Tiered Centralized Education in the Transition-to-Practice Program to Improve Nurses\u27 Level of Confidence on Nursing Sensitive Indicators Outcomes

A tiered Centralized Education in the Transition-to-Practice (TTP) Program is crucial to improving nurses\u27 Level of Confidence on nursing-sensitive quality indicators. The benefits of a structured orientation program taught by trained content experts are evident in the literature. In addition, training transition-to-practice RNs during onboarding with training and assessment sessions throughout the orientation program to increase frequency provides skills acquisition. This study examined the impact of a house-wide education program on the nurses\u27 confidence levels of CLABSI prevention, a measured nursing-sensitive quality indicator. This quasi-experimental quality improvement study measured the confidence and comfort levels of transition-to-practice RNs and identified that centralized house-wide education programs statistically increase the confidence levels of TTP RNs in CLABSI prevention

Making the Minnehaha: The Reengineering of a Creek and the Creation of an Envirotechincal System

University of Minnesota M.A. thesis. May 2019. Major: History of Science, Technology, and Medicine. Advisor: Mark Borrello. 1 computer file (PDF); iv, 106 pages.This history documents the transformation of the Minnehaha Creek from the signing of the treaties of Traverse des Sioux and Mendota in the 1850s, which enabled the settlement of the Minnehaha Creek by American settler-colonists and the statehood of Minnesota, to the visit of President Lyndon Baines Johnson to the Minnehaha Falls in 1964. Located along the southern edge of Minneapolis, Minnesota and its south and western suburbs, the Minnehaha Creek is a twenty-two-mile-long waterway connecting Lake Minnetonka and the Mississippi River. Central in this history is confronting uncritical appraisals of the Minnehaha Creek’s naturalness and uncovering the role technology and culture has played in the transformation of the waterway. Because the Minnehaha’s waterfall has been a tourist attraction for more than one-hundred and seventy years, it has been regarded as being one of Minneapolis’s great “natural” treasures. However, this history of the Minnehaha Creek complicates uncritical appraisals of the Minnehaha Creek’s naturalness, or its “natural mythology,” by showing that the Minnehaha, first through the installation of gristmills, then through the construction of a dam at its headwaters, and last through the creation of parklands, has been transformed into an envirotechnical system. That is, a system where nature, culture, and the artifacts of humanity have melded together to form a system that can no longer be explained by one of these forces alone. By uncovering the technology and ideology embedded in the Minnehaha, and how the Minnehaha itself has been turned into a technology, this history presents itself as a case study about how technology is used to express values and priorities on environments and the mythologies we develop to legitimate and rationalize the new environments we create

Oocytes prevent cumulus cell apoptosis by maintaining a morphogenic paracrine gradient of bone morphogenetic proteins

© The Company of Biologists Ltd 2005Paracrine factors secreted by the oocyte regulate a broad range of cumulus cell functions. Characteristically, cumulus cells have a low incidence of apoptosis and we proposed that this is due to oocyte-secreted factors acting in an anti-apoptotic manner. Bovine cumulus-oocyte complexes (COC) were aspirated from abattoir-derived ovaries and oocytectomized (OOX) by microsurgical removal of the oocyte. OOX were treated with doses of either denuded oocytes (DO) or various growth factors for 24 hours (± rFSH; 0.1 IU/ml). Proportions of apoptotic cumulus cells were assessed using TUNEL and laser confocal scanning microscopy followed by image analysis. Quantification of Bcl-2 and Bax proteins in OOX was undertaken by western analysis. Oocyte removal led to a significant increase in cumulus cell apoptosis compared with COC controls (35% versus 9% TUNEL positive, respectively; P<0.001). Levels of OOX apoptosis were significantly reversed (P<0.001) in a dose-dependent manner when co-cultured with oocytes. Furthermore, the anti-apoptotic effect of oocyte-secreted factors followed a gradient from the site of the oocyte(s). Growth differentiation factor 9 (GDF9) had no significant effect on cumulus cell apoptosis. By contrast, cumulus cell apoptosis was significantly (P<0.001) reduced by bone morphogenetic proteins (BMP) 15, 6 or 7. Accordingly, levels of antiapoptotic Bcl-2 were high in OOX+DO and OOX+BMP15 and low with OOX+GDF9 or OOX alone, whereas the reverse was observed for pro-apoptotic Bax. DO, BMP15 and BMP6 were also able to protect cumulus cells from undergoing apoptosis induced by staurosporine. FSH partially prevented apoptosis in all treatment groups (P<0.001). Follistatin and a BMP6 neutralizing antibody, which antagonized the anti-apoptotic effects of BMP15 and BMP6, respectively, whether alone or combined, blocked ~50% of the anti-apoptotic actions of oocytes. These results are the first to demonstrate that oocyte-secreted factors, and particularly BMP15 and BMP6, maintain the low incidence of cumulus cell apoptosis by establishing a localized gradient of bone morphogenetic proteins.Tamer S. Hussein, David A. Froiland, Fred Amato, Jeremy G. Thompson and Robert B

