Prevention of Hospital-Acquired Pneumonia: An Integrative Review

Background: Hospital-acquired pneumonia (HAP) not only brings about physical challenges to patients that can lead to death, it also involves financial burdens. Research on how to prevent HAP is a necessity; however, a deficit exists in research concerning prevention of non-ventilator hospital-acquired pneumonia (NV-HAP). The purpose of this study is to synthesize the current research on the nurse’s role in prevention of NV-HAP, identify where additional research is needed, and suggest clinical standards of care to prevent pneumonia in hospitalized patients. Methods: Data for this integrative review was collected from the following databases: PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), GoogleScholar, Cochrane Register of Controlled Trials, MEDLINE, and OneSearch. An interview with a local hospital registered nurse was conducted. Results: Four different categories of interventions were researched and the results were synthesized. Oral care, the early mobility bundle and isolations rooms were found to significantly decrease the occurrence of NV-HAP. Incentive spirometry, on the other hand, was not found to effectively decrease NV-HAP. Discussion: While oral care, early mobility and isolation rooms were all found to significantly reduce the occurrence of NV-HAP, these interventions are most effective when the health care workers carrying them out are educated on properly performing each intervention. Conclusion: Enhanced oral care and enhanced mobility should be primary interventions for the prevention of NV-HAP, while incentive spirometry should be considered a secondary intervention. More research is needed to be conclusive on the effectiveness of incentive spirometry and isolation rooms

Nurses\u27 Alumnae Association Bulletin - Volume 2 Number 2

Coming Events Come On, \u2732 Ballot for Officers Hospital News Legislation Scholarship Fund Notes Refresher Course Correspondence Use of Heparin in Modern Treatment The Jefferson Medical College Library Nursing School Education Action - Camera - Seniors Degrees Received Engagements Weddings Births Deaths Attention Alumnae Bulletin Progress Of Special Interest Army Assignments Organized Staff Meeting

A Synthesis of the Daily Behavior Report Card Literature from 2007 to 2017

Daily behavior report cards (DBRCs) have shown to be effective in addressing academic and behavioral challenges for a variety of students in past literature. The purpose of this literature review and analysis is to update and summarize findings on the use of DBRCs on academic and social behavior for students considered to have disruptive behaviors or identified with disabilities. We identified eleven studies in the literature examining DBRCs with 390 participants with attention‐deficit hyperactivity disorder, specific learning disabilities, emotional behavioral disorders, speech and language, multiple disabilities, other health impairments, or considered to have disruptive behavior in Pre‐K through sixth grade academic settings. We also calculated effect sizes overall for each study and student‐based characteristics. Findings suggest that using DBRCs have a range from weak to strong impact on the academic and social behaviors of students considered to have disruptive behaviors or students with disabilities in classroom settings. We present implications for research and practice

Graphics mini manual

The computer graphics capabilities available at the Center are introduced and their use is explained. More specifically, the manual identifies and describes the various graphics software and hardware components, details the interfaces between these components, and provides information concerning the use of these components at LaRC

Best management practices in counting urban black bears

DNA-based capture-mark-recapture (CMR) techniques are commonly used to obtain population parameters of black bears (Ursus americanus) in rural and wildland landscapes; however, these techniques have not been implemented in urban clusters (i.e., 2,500 to 50,000 residents). Black bears can readily habituate to urban clusters, and wildlife managers need to monitor and manage these urban bear populations. We modified DNAbased CMR for black bear using hair-snares to take into account the small home ranges of urban bears, urban bear behavior, and human safety within Mammoth Lakes, California, USA. We conducted this study for 3 fi eld seasons in 2010, 2011, and 2012 from June to July. Each fi eld season, we implemented a CMR with 6 encounter occasions, each 7 days in length. We used the traditional corral hair-snare design modified for human safety and chose multiple non-consumable and minimally consumable lure types to prevent food conditioning and a trap-happy response. In 2012, we also tested 3 additional hair-snare designs more appropriate for urban areas: natural rub, haphazard-wire snare, and tennis ball snare. In 2010, we collected an insufficient number of hair samples for CMR by putting hair-snares in the periphery of the urban cluster, which we call the urban–wildland interface. However, in 2011 and 2012, when we put hair-snares in the city center as well as the surrounding urban–wildlife interface and increased hair-snare density, we obtained a sufficient number of hair samples to estimate population density using closed capture CMR models. These adjustments to hairsnaring study design in urban areas helped increase capture and recapture rates to be similar to our wildland area. To achieve high capture rates using hair-snares in the urban area, we put out hair-snares at a density approximately 4 times greater than in our wildland study area and distributed them throughout the entire urban area, and not just on the urban–wildlife interface. In addition, setting hair-snares near anthropogenic features used by bears in urban areas (e.g., culverts, utility poles, dumpsters) and adding spent cooking oil to lures also increased our capture rate. Finally, the corral hair-snare had the highest capture rates of our 4 hair-snare designs. After adapting a study design for hair-snaring wildland bears, our methods were efficient for urban areas, having high capture and recapture rates (\u3e0.30) and good precision for abundance estimates (coefficient of variatio

A systematic review and meta-analysis of studies evaluating the performance and operational characteristics of dual point-of-care tests for HIV and syphilis.

