Implementation Evaluation of an Education Program in Pediatric Clinics

Background: A public health approach to child maltreatment prevention relies on programs that impact the underlying drivers of maltreatment and that can easily be implemented. Stress in the family, mental illness, unrealistic expectations, and lack of knowledge have all been shown to be preceding factors in maltreatment risk. To help address some of these risks, an education program consisting of the Period of PURPLE crying, a social and economic stressor questionnaire, and the Parenting Action Plan was designed for maternal caregivers of newborns at pediatric clinics. This paper explores implementation challenges and successes of the education program, and describes strategies to implement such a program for maternal caregivers of newborns in pediatric clinics. Methods: The education program was delivered at 4 pediatric clinics serving low-income families in Houston, Texas. Each clinic received a program orientation, topic specific training for implementing staff, and technical assistance as needed. The implementation evaluation of the education program focused on responses from key informant interviews with 18 staff members from the 4 pediatric clinics. Interview data was recorded through note taking then transcribed and coded relying on the grounded theory approach using inductive reasoning for analysis. Results: A majority of the 18 study staff interviewed across all four clinics expressed the need for and benefits of providing an education program to maternal caregivers of newborn during well-child visits. Key themes that emerged were (1) maternal caregivers were receptive to an education program for support during well-child visits and staff saw its benefits, (2) motivational interviewing was helpful in engaging caregivers in conversations, and (3) it is important to establish a workflow that can accommodate the maternal caregivers and clinic needs alike. Conclusions: An education program in pediatric clinics is a valuable resource to support maternal caregivers and their families. This type of program can be achievable when key factors are in place including: leadership and staff buy-in by having program transparency, efficient workflow that carefully considers maternal caregivers and staff time, and willingness of the organization is invest into the program. However, there is no one-size fits-all approach to successfully implement an education program into a routine part of pediatric care. It is vital to understand the organizational and structural strengths of each implementing clinic and leverage personnel in order to implement the program components with the highest fidelity

Electrocatalytic Oxygen Evolution Reaction in Acidic Environments – Reaction Mechanisms and Catalysts

The low efficiency of the electrocatalytic oxidation of water to O2 (oxygen evolution reaction-OER) is considered as one of the major roadblocks for the storage of electricity from renewable sources in form of molecular fuels like H2 or hydrocarbons. Especially in acidic environments, compatible with the powerful proton exchange membrane (PEM), an earth-abundant OER catalyst that combines high activity and high stability is still unknown. Current PEM-compatible OER catalysts still rely mostly on Ir and/or Ru as active components, which are both very scarce elements of the platinum group. Hence, the Ir and/or Ru amount in OER catalysts has to be strictly minimized. Unfortunately, the OER mechanism, which is the most powerful tool for OER catalyst optimization, still remains unclear. In this review, we first summarize the current state of our understanding of the OER mechanism on PEM-compatible heterogeneous electrocatalysts, before we compare and contrast that to the OER mechanism on homogenous catalysts. Thereafter, an overview over monometallic OER catalysts is provided to obtain insights into structure-function relations followed by a review of current material optimization concepts and support materials. Moreover, missing links required to complete the mechanistic picture as well as the most promising material optimization concepts are pointed out

Free Energy Approach to the Formation of an Icosahedral Structure during the Freezing of Gold Nanoclusters

The freezing of metal nanoclusters such as gold, silver, and copper exhibits a novel structural evolution. The formation of the icosahedral (Ih) structure is dominant despite its energetic metastability. This important phenomenon, hitherto not understood, is studied by calculating free energies of gold nanoclusters. The structural transition barriers have been determined by using the umbrella sampling technique combined with molecular dynamics simulations. Our calculations show that the formation of Ih gold nanoclusters is attributed to the lower free energy barrier from the liquid to the Ih phases compared to the barrier from the liquid to the face-centered-cubic crystal phases

Formation of an Icosahedral Structure during the Freezing of Gold Nanoclusters: Surface-Induced Mechanism

The freezing behavior of gold nanoclusters was studied by employing molecular dynamics simulations based on a semi-empirical embedded-atom method. Investigations of the gold nanoclusters revealed that, just after freezing, ordered nano-surfaces with a fivefold symmetry were formed with interior atoms remaining in the disordered state. Further lowering of temperatures induced nano-crystallization of the interior atoms that proceeded from the surface towards the core region, finally leading to an icosahedral structure. These dynamic processes explain why the icosahedral cluster structure is dominantly formed in spite of its energetic metastability.Comment: 9 pages, 4 figures(including 14 eps-files

Oxide-Supported IrNiO_x Core-Shell Particles as Efficient, Cost-Effective, and Stable Catalysts for Electrochemical Water Splitting

