Human Immunodeficiency Virus Screening: Knowledge, Attitudes, Perceived Norms, and Control Beliefs of Advanced Practice Registered Nurses in Colorado

The purpose of this evidence-based practice project was to increase the knowledge base to address the barriers preventing routine screening of the human immunodeficiency virus (HIV). The project consisted of a statewide survey to assess the knowledge, attitudes, perceived norms, control beliefs, barriers, and facilitators of advanced practice registered nurses (APRNs) across Colorado. A statewide assessment is important in the state of Colorado because APRNs are the primary providers in many rural areas. There were 66 responses to the survey. Knowledge of the Centers for Disease Control and Prevention (CDC; 2018) guideline for HIV screening was lacking. About one-third of the APRNs did not know the CDC guideline applied to all patients age 13 to 64 and was not just for high risk groups of which the Black/African American race and healthcare workers were not. The APRNs were influenced by actions of other APRNs but did not screen per CDC guidelines for many reasons. Although the APRNs were confident in HIV screening, they wanted resources for where they could get more information and where to send patients who might have a positive HIV test. This project provided the basis for future education interventions that could utilize a pre/post survey with an educational session either in the rural setting or via webinar

THE MESOCORTICOLIMBIC DOPAMINE PATHWAY RECONSTITUTED IN VITRO: GLUTAMATE RECEPTORS AND CORTICOSTEROID-METHAMPHETAMINE NEUROTOXICITY

Stress promotes the use of methamphetamine and other recreational substances and is often implicated in relapse to stimulant use. Thus, it is of critical importance to examine the consequences of the co-occurance of stress and methamphetamine use. Activity of the glutamatergic N-methyl D-aspartate (NMDA) receptor system appears to be involved in the neurotoxic effects of both chronic stress and methamphetamine exposure. The current studies investigated the hypothesis that chronic pre-exposure to the stress hormone corticosterone (CORT) results in an increase of NMDA receptor activity and that this will potentiate the neurotoxic effects of methamphetamine (METH). Co-cultures of the ventral tegmental area, nucleus accumbens, and medial prefrontal cortex were pre-exposed to CORT (1 μM) for 5 days prior to co-exposure to METH (100 μM) for 24 hours to investigate the combined effects on neurotoxicity and protein density of NMDA receptor subunits. The combination of CORT and METH resulted in significant neurotoxicity within the medial prefrontal cortex compared to either CORT or METH alone. The CORT+METH-induced toxicity was attenuated by co-exposure to the NMDA receptor antagonist (2R)-amino-5-phosphonovaleric acid (APV; 50 μM) during the 24 hour CORT and METH co-exposure. Although CORT alone did not significantly alter the density of the NR1 and NR2B subunits of the NMDA receptor, METH exposure for 24 hours resulted in a significant loss of the polyamine sensitive NR2B subunit. Co-exposure to CORT and METH also resulted in decreased extracellular glutamate while not significantly altering extracellular dopamine. These results suggest an enhancement of NMDA receptor systems or downstream effectors in areas of the mesolimbic reward pathway following chronic pre-exposure to CORT, which leads to enhanced neuronal vulnerability to future excitotoxic insults. This may be of critical importance as use of psychostimulants such as METH and other drugs of abuse may produce excitotoxic events in these areas, thus further compromising neuronal viability

TIME-DEPENDENCE OF DISTAL-TO-PROXIMAL HIPPOCAMPAL NEURODEGENERATION PRODUCED BY N-METHYL-D-ASPARTATE RECEPTOR ACTIVATION

Excitotoxicity is the overexcitation of neurons due to the excessive activation of excitatory amino acid receptors and is thought to be involved in many neurodegenerative states. The manner in which the neuron breaks down during excitotoxicity is still unclear. The current study used the organotypic hippocampal slice culture model to examine the time-dependent loss of the synaptic vesicular protein synaptophysin and the loss of N-methyl-D-aspartate (NMDA) receptor NR1 subunit availability following an excitotoxic insult (20 μM NMDA) to provide a better understanding of the topographical nature of neuronal death following NMDA receptor activation. Significant NMDA-induced cytotoxicity in the CA1 region of the hippocampus (as measured by propidium iodide uptake) was evident early (15 minutes after exposure) while significant loss of the NR1 subunit and synaptophysin was found at later timepoints (72 and 24 hours, respectively), suggesting delayed downregulation or degradation in axons and dendrites as compared to the soma. The addition of the competitive NMDA receptor antagonist 2-amino-7-phosphonovaleric acid (APV) significantly attenuated all NMDA-induced effects. These results suggest that NR1 and synaptophysin levels as measured by immunoreactivity are not reliable indicators of early cell death

Hpv Vaccine Effectiveness In New Haven County, Connecticut Women Age 18-39, 2008-2012

