Broad-Spectrum Supramolecularly Reloadable Antimicrobial Coatings.

Antimicrobial surfaces limit the spread of infectious diseases. To date, there is no antimicrobial coating that has widespread use because of short-lived and limited spectrum efficacy, poor resistance to organic material, and/or cost. Here, we present a paint based on waterborne latex particles that is supramolecularly associated with quaternary ammonium compounds (QACs). The optimal supramolecular pairing was first determined by immobilizing selected ions on self-assembled monolayers exposing different groups. The QAC surface loading density was then increased by using polymer brushes. These concepts were adopted to develop inexpensive paints to be applied on many different surfaces. The paint could be employed for healthcare and food production applications. Its slow release of QAC allows for long-lasting antimicrobial action, even in the presence of organic material. Its efficacy lasts for more than 90 washes, and importantly, once lost, it can readily be restored by spraying an aqueous solution of the QAC. We mainly tested cetyltrimethylammonium as QAC as it is already used in consumer care products. Our antimicrobial paint is broad spectrum as it showed excellent antimicrobial efficiency against four bacteria and four viruses.

Bridging Intention and Action for Employee Well-Being Using the Intentional Action (InAct) Process: Workshop-Lecture Series.

BACKGROUND: Employee wellness programs can help manage stress and alleviate burnout. OBJECTIVE: To pilot and disseminate the Intentional Action(InAct) concept for employee wellbeing. METHODS: Five independent interactive workshop-lectures with an automated audience response system. Descriptive analysis of participant response data. RESULTS: Participants (n = 275): rated spirituality, physical environment and nutrition the most highly in contributing to their present well-being. Ninety-eight percent (n = 269) of participants identified a focus area to work on. The well-being area most selected was Exercise, (35% n = 95), however, other non-traditional areas, including Personal and Professional Development (18% n = 48), Relationships and Communication (17% n = 47), were selected, along with mind-body connection and mindful awareness (6% n = 15 and n = 16). CONCLUSION: The pilot engaged employees to reflect and set goals for their future well-being. Healthcare institutions implementing programs should consider a broad range of whole person strategies addressing employee well-being, which go beyond the traditional focus on exercise and nutrition.

Extending the continuum of care poststroke: creating a partnership to provide a community-based wellness program.

Opportunities for individuals poststroke to continue to exercise once formal rehabilitation has ended are limited and in many cases do not exist. Given the incidence of recurrent stroke, and the known and important role exercise plays in reducing stroke risk factors, extending the continuum of care beyond outpatient and home health services to include life-long fitness opportunities for those living with poststroke disability is needed. This article first describes the creation of a partnership between a health care system and a local fitness center to provide an affordable, accessible, safe, community-based exercise program for individuals poststroke and the subsequent development of the flagship program. The second section of this article describes the program's current operations. This includes the referral process, the physical therapists' role in the program's structure and operation, and both program and participant outcomes. This article is intended to provide a roadmap for others who desire to extend the continuum of care for stroke survivors in their community so that these individuals may remain healthy in the presence of disability and reduce their risk for recurrent stroke.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A47) for an overview of the Stroke Wellness Exercise Program.

New directions in neuroregeneration.

Neurons in the adult mammalian central nervous system (CNS) do not spontaneously regenerate their axons after injury. Despite significant progress in the field of axonal regeneration, effective therapeutic strategies to promote functional recovery after injury are not available. The development of novel therapeutics will require further insights into the intrinsic and extrinsic mechanisms that restrict regeneration in the adult CNS. It is equally important that the mechanisms mediating the restoration of axonal connectivity must be determined. This review summarises the known molecular mechanisms of neurite outgrowth inhibition after CNS injury and provides new insights into the potential future direction of neuroregeneration research.

Acceptability and satisfaction using Quick Start with the contraceptive vaginal ring versus an oral contraceptive.

BACKGROUND: Many women discontinue their use of hormonal contraception, and even those who continue so may have difficulty using oral contraceptive pills consistently. New delivery systems, including the vaginal ring, may be easier to use, but user acceptability and satisfaction with these new methods may be affected by women's experience with their bodies. MATERIALS AND METHODS: Data for this study were collected as part of a randomized clinical trial on 201 women comparing immediate start of vaginal ring use with immediate start of low-dose oral contraceptive use. We assessed user satisfaction and method continuation 3 months after ring or pill initiation. RESULTS: At 3 months, 174 of 201 subjects (87%) had follow-up interviews. Among the 174 study participants with follow-up data, 61% of ring subjects and 34% of pill subjects were very satisfied with their methods (p=.003). For posttrial contraception, 79% of ring subjects chose to continue with the ring whereas 59% of pill subjects chose to continue with the pill (p<.001). Women who reported greater comfort in touching their genitals, greater frequency of masturbation, more comfort with intercourse and past use of vaginal contraceptives and products were not more likely than others to be satisfied with the ring or to continue using it for birth control. CONCLUSION: Women who were allocated to vaginal ring use, regardless of their baseline characteristics or behavior, were likely to be highly satisfied with the method and to continue its use.

Bleeding patterns after immediate initiation of an oral compared with a vaginal hormonal contraceptive.

OBJECTIVE: This study compared 84-day bleeding patterns after immediate initiation of a triphasic oral contraceptive with a 25-mug daily dose of ethinyl estradiol (E2) compared with the contraceptive vaginal ring, which has a 15-mug daily dose of ethinyl E2. METHODS: This was an open-label controlled trial. We randomly assigned 201 women to immediate start of a contraceptive pill or immediate start of the ring in a 1:1 allocation ratio. Our primary outcome was difference in mean bleeding-spotting days per woman according to treatment assignment. Secondary outcomes were differences in World Health Organization-defined menstrual indices, differences in perceived bleeding changes, and differences in bleeding according to cycle day at the start of method. RESULTS: The mean bleeding-spotting days in the 84-day reference period for all subjects was 19.2 days (17.0 days for ring users and 21.4 days for pill users, mean difference 4.4 days). Using the World Health Organization menstrual indices, the ring users experienced fewer days or episodes of bleeding-spotting and shorter intervals. Among ring users, no baseline characteristics were associated with bleeding outcomes. Older nulliparous pill users, however, reported more bleeding-spotting days. Significantly more ring users reported a decrease in duration of bleeding compared with pill users (P < .01). We found no significant differences in bleeding patterns based on analysis of cycle day at study enrollment. CONCLUSION: Our study shows advantageous bleeding patterns for subjects using the contraceptive vaginal ring. It also confirms our previous findings that immediate start of hormonal contraception is an acceptable alternative to waiting for menses. LEVEL OF EVIDENCE: II-1.