Crossing the Line: Experiences of the Formerly Homeless Living Past Homelessness

This grounded theory study explored the experiences of formerly homeless individuals and families who have moved from homelessness into stable housing. This was an ethnographic study and involved the researcher staying in an east coast shelter where some of the formerly homeless participants had become staff members and reside. Data analysis was informed by dimensional analysis. Moving out of homelessness was the studies perspective. Findings of the study revealed the following dimensions that related the formerly homeless\u27s experiences: (a)reacting to circumstances, or how they became homeless; (b)surviving as homeless, or how they lived while homeless; (c)crossing the fine, or what moved them to get out of the homeless life; (d)living past homelessness; and, (e)giving back. Findings of this study have implications for: (a)public policy making; (b)program development for homeless shelters; (c)health clinic staff that serve the homeless population; and, (d)future nursing research

Hepatitis C Virus Screening Strategies to Improve Early Identification and Treatment: ​ A Scoping Review​

Purpose/Background Hepatitis C virus (HCV) is the most common bloodborne infection in the United States (Ludden et al., 2022). Sadly, over half of the individuals living with chronic HCV are unaware of their condition (Halket et al., 2022). Due to rising numbers, HCV screening guidelines have been updated to recommend that every adult be screened at least once (Patel et al, 2021). Despite these guidelines, screening rates remain low. This scoping review aims to examine current research on HCV screening and strategies to improve early diagnosis and treatment. Methods This review began with a literature search using CINAHL and PubMed and the key phrases hepatitis C, screening, birth cohort, CDC, electronic medical record (EMR), and lifestyle risk. Inclusion criteria were publication within the last five years, English language, and full-text availability. Seven of the 28 articles meeting this criteria were selected based on their applicability, high-quality, and rigor. Specific data points were abstracted from these articles and compiled in an Excel spreadsheet. Results Three studies that evaluated the effectiveness of universal screening versus risk and/or birth cohort screening found that universal screening resulted in higher screening rates. EMR interventions based on risk and/or birth cohort were evaluated in six of the studies, with all six reporting increased screening rates. Additionally, one study found that screening rates increased when EMR-based interventions were paired with provider education. Implications for Nursing Practice The results of this review suggest that application of universal screening and the incorporation of EMR-based interventions lead to an appreciable increase in HCV screening and diagnosis, but studies that implement these interventions based on universal screening guidelines are needed. Most importantly, this review revealed that healthcare providers and patients need education on current screening guidelines, testing, and treatment so HCV can be diagnosed and treated early

Optimal Management During Systemic Lupus Erythematosus Cesarean Section: An Educational Module

Abstract Importance: Systemic lupus erythematosus (SLE) is a lifelong multisystem autoimmune disorder characterized by the presence of autoantibodies that are directed against nuclear antigens. The disease is the most common type of lupus that has a heterogeneous presentation, and an affinity for the female gender with a peak onset in normative childbearing years. It becomes important for anesthesia providers to understand the potential complications that they may encounter during the obstetric management of this population, during cesarean sections. Recommendations that address the disease’s heterogeneous presentation and effect on the parturient organ systems provide a template for anesthesia providers during the perioperative management of the obstetric SLE patient. Objective: This quality improvement (QI) project aims to improve healthcare provider knowledge regarding the clinical implications of SLE, during the obstetric management for a cesarean section, to reduce morbidity and mortality for mother and newborn. Setting: A 716-bed acute care hospital in Broward County, Florida, which has a large obstetric population requiring anesthetic services. Anesthesia providers at this facility will be educated on the maternal-fetal dyad that can present during the management of the SLE mother during a cesarian section. Methods: A pretest survey will be administered to assess anesthesia providers’ knowledge, attitudes, and behaviors regarding the management of the SLE parturient during a cesarian section. An educational module will then be provided. Finally, a posttest survey containing the same questions as the pretest will be administered to participants. Results: Following the educational intervention, there was an increase in knowledge scores and stronger attitudes and beliefs regarding the role of anesthesia providers in the management of the SLE parturient during a cesarean section. Furthermore, most participants reported that they were highly likely to implement this into their clinical practice. Conclusion: An educational module can enhance anesthesia provider knowledge and increase the likelihood of improved outcomes for mother and neonate, during the anesthetic management of an SLE parturient during a cesarean section

In vitro co-culture of Solanum tuberosum hairy roots with Meloidogyne chitwoodi: structure, growth and production of volatiles

Meloidogyne spp., commonly known as root- knot nematodes (RKNs), are economically important plant sedentary endoparasites that cause galls on susceptible hosts. The Columbia root-knot nematode (CRKN), M. chitwoodi, is a quarantine A2 type pest by the European and Mediterranean Plant Protection Organization since 1998. This nematode has been found associated with economi- cally important crops such as potato and tomato, causing severe damage and making the agricultural products unac- ceptable for the fresh market and food processing. In vitro co-culture of host and parasite offers an advantageous experimental system for studying plant-RKN interactions. The structure, growth and production of volatiles of Sola- num tuberosum hairy roots (HR) and of S. tuberosum HR/ CRKN co-cultures were compared. HR were induced by inoculation of aseptic potato tuber segments with Rhizo- bium rhizogenes. Co-cultures were initiated by inoculating HR with sterilized CRKN eggs. Infection with CRKN induced the RKN symptomatology in the HR and several nematode life stages were observed by light and scanning electron microscopy. Potato HR and HR/CRKN co-culturesexhibited similar growth patterns, evaluated by measuring fresh and dry weight and by the dissimilation method. Volatiles, isolated by distillation–extraction and analyzed by gas chromatography (GC) and gas chromatography coupled to mass spectrometry, revealed that palmitic acid (37–52 %), n–pentadecanal (10–16 %) and linoleic acid (2–16 %) were the main constitutive components of S. tu- berosum HR, and of the HR/CRKN co-cultures (24–44, 8–22 and 4–18 %, respectively). S. tuberosum HR/CRKN co-cultures can be considered a suitable biotechnological tool to study RKN infection mechanism by mimicking what occurs under field conditions