BACKGROUND: Mother-to-child transmission (MTCT) of syphilis and HIV continue to be important yet preventable causes of perinatal and infant morbidity and mortality. OBJECTIVES: To systematically review, critically appraise and perform a meta-analysis to evaluate the operational characteristics of dual rapid diagnostic tests (RDTs) for HIV/syphilis and evaluate whether they are cost effective, acceptable and easy to use. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched seven electronic bibliographic databases from 2012 to December 2016 with no language restrictions. Search keywords included HIV, syphilis and diagnosis. REVIEW METHODS: We included studies that evaluated the operational characteristics of dual HIV/syphilis RDTs. Outcomes included diagnostic test accuracy, cost effectiveness, ease of use and interpretation and acceptability. All studies were assessed against quality criteria and assessed for risk of bias. RESULTS: Of 1914 identified papers, 18 were included for the meta-analysis of diagnostic accuracy for HIV and syphilis. All diagnostic accuracy evaluation studies showed a very high sensitivity and specificity for HIV and a lower, yet adequate, sensitivity and specificity for syphilis, with some variation among types of test. Dual screening for HIV and syphilis was more cost effective than single rapid tests for HIV and syphilis and prevented more adverse pregnancy outcomes. Qualitative data suggested dual RDTs were highly acceptable to clients, who cited time to result, cost and the requirement of a single finger prick as important characteristics of dual RDTs. CONCLUSION: The results of this systematic review and meta-analysis can be used by policy-makers and national programme managers who are considering implementing dual RDTs for HIV and syphilis. TRIAL REGISTRATION NUMBER: PROSPERO 2016:CRD42016049168

Molecular Competition in G1 Controls When Cells Simultaneously Commit to Terminally Differentiate and Exit the Cell Cycle

Terminal differentiation is essential for the development and maintenance of tissues in all multi-cellular organisms and is associated with permanent exit from the cell cycle. Failure to permanently exit the cell cycle can result in cancer and disease. However, the molecular mechanisms and timing that coordinate differentiation commitment and cell cycle exit are not yet understood. Using live, single-cell imaging of cell cycle progression and differentiation commitment during adipogenesis, we show that a rapid switch mechanism engages exclusively in G1 to trigger differentiation commitment simultaneously with permanent exit from the cell cycle. We identify a molecular competition in G1 between when the differentiation switch is triggered and when the proliferative window closes that allows mitogen and differentiation stimuli to control the balance between terminally differentiating cells produced and progenitor cells kept in reserve, a parameter of critical importance for enabling proper development of tissue domains and organs. Zhao et al. show that in terminally differentiating cells, a rapid switch mechanism engages exclusively during a G1 period to trigger simultaneous differentiation commitment and permanent cell cycle exit. A molecular competition in each G1 period allows cells to control the balance the terminally differentiating cells produced and progenitor cells kept in reserve

The Texture of Surficial Sediments in Central Long Island Sound off Milford, Connecticut.

The purpose of this study was to determine the grain-size distributions and associated statistical parameters of the surficial sediment samples from central Long Island Sound off Milford, Connecticut. These grain-size data, which help to ground-truth a pre-existent sidescan sonar survey (Poppe and others, 1995a; Twichell and others, in press), will eventually be used to describe the sedimentary processes active in this portion of central Long Island Sound. Other potential uses for these textural data include benthic biologic studies that evaluate faunal distributions and relate them to habitats (Zajac and others, 1995), and geochemical studies involving the distribution, transport and deposition of pollutants (Moffett and others, 1994)

One-loop Correction and the Dilaton Runaway Problem

We examine the one-loop vacuum structure of an effective theory of gaugino condensation coupled to the dilaton for string models in which the gauge coupling constant does not receive string threshold corrections. The new ingredients in our treatment are that we take into account the one-loop correction to the dilaton K\"ahler potential and we use a formulation which includes a chiral field $H$ corresponding to the gaugino bilinear. We find through explicit calculation that supersymmetry in the Yang-Mills sector is broken by gaugino condensation. The dilaton and $H$ field have masses on the order of the gaugino condensation scale independently of the dilaton VEV. Although the calculation performed here is at best a model of the full gaugino condensation dynamics, the result shows that the one-loop correction to the dilaton K\"ahler potential as well as the detailed dynamics at the gaugino condensation scale may play an important role in solving the dilaton runaway problem.Comment: 19 page