APPLICATION OF THE SOCIAL DETERMINANTS OF HEALTH TO GERIATRIC PATIENTS BY NURSE PRACTITIONER STUDENTS

ABSTRACT APPLICATION OF THE SOCIAL DETERMINANTS OF HEALTH TO GERIATRIC PATIENTS BY NURSE PRACTITIONER STUDENTS Patient outcomes are influenced by the social determinants of health (SDOH), which influence differing exposures to opportunities or health risks. Holistic care of geriatric patients includes considering SDOH in patient assessment, diagnosis, and care delivery. Understanding how NP students care for geriatric patients using a SDOH lens provides insight into their practice behaviors and helps educators understand how to strengthen NP programs to achieve better patient outcomes and advance health equity for the geriatric population. The purpose of this study was to describe how NP students conceptualize SDOH for geriatric patients, explore NP student comfort in asking about patient SDOH as part of their assessment, and to describe how NP students apply their knowledge of SDOH to their assessment and plan of care for geriatric patients. This study utilized a multi-method descriptive approach with both qualitative and quantitative methods within three separate study arms. Participants included family nurse practitioners (FNP) and adult gerontology primary care nurse practitioners (AGPCNP) in their last clinical practicum who took care of geriatric patients in an outpatient setting. Qualitative and quantitative data was collected from study participants in the form of survey responses, debriefing sessions, and care management plans. The findings of this study revealed that NP students could identify SDOH associated with geriatric patients. They were most comfortable asking about, and most frequently identified, considered, and incorporated SDOH of social support, transportation, and access to care into the plan of care of geriatric patients. NP students were least comfortable asking about, and least frequently identified, considered, and incorporated SDOH of discrimination, civic participation, and crime and violence into the plan of care of geriatric patients. Identification and interventions by NP students were limited to the most common SDOH. This study contributes to the understanding of the transfer of knowledge about SDOH to the clinical practice of NP students when caring for geriatric patients. This study informs nurse educators on how to strengthen NP programs to teach SDOH and practical SDOH mitigation interventions in the plan of care for geriatric patients

Assessment of Skeletal Muscle Characteristics in Female Collegiate Cheer Athletes

PURPOSE: To examine training modalities and muscle architecture characteristics between legs in collegiate cheer athletes. METHODS: Thirteen female collegiate cheer athletes (19 ± 1 years, 164.3 ± 6.8 cm, 63.0 ± 10.2 kg) were assessed for anthropometrics, a survey to assess type of training outside of cheer practice, and B mode ultrasound on both legs during a single visit. All ultrasound images were analyzed at 50% of the vastus lateralis for muscle thickness (MT), pennation angle (PA), and fascicle length (FL). RESULTS: Type of exercise training outside of practice counts: endurance (2), resistance (2), mixed (6), and do not train (3). We observed the following characters in the right leg (MT: 21.2 ± 2.2 mm, PA: 12.3 ± 2.7 deg, FL: 99.2 ± 27.0 mm) and left leg (MT: 21.1 ± 2.4 mm, PA: 13.2 ± 2.6 deg, FL: 86.2 ± 11.0 mm) with no differences observed between legs p\u3e0.05. CONCLUSION: Given our sample size we observed more athletes performing a mix of endurance and resistance exercise, and no differences between legs for skeletal muscle characteristics

Nursing Student Perceptions Regarding Simulation Experience Sequencing

BACKGROUND: The use of simulated learning experiences (SLEs) have increased within nursing curricula with positive learning outcomes for nursing students. The purpose of this study is to explore nursing students\u27 perceptions of their clinical decision making (CDM) related to the block sequencing of different patient care experiences, SLEs versus hospital-based learning experiences (HLEs). METHOD: A qualitative descriptive design used open-ended survey questions to generate information about the block sequencing of SLEs and its impact on nursing students\u27 perceived CDM. RESULTS: Three themes emerged from the data: Preexperience Anxiety, Real-Time Decision Making, and Increased Patient Care Experiences. CONCLUSION: Nursing students identified that having SLEs prior to HLEs provided several benefits. Even when students preferred SLEs prior to HLEs, the sequence did not impact their CDM. This suggests that alternating block sequencing can be used without impacting the students\u27 perceptions of their ability to make decisions

Quantum state preparation, tomography, and entanglement of mechanical oscillators

Precisely engineered mechanical oscillators keep time, filter signals, and sense motion, making them an indispensable part of today's technological landscape. These unique capabilities motivate bringing mechanical devices into the quantum domain by interfacing them with engineered quantum circuits. Proposals to combine microwave-frequency mechanical resonators with superconducting devices suggest the possibility of powerful quantum acoustic processors. Meanwhile, experiments in several mechanical systems have demonstrated quantum state control and readout, phonon number resolution, and phonon-mediated qubit-qubit interactions. Currently, these acoustic platforms lack processors capable of controlling multiple mechanical oscillators' quantum states with a single qubit, and the rapid quantum non-demolition measurements of mechanical states needed for error correction. Here we use a superconducting qubit to control and read out the quantum state of a pair of nanomechanical resonators. Our device is capable of fast qubit-mechanics swap operations, which we use to deterministically manipulate the mechanical states. By placing the qubit into the strong dispersive regime with both mechanical resonators simultaneously, we determine the resonators' phonon number distributions via Ramsey measurements. Finally, we present quantum tomography of the prepared nonclassical and entangled mechanical states. Our result represents a concrete step toward feedback-based operation of a quantum acoustic processor.Comment: 13 pages, 4+5 figure