Evaluation of a Consumer-Generated Marketing Plan for Medication Therapy Management Services

The purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS) provided in community pharmacies. This was accomplished through a six-step process: (1) application of "design thinking" for eliciting consumer input on redesigning MTMS and marketing approaches, (2) exploratory research, (3) focus group analysis, (4) marketing plan development, (5) marketing plan implementation, and (6) marketing plan evaluation. The findings showed that the application of "design thinking" and focus group analysis was useful for creating a consumer-directed marketing plan for medication therapy management services (MTMS). Implementation and evaluation of the MTMS Marketing Plan revealed that the most successful pharmacies were those that had established business associate agreements with the medical clinics closest to their site of practice, including access to electronic health records. This "virtual electronic presence" of pharmacists in the medical care system was highly consistent with the consumer demand we uncovered for a visible relationship between pharmacists, physicians and other health care providers. &nbsp; Type:&nbsp;Original Researc

Protein supplementation in strength and conditioning adepts: knowledge, dietary behaviour and practice in Palermo, Italy

Background: It is known that supplement use is a widespread and accepted practice by athletes and people who attend commercial gyms. Little is known about protein supplement amongst people undertaking strength training in commercial gyms in Italy when compared to the US. Objective: The purpose of this study was to examine the use of protein supplementation, alone or in association with other supplements, and dietary behavior amongst regular fitness center attendees in Palermo, Italy. Design: Resistance training information have been collected from 800 regular fitness center attendees for the initial analysis. A specific questionnaire was generated for the experimentation. Data were collected using a face-to-face interview method. Supplement users were then compared to the non users and analyzed using a one-way ANOVA, Kruskall-Wallis, chi-square test or exact test of Fisher when appropriate. Results: 30.1% of the respondents use dietary supplements during their training as a believe it is the "way to gain muscles and strength". Whey protein shakes (50.0%) mixed with creatine and amino-acids (48.3%) were the most frequent choices amongst the users. A majority of the subjects (34.0%) appeared to rely on their gym instructors' advice for their intake; a lower proportion (13.0%) consulted physicians, while none of them consulted nutritionists. A high consumption of milk has been noticed in both users (67,7%) and non-users (52,8%); supplement non-users consumed significantly more snacks and bakery products than users per week (P < 0.001), while users consumed significantly more protein-rich foods (P < 0.01) with a particular preference for meat (48.0%). Conclusions: A considerable number of regular strength training adepts consume protein supplements mixed with other products (mainly creatine and amino-acids). Limited numbers consult "dietary specialists" and rely mainly on their instructors. We emphasize on the importance of the dissemination of scientifically based information about supplementation in this environment and the promotion of updated educational programs for the instructors

Whey Protein Ingestion Activates mTOR-dependent Signalling after Resistance Exercise in Young Men: A Double-Blinded Randomized Controlled Trial

