Using Technology to Improve Diabetes Self-Management within a Federally Qualified Community Health Center

The Patient Centered Medical Home (PCMH) concept places the patient and family at the center of healthcare. The patient becomes actively involved in their own care. One aspect of PCMH is managing care and increasing chronic disease self-management. Diabetes, a chronic disease, is a leading diagnosis among the patients served by the federally qualified community health center (FQCHC). The prevalence of diabetes in Mississippi in 2012 was 12.3%. The purpose of this DNP Capstone project was to implement a pilot study to increase diabetes self-management knowledge. The program utilized the current technology of text messaging to send biweekly supportive and educational text messages over a four week period. The level of patient knowledge was measured by a before and after implementation survey. Improving diabetes self-management will ultimately lead to improved compliance to the treatment plan while also improving self-management skills and education. The measures of improving diabetic self-management followed the 2014 Diabetes Clinical Practice Recommendations (Cefalu, 2014). To increase communication and improve relationships, the project was guided by the Relationship Based Care Theory and the Chronic Care Model. In an attempt to improve diabetic outcomes, measures of diabetic self-management were provided to patients through text messages. Communication provided through text messaging reminded patients to check blood sugar levels, provided diet recommendations, and provided exercise tips and suggestions. These communications provided a positive and proactive attitude toward diabetes self-management. By providing this information to patients through texting technology, the DNP Capstone Project measured if diabetes self-management skills improved or changed. By increasing the frequency of contact to the diabetic patients through text messages, the health care provider demonstrated an improved patient-provider relationship. The frequent communication will provide reassurance and encouragement to the diabetic patients and ultimately lead to improved diabetic self-management

MSFC Engineering Overview

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Engagement, resilience, and persistence: facilitating success through integrated curriculum design

James Cook University's Diploma of Higher Education (DHE) is a one year, open access, enabling program attracting a diverse array of students from across northern Australia and beyond. The open access nature of the DHE results in a diverse student cohort, where 9% of students identify as having a disability, 11% identify as Indigenous, 14% come from low socioeconomic backgrounds, and 28% are from non-English speaking backgrounds. Moreover, 68% of students are non-school leavers (aged 19 and above) and 40% did not meet traditional tertiary entry requirements (have an ATAR/OP score) upon commencement of the course. The diverse student cohorts characteristic of enabling spaces result in variable levels of digital and academic literacies in the classroom. This showcase demonstrates how the DHE's core subjects, CU1022: Developing Academic Skills and CS1022: Learning in a Digital Environment, respond to the complexities of concurrently teaching academic and digital literacies in an open access enabling space through an integrated curriculum design. Engagement of horizontal knowledge structures (Paxton & Frith, 2014) within the design processes of CS1022 and CU1022 assure alignment across learning outcomes, assessment processes, and supports. Furthermore, conscious discursive alignment across classroom practice and weekly learning episodes facilitate cohesive learning experiences, fostering a sense of belonging. This positively influences students' motivation, engagement, resilience, and persistence (Tinto, 2009), whilst mitigating the impacts of discontinuities between prior learning and new academic contexts (Paxton & Frith, 2014). Paxton and Firth state (2014) that, "quite often the resources that students bring may not be considered legitimate meaning making tools and … [therefore] interfere with learning" (p. 173). By emphasising resilience and experiential reflection, in a cross-disciplinary context, CS1022 and CU1022 work collaboratively to moderate, rather than reinforce, the internalisation of a deficit mindset. The success of the collaborative, horizontal design processes in these subjects is evidenced in student feedback: "CS1022 is great and complements CU1022 … Peer reviewing and working in groups creates a much better student culture" (CS1022, Student Feedback Survey, SP2, 2017), and more broadly in the DHE’s sector leading student achievement data

NASAs Human Landing System: The Strategy for the 2024 Mission and Future Sustainability

In response to the 2018 White House Space Policy Directive- sustainable lunar exploration, and to the Vice Presidents March 2019 direction to do so by 2024, NASA is working to establish humanity's presence on and around the Moon by: 1) sending payloads to its surface, 2) assembling the Gateway outpost in orbit and 3) demonstrating the first human lunar landings since 1972. NASAs Artemis program is implementing a multi-faceted and coordinated agency-wide approach with a focus on the lunar South Pole. The Artemis missions will demonstrate new technologies, capabilities and business approaches needed for future exploration, including Mars. Assessing options to accelerate development of required systems, NASA is utilizing public-private engagements through the Human Exploration and Operations (HEO) Mission Directorates NextSTEP Broad Agency Announcements. The design, development and demonstration of the Human Landing System (HLS) is expected to be led by commercial partners. Utilizing efforts across mission directorates, the Artemis effort will benefit from programs from the Science Mission Directorate (SMD) and Space Technology Mission Directorate (STMD). SMDs Commercial Lunar Payload Services (CLPS) initiative will procure commercial robotic lunar delivery services and the development of science instruments and technology demonstration payloads. The Space Technology Mission Directorate (STMD) portfolio of technology advancements relative to HLS include lunar lander components and technologies for pointing, navigation and tracking, fuel storage and transfer, autonomy and mobility, communications, propulsion and power. In addition to describing the objectives and requirements of the 2024 Artemis mission, this paper will present NASAs approach to accessing the lunar surface with an affordable human-rated landing system, current status and the role o a sustainable lunar presence

