Optimizing Strategies for Care Coordination and Transition Management: Recommendations for Nursing Education

The purpose of this descriptive qualitative study was to explore nurse and healthcare leaders\u27 experiences and perceptions of care coordination and transition management (CCTM®). Four barriers emerged that added insight into the lack of adopting and integrating CCTM knowledge, skills, and attitudes in nursing education in the following categories: curriculum redesign, silos of care settings and care providers, knowledge gap, and faculty development/resistance. Recommendations and implications for education, for both nursing students and practicing nurses, are described

Policies, Practices, and Pedagogies: A Qualitative Study of LGBTQ+ Representation in the Physical Therapy Profession

Introduction APTA collects demographic data regarding racial diversity, but ignores gender and sexual diversity In the US, 4.5 percent of adults identified as LGBTQ+ In Minnesota, 4.1 percent of adults identified as LGBTQ+ Objective Gain an improved understanding of the shared experiences and the potential underlying barriers that practicing and student PTs and PTAs from gender/sexual minorities in Minnesota encounter Results of the study will be used to assist MNPTA task force to improve diversity in PT/PTA education and practice in Minnesota Methods The seven participants were practicing PT/PTAs or student from Minnesota Recruitment through flyer via email and distributed at MNPTA educational events, or personally invited by PI 90 minute online focus groups moderated by a PI Discussed choice of career path, perceived barriers, shared life experiences, and thoughts of improving LGBTQ+ acceptances and equality Groups were audio recorded, de-identified, transcribed, cleaned and then imported into NVIVO 12 software and coded Conclusion Participants shared similar experiences across multiple aspects of their lives and encountered similar barriers and challenges as student and practicing PT/PTAs in Minnesota Future research should be conducted to explore the solutions proposed by participants and determine if there are other common major themes that exist Clinical Relevance Important to understand barriers that LBGTQ+ PT/PTAs face in order to address the health disparities that exist in the Physical Therapy Profession in Minnesota Create an environment that is more inclusive and more representative of the growing diversity that exists in physical therapy by putting potential solutions into action Important to have PTs who are educated on the health disparities that exist in LBGTQ+ and uniquely understand their patients\u27 need

PERANCANGAN ALAT PENJEJAK MATAHARI PADA APLIKASI PEMBANGKIT LISTRIK TENAGA SURYA

Penggunaan panel sel surya sebagai sumber energi utama sudah banyak dikembangkan a ikasi industri maupun pada aplikasi rumah tangga. Namun penggunaan panel sel surya tersebut lebih banyak difokuskan sebagai sumber energi terbarukan dan ramah lingkungan. Penelitian-penelitian untuk mengkaji bagaimana mengefisiensikan penggunaan panel surya sebagai surnber energi utama belum banyak dilakukan. Penelitian ini mengkaji bagaimana mengefisiensikan penggunaan panel sel surya melalui rangkaian sistem alat yang disebut alat penjejak matahari. _Alat penjejak matahari yang akan dirancang menggunakan sensor LDR sebagai komponen deteksi arah pergerakan matahari yang dikendalikan secara otomatis oleh mikro konntroller AVR Atmega 2560. Hasil pengujian menunjukkan penggunaan rancangan alat penjajak matahari dapat meningkatkan rata-rata proseniase tegangan keluaran sel surya bisa mencapai 188% bila dibandingkan dengan kondisi sebelum panel sel surya menggunakan sistem alat penjajak matahar

Low cost production of 3D-printed devices and electrostimulation chambers for the culture of primary neurons

The analysis of primary neurons is a basic requirement for many areas of neurobiology. However, the range of commercial systems available for culturing primary neurons is functionally limiting, and the expense of these devices is a barrier to both exploratory and large-scale studies. This is especially relevant as primary neurons often require unusual geometries and specialised coatings for optimum growth. Fortunately, the recent revolution in 3D printing offers the possibility to generate customised devices, which can support neuronal growth and constrain neurons in defined paths, thereby enabling many aspects of neuronal physiology to be studied with relative ease. In this article, we provide a detailed description of the system hardware and software required to produce affordable 3D-printed culture devices, which are also compatible with live-cell imaging. In addition, we also describe how to use these devices to grow and stimulate neurons within geometrically constrained compartments and provide examples to illustrate the practical utility and potential that these protocols offer for many aspects of experimental neurobiology

