1997 research outputs found
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Capnography Monitoring Education for the Perianesthesia Nurse
Get PDFBackground: Respiratory compromise is one of the most common complications that occur in the Post Anesthesia Care Unit (PACU) and accounts for half of the closed claims involving death in the PACU. However, with appropriate monitoring like capnography, identification of respiratory depression or apnea can occur prior to the adverse respiratory events (ARE). Although capnography is not currently considered a standard monitor in the PACU, it retains many advantages when used in conjunction with pulse oximetry and other standard monitors. Current research supports its use, and many organizations have created position statements and clinical practice recommendations for the use of capnography when patients are given any pharmacotherapeutic that alters sensorium. A knowledge deficit regarding capnography has been found among the perianesthesia nurses of the Indiana University Health Arnett Hospital, and inservice training was deemed a necessity in improving the quality of care provided to the patients. Aim: This project aims to evaluate a knowledge deficit about the utilization and interpretation of capnography among the perianesthesia nurses and subsequently provide in-service training. Methods and Procedure: A repeated measures, pre/post-test design was utilized to evaluate perianesthesia nurses (n = 23). A dependent paired samples t-test was used to compare mean score differences between the pre-and post-test scores. A 15 minutes in-service session was provided in the PACU to a group of 2-5 perianesthesia nurses at the time for three days. Results: Post-test scores were significantly higher than the pre-test scores following the educational intervention (p \u3c 0.001), based on a two-tailed Wilcoxon ranked test. Conclusion: Providing education on the use and interpretation of capnography resulted in better post-test scores indicating an increased acquisition of knowledge pertaining to capnography
Referring Palliative Care Patients: A Process Improvement Project
Get PDFBackground: The lack of palliative care (PC) services poses a significant risk for PC patients. Research indicates that patients\u27 needs often go unmet when PC referral processes are not well established within a health system. Furthermore, PC patients have higher readmission rates, thus increasing health care costs. PC referrals improve the quality of care while also reducing readmissions. Purpose: The purpose of this project was to determine whether PC referrals impacted the readmission rates of chronically and terminally ill patients. Methods: A 2018 practice assessment of an Indiana community hospital revealed a high rate of readmissions among chronically and terminally ill patients. An evidence-based process improvement project was implemented, guided by the Iowa model, in which a sample of 22 terminally and chronically ill patients were identified and referred for PC. Following PC training, risk assessment scores were used to identify PC patients appropriate for referral, after which case managers provided follow-up over the course of six months. Results: Six months before implementation, the sample (n = 22) recorded 19 Emergency Department (ED) visits and 65 total admissions, with some being direct admissions. Results showed that 89% of ED visits resulted in admission. Post-intervention, there were six (27%) ED visits for the same sample (n = 22), only 0.04% of which resulted in actual admission. Conclusions: Educating staff and implementing a PC referral process chronically and terminally ill patients may be an effective method of reducing readmission rates, thereby decreasing costs
Identification of a bone morphogenetic protein type 2 receptor neutralizing antibody
Get PDFThe bone morphogenetic protein (BMP) signaling pathway comprises the largest subdivision of the transforming growth factor (TGFβ) superfamily. BMP signaling plays essential roles in both embryonic development and postnatal tissue homeostasis. Dysregulated BMP signaling underlies human pathologies ranging from pulmonary arterial hypertension to heterotopic ossification. Thus, understanding the basic mechanisms and regulation of BMP signaling may yield translational opportunities. Unfortunately, limited tools are available to evaluate this pathway, and genetic approaches are frequently confounded by developmental requirements or ability of pathway components to compensate for one another. Specific inhibitors for type 2 receptors are poorly represented. Thus, we sought to identify and validate an antibody that neutralizes the ligand-binding function of BMP receptor type 2 (BMPR2) extracellular domain (ECD)
Transcriptional signature primes human oral mucosa for rapid wound healing.
No full textOral mucosal wound healing has long been regarded as an ideal system of wound resolution. However, the intrinsic characteristics that mediate optimal healing at mucosal surfaces are poorly understood, particularly in humans. We present a unique comparative analysis between human oral and cutaneous wound healing using paired and sequential biopsies during the repair process. Using molecular profiling, we determined that wound-activated transcriptional networks are present at basal state in the oral mucosa, priming the epithelium for wound repair. We show that oral mucosal wound-related networks control epithelial cell differentiation and regulate inflammatory responses, highlighting fundamental global mechanisms of repair and inflammatory responses in humans. The paired comparative analysis allowed for the identification of differentially expressed SOX2 (sex-determining region Y-box 2) and PITX1 (paired-like homeodomain 1) transcriptional regulators in oral versus skin keratinocytes, conferring a unique identity to oral keratinocytes. We show that SOX2 and PITX1 transcriptional function has the potential to reprogram skin keratinocytes to increase cell migration and improve wound resolution in vivo. Our data provide insights into therapeutic targeting of chronic and nonhealing wounds based on greater understanding of the biology of healing in human mucosal and cutaneous environments
SoTL 101: An Introduction to the Scholarship of Teaching and Learning
Get PDFIn this workshop held at Marian University Dr. Andy Gavrin discusses the power of the Scholarship of Teaching and Learning (SoTL), how SoTL research is completed, and how to develop one\u27s own plan for conducting SoTL research in the classroom.