Two Cultures Collide: Bridging the Generation Gap in a Non - traditional Mentorship

Cross - cultural mentoring relationships between younger mentors and older mentees are increasing in frequency across all levels of post - secondary education. Generational cultural differences can result in conflict and misunderstanding and therefore should be considered in non - traditional inter - generational mentoring relationships. Through auto - ethnographic inquiry, we, a younger faculty member and older graduate student, explored our mentoring relationship. We identified communication, respect, and ambiguous roles as issues that significantly impacted our mentorship. The manifestation of power was also highlighted in the study.

Gender and palliative care: a call to arms.

There has been a systematic and largely unconscious neglect of gender in palliative care research, practice and policy. This is despite significant, although previously uncollated, evidence that gender influences almost all aspects of end-of-life preferences, experiences and care. The social situations of women, transgender people and men often differ from one another while also intersecting in complex ways with sex differences rooted in biology. If palliative care is to meet its aspiration of providing universal benefit, it urgently needs to address a range of gender inequalities currently (re)produced at the level of the laboratory all the way through to government departments. In this call to arms, we spotlight specific instances where gender inequalities have been documented, for example, regarding end-of-life caregiving, end-of-life intervention and palliative care access and benefit. We highlight how gender inequalities intersect with other social determinants of health including ethnicity and economic status to exacerbate situations of marginality. We conclude by offering some practical steps that can be taken to support the discipline to adopt a more critical gender lens to support more equitable research, policy and practice

Fast Paced, Low Cost Projects at MSFC

What does an orbiting microsatellite, a robotic lander and a ruggedized camera and telescope have in common? They are all fast paced, low cost projects managed by Marshall Space Flight Center (MSFC) teamed with successful industry partners. MSFC has long been synonymous with human space flight large propulsion programs, engineering acumen and risk intolerance. However, there is a growing portfolio/product line within MSFC that focuses on these smaller, fast paced projects. While launching anything into space is expensive, using a managed risk posture, holding to schedule and keeping costs low by stopping at egood enough f were key elements to their success. Risk is defined as the possibility of loss or failure per Merriam Webster. The National Aeronautics and Space Administration (NASA) defines risk using procedural requirement 8705.4 and establishes eclasses f to discern the acceptable risk per a project. It states a Class D risk has a medium to significant risk of not achieving mission success. MSFC, along with industry partners, has created a niche in Class D efforts. How did the big, cautious MSFC succeed on these projects that embodied the antithesis of its heritage in human space flight? A key factor toward these successful projects was innovative industry partners such as Dynetics Corporation, University of Alabama in Huntsville (UAHuntsville), Johns Hopkins Applied Physics Laboratory (JHU APL), Teledyne Brown Engineering (TBE), Von Braun Center for Science and Innovation (VCSI), SAIC, and Jacobs. Fast Affordable Satellite Technology (FastSat HSV01) is a low earth orbit microsatellite that houses six instruments with the primary scientific objective of earth observation and technology demonstration. The team was comprised of Dynetics, UAHuntsvile, SAIC, Goddard Space Flight Center (GSFC) and VCSI with the United States Air Force Space Test Program as the customer. The team completed design, development, manufacturing, environmental test and integration in one year. FastSat HSV01 also deployed a Poly Picosatellite Orbital Deployer (PPOD) for a separate nano ]satellite class spacecraft (Cubesat: Nano Sail Demonstration) in partnership with Ames Research Center. The Robotic lunar lander is a MSFC JHU APL partnership that led to the development of a flexible architecture for landers to support robotic missions to a wide range of lunar and asteroid destinations. The team started with the goal of meeting NASA agency directives that led to the creation of a test bed focusing on GN&C and software to demonstrate the descent and landing on any airless body for the final 30 to 60 meters. The team created a complex technology demonstration as well as Guidance Control and Navigation (GN&C) algorithms providing autonomous control of the lander. The team uses a green propellant of 90% hydrogen peroxide and has completed 18 successful test flights. The International Space Station (ISS) SERVIR Environmental Research and Visualization System (ISERV) is a technology demonstration payload to assist the SERVIR project with environmental monitoring for disaster relief and humanitarian efforts. The ISERV project was a partnership with TBE. The ISERV payload consists of a commercial off the shelf camera, telescope, and MSFC developed power distribution box and interfaces on ISS with the Window Observational Research Facility in the US Lab. MSFC has identified three key areas that enabled the low cost mission success to include culture, partnering, and cost/schedule control. This paper will briefly discuss these three Class D efforts, FastSat HSV-01, the Robotic Lunar Lander and the ISERV camera system, the lessons learned, their successes and challenges