimates for this zone. The magnitude of our conservatively estimated flux highlights the important role of large, swarming macrozooplankton in POC export and, the need to incorporate such processes more mechanistically to improve model projections.

Volatile components of scent material from cotton-top tamarin (Saguinus o. oedipus) : A chemical and behavioral study

The first chemical analysis of the volatile components of scent material from the cotton-top tamarin,Saguinus o. oedipus is presented. In contrast to our previous findings in saddle-back tamarins (Saguinus fuscicollis), the chemical composition of the scent marks is quite variable. Analysis of secretion expressed manually from different areas of the scent pads of sedated animals shows individual and regional variability. Only three components (squalene, cholesterol, andp-methoxybenzaldehyde) were found in all scent mark samples analyzed. However, suprapubic secretions obtained from one sedated female contained, in addition, 12 butyrate esters as well as five acetate esters which were homologous to the butyrates. The butyrate esters have been previously identified in scent material fromSaguinus fuscicollis. The variability of the composition of the scent material is discussed in relation to the scent-marking behavior of the cotton-top tamarins. Behavioral studies tested the ability of the cotton-top tamarins to discriminate between scent marks from conspecifics and scent marks from saddle-back tamarins. The group of 12 subjects discriminated between the scent marks from both species in choice tests during which they could freely contact the scent samples. However, when scent marks were presented under a screen, so that the subjects could smell but not contact the stimuli, no discrimination was shown. Four individuals displayed more interest in the screened scent stimuli than all other subjects. When these animals were tested in a second experiment for their ability to discriminate between material from the two species on the basis of only volatile cues, it became evident that they were able to do so. These results indicate that volatile cues alone enable the tamarins to recognize scent marks from conspecifics, but that additional cues perceived during contact with the scent are important for its full attractiveness and/or informational content.

First Report of In-Vitro Boscalid-Resistant Isolates of Alternaria solani Causing Early Blight of Potato in Idaho

Early blight of potato (Solanum tuberosum) is caused by Alternaria solani and occurs annually to some degree in Idaho. The timing of its appearance and rate of disease progress determine the impact on the potato crop. Though losses rarely exceed 20%, they can be higher and occur in stored potatoes if the disease is not controlled. Early blight is managed mainly by cultural practices such as plant nutrition, water management, and avoidance of plant stress, but also with the use of foliar fungicides. Currently, the main fungicides labeled for control of early blight are in the carboxamide and strobilurin fungicide groups. Development of resistance to some fungicide groups may contribute to the loss of control of early blight. Isolates of A. solani from Idaho potatoes were tested for resistance to boscalid in the carboxamide group. Diseased potato leaves with early blight symptoms were collected from fields near Parma, Rupert, and Aberdeen in southern Idaho in 2009 and 2010 and Bonners Ferry in northern Idaho in 2010. To obtain A. solani isolates from leaves, small pieces of leaf tissue (5 × 5 mm) were taken from the center of early blight lesions and streaked across the surface of a thin layer (3 mm) of water agar. Plates were incubated at 25°C overnight to allow spores to germinate. Single germinated A. solani spores were transferred to acidified potato dextrose agar and incubated in the dark at 25°C. Germinated spores were identified based on spore morphology. Spores of A. solani can be easily distinguished from other Alternaria spp. found on potato because they are ellipsoid to oblong and taper to a long beak that is usually as long as the spore body. The identity of cultures grown from single spores was confirmed by colony and spore morphology. Sensitivity of A. solani isolates to boscalid was determined by the spiral gradient endpoint method (2). For all isolates, the effective concentration for 50% reduction in growth was outside the range of the spiral plate dilution series (i.e., isolates were either completely insensitive or completely sensitive to boscalid). In total, 46 isolates (20 collected in 2009 and 26 collected in 2010) were tested against boscalid. Experiments were carried out twice with 2009 isolates using mycelial strips and conidial suspensions. Experiments with 2010 isolates were carried out three times using only conidial suspensions. Of the isolates from 2009, 15% were insensitive. There was no difference between the use of mycelial strips or conidial suspensions. In 2010, 62% of isolates were insensitive. By location, 72% of isolates from Parma, 73% from Rupert, 63% from Aberdeen, and 44% from Bonners Ferry were insensitive. Resistance to boscalid has been reported in A. alternata isolates from pistachio (1,3). However, to our knowledge, this is the first report of resistance to boscalid in isolates of A. solani on potato. These data suggest that resistance to boscalid is widespread in Idaho, even in areas like Bonners Ferry where potato cultivation is limited. Boscalid insensitivity in vitro may not translate directly to commercial production and currently there is no evidence to suggest that boscalid has failed to control early blight in Idaho. However, the discovery of insensitive isolates suggests that boscalid should be considered at high risk of resistance development. References: (1) H. Avenot et al. Plant Dis. 91:1345, 2007. (2) H. Förster et al. Phytopathology 94:163, 2004. (3) N. Rosenzweig et al. (Abstr.) Phytopathology 93(suppl.):S75, 2003.

