The objective of this study was to investigate the associations between the NICU work environment, quality of care, safety, and patient outcomes. A secondary analysis was conducted of responses of 1247 NICU staff nurses in 171 hospitals to a large nurse survey. Better work environments were associated with higher odds of nurses reporting poor quality, safety and outcomes. Improving the work environment may be a promising strategy to achieve safer settings for at-risk newborns.

Background Supporting family resilience, the ability of families to rebound from stressful events, is a goal of family nursing. Critical care nurses act as liaisons between patients' families and other clinicians and thus are uniquely situated to promote family resilience. Objective To explore how nurses perceive the experiences of long-stay surgical intensive care unit patients and their families in order to gain insights on how nurses could cultivate family resilience. Methods A qualitative study including semistructured interviews (n = 13) and 4 focus groups (n = 17) with nurses in 3 surgical intensive care units in a large teaching hospital. Results Three themes were identified: expectations, support, and communication. Nurses noted that clinicians' and families' unrealistic expectations regarding the patient's recovery can foster false hope. Nurses recognized families as "cheerers" who provide support by being involved in patient care and observed how extensive family involvement can be beneficial to patients but overwhelming for families. Nurses noted that communication among providers, families, and patients is the cornerstone of creating meaningful relationships. Nurses stated that with many teams involved, discrepancies in information can occur and often confuse and disturb patients' families. Thus, nurses identified ways to enhance family resilience through routine and consistent communication.Conclusions Nurses note unique stresses faced by families of patients in surgical intensive care units. Using the family resilience model, nurses can identify and enhance key family resilience factors.

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The prevalence of cardiovascular disease in the United States is extensive and growing rapidly. Contributing factors include the aging population, tobacco abuse, obesity, and diabetes, all of which increase the prevalence of cardiovascular diseases. Treatment paradigms for cardiovascular disease have also been rapidly evolving; minimally invasive, catheter-based approaches are increasingly used as first-line therapy. Physicians from a variety of specialties have responded to this growing patient population and treatment paradigm shift by enhancing their training and expanding their practices to better care for these complex patients. This trend is a natural response of specialists to the evolving needs of their patients. In the vascular field, however, it has led to physicians acquiring skill sets that are new for that specialty and that go beyond the traditional boundaries of their practice, and which may overlap with skills classically practiced by other specialists. Surgeons are learning endovascular techniques previously performed by interventional radiologists; cardiologists are utilizing their knowledge about atherosclerosis and their catheter skills to manage noncardiac disease; neurologists and neurosurgeons are developing catheter-based techniques; and nephrologists are performing dialysis-access intervention. As a result, there is now much more overlap in the capabilities of-and services offered by-each specialty. Unhealthy and counterproductive competition among traditional disciplines has developed in the field of vascular care. This article describes the development of a multispecialty collaborative vascular center at a large urban academic medical center to demonstrate a new practice paradigm designed to improve quality of care for patients and enhance collaborative professional education and research.

Human African Trypanosomiasis (African sleeping sickness) is a potentially fatal disease in sub‐Saharan Africa that is caused by the protozoan parasite Trypanosoma brucei. This vector‐borne disease afflicts tens of thousands of individuals every year, and without a vaccine, it is a prominent threat to the health and safety of many African communities. RNA methylation may be an important mechanism for the regulation of gene expression in T. brucei, as this organism lacks regulatory DNA sequences. The presence of 5‐methylcytosine has been detected in the RNA of T. brucei through sodium bisulfite sequencing. Seven putative RNA methyltransferases were identified in the genome of the parasite via bioinformatics and were named TbCRMTs ( T. brucei cytosine RNA methyl transferases). The levels of TbCRMT RNA in both procyclic and bloodstream forms were measured via RT‐qPCR and demonstrated the expression of all seven genes in both life cycle stages. TbCRMT4 is 103 kDa, and contains the conserved SAM binding domain and catalytic cysteines found inbona fide RNA methyltransferases. TbCRMT4 is required for maximum parasite growth as determined by RNAi knockdowns. In an attempt to determine whether TbCRMT4 functions as an RNA methyltransferase, the gene was expressed in E. coli with an N‐terminal 6x‐His tag. SDS‐PAGE results suggested that the full‐length protein was fragmented due to the presence of multiple bands. In light of this, the 6x‐His tag was moved to the C‐terminus and fragments of the gene containing putative SAM‐binding and catalytic sites were then amplified by PCR. The PCR products were then inserted into the pET101/D vector and transformed into competent E. coli. Expression of each construct in E. coli was induced under different conditions, with varying degrees of success. The construct which contains amino acids 87‐852, when expressed at 37°C, is most reliably produced, as confirmed via SDS‐PAGE/Coomassie blue staining and Western Blot analysis. Isolation of this protein was attempted using denaturing protocols and His‐affinity chromatography. Solubility of the protein has proven difficult, thus optimization of protein isolation is still ongoing. Ultimately, we plan to isolate the TbCRMT4 87‐852 protein and conduct a series of methyltransferase assays, which will determine whether or not this protein catalyzes RNA methylation. By determining if TbCRMT4 functions as an RNA methyltransferase, we can further understand the T. brucei epitranscriptome. Support or Funding Information NIH grant 1R15AI133428‐01 to KTM