Background: HPV vaccines have demonstrated high efficacy in clinical trials against cervical lesions and infections by HPV vaccine types 16 and 18. Together these two types are responsible for approximately 70% of cervical cancer. Data on HPV vaccine effectiveness in general populations is limited. Methods: Surveillance data monitoring high-grade cervical lesions in Connecticut was used. Medical records were reviewed and patients were interviewed to ascertain HPV vaccine history. Patients\u27 biopsy specimens were typed to determine the presence of vaccine or non-vaccine type HPV. Odds ratios were determined using logistic regression, adjusting for age at diagnosis, grade of cervical lesion, race/ethnicity, and insurance type. Results: From 2008-2012, 788 women with known vaccine status and typed biopsy specimens were analyzed. 8.9% of women received at least one vaccine dose. Adjusted vaccine effectiveness for at least one dose was estimated to be 53%. Vaccine type HPV was strongly associated with higher grade cervical lesions, but other statistically significant associations were not found. Conclusions: The data suggests that HPV vaccination provides protection against vaccine type high-grade cervical lesions in women. Although these results are promising, more long term data and greater sample sizes are required to better estimate vaccine effectiveness

I Lost Our Baby

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The DIM system: WOZ Simulation Results - Phase I

Early work in the dield of natural language processing was based on the assumption that humans interact with computers in the same way they do with other humans. However, more recent work seems to indicate otherwise. We conducted an experiment to explore human-computer interactions for a limited domain. The results that we obtained are consistent with recent findings. In a limited domain, when communicating with computers, people keep utterances very brief, pronomial references to a minimum and the conversation very focused. From the data that we have gathered, it is not clear whether it is the conversational partner or the limited domain which influences the speech patterns of people to a greater extent. However, the experimental data strongly suggests that people adapt their style of communication as they get more acquainted with the capabilities of their conversational partner. These findings suggest that to build a natural language system for human-computer dialogue, it is not necessary to model all of human language

Athletic Training Students Demonstrate Supplemental Oxygen Administration Skill Decay, but Retain Knowledge Over Six Months

Purpose: Research suggests skill decay occurs with emergency skills, such as supplemental oxygen administration (OA), since the frequency of medical emergencies in clinical settings is low. Identifying the presence and timeline for skill decay allows educators to employ strategies to prevent this occurrence. Therefore, this study evaluated retention of knowledge and clinical skills associated with supplemental oxygen administration, specifically nasal cannula (NC) and non-rebreather mask (NrM) usage in professional athletic training students. Methods: Cross-sectional study. Twenty-nine athletic training students (males=11, females=18; age=21.03+1.38) enrolled in a Commission on Accreditation of Athletic Training Education (CAATE)-accredited professional athletic training programs. Participants’ supplemental oxygen administration knowledge and skills was assessed five times (baseline-T4). The baseline assessment was followed by an educational review session. Participants’ knowledge and skills were re-assessed (T1) and then randomly assigned to two groups. The experimental group’s supplemental oxygen administration knowledge and skills were re-evaluated at 1-month (T2), 3-months (T3), and 6-months (T4). The control at 6-months (T4). Results: Analysis revealed no significant differences between the groups on knowledge (F2,54=.15, P=.86) and overall clinical skills (F2,54=1.52, P=.23). A significant main effect for time on knowledge (F2,54=65.30, P1.89,50.98=112.55, P1.55,41.88=108.03, P Conclusions: Both groups retained supplemental oxygen administration knowledge over 6-months. Conversely, nasal cannula and non-rebreather mask skills decayed from review session to 6-month follow-up. Regular rehearsal and practice of acute care clinical skills should be integrated into educational programs to avoid decay of skills. Since these skills are not frequently utilized in the clinical education environment, integrating opportunities to practice these skills to maintain the competence level of students and prepare them for clinical practice is warranted

Rummaging through the Attic of New England

The concept of the circular economy has taken off, gaining momentum along with concerns about resource depletion, waste, and the impending ‘end of cheap nature’ (Moore 2014). Environmentalists and industrialists alike have promoted the benefits of reuse as a means toward improved efficiency and reduced resource pressure. Some have called for a new ‘culture of reuse’ (Botsman and Rogers 2010; Stokes et al. 2014). It is in this context that we explore repair, resale, and reuse as practices with deep historical precedent and contemporary continuity. Are there lessons to be learned from places that are already home to circular economies and strong cultures of reuse? And are there dangers inherent in a stronger, more formalized reuse sector? This paper draws on an historical and ethnographic analysis of vibrant reuse practices in the rural northeastern state of Maine. While there is a popular tendency to explain Maine’s persistent reuse practices as a response to economic and geographic marginality, our empirical observations suggest that these explanations do not adequately capture the complexity of reuse markets, discount the power of human agency and sense of place, and preclude important lessons for reuse policy in other contexts. Insights from Maine suggest that any effort to promote reuse would benefit from looking beyond purely economic rationales to attend to matters of place, sociality, and market relationality

Intergroup Dialogue as Praxis for Engaging the Intercultural World

Intergroup Dialogue (IGD) is a formalized program that centers dialogue among students in the classroom. The IGD program uses Martin Buber’s (1970) concept of dialogue, and this semester-long project situates dialogue as a useful addition to an Intercultural Communication course. Bringing components of a formal dialogue program into the classroom as a part of a course allows students to engage with difficult topics, such as race, gender, sexual orientation, class, and ability, among others, in a way that helps students process and better understand perspectives different from their own. This essay provides specific opportunities for meaningful dialogue and concludes an evaluation of our semester-long project and the lessons learned along the way