Developing a Business Case for the Care Coordination and Transition Management Model: Needs, Methods, and Measures

In this descriptive qualitative study, nurse and healthcare leaders\u27 experiences, perceptions of care coordination and transition management (CCTM®), and insights as to how to foster adoption of the CCTM RN role in nursing education, practice across the continuum, and policy were explored. Twenty-five barriers to recognition and adoption of CCTM RN practice across the continuum were identified and categorized. Implications of these findings, recommendations for adoption of CCTM RN practice across the care continuum, and strategies for reimbursement policies are discussed

Developing a Business Case for the Care Coordination and Transition Management Model: Need, Metrics, and Measures

In this descriptive qualitative study, nurse and healthcare leaders\u27 experiences, perceptions of care coordination and transition management (CCTM®), and insights as to how to foster adoption of the CCTM RN role in nursing education, practice across the continuum, and policy were explored. Twenty-five barriers to recognition and adoption of CCTM RN practice across the continuum were identified and categorized. Implications of these findings, recommendations for adoption of CCTM RN practice across the care continuum, and strategies for reimbursement policies are discussed

Chlorination by-products in drinking water and menstrual cycle function.

We analyzed data from a prospective study of menstrual cycle function and early pregnancy loss to explore further the effects of trihalomethanes (THM) on reproductive end points. Premenopausal women ((italic)n(/italic) = 403) collected urine samples daily during an average of 5.6 cycles for measurement of steroid metabolites that were used to define menstrual parameters such as cycle and phase length. Women were asked about consumption of various types of water as well as other habits and demographics. A THM level was estimated for each cycle based on residence and quarterly measurements made by water utilities during a 90-day period beginning 60 days before the cycle start date. We found a monotonic decrease in mean cycle length with increasing total THM (TTHM) level; at > 60 microg/L, the adjusted decrement was 1.1 days [95% confidence interval (CI), -1.8 to -0.40], compared with less than or equal to 40 microg/L. This finding was also reflected as a reduced follicular phase length (difference -0.94 day; 95% CI, -1.6 to -0.24). A decrement in cycle and follicular phase length of 0.18 days (95% CI, -0.29 to -0.07) per 10 microg/L unit increase in TTHM concentration was found. There was little association with luteal phase length, menses length, or cycle variability. Examining the individual THMs by quartile, we found the greatest association with chlorodibromomethane or the sum of the brominated compounds. Incorporating tap water consumption showed a similar pattern of reduced cycle length with increasing TTHM exposure. These findings suggest that THM exposure may affect ovarian function and should be confirmed in other studies

The complex interplay between kidney injury and inflammation

Abstract Acute kidney injury (AKI) has gained significant attention following patient safety alerts about the increased risk of harm to patients, including increased mortality and hospitalization. Common causes of AKI include hypovolaemia, nephrotoxic medications, ischaemia and acute glomerulonephritis, although in reality it may be undetermined or multifactorial. A period of inflammation either as a contributor to the kidney injury or resulting from the injury is almost universally seen. This article was compiled following a workshop exploring the interplay between injury and inflammation. AKI is characterized by some degree of renal cell death through either apoptosis or necrosis, together with a strong inflammatory response. Studies interrogating the resolution of renal inflammation identify a whole range of molecules that are upregulated and confirm that the kidneys are able to intrinsically regenerate after an episode of AKI, provided the threshold of damage is not too high. Kidneys are unable to generate new nephrons, and dysfunctional or repeated episodes will lead to further nephron loss that is ultimately associated with the development of renal fibrosis and chronic kidney disease (CKD). The AKI to CKD transition is a complex process mainly facilitated by maladaptive repair mechanisms. Early biomarkers mapping out this process would allow a personalized approach to identifying patients with AKI who are at high risk of developing fibrosis and subsequent CKD. This review article highlights this process and explains how laboratory models of renal inflammation and injury assist with understanding the underlying disease process and allow interrogation of medications aimed at targeting the mechanistic interplay.</jats:p