Piloting Consumer Health Resources to Nurse and Patient Educators

Objective: The objective of this project is to pilot a consumer health resources train the trainer course and accompanying online guide to nurse and patient educators. Methods: The Clinical Services Librarian and Outreach Coordinator at the University of Arkansas for Medical Sciences proposed a plan to educate the nurse and patient educators in the hospital on reliable consumer health resources. Partnerships were formed within the institution with patient educators, patient advocates, and patient- and family-centered care. Librarians created a course presenting general consumer health resources from the National Library of Medicine as well as other reliable sites. The course was granted nursing, dietician, and patient educator continuing education credit. Parallel with the course, an online resource was built using LibGuides software. The LibGuide contains information on both general and specific health issues, based on local needs. The course walks participants through the guide and was piloted in local hospitals with patient and nurse educators. Results: The course and online guide have been completed and classes are being scheduled at both UAMS and the two local Veterans Administration hospitals. The course has been well received and participant scores have shown an increase between the pre- and post-tests. Conclusions: The course and guide received support from all areas of nursing as well as interest from outside hospitals. Future plans include expansion of the online guide and working with nurse and patient educators in hospitals and clinics throughout the state

Elevating Patient Education through State-wide Instruction of Nurses and Patient Educators on Consumer Health Resources

Background: Patient Education is consistently cited by the Joint Commission as needing work at many institutions. However, with a limited number of patient educators and high nurse to patient ratios it is hard to find the time to adequately teach patients all they may need to know. The goal of this project was to create a course and online guide for nurses and patient educators. The course was approved for continuing education credit for nurses, dieticians, and health education specialists. The guide would serve as a central location for accessing consumer health websites and information for both educators and patients. Description: The Clinical Services Librarian and Outreach Coordinator at an academic health sciences center proposed a plan to educate the nurses and patient educators in the hospital on reliable consumer health resources. Partnerships were formed within the institution with patient and nurse educators, patient advocates, and patient- and family-centered care. Librarians created a course presenting general consumer health resources from the National Library of Medicine as well as other reliable sites. The course was granted nursing, dietician, and certified health education specialist (CHES) continuing education credit. Parallel with the course, an online resource was built using LibGuides software. The guide contains information on both general and specific health issues, based on local needs. The course walks participants through the guide and was piloted in local hospitals with nurses, dieticians and patient educators before classes were arranged around the state. Conclusions: The online guide was completed in July 2018. As topics were suggested at courses, they were added to the guide, including pregnancy/lactation, Women’s Health, and Children’s Health. The course and guide were well received. Results from pre- to post-tests showed an average increase of 20%. Evaluations of the course and instructors were consistently ranked average or above average including: having a better understanding of subject materials and ability to identify, navigate, and analyze resources. Future plans include continued expansion of the online guide and setting up courses around the state

Building a Framework to Guide Residents through Scholarly Activities

Objective: The objective of this project was to build an online resource that will help guide residents through their Accreditation Council for Graduate Medical Education (ACGME) scholarly activity requirement by providing guidelines, advice, and resources on publishing, presenting, and research. Methods: The Clinical Services Librarian first met with the Graduate Medical Education (GME) office to determine the needs of the residencies and clarify current ACGME requirements. Meetings were then set with representatives from the largest residencies to discuss how the scholarly activity requirement was currently being met and to collect resources. After these meetings the librarian began building an online resource in the LibGuides software for both residents and junior faculty. The Research and Scholarly Activity Guide combines practical advice with tips and tricks for completing projects. Sections include information on how to set up and where to print a poster, how to write an abstract, and how to submit articles to journals. Research resources help guide residents through the institutional review board process, finding a mentor, and identifying statistical expertise. Results: The Research and Scholarly Activity Guide was completed over the summer and introduced to new interns and returning residents during noon conferences and orientations. The guide was also presented at both the residency directors’ and residency coordinators’ monthly meetings. The guide was well received and comments and suggestions were incorporated were appropriate. Conclusions: The Research and Scholarly Activity Guide was available starting July 2018. The guide brings a number of disparate resources together easing residents’ road to completion of their scholarly activity requirement as well as assisting junior faculty with research endeavors. Residency directors and coordinators have expressed how much this guide will help their programs

