Nurses Role in Health Home Mixed Methods Study

Managing individuals with chronic health conditions in the primary care setting continues to be a significant challenge in the U.S. health care system. This issue is further compounded for low-income individuals with both mental health and physical health chronic conditions. With the enactment of the Affordable Care Act (ACA), new chronic disease health home opportunities have emerged to address the existing structural and process gaps found in primary healthcare. The nurse’s role is integral to health homes as they empower nurses to play a greater role in improving patient experiences, population health, and lowering healthcare costs. Three research manuscripts presented in this dissertation portfolio focus on improving health care service delivery to individuals with chronic conditions. The first manuscript is a concept analysis of the term care coordination and its application in the primary care setting. The second manuscript is the description of Michigan’s implementation a Section 2703 ACA chronic disease health home, which highlights the importance of the nurse’s health home role. The third manuscript is a mixed methods study aimed to identify the nurse’s perceived role and impact on patients with chronic conditions served in a health home. The study integrated qualitative information obtained from nurse interviews and a focus group with the quantitative data from a sample of 874 patients. The Medicaid Health Home nurse’s role and impact on patients’ health care utilization patterns pre and post implementation are described and related to changes in emergency room use, hospitalizations, office visits, mental healthcare visits, and number of prescription medications

Patch Plate Materials Compatibility Assessment

Lunar dust proved to be a greater problem during the Apollo missions than was originally anticipated. The highly angular, charged dust particles stuck to seals, radiators, and visors; clogged mechanisms; and abraded space suits. As reported by Apollo 12 astronaut Pete Conrad "We must have had more than a hundred hours suited work with the same equipment, and the wear was not as bad on the training suits as it is on these flight suits in just the eight hours we were out.". Dust clinging to surfaces was also transport-ed into habitable spaces leading to lung and eye irritation of the astronauts. The Apollo astronauts were on the Lunar surface less than 24 hours and experienced many dust related problems. With the Artemis program, we are planning longer stays on the surface, with more activities that have the potential to put the astronauts and equipment in contact with greater quantities of Lunar dust. The success of these missions will depend on our understanding of material interactions with Lunar dust and the development of ways to mitigate dust effects in cases where exposure to dust will lead to failure of components, unacceptable loss of power or thermal control, unacceptable loss of visibility, or health issues. Through the Lunar Surface In-novation Initiative (LSII), we are initiating a Patch Plate Materials Compatibility Assessment project. The overall goal of the three year project is to develop passive approaches to mitigate Lunar dust adhesion to surfaces for technologies that are currently at TRL levels 2-3 to bring them to TRL level 5 through ground-based assessment, culminating in a demonstration flight experiment on a Commercial Lunar Payload Services (CLPS) lander in 2022-2023. This paper discusses the detailed technical objectives and approach for this project. References: Gaier, J.R. "The Effects of Lunar Dust on EVA Systems During the Apollo Missions," NASA/TM-2005-213610/REV1, (2005), Apollo 12 Technical Crew Debriefing, December 1, 1969, pp. 10-54

Enhanced low-energy γ\gamma-decay strength of 70^{70}Ni and its robustness within the shell model

Neutron-capture reactions on very neutron-rich nuclei are essential for heavy-element nucleosynthesis through the rapid neutron-capture process, now shown to take place in neutron-star merger events. For these exotic nuclei, radiative neutron capture is extremely sensitive to their $\gamma$-emission probability at very low $\gamma$ energies. In this work, we present measurements of the $\gamma$-decay strength of $^{70}$Ni over the wide range $1.3 \leq E_{\gamma} \leq 8$ MeV. A significant enhancement is found in the $\gamma$-decay strength for transitions with $E_\gamma < 3$ MeV. At present, this is the most neutron-rich nucleus displaying this feature, proving that this phenomenon is not restricted to stable nuclei. We have performed $E1$-strength calculations within the quasiparticle time-blocking approximation, which describe our data above $E_\gamma \simeq 5$ MeV very well. Moreover, large-scale shell-model calculations indicate an $M1$ nature of the low-energy $\gamma$ strength. This turns out to be remarkably robust with respect to the choice of interaction, truncation and model space, and we predict its presence in the whole isotopic chain, in particular the neutron-rich $^{72,74,76}\mathrm{Ni}$.Comment: 9 pages, 9 figure

New coronavirus disease 2019 (COVID-19): Is there an impact on male reproductive health

The male reproductive health depends on several factors that can be divided into two main groups: the first group, genetic or hereditary (in particular, Klinefelter syndrome, etc.), the second acquired factors that depend on the person's lifestyle (bad habits, diet), stress, infectious diseases of the genitourinary system, etc. The presence of infectious and inflammatory diseases of the male reproductive system leads to impaired reproductive and endocrine function, significantly reducing the reproductive potential. In the last three years of our time around the world, including Russia, the number of people who have become ill with a new viral infection (COVID-19) caused by the new coronavirus (SARS-CoV-2), which causes dysfunction and has a negative effect on many organs and organs, body systems.The overview of recent publications is devoted to the study of the effect of SARS-CoV-2 on the reproductive health of men. The search was performed using the Medline, PubMed, and EMBASE databases