Strong dispersive coupling between a mechanical resonator and a fluxonium superconducting qubit

We demonstrate strong dispersive coupling between a fluxonium superconducting qubit and a 690 megahertz mechanical oscillator, extending the reach of circuit quantum acousto-dynamics (cQAD) experiments into a new range of frequencies. We have engineered a qubit-phonon coupling rate of $g\approx2\pi\times14~\text{MHz}$, and achieved a dispersive interaction that exceeds the decoherence rates of both systems while the qubit and mechanics are highly nonresonant ($\Delta/g\gtrsim10$). Leveraging this strong coupling, we perform phonon number-resolved measurements of the mechanical resonator and investigate its dissipation and dephasing properties. Our results demonstrate the potential for fluxonium-based hybrid quantum systems, and a path for developing new quantum sensing and information processing schemes with phonons at frequencies below 700 MHz to significantly expand the toolbox of cQAD.Comment: 22 pages, 12 figure

Observation of electronic excitation transfer through light harvesting complex II using two-dimensional electronic–vibrational spectroscopy

Light Harvesting Complex II (LHCII) serves a central role in light harvesting for oxygenic photosynthesis, and is arguably the most important photosynthetic antenna complex. In this work, we present two-dimensional electronic-vibrational (2DEV) spectra of LHCII isolated from spinach, demonstrating the possibility of using this technique to track the transfer of electronic excitation energy between specific pigments within the complex. We assign the spectral bands via comparison with the 2DEV spectra of the isolated chromophores, chlorophyll a and b, and present evidence that excitation energy between the pigments of the complex are observed in these spectra. Finally, we analyze the essential components of the 2DEV spectra using singular value decomposition, which makes it possible to reveal the relaxation pathways within this complex

Membrane interaction and structure of the transmembrane domain of influenza hemagglutinin and its fusion peptide complex

<p>Abstract</p> <p>Background</p> <p>To study the organization and interaction with the fusion domain (or fusion peptide, FP) of the transmembrane domain (TMD) of influenza virus envelope glycoprotein for its role in membrane fusion which is also essential in the cellular trafficking of biomolecules and sperm-egg fusion.</p> <p>Results</p> <p>The fluorescence and gel electrophoresis experiments revealed a tight self-assembly of TMD in the model membrane. A weak but non-random interaction between TMD and FP in the membrane was found. In the complex, the central TMD oligomer was packed by FP in an antiparallel fashion. FP insertion into the membrane was altered by binding to TMD. An infrared study exhibited an enhanced membrane perturbation by the complex formation. A model was built to illustrate the role of TMD in the late stages of influenza virus-mediated membrane fusion reaction.</p> <p>Conclusion</p> <p>The TMD oligomer anchors the fusion protein in the membrane with minimal destabilization to the membrane. Upon associating with FP, the complex exerts a synergistic effect on the membrane perturbation. This effect is likely to contribute to the complete membrane fusion during the late phase of fusion protein-induced fusion cascade. The results presented in the work characterize the nature of the interaction of TMD with the membrane and TMD in a complex with FP in the steps leading to pore initiation and dilation during virus-induced fusion. Our data and proposed fusion model highlight the key role of TMD-FP interaction and have implications on the fusion reaction mediated by other type I viral fusion proteins. Understanding the molecular mechanism of membrane fusion may assist in the design of anti-viral drugs.</p

Membrane interaction and structure of the transmembrane domain of influenza hemagglutinin and its fusion peptide complex

<p>Abstract</p> <p>Background</p> <p>To study the organization and interaction with the fusion domain (or fusion peptide, FP) of the transmembrane domain (TMD) of influenza virus envelope glycoprotein for its role in membrane fusion which is also essential in the cellular trafficking of biomolecules and sperm-egg fusion.</p> <p>Results</p> <p>The fluorescence and gel electrophoresis experiments revealed a tight self-assembly of TMD in the model membrane. A weak but non-random interaction between TMD and FP in the membrane was found. In the complex, the central TMD oligomer was packed by FP in an antiparallel fashion. FP insertion into the membrane was altered by binding to TMD. An infrared study exhibited an enhanced membrane perturbation by the complex formation. A model was built to illustrate the role of TMD in the late stages of influenza virus-mediated membrane fusion reaction.</p> <p>Conclusion</p> <p>The TMD oligomer anchors the fusion protein in the membrane with minimal destabilization to the membrane. Upon associating with FP, the complex exerts a synergistic effect on the membrane perturbation. This effect is likely to contribute to the complete membrane fusion during the late phase of fusion protein-induced fusion cascade. The results presented in the work characterize the nature of the interaction of TMD with the membrane and TMD in a complex with FP in the steps leading to pore initiation and dilation during virus-induced fusion. Our data and proposed fusion model highlight the key role of TMD-FP interaction and have implications on the fusion reaction mediated by other type I viral fusion proteins. Understanding the molecular mechanism of membrane fusion may assist in the design of anti-viral drugs.</p