The 1,2,4-triazolyl cation: thermolytic and photolytic studies

The generation of the 1,2,4-triazolyl cation (1) has been attempted by the thermolysis and photolysis of 1-(1,2,4-triazol-4-yl)-2,4,6-trimethylpyridinium tetrafluoroborate (2) and the thermolysis of 1- and 4-diazonium-1,2,4-triazoles, using mainly mesitylene as the trapping agent. Thermolysis of 2 gave mostly 1,2,4-triazole, together with 3-(1,2,4-triazol-4-yl)-2,4,6-trimethylpyridine, 4-(1,2,4-triazol-4-ylmethyl)-2,6-dimethylpyridine, and 4-(2,4,6-trimethylbenzyl)-2,6-dimethylpyridine. Thermolysis of each of the diazonium salts in the presence of mesitylene again gave mainly triazole together with very low yields of 1-(1,2,4-triazol-1-yl)-2,4,6-trimethylbenzene and the corresponding -4-yl isomer in about the same ratio. On the other hand, photolysis of 2 in mesitylene gave mainly 1-(1,2,4-triazol-1-yl)-2,4,6-trimethylbenzene. A photoinduced electron transfer from mesitylene to 2 has been observed and preliminary laser flash photolyses of 2 and the corresponding 2,4,6-triphenylpyridinium salt have been carried out. The observed transients are explained as arising from the first excited states of the pyridinium salts rather than from 1. Ab initio MO calculations are reported and indicate that the predicted electronic ground-state of the triazolyl cation is a triplet state of B1 symmetry with five pi electrons, which corresponds to a diradical cation (1c). Possible mechanisms for the formation of the various products are proposed.

Education of the advanced practice nurse in oncology

PURPOSE/OBJECTIVES

To review the education of the advanced practice nurse (APN) with a focus on curriculum and issues related to the oncology specialization.

DATA SOURCES

The State-of-the-Knowledge Conference on Advanced Practice in Oncology Nursing, journal articles, monographs, and authors' personal experiences.

DATA SYNTHESIS

APN education is a current issue in nursing, as well as in the specialty of oncology nursing. Current trends in the delivery of health care require reform of graduate education in nursing to better prepare APNs to shape and respond to the healthcare needs of the public along the entire cancer care continuum.

CONCLUSIONS

APN education remains a dynamic, ever-evolving enterprise. The Oncology Nursing Society (ONS) and the American Cancer Society (ACS) have taken a proactive stand on APN education by revising master's curriculum guidelines and supporting the conference.

IMPLICATIONS FOR NURSING PRACTICE

APN education in oncology will be an ongoing area of exploration for both ONS and ACS, as well as for leaders in oncology nursing. Development of graduate, postgraduate, and continuing education programs at the APN level of expertise will support high-quality advanced practice in oncology nursing. The feedback mechanisms among practice, education, and research will provide educational programs that will make a difference in the care of patients with cancer.

Spiritual well-being, religiousness and hope among women with breast cancer

The purpose of this study was to clarify spiritual health by examining the role of spiritual well-being (SWB), religiousness and hope in spiritual health. This was accomplished by obtaining questionnaire information from a convenience sample of 175 women diagnosed with breast cancer. Patients classified as intrinsically religious were found to have significantly higher scores on SWB than did those classified as extrinsically religious. There was no difference in hope scores between intrinsically religious and extrinsically religious patients, although hope was positively correlated with SWB. Existential well-being, a component of SWB, was the primary contributor of hope. The two major prognostic variables, stage of disease at diagnosis and number of positive lymph nodes, did not predict any of the scores.

Reliability and validity of the productivity environmental preference survey (PEPS)

This study was conducted to establish the reliability and validity of the Dunn, Dunn, and Price Productivity Environmental Preferences Survey (PEPS) with baccalaureate nursing students and to identify differences between subpopulations (age, class level, sex, type of student (RN versus generic] and students at risk. The findings have implications for nurse educators who choose teaching-learning experiences for a diverse student population.