Enhancing Knowledge and Confidence in a Retail Clinic Setting of Practitioners in Treating Primary and Secondary Hypertension

Many adult and adolescent patients in primary care settings are diagnosed with primary hypertension, however the workup often does not include an evaluation of secondary causes. The purpose of this Doctor of Nursing Practice (DNP) project was to improve the diagnosis and treatment of hypertension for patients seeking health care in a retail clinic setting. The PICOT question was, what is the effect of an educational offering on hypertension standards of care in enhancing knowledge and confidence for providers working in a retail health clinic setting? The sampling frame was 40 Nurse Practitioners and Physician Assistants employed at CVS Minute Clinic in Region 38, North Carolina. A 60-minute PowerPoint presentation was developed by the project leader on guidelines for the diagnosis and treatment of primary and secondary hypertension. Provider knowledge and confidence levels (dependent variables) were measured pre- and post-education using an authorcreated tool using valid questions from the literature. Nine providers (22.5%) completed the pre-survey and only one provider completed the post-survey. Pre-survey results revealed knowledge deficits in using current standards and guidelines for the diagnosis and long-term treatment of primary and secondary hypertension. Providers reported being only moderately confident (33%) and somewhat confident (67%) in their ability to diagnose and treat hypertension and secondary hypertension. These findings are congruent with the literature and with Orem’s concept of nursing agency. Nursing agencies can be promoted through comprehensive provider education and additional time and resources for nurse practitioners and physician assistants working in retail clinic 4 settings. The use of best practice standards will enhance hypertensive care for the community

Suivi GPS de Pteropus Lylei à l’interface chauves-souris humains : intérêt pour la conservation et l’étude du risque d’émergence du virus Nipah au Cambodge

Trois espèces de roussettes ont été observées au Cambodge mais peu de données sont disponibles concernant leur écologie et leur déplacement. Les roussettes sont considérées comme le principal réservoir du virus Nipah (NiV). Détecté pour la première fois en Malaisie en 1998 chez les porcs, ce virus émergent a provoqué l’abattage massif de millions de porcs afin de stopper la diffusion du virus. Par la suite, le NiV a été transmis des porcs aux humains, entrainant l’apparition de 265 cas humain en Malaisie causant la mort de 105 personnes. Depuis 2001, des ré-émergences ont été observées au Bangladesh et en Inde provoquant l’apparition de 200 cas humains, fatal dans plus de 70% des cas. L’évidence de la circulation du NiV chez les Pteropodidae a été rapportée en Asie du Sud-est et une distribution saisonnière a été suggérée en Thaïlande. Au Cambodge, l’évidence de la circulation du virus NiV chez les roussettes a préalablement été rapportée mais peu de données existent concernant l’épidémiologie du virus. L’objectif de cette étude sera de décrire la distribution et les mouvements des Pteropus lylei capturées au site dortoir de la province de Kandal à une échelle locale via l’utilisation de 14 émetteurs. Ces émetteurs fourniront la localisation des chauves- souris permettant ainsi de caractériser l’habitat des P.lylei et par conséquent l’interface entre les chauves- souris et les activités humaines, fournissant ainsi d’importantes informations pour la conservation de ces espèces et pour l’estimation du risque de transmission d’agents pathogènes à l’interface Homme chauves-souris

Resilience in the face of food insecurity and food crises : bringing the experiences of women's organizations to the development and humanitarian table; final technical report

This research initiative aimed to contribute to the body of knowledge on resilience-building and disaster risk reduction from a gender and women’s rights perspective. Investments in resilience will not “trickle down” to women if deep-rooted gender inequality and the disproportionate burdens placed on women remain unaddressed. The vulnerabilities people experience are linked to structures of oppression and discrimination. The study focused on how women’s organizations define resilience, identify risk, and implement resilience-building strategies. This paper reviews project activities, outputs, outcomes and recommendations, and includes an annotated bibliography, along with an annex list of women’s organizations

Lise Demailly, Politiques de la relation. Approche sociologique des métiers et activités professionnelles relationnelles

Sociologue des professions et du travail, Lise Demailly s’intéresse depuis de nombreuses années aux métiers de la relation, principalement dans le champ de l’éducation, de la santé, et à l’articulation du travail social et de la santé mentale. Son dernier ouvrage propose une importante synthèse sociologique des professions centrées sur le travail de face à face propre à toute activité éducative, thérapeutique, assistancielle, soignante ou d’accompagnement et – dans une moindre mesure – aux mé..