Active and highly stable oxide-supported IrNiOx core–shell catalysts for electrochemical water splitting are presented. IrNix@IrOx nanoparticles supported on high-surface-area mesoporous antimony-doped tin oxide (IrNiOx /Meso-ATO) were synthesized from bimetallic IrNix precursor alloys (PA-IrNix /Meso-ATO) using electrochemical Ni leaching and concomitant Ir oxidation. Special emphasis was placed on Ni/NiO surface segregation under thermal treatment of the PA-IrNix /Meso-ATO as well as on the surface chemical state of the particle/oxide support interface. Combining a wide array of characterization methods, we uncovered the detrimental effect of segregated NiO phases on the water splitting activity of core–shell particles. The core–shell IrNiOx /Meso-ATO catalyst displayed high water-splitting activity and unprecedented stability in acidic electrolyte providing substantial progress in the development of PEM electrolyzer anode catalysts with drastically reduced Ir loading and significantly enhanced durability

Cellular Therapy for Wounds: Applications of Mesenchymal Stem Cells in Wound Healing

Despite progress in wound treatment including gene therapy, biological dresses and engineered skin equivalents, present treatment options for chronic wounds are restricted and not always effective. For example, inability to get consistent product from the introduced gene, biological covers may give rise to hypoxic conditions and engineered skin models are limited by their construction from substances which are hard to be degraded, and do not always result in complete replication into normal uninjured skin. A growing body of evidence suggests mesenchymal stem cells (MSCs), and their secreted growth factors and microvesicles, may potentiate the wound‐healing process and as such their addition to novel wound‐healing treatments may improve the efficacy of current therapeutic strategies. Recent studies report the ability of bone marrow‐derived MSCs (BM‐MSCs) to migrate and differentiate into skin cells in vivo

. In vitro propagation of the new orchid Dendrobium trankimianum T. Yukawa

Dendrobium trankimianum T. Yukawa is a beautiful, endemic orchid of Vietnam, a new species with a first - published description in 2004. It is very rare and expected to be added to the IUCN Red List status - CR. In vitro studies of orchid D. trankimianum T. Yukawa were conducted in order to conserve and increase the genetic pool of this precious wild orchid species. The results showed that full-strength MS medium supplemented with 2.0 mg/L BA and 0.5 mg/L NAA (10.24 PLBs/explant; 90.11% explants formed PLBs) or full-strength MS medium supplemented with 1.5 mg/L TDZ and 0.5 mg/L NAA (14.11 PLBs/explant; 92.06% explants formed PLBs) were the most suitable for protocorm formation. For subculture, suitable growth of shoots were obtained on full-strength MS medium supplemented 1.5 mg/L BA (22.35 shoots/explant; shoots length of 1.96 cm) and full-strength MS medium supplemented with 60 g ripe banana per liter (25.11 shoots/explant; shoots length of 2.12 cm). The shoots in vitro were transferred to half-strength MS supplemented with different concentrations of IAA, IBA and NAA to investigate root formation. The best rooting occurred at 0,5 mg/L NAA (7.91 roots/shoot; root length of 4.01 cm; 98.51% root formation). The plantlets with uniform growth were planted on different substrate: Eco clean soil, Coconut fiber, Fern fiber, 50% Rice husk in combination with 50% Eco clean soil for research the most suitable substrate. After 60 days of transplantion and acclimatization, the result showed that Fern fiber was suitable substrate for plantlet growth in a nursery garden (8.0 roots/ explant; root length of 5.5 cm; survival rate of 93.29%)

Narrow-band injection seeding of a terahertz frequency quantum cascade laser: Selection and suppression of longitudinal modes

A periodically poled lithium niobate (PPLN) crystal with multiple poling periods is used to generate tunable narrow-bandwidth THz pulses for injection seeding a quantum cascade laser (QCL). We demonstrate that longitudinal modes of the quantum cascade laser close to the gain maximum can be selected or suppressed according to the seed spectrum. The QCL emission spectra obtained by electro-optic sampling from the quantum cascade laser, in the most favorable case, shows high selectivity and amplification of the longitudinal modes that overlap the frequency of the narrow-band seed. Proper selection of the narrow-band THz seed from the PPLN crystal discretely tunes the longitudinal mode emission of the quantum cascade laser. Moreover, the THz wave build-up within the laser cavity is studied as a function of the round-trip time. When the seed frequency is outside the maximum of the gain spectrum the laser emission shifts to the preferential longitudinal mode

Investigation of time-resolved gain dynamics in an injection seeded terahertz quantum cascade laser

The evolution of the gain of terahertz quantum cascade laser during injection seeding is probed as a function of time. Oscillations of the gain are commensurate with the variations of the field envelope