Our Wavin’ Flag: U.S. Public Diplomacy Outreach

In March 2012, U.S. President Barack Obama, an avid sports fan, sat down to talk with sports writer Bill Simmons.1 He explained why competition on the field connects radically different people to each other, People - for all our differencespolitically,regionally,economically-mostfolksunderstandsports.Probablybecauseit\u27soneofthe few places where it\u27s a true meritocracy. There\u27s not a lot of BS. Ultimately, who\u27s winning, who\u27s losing, who\u27s performing, who\u27s not - it\u27s all laid out there. In many ways, sports is a perfect unifier. A fan need not be literate, educated, well-traveled, or wealthy to be personally engaged in the fate of a team or the outcome of a competition. Sports watching is not gender-specific and is generally a safe, widely accepted way to pass significant amounts of time, something that the industry and advertisers rely on heavily. It is, in essence, an ideal vehicle for public relations and public diplomacy

Adoption of Electronic Health Records by Admitting Physicians: A Heuristic Model

Background: Although hospital electronic health records (EHRs) are generally perceived to improve care, physician resistance may hinder EHR adoption. Purpose: This study uses constructs from diffusion of innovations and resource dependence theories to predict adoption and rate of adoption of an EHR by admitting physicians from three of ten hospitals in a highly integrated health system in Virginia. Functions evaluated: computerized physician order entry (CPOE), electronic history and physical (EH&P) and electronic discharge summary (EDS). The study tested hypotheses that adoption would be associated with: working at larger, academic hospitals; financial alignment; larger physician groups; office EHR; youth; males; medical specialty; high volume; hospital-based; high inpatient ratio; and high loyalty. Methods: Administrative data collected for 326 physicians admitting at least ten patients during the six months following EHR activation represented over 80% of the total admissions. Logistic Regression and Cox Regression were used to evaluate how well variables predicted adoption (80% utilization) and adoption rate. Results: The Logistic Regression model predicted significant proportions of variation in adoption of CPOE (66%), EH&P (34%) and EDS (40%). CPOE adoption was more likely (p \u3c .05) for physicians who were male, had a high inpatient ratio, lower patient volume and community hospital setting. EH&P and EDS adoption was more likely for physicians with financial alignment and large, academic hospital setting. The Cox Regression model predicted significant proportions of variation in rate of adoption of CPOE (10%), EH&P (14%) and EDS (19%). The overall model for CPOE was significant (p=.006); no individual predictors were significant. Physicians who were financially aligned or worked at the large, academic hospital adopted EH&P and EDS faster. Conclusion: Personal factors: loyalty, age and gender were generally not predictive. Organizational factors: hospital setting and financial alignment were most predictive of adoption. Study results may help administrators improve EHR installations

The Use of Non-ICU Confusion Assessment Method (CAM) for Delirium Management

The purpose of this study was to determine the effect the use of the non-intensive care unit confusion assessment method (non-ICU CAM) as an early screening tool for delirium would have on the nursing practice of medical surgical nurses. This quasi-experimental study focused on early screening and prevention training of inpatient nurses caring for adult inpatients to proactively reduce episodes of delirium. The training included an educational video on how to perform the non-ICU CAM assessment, 4 scenarios to test knowledge on scoring patient, and techniques for reducing delirium if patient is positive. After one month of multimodal training for the nursing staff, there was statistically significant differences between the results of the pre- and post-intervention surveys. Overall, this study determined that the training and use of non-ICU CAM for had a positive impact on the nursing staff in relation to their ability to manage overall identification of delirium in their patients and management of their care. The findings of this study were: the improvement in the nurses’ beliefs within their own practice with a 12.5% increase in their self-efficacy scores, 29.8% improvement in the intention of assessing their patients for delirium, 17.5% improvement in their perceived social norm within their peers, and 11.9% improvement in their attitudes in managing the care of patients with delirium. This study aimed to address two major gaps in what literature suggests as evidence-based practice and what is the current nursing workflows: a gap in nurse knowledge and a gap in clinical practice. This study contributes to the advancement in the practice of nurses outside of the intensive care units in identifying delirium through patient symptom analysis and improve nurses’ coping and management of challenging patient behaviors related to delirium.https://digitalcommons.odu.edu/gradposters2023_healthsciences/1003/thumbnail.jp

Disability Employment Services in Australia: a brief primer

This review aims to highlight how the chronic condition self-management support (CCSMS) field might inform and enhance the skills of the disability employment services (DES) workforce, particularly in it interactions with clients with complex disability needs. The approach we have taken involves a consideration of current education and training, recruitment of staff into DES and issues of concern arising from these processes. The main findings of our review are that the current DES workforce may not have the required skills to fully meet the needs of the populations they serve given the growing burden of chronic conditions, generally. We conclude by calling for greater consideration of CCSMS education and training as core required skills for the DES workforce, so that they might integrate their practice more collaboratively alongside other support providers