Jones Fracture

CLINICAL PRESENTATION AND EXAM: The Jones Fracture is mostly seen as a stress fracture caused by continuous trauma or impact to the lateral portion of the foot. The fracture can also be caused by an acute forceful trauma to the same area. The Jones Fracture is most commonly seen in athletes or chronic runners. Typically, athletes and runners experience the fracture in the non-dominant leg. ANATOMY AND PATHOLOGY: The Jones fracture is a fracture in the fifth metatarsal occurring at the metaphyseal-diaphyseal junction. The lateral portion of the foot is affected. Pain, swelling, discoloration, and difficulty in regular gait are common symptoms of this fracture. Inflammation can cause limited range of motion of the ankle and excess pain in the distal ankle, in turn radiating pain up the lower leg. DIAGNOSTIC TESTING & CONSIDERATIONS: A patients’ daily activities need to be taken into consideration when diagnosing a Jones Fracture. The diagnosis involves a physical exam. Initially there is a determination of how the injury happened and when the pain started. This is followed by a palpation examination of the foot in order to assess the location of the pain. Additionally, an X-Ray or other imaging scans can be used to verify the facture. TREATMENT & RETURN TO ACTIVITY: The treatment plan will depend on the severity of the fracture. The most common surgical fixation technique utilizes plates and screws to fix the fracture. The screw fixation can have a titanium screw as well as a bone graft, whereas the plate fixation uses both a screw and a titanium plate to help stabilize the fracture. The screw fixation has shown to have a 1-2-week quicker return to participation than the plate fixation. A cast is usually placed on the patients’ foot following surgery. Non-surgical interventions include rest and ankle exercises that aim to alleviate pain and loss of performance. Individuals choosing a non-surgical treatment tend to take a longer time to return to previous participation levels. During the healing process there may be complications with the reunion of the fracture. These complications can include nonunion, delayed union, and refracture, all of which can occur with surgical as well as nonsurgical techniques. Nonunion happens when the fracture does not heal, and the screw or plate has not held them together. Delayed union is when the fracture takes longer than usual to heal. It is the most common due to the athlete participating in their sport before healing has happened. A refracture can occur when previous activity levels are initiated too soon, exposure to high impact on the area, or not having complete union of the fracture. Physical therapy can take 6-8 weeks depending on the healing progression. Due to the distal proximity of the fracture the adequacy of blood flow may affect the healing progression. Additionally, there may be limited range of motion due to swelling, pain and scar tissue build up. Ankle exercises including range of motion work, banded resistance, and stability work are also used to strength the affected ankle. Ultimately the goal of therapy is healing of the fracture along with developing adequate range of motion, proper gait, and reducing pain. Suggestions to prevent an initial or a reoccurrence of the injury include wearing proper footwear, avoid running on uneven surfaces with unstable ankles, and use of proper running technique

Evacuation planning in the Auckland Volcanic Field, New Zealand: a spatio-temporal approach for emergency management and transportation network decisions

Auckland is the largest city in New Zealand (pop. 1.5 million) and is situated atop an active monogenetic volcanic field. When volcanic activity next occurs, the most effective means of protecting the people who reside and work in the region will be to evacuate the danger zone prior to the eruption. This study investigates the evacuation demand throughout the Auckland Volcanic Field and the capacity of the transportation network to fulfil such a demand. Diurnal movements of the population are assessed and, due to the seemingly random pattern of eruptions in the past, a non-specific approach is adopted to determine spatial vulnerabilities at a micro-scale (neighbourhoods). We achieve this through the calculation of population-, household- and car-to-exit capacity ratios. Following an analysis of transportation hub functionality and the susceptibility of motorway bridges to a new eruption, modelling using dynamic route and traffic assignment was undertaken to determine various evacuation attributes at a macro-scale and forecast total network clearance times. Evacuation demand was found to be highly correlated to diurnal population movements and neighbourhood boundary types, a trend that was also evident in the evacuation capacity ratio results. Elevated population to evacuation capacity ratios occur during the day in and around the central city, and at night in many of the outlying suburbs. Low-mobility populations generally have better than average access to public transportation. Macro-scale vulnerability was far more contingent upon the destination of evacuees, with favourable results for evacuation within the region as opposed to outside the region. Clearance times for intra-regional evacuation ranged from one to nine hours, whereas those for inter-regional evacuation were found to be so high, that the results were unrealistic. Therefore, we conclude that, from a mobility standpoint, there is considerable merit to intra-regional evacuation

