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More engaging teaching and learning strategies are needed to teach research-related courses to pre-registration nursing students. Team-based learning was implemented within a second year pre-registration nursing evidence-informed decision making course. Results from a questionnaire survey indicated that 70% believed team-based learning was appropriate for the course, 60% that it was an effective and motivating learning strategy, and 54% recommended using team-based learning in other courses. The results from ten student interviews illustrated the positive way in which team-based learning was perceived, and how the students thought it contributed to their learning. Test results were improved with an increase in the numbers of students achieving 70% or higher; and higher scores for students in the lowest quartile. Team-based learning was shown to be an effective strategy that preserved the benefits of small group teaching with large student groups. [ABSTRACT FROM AUTHOR]

Background Team-based learning was selected as a strategy to help engage pre-registration undergraduate nursing students in a second-year evidence-informed decision making course. Objectives To detail the preparatory work required to deliver a team-based learning course; and to explore the perceptions of the teaching team of their first experience using team-based learning. Design Descriptive evaluation. Methods Information was extracted from a checklist and process document developed by the course leader to document the work required prior to and during implementation. Members of the teaching team were interviewed by a research assistant at the end of the course using a structured interview schedule to explore perceptions of first time implementation. Results There were nine months between the time the decision was made to use team-based learning and the first day of the course. Approximately 60 days were needed to reconfigure the course for team-based learning delivery, develop the knowledge and expertise of the teaching team, and develop and review the resources required for the students and the teaching team. This reduced to around 12 days for the subsequent delivery. Interview data indicated that the teaching team were positive about team-based learning, felt prepared for the course delivery and did not identify any major problems during this first implementation. Conclusions Implementation of team-based learning required time and effort to prepare the course materials and the teaching team. The teaching team felt well prepared, were positive about using team-based learning and did not identify any major difficulties. [ABSTRACT FROM AUTHOR]

A survey of 246 pre-registration nursing students in a University in the South West of England was carried out to explore the impact of course related travel on the student experience. Results from the survey indicated that students' main mode of transport to practice placements was by car which reflects the rural nature of the South West and the relative paucity of public transport. Long distances that many students travel to their study centre and to placements, and the concurrent financial strain that this creates, impacted negatively on the student experience. Students recognised the need to travel to a place of study and clinical placements and suggestions of minimising the negative impact of travel were offered. These included the increased use of electronic delivery of lectures, attendance at local university premises, the provision of shared transport to placements and placements closer to the student's home. Few students, however, considered the environmental impact of travel. Higher Education Institutions need to address issues of sustainability through promoting student wellbeing and taking steps to reduce greenhouse gas emissions. It is therefore important that student awareness of sustainability related issues is increased as well as focusing on reducing the environmental impact through organisational change. [ABSTRACT FROM AUTHOR]

Summary: Elevated hospital noise levels potentially affect communication, stress levels, aggressive behaviour and sleep during treatment. However, few studies have measured noise in the emergency department (ED). In an Australian context, study investigators aimed to assess noise levels in multiple clinical care areas of the ED. Data was collected in decibels (dB) in six ED patient locations over 24hours. Recorded data was analysed and compared across locations and over time, in the light of World Health Organization (WHO) and Australian noise standards. The 24-hour average sound levels varied between 64.0 and 55.8dB, with some diurnal variation in noise levels, thereby consistently exceeding recommended levels. Such high noise levels could potentially affect patient care and well-being whilst in the ED. [Copyright &y& Elsevier]

