Exploring the implementation of child life services with facility dogs.

Many children's hospitals around the United States have programs in which a trained facility dog goes to work daily with a psychosocial healthcare worker, typically a Certified Child Life Specialist (CCLS). CCLSs help children and their families cope with the stress of a healthcare experience by utilizing evidence-based, developmentally appropriate interventions. The purpose of this study was to explore how CCLSs incorporate facility dogs into their treatments and gain their perspectives on handling a facility dog. Participants, four CCLSs, completed a checklist, which assessed patients seen by facility dogs for 10 workdays, and a semi-structured interview. Participants primarily saw patients of ages three to five years and aided with general anxiety and coping support. Findings indicated the dog's specific training, therapeutic value, and ability to bond with patients allowed these interactions to be successful and impactful. This study provides information about the benefits of facility dogs for child life programs and presents data for programs that are considering incorporating this therapeutic modality into their services offered.

The impact of the COVID-19 pandemic on people with diabetes and diabetes services: A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium.

AIM: To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe. METHODS: An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks. RESULTS: Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n = 504) and 48% (n = 873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n = 1486); diabetes distress 65% (n = 1189); depression 49% (n = 893); acute hyperglycaemia 39% (n = 710) and foot complications 18% (n = 323). Forty-seven percent (n = 771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n = 499), 63% (n = 1,027) and 34% (n = 551), respectively. CONCLUSION: The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues, we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.

Chitosan based polymer/bioglass composites for tissue engineering applications.

Composite scaffolds formed from polymers and bioglasses have been widely explored for applications in regenerative medicine as they have suitable organic/inorganic structures and properties similar to human hard tissue. Yet, these materials have only been used for non-load-bearing or low load-bearing purposes as they have limited mechanical strength while research is focused on improving their properties. One method of improving mechanical strength is by covalently bonding the organic and inorganic phases. This has been successfully achieved in Class ll hybrids which have covalent bonding between polymers and bioglasses. As well as improving mechanical strength, the chemical connection of the two phases results in simultaneous degradation. The currently available composite scaffolds use collagen for the polymer phase which can cause allergic reactions and transmit pathogens. An alternative natural polymer is chitosan which has been used to create scaffolds with bioglass avoiding the issues arising from collagen. Additionally, using cross-linking agents has been shown to strengthen chitosan hydrogels improving their mechanical properties. A promising natural cross-linker is genipin which has lower toxicity than other cross-linking agents while producing hydrogels with improved mechanical properties compared to pure chitosan. In this paper we offer an overview of requirements, structures and currently available composite scaffolds for tissue engineering applications. We discuss the limitations of the currently available materials and consider the potential of covalently bonded hybrids particularly in relation to chitosan-based materials and the added benefits of genipin cross-linking.

The Effect of Temperature on Selectivity in the Oscillatory Mode of the Phenylacetylene Oxidative Carbonylation Reaction.

Reaction temperature plays a major role in product selectivity in the oscillatory mode of the palladium-catalyzed phenylacetylene oxidative carbonylation reaction. At 40 °C, dimethyl (2Z)-2-phenyl-2-butenedioate is the major product whereas at 0 °C the major product is 5,5-dimethoxy-3-phenyl-2(5H)-furanone. The occurrence of oscillations in pH coincides with an increase in the rate of phenylacetylene consumption and associated product formation. Experiments were performed isothermally in a reaction calorimeter to correlate reactant consumption and product formation with the occurrence of pH oscillations and the heat released by the reaction. An increase in the size of the pH drop in a single oscillation correlates with an increase in energy, indicating that this section of a single oscillation relates to reactant consumption. Based on these observations, a reaction pathway responsible for product formation is provided.

Approaches to the prevention of type 2 diabetes in Gibraltar.

The incidence of type 2 diabetes mellitus is rising worldwide, with the number of people with the condition expected to reach 552 million by 2030. This is largely due to changing demographics, ageing populations and a worldwide increase in obesity rates. This article explores diabetes in Gibraltar. The main focus is the incidence of type 2 diabetes, in the context of the characteristics of the adult population and how these relate to risk factors, such as obesity, smoking and genetics. Thereis a brief exploration of the history of Gibraltar and how its particular circumstances may account for an increased incidence of diabetes. Finally, the evolution of the local diabetes service and future developments are discussed, along with innovative approaches to diabetes prevention, which may be adapted for use in other communities.

Normative data for three tests of visuocognitive function in primary school children: cross-sectional study.

BACKGROUND/AIMS: There is an increasing recognition that visuocognitive difficulties occur in children with neurodevelopmental problems. We obtained normative data for the performance of primary school children using three tests of visuocognitive function that are practicable in a clinical setting. METHODS: We tested 214 children aged between 4 and 11 years without known developmental problems, using tests to assess (1) orientation recognition and adaptive movement (postbox task), (2) object recognition (rectangles task) and (3) spatial integration (contours task). RESULTS: 96% could do the postbox task with ease-only 4% (all aged <9 years) exhibited minor difficulties. Errors in the rectangles task decreased with age: 33% of children aged 4-5 years had major difficulties but >99% of children aged ≥6 years had no, or minor, difficulties. Median scores for the contours task improved with age, and after age 8 years, 99% could see the contour using long-range spatial integration rather than density. CONCLUSIONS: These different aspects of children's visuocognitive performance were testable in a field setting. The data provide a benchmark by which to judge performance of children with neurodevelopmental problems and may be useful in assessment with a view to providing effective supportive strategies for children whose visuocognitive skills are lower than the expectation for their age.

Interactions of atropine with heterologously expressed and native alpha 3 subunit-containing nicotinic acetylcholine receptors.

(1) Atropine, a classical muscarinic antagonist, has been reported previously to inhibit neuronal nicotinic acetylcholine receptors (nAChRs). In the present study, the action of atropine has been examined on alpha3beta4 receptors expressed heterologously in Xenopus oocytes and native nAChRs in medial habenula neurons. (2) At concentrations of atropine often used to inhibit muscarinic receptors (1 micro M), responses induced by near-maximal nicotine concentrations (100 micro M) at negative holding potentials (-65 mV) are inhibited (14-30%) in a reversible manner in both alpha4 and alpha3 subunit-containing heteromeric nAChRs. Half-maximal effective concentrations (IC(50) values) for atropine inhibition are similar for the four classes of heteromeric receptors studied (4-13 micro M). (3) For alpha3beta4 nAChRs in oocytes, inhibition by atropine (10 micro M) is not overcome at higher concentrations of agonist, and is increased with membrane hyperpolarization. These results are consistent with non-competitive antagonism--possibly ion channel block. (4) At low concentrations of both nicotine (10 micro M) and atropine (<10 micro M), potentiation ( approximately 25%) of alpha3beta4 nAChR responses in oocytes is observed. The relative balance between potentiation and inhibition is dependent upon membrane potential. (5) In rat medial habenula (MHb) neurons, atropine (0.3-3.0 micro M) inhibited nicotine-induced responses in both a concentration and membrane potential-dependent manner (at -40 mV, IC(50)=4 micro M), similar to the effects on alpha3beta4-nAChRs in oocytes. However, unlike heterologously expressed receptors, potentiation was barely detectable at depolarized membrane potentials using low concentrations of nicotine (3-10 micro M). Conversely, the weak agonist, choline (1-3 mM) was observed to augment responses of MHb nAChRs.