Central Sensitivity Syndromes: Mounting Pathophysiologic Evidence to Link Fibromyalgia with Other Common Chronic Pain Disorders

ABSTRACT: The aim of this study was to review emerging data from the fields of nursing, rheumatology, dentistry, gastroenterology, gynecology, neurology, and orthopedics that support or dispute pathophysiologic similarities in pain syndromes studied by each specialty. A literature search was performed through PubMed and Ovid using the terms fibromyalgia, temporomandibular joint disorder, irritable bowel syndrome, irritable bladder/interstitial cystitis, headache, chronic low back pain, chronic neck pain, functional syndromes, and somatization. Each term was linked with pathophysiology and/or central sensitization. This paper presents a review of relevant articles with a specific goal of identifying pathophysiologic findings related to nociceptive processing. The extant literature presents considerable overlap in the pathophysiology of these diagnoses. Given the psychosomatic lens through which many of these disorders are viewed, demonstration of evidence-based links supporting shared pathophysiology between these disorders could provide direction to clinicians and researchers working to treat these diagnoses. ''Central sensitivity syndromes'' denotes an emerging nomenclature that could be embraced by researchers investigating each of these disorders. Moreover, a shared paradigm would be useful in promoting crossfertilization between researchers. Scientists and clinicians could most effectively forward the understanding and treatment of fibromyalgia and other common chronic pain disorders through an appreciation of their shared pathophysiology

Bringing Brotherly Love to Interprofessional Education - Creating a Curriculum of Simulation with Multidisciplinary Objectives

Objectives: Learners attending this presentation/workshop will: Discuss the current trends in an interprofessional education curriculum Explore the possible pinnacles and pitfalls in developing an IPE educational curriculum, including institutional support for IPE programs Acquire the skills to develop simulation cases that foster interprofessional objectives Interprofessional collaboration and teamwork among health care professionals is essential to provide safe, high quality patient care. Unfortunately, dismantling of the existing educational silos between disciplines is fraught with challenges. Success requires multidisciplinary commitment and leadership, and must occur early in each student’s educational training. Although gaining popularity, interprofessional education (IPE) and communication is not commonly a focus in all health care disciplines. Drexel University ‘s College of Medicine and College of Nursing and Health Professions have developed a successful IPE curriculum in Women’s Health, built on a foundation of simulation and communication. Occurring three days per academic year over the last five years, the curriculum engages OB/GYN and anesthesia residents, undergraduate nursing, nurse practitioner, nurse anesthesia, physician assistant and midwifery students in outpatient and inpatient scenarios with active participant communication activities that crescendo through the year. Expert faculty with enhanced credentials in multi-fidelity simulation, Debriefing with Good JudgmentTM, and TeamSTEPPSTM participate in faculty development and interactive curriculum review to provide learners with rigorous, life-like experiences while learning to appropriately give bad news, handle stressful situations, and discuss important health related issues in a collaborative environment. The Drexel University Partnership for Interprofessional Education (DU-PIE) has presented workshops and live demonstrations nationally to teach faculty and staff how to devise an interprofessional curriculum for their institutions. Pinnacles and pitfalls encountered during the development and roll out of the Drexel model can assist programs to sustain and further enrich IPE programs. This interactive workshop will consist of a brief presentation, a small group activity to assist faculty and professional staff in creating the building blocks of an IPE simulation program including identifying stakeholders, lobbying for administrative support, and developing simulation cases that incorporate multidisciplinary IPE objectives, and group debriefing to share gained insights

Impact of shortened crop rotation of oilseed rape on soil and rhizosphere microbial diversity in relation to yield decline

Oilseed rape (OSR) grown in monoculture shows a decline in yield relative to virgin OSR of up to 25%, but the mechanisms responsible are unknown. A long term field experiment of OSR grown in a range of rotations with wheat was used to determine whether shifts in fungal and bacterial populations of the rhizosphere and bulk soil were associated with the development of OSR yield decline. The communities of fungi and bacteria in the rhizosphere and bulk soil from the field experiment were profiled using terminal restriction fragment length polymorphism (TRFLP) and sequencing of cloned internal transcribed spacer regions and 16S rRNA genes, respectively. OSR cropping frequency had no effect on rhizosphere bacterial communities. However, the rhizosphere fungal communities from continuously grown OSR were significantly different to those from other rotations. This was due primarily to an increase in abundance of two fungi which showed 100% and 95% DNA identity to the plant pathogens Olpidium brassicae and Pyrenochaeta lycopersici, respectively. Real-time PCR confirmed that there was significantly more of these fungi in the continuously grown OSR than the other rotations. These two fungi were isolated from the field and used to inoculate OSR and Brassica oleracea grown under controlled conditions in a glasshouse to determine their effect on yield. At high doses, Olpidium brassicae reduced top growth and root biomass in seedlings and reduced branching and subsequent pod and seed production. Pyrenochaeta sp. formed lesions on the roots of seedlings, and at high doses delayed flowering and had a negative impact on seed quantity and quality

Manufacturing Macroporous Monoliths of Microporous Metal-Organic Frameworks

We report the first use of a pressure-assisted sintering technique on metal-organic framework (MOF) powders allowing for fast production of crystalline macro-porous monoliths. Mechanical and micro-structural characterization of the monoliths is presented. The interconnected macro-porosity of the compacts can be adjusted providing an immense interface for gas-solid interaction. The sintering technique is well-established and commercially available, allowing industrial scale-up of the process