Abstract: This paper updates results of an international study aimed at quantifying the links between transport disadvantage (TD), social exclusion (SE) and well-being (WB) in Melbourne, Australia. The study extends knowledge associated with SE and transport by quantify social and behavioural implications of lack of public and private transport and the nature of the social WB benefits associated with improving services. Study aims and methodology are outlined. Recent findings covered relate to car ownership on the urban fringe, patterns of transport disadvantage, the analysis of time poverty related to transport disadvantage, measuring the economic value of additional mobility and use of a Structural Equation Model (SEM) to relate WB and SE to TD and a series of explanatory factors. Overall results suggest that those without a car on the urban fringe adjust well with their circumstances by living close to activity centres. They demonstrate sustainable choices, trading off budgets and home location to balance mobility and accessibility. Poorer households with high car ownership value mobility and cheaper more remote fringe dwellings but demonstrate numerous strategies to reduce high car costs which are acknowledged as a significant burden. Analysis identifies 4 key types of transport disadvantage including a ‘vulnerable/impaired’ group which should be of much greater concern for targeted policy than others due to poor scoring on SE and WB scales. The economic value of new mobility is also explored with results suggesting $AUD 20 per average new trip which is four times larger than conventional values for generated travel. Analysis has also suggested that transport disadvantage can relate to socially advantaged as well as socially disadvantaged groups through time poverty. This was found to be an important mitigating factor when relating TD to WB. A statistically reliable structural equation model is developed suggesting the SE-WB link is strong (−.87) with a modest link between TD-SE (.27). Areas for future research in the project are also summarised. [Copyright &y& Elsevier]

Summary: Providing education to nursing staff in a meaningful, timely, standardised and coordinated manner is a challenge for managers and educators of most emergency departments. The pressures of workload and diminished personnel resources have made providing education increasingly difficult. Education programs can become inequitable, spasmodic, interrupted, and have varying standards. In an area health service in Sydney''s South West, a coordinated approach to address the development, coordination, delivery and evaluation of education in the six emergency departments was developed. This education approach began in the late 1990s when the Nurse educator at the major referral hospital brought together educational representatives (clinical nurse educator or clinical nurse specialist) from each of the six emergency departments. This group became known as South Western Sydney Area Health Service Emergency Educators Committee (SEEC). This group has continued to grow and develop and is now well recognised across the area health service as the group responsible for managing emergency department education. [Copyright &y& Elsevier]

Summary: Background: A degree level EBP module is undertaken by students on post-qualifying programmes to develop critical appraisal skills gained at diploma level. Despite training in EBP skills, there is some suggestion that health care professionals lack confidence in this area and fail to make the links between evidence and practice. The purpose of this study was to investigate this issue further. Aims: To identify how the EBP skills developed on the module were utilised in practice, and to identify what local barriers there were in using these skills. Methods: A survey of all students who had completed the module within the past three years (n =393) followed by interviews to explore further issues that emerged from the survey. Results: One hundred and ninety one completed questionnaires (48.6% response rate). The results showed that the students perceived themselves as ‘quite skilled’ or ‘competent’ with regard to the key EBP skills, and that completion of the module had contributed ‘greatly’ to this skill acquisition. Results from the interviews showed that time and cultural issues were the greatest barriers to using and developing further the EBP skills gained. Conclusions: The value of the module was apparent. For skills to be developed further in the work place, cultural changes need to occur. [Copyright &y& Elsevier]

Several studies have suggested a lack of correlation between sunscreen sun protection factor and protection of the skin immune system, potentially allowing greater damage to the skin by removing the natural protective erythemal response to sun exposure. Despite this, routine testing of immune protection afforded by sunscreens is not performed by industry. Current laboratory methods for investigating the efficacy of sunscreen protection of epidermal immune function use the induction of contact hypersensitivity or epidermal cell alloantigen presentation. Animal models, cell culture systems, and in vivo human studies are commonly employed, but all these systems have significant drawbacks for use in routine testing. The purpose of this study was to develop an in vitro system for testing the immunologic protection afforded by sunscreens in human skin. Five test sunscreens plus a vehicle control were tested in a "blind" fashion for theft in vitro level of immune protection. Creams were applied in a standard manner to human whole skin explants and were irradiated over a range of physiologic doses using an Oriel solar simulator. A mixed epidermal lymphocyte reaction was used to quantify epidermal alloantigen-presenting capacity, in the presence or absence of test cream, for five explants. Results consistently demonstrated that all the test sunscreens protected beyond their designated sun protection factors, whereas the vehicle conferred no protection. The explant-mixed epidermal lymphocyte reaction system gave consistent, reproducible results and may prove useful for the allocation of an immune protection factor to all sunscreens. [ABSTRACT FROM AUTHOR]

