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Teach-back Education in Heart Failure Patients Benchmark Study
Get PDFHeart failure exasperation is one of the most common causes of hospital readmission in the United States (Breathett et al., 2018). It is estimated that greater than half of all heart failure patients will be readmitted to the hospital within six months of discharge (Caluya, 2021). Additionally, one in four individuals with heart failure are readmitted within thirty days of discharge (Rahmani et al., 2020). This data shows a large area of improvement for hospitals in order to improve patient outcomes. Due to the lack of standardized discharge teaching, heart failure patients are often admitted to the hospital for the same reoccurring symptoms (Haney & Shepherd, 2018). Since the patients are frequently hospitalized, they report a decreased quality of life (Rahmani et al., 2020).
The implementation plan will involve a nurse rounding every day to conduct heart failure education using the teach-back method to heart failure patients and their families. This nurse will be educated on heart failure and common questions the families might have. Through implementing this change, the rates of readmission in heart failure patients will be decreased as well as improving health literacy in this patient population (Rahmani et al., 2020).
Heart failure imposes high costs on society and is typically 50-79% more expensive to treat compared to other illnesses (Rahmani et al., 2020). This large amount can great medical debt for patients that they are unable to pay back. The research identified that the teach-back education method decreases readmission rates, improves patient experiences, and increases medication compliance
Implementing a Nurse Residency Program: A Benchmark Study
No full textThe nursing shortage is a complicated situation. Van Camp and Chappy (2017) determined that newly graduated nurses make up for both the largest group of nurses entering, a well as leaving the profession. Research has been done to determine what is causing nurses to leave the profession prematurely and there are many answers to this question. One major reason is lack of support. Another reason is lack of training. Nurse Residency Programs (NRPs) are one proven solution to these problems, and have been shown to increase competency and confidence, nurse satisfaction, patient safety and support these nurses as they transition into practice (Knighten, 2022)
The goal of this project is to establish a structured training program for both new nurses and nurses new to a specialty to increase nurse satisfaction, and by increasing satisfaction, nurse retention will improve. By establishing an NRP current trends in health care could be discussed and different subjects could be incorporated based on need. The NRP could not only work on improving turnover by increasing nurse satisfaction but also incorporate topics such as crisis training, preventing burnout, and utilizing mindfulness in practice, which could help nurses throughout their careers
Analysis of D- and L- Isomers of (Meth)amphetamine in Human K2EDTA Plasma
Get PDFMethamphetamine and its metabolite amphetamine are frequently abused drugs. Whether obtained legally or from clandestine laboratories it is of relevance to determine the chiral makeup of these drugs for investigative purpose. Although urine and oral fluid matrices are commonly offered, less available to independent laboratories are techniques to verify dextro (D-) or levo (L-) (meth)amphetamine from human K2EDTA plasma. This paper outlines the development and validation of a method that includes the addition of internal standard and a two-step liquid-liquid extraction to remove the analytes from human K2EDTA plasma by triple quadrupole mass spectrometry (LC-MS/MS). The assay was validated according to the United States Food and Drug Administration and College of American Pathologists guidelines, including assessment of the following parameters in plasma validation samples: linear range, limit of detection, lower limit of quantitation, matrix effects, inter- and intra-day assay precision and accuracy, carry over, linearity of dilution, matrix effects and stability. The outcome is a validated and reliable method for the determination of D- and L- isomer concentration of meth(amphetamine) human plasma samples that can be easily adopted by independent clinical laboratories
Incidents of Snake Fungal Disease caused by the Fungal Pathogen Ophidiomyces ophidiicola in Texas
