Community Transitions of Care for Hospital Readmission Prevention

Background: Transitions of Care (TOC) occur whenever an individual moves from one healthcare setting to another. Older adults are higher utilizers of healthcare services, including inpatient and emergent visits, than the general population (Tian, 2016), and thus experience more TOCs. Due to risk of poor outcomes at discharge from the hospital, rehospitalizations are a concern. Standardized TOC protocols have been shown to be beneficial in reducing rehospitalizations for this vulnerable population. Purpose: Use current best practices to design and implement TOC for a rural community organization to reduce unintended rehospitalizations for older adults. Methods: Best practices in TOC were assessed, formalized, and informed the intervention. Patients from three local hospitals were evaluated inpatient for TOC services. Registered nurses implemented TOC visits within 24 -72 hours post discharge, and completed a in-home care plan with need for additional followup. Clients were followed for 60 days following discharge for any unintended hospital events. Results: 31 patients were referred for TOC. 21 were deemed appropriate referrals and 9 (42%) consented to the TOC visit. 2 patients (22%) of those who received TOC had an unintended hospital event within 60 days of discharge. Conclusion: Implementation of TOC services post hospital discharge has a beneficial effect on reducing readmission and emergency visits for older adults in the short ter

Le Temps des Copains: Youth and the Making of Modern France in the Era of Decolonization, 1958-1968

This thesis examines the popular yé-yé phenomenon and its role in articulating a vision of modern France in the aftermath of decolonization. Yé-yé, a teen-oriented and music-based popular culture that flourished from roughly 1962-1966, was in a unique position to define what it meant to be young in 1960s France. I argue that the yé-yé popular culture, through its definition of youth, provided an important cultural channel through which to articulate a modern French identity after the Algerian War (1954-1962). Using a combination of advertisements, articles, and sanitized depictions of teenage pop singers, the yé-yé popular culture constructed an idealized vision of adolescence that coupled a technologically-savvy and consumer-oriented outlook with a distinctly conservative, apolitical, and inclusive social stance. It reflected France\u27s reorientation toward a particular technological and consumer modernity while simultaneously serving to obscure France\u27s recent colonial past and the dubious legacy of imperialism. To contextualize yé-yé, this thesis begins by examining the blousons noirs (black jackets) and the societal anxieties that surrounded them in the early Fifth Republic (1958-1962). By tracking the abrupt shift from the blousons noirs to yé-yé in predominant media representations of youth, this thesis provides a unique vantage point with which to interpret dominant discourses of the Gaullist Fifth Republic and its attempt to reinvent France into a modernized and decolonized consumer republic. As the work suggests, it was not a coincidence that the optimistic yé-yé youth, unburdened by the tribulations of France\u27s recent past, appeared in full force within months following the recognition of Algerian independence in 1962

AN INVESTIGATION INTO SPECIFIC SEMINAL PLASMA PROTEINS AND THEIR EFFECT ON THE INNATE IMMUNE RESPONSE TO BREEDING IN THE MARE

The mare experiences a transient innate immune response to breeding, the resolution of which is crucial for optimal fertility. The majority of mares are able to modulate this inflammation in a timely fashion, but a subpopulation exists which fail to do so and are considered susceptible to persistent breeding-induced endometritis (PBIE). Seminal plasma has been shown to modulate aspects of this inflammation. Recently, two seminal plasma proteins have garnered interest for their immune modulating properties: cysteine-rich secretory protein-3 (CRISP-3) and lactoferrin. These proteins have been found to alter the binding between sperm and neutrophils based on sperm viability in vitro, but minimal work has evaluated their effect on endometrial mRNA expression of cytokines and inflammation in response to breeding. Experiments were performed to analyze the expression of equine CRISP-3. Found to be primarily synthesized in the ampulla of the vas deferens and to a lesser extent in the vesicular gland, CRISP-3 expression was only seen in the postpubertal stallion. Due to the effect of sperm viability on protein function in vitro, varying sperm populations were analyzed for their effect on gene expression in the uterus. It was determined that viable sperm suppressed the gene expression of the inflammatory modulating cytokine interleukin-6 (IL-6) in comparison to dead sperm. Next, the effect of CRISP-3 and lactoferrin on endometrial gene expression in the normal and susceptible mare was investigated. Neither protein had a significant effect on the mRNA expression of inflammatory cytokines in the normal mares at six hours post-breeding. In contrast, lactoferrin was found to significantly suppress the expression of the pro-inflammatory cytokine tumor necrosis factor (TNF)-α in susceptible mares. Due to this, lactoferrin was further analyzed as an immunomodulant for the treatment of PBIE. Susceptible mares were infused with varying doses of lactoferrin at six hours post-breeding. Although not in a dose-dependent fashion, lactoferrin was found to decrease both fluid retention and neutrophil migration, in addition to suppressing the expression of the pro-inflammatory cytokine interferon gamma (IFNγ) and increasing the gene expression of the anti-inflammatory cytokine interleukin-1 receptor antagonist (IL-1RN). In conclusion, CRISP-3 expression occurs in secretory aspects of the male reproductive tract, and appears to be up regulated after sexual maturation. Viability of spermatozoa affects the immune response to breeding and should be taken into consideration for experimental design and interpretation of data. The seminal plasma proteins CRISP-3 and lactoferrin have minimal effect on endometrial gene expression in normal mares, but lactoferrin suppresses the expression of TNF in susceptible mares. Finally, lactoferrin was found to function as a potent anti-inflammatory for the persistent inflammation seen in susceptible mares when administered post-breeding. This protein should be further investigated as a potential therapeutic for the treatment of persistent breeding-induced endometritis

Trends in Salmonella shedding by U.S. market hogs, swine 2000.

