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AlN and AlGaN epitaxial films were deposited by metal organic chemical vapor deposition on single crystal AlN substrates processed from AlN boules grown by physical vapor transport. Structural, chemical, and optical characterization demonstrated the high crystalline quality of the films and interfaces. [ABSTRACT FROM AUTHOR]

A case of metastasising colonic carcinoma associated with Peutz-Jeghers syndrome in a 39 year old man is described. The caecal adenocarcinoma had metastasised widely to regional lymph nodes and was associated with several other colonic Peutz-Jeghers polyps, showing no evidence of dysplasia or malignancy. It was not possible to determine whether the carcinoma had arisen from a Peutz-Jeghers polyp. The patient also had gastric and small intestinal polyps. The serum carcinoembryonic antigen (CEA) was normal at presentation in this patient and in one other reported case. The use of this determination as a screening test for so-called high risk groups is, therefore, not supported by this report. The risk of malignancy is not known. It will only be determined by careful follow up of a defined Peutz-Jeghers syndrome population and comparison of carcinoma incidence with a matched sample of the general population. A national registry of Peutz-Jeghers syndrome patients in the United Kingdom would help to resolve this question. [ABSTRACT FROM PUBLISHER]

A letter to the editor is presented in response to an article about the outpatient treatment of ingrowing toenails.

Abstract: Al x Ga1− x N/GaN heterostructures (0≤x≤1) were deposited on (0001)-sapphire by low-pressure (20Torr) organometallic vapor phase epitaxy utilizing a range of group-III precursor and NH3 flow rates and a deposition temperature of 1050°C. The Al-mole fraction of Al x Ga1− x N layers was controlled by variations in the molar flows of triethylgallium (f TEG) and trimethylaluminum (f TMA). Characterization by X-ray diffraction confirmed that increasing the f TMA/f TEG ratio during deposition resulted in increased Al-mole fraction of Al x Ga1− x N layers. A linear relationship between the experimental Al-mole fraction of Al x Ga1− x N layers and the group-III precursor flows was obtained if a correction factor γ was introduced such that x=γf TMA/(γf TMA+f TEG). This correction factor was found to be independent of group-III precursor flows but dependent on NH3 partial pressure. The value of γ for these experiments decreased from 1.4 to 1.0 when the NH3 partial pressure was increased from 0.8 to 16.0Torr during Al x Ga1− x N deposition. The growth rate of Al x Ga1− x N layers was found to be a linear combination of the independent AlN and GaN growth rates when equivalent f TMA and f TEG were utilized under the same deposition conditions. [Copyright &y& Elsevier]

Objective This paper presents a brief description of an activity to redesign a nursing assessment followed by a critique of the practice development process used. Setting Adult acute care general hospital wards. Primary argument Practice development can address shortfalls in clinical practice by using a systematic process to change practice so improving health care. Through the application of a professional development activity addressing assessment the described process provides the basis for a critique that gives directions for ongoing similar activities. Conclusions Directions identified for ongoing practice development activities are: engage all staff in the change process who own the practice; appoint alternative persons with delegated authority for key facilitators; build professional development into the practice change; provide service users (eg patient representatives) with mentoring; develop transformational strategies that address not only the dominant organisational culture but also existing subcultures; and employ an emancipatory practice development process. The main recommendation for practice development in bureaucratic organisations is to develop and establish the evidence base necessary to ensure the process is effective. [ABSTRACT FROM AUTHOR]

The membrane spanning enzyme γ-glutamyl transpeptidase (γ-GT; EC 2.3.2.2) catalyses the breakdown of the tripeptide glutathione and uses free amino acids (AA) to form γ-glutamyl transpeptidase (GT) AA that become transported into cells and converted back into free AA. γ-Glutamyl transpeptidase activity has been shown to be important for mammary AA uptake in rodent systems, and while γ-GT activity is high in lactating bovine mammary tissue, the role of this enzyme in milk protein synthesis of the ruminant has not been defined. The present study shows that γ-GT activity in the ovine mammary gland, like that of rodents, increases during pregnancy and peaks early in lactation. Acivicin, a well-known inhibitor of γ-GT, decreased γGT activity in acini isolated from the ovine mammary gland and did not have secondary toxicity effects on cell viability or the uptake of radiolabeled amino-isobutyric acid. Isolated ovine acini were incubated in the presence of radiolabeled leucine, and incorporation of label into secreted protein increased during incubation. Incubation of acini with acivicin decreased milk protein secretion by 75%, indicating that γ-GT plays an important role in milk protein production in the ruminant. Acivicin did not inhibit secretion of specific caseins but caused a global decrease in individual proteins suggesting that γ-GT may be responsible for providing a complement of AA for milk protein synthesis. [ABSTRACT FROM AUTHOR]