Our knowledge of the functional activity of the epidermal Langerhans cell has been severely hampered by the lack of an easy method of purification of these cells that is both efficient and reproducible. In the present study we have used immunomagnetic beads directly conjugated to an IgM class mouse anti-human human leukocyte antigen DR monoclonal anti-body to positively select human Langerhans cells from an epidermal cell suspension. Cells were then treated with a high-affinity polyclonal anti-mouse immunoglobulin that detached the beads by competing with the antigen for the antigen-binding site on the monoclonal antibody. This procedure allowed removal of the immunomagnetic beads, leaving Langerhans cells free from bound antibody. Recovery of Langerhans cells ranged from 40 to 80% of the starting number of Langerhans cells. The resulting cells were up to 99% CD1a positive and showed potent functional activity in the allogeneic mixed epidermal cell-lymphocyte reaction. Keratinocytes were shown to exert a profound inhibitory effect on Langerhans cell function that could not be prevented by indomethacin. This method is technically simple and allows good recovery of a highly purified population of Langerhans cells that are functionally active. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effects of incorporating fish with 40%- or 30%-fat diets and the differences in response to fish or fish oil ω3 fats. Men with high-normal blood pressure and elevated serum cholesterol were randomly allocated to one of seven diets for 12 wk. Fish or fish oil with a 40%-fat diet increased total cholesterol, HDL cholesterol, HDL2 cholesterol, and LDL cholesterol, and reduced triglycerides. The 30%-fat diet alone reduced cholesterol, LDL cholesterol, and HDL cholesterol, with triglycerides unchanged. Fish with the 30%-fat diet reduced cholesterol, LDL cholesterol, and triglycerides and increased HDL2 cholesterol. This study has shown that plasma lipids are affected similarly by fish or fish oil in men consuming a 40%-fat diet. Adverse effects of ω3 fats on total and LDL cholesterol are reversed by a 30%-fat diet, whereas one daily fish meal substantially lowers triglycerides and reverses the fall in HDL cholesterol that is usual with a low-fat diet. [ABSTRACT FROM AUTHOR]

Nurses should be culturally competent to care appropriately to all patient groups. Whilst there are many opportunities to obtain clinical experiences, there are less curriculum-based opportunities to develop cultural competencies. This multiple cross-sectional study aimed to explore the development of intercultural awareness, knowledge, and competence in two different nursing students' groups (2016 and 2017 program edition) during a one-week study abroad program hosted by a European network of 14 higher education institutions. A questionnaire was designed specifically for the study and reliability established. Factor analysis confirmed three dimensions: perceived benefits, satisfaction, and acquisition of learning outcomes. Fifty-eight students (71.6%) completed the questionnaire for the April 2016 group, and 60 (88.2%) from the April 2017 group. There were minimal differences in responses between the two groups which suggested perceived benefits were retained one year later. Ratings were high for perceived satisfaction, perceived benefits; and the learning outcomes with regard to cultural competencies. Overall, the one-week program was considered a success and students would recommend it to others. This study concludes that a short, one-week study abroad program enabled nursing students to develop individually as well as develop cultural competencies in healthcare. [ABSTRACT FROM AUTHOR]

Summary Scintigraphy using monoclonal antibodies has been suggested as a possible adjunct to conventional staging techniques for the routine staging and diagnosis of Langerhans cell histiocytosis. In this study we have developed a model for Langerhans cell histiocytosis comprising a CD1a-positive subcutaneous xenograft in the flanks of nude (nu/nu) mice. The anti-CD1a murine monoclonal antibody NA1/34 was investigated for its potential both as an imaging and as a therapeutic targeting agent in this model. Biodistribution with NA1/34 compared with irrelevant isotype-matched monoclonal antibody demonstrated specific accumulation within the xenografts of 10.0%id per g (percentage injected dose per gram) and 3.3%id per g at 48 h postinjection, respectively. NA1/34 displayed no specific accumulation to CD1a-negative xenografts. F(ab′)2 fragments of NA1/34 displayed a faster clearance time of 19.6 h compared with the intact antibody, 122.4 h, resulting in a more rapid maximum xenograft uptake time of 5 h compared with 48 h postinjection for the intact antibody. Although the overall xenograft/tissue ratio for the F(ab′)2 was at no time greater than that for the intact antibody, the F(ab′)2 did display dramatically greater xenograft/blood ratios, reaching 19:1 at 120 h postinjection Xenograft regression using single doses of 350 μCi and 500 μCi 131I-labeled NA1/34 significantly (p < 0.001) delayed xenograft progression compared with control nonirradiated xenografts, with average delays of 3.2 and 5.7 times the control, respectively. This study suggests that the anti-CD1a monoclonal antibody, NA1/34, offers advantages in the prognosis and staging of Langerhans cell histiocytosis, in a human setting. We discuss the advantages of radioimmunoscintigraphy over conventional differential diagnostic techniques. The potential for the future radioimmunotherapy of Langerhans cell histiocytosis is also discussed. [ABSTRACT FROM AUTHOR]

