Rural hospital health in the United States

Introduction: Rural hospitals experienced both challenges and opportunities in providing healthcare to the community. As these facilities were one of the largest employers in the area, their impact was significant. Additionally, accessibility to necessary medical services was essential. Thus, sustainability of rural hospitals was vital. In order to assess sustainability, exploration into financial and quality outcomes could help support their ability to thrive. Purpose of the Study: The purpose of this study was to determine the sustainability of rural hospitals in the U.S. by examining variables that affect these institutions such as accessibility, availability of services, quality outcomes, and effective administrative practices. Methodology: This qualitative study utilized a literature review and open-ended survey of an expert in Hospital Administration within or collaborating with rural areas. Five databases were used to collect 48 total sources. These sources were reviewed and reduced to 32 sources that were used in the written research. Of these, 17 sources were used in the results section. Results: The research showed that patient outcomes and mortality rates in rural hospitals fluctuated. However, many rural hospitals offered improvement services or referrals, quality improvement plans for pain management, and quality improvement for end-of-life care. Rural hospitals proved difficulty in maintaining specialties and testing equipment such as a medical ICUs and cardiac intensive care units, neurology, MRI and CT machines, and obstetric services. ROE was more than double in urban as opposed to rural hospitals. However, the state expansion of Medicaid proved profitable for rural hospitals in states that opted to participate. Discussion/Conclusion: The research demonstrated the sustainability of rural hospitals in the U.S. was multifactorial. The online qualitative survey supported both the vitality of rural hospitals as well as the limited resources and need for partnerships with regional hospitals to promote rural hospital sustainability

Progeny of Germ Line Knockouts of \u3cem\u3eASI2\u3c/em\u3e, a Gene Encoding a Putative Signal Transduction Receptor in \u3cem\u3eTetrahymena Thermophila\u3c/em\u3e, Fail to Make the Transition from Sexual Reproduction to Vegetative Growth

The ciliated protozoan Tetrahymena has two nuclei: a germ line micronucleus and a somatic macronucleus. The transcriptionally active macronucleus has about 50 copies of each chromosome. At sexual reproduction (conjugation), the parental macronucleus is degraded and new macronucleus develops from a mitotic product of the zygotic micronucleus. Development of the macronucleus involves massive genome remodeling, including deletion of about 6000 specific internal eliminated sequences (IES) and multiple rounds of DNA replication. A gene encoding a putative signal transduction receptor, ASI2, (anlagen stage induced 2) is up-regulated during development of the new macronuclei (anlagen). Macronuclear ASI2 is nonessential for vegetative growth. Homozygous ASI2 germ line knockout cells with wild type parental macronuclei proceed through mating but arrest at late macronuclear anlagen development and die before the first post-conjugation fission. IES elimination occurs in these cells. Two rounds of postzygotic DNA replication occur normally in progeny of ASI2 germ line knockouts, but endoreduplication of the macronuclear genome is arrested. The germ line ASI2 null phenotype is rescued in a mating of a knockout strain with wild type cells

Sustainability of Rural Hospitals in the United States

Introduction: Rural hospitals experienced both challenges and opportunities in providing healthcare to the community. As these facilities were one of the largest employers in the area, their impact was significant. The purpose of this study was to determine the sustainability of rural hospitals in the U.S. by examining variables that affect these institutions such as accessibility, availability of services, quality outcomes, and effective administrative practices. Methodology: This qualitative study utilized a literature review and open-ended survey of an expert in Hospital Administration within or collaborating with rural areas. Five databases were used to collect 48 total sources. These sources were reviewed and reduced to 32 sources that were used in the written research. Of these, 17 sources were used in the results section. Results: The research showed that patient outcomes and mortality rates in rural hospitals fluctuated. However, many rural hospitals offered improvement services or referrals, quality improvement plans for pain management, and quality improvement for end-of-life care. Rural hospitals proved difficulty in maintaining specialties and testing equipment such as a medical ICUs and cardiac intensive care units, neurology, MRI and CT machines, and obstetric services. ROE was more than double in urban as opposed to rural hospitals. However, the state expansion of Medicaid proved profitable for rural hospitals in states that opted to participate. Discussion/Conclusion: The research demonstrated the sustainability of rural hospitals in the U.S. was multifactorial. The online qualitative survey supported both the vitality of rural hospitals as well as the limited resources and need for partnerships with regional hospitals to promote rural hospital sustainability

ENACT-ing Leadership at the State Level: A National Educational Network for Engaged Citizenship in State Legislatures

The Educational Network for Active Civic Transformation (ENACT) is a nationwide network that serves as a hub for the pedagogical efforts of educators in 16 different states, with the ambitious goal of having an ENACT Faculty Fellow in all 50 states. However, ENACT courses go a step further engaging students directly in experiential learning exercises designed to affect policy change by working with policy advocacy groups, preparing policy briefs, engaging in strategic outreach and messaging, and meeting directly with policymakers in their state capitals to advocate for political change. In this paper, we argue that state politics represents a fruitful, yet often neglected, space for the development of political leadership skills. Accordingly, we will present ENACT as a pedagogical model for empowering students, enhancing their capacity for political leadership. Yet we also remain attuned to localized variation in the policy-making environment and state political culture