Aim: In 2021, infection control guidelines, including those specific to feeding environments, were introduced by the International Olympic and Paralympic Committees to reduce virus transmission at the Tokyo 2020 Summer and Beijing 2022 Winter games. This observational cross-sectional study aimed to investigate caterers' compliance to these guidelines which included measures for personal hygiene, sanitisation, and physical distancing at these events., Methods: Expert sport dietitians attending Tokyo (n = 15) and Beijing (n = 7) games were surveyed to rate 11 COVID-19 countermeasures as fully (100%), partially or non-compliant at nine dining locations across both events. Descriptive analysis of each countermeasure based on observed compliance and location was conducted and reported as a proportion of the total responses. To better understand participant perspectives of the factors influencing compliance, open responses were systematically coded into themes and sub-themes by researchers through content analysis. Themes generated from participant comments were categorised based on their relevance to specific countermeasures and locations to identify commonalities and disparities in participant experiences, perceptions, and observations., Results: All main dining halls at both events were observed as 100% compliant to countermeasures on more occasions compared with Tokyo's venues and satellite villages. However, Beijing's three main dining halls, showed a greater compliance compared with Tokyo's main dining hall, likely due to overcrowding in Tokyo. Comments suggested that smaller dining spaces, with overcrowding, may have contributed to reduced compliance to physical distancing measures. Food safety concerns were raised about gastrointestinal distress in Beijing due to food cross-contamination., Conclusion: Findings suggest that the food service environment may influence caterers' abilities to comply with foodservice safety and infection control guidelines. In the post-pandemic era, enhanced quality control and standardised risk mitigation strategies are needed to improve athletes' health at international sporting events., (© 2024 The Author(s). Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Australia.)

Concept-based approaches to curriculum design have been proposed to solve content and curricula overload and promote conceptual learning. Few health professions have adopted this approach and little is known about how to support this educational change. We aimed to understand how nutrition and dietetics educators may navigate proposed education change towards concept-based curricula. We employed an interpretivist approach and in-depth interviews that explored the views of nutrition and dietetic educators towards using a concept-based approach to curriculum. Employing deductive thematic analysis based on the diffusion of innovation theory, data from twenty experienced dietetics educators were analysed. Three main themes were identified; the need for change champions, concerns about change, and the complexity of the education system. Diffusion of innovation theory highlighted that to enact change, the relative advantage and compatibility of the approach with current structures and systems, with evidence from trialling and observing the new approach in action, were needed. Developing education leaders and infiltrating the social system of education through existing communities of practice is critical to enacting educational change., (© 2024. The Author(s).)

Abstract: The prevalence of ageism in health care prevents nurses from providing the best care to older adults. Nursing education can prepare nurses to proactively dismantle their own ageist views as well as ageist practices within health care settings. Active learning strategies, such as role-play and case studies, can be used to teach nurses how to become anti-ageism advocates and improve the quality of health care for older adults., Competing Interests: The author has declared no conflict of interest., (Copyright © 2023 National League for Nursing.)

Transthoracic echocardiography (TTE) is widely utilised within many aspects of clinical practice, as such the demand placed on echocardiography services is ever increasing. In an attempt to provide incremental value for patients and standardise patient care, the British Society of Echocardiography in collaboration with the British Heart Valve Society have devised updated guidance for the indications and triaging of adult TTE requests for TTE services to implement into clinical practice., (© 2022. The Author(s).)

Aim: A concept-based approach to dietetic curriculum design has been proposed to prevent content overload and promote critical thinking. Fifty-six concepts were identified in a previous study. The aim of the present study was to investigate whether the dietetic profession views these concepts as representative of current practice and key for nutrition and dietetics education, and identify any new or emerging concepts., Methods: Accredited Practising Dietitians (APDs) were invited to participate in a self-administered online survey that included scale responses on the relevance of the 56 concepts and open-ended suggestions of additional concepts. Respondent characteristics were also collected., Results: Ninety-eight APDs completed the survey. Greater than 65% of respondents agreed/strongly agreed that all 56 concepts were relevant. There was less agreement on the concepts of acid-base balance; leadership; management; physical activity, exercise and health; quality assurance and improvement; risk; safety; stakeholder; standards; sustainability; systems and technology and health informatics. Respondents working in regional, rural and remote areas were less likely to agree that leadership was a key concept (χ 2  = 4.45, P = .035). Respondents working in teaching and education were more likely to agree that sustainability was a key concept (χ 2  = 7.02, P = .008). No new concepts were identified., Conclusions: The existing 56 concepts were considered key for nutrition and dietetics education. Although the respondents to this survey view these concepts as relevant to current practice, this may not represent the entire profession. It is yet to be determined if the concepts will meet future priorities for the dietetic workforce., (© 2021 Dietitians Australia.)