406 research outputs found

    Are Higher Education Institutions Addressing the Employment Needs of Clinical Laboratories in Rural Areas?

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    Clinical laboratories across the nation are faced with a shortage of qualified Medical Laboratory Technicians (MLTs) and Medical Laboratory Scientists (MLSs). As the clinical laboratory workforce continues to shrink, it is essential that higher education institutions acknowledge the employment needs of rural laboratories to ensure quality health care in underserved areas. An aging workforce, program closures, and a general increase in demand for laboratory testing have compounded the workforce shortage for rural clinical laboratories, which often face unique challenges. The purpose of this research study was to examine the perceptions of rural clinical laboratory managers toward higher education’s response to the shortage of MLTs and MLSs, and to determine the extent to which MLT and MLS programs are meeting the staffing and professional development needs of rural clinical laboratories. This descriptive mixedmethod study was conducted utilizing a survey of 429 MLT and MLS program directors, in addition to interviews with 10 clinical laboratory managers in rural West Virginia. The results of this study revealed higher education institutions are not adequately meeting the employment needs of rural clinical laboratories, with notable key areas for improvement, including communication, partnership, and promotion of the profession. Interviews with laboratory managers indicated a moderate to severe rural workforce shortage, with a glaring deficiency of MLS candidates. Research findings demonstrated community and technical colleges, specifically MLT programs, were more likely than universities and four-year colleges to establish formal relationships with rural laboratories and served as a primary source of job candidates for rural laboratories. The findings further suggested rural clinical rotations, targeted recruitment efforts, and the creation of online and hybrid programs, would aid rural laboratories in securing a qualified workforce, while the delivery of online continuing education modules would benefit incumbent workers. This research adds to the limited literature in the clinical laboratory science field by addressing workforce issues specific to rural laboratories. The study also provides useful information to higher education institutions by identifying problems with recruitment of students, as well as concerns for the future of rural clinical laboratories that may influence MLT and MLS program creation and sustainability

    Issues emerging from the first 10 pilot sites implementing the Nurse-Family Partnership home-visiting programme in England

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    "Issues emerging from the first 10 pilot sites implementing the FNP home-visiting programme in England" builds on those previously published, and identifies national and local system contributions to effective delivery of FNP, the emerging expertise of FNP practitioners and the influence of FNP practice on universal service provision

    The Mechanical Unfolding of Fibronectin Using Atomic Force Microscopy and Its Relevance to Biocompatibility Studies

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    Protein adsorption to surfaces has hindered advancements made in biocompatible implants and drug delivery. Once a protein adsorbs, it can undergo conformational changes and unfold to expose buried cryptic sites of the protein. These sites are often critical for signaling additional proteins and cells to adsorb to the surface which can eventually lead to an implant's failure or the destruction of drug delivering devices. To improve the biocompatibility of these implants, an understanding of how a surface affects a protein's conformation and stability is required. In this work, an atomic force microscope (AFM) is used to quantify the stability of fibronectin (FN), an adhesion promoting protein, on mica, gold, poly(ethylene glycol), and -CH3, -OH, and -COOH terminated alkanethiol self-assembled monolayers. The thermodynamic parameters associated with this mechanically induced denaturation are presented as a function of surface type and amount of adsorbed protein using two different models. Results indicate greater stabilization of FN in densely deposited films while greater surface denaturation occurs as the proteins become more isolated on the substrate. Additional information about the protein's binding state was also obtained. Proteins aggregated on a hydrophobic surface adopted more rigid conformations apparently as a result of increased surface denaturation and tighter binding while looser conformations were observed on more hydrophilic surfaces. Finally, the force spectroscopy experiments were examined for any biocompatibility correlation by seeding substrates with human umbilical vascular endothelial cells (HUVEC). As predicted from the models used in this work, surfaces with aggregated FN promoted cellular deposition while surfaces with proteins sparsely populated hindered cellular deposition and growth. The AFM's use as a means for projecting cell deposition and perhaps biocompatibility does look promising

    Management of RFID Systems in Hospital Transfusion Services

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    Radio Frequency Identification Devices (RFID) technology is used by hospital supply chains to track various medical products and monitor inventories. To improve overall operations, hospitals have implemented RFID as part of their supply chain processes. Hospitals have also have begun incorporating RFID technology as part of their transfusion services processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion services departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 51 sources referenced. RFID technology is being used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. Through RFID, transfusion departments and hospital supply chains have been able to manage blood samples and components to facilitate identification and transfusion of blood products to the correct patient. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-reduction times and error reduction. A pilot study in one Iowa hospital system yielded a 3%-10% reduction in misidentification of patients and/or blood products during transfusion. A cost-benefit assessment reported showed a 5-year ROI of 2%, with an approximate pay-back period of four years. Cost of RFID tags can be 10-15 times more expensive than barcode systems. There are also risks of this technology involving privacy and the security of patient information. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security and privacy appeared as principal barriers of adoption

