Full Practice Authority: Policy Review and Recommendation for Regional Nurse Practitioner Practice in the Southeastern Region of the United States

This policy analysis examines the limited practice authority for advanced practice registered nurses (APRN) in the Southeastern United States, focusing on Tennessee while drawing comparisons to Georgia and Alabama. The PICO question that guided this policy analysis is: For advanced practice registered nurses within the southeast region of the United States (P), how does the development of a comprehensive policy recommendation for full practice authority (I), compared to existing reduced or restricted practice authority in the southeast region of the United States (C) affect access to care as endorsed by literature (O)? The literature suggests that despite being equipped with the education, accreditation, certification, and licensure, APRNs in the Southeastern states still have regulatory and nonregulatory barriers to practice, impeding their ability to provide access to care, especially in rural and underserved communities. Moreover, the literature strongly advocates adopting evidence-based recommendations by the American Association of Nurse Practitioners, the Consensus Model, and The Academy of Medicine to modernize the outdated regulatory and nonregulatory barriers impeding APRNs. A policy brief is also proposed to engage stakeholders in advocating for these evidence-based recommendations and securing APRNs\u27 full practice authority. Eliminating these barriers allows APRNs to work to their full ability, resulting in enhanced healthcare access, improved quality, reduced healthcare disparities, and potentially lowered healthcare costs

Designing Scholarships To Improve College Success: Final Report On the Performance-Based Scholarship Demonstration

Performance-based scholarships have two main goals: to give students more money for college and to provide incentives for academic progress. They are designed to reduce the financial burden on low-income students and help them progress academically by offering financial aid contingent upon meeting pre-specified academic benchmarks. The scholarships are intended to cover a modest amount of students' educational costs during the semesters they are offered -- generally between 15 and 25 percent of students' unmet financial need, the difference between students' calculated financial need to attend college and the financial aid they are awarded. The money is paid directly to students, on top of their existing federal and state need-based financial aid, and the students themselves decide how best to use the funds. MDRC launched the Performance-Based Scholarship Demonstration in 2008 to evaluate the effectiveness of these scholarships for as broad a range of low-income students as possible, in a variety of settings, and with varying incentive structures. As such, the evaluation includes more than 12,000 students in institutions across six states to test different performance-based scholarship designs. These results show that even relatively moderate investments in low-income students' education can have modest but long-lasting impacts on their academic outcomes. These findings may be especially relevant to states, institutions, and private scholarship providers seeking purposeful and efficient ways to give low-income students additional financial aid that can also help them succeed academically

Characterization of microorganisms associated with pasteurized milk

Growth of psychrotrophic bacteria in refrigerated milk can be detrimental to the shelf life of the product. Normally, the presence of these bacteria are a result of post-pasteurization contamination. In some cases however, the microorganisms which affect shelf life are those that survive pasteurization and grow during refrigerated storage. The objectives of this study were to determine the influence of producer handling of raw milk on the shelf life of the pasteurized product and characterize the microorganisms which survived pasteurization. Raw milk from producers rated as having good or poor sanitation was transported to the University of Tennessee on ice. The samples were transferred aseptically into sterile bottles and pasteurized for 30 min at 62.8°C. The samples were stored at 7.2°C and sampled at the raw, pasteurized and stored stages. Pasteurized samples from poor quality raw milk producers had generally higher standard plate counts than samples from good producers, but no significant difference was detected. No correlations were detected between the shelf life of the pasteurized milk and characteristics of the raw milk from good and poor producers. Bacterial isolates were selected from raw, pasteurized and stored sample plates from one random good and poor producer. All isolates were in two groups: gram positive sporeforming rods and gram negative non-sporeforming rods. These isolates were analyzed for their heat resistance and growth under refrigerated storage. Their heat and growth characteristics were compared to two common milk spoilage microorganisms, Pseudomonas fluorescens and Pseudomonas fragi. Some gram negative isolates were found to survive certain heat treatments better than the Pseudomonas strains. Most gram positive sporeformers survived heating treatments of 80°C to 90°C for 30 min, but they were not unusually heat resistant. In growth testing, selected isolates were inoculated into sterile reconstituted skim milk and stored at 7.2°C for 15 days. Gram positive sporeforming isolates did not grow well and in some cases actually decreased in number over the 15 day incubation. In contrast, the gram negative isolates increased at the same rate as the P. fluorescens and P. fragi. It was therefore concluded that it was possible for microorganisms to survive pasteurization and grow at a relatively rapid rate in the absence of post-pasteurization contamination

An analysis of entry-level librarian ads published in American Libraries, 1982-2002.