Get PDFThe pathogen Ophidiomyces ophidiicola, widely known as the primary cause of snake fungal disease (SFD), has been detected in Texas’s naïve snakes. Our team set out to characterize O. ophidiicola’s spread in eastern Texas. From December 2018 until November 2021, we sampled and screened with ultraviolet (UV) light 176 snakes across eastern Texas and detected 27. O. ophidiicola’s positive snakes using qPCR and one snake in which SFD was confirmed via additional histological examination. Upon finding the ribbon snake with a clear clinical display, we isolated and cultured what we believe to be the first culture from Texas. This cultured O. ophidiicola TX displays a ring halo formation when grown on a solid medium and cellular autofluorescence as expected. Imaging reveals that individual cells within the septated hyphae branches have a distinct nucleus separation from neighboring cells. Overall, we have found over 1/10 snakes that may be infected in East Texas, which gives credence to the onset of SFD in Texas. These results add to the progress of the disease across the continental United States
Magnetic Bistability for a Wider Bandwidth in Vibro-Impact Triboelectric Energy Harvesters
Get PDFMechanical energy from vibrations is widespread in the ambient environment. It may be harvested efficiently using triboelectric generators. Nevertheless, a harvester’s effectiveness is restricted because of the limited bandwidth. To this end, this paper presents a comprehensive theoretical and experimental investigation of a variable frequency energy harvester, which integrates a vibro-impact triboelectric-based harvester and magnetic nonlinearity to increase the operation bandwidth and improve the efficiency of conventional triboelectric harvesters. A cantilever beam with a tip magnet was aligned with another fixed magnet at the same polarity to induce a nonlinear magnetic repulsive force. A triboelectric harvester was integrated into the system by utilizing the lower surface of the tip magnet to serve as the top electrode of the harvester, while the bottom electrode with an attached polydimethylsiloxane insulator was placed underneath. Numerical simulations were performed to examine the impact of the potential wells formed by the magnets. The structure’s static and dynamic behaviors at varying excitation levels, separation distance, and surface charge density are all discussed. In order to develop a variable frequency system with a wide bandwidth, the system’s natural frequency varies by changing the distance between the two magnets to reduce or magnify the magnetic force to achieve monostable or bistable oscillations. When the system is excited by vibrations, the beams vibrate, which causes an impact between the triboelectric layers. An alternating electrical signal is generated from a periodic contact-separation motion between the harvester’s electrodes. Our theoretical findings were experimentally validated. The findings of this study have the potential to pave the way for the development of an effective energy harvester that is capable of scavenging energy from ambient vibrations across a broad range of excitation frequencies. The frequency bandwidth was found to increase by 120% at threshold distance compared to the conventional energy harvester. Nonlinear impact-driven triboelectric energy harvesters can effectively broaden the operational frequency bandwidth and enhance the harvested energy
Preparing for the Future: A Collaborative Design for High-Quality Career and Technical Education Programming
Get PDFEducators in public education as faced with preparing students for college and career after high school graduation. The collaborative efforts of Career and Technical Education programming allows for the development of a high-quality program through exploring non-traditional teacher use goal setting and pedagogy provide a foundation of success for students
AN ECOLOGICAL SURVEY OF EAST TEXAS SALAMANDERS ACROSS THE CAMP TYLER OUTDOOR FIELD SCHOOL IN SMITH COUNTY, TEXAS
Get PDFAmphibians are a unique class of organisms with a very long and storied evolutionary history of survival. Many modern amphibian clades occupy several vital ecological roles within their native freshwater environments. One of these roles, typically includes functioning as an ecological indicator species, whereby the presence of stable and diverse populations of many amphibian species, including salamanders, within a freshwater ecosystem have long been considered ecological indicators of good habitat quality and stable ecosystem health. Similarly, salamanders also function as important members of their local food webs and act as valuable mediators of complex trophic hierarchies to facilitate nutrient cycling between trophic levels throughout their equally complex life histories.
However, countless amphibians today are experiencing significant population declines – with many sensitive and endemic species currently facing the imminent threat of widespread extinction events that are primarily driven by anthropogenic activities. Concerningly, this could also spell disaster for numerous other clades and communities within these same freshwater ecosystems. These changes in amphibian distribution and diversity are only one small component in many broad scale declines in global biodiversity that have been recognized in recent decades. These collective declines have been described as a “sixth mass extinction.” Because of their status as ecological indicator species, the widespread reduction in many amphibian communities may also serve as a harbinger of further biological crises in the near future.
