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Background: Opioid Use Disorder (OUD) has been linked to dopamine and the neurological reward centers. Methylenetetrahydrofolate reductase (MTHFR) is an enzyme involved in the production of many neurotransmitters such as dopamine. As such, MTHFR variants that lead to decreased production of neurotransmitters may play a role in OUD. However, lacunae exist for characterizing the prevalence of the MTHFR mutations in an OUD population. The objective of this study was to determine prevalence of the MTHFR gene mutations in a rural Tennessean population with OUD. Methods: This study was a retrospective cohort of individuals with OUD that evaluated the prevalence of MTHFR variants. Patients were categorized as normal, homozygous C677T, heterozygous C677T, homozygous A1298C, or heterozygous A1298C. The primary outcome was a qualitative comparison of the prevalence of each of the MTHFR variants in our cohort to the publicly reported MTHR polymorphism prevalence. Secondary outcomes include race and ethnicity differences as well as stimulant use differences for each of the variants. Results: A total of 232 patients undergoing care for opioid use disorder were included in the study. Of those included, 30 patients had a normal MTHFR allele and 202 had a variant MTHFR allele. Overall, the prevalence of any MTHFR variant was 87.1% (95% CI 82.6-91.4%). When comparing those with a normal MTHFR allele to those with any MTHFR variant, there was no difference in age, sex, race and ethnicity, or stimulant use. Conclusion: The overall prevalence of MTHFR variants in patients with opioid use disorders is high.

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The emergence of high consequence animal diseases usually requires managing significant mortality. A desirable aspect of any carcass management method is the ability to contain and inactivate the target pathogen. The above-ground burial (AGB) technique was recently developed and proposed as an alternative carcass management method. Here, we investigate the tenacity of swinepox virus (SwPV), as a surrogate model for African swine fever virus (ASFV) in swine carcasses during the AGB process. For this, SwPV was inoculated intrafemorally in 90 adult swine carcasses, which were subsequently disposed under AGB conditions. Bone marrow samples were recovered periodically throughout 12 months and virus viability was assessed by virus isolation (VI), whereas the presence of SwPV DNA was evaluated by quantitative polymerase chain reaction (qPCR). Additionally, an in vitro study assessed the inactivation rate of SwPV, Senecavirus A (SVA), and bovine viral diarrhoea virus (BVDV). Viral suspensions were mixed with bone marrow material and maintained at 21-23°C for 30 days. Virus viability was assessed by VI and viral titration. In the field study, SwPV remained viable only in 11 (55%) bone marrow samples collected on day 7; only viral DNA (and not infectivity) was detected afterwards. SwPV inactivation was estimated to have occurred by day 11. The in vitro testing revealed a variable tenacity of the studied viruses. The viability period was estimated in 28, 80, and 118 days, respectively, for BVDV, SwPV, and SVA. Overall, these findings indicate that the AGB technique was effective in quickly inactivating SwPV. Additionally, the SwPV inactivation rate is comparable to ASFV under field studies and poses a potential model for preliminary ASFV inactivation studies with reduced biosecurity requirements. Moreover, this study contributes to understanding the inactivation kinetics of viruses under specific conditions, which is critical when designing and applying countermeasures in case of biosecurity breaches in sites managing animal mortality.

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Professional nurses are called to provide nursing care using an evidence-based approach. Health-care professionals are challenged to break away from old traditions and search for ways to improve health. Evidence-based practice (EBP) must be threaded throughout nursing curricula to produce critically-thinking professional nurses who will be meeting new and significant health-care challenges. Nursing education must be grounded in the translation of current evidence into practice. Nurse educators must acknowledge the obstacles faced when teaching concepts of research to students who have chosen a practice-focused career. The words evidence-based practice may be intimidating to nursing students. Nurse educators must shift this paradigm to invite students to realize that EBP is an integral component of modern health care that bridges the gap between health-care practices and improved patient outcomes. Faculty in a baccalaureate Adult Health course developed a unique approach inviting students to apply evidence to their student clinical experiences. Survey results showed that this innovative approach increased students' "excellent" or "good" understanding toward EBP concepts from pre-implementation scores of 46% to post-implementation scores of 94%. This active learning strategy allows students to "walk the walk" of EBP rather than simply listen to the "talk."