USDA’s National Animal Health Monitoring System’s (NAHMS) conducted a study of the health and management of swine as part of the Swine ‘95 study and Swine 2000 study. The studies were conducted in the top swine states in the U.S. A subset of participating farms allowed collection of fecal samples (50 samples per farm) from pens containing late finishers. The same methodology and laboratory was used in both studies so comparison of results provides a measure of change in on-farm Salmonella status between 1995 and 2000. Samples were tested for Salmonella and questionnaires were used to obtain management data regarding feed management, environmental conditions, vaccination policies, and other factors. The percent of farms with at least one positive sample was 38% in 1995 and 34% in 2000. The percent of samples positive was 6% in 1995 and 2000. The percent of pens positive was 17% in 1995 and 16% in 2000. In contrast to trends in slaughter HACCP Salmonella samples, the similarity in on-farm Salmonella status suggests that on-farm Salmonella intervention has yet to be initiated on a wide scale by producers and that on-farm Salmonella status is not directly related to slaughter Salmonella status

Building a Life Science Transfer Community: The Transfer-student Research and Integration Program (TRIP)

The Transfer-student Research and Integration Program (TRIP) prepares life science students for placement in graduate school or the STEM workforce by supporting their professional development and integration into the UCF community. TRIP students also receive a team-based research experience and an opportunity to present at regional conferences. An $8,000 scholarship distributed over the course of the 2-year program reduces financial barriers and encourages students to spend more time on campus and in a research environment. This poster provides an overview of the challenges facing transfer students, the solutions offered by TRIP, and early outcomes from the first cohort of our National Science Foundation-sponsored program

Legitimizing the republican monarch a reexamination of French foreign policy in the Atlantic Alliance, 1958-1960

This thesis focuses on the role foreign policy played in legitimizing the early French Fifth Republic from 1958 to 1960. I argue that President Charles de Gaulle employed foreign policy in the service of gaining public support for his new government and the new republic. Many historians have argued previously that his foreign policy of grandeur, as it came to be called, was used to recast international politics and France\u27s role in them. My work diverges from these previous interpretations by arguing that Gaullist foreign policy served, in many instances, overarching domestic goals, not French international interests. I see foreign policy as inseparable from the broader domestic ambition to craft a persuasive narrative of renewal and national unity under Gaullist stewardship. In the process, my study puts de Gaulle\u27s foreign policy into the context of his larger aspiration to precipitate constitutional reform and, thereafter, ensure popular support. De Gaulle exploited opportunities to use foreign policy in order to shape public opinion, both domestically and internationally. These efforts, as my research reflects, helped foster public support for the new regime and, by portraying national renewal, further discredited the preceding Fourth Republic

Prevalence of Salmonella in Swine and Pork: A Farm to Consumer Study

Fecal, tissue, and environmental cultures and serological tests were performed on 100 swine on a multi–site farrow to finish production facility. Salmonella of 10 types were identified in the swine herd and environment but none were recovered from rodents or flies caught in the production units. At slaughter, 52% (24 of 46) of swine were serologically positive for Salmonella antibodies, while 9% (4 of 46) were positive by culture. Although clinical salmonellosis was not detected in the study herd, multiple serotypes of Salmonella were causing endemic infections in the study herd

Seasonality influences cuticle melanization and immune defense in a cricket: support for a temperature-dependent immune investment hypothesis in insects

To improve thermoregulation in colder environments, insects are expected to darken their cuticles with melanin via the phenoloxidase cascade, a phenomenon predicted by the thermal melanin hypothesis. However, the phenoloxidase cascade also plays a significant role in insect immunity, leading to the additional hypothesis that the thermal environment indirectly shapes immune function via direct selection on cuticle color. Support for the latter hypothesis comes from the cricket Allonemobius socius, where cuticle darkness and immune-related phenoloxidase activity increase with latitude. However, thermal environments vary seasonally as well as geographically, suggesting that seasonal plasticity in immunity may also exist. Although seasonal fluctuations in vertebrate immune function are common (because of flux in breeding or resource abundance), seasonality in invertebrate immunity has not been widely explored. We addressed this possibility by rearing crickets in simulated summer and fall environments and assayed their cuticle color and immune function. Prior to estimating immunity, crickets were placed in a common environment to minimize metabolic rate differences. Individuals reared under fall-like conditions exhibited darker cuticles, greater phenoloxidase activity and greater resistance to the bacteria Serratia marcescens. These data support the hypothesis that changes in the thermal environment modify cuticle color, which indirectly shapes immune investment through pleiotropy. This hypothesis may represent a widespread mechanism governing immunity in numerous systems, considering that most insects operate in seasonally and geographically variable thermal environments