A Nurse Practitioner's Experience Using Remote Presence Technology in an Isolated Community: An Autoethnography

There are many barriers to accessing healthcare services, particularly for people living in remote communities. Embracing innovation, such as remote presence technology (RPT), is one approach to reducing barriers. Innovations for healthcare service delivery can affect the care provided at the local level. Research Question and Methodology I examined the effect of RPT on healthcare service delivery in a remote community. Employing analytic autoethnography, I took a three-pronged approach, considering a systems level, patient care level, and nurse practitioner (NP) practice level. Outcomes Systems Level In Saskatchewan, rural and remote dwellers experience a disparity in access to primary and specialist care, allied health professionals, and diagnostic services. Contributing factors involve the centralization of services, distance decay, transportation, and unfunded costs. Social determinants of health and systemic oppression contribute to the disparity. This results in patients receiving altered standards of care and poorer health outcomes. Patient Care Level RPT resulted in superior care provided to patients, resulting in a decrease in morbidity and mortality. Most patients were able to remain in the community rather than being transferred out, and patients and families were actively engaged with developing the care plan. NP Practice Level Working directly with specialists through collaboration, mentorship, and coaching enhanced NP work confidence and competence. Professional isolation and decision fatigue decreased. Challenges included not having access to the necessary providers, provider attitudes, inflexible policies, and having to shoulder the burden of care. Conclusion The introduction of RPT can have a drastic effect on the healthcare system, which is felt most at the local level. Patients can receive appropriate and timely care in their home community. NPs have a unique role working in remote healthcare settings. This model of care could have a significant influence on NP practice. Initiatives should be community-driven and responsive to match needs with services

Individual differences in infant fixation duration relate to attention and behavioral control in childhood

Individual differences in fixation duration are considered a reliable measure of attentional control in adults. However, the degree to which individual differences in fixation duration in infancy (0–12 months) relate to temperament and behavior in childhood is largely unknown. In the present study, data were examined from 120 infants (mean age = 7.69 months, SD = 1.90) who previously participated in an eye-tracking study. At follow-up, parents completed age-appropriate questionnaires about their child’s temperament and behavior (mean age of children = 41.59 months, SD = 9.83). Mean fixation duration in infancy was positively associated with effortful control (β = 0.20, R2 = .02, p = .04) and negatively with surgency (β = −0.37, R2 = .07, p = .003) and hyperactivity-inattention (β = −0.35, R2 = .06, p = .005) in childhood. These findings suggest that individual differences in mean fixation duration in infancy are linked to attentional and behavioral control in childhood

Will Changing Demographics Affect U.S. Cheese Demand?

U.S. cheese consumption has grown considerably over the last three decades. Using a censored demand model and Nielsen Homescan retail data, this study identifies price and non-price factors affecting the demand for differentiated cheese products. Own-price and expenditure elasticities for all of the cheese products are statistically significant and elastic. Results also reveal that a strong substitution relationship exists among all cheese products. Although demographic influences are generally smaller than those related to prices and expenditures, empirical findings show that household size, college educated female heads of household who are age 40 and older, residing in the South, Central, and Western regions of the United States, as well as Black heads of household, have positive statistically significant effects on consumers’ cheese purchases.cheese form, cheese purchase, demand elasticities, demographic and economic factors, Nielsen Homescan data, Food Consumption/Nutrition/Food Safety, Marketing, C25, D12, Q11,

Quantifying physiological influences on otolith microchemistry

Trace element concentrations in fish earstones (‘otoliths’) are widely used to discriminate spatially discrete populations or individuals of marine fish, based on a commonly held assumption that physiological influences on otolith composition are minor, and thus variations in otolith elemental chemistry primarily reflect changes in ambient water chemistry. We carried out a long-term (1-year) experiment, serially sampling seawater, blood plasma and otoliths of mature and immature European plaice (Pleuronectes platessa L.) to test relationships between otolith chemistry and environmental and physiological variables. Seasonal variations in otolith elemental composition did not track seawater concentrations, but instead reflected physiological controls on metal transport and biokinetics, which are likely moderated by ambient temperature. The influence of physiological factors on otolith composition was particularly evident in Sr/Ca ratios, the most widely used elemental marker in applied otolith microchemistry studies. Reproduction also triggered specific variations in otolith and blood plasma metal chemistry, especially Zn/Ca ratios in female fish, which could potentially serve as retrospective spawning indicators. The influence of physiology on the trace metal composition of otoliths may explain the success of microchemical stock discrimination in relatively homogenous marine environments, but could complicate alternative uses for trace element compositions in biominerals of higher organism

ADOPTION OF BEST MANAGEMENT PRACTICES IN STOCKER CATTLE PRODUCTION

This study identifies current production and management practices of Oklahoma stocker cattle producers and analyzes factors affecting the adoption of best management practices (BMPs) using chi-square analysis. Results reveal that factors influencing the adoption of BMPs are operation size, dependency upon income from the operation, and specialization in stocker production.cattle, stockers, management, production, Livestock Production/Industries,

Pyridine is an organocatalyst for the reductive ozonolysis of alkenes

Whereas the cleavage of alkenes by ozone typically generates peroxide intermediates that must be decomposed in an accompanying step, ozonolysis in the presence of pyridine directly generates ketones or aldehydes through a process that neither consumes pyridine nor generates any detectable peroxides. The reaction is hypothesized to involve nucleophile-promoted fragmentation of carbonyl oxides via formation of zwitterionic peroxyacetals

Development of a Self‐Management Theory‐Guided Discharge Intervention for Parents of Hospitalized Children

Background Parents of hospitalized children, especially parents of children with complex and chronic health conditions, report not being adequately prepared for self‐management of their child\u27s care at home after discharge. Problem No theory‐based discharge intervention exists to guide pediatric nurses\u27 preparation of parents for discharge. Purpose To develop a theory‐based conversation guide to optimize nurses\u27 preparation of parents for discharge and self‐management of their child at home following hospitalization. Methods Two frameworks and one method influenced the development of the intervention: the Individual and Family Self‐Management Theory, Tanner\u27s Model of Clinical Judgment, and the Teach‐Back method. A team of nurse scientists, nursing leaders, nurse administrators, and clinical nurses developed and field tested the electronic version of a nine‐domain conversation guide for use in acute care pediatric hospitals. Conclusions The theory‐based intervention operationalized self‐management concepts, added components of nursing clinical judgment, and integrated the Teach‐Back method. Clinical Relevance Development of a theory‐based intervention, the translation of theoretical knowledge to clinical innovation, is an important step toward testing the effectiveness of the theory in guiding clinical practice. Clinical nurses will establish the practice relevance through future use and refinement of the intervention