Nursing Home Implementation of Health Information Technology: Review of the Literature Finds Inadequate Investment in Preparation, Infrastructure, and Training.

Health information technology (HIT) is increasingly adopted by nursing homes to improve safety, quality of care, and staff productivity. We examined processes of HIT implementation in nursing homes, impact on the nursing home workforce, and related evidence on quality of care. We conducted a literature review that yielded 46 research articles on nursing homes' implementation of HIT. To provide additional contemporary context to our findings from the literature review, we also conducted semistructured interviews and small focus groups of nursing home staff (n = 15) in the United States. We found that nursing homes often do not employ a systematic process for HIT implementation, lack necessary technology support and infrastructure such as wireless connectivity, and underinvest in staff training, both for current and new hires. We found mixed evidence on whether HIT affects staff productivity and no evidence that HIT increases staff turnover. We found modest evidence that HIT may foster teamwork and communication. We found no evidence that the impact of HIT on staff or workflows improves quality of care or resident health outcomes. Without initial investment in implementation and training of their workforce, nursing homes are unlikely to realize potential HIT-related gains in productivity and quality of care. Policy makers should consider creating greater incentives for preparation, infrastructure, and training, with greater engagement of nursing home staff in design and implementation

The rhetoric of Dean Koontz\u27s Intensity

This thesis examines the revision of eighteenth century gothic fiction by Dean Koontz\u27s twentieth century horror novel, Intensity. In particular, the novel invites Aristotelian rhetorical analysis through the competing appeals staged by its antagonist, Vess, and its protagonist, Chyna

Population Genetic Structure of the Temperate Scleractinian Coral, Oculina Arbuscula, in Coastal Georgia

Dispersal of marine organisms has generally been assumed to be demographically open with planktonic larvae exploiting ocean currents to travel long distances. However, recent studies report evidence of local larval recruitment. In this study, I hypothesized that populations of the temperate coral, Oculina arbuscula, are maintained primarily by local recruitment off the Georgia coast because: 1) suitable substrate for settlement is patchy and 2) O. arbuscula\u27s branching morphology is conducive to asexual reproduction by fragmentation. To address this hypothesis, I combined data from allozyme electrophoresis, histocompatibility assays, and despersion of established colonies. Results indicated substantial local recruitment maintained primarily by sexual reproduction rather than asexual fragmentation. Sexually produced planulae are not only philopatric, but also show evidence of some migration among populations. In this temperate species, local recruitment primarily maintains aggregated populations of O. arbuscula

mud volcanoes, seeps and diapiric structures imaged by acoustic methods

Black Sea, seafloor seepage, mud volcanoes, seeps, fluid migration, gas hydrates, diapirs. - The Black Sea is the worldwide largest anoxic basin with thick gas rich sediments facilitating seafloor seepage, which is widely distributed along the continental slopes of the Black Sea. In two areas, the Sorokin Trough off Crimea and at the continental slope off Batumi (Georgia), the distribution, structure and evolution of two different vent systems and their relation to fluid migration pathways and gas/gas hydrate occurrences have been investigated by means of high resolution multichannel seismic data. In both regions, the distribution of seafloor seepage is controlled by fluid migration along permeable pathways associated with diapiric uplift in the subsurface. In the Sorokin Trough, seepage is expressed by intensive material upflow and the formation of mud volcanoes; offshore Batumi, gas seeps with low material flux dominate. In the Sorokin Trough, most mud volcanoes are associated with near-subsurface mud diapirs. The great morphological variability of the mud volcanoes reflects different driving mechanisms, which depend on the availability of permeable fluid migration pathways and the depositional environment. A 3D seismic dataset images the detailed three-dimensional ...thesi

Psychometric Investigation & Measurement of Hunger & Pleasure

https://fuse.franklin.edu/ss2018/1045/thumbnail.jp

Evaluating Stress Relief & Stress Effects With Cognitive Appraisal & Perceived Stress Constructs

https://fuse.franklin.edu/ss2018/1029/thumbnail.jp

First Semester BSN Students: Cognitive Appraisal & Perceived Stress

Cognitive appraisal and stress research has been applied to training stressors, creative arts, pregnancy, psychotherapy, academic, and sleep quality (Erschens et al.,2018; Martin, et al., 2018; Gonzalex-Ochoa, 2018; Wersebe et al., 2018; You-wei et al., 2018). The purpose of this investigation was to study the effects of stress and stressors experienced by first semester BSN undergraduate students. The Brief College Student Hassle Scale (BCSHC) measured stressors (Ward & Hay, 2015). Participants rated their school and personal stresss levels, and the area most stressful.https://fuse.franklin.edu/ss2018/1018/thumbnail.jp

Upregulation of Transglutaminase andε(γ-Glutamyl)-Lysine in the Fisher-Lewis Rat Model of Chronic Allograft Nephropathy

Background. Tissue transglutaminase (TG2), a cross-linking enzyme, modulates deposition of extracellular matrix protein in renal fibrosis. This study aimed to examine TG2 and its cross-link product ε(γ-glutamyl)-lysine in the Fisher-Lewis rat renal transplantation (RTx) model of chronic allograft nephropathy (CAN). Materials and Methods. Left renal grafts from male Fisher and Lewis were transplanted into Lewis rats, generating allografts and isografts, respectively. Blood pressure, renal function, and proteinuria were monitored for up to 52 weeks. At termination, CAN was assessed in the renal tissue by light and electron microscopy, TG2 and ε(γ-glutamyl)-lysine by immunofluorescence, and the urinary ε(γ-glutamyl)-lysine by high performance liquid chromatography. Results. Compared to the isograft, the allografts were hypertensive, proteinuric, and uraemic and developed CAN. Extracellular TG2 (glomerulus: 64.55 + 17.61 versus 2.11 + 0.17, P<0.001; interstitium: 13.72 + 1.62 versus 3.19 + 0.44, P<0.001), ε(γ-glutamyl)-lysine (glomerulus: 21.74 + 2.71 versus 1.98 + 0.37, P<0.01; interstitium: 37.96 + 17.06 versus 0.42 + 0.11, P<0.05), TG2 enzyme activity (1.09 + 0.13 versus 0.41 + 0.03 nmol/h/mg protein, P<0.05), TG2 mRNA (20-fold rise), and urinary ε(γ-glutamyl)-lysine (534.2 + 198.4 nmol/24 h versus 57.2 + 4.1 nmol/24 h,P<0.05) levels were significantly elevated in the allografts and showed a positive linear correlation with tubulointerstitial fibrosis. Conclusion. CAN was associated with upregulation of renal TG2 pathway, which has a potential for pharmacological intervention. The elevated urinary ε(γ-glutamyl)-lysine, measured for the first time in RTx, is a potential biomarker of CA

Nursing Panel and Innovative, Interdisciplinary, Collaborative Non-Nursing Course Teaching Strategy

The innovative, interdisciplinary, collaborative teaching strategy is the Nursing Panel (NP) intervention. In the Cultural Competence in Healthcare course, this teaching strategy was designed by social sciences professor. The NP Intervention invites traditional and accelerated Bachelor of Science in Nursing (BSN) students to ask questions of full-time Registered Nurse (RN) Faculty regarding cultural and nursing profession topics. Four RN Faculty share information and professional stories in an engaging, interactive format.https://fuse.franklin.edu/ss2018/1047/thumbnail.jp

Quantitative Analysis of Nursing Panel Teaching Strategy for Non-Nursing Courses

https://fuse.franklin.edu/ss2018/1046/thumbnail.jp