As a result, an updated record of sensitive amphibian species, especially salamanders, needs to be collected and compiled for use in assessing, tracking, and maintaining the health and well-being of many vital freshwater ecosystems. Here, a field survey of several East Texas salamander species was conducted from October of 2022 through April of 2023 – during their peak activity season – to create an updated inventory of historic and anecdotal salamander populations previously reported at the Camp Tyler Outdoor School, a local non-profit field school for grades K-12, located in Smith County, Texas. All three target salamander species were observed and identified during this period, although current findings seem to indicate that some these animals, especially the previously documented population of Western lesser sirens (Siren intermedia nettingi) may have experienced significant population declines since they were last surveyed. This is likely the result of a variety of ecological factors that have changed over time, including an increased anthropogenic presence within the area, land use changes, possible degradations in water and habitat quality, changing climatic conditions, and out competition with more tolerant clades in their aquatic environment
THE MOLECULAR MECHANISMS OF IFN-γ PROMOTED NECROPTOSIS IN MACROPHAGES
Get PDFNecroptosis, a form of programmed lytic cell death, has emerged as a driving factor in the pathogenesis of acute lung injury. One specific inflammatory mediator that is of interest is interferon-γ (IFN-γ). Our laboratory has reported that IFN-γ is the most potent enhancer of necroptosis in primary lung epithelial cells and macrophages by upregulating MLKL expression. How IFN-γ enhances necroptosis and MLKL upregulation is currently unknown. In this research, we utilized multiple approaches to study the potential molecular mechanisms of IFN-γ promoted necroptosis in macrophages. We found that MLKL and ZBP1 are significantly upregulated by IFN-γ through an unknown pathway downstream of Jak kinase. The phosphorylation of RIPK1, RIPK3, and MLKL was accelerated by pretreatment with IFN-γ upon induction of necroptosis. Whereas IFN-γ did not affect the ubiquitination of MLKL. Moreover, we found that necroptosis caused MLKL degradation or loss in the membrane fraction, which was prevented by IFN-γ treatment. This effect may be a critical mechanism responsible for the enhanced necroptosis observed in IFN-γ pretreated macrophages
Teacher Retention: A Closer Look at Finding a Solution
Get PDFThis is an improvement science dissertation in practice that spans over a two-year period that is designed to discover the impacts of teacher mentorship programs on teacher retention. The study occurred at an open enrollment public charter school that focuses on Science, Technology, Engineering, and Math (STEM) by implementing project-based learning (PBL), problem-based learning (PrBL), and personalized learning. The evaluation study occurred within the first year of the study. Teachers that agreed to participate in the study were given qualitative and quantitative surveys to complete about the mentorship program in the current design. These surveys were used to understand the teacher’s perspectives of the program as well as gauging the impacts of the program. Data from Texas Academic Performance Report (TAPR) and Public Education Information Management System (PEIMS) was used for teacher retention data. The results from the evaluation cycle indicated that the program was functioning but not to its full potential with the fidelity needed. The following year, year two, consisted of implementing a change of the number of mentors to mentee ratio as well as giving more guidelines to mentors. The same standards of measures were used to gauge the teachers participating in the research. Overall, the results indicated that the change implemented did have a positive impact on teachers\u27 level of support resulting in teacher retention. Continuing studies would need to occur to collect data to make recommendations for future studies as well as impacts to the educational field in a larger scale
Facilities Beyond Physical Spaces: A Case for the Intentional Design and Use of Learning Space
Get PDFIn 2022, the state department released new standards and a competency-based education curriculum. Simultaneously, the Toledo Creek School District has experienced an unprecedent shift in the student population demographics. The shift has resulted in two distinct zones, east and west, with income averages on the two extremes of the income spectrum. Given the shift in both the curriculum and demographics, the superintendent in consultation with stakeholders decided to implement project-based learning (PBL) as the district’s instructional model. PBL has a significant research-based supporting implement for authentic learning as intended by the new standards and better supporting deeper learning among all students. One barrier to implementation is the existence of aging facilities. The poor quality of the facilities has caused tension among the district’s stakeholders. This case study aims to promote an understanding of issues related to school facilities, and bond and facilities planning for the intentional design and purposeful use of learning spaces aligned with a constructivist instructional model, in this case PBL. How can conflicting views be leveraged to engage stakeholders in productive discourse about school facilities that results in the equitable use of financial and physical resources