Improving patient activation with a tailored nursing discharge teaching intervention for multimorbid inpatients: A quasi-experimental study.

Preliminary effectiveness test of a novel structured personalized discharge teaching intervention for multimorbid inpatients. Using a 2-group sequential pre/post-intervention design, the sample comprised 68 pre-intervention control group and 70 post- intervention group participants. The discharge teaching intervention by trained clinical nurses used structured tools to engage patients and individualize discharge teaching. Outcomes measures included Patient Activation Measure, Readiness for Hospital Discharge Scale, Discharge Care Experiences Survey, and readmission with 10 days post-discharge. The intervention had a statistically significant positive effect on improving patient activation (M=4.8; p = 0.05) from admission to post-discharge. The participation subscale of the Discharge Care Experiences Survey was higher in the intervention (M=4.1, SD=0.7) than the control group (M=3.8, SD=0.7; t (127)= -2.79, p = .01, effect size= .34). There were no significant between-group differences in Readiness for Hospital Discharge Scale and readmission. Our results suggest that a structured personalized discharge teaching intervention can improve patient activation and participation in discharge care. Further refinement of the intervention is needed to evaluate and improve specific components of the intervention. Structured personalized discharge teaching should include patient engagement strategies in the teaching-learning process

Culture And Universal Professional Values In Global Organizations: Is There A Divergence Or Convergence Of Cultural Values?

This article presents and discusses the theory of universal human values, the universal human values of people across cultures, and how culture and values impact organizations. This article reviews the history and research into human values, culture, and behavior, followed by reviews of Hofstede’s Cultural Dimensions and Schwartz and Bilky’s Theory of Universal Human Values.A strong connection exists between these theories and their related empirical research, not only chronologically, but also theologically and methodologically. The subjects are presented in a temporal sequence. Thus, the work of Professor Gert Hofstede is presented first; the work of Schwartz, Bilsky, is more recent, but strongly linked to prior research by Hofstede on values and culture. The objective is to improve ones understanding of work-related values, culture, and the impact that values may have on individuals in different cultural environments that are found in international organizations. This study tests to see if there is a difference in individualism scores of Mexican and American engineers when compared to Hofstede’s original study in 1980. This study also looks at the Mexican and American engineer samples to see if their scores on Hofstede’s cultural dimensions show a correlation with the scores on Schwartz’s culture-level dimensions. The study attempts to determine if there is a divergence or convergence of cultural values. Findings of the study are reported

Applying Moral Development Literature And Ethical Theories To The Administration Of Taxes In Kosovo

The population of Kosovo had suffered years of abuse, ethnic cleansing, turmoil, human atrocities, and constant conflict - the results of which plunged Kosovo into costly war. Following the war Kosovo was placed under the protection of the United Nations in 1999. Kosovo received many years of support and developmental assistance from the international community and became a sovereign nation in February 2008. It was very important for Kosovo’s government to serve the needs of the people without continued oversight and intervention by the United Nations. Public institutions are vital to the success of the government. There is no institution more important to the successful development of a sovereign nation and their economy than the ethical administration of a tax authority. In the spring of 2008, after Kosovo’s declaration of independence, this study was initiated to determine the moral maturity of the members of the Tax Authority of Kosovo. This study provides a review of the current situation in Kosovo and discusses ethical considerations in tax administration. The paper further provides a comprehensive discussion of ethical concerns and discusses the importance of moral development in the tax administration of Kosovo. Recommendations for managers and future research are presented

Microporous Biodegradable Films Promote Therapeutic Angiogenesis

Peripheral arterial disease and critical limb ischemia are common symptoms of cardiovascular disease. Vascular surgery is used to create a bypass around occluded blood vessels to improve blood flow to ischemic muscle, thus avoiding the need for amputation. Attempts to vascularize tissues by therapeutic angiogenesis using delivery of exogenous angiogenic agents are underwhelming. A material-based approach that provides an endogenous stimulus capable of promoting angiogenesis and increased tissue perfusion would provide a paradigm shift in treatment options available. It is reported here that microporous biodegradable films produced using thermally induced phase separation provide a localized biophysical stimulus of proangiogenic genes in vivo that is associated with increased blood vessel density and restoration of blood flow to ischemic tissue. These findings show, for the first time, that acellular, nonfunctionalized biodegradable biomaterials can provide an innovative, material-based approach for therapeutic angiogenesis to enhance tissue reperfusion in vivo

Integrating multiple satellite observations into a coherent dataset to monitor the full water cycle – application to the Mediterranean region

The Mediterranean region is one of the climate hotspots where the climate change impacts are both pronounced and documented. The HyMeX (Hydrometeorological Mediterranean eXperiment) aims to improve our understanding of the water cycle from the meteorological to climate scales. However, monitoring the water cycle with Earth observations (EO) is still a challenge: EO products are multiple, and their utility is degraded by large uncertainties and incoherences among the products. Over the Mediterranean region, these difficulties are exacerbated by the coastal/mountainous regions and the small size of the hydrological basins. Therefore, merging/integration techniques have been developed to reduce these issues. We introduce here an improved methodology that closes not only the terrestrial but also the atmospheric and ocean budgets. The new scheme allows us to impose a spatial and temporal multi-scale budget closure constraint. A new approach is also proposed to downscale the results from the basin to pixel scales (at the resolution of 0.25∘). The provided Mediterranean WC budget is, for the first time, based mostly on observations such as the GRACE water storage or the netflow at the Gibraltar Strait. The integrated dataset is in better agreement with in situ measurements, and we are now able to estimate the Bosporus Strait annual mean netflow.</p