Mycobacterium smegmatis But Not Mycobacterium avium subsp. hominissuis Causes Increased Expression of the Long Non-Coding RNA MEG3 in THP-1-Derived Human Macrophages and Associated Decrease of TGF-β

Pathogenic mycobacteria are able to persist intracellularly in macrophages, whereas non-pathogenic mycobacteria are effectively combated and eliminated after their phagocytosis. It is known that TGF-β plays an important role in this context. Infection with pathogenic mycobacteria such as Mycobacterium tuberculosis or M. avium leads to production of active TGF-β, which blocks the ability of IFN-γ and TNF-α to inhibit intracellular replication. On the other hand, it is known that the long non-coding RNA (lncRNA) maternally expressed 3 (MEG3) is involved in the regulation of TGF-β. In this study, we show how the infection of THP-1-derived human macrophages with the saprophytic M. smegmatis but not with the facultatively pathogenic M. avium subsp. hominissuis leads to increased MEG3 expression. This is associated with the downregulation of DNA methyltransferases (DNMT) 1 and 3b, which are known to regulate MEG3 expression via promoter hypermethylation. Consequently, we observe a significant downregulation of TGF-β in M. smegmatis-infected macrophages but not in M. avium subsp. hominissuis pointing to lncRNAs as novel mediators of host cell response during mycobacterial infections

Résilience et sécurité alimentaire : apprendre de l'expérience des organisations de femmes

Version anglaise disponible dans la Bibliothèque numérique du CRDI : Resilience in times of food insecurity : reflecting on the experiences of women's organizationsVersion espagnole disponible dans la Bibliothèque numérique du CRDI : Resiliencia y seguridad alimentaria : aprendiendo de las experiencias de las organizaciones de mujeresLa résilience implique bien plus que des remèdes d’ordre technique; elle exige une transforma-tion sociale au sens le plus large. Les initiatives pour renforcer la résilience ne pourront avoir de retombées positives pour les femmes que si elles s’attaquent à l'inégalité des sexes et au fardeau disproportionné que portent les femmes vivant dans la pauvreté. Renforcer la rési-lience de façon durable exige d’aller au-delà du statu quo et de s'attaquer aux discriminations systémiques qui mettent les femmes à risque. La communauté internationale devrait recon-naître les organisations de femmes comme des partenaires précieux qui peuvent apporter une contribution unique aux politiques et aux pratiques de résilience

The High School Success Classroom : a case study of student outcomes and factors that contribute to student persistence

The detrimental effects of dropping out of high school are well established in the literature. Programs specifically designed to address the needs of at-risk high school are a targeted intervention to lower the dropout rate. One such program is the High School Success Classroom (HSSC), a self-contained classroom on the campus of Pressly School in North Carolina. Pressly School is an alternative school serving students in grades Kindergarten through 12. The HSSC uses the Teaching Family Model (TFM) of interaction, which emphasizes clear communication and mutual respect. The primary mode of instructional delivery is computer-based learning. The theoretical framework that was utilized in this study is Wehlage’s (1989) theory of School Membership (SM), which is grounded in four concepts explained by Tinto (1975): adjustment, difficulty, incongruence, and isolation. One purpose of this case study was to determine the effect of the HSSC at Pressly School on the graduates. Quantitative data describe how the HSSC affected the outcomes of its students in comparison with students who did not attend the HSSC. Students within the HSSC were paired for the purpose of comparison with students who were not in the HSSC but who also entered high school during the 2005-2006 school year. HSSC and non-HSSC students were paired based on the following factors: socioeconomic status, eighth grade reading end of grade (EOG) test scale score as a measure of student achievement, ethnicity, and gender. The groups were compared with each other based on the following factors: absenteeism, graduation status, and post-graduate intentions. On average, HSSC students were absent 9 more days than non-HSSC students during the 2009-2010 school year. HSSC students and non-HSSC had the same graduation rate (98%). HSSC students tended to select employment as their most likely post-graduate intention while the non-HSSC students selected Community/Technical College most frequently. Another purpose of this study was to evaluate how the HSSC assists students in persisting through graduation. Pressly School HSSC staff and graduates participated in interviews to describe the factors that led to students’ successful completion of high school. The intertwining factors of the HSSC program, the nurturing influence of the HSSC staff, and the personal characteristics of the graduates were key in the persistence through graduation. The implications for professional practice include school staff members using findings from the study to meet the needs of marginalized students and the creation of a new track of student in the graduate-dropout continuum: the state-required credit earning graduate. The suggestions for future research include setting up focus group interviews for HSSC graduates on the day of graduation as well as a longitudinal follow-up study to determine the status of HSSC graduates years after they have graduated

Resiliencia y seguridad alimentaria : aprendiendo de las experiencias de las organizaciones de mujeres

Versión en inglés disponible en la Biblioteca Digital del IDRC: Resilience in times of food insecurity : reflecting on the experiences of women's organizationsVersión en francés disponible en la Biblioteca Digital del IDRC: Résilience et sécurité alimentaire : apprendre de l'expérience des organisations de femmesLa resiliencia consiste en más que soluciones técnicas, requiere una transformación social en el sentido más amplio. Las inversiones en la resiliencia no van a ‘filtrarse’ hasta las mujeres si no hacen frente a la desigualdad profundamente arraigada de género. Un enfoque transforma-tivo a la construcción de resiliencia implica ir más allá del estatus quo, y enfrentarse con las formas sistémicas de la discriminación que ponen en peligro a las mujeres. La comunidad in-ternacional debe reconocer a las organizaciones de mujeres como socias valiosas que pueden aportar una perspectiva única respecto a las políticas y las prácticas de la resiliencia