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To assess current practice and provide a basis for a provincial template, clinicians at a Canadian pediatric hospice reviewed the literature surrounding pediatric advance care planning (pACP) documentation, process, and implementation for children/youth. The scoping review protocol was developed in accordance with the Joanna Briggs Institute methodology for scoping reviews, and was prospectively registered on the Open Science Framework. MEDLINE, Embase, CINAHL, the Web of Science Core Collection, and Google Scholar, as well as sources of unpublished studies and grey literature, were reviewed. Sixty-four articles met the criteria. Fifteen pACP documentation forms/tools were also identified. Overall, the included articles highlighted that pACP should be a structured, collaborative and iterative process between the family and a trusted or relevant healthcare provider, encompassing medical and non-medical issues. Few articles provided insights into specific elements recommended for advance directive forms. Identified strategies for implementation included a structured, step-by-step pACP interventional tool along with ongoing training, mentorship, and defined organizational structures for the clinician. No single specific ACP tool was acknowledged as the gold standard. Use of a pACP tool, along with ongoing provider education and communication skill development, standardized/accessible documentation, and system-wide quality improvement support, were noted as integral components of pACP.
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BACKGROUND: Phytoremediation is determined as an emerging green technology suitable for the safe remediation and restoration of polluted terrestrial and aquatic environments. In this study, the assessment of an ornamental plant, Vinca rosea L., as a phytoremediator of crude oil in polluted soils was conducted. In an open greenhouse experiment, plants were raised in sandy-clayey soils treated with 1, 3, 5, and 7% oil by weight. The experiment was conducted over 5 months. RESULTS: Total petroleum hydrocarbon (TPH) degradation percentage by V. rosea after a 5-month growth period ranged from 86.83 ± 0.44% to 59.05% ± 0.45% in soil treated with 1 and 7%, respectively. Plants raised in polluted soils demonstrated a dramatic reduction in germination rates, in addition to growth inhibition outcomes shown from decreased plant height. An increase in branching was observed with an increase in oil pollution percentages. Moreover, the phytomass allocated to the leaves was higher, while the phytomass witnessed lower values for fine roots, flowering and fruiting when compared to the controls. Apart from the apparent morphological changes, there was a decrease in chlorophyll a/b ratio, which was inversely proportional to the oil pollution level. The contents of carotenoids, tannins, phenolics, flavonoids, and antioxidant capacity were elevated directly with an increase in oil pollution level. The start codon-targeted (SCoT) polymorphisms and inter-simple sequence repeat (ISSR) primers showed the molecular variations between the control and plants raised in polluted soils. The genetic similarity and genomic DNA stability were negatively affected by increased levels of crude oil pollution. CONCLUSIONS: The ability of V. rosea to degrade TPH and balance the increased or decreased plant functional traits at the macro and micro levels of plant structure in response to crude oil pollution supports the use of the species for phytoremediation of crude oil-polluted sites. The genotoxic effects of crude oil on V. rosea still require further investigation. Further studies are required to demonstrate the mechanism of phenolic, flavonoid, and antioxidant compounds in the protection of plants against crude oil pollution stress. Testing different molecular markers and studying the differentially expressed genes will help understand the behavior of genetic polymorphism and stress-resistant genes in response to crude oil pollution.
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Chitosan (CS) has received great attention in tissue engineering, especially in wound healing acceleration. In this study, chitin was isolated from desert locust (Schistocerca gregaria) and shrimp (Penaeus monodon) then deacetylated to chitosan. Then, chitosan was characterized by degree of deacetylation (DD), molecular weight (M.Wt), swelling index (SI), Fourier transform infrared (FTIR) and X ray diffraction (XRD). The chitosan was then casted into 2D scaffolds and was pictured using scanning electron microscope (SEM). In a comparative study, primary cell cultures of neonatal (1-2day old) mice skin tissue, supplemented with 10% fetal calf serum, were seeded onto locust chitosan based scaffolds (LCSBS) and shrimp chitosan based scaffold (SCSBS). Their attachment percentage was determined after 1h. The cell proliferation rate was tested for 5days on LCSBS and SCSBS. Wound healing activity progress of LCSBS and SCSBS was tested in vivo using histopathology, and results revealed that seeded and unseeded LCSBS accelerated healing in contrast to SCSBS. The data demonstrated that LCSBS shows a high degree of biocompatibility in vivo. These results suggest that LCSBS is a potential substitute for the development of low cost implantable materials to accelerate wound healing.
Assuntos
Quitosana/farmacologia , Gafanhotos/química , Penaeidae/química , Alicerces Teciduais/química , Cicatrização/efeitos dos fármacos , Animais , Adesão Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Camundongos , Porosidade , Pele/citologia , Pele/efeitos dos fármacosRESUMO
Screening, brief intervention, and referral to treatment (SBIRT) is an important and effective strategy among injury prevention measures aimed at reducing risky alcohol use (). The trauma patient population is at significant risk for alcohol-related trauma recidivism () and is therefore a priority group in which to implement SBIRT. Vancouver General Hospital (VGH) implemented SBIRT on its 2 inpatient trauma units in the fall of 2014. The alcohol use disorders screening test (AUDIT-C) was chosen as the screening tool for nurses to complete with new patients. A brief intervention was conducted by the trauma social workers in the cases where a patient scored positive on the AUDIT-C. To evaluate the implementation and effectiveness of SBIRT on the 2 inpatient trauma units at VGH and to provide recommendations for improvement, a telephone survey of past trauma patients and a review of the screening process were undertaken in May 2016. Patient follow-up was conducted via a telephone survey. Of the 79 patients who met the follow-up criteria, a total of 19 were successfully contacted. Results from the survey showed that the majority of patients did not recall being screened with the AUDIT-C and were either unsure or did not recall receiving a brief intervention by the social worker. Despite these findings, a rescreening with the AUDIT-C tool revealed that 68% of patients who participated in the survey had a lower score than when they were inpatients. Recommendations for improvement include optimizing the timing of SBIRT with trauma inpatients and implementing a follow-up system. The literature suggests that following up with patients to provide an SBIRT "booster" increases the effectiveness of brief interventions (C. ).