Much discussion has taken place in the literature over the difficulty finding qualified candidates to fill vacancies within libraries. Emphasis has been placed on recruitment, internships, scholarships, and other partnerships by library science schools and libraries to attract new people to the profession. Even so, applicant pools are dwindling [Simmons-Welburn and McNeil, 2004] and many institutions have been forced to rewrite job ads after initial postings to locate a qualified candidate. Factors hindering vacancy searches include: Graying of the profession, “Thousands of librarians will be retiring in the next ten years” [Simmons-Welburn and McNeil, 2004] Budget constraints/less positions [Bureau of Labor Statistics, 2004] Low pay in comparison to other professions [Congress on Professional Education, 1999] Less people entering the profession [Kaufman, 2002] Since more and more experienced candidates are retiring, frequently recruitment must turn towards entry-level candidates. This paper takes a look at the minimum requirements acceptable to employers to hire a candidate with no professional experience. A review of the literature reveals no specific focus on entry-level position requirements. There have been several studies analyzing position announcements for content. These studies focused on different specializations within the library field or a thorough examination of a particular year. Although some studies have included entry-level librarians, none examined these trends for changes in entry-level requirements over time

Malic enzyme : Its purification and characterization from Mucor circinelloides and occurrence in other oleaginous fungi

Malic enzyme was purified 43-fold from Mucor circinelloides. The enzyme was dependent on Mg2+ or Mn2+ for activity, was not active with Dmalate and had a pH optimum at 7.8. The apparent Km values for malate and NADP+ were 488 ΜM and 41 Μm respectively. The Mr of the native enzyme was 160 kDa. Five metabolic analogues of malate: oxaloacetate, tartronic acid, 1-methylenecyclopropane trans-2,3-dicarboxyIic acid, malonic acid and glutaric acid, were found to inhibit malic enzyme activity at 10 mM. Four oleaginous fungi, Mucor circinelloides, Mortierella alpina, Mortierella elongata and Pythium ultimum, were also examined, all possessed a soluble malic enzyme, two also possessed a microsomal malic enzyme

Enzyme Activities in Oleaginous Yeasts Accumulating and Utilizing Exogenous or Endogenous Lipids

The activities of ATP:citrate lyase (ACL; EC 4.1.3.8), carnitine acetyltransferase (CAT; EC 2.3.1.7), NADP+-dependent isocitrate dehydrogenase (ICDH; EC 1.1.1.42), isocitrate lyase (ICL; EC 4.1.3.1) and malic enzyme (malate dehydrogenase; EC 1.1.1.40) were measured in four oleaginous yeasts, Candida curvata D, Trichosporon cutaneum and two strains of Rhodosporidium toruloides, grown either to accumulate lipid, or to utilize their own lipid reserves or an exogenous supply of lipid. During lipid utilization, activities of ACL and malic enzyme diminished to low levels; CAT and ICL increased considerably in activity and ICDH activity was slightly increased but catalase (EC 1.11.1.6) diminished in activity in both strains of R. toruloides. In all cases, yeasts utilizing exogenous lipid showed greater changes in enzyme activities than cells utilizing their endogenous reserves. Electron micrographs of Candida curvata D showed proliferation of peroxisomes in starved cells utilizing their own lipid reserve though peroxisomes were more in evidence when the yeast had been grown on exogenous lipid. In Lipomyces starkeyi, which shows only minimal utilization of its stored lipid and furthermore cannot grow on exogenous lipid, only the occasional peroxisome was seen when cells were starved of carbon

The Problem of the Hero in Shakespeare's King John

This thesis is an attempt to evaluate the evidence for and against the presence of a hero in King John. As such, it is actually a search into the artistic abilities which Shakespeare exercised in this drama to determine whether he created a dramatic work of art which merits recognition for its own sake