Nurses Forming Legal Partnerships to Meet the Needs of the Underserved in Rural America

The impetus for the recognition of the need for legal partners in healthcare came from Boston City Hospital in 1993. The hospital provided care to the largest uninsured and underinsured population in the New England states. The pediatric patients were noted by Dr. Barry Zuckerman to have difficulty in recovering from medical illnesses. He linked their inability to improve their health to poor housing, food insecurity, and basic social determinants of health. His hiring of a part-time lawyer led to a national movement for the development of medical-legal partnerships. The American Bar Association, the National Center for Medical-Legal Partnerships at George Washington University in Washington, DC and the American Academy of Pediatrics formed the first national medical-legal partnership in 2007. Joint resolutions were passed for members to become partners with the other professional colleagues to “address the legal and social issues affecting patient health and well-being.” The American Bar Association resolution led to the creation of the Medical-Legal Partnership Pro Bono Project. In 2015, the East Tennessee State University College of Nursing nurse-led community health center was awarded a small grant from the National Nurse Centers Consortium to participate in the development of a medical-legal partnership. The health center is staffed by Nurse Practitioners who provide health care for the underserved in northeast Tennessee. The patients are diverse and include homeless, migrants, residents of public housing, uninsured, and underinsured. Partnering with the Tennessee Justice Center in Nashville, Tennessee, the nurse-led medical legal partnership improved lives of pediatric patients, adults, pregnant women across the state, and advocacy rights for those who cannot speak for themselves

A Correlational Pilot Study of Fatalism and Self-efficacy among Appalachians with Type II Diabetes Mellitus.

Despite the vast amount of research regarding type II diabetes, little is known about the relationship between fatalistic beliefs and self-efficacy in individual self-care among adult Appalachians with type II diabetes. As a result of multiple predisposing risk factors that include high rates of obesity and poverty, as well as a lack of access to preventative care services, the prevalence of diabetes is very high in this region and has become a major health issue. In addition, a history of exploitation and lack of diverse economic development has profoundly influenced the cultural beliefs of those living within the region, which has resulted in Appalachians being collectively described as fatalistic. The purpose of this study was to determine if a correlation between fatalistic beliefs and self-efficacy in self-care among adult Appalachians with type II diabetes exists. A survey was created that assessed three concept areas pertaining to both fatalism and self-efficacy in self-care: emotional distress, religious/spiritual coping, and perceived self-efficacy. The survey was administered to participants being treated for type II diabetes at a rural clinic in northeast Tennessee. Expected correlations were found when comparing both emotional distress and perceived self-efficacy with religious and spiritual coping. However, an unexpected positive correlation was found when comparing emotional distress with perceived self-efficacy. In conclusion, this study did not demonstrate the hypothesized negative correlation between fatalism and self-efficacy, and the results found are not attributable to a larger population due to the small sample size obtained

Is the Message from Athens Being Heard?

The comment discusses the eight key priorities in EU biodiversity policy, their reception and application in both the EU nature directives and Member StatesJRC.H.1-Water Resource

Effect of Non-uniform Temperature Gradient on Marangoni Convection in a Relatively Hotter or Cooler Layer of Liquid

The effect of non-uniform temperature gradient on the onset of convection driven by surface tension gradients in a relatively hotter or cooler layer of liquid is studied by means of linear stability analysis. the upper boundary is considered to be free and insulating where surface tension gradients arise on account of variation in temperature and the lower boundary is rigid. the single-term Galerkin technique is used to obtain the eigenvalue equation. Eigenvalues are obtained and presented for both thermally conducting and insulating cases of the lower boundary. this analysis predicts that in either case the critical eigenvalues for different non-uniform temperature gradients are greater in a relatively hotter layer of liquid than the cooler one under identical conditions otherwise. this qualitative effect is quite significant quantitatively as well

Kindlin-2 controls bidirectional signaling of integrins.

Control of integrin activation is required for cell adhesion and ligand-induced signaling. Here we report that loss of the focal adhesion protein Kindlin-2 in mice results in peri-implantation lethality caused by severe detachment of the endoderm and epiblast from the basement membrane. We found that Kindlin-2-deficient cells were unable to activate their integrins and that Kindlin-2 is required for talin-induced integrin activation. Furthermore, we demonstrate that Kindlin-2 is required for integrin outside-in signaling to enable firm adhesion and spreading. Our findings provide evidence that Kindlin-2 is a novel and essential element of bidirectional integrin signaling

Comeback of Appalachian Female Stroke Survivors: The Interrelationships of Cognition, Function, Self-Concept, Interpersonal, and Social Relationships.

The purpose of this descriptive correlational study was to examine the comeback phase of the Trajectory of Chronic Illness Management for Appalachian women stroke survivors. This study predicted comeback as a relationship between physical healing, biographical reengagement, and psychological coming to terms that was mediated by rehabilitation. The concepts were evaluated through investigation of function and cognitive abilities, self-assessment of recovery, health rating, ability to control life, relationship changes, physical and mental health, and limitations of activities due to poor physical or mental health. Data were collected using, the Stroke Impact Scale (3.0) (Duncan, Bode, Lia, & Perera, 2003), the Relationship Change Scale (Guerney, 1971), and the Health-Related-Quality-of-Life-4 Scale (Morarity, Zack, & Kobau, 2003). Descriptive statistics summarized patient characteristics. Continuous variables were analyzed using bivariate relationships expressed as Pearson correlation coefficients. The difference between groups (stroke severity and stroke type) and measurement variables were analyzed using independent ttest and ANOVA. Multiple linear regressions were completed to evaluate simultaneous effects of the independent variables. Forty-six English-speaking, Caucasian women ages 40-78 who had experienced stroke at least 1 year prior to enrollment and were independently living in their home environment participated. The mean age was 57 years with survivorship ranging from 1 to 36 years. Function and cognition scores were similar to the established test range for the SIS V 3.0. Women with moderate ischemic stroke scored statistically higher for recovery score (p Study findings suggest comeback can be predicted by the theoretical propositions of the Trajectory Theory of Chronic Illness Management: physical healing, biographical reengagement, and psychologically coming to terms (Corbin & Strauss, 1991). A strong relationship exists among the phases representative of comeback, while rehabilitation procedures and interpersonal relationships demonstrated only modest significance

Activities of 11‐azaartemisinin and N‐sulfonyl derivatives against asexual and transmissible malaria parasites

Dihydroartemisinin (DHA), either used in its own right or as the active drug generated in vivo from the other artemisinins in current clinical use—artemether and artesunate—induces quiescence in ring‐stage parasites of Plasmodium falciparum (Pf). This induction of quiescence is linked to artemisinin resistance. Thus, we have turned to structurally disparate artemisinins that are incapable of providing DHA on metabolism. Accordingly, 11‐azaartemisinin 5 and selected N‐sulfonyl derivatives were screened against intraerythrocytic asexual stages of drug‐sensitive Pf NF54 and drug‐resistant K1 and W2 parasites. Most displayed appreciable activities against all three strains, with IC50 values 2000 toward asexual parasites. Overall, the readily accessible 11‐azaartemisinin 5 and the sulfonyl derivatives 11 and 16 represent potential candidates for further development, in particular for transmission blocking of artemisinin‐resistant parasites.http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1860-71872018-12-19hj2018Biochemistr

Daily Pilot

Includes articles on the first classes held at UC Irvine, Daniel G. Aldrich, and research at the colleg