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taff distribution across the various shifts should be of keen interest to nurse managers if hypertension care in particular and overall patient care in general are to improve. Copyright © 2020 Kennedy Dodam Konlan et al.Because the interpersonal skills of individuals with dementia often decline, family members may question their own ability to interact meaningfully. These family members may experience fear of incompetence (i.e., fear of being unable to relate in a meaningful way or take care of a close family member with dementia). Thus, the goal of this research was to develop, refine, and psychometrically validate a scale (Fear of Incompetence-Dementia Scale; FOI-D) assessing fear of incompetence in the context of relationships with a close family member diagnosed with dementia. Three online studies were conducted to accomplish the primary objective. In Study One, the factor structure of the FOI-D was assessed by conducting an exploratory factor analysis using data from 710 adults who indicated having a close living family member who had been diagnosed with dementia. In Study Two, the factor structure was validated via a confirmatory factor analysis and the psychometric properties were established using data from 636 adults who had a family member with dementia. Finally, Study Three determined the temporal consistency of the scale by retesting 58 participants from Study Two. The results from Study One indicated that the FOI-D Scale accounted for 51.75% of the variance and was comprised of three subscales the Interaction Concerns subscale, the Caregiving Concerns subscale, and the Knowledge Concerns subscale. In Study Two, the three-factor structure was supported, resulting in a 58-item scale. Investigation of the psychometric properties demonstrated the FOI-D to be reliable and valid. In Study Three, the FOI-D Scale demonstrated excellent temporal consistency. This research provides future investigators, educators, and practitioners with an adaptable comprehensive tool assessing fear of incompetence in a variety of settings. Copyright © 2020 Ashley E. Thompson et al.The intermediate hosts of the French heartworm Angiostrongylus vasorum are aquatic and terrestrial gastropods. The present work is aimed at clarifying the sites of penetration and the migratory routes of A. vasorum in Biomphalaria glabrata snail tissues and evaluating their perilarval reaction with regard to the cellular composition and histological alterations involved in the gastropod response to infection. Biomphalaria glabrata snails were individually infected with 1000 first-stage larvae (L1) of A. vasorum each and killed at predetermined times after infection. Percutaneous infection occurred simultaneously with oral infection. Despite larval tropism to the fibromuscular tissue, some larvae were located in different tissues and organs. A perilarval reaction was observed around the larvae in a fibromuscular layer, appearing later around the larvae located in the viscera. The number of hemocytes surrounding the larvae increased gradually, forming a pregranuloma. Larval death and degeneration were not observed. No defined migratory pattern occurred, and larval development was apparently not associated with particular tissues or organs. In addition, the infection by A. vasorum induces a systemic mobilization of hemocytes in perilarval reaction. Copyright © 2020 T. A. Barçante et al.Global surgery is an essential component of Universal Health Coverage. Surgical conditions account for almost one-third of the global burden of disease, with the majority of patients living in low-income and middle-income countries (LMICs). Children account for more than half of the global population; however, in many LMIC settings they have poor access to surgical care due to a lack of workforce and health system infrastructure to match the need for children’s surgery. Surgical providers from high-income countries volunteer to visit LMICs and partner with the local providers to deliver surgical care and trainings to improve outcomes. However, some of these altruistic efforts fail. We aim to share our experience on developing, implementing and sustaining a partnership in global children’s surgery in Tanzania. The use of participatory methods facilitated a successful 17-yearlong partnership, ensured a non-hierarchical environment and encouraged an understanding of the context, local needs, available resources and hospital capacity, including budget constraints, when codesigning solutions. We believe that participatory approaches are feasible and valuable in developing, implementing and sustaining global partnerships for children’s surgery in LMICs. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Background Hepatic computed tomography (CT) with decreased peak kilovoltage (kVp) may be used to reduce contrast medium doses in patients at risk of contrast-induced acute kidney injury (CI-AKI); however, it increases image noise. To preserve image quality, noise has been controlled by X-ray tube loading (mAs) compensation (TLC), i.e. increased mAs. Another option to control image noise would be to use iterative reconstructions (IR) algorithms without TLC (No-TLC). It is unclear whether this may preserve image quality or only reduce image noise. Purpose To evaluate image quality of 80 kVp hepatic CT with TLC and filtered back projection (FBP) compared with 80 kVp with No-TLC and IR algorithms (SAFIRE 3 and 5) in patients with eGFR less then 45 mL/min. Material and Methods Forty patients (BMI 18-32 kg/m2) were examined with both protocols following injection of 300 mg I/kg. Hepatic attenuation, image noise, enhancement, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality were evaluated for each patient. Panobinostat Results Comparing TLC/FBP with No-TLC/IR-S5, there were no significant differences regarding hepatic attenuation, image noise, enhancement, SNR and CNR 114 vs. 115 HU, 14 vs. 14 HU, 55 vs. 57 HU, 8.0 vs. 8.4, and 3.8 vs. 4.0 in median, respectively. No-TLC/IR-S3 resulted in higher image noise and lower SNR and CNR than TLC/FBP. Subjective image quality scoring with visual grading showed statistically significantly inferior scores for IR-S5 images. Conclusion CT of 80 kVp to reduce contrast medium dose in patients at risk of CI-AKI combined with IR algorithms with unchanged tube loading to control image noise does not provide sufficient diagnostic quality. © The Foundation Acta Radiologica 2020.