Responds to the comments of doctors Francis Gasparro, Peter Wolf and Margaret Kripke on the authors' article about the immunologic protection afforded by sun screens, published in the 'Journal of Investigative Dermatology.' Calculation of the immune protection factor (IPF); Problems in developing an IPF using the methodology in the authors' paper; Sensitivity of the assay used.

The possible inductive effect of epidermal cells on T-cell maturation has been examined employing an in vitro co-cultivation technique. Mononuclear cells from 6 patients with cutaneous T-cell lymphoma (CTCL) and from 12 healthy volunteers were studied. In the 6 CTCL patients, all showed an expansion of the helper T-cell subpopulation and in one patient with leukemic CTCL, there was almost complete replacement of peripheral blood mononuclear cells by malignant cells with a helper T-cell phenotype. Epidermal cells derived from normal human skin were cultured to confluent monolayers, and were cocultivated with the mononuclear cells from CTCL patients or normal controls for 48 h at a density of 106/ml. Following cocultivation, the surface phenotype of the cells from the 12 healthy volunteers and 5 of the patients with CTCL showed no significant phentotypic change. In the patient with leukemic CTCL, however, the surface phenotype of the malignant T cells had changed, with the acquisition of the T6 antigen by the majority of the cells. Cells cocultivated in medium alone and with human fibroblast monolayers showed no change in surface phenotype. The malignant T cells from the leukemic CTCL patient failed to react in a mixed lymphocyte culture to lymphocytes from 2 different healthy donors, and showed no phenotypic change following culture with these lymphocytes, indicating that the phenotypic change seen was not due to allogeneic stimulation. [ABSTRACT FROM AUTHOR]

Astaxanthin is a high value carotenoid produced by some bacteria, a few green algae, several fungi but only a limited number of plants from the genus Adonis . Astaxanthin has been industrially exploited as a feed supplement in poultry farming and aquaculture. Consumption of ketocarotenoids, most notably astaxanthin, is also increasingly associated with a wide range of health benefits, as demonstrated in numerous clinical studies. Currently astaxanthin is produced commercially by chemical synthesis or from algal production systems. Several studies have used a metabolic engineering approach to produce astaxanthin in transgenic plants. Previous attempts to produce transgenic potato tubers biofortified with astaxanthin have met with limited success. In this study we have investigated approaches to optimising tuber astaxanthin content. It is demonstrated that the selection of appropriate parental genotype for transgenic approaches and stacking carotenoid biosynthetic pathway genes with the cauliflower Or gene result in enhanced astaxanthin content, to give six-fold higher tuber astaxanthin content than has been achieved previously. Additionally we demonstrate the effects of growth environment on tuber carotenoid content in both wild type and astaxanthin-producing transgenic lines and describe the associated transcriptome and metabolome restructuring. [ABSTRACT FROM AUTHOR]

Abstract: This paper summarises preliminary results of a study to extend knowledge associated with social exclusion and transport by quantifying social and behavioural implications of lack of public transport and the nature of the social well-being benefits associated with improving services. Metropolitan results are outlined including methodologies exploring the distribution of transport disadvantage in Melbourne, Australia and how this relates to public transport services. An exploration of high car ownership for groups on low income is also presented. Gaps in coverage of public transport are identified and future research outlined. [Copyright &y& Elsevier]