The effect of resistance exercise with the ingestion of supplementary protein on the activation of the mTOR cascade, in human skeletal muscle has not been fully elucidated. In this study, the impact of a single bout of resistance exercise, immediately followed by a single dose of whey protein isolate (WPI) or placebo supplement, on the activation of mTOR signalling was analyzed. Young untrained men completed a maximal single-legged knee extension exercise bout and were randomized to ingest either WPI supplement (n = 7) or the placebo (n = 7). Muscle biopsies were taken from the vastus lateralis before, and 2, 4 and 24 h post-exercise. WPI or placebo ingestion consumed immediately post-exercise had no impact on the phosphorylation of Akt (Ser473). However, WPI significantly enhanced phosphorylation of mTOR (Ser2448), 4E-BP1 (Thr37/46) and p70S6K (Thr389) at 2 h post-exercise. This study demonstrates that a single dose of WPI, when consumed in modest quantities, taken immediately after resistance exercise elicits an acute and transient activation of translation initiation within the exercised skeletal muscle

Use of dietary supplements in Olympic athletes is decreasing: a follow-up study between 2002 and 2009

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to assess the frequency of use of dietary supplements (DS) among large sample of elite Finnish athletes and to describe possible changes in dietary supplement use between the years 2002 and 2009.</p> <p>Methods</p> <p>A prospective follow-up study was conducted on Olympic athletes. The first survey was conducted on Olympic athletes in 2002 (N = 446) and the follow-up study was conducted between May 2008 and June 2009 (N = 372).</p> <p>Results</p> <p>In 2002, a total of 81% of the athletes used dietary supplements (a mean of 3.37 ± 3.06 DS per user) and in 2009, a total of 73% of the athletes (a mean of 2.60 ± 2.69 per DS user) used them. After adjusting for age-, sex- and sport type, the OR (95% confidence interval, CI) for use of any dietary supplement was significantly less in 2009 as compared with 2002 results (OR, 0.62; 95% CI, 0.43-0.90). Decrease in DS use was observed in all supplement subgroups (vitamins, minerals, nutritional supplements). Athletes in speed and power events and endurance events reported use of any dietary supplement significantly more often than team sport athletes both in 2002 and 2009. In year 2009, the frequency of all dietary supplement use increased when athlete's age increased and the increase was significant in older age groups: of the athletes under 21 years 63%, 21-24 years 83% and over 24 years 90% consumed nutritional supplements.</p> <p>Conclusions</p> <p>Based in our study, there seems to be a lowering trend of dietary supplement use among elite Finnish athletes although differences between sport subgroups and age groups are considerable.</p

Comparison of diet consumption, body composition and lipoprotein lipid values of Kuwaiti fencing players with international norms

<p>Abstract</p> <p>Background</p> <p>No published data is currently available that describes the dietary patterns or physiological profiles of athletes participating on the Kuwaiti national fencing team and its potential impact on health and physical performance. The purpose of this investigation was to: 1) collect baseline data on nutrient intake 2) collect, analyze and report baseline for body composition, plasma lipid and lipoprotein concentrations during the competitive season, 3) compare the results with the international norms, 4) and provide necessary health and nutritional information in order to enhance the athletes' performance and skills.</p> <p>Methods</p> <p>Fifteen national-class fencers 21.5 ± 2.6 years of age participated in this study. Food intake was measured using a 3-day food record. Body composition was estimated using both the BOD POD and Body Mass Index (BMI). Total blood lipid profiles and maximum oxygen consumption was measured for each of the subjects during the competitive season.</p> <p>Results</p> <p>The results of the present study showed significant differences in dietary consumption in comparison with the recommended dietary allowances (RDA). The blood lipids profile and body composition (BMI and % body fat) were in normal range in comparison with international norms However, the average VO_{2 max}value was less than the value of the other fencers.</p> <p>Conclusion</p> <p>Due to the results of the research study, a dietary regimen can be designed that would better enhance athletic performance and minimize any health risks associated with nutrition. Percent body fat and BMI will also be categorized for all players. In addition, the plasma blood tests will help to determine if any of the players have an excessive level of lipids or any blood abnormalities. The outcomes of present study will have a direct impact on the players health and therefore their skills and athletic performance.</p