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BACKGROUND: Accurate blood pressure measurements (BPM) are important, as clinicians are tasked daily with using such measurements to make clinical diagnoses and patient care judgments. Research studies and controlled trials hold such measurements to a higher standard than everyday clinical practice. OBJECTIVE: The aim of this study was to evaluate difference in BPM outcomes of individuals in a clinic setting when clinicians collect BPM as usual vs BPM after 5- (USPSTF recommendation) and 10- minute (study unique intervention) timed rest interval. METHODS: A repeated-measures design was used to examine individual BPMs at the intervals of baseline, after a 5-minute rest interval post-baseline, and after a 10-minute rest interval post-baseline. Results Pairwise comparisons indicated that baseline SBP was the highest when compared to SBP measured at both 5- and 10-minutes post-baseline. SBP measured at 5-minutes was also significantly higher compared to SBP collected at 10-minutes post-baseline (ps < .05). For DBP, the repeated-measures ANOVA indicated that there was no significant difference across BPMs, F(2,198) = 1.25, p = .29. CONCLUSIONS: Results from this study revealed that implementing a 5-minute rest interval before BPMs are taken in a clinic setting produces a "clinically observable" reduction in the overall mean systolic BPs as seen at both 5- and 10-minute BPM intervals. It is important for all healthcare clinicians to recognize the importance of accurate BPM and the need to encourage better regulated BPM standard in everyday practice.

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Providing clinical opportunities for students to gain experience in managing cardiac dysrhythmias is a challenge for nursing faculty. High-risk experiences are often not available for all students or are too life-threatening to entrust to students. Faculty shortages and increasing enrollments add to declines in clinical opportunities. The use of human patient simulation (HPS) has added opportunities to experience high-risk, low-frequency clinical situations. HPS may be employed in the classroom setting to teach content related to dysrhythmia treatments. This innovative approach to HPS utilization engages students and helps them apply theory into clinical nursing practice.

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BACKGROUND: The clinical track is a newer concept for universities traditionally placing a hefty emphasis on research and funding. OBJECTIVE: Guidelines should ensure equitable criteria for promotion of practicing faculty reflect teaching, scholarship, and academic outreach milestones. METHODS: This article describes the process, challenges, and overall experience of developing clinical track promotion guidelines within a research-focused university setting. RESULTS: The department's outdated clinical track promotion guidelines were revised to reflect current roles of clinical faculty. CONCLUSIONS: As DNP and clinically focused advanced practice faculty flood into 4-year academic settings, universities must ensure that criteria for promotion reflects clear and equitable teaching, scholarship, and academic outreach milestones. IMPLICATIONS FOR NURSING: The recent influx of DNP clinical faculty and advanced nursing practice faculty roles requires an overhaul of outdated guidelines.

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It is well known that active teaching strategies improve student learning outcomes. By using simulation scenarios as a tool to teach systematic decision making in the classroom, faculty allow a large group of students to develop abstract thinking and gain experience in a setting that has traditionally delivered information in a linear format. This article will describe the process of using a high-fidelity simulation scenario as an unfolding case study to teach students how to manage and care for a patient.

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This article describes how a faculty rallied together and developed a positive progression approach to promote student success on standardized specialty and comprehensive examinations, which fosters critical thinking, clinical judgment, student self-assessment, and individualized plans of action. Specific strategies implemented are discussed. Aggregate student data related to course grades, specialty and comprehensive exit examination scores, and NCLEX pass rates support this innovative approach to student success.

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Solubility profiles of uranium dusts in a uranium recycling plant were determined by performing in vitro solubility tests on breathing zone air samples conducted in all process areas of the processing plant. The recycling plant produces high density shields, closed end tubes that are punched and formed from uranium sheet metal, and high-fired uranium oxide, which is used as a catalyst. The recycled uranium is cut and melted in a vacuum furnace, and part of the molten uranium is poured into molds for further processing. Air samples were taken in process areas under normal working conditions. The dissolution rate of the uranium in a simulant solution of extracellular airway lining fluid (Gamble's solution) was then determined over the next 28 d. Airborne uranium in the oxide section of the plant was found to be highly insoluble with 99% of the uranium having a dissolution half time in excess of 100 d. The solubility of the airborne uranium in other areas of the facility was only slightly more soluble with over 90% of the airborne uranium having dissolution half times in excess of 90 d.

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This study is based on interviews with four focus groups consisting of fourteen white, Latina, and black girls, ages 13 to 16 years, from diverse backgrounds. The objectives of the study are to gain insight into what forum girls use to learn about the adolescent experience and to examine teenage girls' views of their sexuality and femininity. The girls' discussion of their lives and perceptions of the teen magazine Seventeen reveal a displacement of female sexuality. The magazine's message to teenage girls of gaining self-worth through emphasized femininity seems to resonate with these girls regardless of class and race. We conclude that responsible adults need to challenge the distorted media images of adolescent development and teenage girls' sexuality.

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