Assessment Of Prediabetes Testing Practices Among Primary Care Providers In Mississippi

Prediabetes is a condition in which a person has impaired glucose metabolism; however, his or her glucose levels do not meet criteria for the diagnosis of diabetes (ADA, 2019). Prediabetes is associated with an increased risk of developing diabetes and cardiovascular disease (ADA, 2019). Early diagnosis and treatment of prediabetes, including lifestyle interventions and medical management, are vital in preventing prediabetes from progressing to diabetes. The review of current literature indicates that prediabetes testing is not being properly utilized in primary care settings. The purpose of this study was to determine if primary care providers (PCPs) were performing prediabetes A1C screenings for patients 18 and older who were overweight, obese, or had a BMI that was 25 or greater, as well as one or more additional risk factors for prediabetes; the study also included patients who were 45 or greater without further risk factors. The intention was to bring awareness of the proper guidelines required of PCPs in testing patients for prediabetes. It is the obligation of PCPs to test asymptomatic patients who are at risk of developing prediabetes or diabetes mellitus (ADA, 2019). Primary care providers can use this information to increase their knowledge and practice of performing appropriate testing on overweight and obese patients

The Atacama Cosmology Telescope: measuring radio galaxy bias through cross-correlation with lensing

We correlate the positions of radio galaxies in the FIRST survey with the cosmic microwave background lensing convergence estimated from the Atacama Cosmology Telescope over 470 deg2 to determine the bias of these galaxies. We remove optically cross-matched sources below redshiftz = 0.2 to preferentially select active galactic nuclei (AGN). We measure the angular cross-power spectrum Cκgl at 4.4σ significance in the multipole range 100 \u3c l \u3c 3000, corresponding to physical scales within ≈2–60 Mpc at an effective redshift zeff = 1.5. Modelling the AGN population with a redshift-dependent bias, the cross-spectrum is well fitted by the Planck best-fitting Λ cold dark matter cosmological model. Fixing the cosmology and assumed redshift distribution of sources, we fit for the overall bias model normalization, finding b(zeff) = 3.5 ± 0.8 for the full galaxy sample and b(zeff) = 4.0 ± 1.1(3.0 ± 1.1) for sources brighter (fainter) than 2.5 mJy. This measurement characterizes the typical halo mass of radio-loud AGN: we find log(Mhalo/M⊙)=13.6+0.3−0.4

Evolution in the bias of faint radio sources to z ~ 2.2

Quantifying how the baryonic matter traces the underlying dark matter distribution is key to both understanding galaxy formation and our ability to constrain the cosmological model. Using the cross-correlation function of radio and near-infrared galaxies, we present a large-scale clustering analysis of radio galaxies to z ~ 2.2. We measure the angular auto-correlation function of Ks90μJy to infer linear bias of radio galaxies in four redshift bins. We find that the bias evolves from b = 0.57 ± 0.06 at z ~ 0.3 to 8.55 ± 3.11 at z ~ 2.2. Furthermore, we separate the radio sources into subsamples to determine how the bias is dependent on the radio luminosity, and find a bias which is significantly higher than predicted by the simulations of Wilman et al., and consistent with the lower luminosity but more abundant FR-I population having a similar bias to the highly luminous but rare FR-IIs. Our results are suggestive of a higher mass, particularly for FR-I sources than assumed in simulations, especially towards higher redshift.Peer reviewe

A Field Computer for Animal Trackers

The field computer system has been developed to gather complex data on animal behaviour that is observed by expert animal trackers. The system is location aware using the satellite Global Positioning System. The system has been designed to empower semi-literate trackers. User testing showed that trackers were easily able to master the interface. They benefit from greater recognition, while the wider community gains from access to the knowledge of the trackers on animal behaviour