Dr. Andy Gavrin is Associate Professor and Chair of Physics at Indiana University Purdue University Indianapolis (IUPUI), and a member of IUPUI’s University College faculty. He is a co-developer of the Just-in-Time Teaching method, and a “serial adopter” of educational technologies. He is a Fellow of the American Association of Physics Teachers (AAPT) and winner of the AAPT’s David Halliday and Robert Resnick Award for Undergraduate Teaching. His research is focused on the use of technology in science education. He received his BS in physics from MIT, and his MS and PhD in physics from The Johns Hopkins University. He joined the faculty of IUPUI in 1995
Identification of p38 MAPK as a novel therapeutic target for Friedreich\u27s ataxia.
Get PDFFriedreich ataxia (FRDA) is an autosomal recessive neuro- and cardio-degenerative disorder caused by decreased expression of frataxin, a protein that localizes to mitochondria and is critical for iron-sulfur-cluster (ISC) assembly. There are no proven effective treatments for FRDA. We previously screened a random shRNA library and identified a synthetic shRNA (gFA11) that reverses the growth defect of FRDA cells in culture. We now report that gFA11 decreases cytokine secretion in primary FRDA fibroblasts and reverts other changes associated with cell senescence. The gene-expression profile induced by gFA11 is remarkably similar to the gene-expression profile induced by the p38 MAPK inhibitor SB203580. We found that p38 phosphorylation, indicating activation of the p38 pathway, is higher in FRDA cells than in normal control cells, and that siRNA knockdown of frataxin in normal fibroblasts also increases p38 phosphorylation. Treatment of FRDA cells with p38 inhibitors recapitulates the reversal of the slow-growth phenotype induced by clone gFA11. These data highlight the involvement of the p38 MAPK pathway in the pathogenesis of FRDA and the potential use of p38 inhibitors as a treatment for FRDA
The Church Besieged, the French Revolution, Nationalism, and the Battle over Modernity
Get PDFFrom the French Revolution, 1798, right through the nineteenth century and into the 20th Century, in nearly every major European country the Catholic Church found itself embattled. Its monopoly in religion ended or challenged by anti-clericalism, secularism, liberalism targeting the Church’s authority and putting its privileges, property, prestige, and independence under siege.
Every pope from Pius VI (1775-1799) to Pius X (1903-1914) fought against the enemy--modernity. They revived the Index of Prohibited Books, declared monarchy the best polity, and condemned church-state separation, toleration, freedom of conscience, and any idea the Church needed reform
The Clinical Conscience Support Tool
Get PDF1. The Problem. “Proportionate means,” “ordinary means,” “the principle of double effect,” “moral certitude,” and “proximal material cooperation” are some of the philosophical concepts used in medical ethics. Oftentimes, well-intentioned clinicians misunderstand or misapply these concepts – or worse, they think that ethics is too complex and should be left to professionals. 2. The Solution. The Clinical Conscience Support Tool takes challenging, abstract concepts and translates them in a clinical context. This tool is designed to act like a good system ethicist - when you ask the right medical questions you can arrive at a morally sound conclusion. 3. The Technique. This is a tool designed to help form the provider’s conscience and to assist with patient counseling. This is not an “ethics algorithm” or a “decision tree.” Rather than forcing a physician/nurse to know ethics and ethical considerations and then apply abstract principles to specific cases, this method brings the relevant ethical consideration to the physician/nurse and asks them to do what they do best - make a medical judgment. 4. Conclusion. Catholics are duty-bound to follow their well-formed consciences when considering open questions. This tool should help physicians/nurses employ their conscience to arrive at a sound ethical decision. 5. The Ultimate Goal. This tool is made into a free mobile application for all Catholic health professionals and students. The tool can then be expanded, edited, and updated by experts in medical ethics
Selective Inhibition of Aspartate Aminotransferase by L-Cycloserine in the Presence of Vitamin B6
No full textBacterial Contamination of a Marking Pen in Anterior Cruciate Ligament Reconstruction
No full textBackground:
A sterile surgical marking pen is commonly used during anterior cruciate ligament reconstruction (ACLR) to outline the proposed skin incision and then to mark the graft during preparation. Once in contact with the skin, the pen is a potential source of bacterial transmission and subsequent infections after ACLR. Purpose/Hypothesis:
The purpose of this study was to assess whether the skin marking pen is a fomite for contamination during arthroscopic ACLR. We hypothesized that there would be a difference in the rate of culture-positive pens between control pens and the study pens used to delineate the proposed skin incision. Study Design:
Controlled laboratory study. Methods:
Twenty surgical marking pens were collected prospectively from patients undergoing ACLR over a 12-month period. All patients underwent standard preoperative sterile preparation and draping procedures. Proposed incisions were marked with a new sterile pen, and the pen tip was immediately sent for a 5-day inoculation in broth and agar. Negative controls (unopened new pen) and positive controls (used to mark the skin incisions preoperatively) were also cultured. Additionally, blank culture dishes were observed during the growth process. All pens were removed from the surgical field before incision, and new marking pens were used when needed during the procedure. Results:
Three of the 20 study pens (15%) demonstrated positive growth. All 3 pens grew species of Staphylococcus. None of the negative controls demonstrated growth, 6 of the 12 positive controls showed growth, and none of the blank dishes exhibited growth. Conclusion:
This study found a 15% rate of surgical marking pen contamination by Staphylococcus during ACLR. It is recommended that the skin marking pen not be used for any further steps of the surgical case and be discarded once used. Clinical Relevance:
Infections after ACLR are rare but may result in significant morbidity, and all measures to reduce them should be pursued. Surgeons performing ACLR should dispose of the surgical marking pen after skin marking and before intraoperative use such as graft markup