Smooth muscle cell-specific knockout of neuropilin-1 impairs postnatal lung development and pathological vascular smooth muscle cell accumulation

Neuropilin 1 (NRP1) is important for neuronal and cardiovascular development due to its role in conveying class 3 semaphorin and vascular endothelial growth factor signaling, respectively. NRP1 is expressed in smooth muscle cells (SMCs) and mediates their migration and proliferation in cell culture and is implicated in pathological SMC remodeling in vivo. To address the importance of Nrp1 for SMC function during development, we generated conditional inducible Nrp1 SMC-specific knockout mice. Induction of early postnatal SMC-specific Nrp1 knockout led to pulmonary hemorrhage associated with defects in alveogenesis and revealed a specific requirement for Nrp1 in myofibroblast recruitment to the alveolar septae and PDGF-AA-induced migration in vitro. Furthermore, SMC-specific Nrp1 knockout inhibited PDGF-BB-stimulated SMC outgrowth ex vivo in aortic ring assays and reduced pathological arterial neointima formation in vivo. In contrast, we observed little significant effect of SMC-specific Nrp1 knockout on neonatal retinal vascularization. Our results point to a requirement of Nrp1 in vascular smooth muscle and myofibroblast function in vivo, which may have relevance for postnatal lung development and for pathologies characterized by excessive SMC and/or myofibroblast proliferation

Luminous AGB stars in nearby galaxies. A study using Virtual Observatory tools

Aims. This study focuses on very luminous Mbol<-6.0 mag AGB stars with J-Ks>1.5 mag and H-Ks>0.4 mag in the LMC, SMC, M31, and M33 from 2MASS data. Methods.The data were taken from the 2MASS All-Sky Point Source catalogue archive. We used Virtual Observatory tools and took advantage of its capabilities at various stages in the analysis. Results. It is well known that stars with the colors we selected correspond mainly to carbon stars. Although the most luminous AGBs detected here contain a large number of carbon stars,they are not included in existing catalogues produced from data in the optical domain, where they are not visible since they are dust-enshrouded. A comparison of the AGB stars detected with combined near and mid-infrared data from MSX and 2MASS in the LMC shows that 10% of the bright AGB stars are bright carbon stars never detected before and that the other 50% are OH/IR oxygen rich stars, whereas the 40% that remain were not cross-matched. Conclusions. The catalogues of the most luminous AGB stars compiled here are an important complement to existing data. In the LMC, these bright AGB stars are centrally located, whereas they are concentrated in an active star-formation ring in M31. In the SMC and M33, there are not enough of them to draw definite conclusions, although they tend to be centrally located. Their luminosity functions are similar for the four galaxies we studied.Comment: 16 pages, 12 figures, 4 tables (Appendix A), accepted in A&

A perspective on using experiment and theory to identify design principles in dye-sensitized solar cells

Dye-sensitized solar cells (DSCs) have been the subject of wide-ranging studies for many years because of their potential for large-scale manufacturing using roll-to-roll processing allied to their use of earth abundant raw materials. Two main challenges exist for DSC devices to achieve this goal; uplifting device efficiency from the 12 to 14% currently achieved for laboratory-scale ‘hero’ cells and replacement of the widely-used liquid electrolytes which can limit device lifetimes. To increase device efficiency requires optimized dye injection and regeneration, most likely from multiple dyes while replacement of liquid electrolytes requires solid charge transporters (most likely hole transport materials – HTMs). While theoretical and experimental work have both been widely applied to different aspects of DSC research, these approaches are most effective when working in tandem. In this context, this perspective paper considers the key parameters which influence electron transfer processes in DSC devices using one or more dye molecules and how modelling and experimental approaches can work together to optimize electron injection and dye regeneration. This paper provides a perspective that theory and experiment are best used in tandem to study DSC device

Superbubble evolution including the star-forming clouds: Is it possible to reconcile LMC observations with model predictions?

Here we present a possible solution to the apparent discrepancy between the observed properties of LMC bubbles and the standard, constant density bubble model. A two-dimensional model of a wind-driven bubble expanding from a flattened giant molecular cloud is examined. We conclude that the expansion velocities derived from spherically symmetric models are not always applicable to elongated young bubbles seen almost face-on due to the LMC orientation. In addition, an observational test to differentiate between spherical and elongated bubbles seen face-on is discussed.Comment: 25 pages, 7 figures, accepted to ApJ (September, 1999 issue

Multicolor photometry of 145 of the HII regions in M33

This paper is the first in a series presenting CCD multicolor photometry for 145 HII regions, selected from 369 candidate regions from Boulesteix et al. (1974), in the nearby spiral galaxy M33. The observations, which covered the whole area of M33, were carried out by the Beijing Astronomical Observatory 60/90 cm Schmidt Telescope, in 13 intermediate-band filters, covering a range of wavelength from 3800 to 10000 A. This provides a series of maps which can be converted to a multicolor map of M33, in pixels of 1.7''*1.7''. Using aperture photometry we obtain the spectral energy distributions (SEDs) for these HII regions. We also give their identification charts. Using the relationship between the BATC intermediate-band system used for the observations and the UBVRI broad-band system, the magnitudes in the B and V bands are then derived. Histograms of the magnitudes in V and in B-V are plotted, and the color-magnitude diagram is also given. The distribution of magnitudes in the V band shows that the apparent magnitude of almost all the regions is brighter than 18, corresponding to an absolute magnitude of -6.62 for an assumed distance modulus of 24.62, which corresponds to a single main sequence O5 star, while the distribution of color shows that the sample is blue, with a mode close to -0.05 as would be expected from a range of typical young clusters.Comment: 34 pages, 19 figures including 16 of jpg form, will appear in the December 2002 issue of A