Proposed media center services to Chiricahua Apache elementary school students

This paper is intended to serve as a preliminary study for the formation of an elementary school media center designed to serve Chiricahua Apache children. At present time the Chiricahua do not have a home reservation. A lawsuit has been filed to regain their reservation in the southeas.t corner of Arizona which was terminated by executive order in 1877, The Chiricahua people are scattered, with some making their homes on the Mescalero Reservation in New Mexico, the San Carlos Reservation in Arizona, and at Ft. Sill, Oklahoma.. The majority of the group lives in the Sierra Madre Mountains of Mexico. While this paper is applicable primarily to the Chiricahua 2u. S., Commission on Civil Rights, The Southwest Indian Report of the U. s. Commission on Civil Rights (Washington, D. C,: Government Printing Office, May, 1973, p. 26. 3 Apache, it may also be useful for people working with other Apache group:;. Although the Chiricahua are the most traditional of the Apache, the basic philosophies remain primarily the same for most Apache. With the present federal Indian policy of self-determination and the passage of the Indian Education Act al 1972, Indian people now have the opportunity to contract with the Federal Government to control their own educational programs. Before proceeding to a discussion of a media center designed for elementary Chiricahua Apache students, this paper will summarize essential background materials relating to the history of Indian education in the United States and to the Chiricahua Apache culture

Facial Soft Tissue Measurement in Microgravity-induces Fluid Shifts

Fluid shifts are a wellknown phenomenon in microgravity, and one result is facial edema. Objective measurement of tissue thickness in a standardized location could provide a correlate with the severity of the fluid shift. Previous studies of forehead tissue thickness (TTf) suggest that when exposed to environments that cause fluid shifts, including hypergravity, headdown tilt, and highaltitude/lowpressure, TTf changes in a consistent and measurable fashion. However, the technique in past studies is not well described or standardized. The International Space Station (ISS) houses an ultrasound (US) system capable of accurate submillimeter measurements of TTf. We undertook to measure TTf during longduration space flight using a new accurate, repeatable and transferable technique. Methods: Inflight and postflight Bmode ultrasound images of a single astronaut's facial soft tissues were obtained using a Vividq US system with a 12LRS highfrequency linear array probe (General Electric, USA). Strictly midsagittal images were obtained involving the lower frontal bone, the nasofrontal angle, and the osseocartilaginous junction below. Single images were chosen for comparison that contained identical views of the bony landmarks and identical acoustical interface between the probe and skin. Using Gingko CADx DICOM viewing software, soft tissue thickness was measured at a right angle to the most prominent point of the inferior frontal bone to the epidermis. Four independent thickness measurements were made. Conclusions: Forehead tissue thickness measurement by ultrasound in microgravity is feasible, and our data suggest a decrease in tissue thickness upon return from microgravity environment, which is likely related to the cessation of fluid shifts. Further study is warranted to standardize the technique with regard to the individual variability of the local anatomy in this area

Progeny of germ line knockouts of ASI2, a gene encoding a putative signal transduction receptor in Tetrahymena thermophila, fail to make the transition from sexual reproduction to vegetative growth

AbstractThe ciliated protozoan Tetrahymena has two nuclei: a germ line micronucleus and a somatic macronucleus. The transcriptionally active macronucleus has about 50 copies of each chromosome. At sexual reproduction (conjugation), the parental macronucleus is degraded and new macronucleus develops from a mitotic product of the zygotic micronucleus. Development of the macronucleus involves massive genome remodeling, including deletion of about 6000 specific internal eliminated sequences (IES) and multiple rounds of DNA replication. A gene encoding a putative signal transduction receptor, ASI2, (anlagen stage induced 2) is up-regulated during development of the new macronuclei (anlagen). Macronuclear ASI2 is nonessential for vegetative growth. Homozygous ASI2 germ line knockout cells with wild type parental macronuclei proceed through mating but arrest at late macronuclear anlagen development and die before the first post-conjugation fission. IES elimination occurs in these cells. Two rounds of postzygotic DNA replication occur normally in progeny of ASI2 germ line knockouts, but endoreduplication of the macronuclear genome is arrested. The germ line ASI2 null phenotype is rescued in a mating of a knockout strain with wild type cells

Socioeconomic inequalities in early adulthood disrupt the immune transcriptomic landscape via upstream regulators

Disparities in socio-economic status (SES) predict many immune system-related diseases, and previous research documents relationships between SES and the immune cell transcriptome. Drawing on a bioinformatically-informed network approach, we situate these findings in a broader molecular framework by examining the upstream regulators of SES-associated transcriptional alterations. Data come from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative sample of 4543 adults in the United States. Results reveal a network—of differentially expressed genes, transcription factors, and protein neighbors of transcription factors—that shows widespread SES-related dysregulation of the immune system. Mediational models suggest that body mass index (BMI) plays a key role in accounting for many of these associations. Overall, the results reveal the central role of upstream regulators in socioeconomic differences in the molecular basis of immunity, which propagate to increase risk of chronic health conditions in later-life