    Benefits and Barriers of Implementation and Utilization of Radio-Frequency Identification (RFID) Systems in Transfusion Medicine

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    Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled transfusion practices have successfully increased provider productivity and product quality through work-time reduction and error reduction. Findings of this research study suggest that RFID has provided improvements in quality of care and efficiency, while initial costs, security, and privacy appear to be the principal barriers to adoption

    Utilizing Radiofrequency Identification Technology to Improve Safety and Management of Blood Bank Supply Chains

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    The importance of efficiency in the supply chain of perishable products, such as the blood products used in transfusion services, cannot be overstated. Many problems can occur, such as the outdating of products, inventory management issues, patient misidentification, and mistransfusion. The purpose of this article was to identify the benefits and barriers associated with radiofrequency identification (RFID) usage in improving the blood bank supply chain. Materials and Methods: The methodology for this study was a qualitative literature review following a systematic approach. The review was limited to sources published from 2000 to 2014 in the English language. Sixty-five sources were found, and 56 were used in this research study. Results: According to the finding of the present study, there are numerous benefits and barriers to RFID utilization in blood bank supply chains. RFID technology offers several benefits with regard to blood bank product management, including decreased transfusion errors, reduction of product loss, and more efficient inventory management. Barriers to RFID implementation include the cost associated with system implementation and patient privacy issues. Conclusions: Implementation of an RFID system can be a significant investment. However, when observing the positive impact that such systems may have on transfusion safety and inventory management, the cost associated with RFID systems can easily be justified. RFID in blood bank inventory management is vital to ensuring efficient product inventory management and positive patient outcomes

    Roles of binding elements, FOXL2 domains, and interactions with cJUN and SMADs in regulation of FSHβ.

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    We previously identified FOXL2 as a critical component in FSHβ gene transcription. Here, we show that mice deficient in FOXL2 have lower levels of gonadotropin gene expression and fewer LH- and FSH-containing cells, but the same level of other pituitary hormones compared to wild-type littermates, highlighting a role of FOXL2 in the pituitary gonadotrope. Further, we investigate the function of FOXL2 in the gonadotrope cell and determine which domains of the FOXL2 protein are necessary for induction of FSHβ transcription. There is a stronger induction of FSHβ reporter transcription by truncated FOXL2 proteins, but no induction with the mutant lacking the forkhead domain. Specifically, FOXL2 plays a role in activin induction of FSHβ, functioning in concert with activin-induced SMAD proteins. Activin acts through multiple promoter elements to induce FSHβ expression, some of which bind FOXL2. Each of these FOXL2-binding sites is either juxtaposed or overlapping with a SMAD-binding element. We determined that FOXL2 and SMAD4 proteins form a higher order complex on the most proximal FOXL2 site. Surprisingly, two other sites important for activin induction bind neither SMADs nor FOXL2, suggesting additional factors at work. Furthermore, we show that FOXL2 plays a role in synergistic induction of FSHβ by GnRH and activin through interactions with the cJUN component of the AP1 complex that is necessary for GnRH responsiveness. Collectively, our results demonstrate the necessity of FOXL2 for proper FSH production in mice and implicate FOXL2 in integration of transcription factors at the level of the FSHβ promoter

    Diagnosis of Partial Body Radiation Exposure in Mice Using Peripheral Blood Gene Expression Profiles

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    In the event of a terrorist-mediated attack in the United States using radiological or improvised nuclear weapons, it is expected that hundreds of thousands of people could be exposed to life-threatening levels of ionizing radiation. We have recently shown that genome-wide expression analysis of the peripheral blood (PB) can generate gene expression profiles that can predict radiation exposure and distinguish the dose level of exposure following total body irradiation (TBI). However, in the event a radiation-mass casualty scenario, many victims will have heterogeneous exposure due to partial shielding and it is unknown whether PB gene expression profiles would be useful in predicting the status of partially irradiated individuals. Here, we identified gene expression profiles in the PB that were characteristic of anterior hemibody-, posterior hemibody- and single limb-irradiation at 0.5 Gy, 2 Gy and 10 Gy in C57Bl6 mice. These PB signatures predicted the radiation status of partially irradiated mice with a high level of accuracy (range 79–100%) compared to non-irradiated mice. Interestingly, PB signatures of partial body irradiation were poorly predictive of radiation status by site of injury (range 16–43%), suggesting that the PB molecular response to partial body irradiation was anatomic site specific. Importantly, PB gene signatures generated from TBI-treated mice failed completely to predict the radiation status of partially irradiated animals or non-irradiated controls. These data demonstrate that partial body irradiation, even to a single limb, generates a characteristic PB signature of radiation injury and thus may necessitate the use of multiple signatures, both partial body and total body, to accurately assess the status of an individual exposed to radiation
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