Key Topics on End-of-Life Care for African Americans

Racial classifications of human populations are politically and socially determined. There is no biological or genetic basis for these racial classifications. Health behaviors may be influenced by culture and poverty. Disparities in health outcomes, sometimes resulting in higher mortality rates for African-Americans appear to influence end of life decision-making attitudes and behaviors. To improve the quality of end of life care in African-American communities, health care professionals must better understand and work to eliminate disparities in health care, increase their own skills, knowledge and confidence in palliative and hospice care, and improve awareness of the benefits and values of hospice and palliative care in their patients and families

The SCottish Alcoholic Liver disease Evaluation: a population-level matched cohort study of hospital-based costs, 1991-2011

Studies assessing the costs of alcoholic liver disease are lacking. We aimed to calculate the costs of hospitalisations before and after diagnosis compared to population controls matched by age, sex and socio-economic deprivation. We aimed to use population level data to identify a cohort of individuals hospitalised for the first time with alcoholic liver disease in Scotland between 1991 and 2011.Incident cases were classified by disease severity, sex, age group, socio-economic deprivation and year of index admission. 5 matched controls for every incident case were identified from the Scottish population level primary care database. Hospital costs were calculated for both cases and controls using length of stay from morbidity records and hospital-specific daily rates by specialty. Remaining lifetime costs were estimated using parametric survival models and predicted annual costs. 35,208 incident alcoholic liver disease hospitalisations were identified. Mean annual hospital costs for cases were 2.3 times that of controls pre diagnosis (£804 higher) and 10.2 times (£12,774 higher) post diagnosis. Mean incident admission cost was £6,663. Remaining lifetime cost for a male, 50-59 years old, living in the most deprived area diagnosed with acoholic liver disease was estimated to be £65,999 higher than the matched controls (£12,474 for 7.43 years remaining life compared to £1,224 for 21.8 years). In Scotland, alcoholic liver disease diagnosis is associated with significant increases in admissions to hospital both before and after diagnosis. Our results provide robust population level estimates of costs of alcoholic liver disease for the purposes of health-care delivery, planning and future cost-effectiveness analyses

Filling Key Gaps in Population and Community Ecology

We propose research to fill key gaps in the areas of population and community ecology, based on a National Science Foundation workshop identifying funding priorities for the next 5–10 years. Our vision for the near future of ecology focuses on three core areas: predicting the strength and context-dependence of species interactions across multiple scales; identifying the importance of feedbacks from individual interactions to ecosystem dynamics; and linking pattern with process to understand species coexistence. We outline a combination of theory development and explicit, realistic tests of hypotheses needed to advance population and community ecology

Epidermal Growth Factor Receptor-Mediated Membrane Type 1 Matrix Metalloproteinase Endocytosis Regulates the Transition between Invasive versus Expansive Growth of Ovarian Carcinoma Cells in Three-Dimensional Collagen

Abstract The epidermal growth factor receptor (EGFR) is overexpressed in ovarian carcinomas and promotes cellular responses that contribute to ovarian cancer pathobiology. In addition to modulation of mitogenic and motogenic behavior, emerging data identify EGFR activation as a novel mechanism for rapid modification of the cell surface proteome. The transmembrane collagenase membrane type 1 matrix metalloproteinase (MT1-MMP, MMP-14) is a major contributor to pericelluar proteolysis in the ovarian carcinoma microenvironment and is subjected to extensive posttranslational regulation. In the present study, the contribution of EGFR activation to control of MT1-MMP cell surface dynamics was investigated. Unstimulated ovarian cancer cells display caveolar colocalization of EGFR and MT1-MMP, whereas EGFR activation prompts internalization via distinct endocytic pathways. EGF treatment results in phosphorylation of the MT1-MMP cytoplasmic tail, and cells expressing a tyrosine mutated form of MT1-MMP (MT1-MMP-Y 573 F) exhibit defective MT1-MMP internalization. As a result of sustained cell surface MT1-MMP activity, a phenotypic epithelial-mesenchymal transition is observed, characterized by enhanced migration and collagen invasion, whereas growth within three-dimensional collagen gels is inhibited. These data support an EGFR-dependent mechanism for regulation of the transition between invasive and expansive growth of ovarian carcinoma cells via modulation of MT1-MMP cell surface dynamics

Developing agency through good work: longitudinal effects of job autonomy and skill utilization on locus of control

An internal locus of control has benefits for individuals across multiple life domains. Nevertheless, whether it is possible to enhance an individual’s internal locus of control has rarely been considered. The authors propose that the presence of job autonomy and skill utilization in work can enhance internal locus of control, both directly and indirectly via job satisfaction. Three waves of data over a four-year period from the Household, Income and Labour Dynamics in Australia Survey (N = 3,045) were analyzed. Results showed that job autonomy directly shaped internal locus of control over time, as did job satisfaction. Skill utilization did not play a role in terms of affecting locus of control, and the indirect effects of both job autonomy and skill utilization via job satisfaction were weak. This study suggests the importance of job autonomy in promoting the development of an employee’s internal locus of control