We have isolated new temperature-sensitive mutations in five complementation groups, sec31-sec35, that are defective in the transport of proteins from the endoplasmic reticulum (ER) to the Golgi complex. The sec31-sec35 mutants and additional alleles of previously identified sec and vacuolar protein sorting (vps) genes were isolated in a screen based on the detection of α-factor precursor in yeast colonies replicated to and lysed on nitrocellulose filters. Secretory protein precursors accumulated in sec31-sec35 mutants at the nonpermissive temperature were core-glycosylated but lacked outer chain carbohydrate, indicating that transport was blocked after translocation into the ER but before arrival in the Golgi complex. Electron microscopy revealed that the newly identified sec mutants accumulated vesicles and membrane structures reminiscent of secretory pathway organelles. Complementation analysis revealed that sec32-1 is an allele of BOS1, a gene implicated in vesicle targeting to the Golgi complex, and sec33-1 is an allele of RET1, a gene that encodes the α subunit of coatomer.
Background
Concussion recognition, treatment and management is crucial in supporting recovery and decreasing the risk of long-term brain damage. Long-term effects are often not recognized early enough to prevent post-concussion syndrome, resulting in an impact on social and professional lives. The need to standardize care is vital in preventing adverse concussion outcomes.
Objective
To determine if concussion knowledge, attitudes and practices (KAP) are significantly improved among physicians and nurses following completion of CATT.
Design
A pre/post-intervention questionnaire designed to measure changes in physician/nurse KAP.
Setting
Primary setting was hospital emergency departments in the Lower Mainland, British Columbia.
Participants
Physicians/nurses working in emergency departments/trauma care facilities.
Intervention
Based upon established international principles, CATT is an online toolkit (www.cattonline.com) providing learner-directed concussion awareness training for health practitioners as well as assessment resources (SCAT3, Child-SCAT3), links to clinical resources, patient handouts, journal articles (including the Zurich Consensus Statement), related websites, concussion videos and study cases.
Main outcome measures
Change in physician/nurse knowledge, attitudes and practices regarding concussion recognition, treatment and management.
Results
44 physicians and 35 nurses were recruited. Post-intervention questionnaires were completed by 34 physicians (77.3%) and 25 nurses (71.4%). Physicians demonstrated a statistically significant positive change in concussion practices (P=.001). Change in physician knowledge was not significant, while attitudes had a negative change (P=.041). Positive change in physician knowledge was detected for those who typically see more than 10 concussions per year (P=.039). Nurses demonstrated statistically significant positive change in practices (P=.005) and attitudes (P=.035), but no change in knowledge.
Conclusions
CATT is effective in improving concussion knowledge and practices among physicians and nurses, which will potentially minimize adverse concussion outcomes and lower health care costs among concussion patients. Phase 2 includes a toolkit for Parents, Players and Coaches, currently undergoing an evaluation with sporting associations in BC.
Community-acquired pneumonia (CAP) is diagnosed in >1.2 million children in outpatient settings and emergency departments (EDs) each year in the United States. 1, 2 Most antibiotic prescribing for CAP occurs in the outpatient setting. In 2011, members of the Pediatric Infectious Diseases Society and Infectious Diseases Society of America published an evidence-based guideline for the management of CAP in children. The authors of the recommendations encourage prescribing narrow
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